Cost Analysis of Long-Term Treatment of Patients with Symptomatic Gastroesophageal Reflux Disease (GERD) with Esomeprazole On-Demand Treatment or Esomeprazole Continuous Treatment: An Open, Randomized, Multicenter Study in Switzerland.

Objectives: To assess the difference in direct medical costs between on-demand (OD) treatment with esomeprazole (E) 20 mg and continuous (C) treatment with E 20 mg q.d. from a clinical practice view in patients with gastroesophageal reflux disease (GERD) symptoms. Methods: This open, randomized study (ONE: on-demand Nexium evaluation) compared two long-term management options with E 20 mg in endoscopically uninvestigated patients seeking primary care for GERD symptoms who demonstrated complete relief of symptoms after an initial treatment of 4 weeks with E 40 mg. Data on consumed quantities of all cost items were collected in the study, while data on prices during the time of study were collected separately. The analysis was done from a societal perspective. Results: Forty-nine percent (484 of 991) of patients randomized to the OD regimen and 46% (420 of 913) of the patients in the C group had at least one contact with the investigator that would have occurred nonprotocol-driven. The difference of the adjusted mean direct medical costs between the treatment groups was CHF 88.72 (95% confidence interval: CHF 41.34-153.95) in favor of the OD treatment strategy (Wilcoxon rank-sum test: P < 0.0001). Adjusted direct nonmedical costs and productivity loss were similar in both groups. Conclusions: The adjusted direct medical costs of a 6-month OD treatment with esomeprazole 20 mg in uninvestigated patients with symptoms of GERD were significantly lower compared with a continuous treatment with E 20 mg once a day. The OD therapy represents a cost-saving alternative to the continuous treatment strategy with E.

Modeling and mitigation of supply-demand mismatches

In this thesis, I develop analytical models to price the value of supply chain investments under demand uncer¬tainty. This thesis includes three self-contained papers. In the first paper, we investigate the value of lead-time reduction under the risk of sudden and abnormal changes in demand forecasts. We first consider the risk of a complete and permanent loss of demand. We then provide a more general jump-diffusion model, where we add a compound Poisson process to a constant-volatility demand process to explore the impact of sudden changes in demand forecasts on the value of lead-time reduction. We use an Edgeworth series expansion to divide the lead-time cost into that arising from constant instantaneous volatility, and that arising from the risk of jumps. We show that the value of lead-time reduction increases substantially in the intensity and/or the magnitude of jumps. In the second paper, we analyze the value of quantity flexibility in the presence of supply-chain dis- intermediation problems. We use the multiplicative martingale model and the "contracts as reference points" theory to capture both positive and negative effects of quantity flexibility for the downstream level in a supply chain. We show that lead-time reduction reduces both supply-chain disintermediation problems and supply- demand mismatches. We furthermore analyze the impact of the supplier's cost structure on the profitability of quantity-flexibility contracts. When the supplier's initial investment cost is relatively low, supply-chain disin¬termediation risk becomes less important, and hence the contract becomes more profitable for the retailer. We also find that the supply-chain efficiency increases substantially with the supplier's ability to disintermediate the chain when the initial investment cost is relatively high. In the third paper, we investigate the value of dual sourcing for the products with heavy-tailed demand distributions. We apply extreme-value theory and analyze the effects of tail heaviness of demand distribution on the optimal dual-sourcing strategy. We find that the effects of tail heaviness depend on the characteristics of demand and profit parameters. When both the profit margin of the product and the cost differential between the suppliers are relatively high, it is optimal to buffer the mismatch risk by increasing both the inventory level and the responsive capacity as demand uncertainty increases. In that case, however, both the optimal inventory level and the optimal responsive capacity decrease as the tail of demand becomes heavier. When the profit margin of the product is relatively high, and the cost differential between the suppliers is relatively low, it is optimal to buffer the mismatch risk by increasing the responsive capacity and reducing the inventory level as the demand uncertainty increases. In that case, how¬ever, it is optimal to buffer with more inventory and less capacity as the tail of demand becomes heavier. We also show that the optimal responsive capacity is higher for the products with heavier tails when the fill rate is extremely high.

Secure Dynamic MANET On-demand (SEDYMO) Routing Protocol

This paper describes the state of the art of secure ad hoc routing protocols and presents SEDYMO, a mechanism to secure a dynamic multihop ad hoc routing protocol. The proposed solution defeats internal and external attacks usinga trustworthiness model based on a distributed certification authority. Digital signatures and hash chains are used to ensure the correctness of the protocol. The protocol is compared with other alternatives in terms of security strength, energy efficiency and time delay. Both computational and transmission costs are considered and it is shown that the secure protocol overhead is not a critical factor compared to the high network interface cost.

Distributed Energy Production in the North-West Region of Russia

The energy system of Russia is the world's fourth largest measured by installed power. The largest are that of the the United States of America, China and Japan. After 1990, the electricity consumption decreased as a result of the Russian industry crisis. The vivid economic growth during the latest few years explains the new increase in the demand for energy resources within the State. In 2005 the consumption of electricity achieved the maximum level of 1990 and continues to growth. In the 1980's, the renewal of power facilities was already very slow and practically stopped in the 1990's. At present, the energy system can be very much characterized as outdated, inefficient and uneconomic because of the old equipment, non-effective structure and large losses in the transmission lines. The aim of Russia's energy reform, which was started in 2001, is to achieve a market based energy policy by 2011. This would thus remove the significantly state-controlled monopoly in Russia's energy policy. The reform will stimulateto decrease losses, improve the energy system and employ energy-saving technologies. The Russian energy system today is still based on the use of fossil fuels, and it almost totally ignores the efficient use of renewable sources such as wind, solar, small hydro and biomass, despite of their significant resources in Russia. The main target of this project is to consider opportunities to apply renewable energy production in the North-West Federal Region of Russia to partly solve the above mentioned problems in the energy system.

Investment Determinants and Future Shape of Russia's Power Generation

The reformation of power sector is still in the process of development. The present day situation in Russian electricity power market ischaracterized as transitional period: competitive electricity market is forming, new companies are being created and the power of government regulation is decreasing. The main aim of the reformation is to attract much-needed private investments to the power sector. The electricity consumption increases very rapidly and power sector has to cope with high demand. The goal of this master's thesis is to analyze the nowadays situation in Russian power sector, such as generation structure, condition of electricity networks, electricity price formation for end-users, shape of fuel sector and investments risks and attraction.The final result of this work is creation of scenario of Russian power sector future shape and analysis of the present day situation.

The electricity distribution network in Saint-Petersburg area and benchmark between Saint-Petersburg and City of Stockholm related distribution companies' performance

The main objective of the Thesis is the description of the electricity distribution networks in Saint-Petersburg area and Stockholm as well. Main similarity and differences in the construction and technicalperformance are presented in the study. Present and future development and investment into the electricity distribution network of OJSC Lenenergo are viewed. The Thesis presents the overview of the power industry reform in Russia. The current state of the electricity distribution sector is described. The study views the participation of the foreign investor "Fortum Power and Heat Oy" inthe development and management of the OJSC Lenenergo. Benchmark comparison of the prices and tangible assets of the main electricity distribution companies in Saint-Petersburg and Stockholm areas is done.

Scenarios for electricity power sector development in the North-West of Russia

Focus of this thesisis made on development of electricity sector of Russian North-West. The objective was to determine the most likely scenarios for development of the most critical (western) part of Interregional Power System of North-West, from where the most part of Russian electricity exports to the countries of European Union take place. For this purpose all the involved sides were analyzed: generation, transmission system and electricity consumption in different regions of Russian North-West. The analysis was performed through investigation of existing generation andtransmission capacities and plans for their development to be performed by the generation and transmission companies operating in the region. Principles of Russian electricity sector restructuring and electricity market design are also discussed as well as factors that may influence on future electricity price in the region.

Forecasting tourism demand to Catalonia: neural networks vs. time series models

The increasing interest aroused by more advanced forecasting techniques, together with the requirement for more accurate forecasts of tourismdemand at the destination level due to the constant growth of world tourism, has lead us to evaluate the forecasting performance of neural modelling relative to that of time seriesmethods at a regional level. Seasonality and volatility are important features of tourism data, which makes it a particularly favourable context in which to compare the forecasting performance of linear models to that of nonlinear alternative approaches. Pre-processed official statistical data of overnight stays and tourist arrivals fromall the different countries of origin to Catalonia from 2001 to 2009 is used in the study. When comparing the forecasting accuracy of the different techniques for different time horizons, autoregressive integrated moving average models outperform self-exciting threshold autoregressions and artificial neural network models, especially for shorter horizons. These results suggest that the there is a trade-off between the degree of pre-processing and the accuracy of the forecasts obtained with neural networks, which are more suitable in the presence of nonlinearity in the data. In spite of the significant differences between countries, which can be explained by different patterns of consumer behaviour,we also find that forecasts of tourist arrivals aremore accurate than forecasts of overnight stays.

Ilmastonmuutoksen vaikutussähköverkkoliiketoimintaan

Tässä diplomityössä tutkittiin ilmastonmuutoksen vaikutusta sähköverkkoliiketoimintaan. Ilmastonmuutosennusteet laadittiin RCAOilmastomallin antamien laskelmien perusteella. Ilmastomuuttujien ennusteet tehtiin ajanjaksolle 2016 - 2045 ja ennusteiden vertailujaksona käytettiin ajanjaksoa 1960 - 1990. Ennusteet laadittiin sadannalle, lämpötilalle, kuuraantumiselle, huurteelle, ukkoselle, routaantumiselle ja tuulisuudelle. Ilmastomuuttujien vaikutukset arvioitiin sekä tekniseltä että taloudelliselta kannalta. Ilmastonmuutoksen myötä on odotettavissa, että ilmastomuuttujien aiheuttamat rasitukset verkkoliiketoimintaa kohtaan tulevat olemaan niistä saatuja hyötyjä suuremmat. Vikamäärien kasvu on merkittävin ja haastavin ilmastonmuutoksen aiheuttama haitta. Ukkonen, lumikuormat ja tuuli tulevat aiheuttamaan nykyistä enemmän vikoja erityisesti keskijänniteverkoissa avojohdoille ellei verkkoja kehitetä vikavarmemmiksi. Lämpötilan nousun seurauksena lämmitystarve laskee ja jäähdytystarve nousee. Tämä näkyy merkittävimmin voimakkaasti lämpötilariippuvaisten käyttäjäryhmien sähkönkulutuksessa ja huippukuormissa.

When supply travels far beyond demand: Causes of oversupply in Spain’s transport infrastructure

Spain’s transport infrastructure policy has become a paradigmatic case of oversupply and of mismatch with demand. The massive expansion of the country’s transport infrastructure over the last decade has not been a response to demand bottlenecks or previously identified needs. For this reason, the intensity of use today on all interurban modes of transport in Spain falls well below that of other EU countries. This paper analyzes the institutional and regulatory factors that have permitted this policy, allowing us to draw lessons from the Spanish case that should help other countries avoid the pitfalls and shortcomings of Spanish policy.

When supply travels far beyond demand: Causes of oversupply in Spain’s transport infrastructure

Spain’s transport infrastructure policy has become a paradigmatic case of oversupply and of mismatch with demand. The massive expansion of the country’s transport infrastructure over the last decade has not been a response to demand bottlenecks or previously identified needs. For this reason, the intensity of use today on all interurban modes of transport in Spain falls well below that of other EU countries. This paper analyzes the institutional and regulatory factors that have permitted this policy, allowing us to draw lessons from the Spanish case that should help other countries avoid the pitfalls and shortcomings of Spanish policy.

Maintenance and construction outsourcing in a public-owned electricity network company

Euroopan sähkösektori on ollut viimeisen vuosikymmenen suurten mullistusten kourissa. Sähkömarkkinoiden avautumisen jälkeen monopoliliiketoimintaa harjoittavien sähköyhtiöiden on ollut pakko parantaa tuottavuuttaan. Ratkaisuksi tähän on etsitty apua huolto- ja rakennustoimintojen ulkoistamisella. Ulkoistaminen on kuitenkin uusi menetelmä tällä sektorilla. Tämän tutkielman tavoitteena on selvittää syyt, jotka tanskalaisella sähköverkkoyhtiöllä oli huolto- ja rakennustoimintojen ulkoistamiseen, sekä löytää siitä saatavat hyödyt ja siihen sisältyvät riskit. Tutkimus suoritetaan käyttäen apuna kirjallisuutta, saatavilla olevia due diligence-, sekä muita raportteja ja analyysejä, sekä tapausta koskettavien tahojen haastatteluja.Lisäksi sähköverkkoalan asiantuntijoiden kanssa käytyjä konsultointia käytetäänselvitykseen. Tutkimus osoittaa, että perimmäiset ajurit huolto- ja rakennustoimintojen ulkoistamiseen tulivat lainmuutosten ja vapautuneiden sähkömarkkinoiden asettamista paineista. Kunnallisessa organisaatiossa parantaa tehokkuutta ulkoistamalla jotain toimintoja yksityisomisteiselle palvelun tuottajalle. Muut ulkoistamisesta odotetut hyödyt olivat alentuneet kustannukset, virtaviivaisempi organisaation ja sähköverkkoyhtiön tehottomista osista eroon pääseminen ennen sen myymistä.

Tasasähkön hyödyntämismahdollisuudet sähkönjakelussa

Tässä työssä on tutkittu tasasähkönsiirron tuomia mahdollisuuksia sähkönjakelussa, kun pienjännitedirektiivin pienjännitemäärittelyn soveltamista laajennetaan koskemaan vaihtojännitteen lisäksi myös tasajännitettä. Aiemmin tasasähköjärjestelmiä on käytetty ainoastaan sähköistymisen alkuaikoina 1900-luvun alussa. Viime vuosikymmeninä on sähkönjakelussa käytetty pelkästään vaihtosähköverkkoja, koska tehoelektronisten laitteiden korkea hintataso ja tekniset ominaisuudet ovat mahdollistaneet tasasähkön käytön vain suurjännitteellä. Suomalaisten sähkönkäyttö on lisääntynyt muutamalla prosenttiyksiköllä vuosittain ja kasvun taantumista ei ole odotettavissa lähiaikoina. Samaan aikaan yhteiskunta muuttuu jatkuvasti yhä riippuvaisemmaksi sähköstä ja odotukset toteutuvasta sähkönlaadusta ovat jatkuvasti korkeammat. Sähkönlaadun näkökulmasta ilmasto on tuonut aiempia suurempia haasteita sähkön toimitusvarmuudelle, kun myrskyjen aiheuttamat tuhot ovat olleet yhä entisiä suurempia. Toimitusvarmuuden parantamiseksi ovat muutamat vuosikymmenen alun rajut myrskyt johtaneet pohdintaan tulevien haasteiden hoitamiseksi ja edelleen uuden 3-portaiseen 20/1/0,4 kV vaihtosähköjärjestelmän kehittämiseen. Tasasähkönsiirron avulla halutaan tuoda käyttöön niitä hyötyjä, joita järjestelmän vaihdolla on saavutettavissa. Täysimääräisellä tasajännitteen hyödyntämisellä voidaan saavuttaa mm. aiempaa edullisempia investointivaihtoehtoja,parempi sähkönlaatu, parempi hajautetun tuotannon liitettävyys verkkoon ja erilaisten asiakaskohtaisten laitteiden helppo integroitavuus osaksi jakelujärjestelmää. Tämän työn puitteissa on pohdittu sekä teknisiä ratkaisuja että järjestelmän teknistaloudellista käyttöaluetta. Lisäksi on pyritty hahmottamaan eri tekijöiden vaikutuksia sähkönjakeluun.

Developing of Service Platform Thinking in Modern Electricity Distribution Business

Palvelukehitystoiminta sitoo huomattavan määrän resursseja ja on pitkäkestoista toimintaa. Innovatiivisuuteen tähtäämällä ja systemaattisella tuotekehitystyöllä yritys parantaa jatkuvuutta omassa liiketoiminnassaan. Alusta-ajattelu tuo uuden ulottuvuuden tuotteiden ja palveluiden kehitykseen. Alustan kehittäminen tukemaan tuote- ja palvelukehitystoimintaa ja yksinkertaistamaan tuote/palvelurakenteita antaa yrityksissä lisäpotentiaalia esimerkiksi lyhentyneiden kehitysaikojen, paremman kompleksisuuden hallinnan ja kustannustehokkuuden nousun myötä. Toimintojen tehostuminen yritystasolla saa aikaan mahdollisuuksien lisääntymisen nykyisillä liiketoimintasektoreilla. Palvelualustan kehityksellä päästään palvelurakenteen mallintamisen kautta parempaan liiketoiminnan hallitsemiseen ja systemaattisempaan tuotekehityksen läpivientiin. Palvelualustan yhtenä tärkeimpänä hyötynä on, että palvelun rakenteellisuus saadaan kuvattua alustaan. Lisäksi on tärkeää määritellä vastuutukset alustan kehityksessä, sekä pystyä mallintamaan informaation kulku (rajapinnat) prosesseissa.