18 research outputs found
Setting the stage for expertise and exploration: Reframing COALA’s Digital Intelligent Assistant (DIA) within the Diversey factory
No full textIntelligent and connected services have become essential in the manufacturing industry. The surge of these services has even started a new phase of industry; industry 4.0. The COALA consortium aims to develop a service to assist operators within this new industry. The COALA consortium is an European Union Programme and aims to develop a Digital Intelligent Assistant (DIA). The DIA supports operators in situations characterised by cognitive load, time pressure, and little or zero tolerance for quality issues with trustworthy AI components. Diversey is one of the consortium’s partners and perceives COALA’s DIA as a viable solution to their stoppage challenge on their production lines in the factory. These stoppages can be caused by various bottlenecks, which are hard to determine due to the production lines’ complexity and processes. Therefore, this thesis explores how to prepare for AI service adoption within the factory of Diversey. However, management from the Diversey factory has attempted to identify the bottlenecks by collecting production information through operator data entries. Unfortunately, the operators did not provide the tool with quality data entries. Therefore, replacing this tool with the DIA most likely not succeed, especially when the new tool utilises AI technology that requires learning data to generate insights. In order to explore this resistance toward new tools within the factory, I used the frame creation method of Dorst. This method excels at finding innovative solutions for problem definitions with previously unsuccessful attempts. The method explores underlying themes within the context to reframe the problem definition and find new solution spaces. The themes are formulated from interviews with management, eight support staff employees across four departments, a team lead, and six operators. Four themes are generated by analysing the values, interactions, and ‘currency’ exchanged between stakeholders. These themes regarding new tools describe the unclear contributions to operators’ work, the lack of acknowledgement regarding operators’ role and expertise towards production improvements. These themes result in a lack of trust between operators and management, which diminish the willingness to adopt new tools. Additionally, management expresses concerns about the themes expertise and consistency, which are essential to the manufacturing industry. In order to address these themes, COALA’s DIA is reframed as a stage for expertise and exploration. Instead of simply requesting data entries, operators are put in the spotlight where they can showcase their knowledge and expertise. Additionally, this stage provides a space for operators to explore production improvements through collaboration with COALA’s DIA. The framing of the problem definition addresses the data collection aspect of COALA’s DIA. However, AI systems change over time as the systems adapt to the data input. Additionally, the thesis did not assess the users’ perception of the current DIA interface. Therefore, I recommend further research into human-AI interaction with regards to the system’s evolution over time and the interface. Lastly, the themes are generated from one production line’s operators who are experiencing the most stoppages. The themes cannot directly be generalised to other production lines as the number of stoppages, or other contextual factors can influence the themes.Strategic Product Desig
Prerequisites for Cost-effective Home Blood Pressure Monitoring:Insights From an Early Health Economic Model Analysis
No full textPrerequisites for Cost-Effective Home Blood Pressure Telemonitoring:Early Health Economic Analysis
No full textBACKGROUND: Home blood pressure telemonitoring (HBPT) has been proposed to enhance adherence and optimize health care delivery, yet its prerequisites for cost-effective implementation remain unclear.OBJECTIVE: This study aims to quantify the potential cost-effectiveness of HBPT and identify prerequisites for cost-effective implementation of HBPT in comparison to standard hypertension management, using an early health economic analysis from a societal perspective.METHODS: A decision-analytic Markov model with a lifetime horizon (30 years) and a willingness-to-pay threshold of €20,000 (€1=US $1.09) per quality-adjusted life year (QALY) was developed to assess the cost-effectiveness of HBPT compared to standard of care (SOC). The HBPT intervention was based on an existing HBPT program applied by the Maasstad Hospital, Rotterdam, the Netherlands. The model incorporated 12 health states: 7 blood pressure states, 1 cardiovascular (CV) event, 1 recurrent CV event, 1 postrecurrent CV event, 1 all-cause death, and 1 CV disease-related death. A hypothetical cohort of 1000 patients (average age 65.3 years) was modeled, and results were reported in costs, QALYs, and the incremental cost-effectiveness ratio (ICER). The model assumed 3 in-person outpatient department (OPD) consultations in the SOC group and 1.5 in the HBPT group. Extensive sensitivity analyses were performed to identify important variables for the cost-effective implementation of HBPT.RESULTS: Following the base-case analysis, HBPT was not cost-effective with an ICER of €20,386 per QALY. Sensitivity analyses indicated that reducing the number of in-person OPD consultations resulted in a more favorable ICER. Specifically, reducing the number of in-person OPD consultations to 1.48 annually resulted in an ICER below the willingness-to-pay threshold. Reducing the in-person OPD consultations to an average of 1.18 per year would make HBPT cost-saving. Scenario analyses revealed that extending the duration of HBPT's clinical effect to 2 or 3 years substantially improved the ICER. Additionally, targeting HBPT toward patients aged 64 years or below further improved the ICER.CONCLUSIONS: HBPT could result in cost-effective or cost-saving outcomes with only minor reductions in in-person OPD consultations. These findings highlight the potential of HBPT to transform hypertension management by replacing traditional hypertension management with more efficient care using remote patient monitoring.</p
Hybrid business models for ‘Organ-on-a-Chip’ technology: The best of both worlds
No full textCurrent in vitro and in vivo preclinical models often have limited predictive value for translation to the clinical setting. The emerging ‘Organ-on-a-Chip’ (OOC) technology provides a better resemblance to the human physiology through combining 3D configuration of human-derived cells with microfluidic techniques, potentially improving translation. However, due to the disruptive nature of the OOC technology, it is unclear how to best achieve a product-market fit. Data on currently employed business models was collected by 14 semi-structured interviews with representatives from OOC companies. Customer needs were collected by means of an online questionnaire among 62 (potential) end-users. Both companies and customers preferred the Hybrid business model, in which both products and services were offered. Customized services were only moderately preferred over standard services, limiting the potential for price premiums. Razor blade business models facilitate investments in laboratory equipment while locking in the purchase of disposable OOC devices. Current and future generations of in vitro technologies would benefit from combining the best of product and service business models into the Hybrid business model. Downward price pressures are expected to lead to ever-lower pricing and to facilitate more predictive, high throughput screening with a high societal impact on the longer term
Holes in wrist patches improve wearing comfort
No full textPurpose: The purpose of this paper was to investigate whether small holes in an impermeable patch at the wrist improve perceived comfort during exercise. Design/methodology/approach: Nine male participants participated in this study. During the experiment, participants cycled 60 W in a hot room (35°C, 30 percent relative humidity) while an impermeable 20 cm2 patch was located on the ventral side of one wrist and at the same time a patch of identical shape with 5 mm diameter holes (17.7 percent uncovered) on the other wrist. The participants could not see the patches. Participants were forced to choose which patch they perceived as more comfortable. Chest and arm skin temperature, thermal comfort, thermal sensation and wetness perception were assessed. Findings: Participants preferred 5 mm holes over no holes (p=0.017). Chest skin temperature (p=0.018) but not arm skin temperature correlates with this preference. Thermal comfort, thermal sensation and wetness perception did not differ significantly between patches. It is concluded that patches with 5 mm holes are preferred over impermeable patches during work in the heat in particular when the torso skin is warm. Originality/value: The wrist is a preferred location for smart wearables. Generally, wrist bands are made of air-impermeable materials leading to sensation of wetness and discomfort. This study has shown that manufacturers should consider to make small holes in their wrist bands to optimize wearing comfort
Co-benefits of black carbon mitigation for climate and air quality
No full textMitigation of black carbon (BC) aerosol emissions can potentially contribute to both reducing air pollution and climate change, although mixed results have been reported regarding the latter. A detailed quantification of the synergy between global air quality and climate policy is still lacking. This study contributes with an integrated assessment model-based scenario analysis of BC focused mitigation strategies aimed at maximizing air quality and climate benefits. The impacts of these policy strategies have been examined under different socio-economic conditions, climate ambitions and BC mitigation strategies. The study finds that measures targeting BC emissions (including reduction of co-emitted organic carbon, sulphur dioxide and nitrogen dioxides) result in significant decline in premature mortality due to ambient air pollution, in the order of 4 to 12 million avoided deaths between 2015 and 2030. Under certain circumstances, BC mitigation can also reduce climate change, i.e. mainly by lowering BC emissions in the residential sector and in high BC emissions scenarios. Still, the effect of BC mitigation on global mean temperature is found to be modest at best (with a maximum short-term GMT decrease of 0.02 oC in 2030), and could even lead to warming (with a maximum increase of 0.05 oC in case of a health focused strategy, where all aerosols are strongly reduced). At the same time, strong climate policy would improve air quality (the opposite relation) through reduced fossil fuel use, leading to an estimated 2 to 5 million avoided deaths in the period up to2030. By combining both air quality and climate goals, net health benefits can be maximized.JRC.C.5 - Air and Climat
Cost-Effectiveness of Test-and-Treat Strategies to Reduce the Antibiotic Prescription Rate for Acute Febrile Illness in Primary Healthcare Clinics in Africa
No full textBackground: Inappropriate antibiotic use increases selective pressure, contributing to antimicrobial resistance. Point-of-care rapid diagnostic tests (RDTs) would be instrumental to better target antibiotic prescriptions, but widespread implementation of diagnostics for improved management of febrile illnesses is limited.Objective: Our study aims to contribute to evidence-based guidance to inform policymakers on investment decisions regarding interventions that foster more appropriate antibiotic prescriptions, as well as to address the evidence gap on the potential clinical and economic impact of RDTs on antibiotic prescription.Methods: A country-based cost-effectiveness model was developed for Burkina Faso, Ghana and Uganda. The decision tree model simulated seven test strategies for patients with febrile illness to assess the effect of different RDT combinations on antibiotic prescription rate (APR), costs and clinical outcomes. The incremental cost-effectiveness ratio (ICER) was expressed as the incremental cost per percentage point (ppt) reduction in APR.Results: For Burkina Faso and Uganda, testing all patients with a malaria RDT was dominant compared to standard-of-care (SoC) (which included malaria testing). Expanding the test panel with a C-reactive protein (CRP) test resulted in an ICER of 0.08 per ppt reduction in APR for Burkina Faso and Uganda, respectively. For Ghana, the pairwise comparison with SoC—including malaria and complete blood count testing—indicates that both testing with malaria RDT only and malaria RDT + CRP are dominant.Conclusion: The use of RDTs for patients with febrile illness could effectively reduce APR at minimal additional costs, provided diagnostic algorithms are adhered to. Complementing SoC with CRP testing may increase clinicians’ confidence in prescribing decisions and is a favourable strategy.</p
Co-benefits of black carbon mitigation for climate and air quality
No full textMitigation of black carbon (BC) aerosol emissions can potentially contribute to both reducing air pollution and climate change, although mixed results have been reported regarding the latter. A detailed quantification of the synergy between global air quality and climate policy is still lacking. This study contributes with an integrated assessment model-based scenario analysis of BC-focused mitigation strategies aimed at maximizing air quality and climate benefits. The impacts of these policy strategies have been examined under different socio-economic conditions, climate ambitions, and BC mitigation strategies. The study finds that measures targeting BC emissions (including reduction of co-emitted organic carbon, sulfur dioxide, and nitrogen dioxides) result in significant decline in premature mortality due to ambient air pollution, in the order of 4 to 12 million avoided deaths between 2015 and 2030. Under certain circumstances, BC mitigation can also reduce climate change, i.e., mainly by lowering BC emissions in the residential sector and in high BC emission scenarios. Still, the effect of BC mitigation on global mean temperature is found to be modest at best (with a maximum short-term GMT decrease of 0.02 °C in 2030) and could even lead to warming (with a maximum increase of 0.05 °C in case of a health-focused strategy, where all aerosols are strongly reduced). At the same time, strong climate policy would improve air quality (the opposite relation) through reduced fossil fuel use, leading to an estimated 2 to 5 million avoided deaths in the period up to2030. By combining both air quality and climate goals, net health benefits can be maximized
Early health economic analysis of virtual reality therapy for pain management after surgery
No full textINTRODUCTION: Virtual reality (VR) therapy is increasingly used to mitigate pain and anxiety in inpatient settings, with varying effectiveness in postoperative settings. The costs of VR therapy also differ among suppliers. This health-economic analysis aims to inform policy- and decision-makers on the potential impact of VR therapy from a societal perspective based on pain management at discharge and the development of chronic postsurgical pain (CPSP). METHODS: A Markov model was developed to simulate 1-year postoperative costs and effects. Using a threshold and headroom analysis, the Incremental Cost-effectiveness Ratio (ICER) was calculated for various VR effectiveness estimates and costs when VR therapy demonstrated cost-effectiveness or cost-savings for postoperative pain management. VR effectiveness was based on opioid use at discharge, affecting the Markov model's initial distribution and CPSP development. The ICER was calculated from quality-adjusted life-years (QALYs) and costs associated with CPSP. A univariate sensitivity analysis was used to assess parameter uncertainty by varying each parameter by ±20% from the base-case value. RESULTS: VR therapy needs to reduce opioid use at discharge by at least 2.8% to be cost-effective at a willingness-to-pay threshold of €20 000 per QALY and VR costs of €47.48 per patient. To be cost-saving, a reduction of at least 6.5% is needed. The sensitivity analysis indicated that the transition probability from "pain with opioid" to "pain free" in month 2 had the most impact on the ICER. Other significant variables included VR effectiveness and costs, each influencing the ICER by over €5000. CONCLUSION: The needed 2.8% reduction in opioid use at discharge seems plausible based on literature. However, knowledge gaps regarding the effectiveness of VR, the incidence of chronic postoperative pain, and societal costs of chronic pain need to be addressed, to better understand VR therapy's role in optimizing postoperative pain management.</p
Co-benefits of black carbon mitigation for climate and air quality
No full textMitigation of black carbon (BC) aerosol emissions can potentially contribute to both reducing air pollution and climate change, although mixed results have been reported regarding the latter. A detailed quantification of the synergy between global air quality and climate policy is still lacking. This study contributes with an integrated assessment model-based scenario analysis of BC-focused mitigation strategies aimed at maximizing air quality and climate benefits. The impacts of these policy strategies have been examined under different socioeconomic conditions, climate ambitions, and BC mitigation strategies. The study finds that measures targeting BC emissions (including reduction of co-emitted organic carbon, sulfur dioxide, and nitrogen dioxides) result in significant decline in premature mortality due to ambient air pollution, in the order of 4 to 12 million avoided deaths between 2015 and 2030. Under certain circumstances, BC mitigation can also reduce climate change, i.e., mainly by lowering BC emissions in the residential sector and in high BC emission scenarios. Still, the effect of BC mitigation on global mean temperature is found to be modest at best (with a maximum short-term GMT decrease of 0.02 °C in 2030) and could even lead to warming (with a maximum increase of 0.05 °C in case of a health-focused strategy, where all aerosols are strongly reduced). At the same time, strong climate policy would improve air quality (the opposite relation) through reduced fossil fuel use, leading to an estimated 2 to 5 million avoided deaths in the period up to2030. By combining both air quality and climate goals, net health benefits can be maximized
