Evaluating economic efficiency of the national high-tech industrial development districts in the Yangtze River Delta by stochastic frontier analysis

The High-tech Industrial Development Districts (HIDDs) are technological engines for the regional economy in China. The Chinese government implemented the Torch Initiative to accelerate industrial agglomeration and innovation development by administratively upgrading the local HIDDs into a national list since 1989. The policy intervention emphasizes the labor and capital inputs on science and technology. The study adopts the Stochastic Frontier Analysis (SFA) to understand the economic efficiency of the enlisted national HIDDs in the Yangtze River Delta. The results suggest that the average efficiency trends of the all-in-total sales, product sales and commodity sales are decreasing while that of technology sales is increasing from 2007 to 2019. In the total sales efficiency evaluation, most early-enrolled HIDDs are in the high-efficiency group whereas the newcomers are in the low-efficiency group. The Nantong HIDD has the highest efficiency, followed by Wuxi, Taizhou, Suzhou, Nanjing, Shanghai ZJ, Xiaoshan, Ningbo, Suzhou IP and Jiangyin HIDDs. Huainan, Huaian, Tongling, Shanghai ZZ, Lianyungang and Suqian HIDDs rank very low in the total sales evaluation. Besides, Hangzhou, Nantong and Ningbo HIDDs rank first in the technology, product and commodity sales efficiency evaluation correspondingly. In addition, the increase of S&T labor inputs would decrease the efficiency of the product, commodity and total sales while the increase of the S&T capital inputs is as expected a facilitator to the efficiency of product, commodity and total sales. This study contributes to the discussion on the role of political intervention in technological innovation by breaking down the economic efficiency into three major parts, the efficiency of technology, product and commodity sales. The findings could help policymakers strike a balance between the human and capital inputs in regional innovation capability.

Enhancing green total factor productivity through manufacturing output servitization: A case study in China

In the context of the growing environmental pollution and resource depletion caused by traditional manufacturing industries, the need for sustainable and eco-friendly practices has become a critical issue for the upgrading and transformation of the manufacturing industry worldwide. Based on data from listed manufacturing companies in China, which is the world's largest manufacturing country and exhibits significant diversity regarding the ownership, scale and level of enterprises, the impact of manufacturing output servitization on green total factor productivity (GTFP), which is a measurement of economic efficiency that takes into account environmental impacts, is analyzed in this article. The results show that manufacturing output servitization can improve the GTFP of enterprises, and this can be achieved through mechanisms such as increased profitability and innovation capabilities. The positive effect on the GTFP of enterprises in less developed regions is greater than that in developed regions and is more significant for private and foreign-funded enterprises than for state-owned enterprises. The companies that adhere to the Global Reporting Initiative framework for environmental, social and governance reporting experience a more significant positive impact on GTFP as a result of their manufacturing output servitization efforts. This research offers valuable insights into the potential of servitization as a strategy for enhancing GTFP and provides actionable guidance for policy-makers and industry stakeholders seeking to align manufacturing practices with sustainability goals.

Multi-dimension analysis of volatile sulfur compound emissions from an urban wastewater treatment plant

Long-term monitoring of volatile sulfur compounds (VSCs) released at the water-air interface from different treatment units of an anaerobic/oxic (A/O) wastewater treatment plant (WWTP) was carried out to assess the temporal and spatial emission characteristics of VSCs, to explore relationships between wastewater quality and VSC release. The VSC from non-aerated and aerated units were collected using dynamic and static chambers, respectively, and determined using gas chromatography. The VSC emission fluxes diminished in the order of primary sedimentation tank (PST) > anaerobic areas (ANA) > oxic section 1 (OX1). VSCs were not detected in the oxic section 2 (OX2), the oxic areas section 3 (OX3), and the final setting basin (FSB). Release capacities of VSCs descended in the order of summer > fall > spring > winter, with July, August, and September being the months with the highest VSC release capacities. VSC emission fluxes correlated well with wastewater temperatures, sulfate concentrations, and COD. VSC emission flux empirical equations based on wastewater temperature, sulfate concentrations, and COD were established. Based on the established VSC emission empirical equation, a control strategy to reduce the operating costs of deodorization facilities was proposed. This strategy is economically efficient and reduces the consumption of electrical energy.

Physicians' assessment of the Bavarian drug-expenditure control system: a qualitative study

BACKGROUND

In 2014 a new system for drug expenditures, the Wirkstoffvereinbarung (WSV, English: Active substance agreement) was implemented in Bavaria. In pre-defined indication groups, economic prescription of medications shall be enabled based on the selection, quantity, and proportion of an individual drug. Ambulatory care physicians receive quarterly trend reports on their prescribing behavior. This study examines physicians' perceptions of the WSV.

METHODS

Qualitative interviews (n = 20) and seven focus groups (n = 36) were conducted with ambulatory care physicians (e.g. general practitioners, cardiologists, pulmonologists). The methodology followed Qualitative Content Analysis.

RESULTS

Physicians generally accepted the necessity of prescribing economically. The majority of them rated the WSV positively and better than the previous system. As an improvement, they especially named timely feedback in form of easily understandable trend reports, encouraging self-reflection as well as allowing early control options. Problems perceived were drug discount contracts that were strongly criticized as leading to patients mixing up medications. Some perceived constraints of therapeutic freedom.

CONCLUSIONS

The implementation of the WSV is mostly viewed positively by physicians. The restrictions of therapeutic freedom partially perceived might be met by improved information on the reasons why some drugs are rated as less economical than others.

TRIAL REGISTRATION NUMBER

Main ID: DRKS00019820 (German Register of Clinical Studies and World Health Organization).

Sustainable orthopaedic surgery: Initiatives to improve our environmental, social and economic impact

In response to appeals from the WHO and The Lancet, a collaborative statement from over 200 medical journals was published in September 2021, advising international governments to combat the "catastrophic harm to health" from climate change. Healthcare, specifically surgery, constitutes a major contributor to environmental harm that remains unaddressed. This article provides practical guidance that can be instituted at a departmental, hospital and national level to institute transformative, sustainable efforts into practice. We also aim to provoke healthcare leaders to discuss policy-making with respect to this issue and highlight the necessity for sustainability to become a core domain of quality improvement. The average orthopaedic service produces 60% more waste than any other surgical specialty. Fortunately, simple measures such as a comprehensive education programme can decrease waste disposal costs by 20-fold. Other simple and effective "green" measures include integrating carbon literacy into surgical training, prioritising regional anaesthesia and conducting recycling audits. Furthermore, industry must take accountability and be incentivised to limit the use of single-item packaging and single-use items. National policymakers should consider the benefits of reusable implants, reusable surgical drapes and refurbishing crutches as these are proven cost and climate-effective interventions. It is crucial to establish a local sustainability committee to maintain these interventions and to bridge the gap between clinicians, industry and policymakers.

Exploring economic and environmental efficiency in renewable energy utilization: a case study in the Organization for Economic Cooperation and Development countries

The share of renewable energy has grown significantly in global energy supply, yet the evaluation of renewable energy utilization has remained limited. Hence, this research explored economic and environmental efficiency in renewable energy utilization in 20 OECD (The Organization for Economic Cooperation and Development) countries from 2015 to 2020. The study approached the data envelopment analysis-slack-based measure (DEA-SBM) to evaluate economic efficiency, and the DEA undesirable output to measure environmental efficiency. Four inputs as labor force, gross capital formation, total renewable energy capacity, and share of renewable energy were compared to two desirable outputs as the gross domestic product (GDP), and total energy production in the economic efficiency model. In the environmental efficiency model, the same inputs were evaluated with GDP as the desirable output and CO₂ emissions as the undesirable output. The DEA-SBM revealed that Australia, Belgium, Norway, the UK, and the USA were efficient in economic evaluation, whereas DEA undesirable output indicated that Belgium, France, Sweden, the UK, and the USA were efficient in environmental evaluation. The governments are suggested to adjust the resources management since the number of efficient units decreased in the economic assessment while fluctuating in the environmental assessment.

Evaluating the total-factor efficiency of E3 in oil-producing countries, with emphasis on education

Global warming is one of the greatest challenges of the contemporary world. Overcoming this problem requires a global determination in energy management and a significant reduction in the use of fossil fuels worldwide. The objectives of this article are to investigate the role of education in economic growth and to evaluate the total-factor energy, economic and environmental efficiency (E3) of oil-producing countries and productivity changes between 2000 and 2019. These countries were divided into two categories of middle- and high-income ones. The panel data model was used to estimate the role of education in the countries' economic growth, and the data envelopment analysis (DEA) method was used to measure their total-factor efficiency (E3). The findings indicate that education has a positive role in economic growth. In general, Norway proved to be efficient in all indicators of e1, e2, e3, and E3. The worst performance in e1 belonged to Canada (0.45) and Saudi Arabia (0.45); in e2, to Algeria (0.67) and Saudi Arabia (0.73); in e3, to the USA (0.04) and Canada (0.08); and in E3, to Canada (0.46), Saudi Arabia (0.48), and the USA (0.64). The average total-factor efficiency of all indicators for the selected countries was low. Average changes in total-factor productivity and technological changes for all the selected countries had decreased in e1 and e3 but improved in e2 and E3 during the studied period. The changes in technical efficiency also decreased during the period. Moving towards a low-carbon economy, developing creative and environment-friendly technologies, more investment in clean and renewable energy, and creating diversity in production, especially for OPEC and countries with single-product economies, are some of the ways suggested for improving E3 efficiency in the countries.

Influence of macronutrients and micronutrients on maize hybrids for biogas production

Important in the cultivation of corn for biogas production is the selection of appropriate hybrids, macro- and micronutrient dozing and the evaluation of energy and economic efficiency of their use. Therefore, this article presents the results of 3-year field research (2019-2021) on the yield of maize hybrids of different maturity groups grown for silage. The influence of the application of macronutrients and micronutrients on fresh and dry mass yield, chemical composition, methane yield, energy, and economic efficiency was analysed. It was established that depending on the maize hybrid, the application of macro- and micro-fertilizers increased the yield of the fresh mass of maize by 1.4-24.0% compared to options without their use. The evaluation of the theoretical yield of CH₄ based on the content of fats, protein, cellulose, and hemicellulose is also presented in different samples of maize. The findings show that the application of macro-and micro-fertilizers is suitable from the energy and economic points of view - profitability begins to appear at the price of biomethane of 0.3-0.4 euros per 1 m³.

Replacing ground Rhodes grass hay with soyhulls in the pelleted diet: effects on ingestive behavior, nutrient digestibility, blood metabolites, growth performance, and economic viability of intensive fattening Lohi lambs

This study aimed to evaluate the effects of replacing soyhulls (SH) for ground Rhodes grass hay (RGH) in a pelleted diet on ingestive behavior, digestibility, blood metabolites, growth performance, and economic viability of fattening Lohi lambs. A total of thirty male lambs (age: 5 months; body weight 20.4 ± 0.24 kg) were allotted to one of the three diets (n = 10 lambs/diet) under a completely randomized design. The diets were with 25% RGH inclusion (control), replacing 15% RGH with 15% SH as a fiber source (SH-15), and containing only 25% SH inclusion on a dry basis (SH-25). Ingestive behavior parameters like time spent (min/day), bouts frequency (number/day), and bout length (min/bout) for feeding, drinking, rumination, chewing, standing, and lying were not influenced (P > 0.05) by replacing RGH with SH. The dry matter (DM) and neutral detergent fiber (NDF) chewing rate, rumination rate, and feeding efficiency were also not changed (P > 0.05) by dietary treatments, whereas total dry matter and NDF intakes, and their rumination efficiencies were lower (P < 0.05) for the SH-25 than for the rest of the treatments. The digestibility of NDF and acid detergent fiber (ADF) was higher (P < 0.05) for the SH-25 than for the rest of the treatments. The concentrations of blood metabolites like glucose, blood nitrogen, and cholesterol were not changed (P > 0.05) among the treatment groups. Similarly, performance parameters like dry matter intake, initial and final body weight, average daily gain, and feed conversion ratio were similar (P > 0.05) across the treatments. However, the incidence of loose fecal consistency was higher (P < 0.05) for SH-25 than for the control. The values of economic efficiency were better for SH-25-fed lambs than those fed the rest of the treatments. Based on the results, substituting SH for RGH in a pelleted diet improved the digestibility of fiber fractions, and economics without affecting the growth performance, and blood metabolites of fattening lambs. However, lower rumination efficiency and loos fecal consistency are evidencing less effectiveness of SH fiber.

Economic Efficiency of an Open-Source National Medical Lab Software in Canada

Although the Canada federal government has invested over $3.1 billion developing health information technology (HIT), all 10 provinces still have their own separate HIT systems, which are non-interoperable, expensive, and inconsistent. After first reviewing how these systems operate, this paper analyzes the costs and savings of integrating the common billing, lab results, and diagnostic imaging (BLD) functions of these separate systems using free and open-source software and proposes a system for this, HermesAPI. Currently, 8 provincial governments representing over 95% of Canada's population allow private companies to create their own electronic medical records (EMR) system and integrate with provincial BLD systems. This study found the cost to develop and maintain HermesAPI would be between CAD$610,000 to CAD$740,000, but would prevent CAD$120,000 per company per province in development costs for a total savings of $6.4 million. HermesAPI would lower barriers to entry for the HIT industry to increase competition, improve the quality of HIT products, and ultimately patient care. The proposed open-source approach of the HermesAPI is one option towards building a more interoperable, less expensive, and more consistent HIT system for Canada.

Performance and economic efficiency analysis of an integrated, outdoor fan-ventilated cooling device

Recently, the importance of mechanical facilities in charge of the safety and comfort of occupants in buildings has once again been highlighted in accordance with global social issues such as the spread of COVID-19. In response, various ventilation systems are being developed to improve indoor air quality, and efforts are being made to satisfy the indoor comfort of the occupants. Such advanced facilities allow occupants to secure indoor air quality, while frequent ventilation systems can affect the cooling and heating load in the building, and there is also a problem that it can occupy a relatively large amount of space in the building. This study proposes an integrated, outdoor fan-ventilated cooling device and analyzes its performance and economic efficiency. The EnergyPlus simulation program was used to model two types of systems for comparison: an existing (base) model with a condenser located in the outdoor unit, and a developed model with the condenser integrated within the cooling system. The state of the air passing through the condenser was analyzed prior to comparing the efficiency of the integrated, outdoor fan-ventilated cooling device, followed by an in-depth analysis of the performance and economic efficiency based on total energy consumption. In Case 1, the air passing through the cooling system was approximately 5  °C lower than the base model and showed 11% peak load reduction in comparison to the maximum energy consumption. Additionally, a comparison between regions with different outdoor air temperatures showed an average cost reduction of 16% in Daejeon and Busan City.

Production performance, protein digestibility, gut health and economic efficiency in sexed broilers with super dozing of lysine

Modern commercial broiler is growing very rapidly and its amino acid requirement is not fulfilling. An experimental trial was conducted to study the effect of super-dosing of lysine in fish meal-based diets (50% fish meal and 50% SBM) on production performance, protein digestibility and economic efficiency in male and female broiler chickens. Four hundred and eighty (480) one-day-old male and female broiler chicks were divided into forty experimental units of 12 birds each. Five levels of dietary lysine i.e. 90, 100, 110, 120 and 130% of Ross-308 recommendation in male and female birds were separately used. Weight gain and feed intake were higher (p < 0.05) in birds received 100 and 110% recommended lysine than other levels. Feed conversion ratio and EPEF were improved (p < 0.05) in birds received 100% recommended lysine than other levels. Higher (p < 0.05) CP digestibility and lower production cost per kg live weight were noted for birds fed diet containing lysine 100, 110 and 120% than 90 and 130%. Male birds had higher (p < 0.05) WG, FI, EPEF, protein digestibility and lower production cost per kg live weight than female birds. In conclusion, lysine levels below 100% and above 110% of Ross recommended levels had poor production performance, protein digestibility and economic efficiency.

[Economics of operating room use at a university eye hospital]

BACKGROUND

In ophthalmologic surgery, there are usually short operation times and thus many changes between the individual operations, which are not subject to remuneration. As in maximum care hospitals consecutive different operations with different durations are often performed, emergency operations have to be inserted and further training of colleagues is practiced, it is particularly important to generate the shortest possible transfer times in order to have both sufficient operation time and to be able to treat as many cases as possible. The aim of this work is to evaluate the efficiency of the surgical performance of a university eye hospital.

MATERIAL AND METHOD

The surgeries performed in 2021 at the MHH Eye Clinic were evaluated with respect to the spectrum, number, surgery duration, transfer times and process times. In terms of personnel, each operating room was staffed with one assistant anesthesiologist, one nurse anesthetist, two operating room nurses, one surgeon, and 20% senior anesthesiologist supervision. Based on a theoretical concept, which provides an increased staffing ratio while maintaining the same infrastructure, it was calculated how many more surgeries could be performed if the transfer time was halved and whether the additional financial expense could be compensated.

RESULTS

With a total of n = 2712 surgeries performed during regular duty hours (244 working days) in 2 operating rooms (average daily n = 11.1; weekly n = 53.6 and monthly n = 237.1), the average surgery duration was 37 min and the transition time 43 min. This means that the operating rooms were used for surgery for 51% of the total operating time. Main procedures were vitrectomy with n = 1350 and cataract surgery with n = 1308. The new personnel concept provided one additional operating room nurse per operating room and one additional anesthesiologist for both operating rooms. The additional costs for this personnel expenditure were calculated at approx. 300,000 € per year. The halving of the transfer time from 43 min to about 21 min through possible overlapping induction and parallel work, which was not possible until now, results in an additional operation time of about 100 min per operating room, so that at least 4 additional operations can be planned and performed. In this way, with stringent implementation and the same spatial structures with stable fixed costs, n = 976 more operations could be performed, which, minus the personnel costs, the additional material costs for surgery and anesthesia of 557,042 € and the inpatient hotel costs of 600,663 €, with an average length of stay of 2.8 days, would result in an additional revenue of about 2.4 times the additional personnel costs at the current flat rate of 3739.40 € and an average case mix index of the MHH Eye Hospital of 0.649 (total revenue: 2,155,449 €; profit margin II: 701,389 €) for the considered surgical patient collective in 2021.

CONCLUSION

An increase of the personnel expenditure in the operating room for surgical subjects such as ophthalmology with shorter interventions and many changes is economically worthwhile also for a large hospital in order to enable and optimize overlapping transfers of anesthesia and surgical care. This should therefore also be considered separately, contrary to standardized staffing of the overall hospital, in order to use existing resources with their fixed costs as optimally as possible.

The stochastic frontier analysis technique in measuring the technical and economic efficiency of hospital diagnostic laboratories: a case study in Iran

An inefficient health system wastes scarce resources even if it makes considerable gains in accountability and equity. Such a system is expected to perform better. Therefore, it is vital to examine the current performance of health systems and their constituents and assess how to reach their maximum potential. This study aimed to evaluate the technical and economic efficiency of medical diagnostic laboratories in hospitals affiliated with Urmia University of Medical Sciences (UUMS) in 2016. In this descriptive-analytical study, data from diagnostic laboratories of the hospitals of UUMS have been inputted into Frontier_4.1 software after taking the log of variables. Then, the technical and economic efficiency of the laboratories were obtained by estimating the production and cost function using the stochastic frontier analysis method, assuming input minimization for 2016. The mean technical and economic efficiency score of the diagnostic laboratories were determined to be 93.1% and 51.9%, respectively. These laboratories need to reduce their inputs and costs in order to achieve full efficiency without changing the amount of their output. Although the average economic efficiency of the diagnostic laboratories of the studied hospitals was high, there is still an increase in the efficiency of these units, given the cost of inputs at the time of allocating resources. In addition, it is possible to improve the technical efficiency of the clinical laboratories of hospitals affiliated with UUMS by 48.1% by applying the same level of inputs and without increasing the costs.

Impact of spatial misallocation of electric power resources on economic efficiency and carbon emissions in China

The relationship between resource misallocation and productivity has become a hot topic in recent years, but few studies examined the impact of spatial misallocation of electric power resources (SMEPRs) on economic efficiency and carbon emissions. Here, we constructed a calculation model of SMEPRs that can measure both the misallocation degree and direction and uncovered the spatiotemporal evolvement mechanism of SMEPRs. On this basis, we explored the impact of SMEPRs on regional economic efficiency and carbon emissions using panel data from 29 provinces in China from 1988 to 2017. The results demonstrate that the high level of SMEPRs in China shows complex spatiotemporal characteristics and significantly affects the regional economic efficiency and carbon emissions. Specifically speaking, first, SMEPRs present the characteristics of the coexistence of excessive and insufficient allocation among provinces and regions, the increasing extent of misallocation in the eastern and western regions, and the gradual decline in the central region; second, SMEPRs have a strong negative effect on the regional economic efficiency and carbon emissions by affecting regional industrial structures, which indicates that SMEPRs are an important factor restricting the high-quality development of regional economies. The research is conducive to the development of resource misallocation theory. Moreover, the research observations offer fresh insights to upgrading the high-quality and green development of China's power sector and promoting regional economic transformation and ecological sustainability.

Benchmarking Canadian solid waste management system integrating fuzzy analytic hierarchy process (FAHP) with efficacy methods

Solid waste management is a recent challenge for both developed and developing countries because of urbanization and population growth. This research aims to identify and compare the economic efficiency of Canadian waste management systems integrating the fuzzy analytic hierarchy process (FAHP) with the efficacy method. Six economic indicators-diversion gross domestic product (DGDP) ratio, gross domestic product (GDP) of all industries, GDP of Sector 562, diversion rate, waste management output indicator, and diversion size indicator-are considered in this study. Initially, the FAHP method was used to calculate the indicator weights, and the efficacy method then ranked the DGDP ratio as the most influential factor for the GDP-related indicators. The DGDP ratio and diversion rate were determined to be most critical in the assessment of the economic efficiency of a solid waste management system in Canada. The result also revealed that the economic performance of the waste management systems of Nova Scotia, British Columbia, and Ontario are better compared to those of other provinces. The outcome of this study will aid the government and provincial organizations in establishing an effective solid waste management plan to improve their overall performance.

Analyzing the Economic Effectiveness of Genomic Selection Relative to Conventional Breeding Approaches

Comparing the economic efficiency of alternative strategies for breeding requires to compare the genetic gain obtained with breeding schemes that represent the same total investment. In this chapter, we present a generic method to assess this economic efficiency for alternative breeding schemes. After presenting the baseline framework and the necessity of comparing breeding schemes with equivalent total investment, we propose one illustrative example on wheat breeding. In this application, we compare the use of conventional breeding and genomic selection. With this example, we explain the requirements and the different steps to implement this method. At last, we discuss several extensions of the baseline model.

Development of corporate investment funds as a tool to achieve the goals of international treaties in the field of climate change

The UNFCCC and Paris Climate Agreement set the environmental agenda for many years to come, making environmental protection a global trend. Herewith, these documents created many unprecedented challenges for business, shifting the focus from the original role of commercial benefit to the trade-off between profit and social responsibility. The need to adapt business strategies to the existing agenda has created new requirements for shaping the investment environment. In this aspect, there arises the question regarding the organizational and legal form the investment activities can be carried out in and what additional regulatory instruments can be applied to simplify the procedure for attracting environmental investments. In the current conditions, corporate investment funds may be considered as promising instruments for achieving the goals of international climate agreements. The study suggests that corporate investment funds can become an effective tool for attracting environmental investments. The study purpose is to assess the role of corporate investment funds in international climate agreements goals achievement, to consider the possibility of development strategies to improve management efficiency in the corporate investment funds in terms of their linkage to UNFCCC, Paris Climate Agreement and in a comparative perspective. The study methodology is based on the analysis of world and Russian law enforcement practices in the corporate activities field through the application of a systematic approach. The relationship between corporate governance represented by big businesses and the state is considered in the framework of the investment mechanism and the institutional environment, which is visualized in the model of the business landscape of a corporate investment fund in order to determine management strategies in the operation and development of a corporate investment fund. The study results can be put into practice by financial market participants and other entities in order to increase the efficiency of the use of assets and knowledge of national jurisdictions in the context of world and Russian practices.

Dynamic linkages among economic development, environmental pollution and human health in Chinese

Background

Research on the relationships between economic development, energy consumption, environmental pollution, and human health has tended to focus on the relationships between economic growth and air pollution, energy and air pollution, or the impact of air pollution on human health. However, there has been little past research focused on all the above associations.

Methods

The few studies that have examined the interconnections between the economy, energy consumption, environmental pollution and health have tended to employ regression analyses, DEA (Data Envelopment Analysis), or DEA efficiency analyses; however, as these are static analysis tools, the analyses did not fully reveal the sustainable economic, energy, environmental or health developments over time, did not consider the regional differences, and most often ignored community health factors. To go some way to filling this gap, this paper developed a modified two stage Undesirable Meta Dynamic Network model to jointly analyze energy consumption, economic growth, air pollution and health treatment data in 31 Chinese high-income and upper-middle income cities from 2013-2016, for which the overall efficiency, production efficiency, healthcare resource utilization efficiency and technology gap ratio (TGR) for all input and output variables were calculated.

Results

It was found that: (1) the annual average overall efficiency in China's eastern region was the highest; (2) the production stage efficiencies were higher than the healthcare resource utilization stage efficiencies in most cities; (3) the high-income cities had lower TGRs than the upper-middle income cities; (4) the high-income cities had higher average energy consumption efficiencies than the upper-middle income cities; (5) the health expenditure efficiencies were the lowest of all inputs; (6) the high-income cities' respiratory disease and mortality rate efficiencies were higher than in the upper-middle income cities, which had improving mortality rate efficiencies; and (7) there were significant regional differences in the annual average input and output indicator efficiencies.

Conclusions

First, the high-income cities had higher average efficiencies than the upper-middle income cities. Of the ten eastern region high-income cities, Guangzhou and Shanghai had average efficiencies of 1, with the least efficient being Shijiazhuang. In the other regions, the upper-middle income cities required greater technology and health treatment investments. Second, Guangzhou, Lhasa, Nanning, and Shanghai had production efficiencies of 1, and Guangzhou, Lhasa, Nanning, Shanghai and Fuzhou had healthcare resource utilization efficiencies of 1. As the average production stage efficiencies in most cities were higher than the healthcare resource utilization stage efficiencies, greater efforts are needed to improve the healthcare resource utilization. Third, the technology gap ratios (TGRs) in the high-income cities were slightly higher than in the upper-middle income cities. Therefore, the upper-middle income cities need to learn from the high-income cities to improve their general health treatment TGRs. Fourth, while the high-income cities had higher energy consumption efficiencies than the upper-middle income cities, these were decreasing in most cities. There were few respiratory disease efficiency differences between the high-income and upper-middle income cities, the high-income cities had falling mortality rate efficiencies, and the upper-middle income cities had increasing mortality rate efficiencies. Overall, therefore, most cities needed to strengthen their health governance to balance economic growth and urban expansion. Fifth, the average AQI efficiencies in both the high-income and upper-middle income cities were higher than the average CO₂ efficiencies. However, the high-income cities had lower average CO₂ emissions and AQI efficiencies than the upper-middle income cities, with the AQI efficiency differences between the two city groups expanding. As most cities were focusing more on air pollution controls than carbon dioxide emissions, greater efforts were needed in coordinating the air pollution and carbon dioxide emissions treatments. Therefore, the following suggestions are given. (1) The government should reform the hospital and medical systems. (2) Local governments need to strengthen their air pollution and disease education. (3) High-income cities need to improve their healthcare governance to reduce the incidence of respiratory diseases and the associated mortality. (4) Healthcare governance efficiency needs to be prioritized in 17 upper-middle income cities, such as Hangzhou, Changchun, Harbin, Chengdu, Guiyang, Kunming and Xi'an, by establishing sound medical management systems and emergency environmental pollution treatments, and by increasing capital asset medical investments. (5) Upper-middle income cities need to adapt their treatment controls to local conditions and design medium to long-term development strategies. (6) Upper-middle income cities need to actively learn from the technological and governance experiences in the more efficient higher-income cities.

Economic efficiency of rainfed wheat farmers under changing climate: evidence from Pakistan

Rainfed wheat farming directly depends upon climatic indicators and is mostly at the mercy of climatic extremes. This study analyzed the relationship between the economic efficiency of rainfed wheat farmers and indicators of climate variability in Pakistan employing a two-stage methodological framework. We used farm household level crop input-output and management data and secondary data on climate. In the first stage, a stochastic production frontier (SPF) approach was used to calculate economic efficiency. Then, in the second stage, the calculated economic efficiency scores were regressed against the temperature threshold, temperature anomaly, and total rainfall, in addition to socioeconomic, institutional, and farm variables, using OLS and quantile regression models. The results showed that temperature anomaly and the number of days when temperatures exceed 30 °C have negative and significant impacts on the economic efficiency of rainfed wheat farmers. Total rainfall showed positive and significant impacts across both OLS and quantile regression models. Further, we modeled a novel and very important variable in the context of rainfed wheat production in Pakistan, that is, farmers' participation in trainings in climate-resilient crop farming. This variable showed a positive and highly significant impact on economic efficiency of wheat farmers across all regression models. Our findings call for important policy implications, including developing up-to-date climate resilient adaptation strategies that are particularly focused on rainfed wheat farming. Establishing strong linkages between extension departments and rainfed wheat farmers could help sustain and improve the efficiency of rainfed wheat farmers and hence food and livelihood security.

A comprehensive study on the effect of light quality imparted by light-emitting diodes (LEDs) on the physiological and biochemical properties of the microalgal consortia of Chlorella variabilis and Scenedesmus obliquus cultivated in dairy wastewater

The effect of light wavelengths on the physiological, biochemical and lutein content of the microalgal consortia Chlorella variabilis and Scenedesmus obliquus was evaluated using different light sources. Among different light treatments, cool-white fluorescent light produced the highest biomass of 673 mg L^-1 with a specific growth rate of 0.75 day^-1 followed by blue (500 mg L^-1; 0.73 day^-1). The chlorophyll content was enhanced under blue light (10.7 mg L^-1) followed by cool fluorescent light (9.3 mg L^-1), whereas the lutein productivity was enhanced under cool fluorescent light (7.22 mg g^-1). Protein content of the microalgal consortia was enhanced under all light treatments with the highest protein accumulation under cool-white fluorescent light (~56% of dry mass) closely followed by amber light (52% of dry mass), whereas the carbohydrate content was higher under amber light (~35% of dry mass). The results revealed that the consortia could grow well on diluted dairy wastewater thereby reducing the cost of algal production when compared with the use of inorganic media and a two-phase culture process utilizing cool fluorescent and amber light could be employed for maximizing algal biomass and nutrient composition with enhanced lutein production. The study also emphasizes on the economic efficiency of LED lights in terms of biomass produced based on the modest electricity consumed and the importance of using amber light for cultivating microalgae for its nutrient content which has seldom been studied.

Application of magnetic field improves growth, yield and fruit quality of tomato irrigated alternatively by fresh and agricultural drainage water

Although the North Delta region in Egypt is one of the most densely populated areas in the world, it suffers from a severe shortage of fresh water needed to irrigate crops. So usually farmers resort to the use of low-quality water, such as agricultural drainage water, which could pose a threat to the quality of crops and then human health. Two field experiments were carried out during two consecutive summer seasons of 2014 and 2015 aimed at delivering more information about the pros and cons of alternative irrigation for tomato using fresh and agricultural drainage water with or without applying of magnetic field. The twelve surface irrigations, which tomato needs during its whole growing season, were applied alternatively between fresh and agricultural drainage water, respectively, at the following percentages (100 + 0), (75 + 25), (50 + 50), (25 + 75) and (0 + 100). Magnetic field was applied using iron fillings at a rate of 150 kg ha^-1. The results revealed that growth parameters, early, total and relative yield, marketable yield and total chlorophyll and NPK content of leaves were gradually decreased with increasing the irrigation using agricultural drainage water. However, irrigating tomato by 100% fresh water had the highest values, while using of 100% agricultural drainage water displayed the lowest values. Contrarily, vitamin C, total soluble solids (TSS) and fruit firmness where at their highest values when tomato irrigated by 100% of agricultural drainage water. Applying of magnetic field not only enhances the growth, yield and quality of tomato under irrigation using agricultural water but also under fresh water. These results are of importance in areas where the use of agricultural drainage water irrigating crops is inevitable for enhancing yield and its quality and consequently ensuring food safety.

Factors influencing economic efficiency of milk production among small-scale dairy farms in Mukurweini, Nyeri County, Kenya

This paper highlights the factors likely to influence the economic efficiency of small-scale dairy farms in Mukurweini, Nyeri County, Kenya. A total of 91 small-scale dairy farms previously involved in a nutritional training in 2013 were administered with semi-structured questionnaires. Data collected were entered into SPSS and FRONTIER 4.1 was used to compute the technical, allocative and economic efficiency scores for each farm. The scores were then regressed against a set of variables using the Tobit model in STATA to determine the factors associated with the scores. The average age of the household members involved in dairy farming, household size, labour, cost of concentrates and size of land owned had a negative significant influence on economic efficiency. It was concluded that lowering costs, proper utilization of hired labour and intensive use of the available land for dairy farming would lead to an increase in economic efficiency. The study recommends subsidized prices for concentrates, intensive dairy farming, minimization of hired labour and organization of dairy training and workshops in order to increase the efficiency of milk production in small-scale farms in the study area and other parts of Kenya with similar agro-ecological and cultural conditions.

Economic efficiency versus accessibility: Planning of the hospital landscape in rural regions using a linear model on the example of paediatric and obstetric wards in the northeast of Germany

BACKGROUND

Costs for the provision of regional hospital care depend, among other things, on the population density and the maximum reasonable distance to the nearest hospital. In regions with a low population density, it is a challenge to plan the number and location of hospitals with respect both to economic efficiency and to the availability of hospital care close to residential areas. We examined whether the hospital landscape in rural regions can be planned on the basis of a regional economic model using the example which number of paediatric and obstetric wards in a region in the Northeast of Germany is economically efficient and what would be the consequences for the accessibility when one or more of the three current locations would be closed.

METHODS

A model of linear programming was developed to estimate the costs and revenues under different scenarios with up to three hospitals with both a paediatric and an obstetric ward in the investigation region. To calculate accessibility of the wards, geographic analyses were conducted.

RESULTS

With three hospitals in the study region, there is a financial gap of €3.6 million. To get a positive contribution margin for all three hospitals, more cases have to be treated than the region can deliver. Closing hospitals in the parts of the region with the smallest population density would lead to reduced accessibility for about 8% of the population under risk.

CONCLUSIONS

Quantitative modelling of the costs of regional hospital care provides a basis for planning. A qualitative discussion to the locations of the remaining departments and the implementation of alternative healthcare concepts should follow.

High voltage fragmentation of composites from secondary raw materials - Potential and limitations

The comminution of composites for liberation of valuable components is a costly and energy-intensive process within the recycling of spent products. It therefore is continuously studied and optimized. In addition to conventional mechanical comminution innovative new principles for size reduction have been developed. One is the use of high voltage (HV) pulses, which is known to be a technology selectively liberating along phase boundaries. This technology offers the advantage of targeted liberation, preventing overgrinding of the material and thus improving the overall processing as well as product quality. In this study, the high voltage fragmentation of three different non-brittle composites (galvanized plastics, carbon fibre composites, electrode foils from Li-ion batteries) was investigated. The influence of pulse rate, number of pulses and filling level on the liberation and efficiency of comminution is discussed. Using the guideline VDI 2225 HV, fragmentation is compared to conventional mechanical comminution with respect to numerous criteria such as cost, throughput, energy consumption, availability and scalability. It was found that at current state of development, HV fragmentation cannot compete with mechanical comminution beyond laboratory scale.

Achieving an optimal allocation of resources for animal health surveillance, intervention and disease mitigation

The primary role of animal health economics is to inform decision-making by determining optimal investments for animal health. Animal health surveillance produces information to guide interventions. Consequently, investments in surveillance and intervention must be evaluated together. This article explores the different theoretical frameworks and methods developed to assess and optimise the spending of resources in surveillance and intervention and their technical interdependence. The authors present frameworks that define the relationship between health investment and losses due to disease, and the relationship between surveillance and intervention resources. Surveillance and intervention are usually considered as technical substitutes, since increased investments in surveillance reduce the level of intervention resources required to reach the same benefit. The authors also discuss approaches used to quantify externalities and non-monetary impacts. Finally, they describe common economic evaluation types, including optimisation, acceptability and least-cost studies.

Who Should Decide How Machines Make Morally Laden Decisions?

Who should decide how a machine will decide what to do when it is driving a car, performing a medical procedure, or, more generally, when it is facing any kind of morally laden decision? More and more, machines are making complex decisions with a considerable level of autonomy. We should be much more preoccupied by this problem than we currently are. After a series of preliminary remarks, this paper will go over four possible answers to the question raised above. First, we may claim that it is the maker of a machine that gets to decide how it will behave in morally laden scenarios. Second, we may claim that the users of a machine should decide. Third, that decision may have to be made collectively or, fourth, by other machines built for this special purpose. The paper argues that each of these approaches suffers from its own shortcomings, and it concludes by showing, among other things, which approaches should be emphasized for different types of machines, situations, and/or morally laden decisions.

Performance of growing rabbits fed increasing levels of discarded Salvia hispanica L. (chia) seed

This experiment was carried out to evaluate the effect of including five levels of discarded chia seed (DCS) on growth, energy, and economic efficiency in rabbits. Fifty crossbred (New Zealand × Californian) weaning rabbits, weighing 798 ± 170 g, were randomly assigned to the following treatments: 0 % (control), 10 % (Ch10), 20 % (Ch20), 30 % (Ch30), and 40 % (Ch40) of DCS. Ten unsexed rabbits were allocated to each treatment and housed individually in cages; the experimental period was 6 weeks. There were no statistically significant differences between treatments in final body weight (2050 g), body weight gain (30 g/rabbit/day), and carcass weight (1010 g); however, feed intake (91 g/rabbit/day in Ch20 vs. 80 g/rabbit/day in Ch40), feed conversion ratio (2.77 in control and Ch40 vs. 2.95 in Ch10, Ch20, and Ch30), energy conversion ratio (32 MJ/kg in Ch20 vs. 29 MJ/kg on average in control, Ch10, Ch20, Ch30, and Ch40), and economic efficiency (358 % in control vs. 433 % in Ch40) showed differences (P < 0.05) between treatments. Discarded chia seed can be included up to 40 % in growing rabbit diets without any adverse effects on growth and carcass weight, and increased economic efficiency.

Health care market deviations from the ideal market

A common argument in the health policy debate is that market forces allocate resources efficiently in health care, and that government intervention distorts such allocation. Rarely do those making such claims state explicitly that the market they refer to is an ideal in economic theory which can only exist under very strict conditions. This paper explores the strict conditions necessary for that ideal market in the context of health care as a means of examining the claim that market forces do allocate resources efficiently in health care.

Race to the bottom or swimming upstream: Performance analysis of US airlines

Data envelopment analysis is used to examine inter-temporal and peer group airline efficiency. Results for the US for 1985-2006 indicate that airline performance is converging over time. In particular, airlines inter-temporal inefficiency peaked earlier and then converged. Furthermore, using Tobit specifications it is seen that while demand intensity matters less in determining airlines inter-temporal inefficiency, their influence is stronger in determining peer group inefficiency. Block time, a representative of operational factors, tends to negatively impact airlines efficiency by imposing burdens on airline operations. Among the structural cost and revenue factors, fuel cost tends to affect inter-temporal inefficiency more robustly than it does to peer group efficiency. Labor pay tends to reduce inefficiency in case of inter-temporal while increasing peer group inefficiency. The events of September 11th had little or no impact on inter-temporal inefficiency but tended to reduce peer group inefficiency in a significant way. Finally, airlines efficiency tends to be robustly affected by block hours; reducing them increases efficiency.