Vers une science de la politique internationale : Perspectives, promesses et résultats

Concentrating on "the how of International Relations", this article deals in its first half with three major issues in scientific methodology : 1) importance of the scientific mode in acquiring and transmitting knowledge, and also rendering it more policy-relevant; 2) methods of forecasting international events and their evaluation; 3) different routes to theory-building : induction, deduction, analogy, gaming and computer simulation. The second half of the paper substantiates this methodological survey by presenting some findings from the Correlates of War Project that has been going on at the University of Michigan for two decades. The emphasis is on the rigorous identification of the phenomenon (War) and on the presentation of data on different factors at different levels of analysis correlated with its incidence

Medicaid spending burden among beneficiaries with treatment-resistant depression.

AIM: To evaluate Medicaid spending and healthcare resource utilization (HRU) in treatment-resistant depression (TRD). MATERIALS & METHODS: TRD beneficiaries were identified from Medicaid claims databases (January 2010-March 2017) and matched 1:1 with major depressive disorder (MDD) beneficiaries without TRD (non-TRD-MDD) and randomly selected patients without MDD (non-MDD). Differences in HRU and per-patient-per-year costs were reported in incidence rate ratios (IRRs) and cost differences (CDs), respectively. RESULTS: TRD beneficiaries had higher HRU than 1:1 matched non-TRD-MDD (e.g., inpatient visits: IRR = 1.41) and non-MDD beneficiaries (N = 14,710 per cohort; e.g., inpatient visits: IRR = 3.42, p \u3c 0.01). TRD beneficiaries incurred greater costs versus non-TRD-MDD (CD = US$4382) and non-MDD beneficiaries (CD = US$8294; p \u3c 0.05). CONCLUSION: TRD is associated with higher HRU and costs versus non-TRD-MDD and non-MDD. TRD poses a significant burden to Medicaid

Adapting to Changes in Design Requirements Using Set‐Based Design

Ship design is a highly intensive and complex process mainly due to the large number of components and competing requirements. With advancement in technology, design, and evaluation processes, more emphasis has been placed on obtaining not just a feasible design, but also an optimal one. Advanced design methods such as set‐based design (SBD) can provide a structured approach to evaluating the design space in order to make accurate and informed decisions toward a more globally optimal design. This paper presents the general application of the SBD process for US Naval vessels as well as a specialized focus on changes in design requirements. Specifically, the two main objectives are an evaluation of how delaying decisions using SBD could cause higher adaptability to changes later in the design process and development of a tradeoff space for evaluating reduced sets. A design experiment that simulated cycles of the SBD process was developed and implemented to provide insight into this objective. The different stages of the experiment included determining intersections between design components in the design space, narrowing variable sets to eliminate infeasible regions, and evaluating the effects of changing design requirements.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90342/1/j.1559-3584.2011.00331.x.pd

The economic implications of HLA matching in cadaveric renal transplantation.

Abstract Background: The potential economic effects of the allocation of cadaveric kidneys on the basis of tissue-matching criteria are controversial. We analyzed the economic costs associated with the transplantation of cadaveric kidneys with various numbers of HLA mismatches and examined the potential economic benefits of a local, as compared with a national, system designed to minimize HLA mismatches between donor and recipient in first cadaveric renal transplantations. Methods: All data were supplied by the U.S. Renal Data System. Data on all payments made by Medicare from 1991 through 1997 for the care of recipients of a first cadaveric renal transplant were analyzed according to the number of HLA-A, B, and DR mismatches between donor and recipient and the duration of cold ischemia before transplantation. Results: Average Medicare payments for renal-transplant recipients in the three years after transplantation increased from $60,436 per patient for fully HLA-matched kidneys (those with no HLA-A, B, or DR mismatches) to$80,807 for kidneys with six HLA mismatches between donor and recipient, a difference of 34 percent (P\u3c0.001). By three years after transplantation, the average Medicare payments were $64,119 for transplantations of kidneys with less than 12 hours of cold-ischemia time and$74,997 for those with more than 36 hours (P\u3c0.001). In simulations, the assignment of cadaveric kidneys to recipients by a method that minimized HLA mismatching within a local geographic area (i.e., within one of the approximately 50 organ-procurement organizations, which cover widely varying geographic areas) produced the largest cost savings ($4,290 per patient over a period of three years) and the largest improvements in the graft-survival rate (2.3 percent) when the potential costs of longer cold-ischemia time were considered. Conclusions: Transplantation of better-matched cadaveric kidneys could have substantial economic advantages. In our simulations, HLA-based allocation of kidneys at the local level produced the largest estimated cost savings, when the duration of cold ischemia was taken into account. No additional savings were estimated to result from a national allocation program, because the additional costs of longer cold-ischemia time were greater than the advantages of optimizing HLA matching

Control theory for principled heap sizing

We propose a new, principled approach to adaptive heap sizing based on control theory. We review current state-of-the-art heap sizing mechanisms, as deployed in Jikes RVM and HotSpot. We then formulate heap sizing as a control problem, apply and tune a standard controller algorithm, and evaluate its performance on a set of well-known benchmarks. We find our controller adapts the heap size more responsively than existing mechanisms. This responsiveness allows tighter virtual machine memory footprints while preserving target application throughput, which is ideal for both embedded and utility computing domains. In short, we argue that formal, systematic approaches to memory management should be replacing ad-hoc heuristics as the discipline matures. Control-theoretic heap sizing is one such systematic approach