In 1996, Duke Children's Hospital was in serious trouble. Its $11 million annual operating loss had forced administrators to make cutbacks. As a result, some caregivers felt that the quality of care had deteriorated. Parents' complaints were on the rise. Frustrated staff members were quitting. In this article, Jon Meliones, DCH's chief medical director, candidly describes how his debt-ridden ho...

This paper proposes an approach for improving the plant efficiency by reducing the heat rejection temperature of power cycle using Kalina Cycle System 11 (KCS11) which is integrated at the steam condenser of a 500 MWe SubC (subcritical) coal-fired power plant. It is modelled by using power plant simulation software ‘Cycle Tempo’ at different plant operating conditions. Results show t...

BACKGROUND The economic merit of universal prophylaxis and preemptive therapy in the management of cytomegalovirus (CMV) infection for serology positive (R+) kidney transplant patients remains undefined. We performed cost effectiveness and cost utility modeling comparing these two approaches. METHODS The incidence of CMV infection under universal prophylaxis and preemptive therapy was determi...

The purpose of this paper is to analyse and compare the values of a marginal change in the area of land as a pollutant sink under different decision-making contexts and objectives: international coordination versus national policies for pollutant reduction, and maximization of net benefits versus minimization of costs for pollutant reductions. The analytical results show that a coordinated poli...

Due to energy shortage and global warming, issues of energy saving have become more important. To increase the energy efficiency and reduce the fuel consumption, waste heat recovery is a significant method for energy saving. The organic Rankine cycle (ORC) has great potential to recover the waste heat from the core jet exhaust of a turbofan engine and use it to produce power. Preliminary study ...

In this paper we propose a modelling technique for the control of computational processes. The Petri Net model, particularly a Timed Event Graph (TEG) can be used for analyzing. The proposed model enables the determination of state equations. The max-plus algebra represents linear algebraic form of discrete systems and supplies new tools to their modelling. We develop a linear mathematical mode...

Explicit forest management planning for timber production beyond the first few years at any time necessitates use of information which can best be described as suspect. The two-step approach outlined here concentrates on the planning strategy over the next few years without losing sight of the long-run productivity. Frequent updating of the long-range and short-range plan makes it possible to k...

In the recent times, Customer Relationship Management (CRM) has become one of the most dynamic topics of Information and Communication Technologies (ICT), both in the academia and the market. This popularity is indeed a result of the promising features offered by CRM. All the studies to date have highlighted elements associated with CRM success by studying its adoption and implementation in the...

Different methods of urban sewage sludge energy recovery such as burning, gasification, pyrolysis and digestion based on the net energy production efficiency, advantages and disadvantages and complexity of these processes have been investigated in this article. The best method for energy production from sludge was selected among different methods according to energy and the amount of the greenh...

The issue of online privacy and security is a challenging subject, as it concerns the privacy of data that are increasingly more accessible via the internet. In other words, people who intend to access the private information of other users can do so more efficiently over the internet. This study is an attempt to address the privacy issue of distributed big data in the context of cloud computin...