Efficiency and Returns to Scale Measurements with Shared Inputs in Multi-Activity Data Envelopment Analysis: An Application to Farmers' Organizations in Taiwan

This paper addresses the question how team production promotes efficiency of a firm when some inputs can be rewarded on the basis of outputs but some cannot because they are shared among outputs and non-separable. A multi-activity DEA model with variable returns to scale is proposed to provide information on the efficiency performance for organizations with inputs shared among several closely related activities. The model is applied to study the case of 279 farmers' associations in Taiwan. The result suggests that it is important to improve the efficiency of the non-profit oriented activities to improve their overall performances. Three out of four departments of TFAs can gain from economies of scale through expansion, while the remaining one gains through contraction. Thus, policies promoting structural adjustment and consolidations of TFAs would not be inconsistent with public interests.multi-activity DEA, shared inputs, efficiency measure, directional distance function, Productivity Analysis,

Productivity Change in Taiwan's Farmers' Credit Unions: A Nonparametric Risk-Adjusted Malmquist Approach

This article proposes an extended three-stage DEA methodology similar to Fried et al. (2002) to improve the measurement of productivity growth then the assumption of free disposability of undesirable outpu t does not apply. A directional distance function is used to construct adjusted Malmquist-Luenberger productivity indexes which simultaneously account for the impacts of undesirable outputs, environmental variables, and statistical noise. Panel data for 264 farmers' credit unions (FCUs) in Taiwan covering the 1998-2000 period are employed to illustrate the advantages of this method. On average, the productivity of Taiwan's FCUs is found to have deteriorated over the 1998-2000 period. Although an improvement in efficiency has been observed, the major reason for the deterioration is found to be due to the regression of techno logy.Malmquist-Luenberger productivity index, three-stage DEA, undesirable outputs, directional distance function, Agricultural Finance, Productivity Analysis,

Precision Medicine for Frontotemporal Dementia

Frontotemporal dementia (FTD) is a common young-onset dementia presenting with heterogeneous and distinct syndromes. It is characterized by progressive deficits in behavior, language, and executive function. The disease may exhibit similar characteristics to many psychiatric disorders owing to its prominent behavioral features. The concept of precision medicine has recently emerged, and it involves neurodegenerative disease treatment that is personalized to match an individual's specific pattern of neuroimaging, neuropathology, and genetic variability. In this paper, the pathophysiology underlying FTD, which is characterized by the selective degeneration of the frontal and temporal cortices, is reviewed. We also discuss recent advancements in FTD research from the perspectives of clinical, imaging, molecular characterizations, and treatment. This review focuses on the approach of precision medicine to manage the clinical and biological complexities of FTD

Unusual dyspnea in a hemodialysis patient: A case report

The typical clinical symptoms of hemothorax include a rapid development of chest pain or dyspnea, which may be life-threatening without immediate management. As we know, spontaneous hemothorax, a collection of blood within the pleural cavity without previous history of trauma or other cause, which usually onsets suddenly. The early and accurate diagnosis of spontaneous hemothorax is imperative in clinical practice. We reported a middle-age male undergoing regular hemodialysis was referred to our emergency department due to unknown cause of dyspnea and acute respiratory failure. Chest radiography revealed bilateral patchy infiltration of lung. Pleural tap analysis showed exudative pleural effusion with numerous red blood cells. Video-assisted thoracic surgery (VATS) were performed and confirmed the final diagnosis of spontaneous hemothorax. He was then successfully treated with the surgery of VATS combined chest tube thoracostomy

Fluoroquinolone therapy for bloodstream infections caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae

AbstractBackground/PurposeFor extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae infections, carbapenems are recommended as first line therapy, and clinical data on the therapeutic efficacy of fluoroquinolones (FQs) is limited. This study compares the efficacy of FQs and carbapenems for bloodstream infections caused by ESBL-producing Escherichia coli or Klebsiella pneumoniae.MethodsBetween 2008 and 2010, adults with ESBL-producing E. coli or K. pneumoniae bacteremia at two medical centers were reviewed. Adults receiving definitive FQ or carbapenem therapy were compared in a propensity score-matched analysis, and 30-day mortality was the primary endpoint.ResultsA total of 299 patients were eligible. Patients receiving a FQ (n = 24), either ciprofloxacin or levofloxacin, had a lower 30-day mortality rate than those with carbapenem therapy (8.3%, 2/24 vs. 23.3%, 64/275; p = 0.12). Multivariate regression analysis revealed that a critical illness [Pitt bacteremia score ≥ 4 points; odds ratio (OR), 7.09; p < 0.001], rapidly fatal underlying disease (OR, 5.73; p < 0.001), and hospital-associated infection (OR, 2.57; p = 0.01) were independently associated with 30-day mortality. By contrast, FQ definitive therapy was a protective factor compared with carbapenems (OR, 0.18; p = 0.04). There were 72 matched cases with carbapenem therapy in a propensity score-matched analysis, and a difference in the 30-day mortality rate of two groups was noted (8.3% vs. 29.2%; p = 0.05).ConslusionFor ESBL-producing E. coli or K. pneumoniae bacteremia, ciprofloxacin or levofloxacin, if active in vitro, can be considered as a carbapenem-sparing alternative

Non-Radial Directional Performance Measurement with Undesirable Outputs

The objective of this paper is to provide a comprehensive efficiency measures to estimate the performances of OECD and non-OECD countries. A Russell directional distance function that appropriately credits the decision making unit not only for increase in desirable outputs but also for the decrease of undesirable outputs is derived from the proposed weighted Russell directional distance model. The method was applied to a panel of 99 countries over 1991 and 2003. This framework also decomposes the comprehensive efficiency measure into individual input/output components’ inefficiency scores that are useful for policy making. The results reveal that the OECD countries perform better than the non-OECD countries in overall, goods, labor and capital efficiencies, but worse in bad and energy efficiencies

Non-Radial Directional Performance Measurement with Undesirable Outputs

The objective of this paper is to provide a comprehensive efficiency measures to estimate the performances of OECD and non-OECD countries. A Russell directional distance function that appropriately credits the decision making unit not only for increase in desirable outputs but also for the decrease of undesirable outputs is derived from the proposed weighted Russell directional distance model. The method was applied to a panel of 99 countries over 1991 and 2003. This framework also decomposes the comprehensive efficiency measure into individual input/output components’ inefficiency scores that are useful for policy making. The results reveal that the OECD countries perform better than the non-OECD countries in overall, goods, labor and capital efficiencies, but worse in bad and energy efficiencies