During 2015 the ATLAS experiment recorded of proton–proton collision data at a centre-of-mass energy of . The ATLAS trigger system is a crucial component of the experiment, responsible for selecting events of interest at a recording rate of approximately 1 kHz from up to 40 MHz of collisions. This paper presents a short overview of the changes to the trigger and data acquisition systems during the first long shutdown of the LHC and shows the performance of the trigger system and its components based on the 2015 proton–proton collision data.
As companies, countries, and governments consider investments in vaccine production for routine immunization and outbreak response, understanding the complexity and cost drivers associated with vaccine production will help to inform business decisions. Leading multinational corporations have good understanding of the complex manufacturing processes, high technological and R&D barriers to entry, and the costs associated with vaccine production. However, decision makers in developing countries, donors and investors may not be aware of the factors that continue to limit the number of new manufacturers and have caused attrition and consolidation among existing manufacturers. This paper describes the processes and cost drivers in acquiring and maintaining licensure of childhood vaccines. In addition, when export is the goal, we describe the requirements to supply those vaccines at affordable prices to low-resource markets, including the process of World Health Organization (WHO) prequalification and supporting policy recommendation. By providing a generalized and consolidated view of these requirements we seek to build awareness in the global community of the benefits and costs associated with vaccine manufacturing and the challenges associated with maintaining consistent supply. We show that while vaccine manufacture may prima facie seem an economic growth opportunity, the complexity and high fixed costs of vaccine manufacturing limit potential profit. Further, for most lower and middle income countries a large majority of the equipment, personnel and consumables will need to be imported for years, further limiting benefits to the local economy.
Aims
Improvement collaboratives consisting of various components are used throughout healthcare to improve quality, but no study has identified which components work best. This study tested the effectiveness of different components in addiction treatment services, hypothesizing that a combination of all components would be most effective.
Design
An unblinded cluster-randomized trial assigned clinics to one of four groups: interest circle calls (group teleconferences), clinic-level coaching, learning sessions (large face-to-face meetings), and a combination of all three. Interest circle calls functioned as a minimal intervention comparison group.
Setting
Outpatient addiction treatment clinics in the U.S.
Participants
201 clinics in 5 states.
Measurements
Clinic data managers submitted data on three primary outcomes: waiting time (mean days between first contact and first treatment), retention (percent of patients retained from first to fourth treatment session), and annual number of new patients. State and group costs were collected for a cost-effectiveness analysis.
Findings
Waiting time declined significantly for 3 groups: coaching (an average of −4.6 days/clinic, P=0.001), learning sessions (−3.5 days/clinic, P=0.012), and the combination (−4.7 days/clinic, P=0.001). The coaching and combination groups significantly increased the number of new patients (19.5%, P=0.028; 8.9%, P=0.029; respectively). Interest circle calls showed no significant effects on outcomes. None of the groups significantly improved retention. The estimated cost/clinic was $2,878 for coaching versus $7,930 for the combination. Coaching and the combination of collaborative components were about equally effective in achieving study aims, but coaching was substantially more cost effective.
Conclusions
When trying to improve the effectiveness of addiction treatment services, clinic-level coaching appears to help improve waiting time and number of new patients while other components of improvement collaboratives (interest circles calls and learning sessions) do not seem to add further value.
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