scholarly journals Modified ovarian response prediction index: a novel index for ovarian response prediction in GnRH agonist cycles

2019 ◽  
Vol 8 (7) ◽  
pp. 2575
Author(s):  
B. Kalpana ◽  
Soumya Ranjan Panda
Keyword(s):  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Cost Benefit ◽  
Cost Effective ◽  
Ovarian Response ◽  
Response Prediction ◽  
Endocrine Disorders ◽  
Simple Index ◽  
Good Ability ◽  
Cost Benefit Ratio

Background: Evaluation of the ovarian reserve is necessary to achieve an appropriate controlled ovarian stimulation (COS). This can be done by correctly predicting the ovarian response. The objective of this study was to derive a simple index by combining the above parameters which will be helpful determining ovarian response.Methods: This retrospective analysis was performed at Guru hospital, Madurai, involving 162 patients between July 2016 and July 2018. Inclusion criteria was all patients attending for their first ICSI (intracytoplasmic sperm injection) cycle between the above period, GnRH agonist protocol as the method of ovarian stimulation, no history of any previous ovarian surgery, presence of both ovaries and no evidence of any obvious endocrine disorders. We calculated MORPI values by multiplying the AMH (ng/ml) level by the number of antral follicles (2-9 mm), and the result was divided by the age (years) of the patient and the day- 3 serum FSH level.Results: At a cut-off value of 35 (AUC-0.952) for collection of ≥ 4 oocytes and 140 (AUC-0.952) for collection of ≥ 15 oocytes, MORPI was found to have optimum sensitivity and specificity under ROC curve analysis.Conclusions: MORPI is a simple, precise and cost effective index to predict a low ovarian response, the collection of >4 MII oocytes and an excessive ovarian response in infertile women. This index also has a good ability to predict the clinical pregnancy rate. This might be used to improve the cost-benefit ratio of ovarian stimulation regimens.

scholarly journals Prognosticating ovarian reserve by the new ovarian response prediction index

2018 ◽  
Vol 7 (3) ◽  
pp. 1196
Author(s):  
Apoorva Tak ◽  
Madhubala Chauhan ◽  
Bharti Tak
Keyword(s):  
Ovarian Stimulation ◽  
Cost Benefit ◽  
Ovarian Response ◽  
Response Prediction ◽  
Endocrine Disorders ◽  
Benefit Ratio ◽  
Cost Benefit Ratio ◽  
History Of ◽  
The Cost ◽  
Selection Of

Background: Knowledge of patient's potential ovarian response can help individualise the medication dosage and thus prevent adverse effect of excessive ovarian response and, decrease the rates of cancelled cycles, overall it will help to improve the cost benefit ratio of ovarian stimulation regimes. In addition to age, several clinical, endocrine and USG markers and dynamic tests have been proposed for the prediction of ovarian response to stimulation. Among these use of AMH levels and AFC are of particular interest However, despite the predictive power that each marker for the ovarian response may individually have, all these markers have errors associated with their estimation. So, prediction of ovarian response using a single biomarker may not be sufficient for formulation of a precise treatment plan.Methods: This study includes 50 patients undergoing ivf cycle. All patients satisfied the following criteria; age <or equal to 39 yrs, BMI between 20-30, regular menstrual cycles, both ovaries present, no history of ovarian surgery, no severe endometriosis and no evidence of endocrine disorders. The only exclusion criteria was the presence of ovarian cysts as assessed by TVS.Results: The results showed significant correlation between the number of obtained follicles and the number and maturity of collected oocytes. In addition, the results using the ORPI were always better than those obtained using other predictive factors (AFC, AGE and AMH) separately.Conclusions: The present study reinforces the ORPI, which is a simple 3 variable index that exhibits an excellent ability to predict low and excessive ovarian response. ORPI might be used to improve the cost benefit ratio of ovarian stimulation regimens by guiding the selection of medication and by tailoring the doses and regimens to the actual needs of patients.

Efficacy of quinalphos 25 EC for the management of wheat aphid

2016 ◽  
Vol 36 (4) ◽  
Author(s):  
Ajai Srivastava ◽  
Sudheer Rana ◽  
Vijay Rana ◽  
Sandeep Manuja
Keyword(s):  
Grain Yield ◽  
Cost Benefit ◽  
Cost Effective ◽  
Control Measures ◽  
Control Cost ◽  
Benefit Ratio ◽  
Net Profit ◽  
Cost Benefit Ratio ◽  
Untreated Check ◽  
Better Than

The present investigation was undertaken to find out the effective and economical control measures for the management of foliage feeding wheat aphids, for which three insecticides viz quinalphos 25 EC, thiamethoxam 25 % WG, and spinosad 45 EC were evaluated. Minimum aphid population was observed in case of quinalphos 25 EC @1600 ml/ha and was found at par with spinosad 45 EC @125 ml/ha and was found significantly better than other treatments, viz. quinalphos @1200 ml/ha and thiamethoxam 25 % WG @ 100 gm/ha including untreated check after 7 days of treatment. However, quinalphos 25 EC @1600 ml/ha and spinosad 45 EC @125 ml/ha and significantly better than other treatments including untreated check. Grain yield of plot treated with quinalphos 25 EC @1600 ml/ha was registered with highest yield (39.25 q/ha) and significantly better than other treatments including control. Cost-benefit ratio and net profit calculated for different insecticidal treatments revealed that quinalphos 25 EC @1600 ml/ha (1:9.65) was found highly cost effective as compare to other insecticides.

scholarly journals Expand evaluation of the ovarian response prediction index (ORPI) for individualised controlled ovarian stimulation

2013 ◽  
Vol 17 (2) ◽  
Author(s):  
Joao Batista A Oliveira ◽  
Claudia G Petersen ◽  
Ana L Mauri ◽  
Mario Cavagna ◽  
Ricardo LR Baruffi ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Response ◽  
Response Prediction ◽  
Controlled Ovarian Stimulation

Laser-Cutting and Welding of DDG-51 Structural Shapes

2000 ◽  
Vol 16 (04) ◽  
pp. 183-192
Author(s):  
Paul A. Blomquist ◽  
David L. Forrest
Keyword(s):  
Laser Cutting ◽  
High Speed ◽  
Cost Benefit ◽  
Cost Effective ◽  
High Accuracy ◽  
Purchase Price ◽  
Benefit Ratio ◽  
Cost Effective Approach ◽  
Cost Benefit Ratio ◽  
Hot Rolled

The application of high-power industrial lasers to the production of structural shapes for shipbuilding has been analyzed. Requirements for T-and I-sections used in a DDG-51 class vessel were used to evaluate a cost/benefit ratio for fabricating shapes vice purchasing hot rolled sections. Results of the study indicate that fabricated shapes offer significant tangible and intangible benefits to the shipbuilder, and that the entire shipset of T's and I's can be cut from plate and welded to actual net shape for less cost than the purchase price of stock lengths of hot-rolled shapes. Savings from elimination of complex layout and cutting operations further add to the benefit. The high speed and high accuracy of modern industrial lasers makes possible an efficient, flexible, and cost-effective approach to the production of structural shapes. A further benefit is the potential to design a ship with structurals having the same depth, vastly improving the speed of outfitting such as the installation of piping, wireways and vent runs.

Clinical decision in ovarian stimulation guided by the ovarian response prediction index (ORPI)

2013 ◽  
Vol 100 (3) ◽  
pp. S275 ◽  
Author(s):  
J.B.A. Oliveira ◽  
A.L. Mauri ◽  
C.G. Petersen ◽  
M. Cavagna ◽  
R.L.R. Baruffi ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Response ◽  
Response Prediction ◽  
Clinical Decision

scholarly journals Cost-effectiveness of a physician-nurse supplementary triage assessment team at an academic tertiary care emergency department

CJEM ◽  
2015 ◽  
Vol 18 (3) ◽  
pp. 191-204 ◽  
Author(s):  
Ivy Cheng ◽  
Maaret Castren ◽  
Alex Kiss ◽  
Merrick Zwarenstein ◽  
Mats Brommels ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cost Effectiveness ◽  
Tertiary Care ◽  
Cost Benefit ◽  
Cost Effective ◽  
Additional Patient ◽  
Patient Volume ◽  
Benefit Ratio ◽  
Cost Benefit Ratio ◽  
The Cost

ABSTRACTObjectiveThe purpose of this study was to evaluate the cost-effectiveness of physician-nurse supplementary triage assistance team (MDRNSTAT) from a hospital and patient perspective.MethodsThis was a cost-effectiveness evaluation of a cluster randomized control trial comparing the MDRNSTAT with nurse-only triage in the emergency department (ED) between the hours of 0800 and 1500. Cost was MDRNSTAT salary. Revenue was from Ontario’s Pay-for-Results and patient volume-case mix payment programs. The incremental cost-effectiveness ratio was based on MDRNSTAT cost and three consequence assessments: 1) per additional patient-seen; 2) per physician initial assessment (PIA) hour saved; and 3) per ED length of stay (EDLOS) hour saved. Patient opportunity cost was determined. Patient satisfaction was quantified by a cost-benefit ratio. A sensitivity analysis extrapolating MDRNSTAT to different working hours, salary, and willingness-to-pay data was performed.ResultsThe added cost of the MDRNSTAT was $3,597.27 [$1,729.47 to ∞] per additional patient-seen, $75.37 [$67.99 to $105.30] per PIA hour saved, and $112.99 [$74.68 to $251.43] per EDLOS hour saved. From the hospital perspective, the cost-benefit ratio was 38.6 [19.0 to ∞] and net present value of –$447,996 [–$435,646 to –$459,900]. For patients, the cost-benefit ratio for satisfaction was 2.8 [2.3 to 4.6]. If MDRNSTAT performance were consistently implemented from noon to midnight, it would be more cost-effective.ConclusionsThe MDRNSTAT is not a cost-effective daytime strategy but appears to be more feasible during time periods with higher patient volume, such as late morning to evening.

scholarly journals Cost and impact analysis of preventive and remedial measures for safe drinking water

2013 ◽  
Vol 6 (1) ◽  
pp. 1-26 ◽  
Author(s):  
M. A. Tahir ◽  
H. Rasheed
Keyword(s):  
Drinking Water ◽  
Impact Analysis ◽  
Preventive Measures ◽  
Cost Benefit ◽  
Cost Effective ◽  
Water Quality Monitoring ◽  
Personal Hygiene ◽  
Remedial Measures ◽  
Cost Benefit Ratio ◽  
Water Borne

<p><strong>Abstract.</strong> Preventive measures yield much higher cost effective benefits as compared to remedial measures. To verify this hypothesis, a survey was conducted in two different regions of Rawalpindi district of Pakistan by comparing the cost on medication and mitigation expenditures for reduction in the burden of water borne diseases. Water Quality monitoring of the study areas in comparison to WHO Drinking Water Guidelines revealed the satisfactory level of physico-chemical parameters, however; significant bacteriological contamination was found at 86% of the monitored sites in Gujar Khan and 87% in Murree region. A field questionnaire was used to estimate the expenditures on disinfection and sanitation and concluded that 8.09% of total income of each family were spent by the inhabitants of the study area on medication for water borne diseases. Correlation was worked out between the rate of water related diseases (<i>V</i><sub>WRD</sub>), unsafe drinking water (<i>C</i><sub>DW</sub>), poor sanitation (<i>P</i><sub>S</sub>), unhealthy personal hygiene and environment (UH<sub>PHE</sub>). A simulation model "Victim's Rate Calculator" was developed to forecast the estimated number of victims within a population. Findings of the study verified the hypothesis that preventive measures are better choice than remedial measures due to cost benefit ratio (1 : 1.6) with a clear advantage of 60%.</p>

scholarly journals Why Some Firms Train Apprentices and Many Others Do Not

2006 ◽  
Vol 7 (3) ◽  
pp. 249-264 ◽  
Author(s):  
Stefan C. Wolter ◽  
Jürg Schweri ◽  
Samuel Mühlemann
Keyword(s):  
Labour Market ◽  
Cost Benefit ◽  
Cost Effective ◽  
Training System ◽  
Benefit Ratio ◽  
Apprenticeship Training ◽  
Effective Training ◽  
Market Situation ◽  
Cost Benefit Ratio ◽  
The Cost

Abstract The latest study investigating the cost-benefit ratio of apprenticeship training for Swiss companies has shown that most apprentices offset the cost of their training during their apprenticeship on the basis of the productive contribution of the work they perform. Given this outcome, it is worth investigating why so many firms choose not to train apprentices. Maximum-likelihood selection models were used to estimate the net cost of training for firms without an apprenticeship programme. The models show, firstly, that non-training firms would incur significantly higher net cost during the apprenticeship period if they would switch to a training policy and, secondly, that this less favourable cost-benefit ratio is determined less by cost than by absence of benefit. For the apprenticeship system as such the results indicate that, as long as training regulations and the market situation permit a cost-effective training of apprentices, companies do not need specific labour market regulations or institutions to offer training posts. In this respect, the Swiss findings might be of interest for the ongoing German discussion about the expected repercussions of a more general labour market deregulation on the apprenticeship training system.

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