20 CFR 404.272 - Indexes we use to measure the rise in the cost-of-living.

Science.gov (United States)

2010-04-01

... cost-of-living. 404.272 Section 404.272 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.272 Indexes we use to measure the rise in the cost-of-living. (a) The bases. To measure...

Forecasting Construction Cost Index based on visibility graph: A network approach

Science.gov (United States)

Zhang, Rong; Ashuri, Baabak; Shyr, Yu; Deng, Yong

2018-03-01

Engineering News-Record (ENR), a professional magazine in the field of global construction engineering, publishes Construction Cost Index (CCI) every month. Cost estimators and contractors assess projects, arrange budgets and prepare bids by forecasting CCI. However, fluctuations and uncertainties of CCI cause irrational estimations now and then. This paper aims at achieving more accurate predictions of CCI based on a network approach in which time series is firstly converted into a visibility graph and future values are forecasted relied on link prediction. According to the experimental results, the proposed method shows satisfactory performance since the error measures are acceptable. Compared with other methods, the proposed method is easier to implement and is able to forecast CCI with less errors. It is convinced that the proposed method is efficient to provide considerably accurate CCI predictions, which will make contributions to the construction engineering by assisting individuals and organizations in reducing costs and making project schedules.

"Climate Cost of Cultivation": A New Crop Index Method to Quantify Farmers' Cost of Climate Change Exemplified in Rural India

NARCIS (Netherlands)

N. Jangle (Nihar); M. Mehra (Mamta); D.M. Dror (David)

2016-01-01

textabstractWe model the impact of agricultural droughts with a new multi-parameter index (using both climatic and non-climatic parameters) and propose a new risk transfer solution for crop insurance, called Climate Cost of Cultivation (CCC). We used 1979/80 to 2012/13 data relevant for wheat in

Low-cost and high-capacity short-range optical interconnects using graded-index plastic optical fiber

NARCIS (Netherlands)

Tangdiongga, E.; Yang, H.; Lee, S.C.J.; Okonkwo, C.M.; Boom, van den H.P.A.; Randel, S.; Koonen, A.M.J.

2010-01-01

We demonstrate a transmission rate of 51.8 Gb/s over 100-meters of perfluorinated multimode graded-index plastic optical fiber using discrete multitone modulation. The results prove suitability of plastic fibers for low-cost high-capacity optical interconnects.

Effect of Body Mass Index and Psychosocial Traits on Total Knee Replacement Costs in Patients with Osteoarthritis.

Science.gov (United States)

Waimann, Christian A; Fernandez-Mazarambroz, Rodrigo J; Cantor, Scott B; Lopez-Olivo, Maria A; Barbo, Andrea G; Landon, Glenn C; Siff, Sherwin J; Lin, Heather; Suarez-Almazor, Maria E

2016-08-01

Clinical and psychosocial attributes are associated with clinical outcomes after total knee replacement (TKR) surgery in patients with osteoarthritis (OA), but their relationship with TKR-related costs is less clear. Our objective was to evaluate the effect of clinical and psychosocial attributes on TKR costs. We conducted a 6-month prospective cohort study of patients with knee OA who underwent TKR. We examined baseline demographic, clinical [body mass index (BMI) and comorbidities], and psychosocial attributes (social support, locus of control, coping, depression, anxiety, stress, and self-efficacy); baseline and 6-month OA clinical outcomes [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function]; and 6-month direct and indirect TKR-related costs. Multiple regression was performed to identify determinants of TKR-related costs. We included 212 patients; 66% were women, 71% were white, and the mean age was 65.2 years. The mean baseline WOMAC pain score was 55 (SD 19) and WOMAC function score was 54 (SD 20). Mean total TKR-related costs were US$30,831 (SD $9893). Multivariate regression analyses showed that increasing BMI and anxiety levels and decreasing levels of positive social interactions were associated with increased costs. A lower cost scenario with a lower range of normal BMI (19.5), highest positive social interaction, and no anxiety predicted TKR costs to be $22,247. Predicted costs in obese patients (BMI 36) with lowest positive social interaction and highest anxiety were $58,447. Increased baseline BMI, anxiety, and poor social support lead to higher TKR-related costs in patients with knee OA. Preoperative interventions targeting these factors may reduce TKR-related costs, and therefore be cost-effective.

Municipal solid waste management: Identification and analysis of engineering indexes representing demand and costs generated in virtuous Italian communities

Energy Technology Data Exchange (ETDEWEB)

Gamberini, R., E-mail: rita.gamberini@unimore.it; Del Buono, D.; Lolli, F.; Rimini, B.

2013-11-15

Highlights: • Collection and analysis of real life data in the field of Municipal Solid Waste (MSW) generation and costs for management. • Study of 92 virtuous Italian communities. • Elaboration of trends of engineering indexes useful during design and evaluation of MSWM systems. - Abstract: The definition and utilisation of engineering indexes in the field of Municipal Solid Waste Management (MSWM) is an issue of interest for technicians and scientists, which is widely discussed in literature. Specifically, the availability of consolidated engineering indexes is useful when new waste collection services are designed, along with when their performance is evaluated after a warm-up period. However, most published works in the field of MSWM complete their study with an analysis of isolated case studies. Conversely, decision makers require tools for information collection and exchange in order to trace the trends of these engineering indexes in large experiments. In this paper, common engineering indexes are presented and their values analysed in virtuous Italian communities, with the aim of contributing to the creation of a useful database whose data could be used during experiments, by indicating examples of MSWM demand profiles and the costs required to manage them.

How indexes have changed

International Nuclear Information System (INIS)

Farrar, G.L.

1993-01-01

The accompanying table compares refinery construction and operating wages monthly for the years 1990 and 1991. The Nelson-Farrar refinery construction cost indexes are inflation indexes, while the operating indexes incorporate a productivity which shows improvement with experience and the increasing size of operations. The refinery construction wage indexes in the table show a steady advance over the 2-year period. Common labor indexes moved up faster than skilled indexes. Refinery operating wages showed a steady increase, while productivities averaged higher near the end of the period. Net result is that labor costs remained steady for the period

Maximizing Efficiency and Reducing Robotic Surgery Costs Using the NASA Task Load Index.

Science.gov (United States)

Walters, Carrie; Webb, Paula J

2017-10-01

Perioperative leaders at our facility were struggling to meet efficiency targets for robotic surgery procedures while also maintaining the satisfaction of the surgical team. We developed a human resources time and motion study tool and used it in conjunction with the NASA Task Load Index to observe and analyze the required workload of personnel assigned to 25 robotic surgery procedures. The time and motion study identified opportunities to enlist the help of nonlicensed support personnel to ensure safe patient care and improve OR efficiency. Using the NASA Task Load Index demonstrated that high temporal, effort, and physical demands existed for personnel assisting with and performing robotic surgery. We believe that this process could be used to develop cost-effective staffing models, resulting in safe and efficient care for all surgical patients. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

[Index of Nutritional Purchasing Power Parity: comparison of caloric costs of a healthy versus an unhealthy diet].

Science.gov (United States)

Mendoza Velázquez, Alfonso

2012-01-01

Develop the Index of Nutritional Purchasing Power Parity (Nut3-CiO) as an instrument to compare the caloric costs of a healthy versus an unhealthy diet between regions or cities in a country over time. Indices of caloric prices were constructed and the "law of one price" was used to derive the Nut3-CiO index. Caloric inflation rates were obtained using basic descriptive statistics. The Nut3-CiO was applied in the major cities of Mexico during the period from January 1996 to December 2010. The statistical behavior of the Nut3-CiO revealed that, in Mexican cities, products for a typical diet are less expensive than products for a healthy diet. The findings showed a cyclical behavior to the index, a high correlation between inflation for the typical diet and inflation for the market basket, and a high persistence of prices. The Nut3-CiO index makes it possible to periodically compare the price differential of two types of diets-typical and healthy-between cities in a single country. This instrument could help health authorities identify the cities where it is easier or more difficult for consumers to access a typical or healthy diet in terms of cost. Furthermore, it makes it possible to estimate the percentage adjustment necessary in each city to attain levels of nutritional purchasing power parity.

Optofluidic refractive-index sensors employing bent waveguide structures for low-cost, rapid chemical and biomedical sensing.

Science.gov (United States)

Liu, I-Chen; Chen, Pin-Chuan; Chau, Lai-Kwan; Chang, Guo-En

2018-01-08

We propose and develop an intensity-detection-based refractive-index (RI) sensor for low-cost, rapid RI sensing. The sensor is composed of a polymer bent ridge waveguide (BRWG) structure on a low-cost glass substrate and is integrated with a microfluidic channel. Different-RI solutions flowing through the BRWG sensing region induce output optical power variations caused by optical bend losses, enabling simple and real-time RI detection. Additionally, the sensors are fabricated using rapid and cost-effective vacuum-less processes, attaining the low cost and high throughput required for mass production. A good RI solution of 5.31 10 -4 × RIU -1 is achieved from the RI experiments. This study demonstrates mass-producible and compact RI sensors for rapid and sensitive chemical analysis and biomedical sensing.

Two- and three-index formulations of the minimum cost multicommodity k-splittable flow problem

DEFF Research Database (Denmark)

Gamst, Mette; Jensen, Peter Neergaard; Pisinger, David

2010-01-01

The multicommodity flow problem (MCFP) considers the efficient routing of commodities from their origins to their destinations subject to capacity restrictions and edge costs. Baier et al. [G. Baier, E. Köhler, M. Skutella, On the k-splittable flow problem, in: 10th Annual European Symposium...... of commodities has to be satisfied at the lowest possible cost. The problem has applications in transportation problems where a number of commodities must be routed, using a limited number of distinct transportation units for each commodity. Based on a three-index formulation by Truffot et al. [J. Truffot, C...... on Algorithms, 2002, 101–113] introduced the maximum flow multicommodity k-splittable flow problem (MCkFP) where each commodity may use at most k paths between its origin and its destination. This paper studies the -hard minimum cost multicommodity k-splittable flow problem (MCMCkFP) in which a given flow...

Costs of detection bias in index-based population monitoring

Science.gov (United States)

Moore, C.T.; Kendall, W.L.

2004-01-01

Managers of wildlife populations commonly rely on indirect, count-based measures of the population in making decisions regarding conservation, harvest, or control. The main appeal in the use of such counts is their low material expense compared to methods that directly measure the population. However, their correct use rests on the rarely-tested but often-assumed premise that they proportionately reflect population size, i.e., that they constitute a population index. This study investigates forest management for the endangered Red-cockaded Woodpecker (Picoides borealis) and the Wood Thrush (Hylocichla mustelina) at the Piedmont National Wildlife Refuge in central Georgia, U.S.A. Optimal decision policies for a joint species objective were derived for two alternative models of Wood Thrush population dynamics. Policies were simulated under scenarios of unbiasedness, consistent negative bias, and habitat-dependent negative bias in observed Wood Thrush densities. Differences in simulation outcomes between biased and unbiased detection scenarios indicated the expected loss in resource objectives (here, forest habitat and birds) through decision-making based on biased population counts. Given the models and objective function used in our analysis, expected losses were as great as 11%, a degree of loss perhaps not trivial for applications such as endangered species management. Our analysis demonstrates that costs of uncertainty about the relationship between the population and its observation can be measured in units of the resource, costs which may offset apparent savings achieved by collecting uncorrected population counts.

The Association between Charlson Comorbidity Index and the Medical Care Cost of Cancer: A Retrospective Study

Directory of Open Access Journals (Sweden)

Seok-Jun Yoon

2015-01-01

Full Text Available Background. This study compared comorbidity-related medical care cost associated with different types of cancer, by examining breast (N=287, colon (N=272, stomach (N=614, and lung (N=391 cancer patients undergoing surgery. Methods. Using medical benefits claims data, we calculated Charlson Comorbidity Index (CCI and total medical cost. The effect of comorbidity on the medical care cost was investigated using multiple regression and logistic regression models and controlling for demographic characteristics and cancer stage. Results. The treatment costs incurred by stomach and colon cancer patients were 1.05- and 1.01-fold higher, respectively, in patients with higher CCI determined. For breast cancer, the highest costs were seen in those with chronic obstructive pulmonary disease (COPD, but the increase in cost reduced as CCI increased. Colon cancer patients with diabetes mellitus and a CCI = 1 score had the highest medical costs. The lowest medical costs were incurred by lung cancer patients with COPD and a CCI = 2 score. Conclusion. The comorbidities had a major impact on the use of medical resources, with chronic comorbidities incurring the highest medical costs. The results indicate that comorbidities affect cancer outcomes and that they must be considered strategies mitigating cancer’s economic and social impact.

Complexity index indicates refinery capability, value

International Nuclear Information System (INIS)

Johnston, D.

1996-01-01

Refinery size usually is measured in terms of distillation capacity. Relative size, however, can be measured using refinery complexity--a concept developed by W.L. Nelson in the 1960s. Nelson developed the complexity index to quantify the relative cost of components that make up a refinery. It is a pure cost index that provides a relative measure of the construction costs of a particular refinery based on its crude and upgrading capacity. The Nelson index compares the costs of various upgrading units--such as a fluid catalytic cracking (FCC) unit or a catalytic reformer--to the cost of a crude distillation unit. Computation of the index is an attempt to quantify the relative cost of a refinery based on the added cost of various upgrading units and the relative upgrading capacity. A review of complexity calculations, and an explanation of how indices have changed, provide a simple means of determining the complexity of single refineries or refining regions. The impact of complexity on product slate is also examined in this paper

Yearly refinery construction indexes listed for 68 years

International Nuclear Information System (INIS)

Farrar, G.

1996-01-01

Yearly values are presented for the Nelson-Farrar refinery inflation cost index since 1926. They are based on 1946 as 100, since that was the date of index inception. Values from 1926 to 1945 were back calculated. Data are presented on indexed cost of materials, labor, and miscellaneous equipment for 1926 through 1994. A second table of itemized refining cost indexes for the years 1954, 1972, 1992--1994, and the first eight months of 1995 is also presented. This table subdivides materials, labor, and equipment into component costs

Parametric Analysis of the Exergoeconomic Operation Costs, Environmental and Human Toxicity Indexes of the MF501F3 Gas Turbine

Directory of Open Access Journals (Sweden)

Edgar Vicente Torres-González

2016-08-01

Full Text Available This work presents an energetic, exergoeconomic, environmental, and toxicity analysis of the simple gas turbine M501F3 based on a parametric analysis of energetic (thermal efficiency, fuel and air flow rates, and specific work output, exergoeconomic (exergetic efficiency and exergoeconomic operation costs, environmental (global warming, smog formation, acid rain indexes, and human toxicity indexes, by taking the compressor pressure ratio and the turbine inlet temperature as the operating parameters. The aim of this paper is to provide an integral, systematic, and powerful diagnostic tool to establish possible operation and maintenance actions to improve the gas turbine’s exergoeconomic, environmental, and human toxicity indexes. Despite the continuous changes in the price of natural gas, the compressor, combustion chamber, and turbine always contribute 18.96%, 53.02%, and 28%, respectively, to the gas turbine’s exergoeconomic operation costs. The application of this methodology can be extended to other simple gas turbines using the pressure drops and isentropic efficiencies, among others, as the degradation parameters, as well as to other energetic systems, without loss of generality.

Prediction of higher cost of antiretroviral therapy (ART) according to clinical complexity. A validated clinical index.

Science.gov (United States)

Velasco, Cesar; Pérez, Inaki; Podzamczer, Daniel; Llibre, Josep Maria; Domingo, Pere; González-García, Juan; Puig, Inma; Ayala, Pilar; Martín, Mayte; Trilla, Antoni; Lázaro, Pablo; Gatell, Josep Maria

2016-03-01

The financing of antiretroviral therapy (ART) is generally determined by the cost incurred in the previous year, the number of patients on treatment, and the evidence-based recommendations, but not the clinical characteristics of the population. To establish a score relating the cost of ART and patient clinical complexity in order to understand the costing differences between hospitals in the region that could be explained by the clinical complexity of their population. Retrospective analysis of patients receiving ART in a tertiary hospital between 2009 and 2011. Factors potentially associated with a higher cost of ART were assessed by bivariate and multivariate analysis. Two predictive models of "high-cost" were developed. The normalized estimated (adjusted for the complexity scores) costs were calculated and compared with the normalized real costs. In the Hospital Index, 631 (16.8%) of the 3758 patients receiving ART were responsible for a "high-cost" subgroup, defined as the highest 25% of spending on ART. Baseline variables that were significant predictors of high cost in the Clinic-B model in the multivariate analysis were: route of transmission of HIV, AIDS criteria, Spanish nationality, year of initiation of ART, CD4+ lymphocyte count nadir, and number of hospital admissions. The Clinic-B score ranged from 0 to 13, and the mean value (5.97) was lower than the overall mean value of the four hospitals (6.16). The clinical complexity of the HIV patient influences the cost of ART. The Clinic-B and Clinic-BF scores predicted patients with high cost of ART and could be used to compare and allocate costs corrected for the patient clinical complexity. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Development of a low cost UV index datalogger and comparison between UV index sensors

Science.gov (United States)

Gomes, L. M.; Ventura, L.

2018-02-01

Ultraviolet radiation (UVR) is the part of radiation emitted by the Sun, with range between 280 nm and 400 nm, and that reaches the Earth's surface. The UV rays are essential to the human because it stimulates the production of vitamin D but this radiation may be related to several health problems, including skin cancer and ocular diseases like pterygium, photokeratitis, cataract and more. To inform people about UV radiation, it is adopted the Ultraviolet Index (UVI). This UVI consists in a measure of solar UV radiation level, which contributes to cause sunburn on skin, also known as Erythema, and is indicated as an integer number between 1 and 14, associated to categories from low to extreme respectively. The aim of this work was to develop a low cost UVI datalogger capable of measuring three different UVI sensors simultaneously, record their data with timestamp and serve the measures online through a dedicated server, so general public can access their data and see the current UV radiation conditions. We also compared three different UVI sensors (SGlux UV cosine, Skye SKU440 and SiLabs SI1145) between them and with meteorological models during a period of months to verify their compliance. With five months data, we could verify the sensors working characteristics and decide which among them are the most suitable for research purposes.

The physiological cost index of walking with a powered knee-ankle-foot orthosis in subjects with poliomyelitis: A pilot study.

Science.gov (United States)

Arazpour, Mokhtar; Ahmadi Bani, Monireh; Samadian, Mohammad; Mousavi, Mohammad E; Hutchins, Stephen W; Bahramizadeh, Mahmood; Curran, Sarah; Mardani, Mohammad A

2016-08-01

A powered knee-ankle-foot orthosis was developed to provide restriction of knee flexion during stance phase and active flexion and extension of the knee during swing phase of gait. The purpose of this study was to determine its effect on the physiological cost index, walking speed and the distance walked in people with poliomyelitis compared to when walking with a knee-ankle-foot orthosis with drop lock knee joints. Quasi experimental study. Seven subjects with poliomyelitis volunteered for the study and undertook gait analysis with both types of knee-ankle-foot orthosis. Walking with the powered knee-ankle-foot orthosis significantly reduced walking speed (p = 0.015) and the distance walked (p = 0.004), and also, it did not improve physiological cost index values (p = 0.009) compared to walking with the locked knee-ankle-foot orthosis. Using a powered knee-ankle-foot orthosis did not significantly improve any of the primary outcome measures during walking for poliomyelitis subjects. This powered knee-ankle-foot orthosis design did not improve the physiological cost index of walking for people with poliomyelitis when compared to walking with a knee-ankle-foot orthosis with drop lock knee joints. This may have been due to the short training period used or the bulky design and additional weight of the powered orthosis. Further research is therefore warranted. © The International Society for Prosthetics and Orthotics 2015.

Impact of a Novel Cost-Saving Pharmacy Program on Pregabalin Use and Health Care Costs.

Science.gov (United States)

Martin, Carolyn; Odell, Kevin; Cappelleri, Joseph C; Bancroft, Tim; Halpern, Rachel; Sadosky, Alesia

2016-02-01

Pharmacy cost-saving programs often aim to reduce costs for members and payers by encouraging use of lower-tier or generic medications and lower-cost sales channels. In 2010, a national U.S. health plan began a novel pharmacy program directed at reducing pharmacy expenditures for targeted medications, including pregabalin. The program provided multiple options to avoid higher cost sharing: use mail order pharmacy or switch to a lower-cost alternative medication via mail order or retail. Members who did not choose any option eventually paid the full retail cost of pregabalin. To evaluate the impact of the pharmacy program on pregabalin and alternative medication use, health care costs, and health care utilization. This retrospective analysis of claims data included adult commercial health plan members with a retail claim for pregabalin in the first 13 months of the pharmacy program (identification [ID] period: February 1, 2010-February 28, 2011). Members whose benefit plan included the pharmacy program were assigned to the program cohort; all others were assigned to the nonprogram cohort. The program cohort index date was the first retail pregabalin claim during the ID period and after the program start; the nonprogram cohort index date was the first retail pregabalin claim during the ID period. All members were continuously enrolled for 12 months pre- and post-index and had at least 1 inpatient claim or ≥ 2 ambulatory visit claims for a pregabalin-indicated condition. Cohorts were propensity score matched (PSM) 1:1 with logistic regression on demographic and pre-index characteristics, including mail order and pregabalin use, comorbidity, health care costs, and health care utilization. Pregabalin, gabapentin and other alternative medication use, health care costs, and health care utilization were measured. The program cohort was also divided into 2 groups: members who changed to gabapentin post-index and those who did not. A difference-in-differences (Di

Relation between diet cost and Healthy Eating Index 2010 scores among adults in the United States 2007-2010.

Science.gov (United States)

Rehm, Colin D; Monsivais, Pablo; Drewnowski, Adam

2015-04-01

Food prices may be one reason for the growing socioeconomic disparities in diet quality. To evaluate the association between diet costs and the Healthy Eating Index-2010 (HEI-2010). Cross-sectional study based on 11,181 adults from the 2007-2010 National Health and Nutrition Examination Survey, analyzed in spring 2014. Diet cost was estimated by linking dietary data with a national food price database. The HEI-2010, a measure of adherence to the dietary guidelines, was the outcome. The population ratio method was used to estimate the average HEI-2010 scores by quintile of energy-adjusted diet cost. Additional analyses evaluated the association between cost and HEI-2010 components. There was a strong positive association between lower energy-adjusted diet costs and lower HEI-2010 scores. The association was stronger among women (p-interaction=0.003). Lower diet costs were associated with lower consumption of vegetables, fruits, whole grains, and seafood, and higher consumption of refined grains and solid fat, alcohol and added sugars. Lower energy-adjusted diet costs were associated with lower-quality diets. Future efforts to improve the nutritional status of the US public should take food prices and diet costs into account. Copyright © 2015. Published by Elsevier Inc.

Relation between diet cost and Healthy Eating Index 2010 scores among adults in the United States 2007-2010

Science.gov (United States)

Rehm, Colin D.; Monsivais, Pablo; Drewnowski, Adam

2016-01-01

Background Food prices may be one reason for the growing socioeconomic disparities in diet quality. Objective To evaluate the association between diet costs and the Healthy Eating Index-2010 (HEI-2010). Methods Cross-sectional study based on 11,181 adults from the 2007-2010 National Health and Nutrition Examination Survey, analyzed in spring 2014. Diet cost was estimated by linking dietary data with a national food price database. The HEI-2010, a measure of adherence to the Dietary Guidelines, was the outcome. The population ratio method was used to estimate the average HEI-2010 scores by quintile of energy-adjusted diet cost. Additional analyses evaluated the association between cost and HEI-2010 components. Results There was a strong positive association between lower energy-adjusted diet costs and lower HEI-2010 scores. The association was stronger among women (p-interaction=0.003). Lower diet costs were associated with lower consumption of vegetables, fruit, whole grains, and seafood, and higher consumption of refined grains and solid fat, alcohol and added sugars. Conclusions Lower energy-adjusted diet costs were associated with lower-quality diets. Future efforts to improve the nutritional status of the US public should take food prices and diet costs into account. PMID:25625693

Municipal solid waste management: identification and analysis of engineering indexes representing demand and costs generated in virtuous Italian communities.

Science.gov (United States)

Gamberini, R; Del Buono, D; Lolli, F; Rimini, B

2013-11-01

The definition and utilisation of engineering indexes in the field of Municipal Solid Waste Management (MSWM) is an issue of interest for technicians and scientists, which is widely discussed in literature. Specifically, the availability of consolidated engineering indexes is useful when new waste collection services are designed, along with when their performance is evaluated after a warm-up period. However, most published works in the field of MSWM complete their study with an analysis of isolated case studies. Conversely, decision makers require tools for information collection and exchange in order to trace the trends of these engineering indexes in large experiments. In this paper, common engineering indexes are presented and their values analysed in virtuous Italian communities, with the aim of contributing to the creation of a useful database whose data could be used during experiments, by indicating examples of MSWM demand profiles and the costs required to manage them. Copyright © 2013 Elsevier Ltd. All rights reserved.

Annual Equivalent Value, Benefit Cost Ratio, and Composite Performance Index as Valuation Appraisal Support of Teakwood Plantation

Directory of Open Access Journals (Sweden)

Sugiharto Soeleman

2014-04-01

Full Text Available Teak (Tectona grandis L.f is a premium high-value hardwood species being viewed as the most preferred species for investment opportunity. Recently, there has been a gradual move away from state control of teakwood plantation toward the participation of private enterprises. Several enterprises offer investment opportunity of teakwood plantation in which one of the main selling points being offered is a quick harvesting schedule. A quick harvesting time, however, might not provide the best outcome to the investors. This research exercise and compare the valuation appraisal of different harvesting schedules. The research focused on project planning, enterprise budget, financial projection, and valuation measurements to arrive at overall appraisal. To avoid any possible bias of individual investor's preference on common valuation criteria such as total investment, net cash flow (NCF, net present value (NPV, internal rate of return (IRR, profit on investment (P/I, and payback period (PBP, 3 otherS criteria namely benefit cost ratio (BCR, annual equivalent value (AEV, and composite performance index (CPI have been applied to arrive at a more fair valuation. It is concluded that the longer the harvesting schedule, the better valuation outcome could be achieved, and therefore, investors should critically review any investment proposal in accordance to their preference on valuation criteria. Keywords : annual equivalent value, benefit cost ratio, composite performance index, valuation appraisal

Cost-derived indices for building design and construction ...

African Journals Online (AJOL)

Also as multiples of gfi, substructure cost index, sci and roofing cost index, rci could predict componental costs of substructure and roofing for phased development purposes. Keywords: Cost Indices, Building Design, Building Construction Journal of Modeling, Design and Management of Engineering Systems, Vol.

Ventilation cost impact of reduced radon-daughter working levels

International Nuclear Information System (INIS)

Bates, R.C.

1981-01-01

Published information on costs of radon-daughter control in uranium mines was analyzed to develop estimates of the cost per ton for any level of radiation exposure control. All data were converted to 1967 cost of living index to provide a common analysis base. Results of the analysis show that the cost per ton increases exponentially as the radiation level is lowered. A linear relationship with the cost of living index is assumed, and equations and graphs are provided to estimate control cost per ton for any exposure control level and cost of living index

12 CFR 602.9 - Current FOIA index.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Current FOIA index. 602.9 Section 602.9 Banks... Records of the Farm Credit Administration § 602.9 Current FOIA index. FCA will make a current index available for public inspection and copying, as required by the FOIA. We will give you an index for the cost...

A self-made, low-cost infrared system for evaluating the sciatic functional index in mice

Directory of Open Access Journals (Sweden)

Lukas Fricker

2016-01-01

Full Text Available The sciatic functional index (SFI is a popular parameter for peripheral nerve evaluation that relies on footprints obtained with ink and paper. Drawbacks include smearing artefacts and a lack of dynamic information during measurement. Modern applications use digitized systems that can deliver results with less analytical effort and fewer mice. However, the systems are expensive (€40,000. This study aimed to evaluate the applicability and precision of a self-made, low-cost infrared system for evaluating SFI in mice. Mice were subjected to unilateral sciatic nerve crush injury (crush group; n = 7 and sham operation (sham group; n = 4. They were evaluated on the day before surgery, the 2 nd , 4 th and 6 th days after injury, and then every day up to the 23 rd day after injury. We compared two SFI evaluation methods, i.e., conventional ink-and-paper SFI (C-SFI and our infrared system (I-SFI. Our apparatus visualized footprints with totally internally reflected infrared light (950 nm and a camera that can only detect this wavelength. Additionally we performed an analysis with the ladder beam walking test (LBWT as a reference test. I-SFI assessment reduced the standard deviation by about 33 percent, from 11.6 to 7.8, and cut the variance around the baseline to 21 percent. The system thus requires fewer measurement repetitions and fewer animals, and cuts the cost of keeping the animals. The apparatus cost €321 to build. Our results show that the process of obtaining the SFI can be made more precise via digitization with a self-made, low-cost infrared system.

A self-made, low-cost infrared system for evaluating the sciatic functional index in mice.

Science.gov (United States)

Fricker, Lukas; Penna, Vincenzo; Lampert, Florian; Stark, G Bjoern; Witzel, Christian; Koulaxouzidis, Georgios

2016-05-01

The sciatic functional index (SFI) is a popular parameter for peripheral nerve evaluation that relies on footprints obtained with ink and paper. Drawbacks include smearing artefacts and a lack of dynamic information during measurement. Modern applications use digitized systems that can deliver results with less analytical effort and fewer mice. However, the systems are expensive (€40,000). This study aimed to evaluate the applicability and precision of a self-made, low-cost infrared system for evaluating SFI in mice. Mice were subjected to unilateral sciatic nerve crush injury (crush group; n = 7) and sham operation (sham group; n = 4). They were evaluated on the day before surgery, the 2(nd), 4(th) and 6(th) days after injury, and then every day up to the 23(rd) day after injury. We compared two SFI evaluation methods, i.e., conventional ink-and-paper SFI (C-SFI) and our infrared system (I-SFI). Our apparatus visualized footprints with totally internally reflected infrared light (950 nm) and a camera that can only detect this wavelength. Additionally we performed an analysis with the ladder beam walking test (LBWT) as a reference test. I-SFI assessment reduced the standard deviation by about 33 percent, from 11.6 to 7.8, and cut the variance around the baseline to 21 percent. The system thus requires fewer measurement repetitions and fewer animals, and cuts the cost of keeping the animals. The apparatus cost €321 to build. Our results show that the process of obtaining the SFI can be made more precise via digitization with a self-made, low-cost infrared system.

Combined use of Kappa Free Light Chain Index and Isoelectrofocusing of Cerebro-Spinal Fluid in Diagnosing Multiple Sclerosis: Performances and Costs.

Science.gov (United States)

Crespi, Ilaria; Sulas, Maria Giovanna; Mora, Riccardo; Naldi, Paola; Vecchio, Domizia; Comi, Cristoforo; Cantello, Roberto; Bellomo, Giorgio

2017-03-01

Isoelectrofocusing (IEF) to detect oligoclonal bands (OBCs) in cerebrospinal fluid (CSF) is the gold standard approach for evaluating intrathecal immunoglobulin synthesis in multiple sclerosis (MS) but the kappa free light chain index (KFLCi) is emerging as an alternative marker, and the combined/sequential uses of IEF and KFLCi have never been challenged. CSF and serum albumin, IgG, kFLC and lFLC were measured by nephelometry; albumin, IgG and kFLC quotients as well as Link and kFLC indexes were calculated; OCBs were evaluated by immunofixation. A total of 150 consecutive patients: 48 with MS, 32 with other neurological inflammatory diseases (NID), 62 with neurological non-inflammatory diseases (NNID), and 8 without any detectable neurological disease (NND) were investigated. Both IEF and KFLCi showed a similar accuracy as diagnostic tests for multiple sclerosis. The high sensitivity and specificity associated with the lower cost of KFLCi suggested to use this test first, followed by IEF as a confirmative procedure. The sequential use of IEF and KFLCi showed high diagnostic efficiency with cost reduction of 43 and 21%, if compared to the contemporary use of both tests, or the unique use of IEF in all patients. The "sequential testing" using KFLCi followed by IEF in MS represents an optimal procedure with accurate performance and lower costs.

Energy Transition-Index Germany. Costs are increasing steadily; Energiewende-Index Deutschland. Die Kosten steigen weiter

Energy Technology Data Exchange (ETDEWEB)

Vahlenkamp, Thomas; Kropeit, Julia [McKinsey and Company, Duesseldorf (Germany); Ritzenhofen, Ingmar [McKinsey and Company, Koeln (Germany); Gersema, Gerke [McKinsey and Company, Hamburg (Germany)

2017-03-15

How expensive the energy transition truly will be? The question of costs is coming more and more into the focus: The Bundesrechnungshof calls for more transparency, the policy confronted with the complexity of the subject matter is not able to quantify concrete costs. At the same time, all participants are working to curb spending growth. The fact is, the total costs will continue to rise. It is already foreseeable that by 2025 the annual electricity costs will increase by Euro 14 billion - to then Euro 77 billion. The main drivers are grid charges and rising fuel costs. [German] Wie teuer wird die Energiewende wirklich? Die Frage nach den Kosten geraet zunehmend in den Fokus: Der Bundesrechnungshof fordert mehr Transparenz, die Politik sieht sich mit Blick auf die Komplexitaet der Thematik ausserstande, konkrete Kosten zu beziffern. Gleichzeitig treten alle Beteiligten dafuer ein, die Ausgabenentwicklung zu bremsen. Fakt ist: Die Gesamtkosten werden weiter steigen. Bereits heute ist absehbar, dass sich bis 2025 die jaehrlich anfallenden Stromkosten um 14 Mrd. Euro erhoehen werden - auf dann 77 Mrd. Euro. Haupttreiber sind die Netzentgelte und steigende Brennstoffkosten.

Relation between cost of drug treatment and body mass index in people with type 2 diabetes in Latin America.

Science.gov (United States)

Elgart, Jorge Federico; Prestes, Mariana; Gonzalez, Lorena; Rucci, Enzo; Gagliardino, Juan Jose

2017-01-01

Despite the frequent association of obesity with type 2 diabetes (T2D), the effect of the former on the cost of drug treatment of the latest has not been specifically addressed. We studied the association of overweight/obesity on the cost of drug treatment of hyperglycemia, hypertension and dyslipidemia in a population with T2D. This observational study utilized data from the QUALIDIAB database on 3,099 T2D patients seen in Diabetes Centers in Argentina, Chile, Colombia, Peru, and Venezuela. Data were grouped according to body mass index (BMI) as Normal (18.5≤BMI<25), Overweight (25≤BMI<30), and Obese (BMI≥30). Thereafter, we assessed clinical and metabolic data and cost of drug treatment in each category. Statistical analyses included group comparisons for continuous variables (parametric or non-parametric tests), Chi-square tests for differences between proportions, and multivariable regression analysis to assess the association between BMI and monthly cost of drug treatment. Although all groups showed comparable degree of glycometabolic control (FBG, HbA1c), we found significant differences in other metabolic control indicators. Total cost of drug treatment of hyperglycemia and associated cardiovascular risk factors (CVRF) increased significantly (p<0.001) with increment of BMI. Hyperglycemia treatment cost showed a significant increase concordant with BMI whereas hypertension and dyslipidemia did not. Despite different values and percentages of increase, this growing cost profile was reproduced in every participating country. BMI significantly and independently affected hyperglycemia treatment cost. Our study shows for the first time that BMI significantly increases total expenditure on drugs for T2D and its associated CVRF treatment in Latin America.

A note on Youden's J and its cost ratio

Directory of Open Access Journals (Sweden)

Smits Niels

2010-09-01

Full Text Available Abstract Background The Youden index, the sum of sensitivity and specificity minus one, is an index used for setting optimal thresholds on medical tests. Discussion When using this index, one implicitly uses decision theory with a ratio of misclassification costs which is equal to one minus the prevalence proportion of the disease. It is doubtful whether this cost ratio truly represents the decision maker's preferences. Moreover, in populations with a different prevalence, a selected threshold is optimal with reference to a different cost ratio. Summary The Youden index is not a truly optimal decision rule for setting thresholds because its cost ratio varies with prevalence. Researchers should look into their cost ratio and employ it in a decision theoretic framework to obtain genuinely optimal thresholds.

The health and cost implications of high body mass index in Australian defence force personnel

Directory of Open Access Journals (Sweden)

Peake Jonathan

2012-06-01

Full Text Available Abstract Background Frequent illness and injury among workers with high body mass index (BMI can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI. Methods Personnel were grouped into cohorts according to the following ranges for (BMI: normal (18.5 − 24.9 kg/m2; n = 197, overweight (25–29.9 kg/m2; n = 154 and obese (≥30 kg/m2 with restricted body fat (≤28% for females, ≤24% for males (n = 148 and with no restriction on body fat (n = 180. Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions and administrative outcomes (e.g., discharge from service over one year. These data were then grouped and compared between the cohorts. Results The prevalence of injury and illness, cost of medical specialist consultations and cost of medical scans were all higher (p  Conclusions High BMI in the military increases healthcare usage, but does not disrupt workforce maintenance. The greater prevalence of injury and illness, greater healthcare usage and lower productivity in obese Australian Defence Force personnel is not related to higher levels of body fat.

Cost-identification analysis of total laryngectomy: an itemized approach to hospital costs.

Science.gov (United States)

Dedhia, Raj C; Smith, Kenneth J; Weissfeld, Joel L; Saul, Melissa I; Lee, Steve C; Myers, Eugene N; Johnson, Jonas T

2011-02-01

To understand the contribution of intraoperative and postoperative hospital costs to total hospital costs, examine the costs associated with specific hospital services in the postoperative period, and recognize the impact of patient factors on hospital costs. Case series with chart review. Large tertiary care teaching hospital system. Using the Pittsburgh Head and Neck Organ-Specific Database, 119 patients were identified as having total laryngectomy with bilateral selective neck dissection and primary closure from 1999 to 2009. Cost data were obtained for 112 patients. Costs include fixed and variable costs, adjusted to 2010 US dollars using the Consumer Price Index. Mean total hospital costs were $29,563 (range, $10,915 to $120,345). Operating room costs averaged 24% of total hospital costs, whereas room charges, respiratory therapy, laboratory, pharmacy, and radiology accounted for 38%, 14%, 8%, 7%, and 3%, respectively. Median length of stay was 9 days (range, 6-43), and median Charlson comorbidity index score was 8 (2-16). Patients with ≥1 day in the intensive care unit had significantly higher hospital costs ($46,831 vs $24,601, P cost differences with stratification based on previous radiation therapy ($27,598 vs $29,915 with no prior radiation, P = .62) or hospital readmission within 30 days ($29,483 vs $29,609 without readmission, P = .97). This is one of few studies in surgery and the first in otolaryngology to analyze hospital costs for a relatively standardized procedure. Further work will include cost analysis from multiple centers with investigation of global cost drivers.

The Development of Alternative Food Cost Indexes

Science.gov (United States)

1974-11-01

this total effort were to develop a new uniform ration cost system which would be directly related to known consumer preferences and nutritional...usage by all military services. 6. Be easy to understand and use. 7. Provide a BDFA capable of meeting consumer preferences and requirements as well... consumer preferences . in addition, historical usage data cannot help but reflect certain undesirable influences that mi I itary food service has

DIDA: Distributed Indexing Dispatched Alignment.

Directory of Open Access Journals (Sweden)

Hamid Mohamadi

Full Text Available One essential application in bioinformatics that is affected by the high-throughput sequencing data deluge is the sequence alignment problem, where nucleotide or amino acid sequences are queried against targets to find regions of close similarity. When queries are too many and/or targets are too large, the alignment process becomes computationally challenging. This is usually addressed by preprocessing techniques, where the queries and/or targets are indexed for easy access while searching for matches. When the target is static, such as in an established reference genome, the cost of indexing is amortized by reusing the generated index. However, when the targets are non-static, such as contigs in the intermediate steps of a de novo assembly process, a new index must be computed for each run. To address such scalability problems, we present DIDA, a novel framework that distributes the indexing and alignment tasks into smaller subtasks over a cluster of compute nodes. It provides a workflow beyond the common practice of embarrassingly parallel implementations. DIDA is a cost-effective, scalable and modular framework for the sequence alignment problem in terms of memory usage and runtime. It can be employed in large-scale alignments to draft genomes and intermediate stages of de novo assembly runs. The DIDA source code, sample files and user manual are available through http://www.bcgsc.ca/platform/bioinfo/software/dida. The software is released under the British Columbia Cancer Agency License (BCCA, and is free for academic use.

The diet-related GHG index

DEFF Research Database (Denmark)

Lund, Thomas Bøker; Watson, David; Smed, Sinne

2017-01-01

The aim was to construct and validate a cost-efficient index to measure GHG emissions (GHGe) caused by Danish consumers’ diets to be employed in questionnaire-based surveys. The index was modelled on the basis of actual food purchase data from a panel of ordinary Danish households...... and a questionnaire consisting of food frequency questions issued to the same panel. Based on the purchase data, diet-related GHGe were calculated for 2012. The data was then split into a learning sample and a validation sample. The index was constructed using the learning sample where a scoring procedure...... was calculated from responses to the questionnaire-based food frequency questions that predicted diet-related GHGe. Subsequently, the index scoring procedure was employed on the validation sample and the empirical relevance of the index was examined. In the learning sample, a scoring procedure to construct...

Concurrent Validity of Physiological Cost Index in Walking over Ground and during Robotic Training in Subacute Stroke Patients

Directory of Open Access Journals (Sweden)

Anna Sofia Delussu

2014-01-01

Full Text Available Physiological Cost Index (PCI has been proposed to assess gait demand. The purpose of the study was to establish whether PCI is a valid indicator in subacute stroke patients of energy cost of walking in different walking conditions, that is, over ground and on the Gait Trainer (GT with body weight support (BWS. The study tested if correlations exist between PCI and ECW, indicating validity of the measure and, by implication, validity of PCI. Six patients (patient group (PG with subacute stroke and 6 healthy age- and size-matched subjects as control group (CG performed, in a random sequence in different days, walking tests overground and on the GT with 0, 30, and 50% BWS. There was a good to excellent correlation between PCI and ECW in the observed walking conditions: in PG Pearson correlation was 0.919 (p<0.001; in CG Pearson correlation was 0.852 (p<0.001. In conclusion, the high significant correlations between PCI and ECW, in all the observed walking conditions, suggest that PCI is a valid outcome measure in subacute stroke patients.

Concurrent validity of Physiological Cost Index in walking over ground and during robotic training in subacute stroke patients.

Science.gov (United States)

Delussu, Anna Sofia; Morone, Giovanni; Iosa, Marco; Bragoni, Maura; Paolucci, Stefano; Traballesi, Marco

2014-01-01

Physiological Cost Index (PCI) has been proposed to assess gait demand. The purpose of the study was to establish whether PCI is a valid indicator in subacute stroke patients of energy cost of walking in different walking conditions, that is, over ground and on the Gait Trainer (GT) with body weight support (BWS). The study tested if correlations exist between PCI and ECW, indicating validity of the measure and, by implication, validity of PCI. Six patients (patient group (PG)) with subacute stroke and 6 healthy age- and size-matched subjects as control group (CG) performed, in a random sequence in different days, walking tests overground and on the GT with 0, 30, and 50% BWS. There was a good to excellent correlation between PCI and ECW in the observed walking conditions: in PG Pearson correlation was 0.919 (p < 0.001); in CG Pearson correlation was 0.852 (p < 0.001). In conclusion, the high significant correlations between PCI and ECW, in all the observed walking conditions, suggest that PCI is a valid outcome measure in subacute stroke patients.

Evaluating the Welfare of Index Insurance

DEFF Research Database (Denmark)

Harrison, Glenn W.; Martínez-Correa, Jimmy; Ng, Jia Min

affects both the demand for the product and the welfare of individuals making take-up decisions. We study the impact of basis risk on insurance take-up and on expected welfare in a laboratory experiment with an insurance frame. We measure the expected welfare of index insurance to individuals while......Index insurance was conceived to be a product that would simplify the claim settlement process and make it more objective, reducing transaction costs and moral hazard. However, index insurance also exposes the insured to basis risk, which arises because there can be a mismatch between the index...... risks that are different from preferences exhibited for their actuarially-equivalent counterparts. We study the potential link between index insurance demand and attitudes towards compound risks. We test the hypothesis that the compound risk nature of index insurance induced by basis risk negatively...

The cost and cost-effectiveness of expedited partner therapy compared with standard partner referral for the treatment of chlamydia or gonorrhea.

Science.gov (United States)

Gift, Thomas L; Kissinger, Patricia; Mohammed, Hamish; Leichliter, Jami S; Hogben, Matthew; Golden, Matthew R

2011-11-01

Partner treatment is an important component of sexually transmitted disease control. Several randomized controlled trials have compared expedited partner treatment (EPT) to unassisted standard partner referral (SR). All of these trials found that EPT significantly increased partner treatment over SR, whereas some found that EPT significantly lowered reinfection rates in index patients. We collected cost data to assess the payer-specific, health care system, and societal-level cost of EPT and SR. We used data on partner treatment and index patient reinfection rates from 2 randomized controlled trials examining EPT and SR for patients diagnosed with chlamydia or gonorrhea. Additional elements were estimated or drawn from the literature. We used a Monte Carlo simulation to assess the impact on cost and effectiveness of varying several variables simultaneously, and calculated threshold values for selected variables at which EPT and SR costs per patient were equal. From a health care system or societal perspective, EPT was less costly and it treated more partners than SR. From the perspective of an individual payer, EPT was less costly than SR if ≥32% to 37% of male index patients' female partners or ≥29% of female index patients' male partners received care from the same payer. EPT has a lower cost from a societal or health care system perspective than SR and treats more partners. Individual payers may find EPT to be more costly than SR, depending on how many of their patients' partners receive care from the same payer.

Clustering of financial time series with application to index and enhanced index tracking portfolio

Science.gov (United States)

Dose, Christian; Cincotti, Silvano

2005-09-01

A stochastic-optimization technique based on time series cluster analysis is described for index tracking and enhanced index tracking problems. Our methodology solves the problem in two steps, i.e., by first selecting a subset of stocks and then setting the weight of each stock as a result of an optimization process (asset allocation). Present formulation takes into account constraints on the number of stocks and on the fraction of capital invested in each of them, whilst not including transaction costs. Computational results based on clustering selection are compared to those of random techniques and show the importance of clustering in noise reduction and robust forecasting applications, in particular for enhanced index tracking.

KWIC Index to Government Publications

Directory of Open Access Journals (Sweden)

Margaret Norden

2013-05-01

Full Text Available United States and United Nations publications were not efficiently proc- essed nor readily available to the reader at Brandeis University Library. Data processing equipment was used to make a list of this material which could be referred to by a computer produced KWIC index. Currency and availability to the user, and time and cost efficiencies for the library were given precedence over detailed subject access. United States and United Nations classification schemes> and existing bibliographies and indexes were used extensively.

Optimized Data Indexing Algorithms for OLAP Systems

Directory of Open Access Journals (Sweden)

Lucian BORNAZ

2010-12-01

Full Text Available The need to process and analyze large data volumes, as well as to convey the information contained therein to decision makers naturally led to the development of OLAP systems. Similarly to SGBDs, OLAP systems must ensure optimum access to the storage environment. Although there are several ways to optimize database systems, implementing a correct data indexing solution is the most effective and less costly. Thus, OLAP uses indexing algorithms for relational data and n-dimensional summarized data stored in cubes. Today database systems implement derived indexing algorithms based on well-known Tree, Bitmap and Hash indexing algorithms. This is because no indexing algorithm provides the best performance for any particular situation (type, structure, data volume, application. This paper presents a new n-dimensional cube indexing algorithm, derived from the well known B-Tree index, which indexes data stored in data warehouses taking in consideration their multi-dimensional nature and provides better performance in comparison to the already implemented Tree-like index types.

Audit report on GDF Suez's supply costs and non-supply related costs in natural gas regulated sale tariffs - May 2014

International Nuclear Information System (INIS)

2014-05-01

After having recalled the legal context of objectives of this audit performed by the French Commission for Energy Regulation (CRE), this report proposes an analysis of GDF Suez's dissociated accounting which showed that costs are covered by natural gas regulated sale tariffs. In the second part, it comments the current market indexing used in tariff formula, comments current and present negotiations and their consequences for the market indexing share in long term contracts, discusses the issue of tariff volatility related to an increased market indexing share, discusses the possible re-examination of indices at the occasion of formula reviewing, and outlines that the diversified supplier portfolio allows optimisation operations. The third part addresses non-supply related costs: evolution of different infrastructure costs (related to distribution, transport, and storage) to be taken into account in regulated sale tariffs, evolution of commercial costs. Some recommendations are then made regarding the perspective of a tariff formula revision, and the perspectives of evolution of non-supply related costs

A review on fuzzy and stochastic extensions of the multi index transportation problem

Directory of Open Access Journals (Sweden)

Singh Sungeeta

2017-01-01

Full Text Available The classical transportation problem (having source and destination as indices deals with the objective of minimizing a single criterion, i.e. cost of transporting a commodity. Additional indices such as commodities and modes of transport led to the Multi Index transportation problem. An additional fixed cost, independent of the units transported, led to the Multi Index Fixed Charge transportation problem. Criteria other than cost (such as time, profit etc. led to the Multi Index Bi-criteria transportation problem. The application of fuzzy and stochastic concept in the above transportation problems would enable researchers to not only introduce real life uncertainties but also obtain solutions of these transportation problems. The review article presents an organized study of the Multi Index transportation problem and its fuzzy and stochastic extensions till today, and aims to help researchers working with complex transportation problems.

The Association Between NIMH Funding and h-index in Psychiatry.

Science.gov (United States)

Saraykar, Smita; Saleh, Ayman; Selek, Salih

2017-08-01

Academic productivity is measured under many domains: number of high impact publications, objective bibliometrics, securing extra-mural funding, etc. Citation impact is measured by an objective bibliometric called h-index. Securing funding from the National Institute of Mental Health (NIMH) is considered prestigious in the field of psychiatry. It is unknown if NIMH takes into consideration the author's h-index during the grant review process. The goal of this study was to determine the correlation between a principal investigator's (PI's) h-index and the NIMH funding. Correlational analysis was conducted on publicly available 2012 NIMH funding data to assess the relationship between NIMH funding and a PI's h-index. A simple linear regression was calculated to predict the h-index based on the amount of funding offered to the PI. A total of 139 PIs and their corresponding h-index and NIMH funding (direct, indirect, and total cost) were included. A strong correlation was found between h-index and NIMH funding: direct cost (r = 0.632, p h-index, β = 0.821, t (2.599), p h-index, R 2  = 0.410, F (3, 119) = 27.59, p h-index and securing NIMH funding. Thus, h-index stands out as a reliable measure for assessing the impact of scholarly contributions in academic psychiatry and can be used as an adjunct for performance evaluations, appointment, and promotions in academia.

5 CFR 591.219 - How does OPM compute shelter price indexes?

Science.gov (United States)

2010-01-01

... REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.219 How does OPM compute shelter price indexes? (a) In addition to rental...

Global Solar UV Index (invited paper)

International Nuclear Information System (INIS)

Repacholi, M.H.

2000-01-01

Excessive solar ultraviolet (UV) radiation exposure produces a significant burden of disease to the skin, eyes and immune system. Effective programmes for the reduction of UV exposure are needed to reduce this disease burden and the associated health care costs. The UV index is seen as an effective tool for communicating important protection information to the public through its use in media news and weather information. The index is described and it is suggested that universally common messages should be associated with its ranges. (author)

Costs in Swedish Public Transport : An analysis of cost drivers and cost efficiency in public transport contracts

OpenAIRE

Vigren, Andreas

2015-01-01

During the last seven years, the total cost for Swedish public transport provision has increased by over 30 percent in real terms according to figures from the government agency Transport Analysis. A similar pattern is found if considering a longer time span. Part of the cost increase can be attributed to an increased supply, and part is due to price increases on input factors that are measured by an industry index produced by the public transport industry. The fact that about half of the cos...

Nano-imprint gold grating as refractive index sensor

International Nuclear Information System (INIS)

Kumari, Sudha; Mohapatra, Saswat; Moirangthem, Rakesh S.

2016-01-01

Large scale of fabrication of plasmonic nanostructures has been a challenging task due to time consuming process and requirement of expensive nanofabrication tools such as electron beam lithography system, focused ion beam system, and extreme UV photolithography system. Here, we present a cost-effective fabrication technique so called soft nanoimprinting to fabricate nanostructures on the larger sample area. In our fabrication process, a commercially available optical DVD disc was used as a template which was imprinted on a polymer glass substrate to prepare 1D polymer nano-grating. A homemade nanoimprinting setup was used in this fabrication process. Further, a label-free refractive index sensor was developed by utilizing the properties of surface plasmon resonance (SPR) of a gold coated 1D polymer nano-grating. Refractive index sensing was tested by exposing different solutions of glycerol-water mixture on the surface of gold nano-grating. The calculated bulk refractive index sensitivity was found to be 751nm/RIU. We believed that our proposed SPR sensor could be a promising candidate for developing low-cost refractive index sensor with high sensitivity on a large scale.

76 FR 39474 - Monthly Median Cost of Funds Reporting, and Publication of Cost of Funds Indices

Science.gov (United States)

2011-07-06

... Semiannual Cost of Funds Index (SCOF), and other related cost of funds ratios currently published monthly in... discussed in this notice, please contact Jim Caton, Managing Director--Economic and Industry Analysis, at... Thrift Financial Report (TFR): \\2\\ \\2\\ Copies of the reporting forms and instructions for the TFR (OMB No...

Options for refractive index and viscosity matching to study variable density flows

Science.gov (United States)

Clément, Simon A.; Guillemain, Anaïs; McCleney, Amy B.; Bardet, Philippe M.

2018-02-01

Variable density flows are often studied by mixing two miscible aqueous solutions of different densities. To perform optical diagnostics in such environments, the refractive index of the fluids must be matched, which can be achieved by carefully choosing the two solutes and the concentration of the solutions. To separate the effects of buoyancy forces and viscosity variations, it is desirable to match the viscosity of the two solutions in addition to their refractive index. In this manuscript, several pairs of index matched fluids are compared in terms of viscosity matching, monetary cost, and practical use. Two fluid pairs are studied in detail, with two aqueous solutions (binary solutions of water and a salt or alcohol) mixed into a ternary solution. In each case: an aqueous solution of isopropanol mixed with an aqueous solution of sodium chloride (NaCl) and an aqueous solution of glycerol mixed with an aqueous solution of sodium sulfate (Na_2SO_4). The first fluid pair allows reaching high-density differences at low cost, but brings a large difference in dynamic viscosity. The second allows matching dynamic viscosity and refractive index simultaneously, at reasonable cost. For each of these four solutes, the density, kinematic viscosity, and refractive index are measured versus concentration and temperature, as well as wavelength for the refractive index. To investigate non-linear effects when two index-matched, binary solutions are mixed, the ternary solutions formed are also analyzed. Results show that density and refractive index follow a linear variation with concentration. However, the viscosity of the isopropanol and NaCl pair deviates from the linear law and has to be considered. Empirical correlations and their coefficients are given to create index-matched fluids at a chosen temperature and wavelength. Finally, the effectiveness of the refractive index matching is illustrated with particle image velocimetry measurements performed for a buoyant jet in a

Report on ENGIE's regulated tariffs for gas sale - Audit supply costs and non-supply related costs. Deliberation of the Commission for energy regulation on the 25 May 2016 bearing approval of the audit report on supply costs and non-supply related costs as basis for the calculation of the evolution of ENGIE's regulated tariffs for natural gas sale

International Nuclear Information System (INIS)

Ladoucette, Philippe De; Edwige, Catherine; Gassin, Helene; Padova, Yann; Sotura, Jean-Pierre

2016-05-01

After a recall of the context and objectives of the analysis performed by the French Commission for Energy Regulation (CRE), and a synthetic presentation of the main conclusions, this report first proposes an assessment for 2015 by discussing the share of consumptions provided under the regulated tariff with respect to those provided on the retail market, the evolution of these tariffs, by noticing that ENGIE costs have been covered by income associated with sales at regulated tariffs. The second part addresses perspectives of evolution for supply costs by outlining the existence of market indexing, the lack of factors which would justify an evolution of gas price indexing level, and a possible reviewing of indices at the moment of revision of the indexing formula. The third part addresses the perspectives of evolution of non-supply related costs. It notices the impact of recent evolution of infrastructure costs, some lack of information regarding provisional trade costs, and a significant decrease of these costs for 2016

Indexing for summary queries

DEFF Research Database (Denmark)

Yi, Ke; Wang, Lu; Wei, Zhewei

2014-01-01

), of a particular attribute of these records. Aggregation queries are especially useful in business intelligence and data analysis applications where users are interested not in the actual records, but some statistics of them. They can also be executed much more efficiently than reporting queries, by embedding...... returned by reporting queries. In this article, we design indexing techniques that allow for extracting a statistical summary of all the records in the query. The summaries we support include frequent items, quantiles, and various sketches, all of which are of central importance in massive data analysis....... Our indexes require linear space and extract a summary with the optimal or near-optimal query cost. We illustrate the efficiency and usefulness of our designs through extensive experiments and a system demonstration....

5 CFR 591.224 - How does OPM adjust price indexes between surveys?

Science.gov (United States)

2010-01-01

... REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.224 How does OPM adjust price indexes between surveys? (a) OPM adjusts...

5 CFR 591.218 - How does OPM compute price indexes?

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false How does OPM compute price indexes? 591.218 Section 591.218 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living...

Cost Overrun Optimism: Fact or Fiction

Science.gov (United States)

2016-02-29

Base, OH. Homgren, C. T. (1990). In G. Foster (Ed.), Cost accounting : A managerial emphasis (7th ed.). Englewood Cliffs, NJ: Prentice Hall. Morrison... Accounting Office. Gansler, J. S. (1989). Affording defense. Cambridge, MA: The MIT Press. Heise, S. R. (1991). A review of cost performance index...Image designed by Diane Fleischer Cost Overrun Optimism: FACT or FICTION? Maj David D. Christensen, USAF Program managers are advocates by

Dealer Inventory and the Cost of Immediacy

DEFF Research Database (Denmark)

Dick-Nielsen, Jens

This study shows that the recent 80% decrease in dealer inventories of corporate bonds has increased the cost of immediacy. For safe bonds which are quickly turned over again by dealers the increase is up to 15%, while for risky bonds which are kept on inventory by dealers the increase is up to 100......% on average. The time series of transaction costs is estimated using the natural experiment of corporate bond index exclusions. The exclusions are monthly and information-free events where index trackers seeking to minimize tracking error request immediacy in order to sell close to the exclusion date....... The drop in dealer inventories, and thus the rise in transaction costs, is a side-eect of anticipated tighter regulation, primarily Basel III and the Volcker Rule....

"The Consumer Price Index As a Measure of Inflation"

OpenAIRE

Dimitri B. Papadimitriou; L. Randall Wray

1996-01-01

As inflation approaches zero, it becomes increasingly important to examine the price indices on which monetary policy is based. The most popularly used aggregate price statistic in the U.S. is the Consumer Price Index (CPI), a statistic that appears to be a focal point in monetary policy deliberations. A problem associated with using the CPI, a fixed weight index of the cost-of-living, is that there are likely to be biases in the index as a measure of inflation. In this paper we use a simple ...

Impact of body mass index on surgical outcomes, narcotics consumption, and hospital costs following anterior cervical discectomy and fusion.

Science.gov (United States)

Narain, Ankur S; Hijji, Fady Y; Haws, Brittany E; Kudaravalli, Krishna T; Yom, Kelly H; Markowitz, Jonathan; Singh, Kern

2018-02-01

OBJECTIVE Given the increasing prevalence of obesity, more patients with a high body mass index (BMI) will require surgical treatment for degenerative spinal disease. In previous investigations of lumbar spine pathology, obesity has been associated with worsened postoperative outcomes and increased costs. However, few studies have examined the association between BMI and postoperative outcomes following anterior cervical discectomy and fusion (ACDF) procedures. Thus, the purpose of this study was to compare surgical outcomes, postoperative narcotics consumption, complications, and hospital costs among BMI stratifications for patients who have undergone primary 1- to 2-level ACDF procedures. METHODS The authors retrospectively reviewed a prospectively maintained surgical database of patients who had undergone primary 1- to 2-level ACDF for degenerative spinal pathology between 2008 and 2015. Patients were stratified by BMI as follows: normal weight (costs. Regression analyses were controlled for preoperative demographic and procedural characteristics. RESULTS Two hundred seventy-seven patients were included in the analysis, of whom 20.9% (n = 58) were normal weight, 37.5% (n = 104) were overweight, 24.9% (n = 69) were obese I, and 16.6% (n = 46) were obese II-III. A higher BMI was associated with an older age (p = 0.049) and increased comorbidity burden (p = 0.001). No differences in sex, smoking status, insurance type, diagnosis, presence of neuropathy, or preoperative VAS pain scores were found among the BMI cohorts (p > 0.05). No significant differences were found among these cohorts as regards operative time, intraoperative blood loss, length of hospital stay, and number of operative levels (p > 0.05). Additionally, no significant differences in postoperative narcotics consumption, VAS score improvement, complication rates, arthrodesis rates, reoperation rates, or total direct costs existed across BMI stratifications (p > 0.05). CONCLUSIONS Patients with a

Social accounting matrix and the effects of economic reform on health price index and household expenditures: Evidence from Iran.

Science.gov (United States)

Keshavarz, Khosro; Najafi, Behzad; Andayesh, Yaghob; Rezapour, Aziz; Abolhallaj, Masoud; Sarabi Asiabar, Ali; Hashemi Meshkini, Amir; Sanati, Ehsan; Mirian, Iman; Nikfar, Shekoofeh; Lotfi, Farhad

2017-01-01

Background: Socioeconomic indicators are the main factors that affect health outcome. Health price index (HPI) and households living costs (HLC) are affected by economic reform. This study aimed at examining the effect of subsidy targeting plan (STP) on HPI and HLC. Methods: The social accounting matrix was used to study the direct and indirect effects of STP. We chose 11 health related goods and services including insurance, compulsory social security services, hospital services, medical and dental services, other human health services, veterinary services, social services, environmental health services, laundry& cleaning and dyeing services, cosmetic and physical health services, and pharmaceutical products in the social accounting matrix to examine the health price index. Data were analyzed by the I-O&SAM software. Results: Due to the subsidy release on energy, water, and bread prices, we found that (i) health related goods and services groups' price index rose between 33.43% and 77.3%, (ii) the living cost index of urban households increased between 48.75% and 58.21%, and (iii) the living cost index of rural households grew between 53.51% and 68.23%. The results demonstrated that the elimination of subsidy would have negative effects on health subdivision and households' costs such that subsidy elimination increased the health prices index and the household living costs, especially among low-income families. The STP had considerable effects on health subdivision price index. Conclusion: The elimination or reduction of energy carriers and basic commodities subsidies have changed health price and households living cost index. Therefore, the policymakers should consider controlling the price of health sectors, price fluctuations and shocks.

Survey of Swiss nuclear's cost study 2016

International Nuclear Information System (INIS)

Alt, Stefan; Ustohalova, Veronika

2017-01-01

The report discusses the Swiss nuclear cost study 2016 concerning the following issues: evaluation of the aspects of the cost study: cost structure, cost classification and risk provision, additional payment liability, option of lifetime extension for Swiss nuclear power plants; specific indications on the report ''cost study 2016 (KS16) - estimation of the decommissioning cost of Swiss nuclear power plants'': decommissioning costs in Germany, France and the USA, indexing the Swiss cost estimation for decommissioning cost, impact factors on the decommissioning costs; specific indications on the report ''cost study 2016 (KS16) - estimation of the disposal cost - interim storage, transport, containers and reprocessing''; specific indications on the report ''cost studies (KS16) - estimation of disposal costs - geological deep disposal'': time scale and costs incurred, political/social risks, retrievability, comparison with other mining costs.

The Changing Cost of Performing Agricultural Research: An Index Approach

OpenAIRE

Murphy, Joseph W.; Kaldor, Donald R.

1981-01-01

Inflation erodes the purchasing power of dollars in every budget in our society. Budgets of agricultural research organizations have been no exception. Inflation has been defined as an increase in the average of prices {I}. A popular indicator of the rate of inflation is the annual percentage change in the Consumer Price Index (cpr) {2}, The CPI is intended to apply to consumer purchases, yet the concept implies that a similar indicator of the annual percentage change in prices of inputs purc...

A new methodology for modeling of direct landslide costs for transportation infrastructures

Science.gov (United States)

Klose, Martin; Terhorst, Birgit

2014-05-01

The world's transportation infrastructure is at risk of landslides in many areas across the globe. A safe and affordable operation of traffic routes are the two main criteria for transportation planning in landslide-prone areas. The right balancing of these often conflicting priorities requires, amongst others, profound knowledge of the direct costs of landslide damage. These costs include capital investments for landslide repair and mitigation as well as operational expenditures for first response and maintenance works. This contribution presents a new methodology for ex post assessment of direct landslide costs for transportation infrastructures. The methodology includes tools to compile, model, and extrapolate landslide losses on different spatial scales over time. A landslide susceptibility model enables regional cost extrapolation by means of a cost figure obtained from local cost compilation for representative case study areas. On local level, cost survey is closely linked with cost modeling, a toolset for cost estimation based on landslide databases. Cost modeling uses Landslide Disaster Management Process Models (LDMMs) and cost modules to simulate and monetize cost factors for certain types of landslide damage. The landslide susceptibility model provides a regional exposure index and updates the cost figure to a cost index which describes the costs per km of traffic route at risk of landslides. Both indexes enable the regionalization of local landslide losses. The methodology is applied and tested in a cost assessment for highways in the Lower Saxon Uplands, NW Germany, in the period 1980 to 2010. The basis of this research is a regional subset of a landslide database for the Federal Republic of Germany. In the 7,000 km² large Lower Saxon Uplands, 77 km of highway are located in potential landslide hazard area. Annual average costs of 52k per km of highway at risk of landslides are identified as cost index for a local case study area in this region. The

Cost update technology, safety, and costs of decommissioning a reference uranium hexafluoride conversion plant

International Nuclear Information System (INIS)

Miles, T.L.; Liu, Y.

1995-08-01

The purpose of this study is to update the cost estimates developed in a previous report, NUREG/CR-1757 (Elder 1980) for decommissioning a reference uranium hexafluoride conversion plant from the original mid-1981 dollars to values representative of January 1993. The cost updates were performed by using escalation factors derived from cost index trends over the past 11.5 years. Contemporary price quotes wee used for costs that have increased drastically or for which is is difficult to find a cost trend. No changes were made in the decommissioning procedures or cost element requirements assumed in NUREG/CR-1757. This report includes only information that was changed from NUREG/CR-1757. Thus, for those interested in detailed descriptions and associated information for the reference uranium hexafluoride conversion plant, a copy of NUREG/CR-1757 will be needed

Costs of decommissioning nuclear power plants as reported to the public to date

International Nuclear Information System (INIS)

Strasma, J.D.

1982-01-01

This paper attempts to determine what information has been available to the public, in the United States, concerning the cost of decommissioning nuclear power plants. The search was conducted in the Television News Index and Abstracts, in the annual indexes to The Reader's Digest, and in two computer-based bibliographic retrieval systems, Lockheed's DIALOG Magazine Index and the New York Times Information Bank. Fewer than ten articles appeared in widely read places, with none at all in the Reader's Digest and none on the evening TV news, from 1974 to date. The cost of decommissioning nuclear power plants was reported in various ways, with a wide range of estimates and relatively little actual experience. Costs were given in dollars of different years, in percentages of construction costs, in cost per KWH as per month to the consumer, etc., making the range of reported costs seem even wider than it really was. It is not surprising that the public fears that decommissioning costs will be alarmingly high. The public debate on energy policy might be more rational with better information on decommissioning costs. 16 references

Effect of increasing energy cost on arm coordination in elite sprint swimmers.

Science.gov (United States)

Komar, J; Leprêtre, P M; Alberty, M; Vantorre, J; Fernandes, R J; Hellard, P; Chollet, D; Seifert, L

2012-06-01

The purpose of this study was to analyze the changes in stroke parameters, motor organization and swimming efficiency with increasing energy cost in aquatic locomotion. Seven elite sprint swimmers performed a 6×300-m incremental swimming test. Stroke parameters (speed, stroke rate and stroke length), motor organization (arm stroke phases and arm coordination index), swimming efficiency (swimming speed squared and hand speed squared) and stroke index were calculated from aerial and underwater side-view cameras. The energy cost of locomotion was assessed by measuring oxygen consumption and blood lactate. Results showed that the increase in energy cost of locomotion was correlated to an increase in the index of coordination and stroke rate, and a decrease in stroke length (pstroke index did not change significantly with the speed increments (pstroke rate were observed, along with a decrease in stroke length, stroke index and hand speed squared with each increment, revealing an adaptation to the fatigue within the 300m. Copyright © 2011 Elsevier B.V. All rights reserved.

Societal costs of traffic crashes and crime in Michigan : 2011 update.

Science.gov (United States)

2011-06-01

"Cost estimates, including both monetary and nonmonetary quality-of-life costs specific to Michigan, were : estimated for overall traffic crashes and index crimes by experts in the field of economics of traffic crashes : and crimes. These cost estima...

Cost of tumor necrosis factor blockers per patient with rheumatoid arthritis in a multistate Medicaid population

Directory of Open Access Journals (Sweden)

Bonafede M

2014-09-01

Full Text Available Machaon Bonafede,1 George J Joseph,2 Neel Shah,2 Nicole Princic,1 David J Harrison2 1Truven Health Analytics, Cambridge, MA, 2Amgen Inc., Thousand Oaks, CA, USA Background: The purpose of this study was to estimate the annual cost per treated patient for the tumor necrosis factor (TNF blockers, etanercept, adalimumab, and infliximab in rheumatoid arthritis (RA patients covered by Medicaid. Methods: The MarketScan Medicaid Multistate Database was used to identify adult RA patients who used etanercept, adalimumab, or infliximab (index agents from 2007 to 2011. The index date was the first claim preceded by 180 days and followed by 360 days of continuous enrollment. Patients with other conditions for which these agents are approved by the US Food and Drug Administration were excluded. “Continuing” patients had one or more pre-index claim for their index biologic, and "new" patients did not. Cost per treated patient was calculated in the 360 day post-index period for each index agent as the total index drug and administration cost to the payer and the costs of switched-to agents divided by the number of patients who received the index agent. Results: A total of 1,085 patients met the study criteria. Forty-eight percent received etanercept (n=521; 37% received adalimumab (n=405; and 15% received infliximab (n=159. Patient characteristics were similar across groups (mean age 47.4 years, 83% female. The annual cost per treated patient was lowest for etanercept ($18,466, followed by adalimumab ($20,983 and infliximab ($26,516. For all agents, annual costs were lower for new patients ($17,996 for etanercept, $18,992 for adalimumab, and $24,756 for infliximab than for continuing patients ($19,004 for etanercept, $24,438 for adalimumab, and $28,127 for infliximab. Conclusion: Etanercept had lower costs per treated patient than adalimumab or infliximab in both new and continuing Medicaid enrollees with RA. Keywords: cost, tumor necrosis factor

Impact of Capital and Current Costs Changes of the Incineration Process of the Medical Waste on System Management Cost

Science.gov (United States)

Jolanta Walery, Maria

2017-12-01

The article describes optimization studies aimed at analysing the impact of capital and current costs changes of medical waste incineration on the cost of the system management and its structure. The study was conducted on the example of an analysis of the system of medical waste management in the Podlaskie Province, in north-eastern Poland. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. capital and current costs of medical waste incineration on economic efficiency index (E) and the spatial structure of the system was determined. Optimization studies were conducted for the following cases: with a 25% increase in capital and current costs of incineration process, followed by 50%, 75% and 100% increase. As a result of the calculations, the highest cost of system operation was achieved at the level of 3143.70 PLN/t with the assumption of 100% increase in capital and current costs of incineration process. There was an increase in the economic efficiency index (E) by about 97% in relation to run 1.

Hospital costs estimation and prediction as a function of patient and admission characteristics.

Science.gov (United States)

Ramiarina, Robert; Almeida, Renan Mvr; Pereira, Wagner Ca

2008-01-01

The present work analyzed the association between hospital costs and patient admission characteristics in a general public hospital in the city of Rio de Janeiro, Brazil. The unit costs method was used to estimate inpatient day costs associated to specific hospital clinics. With this aim, three "cost centers" were defined in order to group direct and indirect expenses pertaining to the clinics. After the costs were estimated, a standard linear regression model was developed for correlating cost units and their putative predictors (the patients gender and age, the admission type (urgency/elective), ICU admission (yes/no), blood transfusion (yes/no), the admission outcome (death/no death), the complexity of the medical procedures performed, and a risk-adjustment index). Data were collected for 3100 patients, January 2001-January 2003. Average inpatient costs across clinics ranged from (US$) 1135 [Orthopedics] to 3101 [Cardiology]. Costs increased according to increases in the risk-adjustment index in all clinics, and the index was statistically significant in all clinics except Urology, General surgery, and Clinical medicine. The occupation rate was inversely correlated to costs, and age had no association with costs. The (adjusted) per cent of explained variance varied between 36.3% [Clinical medicine] and 55.1% [Thoracic surgery clinic]. The estimates are an important step towards the standardization of hospital costs calculation, especially for countries that lack formal hospital accounting systems.

Query and Update Efficient B+-Tree Based Indexing of Moving Objects

DEFF Research Database (Denmark)

Jensen, Christian Søndergaard; Lin, Dan; Ooi, Beng Chin

2004-01-01

. This motivates the design of a solution that enables the B+-tree to manage moving objects. We represent moving-object locations as vectors that are timestamped based on their update time. By applying a novel linearization technique to these values, it is possible to index the resulting values using a single B...... are streamed to a database. Indexes for moving objects must support queries efficiently, but must also support frequent updates. Indexes based on minimum bounding regions (MBRs) such as the R-tree exhibit high concurrency overheads during node splitting, and each individual update is known to be quite costly......+-tree that partitions values according to their timestamp and otherwise preserves spatial proximity. We develop algorithms for range and k nearest neighbor queries, as well as continuous queries. The proposal can be grafted into existing database systems cost effectively. An extensive experimental study explores...

An efficient modularized sample-based method to estimate the first-order Sobol' index

International Nuclear Information System (INIS)

Li, Chenzhao; Mahadevan, Sankaran

2016-01-01

Sobol' index is a prominent methodology in global sensitivity analysis. This paper aims to directly estimate the Sobol' index based only on available input–output samples, even if the underlying model is unavailable. For this purpose, a new method to calculate the first-order Sobol' index is proposed. The innovation is that the conditional variance and mean in the formula of the first-order index are calculated at an unknown but existing location of model inputs, instead of an explicit user-defined location. The proposed method is modularized in two aspects: 1) index calculations for different model inputs are separate and use the same set of samples; and 2) model input sampling, model evaluation, and index calculation are separate. Due to this modularization, the proposed method is capable to compute the first-order index if only input–output samples are available but the underlying model is unavailable, and its computational cost is not proportional to the dimension of the model inputs. In addition, the proposed method can also estimate the first-order index with correlated model inputs. Considering that the first-order index is a desired metric to rank model inputs but current methods can only handle independent model inputs, the proposed method contributes to fill this gap. - Highlights: • An efficient method to estimate the first-order Sobol' index. • Estimate the index from input–output samples directly. • Computational cost is not proportional to the number of model inputs. • Handle both uncorrelated and correlated model inputs.

Estimating the variation in need for community-based social care by body mass index in England and associated cost: population-based cross-sectional study

Directory of Open Access Journals (Sweden)

Vicky R. Copley

2017-08-01

Full Text Available Abstract Background Adult obesity is linked to a greater need for social care because of its association with the development of long term conditions and because obese adults can have physical and social difficulties which inhibit daily living. Obesity thus has considerable social care cost implications but the magnitude of these costs is currently unknown. This paper outlines an approach to estimating obesity-related social care costs in adults aged over 65 in England. Methods We used univariable and multivariable logistic regression models to investigate the relation between the self-reported need for social care and potential determinants, including body mass index (BMI, using data from Health Survey for England. We combined these modelled estimates of need for social care with the mean hours of help received, conditional on receiving any help, to calculate the expected hours of social care received per adult by BMI. Results BMI is positively associated with self-reported need for social care. A one unit (ie 1 kg/m2 increase in BMI is on average associated with a 5% increase in the odds of need for help with social care (odds ratio 1.05, 95% CI 1.04 to 1.07 in an unadjusted model. Adjusting for long term illness and sociodemographic characteristics we estimate the annual cost of local authority funded care for those who receive it is £599 at a BMI of 23 but £1086 at a BMI of 40. Conclusion BMI is positively associated with self-reported need for social care after adjustment for sociodemographic factors and limiting long term illness. The increase in need for care with BMI gives rise to additional costs in social care provision which should be borne in mind when calculating the cost-effectiveness of interventions aimed at reducing obesity.

KWIC Index to Government Publications

OpenAIRE

Norden, Margaret

2013-01-01

United States and United Nations publications were not efficiently proc- essed nor readily available to the reader at Brandeis University Library. Data processing equipment was used to make a list of this material which could be referred to by a computer produced KWIC index. Currency and availability to the user, and time and cost efficiencies for the library were given precedence over detailed subject access. United States and United Nations classification schemes> and existing bibliograp...

Lamb Production Costs: Analyses of Composition and Elasticities Analysis of Lamb Production Costs

Directory of Open Access Journals (Sweden)

C. Raineri

2015-08-01

Full Text Available Since lamb is a commodity, producers cannot control the price of the product they sell. Therefore, managing production costs is a necessity. We explored the study of elasticities as a tool for basing decision-making in sheep production, and aimed at investigating the composition and elasticities of lamb production costs, and their influence on the performance of the activity. A representative sheep production farm, designed in a panel meeting, was the base for calculation of lamb production cost. We then performed studies of: i costs composition, and ii cost elasticities for prices of inputs and for zootechnical indicators. Variable costs represented 64.15% of total cost, while 21.66% were represented by operational fixed costs, and 14.19% by the income of the factors. As for elasticities to input prices, the opportunity cost of land was the item to which production cost was more sensitive: a 1% increase in its price would cause a 0.2666% increase in lamb cost. Meanwhile, the impact of increasing any technical indicator was significantly higher than the impact of rising input prices. A 1% increase in weight at slaughter, for example, would reduce total cost in 0.91%. The greatest obstacle to economic viability of sheep production under the observed conditions is low technical efficiency. Increased production costs are more related to deficient zootechnical indexes than to high expenses.

Tradeoffs between Price and Quality: How a Value Index Affects Preference Formation.

Science.gov (United States)

Creyer, Elizabeth H.; Ross, William T., Jr.

1997-01-01

Some of a group of 143 consumers were given a choice between higher-priced, higher-quality items and items with lower price and quality but higher value index (benefit/cost tradeoff); others were given price and quality information only. Consumers were more likely to choose lower-priced, higher-value options when the index information was…

INDEXING AND INDEX FUNDS

Directory of Open Access Journals (Sweden)

HAKAN SARITAŞ

2013-06-01

Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

The costs of nuclear power

International Nuclear Information System (INIS)

Vestenhaug, O.; Sauar, T.O.; Nielsen, P.O.

1979-01-01

A study has been made by Scandpower A/S of the costs of nuclear power in Sweden. It is based on the known costs of existing Swedish nuclear power plants and forecasts of the expected costs of the Swedish nuclear power programme. special emphasis has been put on the fuel cycle costs and future costs of spent fuel processing, waste disposal and decommissioning. Costs are calculated in 1978 Swedish crowns, using the retail price index. An actual interest rate of 4% is used, with depreciation period of 25 years and a plant lifetime of 30 years. Power production costs are estimated to be about 7.7 oere/kWh in 1978, rising to 10.5 oere/kWh in 2000. The cost is distributed with one third each to capital costs, operating costs and fuel costs, the last rising to 40% of the total at the end of the century. The main single factor in future costs is the price of uranium. If desired, Sweden can probably be self-sufficient in uranium in 2000 at a lower cost than assumed here. National research costs which, in Scandpower's opinion, can be debited to the commercial nuclear power programme are about 0.3 oere/kWh. (JIW)

Healthcare costs in psoriasis and psoriasis sub-groups over time following psoriasis diagnosis.

Science.gov (United States)

Al Sawah, Sarah; Foster, Shonda A; Goldblum, Orin M; Malatestinic, William N; Zhu, Baojin; Shi, Nianwen; Song, Xue; Feldman, Steven R

2017-09-01

To quantify healthcare costs in patients with psoriasis overall and in psoriasis patient sub-groups, by level of disease severity, presence or absence of psoriatic arthritis, or use of biologics. Administrative data from Truven Health Analytics MarketScan Research Database were used to select adult patients with psoriasis from January 2009 to January 2014. The first psoriasis diagnosis was set as the index date. Patients were required to have ≥6 months of continuous enrollment with medical and pharmacy benefits pre-index and ≥12 months post-index. Patients were followed from index until the earliest of loss to follow-up or study end. All-cause healthcare costs and outpatient pharmacy costs were calculated for the overall psoriasis cohort and for the six different psoriasis patient sub-groups: (a) patients with moderate-to-severe disease and mild disease, (b) patients with psoriatic arthritis and those without, and (c) patients on biologics and those who are not. Costs are presented per-patient-per-year (PPPY) and by years 1, 2, 3, 4, and 5 of follow-up, expressed in 2014 US dollars. A total of 108,790 psoriasis patients were selected, with a mean age of 46.0 years (52.7% females). Average follow-up was 962 days. All-cause healthcare costs were $12,523 PPPY. Outpatient pharmacy costs accounted for 38.6% of total costs. All-cause healthcare costs were highest for patients on biologics ($29,832), then for patients with psoriatic arthritis ($23,427) and those with moderate-to-severe disease ($21,481). Overall, all-cause healthcare costs and outpatient pharmacy costs presented an upward trend over a 5-year period. Psoriasis is associated with significant economic burden, which increases over time as the disease progresses. Patients with moderate-to-severe psoriasis, those with psoriatic arthritis, or use of biologics contributes to higher healthcare costs. Psoriasis-related pharmacy expenditure is the largest driver of healthcare costs in patients with psoriasis.

Indexations in 2009: will the Management and Member States respect their commitments?

CERN Multimedia

Association du personnel

2008-01-01

The salary adjustment method must be respected At the end of each year, CERN Council determines the value of the cost variation index for the following year. At its meeting on 5 November, Finance Committee discussed the index to be applied to the personnel budget according to the method1 introduced in 2001 and confirmed in 2007.

Costs and cost effectiveness of different strategies for chlamydia screening and partner notification: an economic and mathematical modelling study.

Science.gov (United States)

Turner, Katy; Adams, Elisabeth; Grant, Arabella; Macleod, John; Bell, Gill; Clarke, Jan; Horner, Paddy

2011-01-04

To compare the cost, cost effectiveness, and sex equity of different intervention strategies within the English National Chlamydia Screening Programme. To develop a tool for calculating cost effectiveness of chlamydia control programmes at a local, national, or international level. An economic and mathematical modelling study with cost effectiveness analysis. Costs were restricted to those of screening and partner notification from the perspective of the NHS and excluded patient costs, the costs of reinfection, and costs of complications arising from initial infection. England. Population Individuals eligible for the National Chlamydia Screening Programme. Cost effectiveness of National Chlamydia Screening Programme in 2008-9 (as cost per individual tested, cost per positive diagnosis, total cost of screening, number screened, number infected, sex ratio of those tested and treated). Comparison of baseline programme with two different interventions-(i) increased coverage of primary screening in men and (ii) increased efficacy of partner notification. In 2008-9 screening was estimated to cost about £46.3m in total and £506 per infection treated. Provision for partner notification within the screening programme cost between £9 and £27 per index case, excluding treatment and testing. The model results suggest that increasing male screening coverage from 8% (baseline value) to 24% (to match female coverage) would cost an extra £22.9m and increase the cost per infection treated to £528. In contrast, increasing partner notification efficacy from 0.4 (baseline value) to 0.8 partners per index case would cost an extra £3.3m and would reduce the cost per infection diagnosed to £449. Increasing screening coverage to 24% in men would cost over six times as much as increasing partner notification to 0.8 but only treat twice as many additional infections. In the English National Chlamydia Screening Programme increasing the effectiveness of partner notification is likely

Planning of continuity of service: The nuisance index, a measurement of the impact of interruptions

International Nuclear Information System (INIS)

Naggar, R.

1992-01-01

An improved approach has been developed by Hydro-Quebec to integrate its customers' needs into the planning for service continuity. A nuisance index has been developed to measure the impact of service interruptions and is currently being tested with a pilot project in the Richelieu service area. The analytic framework used differentiates three categories of customers for which a normative cost of interrptions is calculated. The classification of networks according to load density and use characteristics allows the utility to define appropriate service continuity objectives. Service continuity is measured using an indicator which is directly deduced from the cost of interruptions. The index takes into account the circumstances surrounding each interruption and an individual nuisance index is calculated for each customer. Then an average individual nuisance index is computed for customers within each category. Finally, an aggregated nuisance index is calculated for all categories as a whole. The cost of interruptions may then be derived through multiplying the nuisance indexes by the energy consumption of the corresponding set of customers and by a constant. It is possible to check whether a customer is receiving acceptable service continuity. An indicator determines the share of energy consumption for which a tolerance threshold has been exceeded. Once integrated into the planning process, these concepts enable optimal distribution network design and operation. Adjustments of network classes that match both the evolution of customers and load contribute to the permanent improvement of networks and their operation. 4 figs

Multi-scale structural similarity index for motion detection

Directory of Open Access Journals (Sweden)

M. Abdel-Salam Nasr

2017-07-01

Full Text Available The most recent approach for measuring the image quality is the structural similarity index (SSI. This paper presents a novel algorithm based on the multi-scale structural similarity index for motion detection (MS-SSIM in videos. The MS-SSIM approach is based on modeling of image luminance, contrast and structure at multiple scales. The MS-SSIM has resulted in much better performance than the single scale SSI approach but at the cost of relatively lower processing speed. The major advantages of the presented algorithm are both: the higher detection accuracy and the quasi real-time processing speed.

The "costs" of urinary incontinence for women.

Science.gov (United States)

Subak, Leslee L; Brown, Jeanette S; Kraus, Stephen R; Brubaker, Linda; Lin, Feng; Richter, Holly E; Bradley, Catherine S; Grady, Deborah

2006-04-01

To estimate costs of routine care for female urinary incontinence, health-related quality of life, and willingness to pay for incontinence improvement. In a cross-sectional study at 5 U.S. sites, 293 incontinent women quantified supplies, laundry, and dry cleaning specifically for incontinence. Costs were calculated by multiplying resources used by national resource costs and presented in 2005 United States dollars (2005). Health-related quality of life was estimated with the Health Utilities Index. Participants estimated willingness to pay for 25-100% improvement in incontinence. Potential predictors of these outcomes were examined using multivariable linear regression. Mean age was 56 +/- 11 years; participants were racially diverse and had a broad range of incontinence severity. Nearly 90% reported incontinence-related costs. Median weekly cost (25%, 75% interquartile range) increased from 0.37 dollars (0, 4 dollars) for slight to 10.98 dollars (4, 21 dollars) for very severe incontinence. Costs increased with incontinence severity (P women (P women with urge compared with those having stress incontinence (P lower Health Utilities Index score (mean 0.90 +/- 0.11 for weekly and 0.81 +/- 0.21 for daily incontinence; P = .02). Women were willing to pay a mean of 70 dollars +/- 64 dollars per month for complete resolution of incontinence, and willingness to pay increased with income and greater expected benefit. Women with severe urinary incontinence pay 900 dollars annually for incontinence routine care, and incontinence is associated with a significant decrement in health-related quality of life. Effective incontinence treatment may decrease costs and improve quality of life. III.

More reliable financing of future nuclear waste costs

International Nuclear Information System (INIS)

1994-01-01

This appendix contains seven reports written by consultants to the Commission. The report titles are: Basic document regarding the inquiry on fund management; Scenarios for growth and real interest rates in a long perspective; Stability of the Swedish financing system; Report concerning the financing of nuclear waste management in Sweden and Finland and the cost control system in Sweden; Evaluation of the cost estimates and calculation methods of SKB; A study of the costs for nuclear waste - The basis for cost estimation; A review of scope and costs for the Swedish system for management of nuclear waste. The four last reports are separately indexed

Aneurysm coil embolization: cost per volumetric filling analysis and strategy for cost reduction.

Science.gov (United States)

Wang, Charlie; Ching, Esteban Cheng; Hui, Ferdinand K

2016-05-01

One of the primary device expenditures associated with the endovascular treatment of aneurysms is that of detachable coils. Analyzing the cost efficiency of detachable coils is difficult, given the differences in design, implantable volume, and the presence of additives. However, applying a volume per cost metric may provide an index analogous to unit price found in grocery stores. The price information for 509 different coils belonging to 31 different coil lines, available as of September 2013, was obtained through the inventory management system at the study site, and normalized to the price of the least expensive coil. Values were used to calculate the logarithmic ratio of volume over cost. Operator choice among coil sizes can vary the material costs by five-fold in a hypothetical aneurysm. The difference in coil costs as a function of cost per volume of coil can vary tremendously. Using the present pricing algorithms, using the longest available length at a particular helical dimension and system yields improved efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Annual Equivalent Value, Benefit Cost Ratio, and Composite Performance Index as Valuation Appraisal Support of Teakwood Plantation

Directory of Open Access Journals (Sweden)

Sugiharto Soeleman

2014-04-01

Full Text Available Teak (Tectona grandis L.f is a premium high-value hardwood species being viewed as the most preferred species for investment opportunity. Recently, there has been a gradual move away from state control of teakwood plantation toward the participation of private enterprises. Several enterprises offer investment opportunity of teakwood plantation in which one of the main selling points being offered is a quick harvesting schedule. A quick harvesting time, however, might not provide the best outcome to the investors. This research exercise and compare the valuation appraisal of different harvesting schedules. The research focused on project planning, enterprise budget, financial projection, and valuation measurements to arrive at overall appraisal. To avoid any possible bias of individual investor's preference on common valuation criteria such as total investment, net cash flow (NCF, net present value (NPV, internal rate of return (IRR, profit on investment (P/I, and payback period (PBP, 3 otherS criteria namely benefit cost ratio (BCR, annual equivalent value (AEV, and composite performance index (CPI have been applied to arrive at a more fair valuation. It is concluded that the longer the harvesting schedule, the better valuation outcome could be achieved, and therefore, investors should critically review any investment proposal in accordance to their preference on valuation criteria.

Index Tracking with Control on the Number of Assets

Directory of Open Access Journals (Sweden)

Leonardo Riegel Sant'Anna

2014-06-01

Full Text Available Index tracking is a passive investment strategy, which aims at generating portfolios to reproduce a specific market index’s performance. This article proposes a model for a index tracking problem with control on the number of assets in the portfolio, which corresponds to a restriction in transaction costs. The model is applied to Ibovespa (sample: 67 stocks from January/2009 to July/2012. Portfolios were formed without limiting the amount of stocks and limiting this amount to 40, 30 and 20 stocks, with rebalancing periods of 20, 40 and 60 trading days. The results were satisfactory especially for the 60 days rebalancing period, in which transaction costs become lower due to the longer rebalancing period. We also verified that changes in Cplex parameters didn’t influence the results especially in relation to the computational times. Therefore, we also conclude about the need of using heuristic approaches to form portfolios with smaller amounts of assets.

Preliminary evaluation of the profitability indexes of the Laguna Verde nuclear power plant

International Nuclear Information System (INIS)

Villanueva M, C.

2010-10-01

The Laguna Verde nuclear power plant of the Federal Commission of Electricity has an installed capacity of 1,350 MW and unit 1 started commercial operation in 1990 and unit 2 in 1995. This paper is a synthesis of the results of a preliminary evaluation of the expected profitability indexes of the power plant during an economic lifetime of 40 years. The following data was used as input to the evaluation model prescribed by the Finance and Public Credit Secretary for public investment projects. Unit investment cost: 3,500 US D/k W; Fixed operation and maintenance cost: 54. 45 US D/year-k W; Variable operation and maintenance cost: 0. 38 US D/M Wh; Nuclear fuel cycle cost: 10. 28 US D/M Wh; Lifetime capacity factor: 85%; Discount rate: 12.0% per year; Sale price of electricity to the interconnected electric system: 80. 75 US D/M Wh. The output of the evaluation model is the following: Cost of electricity generated: 60. 2 1 US D/M Wh; fixed cost 49. 55 US D/M Wh; variable cost 10. 66 US D/M Wh; Internal rate of return (Irr): 18.0%; Benefit to cost quotient (B/C): 1.341. A very systematic sensitivity analysis was done, that shows that the cost is very sensitive to the capacity factor and to the investment cost, but is very insensitive to the fixed operation and maintenance cost and to the nuclear fuel cost. Finally, a comparison was made to the evaluation of the profitability indexes of a natural gas fired combined cycle power plant. (Author)

Charting the cost of nutritionally-adequate diets in Uganda, 2000-2011

African Journals Online (AJOL)

To compare food costs over time, prices are deflated using the monthly consumer price index\\ (CPI). Food prices are converted to prices per 100 gram portions, so as to maintain consistency with units of nutrient composition for given food items. The diet cost is compared to the Ugandan poverty line over time. The real cost ...

The costs of obesity in the workplace.

Science.gov (United States)

Finkelstein, Eric A; DiBonaventura, Marco daCosta; Burgess, Somali M; Hale, Brent C

2010-10-01

To quantify per capita and aggregate medical expenditures and the value of lost productivity, including absenteeism and presenteeism, because of overweight, and grade I, II, and III obesity among U.S. employees. Cross-sectional analysis of the 2006 Medical Expenditure Panel Survey and the 2008 National Health and Wellness Survey. Among men, estimates range from -$322 for overweight to $6087 for grade III obese men. For women, estimates range from $797 for overweight to $6694 for grade III. In aggregate, the annual cost attributable to obesity among full-time employees is $73.1 billion. Individuals with a body mass index >35 represent 37% of the obese population but are responsible for 61% of excess costs. Successful efforts to reduce the prevalence of obesity, especially among those with a body mass index >35, could result in significant savings to employers.

Development of hospital data warehouse for cost analysis of DPC based on medical costs.

Science.gov (United States)

Muranaga, F; Kumamoto, I; Uto, Y

2007-01-01

To develop a data warehouse system for cost analysis, based on the categories of the diagnosis procedure combination (DPC) system, in which medical costs were estimated by DPC category and factors influencing the balance between costs and fees. We developed a data warehouse system for cost analysis using data from the hospital central data warehouse system. The balance data of patients who were discharged from Kagoshima University Hospital from April 2003 to March 2005 were determined in terms of medical procedure, cost per day and patient admission in order to conduct a drill-down analysis. To evaluate this system, we analyzed cash flow by DPC category of patients who were categorized as having malignant tumors and whose DPC category was reevaluated in 2004. The percentages of medical expenses were highest in patients with acute leukemia, non-Hodgkin's lymphoma, and particularly in patients with malignant tumors of the liver and intrahepatic bile duct. Imaging tests degraded the percentages of medical expenses in Kagoshima University Hospital. These results suggested that cost analysis by patient is important for hospital administration in the inclusive evaluation system using a case-mix index such as DPC.

Performance Evaluation of Some Index Funds-Indian Perspective

Directory of Open Access Journals (Sweden)

Pranav Mishra

2016-04-01

Full Text Available The popularity of the index funds as an investment option has increased manifolds ever since they were introduced. This is primarily because of the merits that the investor enjoys through passive style of funds management. This includes the low cost involved in managing such funds and the significant tax savings. Most of the researchers have compared the performance of the actively managed funds with that of index funds. However the index funds of US and for that reason other parts of the world are different from that of India. Unlike other countries in India the benchmark indices comprise of very less number of securities and thus are unable to represent the entire economy. So in Indian context comparison of performance of actively managed funds with index funds is not logical. Therefore this paper attempts to make an intra-class performance evaluation of some Indian index funds based on some statistics. The study includes the use of graphical interpretations coupled with statistical tools like R-square and tracking error values. Two models of tracking error have been employed to test empirically the performance of the selected index funds. The study is useful for those interested in mutual funds, which includes researchers, academicians, and financial advisors. The paper suits the requirement and the situations prevalent in Indian economy during the period under study.

Forecasting Canadian nuclear power station construction costs

International Nuclear Information System (INIS)

Keng, C.W.K.

1985-01-01

Because of the huge volume of capital required to construct a modern electric power generating station, investment decisions have to be made with as complete an understanding of the consequences of the decision as possible. This understanding must be provided by the evaluation of future situations. A key consideration in an evaluation is the financial component. This paper attempts to use an econometric method to forecast the construction costs escalation of a standard Canadian nuclear generating station (NGS). A brief review of the history of Canadian nuclear electric power is provided. The major components of the construction costs of a Canadian NGS are studied and summarized. A database is built and indexes are prepared. Based on these indexes, an econometric forecasting model is constructed using an apparently new econometric methodology of forecasting modelling. Forecasts for a period of 40 years are generated and applications (such as alternative scenario forecasts and range forecasts) to uncertainty assessment and/or decision-making are demonstrated. The indexes, the model, and the forecasts and their applications, to the best of the author's knowledge, are the first for Canadian NGS constructions. (author)

[Total knee and hip prosthesis: variables associated with costs].

Science.gov (United States)

Herrera-Espiñeira, Carmen; Escobar, Antonio; Navarro-Espigares, José Luis; Castillo, Juan de Dios Lunadel; García-Pérez, Lidia; Godoy-Montijano, Amparo

2013-01-01

The elevated prevalence of osteoarthritis in Western countries, the high costs of hip and knee arthroplasty, and the wide variations in the clinical practice have generated considerable interest in comparing the associated costs before and after surgery. To determine the influence of a number of variables on the costs of total knee and hip arthroplasty surgery during the hospital stay and during the one-year post-discharge. A prospective multi-center study was performed in 15 hospitals from three Spanish regions. Relationships between the independent variables and the costs of hospital stay and postdischarge follow-up were analyzed by using multilevel models in which the "hospital" variable was used to group cases. Independent variables were: age, sex, body mass index, preoperative quality of life (SF-12, EQ-5 and Womac questionnaires), surgery (hip/knee), Charlson Index, general and local complications, number of beds and economic-institutional dependency of the hospital, the autonomous region to which it belongs, and the presence of a caregiver. The cost of hospital stay, excluding the cost of the prosthesis, was 4,734 Euros, and the post-discharge cost was 554 Euros. With regard to hospital stay costs, the variance among hospitals explained 44-46% of the total variance among the patients. With regard to the post-discharge costs, the variability among hospitals explained 7-9% of the variance among the patients. There is considerable potential for reducing the hospital stay costs of these patients, given that more than 44% of the observed variability was not determined by the clinical conditions of the patients but rather by the behavior of the hospitals.

Morbidity, outcomes and cost-benefit analysis of wildlife rehabilitation in Catalonia (Spain.

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Rafael Angel Molina-López

Full Text Available There are few studies of careful examination of wildlife casualties in Wildlife Rehabilitation Centers. These studies are essential for detecting menaces to wild species and providing objective criteria about cost-benefit of treatments in those centers. The release rate is considered the main outcome indicator, but other parameters such as length of stay at the center and a cost-benefit index expressed as number of released animals per euro and day, could be used as reliable estimators of the rehabilitation costs.A retrospective study based on 54772 admissions recorded from 1995-2013 in the database of the Wildlife Rehabilitation Center of Torreferrussa (Catalonia, NW Spain assessed the morbidity, outcomes and cost-benefits of the rehabilitation practices.Three hundred and two species were included: 232 birds (n = 48633, 37 mammals (n = 3293, 20 reptiles (n = 2705 and 13 amphibians (n = 141. The most frequent causes of admission were: 39.8% confiscation of protected species (89.4% passerines, 31.8% orphaned young animals (35.3% swifts, 21.7% diurnal raptors and owls and 17.4% trauma casualties (46.7% raptors and owls. The highest proportion of releases was found in the captivity confiscation category [87.4% passerines (median time of stay: 12 days], followed by the orphaned category [78% owls (66 days, 76.5% diurnal birds of prey (43 days, 75.6% hedgehogs (49 days, 52.7% swifts (19 days and 52% bats (55 days]. For the trauma group, 46.8% of releases were hedgehogs (44 days and 25.6% owls (103 days. As regards the cost-benefit index, the trauma casualties and infectious diseases had the worse values with 1.3 and 1.4 released animals/euro/day respectively, and were particularly low in raptors, waders, marine birds and chiroptera. On the contrary, captivity (4.6 and misplacement (4.1 had the best index, particulary in amphibian, reptiles and passerines.Cost-benefit studies including the release rate, the time of stay at the center and the cost

Lifestyle factors, direct and indirect costs for a Brazilian airline company

Science.gov (United States)

Rabacow, Fabiana Maluf; Luiz, Olinda do Carmo; Malik, Ana Maria; Burdorf, Alex

2014-01-01

OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population. PMID:26039398

Lifestyle factors, direct and indirect costs for a Brazilian airline company.

Science.gov (United States)

Rabacow, Fabiana Maluf; Luiz, Olinda do Carmo; Malik, Ana Maria; Burdorf, Alex

2014-12-01

OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

Lifestyle factors, direct and indirect costs for a Brazilian airline company

Directory of Open Access Journals (Sweden)

Fabiana Maluf Rabacow

2014-12-01

Full Text Available OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking, was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

Socio-economic costs of osteoarthritis: a systematic review of cost-of-illness studies.

Science.gov (United States)

Puig-Junoy, Jaume; Ruiz Zamora, Alba

2015-04-01

The burden of illness that can be attributed to osteoarthritis is considerable and ever increasing. The aim of this systematic review is to analyze currently available data derived from cost-of-illness studies on the healthcare and non-healthcare costs of osteoarthritis. PubMed, Index Medicus Español (IME), and the Spanish Database of Health Sciences [Índice Bibliográfico Español en Ciencias de la Salud (IBECS)] were searched up to the end of April 2013. This study adhered to the PRISMA guidelines. Articles were reviewed and the study quality assessed by two independent investigators with consensus resolution of discrepancies. We identified 39 studies that investigated the socio-economic cost of osteoarthritis. Only nine studies took a social perspective. Rather than estimating the incremental cost of osteoarthritis, nine studies estimated the total cost of treating patients with osteoarthritis without a control for comorbidity. The other 30 studies determined the incremental cost with or without a control group. Only nine studies assessed a comprehensive list of healthcare resources. The annual incremental healthcare costs of generalized osteoarthritis ranged from €705 to €19,715. The annual incremental non-healthcare-related costs of generalized osteoarthritis ranged from €432 to €11,956. The study concludes that the social cost of osteoarthritis could be between 0.25% and 0.50% of a country׳s GDP. This should be considered in order to foster studies that take into account both healthcare and non-healthcare costs. Copyright © 2014 Elsevier Inc. All rights reserved.

5 CFR 591.228 - How does OPM convert the price index plus adjustment factor to a COLA rate?

Science.gov (United States)

2010-01-01

... MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.228 How does OPM convert the price index plus...

The high price of depression: Family members' health conditions and health care costs.

Science.gov (United States)

Ray, G Thomas; Weisner, Constance M; Taillac, Cosette J; Campbell, Cynthia I

2017-05-01

To compare the health conditions and health care costs of family members of patients diagnosed with a Major Depressive Disorder (MDD) to family members of patients without an MDD diagnosis. Using electronic health record data, we identified family members (n=201,914) of adult index patients (n=92,399) diagnosed with MDD between 2009 and 2014 and family members (n=187,011) of matched patients without MDD. Diagnoses, health care utilization and costs were extracted for each family member. Logistic regression and multivariate models were used to compare diagnosed health conditions, health services cost, and utilization of MDD and non-MDD family members. Analyses covered the 5years before and after the index patient's MDD diagnosis. MDD family members were more likely than non-MDD family members to be diagnosed with mood disorders, anxiety, substance use disorder, and numerous other conditions. MDD family members had higher health care costs than non-MDD family members in every period analyzed, with the highest difference being in the year before the index patient's MDD diagnosis. Family members of patients with MDD are more likely to have a number of health conditions compared to non-MDD family members, and to have higher health care cost and utilization. Copyright © 2017. Published by Elsevier Inc.

The Cost of Immediacy for Corporate Bonds

DEFF Research Database (Denmark)

Dick-Nielsen, Jens; Marco, Rossi

Liquidity provision in the corporate bond market has become significantly more expensive after the 2008 credit crisis. Using index exclusions as a natural experiment during which uninformed index trackers request immediacy, we find that the price of immediacy has doubled for short-term investment...... grade bonds, and more than tripled for speculative-grade bonds. The increased cost of immediacy is a side-effect of a ban on proprietary trading (Volker Rule) and tighter post-crisis capital regulations, which have resulted in lower aggregate dealer inventories....

The triglyceride and glucose index is useful for recognising insulin resistance in children.

Science.gov (United States)

Rodríguez-Morán, M; Simental-Mendía, L E; Guerrero-Romero, F

2017-06-01

Although recognising insulin resistance (IR) in children is particularly important, the gold standard test used to diagnose it, the euglyceamic glucose clamp, is costly, invasive and is not routinely available in our clinical settings in Mexico. This study evaluated whether the triglyceride-glucose (TyG) index would provide a useful alternative. A total of 2779 school children aged seven to 17 years, from Durango, Mexico, were enrolled during 2015-2016. The gold standard euglyceamic-hyperinsulinemic clamp test was performed in a randomly selected subsample of 125 children, and diagnostic concordance between the TyG index and the homoeostasis model assessment of IR was evaluated in all of the 2779 enrolled children. The best cut-off values for recognising IR using the TyG index were 4.65 for prepubertal girls and boys, 4.75 for pubertal girls and 4.70 for pubertal boys. Concordance between the TyG index and the homoeostasis model assessment of IR was 0.910 and 0.902 for the prepubertal girls and boys, 0.932 for the pubertal girls and 0.925 for the pubertal boys. The TyG index was useful for recognising IR in both prepubertal and pubertal children and could provide a feasible alternative to the costly and invasive gold standard test for IR in resource-limited settings. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Inequalities in the distribution of the costs of alcohol misuse in Scotland: a cost of illness study.

Science.gov (United States)

Johnston, Marjorie C; Ludbrook, Anne; Jaffray, Mariesha A

2012-01-01

To examine the distribution of the costs of alcohol misuse across Scotland in 2009/2010, in relation to deprivation. A cost of illness approach was used. Alcohol-related harmful effects were assessed for inclusion using a literature review. This was based upon the following categories: direct healthcare costs, intangible health costs, social care costs, crime costs and labour and productivity costs. An analysis of secondary data supplemented by a literature review was carried out to quantify each harmful effect, determine its value and provide an estimate of the distribution by deprivation. The deprivation distributions used were area measures (primarily the Scottish Index of Multiple Deprivation). The overall cost was £7457 million. Two alcohol harmful effects were not included in the overall cost by deprivation due to a lack of data. These were 'children's social work and hearing system' and the criminal justice system costs from 'alcohol-specific offences'. The included alcohol harmful effects demonstrated that 40.41% of the total cost arose from the 20% most deprived areas. The intangible cost category was the largest category (78.65%). The study found that the burden of alcohol harmful effects is greater in deprived groups and these burdens do not simply arise from deprived groups but are also experienced more by these groups. The study was limited by a lack of data availability in certain areas, leading to less-precise cost estimates.

Cost escalation in nuclear power

International Nuclear Information System (INIS)

Montomery, W.D.; Quirk, J.P.

1978-01-01

This report is concerned with the escalation of capital costs of nuclear central station power plants between the early 1960s and the present. The report presents an historical overview of the development of the nuclear power industry and cost escalation in the industry, using existing data on orders and capital costs. New data are presented on regulatory delays in the licensing process, derived from a concurrent study being carried on in the Social Science group at Caltech. The conclusions of the study are that nuclear capital costs have escalated more rapidly than the GNP deflator or the construction industry price index. Prior to 1970, cost increases are related to bottleneck problems in the nuclear construction and supplying industries and the regulatory process; intervenors play only a minor role in cost escalation. After 1970, generic changes introduced into the licensing process by intervenors (including environmental impact reviews, antitrust reviews, more stringent safety standards) dominate the cost escalation picture, with bottlenecks of secondary importance. Recent increases in the time from application for a construction permit to commercial operation are related not only to intervenor actions, but also to suspensions, cancellations or postponements of construction by utilities due to unfavorable demand or financing conditions

The impact of Pulpwood Rail Freight Costs on the Minnesota-Wisconsin Pulpwood Market

Science.gov (United States)

David C. Lothner

1976-01-01

Transportation costs affect the marketing and utilization of pulpwood. Their impact on the procurement and utilization of pulpwood often prove difficult to measure because deriving an average annual measure of the transportation cost is difficult. This note, by means of a simple index method for measuring regional interstate pulpwood rail freight costs, illustrates...

Cultural Differences in Opportunity Cost Consideration.

Science.gov (United States)

Zhang, Ning; Ji, Li-Jun; Li, Ye

2017-01-01

Two studies were conducted to investigate cultural differences in opportunity cost consideration between Chinese and Euro-Canadians. Opportunity cost is defined as the cost of a benefit that must be forgone in order to pursue a better alternative (Becker et al., 1974). In both studies, participants read about hypothetical purchase scenarios, and then decided whether they would buy a certain product. Opportunity cost consideration was measured in two ways: (1) participants' thoughts pertaining to other (nonfocal) products while making decisions; (2) participants' decisions not to buy a focal product (Study 1) or a more expensive product (Study 2). Across both indexes, we found that after controlling for individual difference variables and amount of pocket money, Chinese participants in China considered financial opportunity cost more than Euro-Canadians in Study 1. Similar results were observed in Study 2 when comparing Chinese in Canada with Euro-Canadians However, the cultural effect on opportunity cost consideration was confounded by family income in Study 2. Implications for resource management, limitations of the current research and directions for future research are discussed.

Hospital staffing and hospital costs.

Science.gov (United States)

Andrew, R R

1976-08-07

A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

Cost-effectiveness of Bariatric Surgery in Adolescents With Obesity.

Science.gov (United States)

Klebanoff, Matthew J; Chhatwal, Jagpreet; Nudel, Jacob D; Corey, Kathleen E; Kaplan, Lee M; Hur, Chin

2017-02-01

Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery. In the no surgery strategy, patients remained at their initial body mass index (calculated as weight in kilograms divided by height in meters squared) over time. In the bariatric surgery strategy, patients were subjected to risks of perioperative mortality and complications as well as initial morbidity but also experienced longer-term quality-of-life improvements associated with weight loss. Cohort demographic information-of the 228 patients included, the mean (SD) age was 17 (1.6) years, the mean (range) body mass index was 53 (34-88), and 171 (75.0%) were female-surgery-related outcomes, and base case time horizon (3 years) were based on data from the Teen-Longitudinal Assessment of Bariatric Surgery study. One-way and probabilistic sensitivity analyses were performed. Quality-adjusted life-years (QALYs), total costs (in US dollars adjusted to 2015-year values using the Consumer Price Index), and incremental cost-effectiveness ratios (ICERs). A willingness-to-pay threshold of $100 000 per QALY was used to assess cost-effectiveness. After 3 years, surgery led to a gain of 0.199 QALYs compared with no surgery at an incremental cost of $30 747, yielding an unfavorable ICER of $154 684 per QALY. When the clinical study results were extrapolated to 4 years, the ICER decreased to $114 078 per QALY and became cost-effective by 5 years with an ICER of $91 032 per QALY. Outcomes were robust in most 1-way and probabilistic sensitivity analyses. Bariatric surgery incurs

Anxiety disorders, major depressive disorder and the dynamic relationship between these conditions: treatment patterns and cost analysis.

Science.gov (United States)

François, Clément; Despiégel, Nicolas; Maman, Khaled; Saragoussi, Delphine; Auquier, Pascal

2010-03-01

To determine the treatment pattern and impact on healthcare costs of anxiety disorders and major depressive disorder (MDD), and influence of their concomitance and subsequence. A retrospective cohort study was conducted using a US reimbursement claims database. Adult patients with an incident diagnosis of anxiety or MDD (index date) were included. Their sociodemographic data, diagnoses, healthcare resource use and associated costs were collected over the 6 months preceding and 12 months following index date. A total of 599,624 patients were identified and included. Patients with phobia or post-traumatic stress disorder had the highest 12-month costs ($8,442 and $8,383, respectively). Patients with social anxiety disorder had the lowest costs ($3,772); generalized anxiety disorder ($6,472) incurred costs similar to MDD ($7,170). Costs were substantially increased with emergence of anxiety during follow-up in MDD patients ($10,031) or emergence of MDD in anxiety patients ($9,387). This was not observed in patients with both anxiety and MDD at index date ($6,148). This study confirms the high burden of costs of anxiety, which were within the same range as MDD. Interestingly, the emergence of anxiety or MDD in the year following a first diagnosis of MDD or anxiety, respectively, increased costs substantially. Major limitations were short follow-up and lack of absenteeism costs.

Statistical methods of estimating mining costs

Science.gov (United States)

Long, K.R.

2011-01-01

Until it was defunded in 1995, the U.S. Bureau of Mines maintained a Cost Estimating System (CES) for prefeasibility-type economic evaluations of mineral deposits and estimating costs at producing and non-producing mines. This system had a significant role in mineral resource assessments to estimate costs of developing and operating known mineral deposits and predicted undiscovered deposits. For legal reasons, the U.S. Geological Survey cannot update and maintain CES. Instead, statistical tools are under development to estimate mining costs from basic properties of mineral deposits such as tonnage, grade, mineralogy, depth, strip ratio, distance from infrastructure, rock strength, and work index. The first step was to reestimate "Taylor's Rule" which relates operating rate to available ore tonnage. The second step was to estimate statistical models of capital and operating costs for open pit porphyry copper mines with flotation concentrators. For a sample of 27 proposed porphyry copper projects, capital costs can be estimated from three variables: mineral processing rate, strip ratio, and distance from nearest railroad before mine construction began. Of all the variables tested, operating costs were found to be significantly correlated only with strip ratio.

Costs and quality of life of patients with ankylosing spondylitis in Hong Kong.

Science.gov (United States)

Zhu, T Y; Tam, L-S; Lee, V W-Y; Hwang, W W; Li, T K; Lee, K K; Li, E K

2008-09-01

To assess the annual direct, indirect and total societal costs, quality of life (QoL) of AS in a Chinese population in Hong Kong and determine the cost determinants. A retrospective, non-randomized, cross-sectional study was performed in a cohort of 145 patients with AS in Hong Kong. Participants completed questionnaires on sociodemographics, work status and out-of-pocket expenses. Health resources consumption was recorded by chart review. Functional impairment and disease activity were measured using the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), respectively. Patients' QoL was assessed using the Short Form-36 (SF-36). The mean age of the patients was 40 yrs with mean disease duration of 10 yrs. The mean BASDAI score was 4.7 and BASFI score was 3.3. Annual total costs averaged USD 9120. Direct costs accounted for 38% of the total costs while indirect costs accounted for 62%. Costs of technical examinations represented the largest proportion of total cost. Patients with AS reported significantly impaired QoL. Functional impairment became the major cost driver of direct costs and total costs. There is a substantial societal cost related to the treatment of AS in Hong Kong. Functional impairment is the most important cost driver. Treatments that reduce functional impairment may be effective to decrease the costs of AS and improve the patient's QoL, and ease the pressure on the healthcare system.

Canadian nuclear power plant construction cost forecast and analysis

International Nuclear Information System (INIS)

Keng, C.W.K.

1985-01-01

Because of the huge volume of capital required to construct a modern electric power generating station, investment decisions have to be made with as complete an understanding of the consequence of the decision as possible. This understanding must be provided by the evaluation of the situation to take place in the future. This paper attempts to use an econometric method to forecast the construction costs escalation of a standard Canadian nuclear generating station (NGS). A review of the history of Canadian nuclear electric power is provided. The major components of the construction costs of a Canadian NGS are studied and summarized. A data base is built and indexes are prepared. Based on these indexes an econometric forecasting model is constructed using an apparently new econometric methodology of forecasting modelling. Forecasts for a period of forty years are generated and applications of alternative scenario forecasts and range forecasts to uncertainty assessment are demonstrated. The indexes, the model, and the forecasts and their applications, to the best of the author's knowledge, are the very first ever done for Canadian NGS constructions

What Does It Cost to Prevent On-Duty Firefighter Cardiac Events? A Content Valid Method for Calculating Costs

Directory of Open Access Journals (Sweden)

P. Daniel Patterson

2013-01-01

Full Text Available Cardiac arrest is a leading cause of mortality among firefighters. We sought to develop a valid method for determining the costs of a workplace prevention program for firefighters. In 2012, we developed a draft framework using human resource accounting and in-depth interviews with experts in the firefighting and insurance industries. The interviews produced a draft cost model with 6 components and 26 subcomponents. In 2013, we randomly sampled 100 fire chiefs out of >7,400 affiliated with the International Association of Fire Chiefs. We used the Content Validity Index (CVI to identify the content valid components of the draft cost model. This was accomplished by having fire chiefs rate the relevancy of cost components using a 4-point Likert scale (highly relevant to not relevant. We received complete survey data from 65 fire chiefs (65% response rate. We retained 5 components and 21 subcomponents based on CVI scores ≥0.70. The five main components include, (1 investment costs, (2 orientation and training costs, (3 medical and pharmaceutical costs, (4 education and continuing education costs, and (5 maintenance costs. Data from a diverse sample of fire chiefs has produced a content valid method for calculating the cost of a prevention program among firefighters.

Quality-Adjusted Cost Functions for Child-Care Centers.

OpenAIRE

Mocan, H Naci

1995-01-01

Using a newly compiled data set, this paper estimates multi- product translog cost functions for 399 child care centers from California, Colorado, Connecticut, and North Carolina. Quality of child care is controlled by a quality index, which has been shown to be positively related to child outcomes by previous research. Nonprofit centers that receive public money, either from the state or federal government, (which is tied to higher standards), have total variable costs that are 18 percent hi...

Quality Indexes and Feasibility Analysis of Traditional Dried Anchovy From Buru Island

Science.gov (United States)

Krisanta Enda Savitri, Imelda; Sormin, R. B. D.; Silaban, Bernita

2017-10-01

Dried anchovy is a prominent fishery product in Buru Island Maluku. It is produce traditionally in villages Batuboi and Siahoni at Kayeli bay. Drying process was done in open air under the sun directly during two days to produce dried anchovy with a prospective marketable. This preliminary research was aimed to investigated the quality indexes and business feasibility of dried anchovy produced by processor comunity. The quality index was found by laboratory analysis of sample dried anchovy referring to Indonesian National Standard. The data for feasibility analysis was found by interview and by using quesioner list. The average Quality indexes of dried anchovy as follows: Water 14.22 grams percent; Protein 55.68 grams percent; Fat 2.29 grams percent; Ash 9.02 grams percent; Total Bacteri (TPC) 3,5 × 102-; organoleptic value 7.79; E. coli, Salmonella and Mold were unidentified. Total cost of dried anchovy production is 37,050,720 Rupiahs/year with the income was 224,000,000 Rupiahs/year. Total profit is 217,824,880 Rupiahs/year and the Revenue Cost ratio was 6.05. Dried anchovy from Buru Island has a good quality and also has a good business feasibility.

Profitability of simple technical trading rules of Chinese stock exchange indexes

Science.gov (United States)

Zhu, Hong; Jiang, Zhi-Qiang; Li, Sai-Ping; Zhou, Wei-Xing

2015-12-01

Although technical trading rules have been widely used by practitioners in financial markets, their profitability still remains controversial. We here investigate the profitability of moving average (MA) and trading range break (TRB) rules by using the Shanghai Stock Exchange Composite Index (SHCI) from May 21, 1992 through December 31, 2013 and Shenzhen Stock Exchange Component Index (SZCI) from April 3, 1991 through December 31, 2013. The t-test is adopted to check whether the mean returns which are conditioned on the trading signals are significantly different from unconditioned returns and whether the mean returns conditioned on the buy signals are significantly different from the mean returns conditioned on the sell signals. We find that TRB rules outperform MA rules and short-term variable moving average (VMA) rules outperform long-term VMA rules. By applying White's Reality Check test and accounting for the data snooping effects, we find that the best trading rule outperforms the buy-and-hold strategy when transaction costs are not taken into consideration. Once transaction costs are included, trading profits will be eliminated completely. Our analysis suggests that simple trading rules like MA and TRB cannot beat the standard buy-and-hold strategy for the Chinese stock exchange indexes.

The Biodiversity Informatics Potential Index

Science.gov (United States)

2011-01-01

Background Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP) Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a) the intrinsic biodiversity potential (the biological richness or ecological diversity) of a country; (b) the capacity of the country to generate biodiversity data records; and (c) the availability of technical infrastructure in a country for managing and publishing such records. Methods Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF) network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Results Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most non-participant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. Conclusions The BIP Index could potentially help in (a) identifying countries most likely to

Computing discharge using the index velocity method

Science.gov (United States)

Levesque, Victor A.; Oberg, Kevin A.

2012-01-01

Application of the index velocity method for computing continuous records of discharge has become increasingly common, especially since the introduction of low-cost acoustic Doppler velocity meters (ADVMs) in 1997. Presently (2011), the index velocity method is being used to compute discharge records for approximately 470 gaging stations operated and maintained by the U.S. Geological Survey. The purpose of this report is to document and describe techniques for computing discharge records using the index velocity method. Computing discharge using the index velocity method differs from the traditional stage-discharge method by separating velocity and area into two ratings—the index velocity rating and the stage-area rating. The outputs from each of these ratings, mean channel velocity (V) and cross-sectional area (A), are then multiplied together to compute a discharge. For the index velocity method, V is a function of such parameters as streamwise velocity, stage, cross-stream velocity, and velocity head, and A is a function of stage and cross-section shape. The index velocity method can be used at locations where stage-discharge methods are used, but it is especially appropriate when more than one specific discharge can be measured for a specific stage. After the ADVM is selected, installed, and configured, the stage-area rating and the index velocity rating must be developed. A standard cross section is identified and surveyed in order to develop the stage-area rating. The standard cross section should be surveyed every year for the first 3 years of operation and thereafter at a lesser frequency, depending on the susceptibility of the cross section to change. Periodic measurements of discharge are used to calibrate and validate the index rating for the range of conditions experienced at the gaging station. Data from discharge measurements, ADVMs, and stage sensors are compiled for index-rating analysis. Index ratings are developed by means of regression

Printable photonic crystals with high refractive index for applications in visible light

International Nuclear Information System (INIS)

Calafiore, Giuseppe; Mejia, Camilo A; Munechika, Keiko; Peroz, Christophe; Piña-Hernandez, Carlos; Fillot, Quentin; Dhuey, Scott; Sassolini, Simone; Salvadori, Filippo; Cabrini, Stefano

2016-01-01

Nanoimprint lithography (NIL) of functional high-refractive index materials has proved to be a powerful candidate for the inexpensive manufacturing of high-resolution photonic devices. In this paper, we demonstrate the fabrication of printable photonic crystals (PhCs) with high refractive index working in the visible wavelengths. The PhCs are replicated on a titanium dioxide-based high-refractive index hybrid material by reverse NIL with almost zero shrinkage and high-fidelity reproducibility between mold and printed devices. The optical responses of the imprinted PhCs compare very well with those fabricated by conventional nanofabrication methods. This study opens the road for a low-cost manufacturing of PhCs and other nanophotonic devices for applications in visible light. (paper)

Amorphous silicon as high index photonic material

Science.gov (United States)

Lipka, T.; Harke, A.; Horn, O.; Amthor, J.; Müller, J.

2009-05-01

Silicon-on-Insulator (SOI) photonics has become an attractive research topic within the area of integrated optics. This paper aims to fabricate SOI-structures for optical communication applications with lower costs compared to standard fabrication processes as well as to provide a higher flexibility with respect to waveguide and substrate material choice. Amorphous silicon is deposited on thermal oxidized silicon wafers with plasma-enhanced chemical vapor deposition (PECVD). The material is optimized in terms of optical light transmission and refractive index. Different a-Si:H waveguides with low propagation losses are presented. The waveguides were processed with CMOS-compatible fabrication technologies and standard DUV-lithography enabling high volume production. To overcome the large mode-field diameter mismatch between incoupling fiber and sub-μm waveguides three dimensional, amorphous silicon tapers were fabricated with a KOH etched shadow mask for patterning. Using ellipsometric and Raman spectroscopic measurements the material properties as refractive index, layer thickness, crystallinity and material composition were analyzed. Rapid thermal annealing (RTA) experiments of amorphous thin films and rib waveguides were performed aiming to tune the refractive index of the deposited a-Si:H waveguide core layer after deposition.

Healthcare resource use and costs of multiple sclerosis patients in Germany before and during fampridine treatment.

Science.gov (United States)

Ziemssen, Tjalf; Prosser, Christine; Haas, Jennifer Scarlet; Lee, Andrew; Braun, Sebastian; Landsman-Blumberg, Pamela; Kempel, Angela; Gleißner, Erika; Patel, Sarita; Huang, Ming-Yi

2017-03-27

Multiple sclerosis (MS) patients often suffer from gait impairment and fampridine is indicated to medically improve walking ability in this population. Patient characteristics, healthcare resource use, and costs of MS patients on fampridine treatment for 12 months in Germany were analyzed. A retrospective claims database analysis was conducted including MS patients who initiated fampridine treatment (index date) between July 2011 and December 2013. Continuous insurance enrollment during 12 months pre- and post-index date was required, as was at least 1 additional fampridine prescription in the fourth quarter after the index date. Patient characteristics were evaluated and pre- vs post-index MS-related healthcare utilization and costs were compared. A total of 562 patients were included in this study. The mean (standard deviation [SD]) age was 50.5 (9.8) years and 63% were female. In the treatment period, almost every patient had at least 1 MS-related outpatient visit, 24% were hospitalized due to MS, and 79% utilized MS-specific physical therapy in addition to the fampridine treatment. Total MS-related healthcare costs were significantly higher in the fampridine treatment period than in the period prior to fampridine initiation (€17,392 vs €10,960, P treatment (€1,333 vs €1,565, P treatment. While healthcare costs were higher during fampridine treatment compared to the pre-treatment period, inpatient costs were lower. Further research is necessary to better understand the fampridine influence.

Coffee Index as Quick and Simple Indicator of Purchasing Power Parity

Directory of Open Access Journals (Sweden)

Jakub Fischer

2018-03-01

Full Text Available Purchasing Power Parity is the corner stone of all international comparisons. Various approaches to Purchasing Power Parity, such as the Big Mac Index, KFC Index, iPad Index, Tall Latte Index or Ikea Index were popularized to the broader audience besides the OECD Purchasing Power Parity indices. The aim of this paper is to develop a new ready-to-use quick and simple index based on the prices of Nespresso coffee’s capsules and show the main challenges of such indices as well as of the PPP concept. For the purpose of our research the data on the Nespresso capsules prices were collected. Taking into account also the popularity (demand side of the capsules types, the Espresso line was chosen as the basis for which all further calculations are made. The Nespresso Index provides us with clear evidence that the Law of One Price cannot work in recent world because of three key features. Firstly, differences in taxes make the perfect parity impossible. Secondly, the price discrimination prevents the rational subjects from arbitrage. Finally, the changes in the exchange rate make such indices highly volatile. Despite these weaknesses, the Nespresso Index could be used as the useful supplement of the OECD PPP as it is low cost, easy and fast to compute and digestible for the lay public.

Association of obesity with healthcare resource utilization and costs in a commercial population.

Science.gov (United States)

Kamble, Pravin S; Hayden, Jennifer; Collins, Jenna; Harvey, Raymond A; Suehs, Brandon; Renda, Andrew; Hammer, Mette; Huang, Joanna; Bouchard, Jonathan

2018-05-10

To examine the association of obesity with healthcare resource utilization (HRU) and costs among commercially insured individuals. This retrospective observational cohort study used administrative claims from 1 January 2007 to 1 December 2013. The ICD-9-CM status codes (V85 hierarchy) from 2008 to 2012 classified body mass index (BMI) into the World Health Organizations' BMI categories. The date of first observed BMI code was defined as the index date and continuous eligibility for one year pre- and post- index date was ensured. Post-index claims determined individuals' HRU and costs. Sampling weights developed using the entropy balance method and National Health and Nutrition Examination Survey data ensured representation of the US adult commercially insured population. Baseline characteristics were described across BMI classes and associations between BMI categories, and outcomes were examined using multivariable regression. The cohort included 9651 individuals with BMI V85 codes. After weighting, the BMI distribution was: normal (31.1%), overweight (33.4%), obese class I (22.0%), obese class II (8.1%) and obese class III (5.4%). Increasing BMI was associated with greater prevalence of cardiometabolic conditions, including hypertension, type 2 diabetes and metabolic syndrome. The use of antihypertensives, antihyperlipidemics, antidiabetics, analgesics and antidepressants rose with increasing BMI. Greater BMI level was associated with increased inpatient, emergency department and outpatient utilization, and higher total healthcare, medical and pharmacy costs. Increasing BMI was associated with higher prevalence of cardiometabolic conditions and higher HRU and costs. There is an urgent need to address the epidemic of obesity and its clinical and economic impacts.

Index of Free and Inexpensive Food and Nutrition Information Materials.

Science.gov (United States)

Gordon, Kathleen, Comp.; And Others

This annotated index contains approximately 2,000 free or inexpensive pamphlets or brochures about food and nutrition. The prime criterion for inclusion of materials was that they be easily available and inexpensive; the cut-off cost was set at $3.00. The majority of materials listed were produced in either Canada or the United States. These…

Allocation of Load-Loss Cost Caused by Voltage Sag

Science.gov (United States)

Gao, X.

2017-10-01

This paper focuses on the allocation of load-loss cost caused by voltage sag in the environment of electricity market. To compensate the loss of loads due to voltage sags, the load-loss cost is allocated to both sources and power consumers. On the basis of Load Drop Cost (LDC), a quantitative evaluation index of load-loss cost caused by voltage sag is identified. The load-loss cost to be allocated to power consumers themselves is calculated according to load classification. Based on the theory of power component the quantitative relation between sources and loads is established, thereby a quantitative calculation method for load-loss cost allocated to each source is deduced and the quantitative compensation from individual source to load is proposed. A simple five-bus system illustrates the main features of the proposed method.

The case for indexed price caps for U.S. electric utilities

International Nuclear Information System (INIS)

Lowry, M.N.

1991-01-01

Indexed price caps are a promising alternative to traditional, cost-of-service utility rate regulation. In just a decade, they have sprung from the drawing boards of economists to use by major utilities in a number of industries. Several authors have discussed the merits of indexed price caps for U.S. electric utilities. Despite their efforts, many parties to electric utility policy making are unfamiliar with the subject. This is unsurprising given the policy controversies that already embroil the industry. It is also unfortunate, since indexed price caps may help solve some of the problems that prompt these controversies. Indexed price caps can improve electric utility rate regulation in two ways. Utilities would have strong incentives to improve performance without the micromanagement that increasingly characterizes state-level regulation. Utilities could also be granted more extensive marketing freedoms, since indexes can protect customers from cross-subsidization. Two areas of concern about indexed price cap plans have emerged in recent discussions that the author has held with officials of electric utilities, intervenor groups, and regulatory agencies. Officials are often unclear on plan details, and therefore may not appreciate the degree of flexibility that is possible in plan design. Confusion over the available options in price cap adjustment indexes and the logic behind them is especially widespread. Officials also desire a clearer expression of how indexed price caps can coexist with current regulatory initiatives. This article details the major attributes of index plans, provides a brief history of indexing, discusses index design options in depth, and concludes with a vision of how indexed price caps can be made operational in today's electric utility industry

Assessment of transport performance index for urban transport development strategies — Incorporating residents' preferences

Energy Technology Data Exchange (ETDEWEB)

Ambarwati, Lasmini, E-mail: L.Ambarwati@tudelft.nl [Department of Transport and Planning, TU Delft (Netherlands); Department of Civil Engineering, Brawijaya University (Indonesia); Verhaeghe, Robert, E-mail: R.Verhaeghe@tudelft.nl [Department of Transport and Planning, TU Delft (Netherlands); Arem, Bart van, E-mail: B.vanArem@tudelft.nl [Department of Transport and Planning, TU Delft (Netherlands); Pel, Adam J., E-mail: A.J.Pel@tudelft.nl [Department of Transport and Planning, TU Delft (Netherlands)

2017-03-15

The performance of urban transport depends on a variety of factors related to metropolitan structure; in particular, the patterns of commuting, roads and public transport (PT) systems. To evaluate urban transport planning efforts, there is a need for a metric expressing the aggregate performance of the city's transport systems which should relate to residents' preferences. The existing metrics have typically focused on a measure to express the proximity of job locations to residences. A Transport Performance Index (TPI) is proposed in which the total cost of transportation system (operational and environmental costs) is divided by willingness to pay (WTP) for transport plus the willingness to accept (WTA) the environmental effects on residents. Transport operational as well as the environmental costs are derived from a simulation of all transport systems, to particular designs of spatial development. Willingness to pay for transport and willingness to accept the environmental effects are derived from surveys among residents. Simulations were modelled of Surabaya's spatial structure and public transport expansion. The results indicate that the current TPI is high, which will double by 2030. With a hypothetical polycentric city structure and adjusted job housing balance, a lower index occurs because of the improvements in urban transport performance. A low index means that the residents obtain much benefit from the alternative proposed. This illustrates the importance of residents' preferences in urban spatial planning in order to achieve efficient urban transport. Applying the index suggests that city authorities should provide fair and equitable public transport systems for suburban residents in the effort to control the phenomenon of urban sprawl. This index is certainly a good tool and prospective benchmark for measuring sustainability in relation to urban development.

Assessment of transport performance index for urban transport development strategies — Incorporating residents' preferences

International Nuclear Information System (INIS)

Ambarwati, Lasmini; Verhaeghe, Robert; Arem, Bart van; Pel, Adam J.

2017-01-01

The performance of urban transport depends on a variety of factors related to metropolitan structure; in particular, the patterns of commuting, roads and public transport (PT) systems. To evaluate urban transport planning efforts, there is a need for a metric expressing the aggregate performance of the city's transport systems which should relate to residents' preferences. The existing metrics have typically focused on a measure to express the proximity of job locations to residences. A Transport Performance Index (TPI) is proposed in which the total cost of transportation system (operational and environmental costs) is divided by willingness to pay (WTP) for transport plus the willingness to accept (WTA) the environmental effects on residents. Transport operational as well as the environmental costs are derived from a simulation of all transport systems, to particular designs of spatial development. Willingness to pay for transport and willingness to accept the environmental effects are derived from surveys among residents. Simulations were modelled of Surabaya's spatial structure and public transport expansion. The results indicate that the current TPI is high, which will double by 2030. With a hypothetical polycentric city structure and adjusted job housing balance, a lower index occurs because of the improvements in urban transport performance. A low index means that the residents obtain much benefit from the alternative proposed. This illustrates the importance of residents' preferences in urban spatial planning in order to achieve efficient urban transport. Applying the index suggests that city authorities should provide fair and equitable public transport systems for suburban residents in the effort to control the phenomenon of urban sprawl. This index is certainly a good tool and prospective benchmark for measuring sustainability in relation to urban development.

Investing in Port Infrastructure to Lower Trade Costs in East Asia

Directory of Open Access Journals (Sweden)

Kazutomo Abe

2011-06-01

Full Text Available We examine how port infrastructure affects trade and role of transport costs in driving exports and imports for East Asia. Existing studies use survey indexes to explain transport costs. These do not link investment in port infrastructure to transport costs. We include in our estimates a variable to represent the congestion of the ports to explain the transport costs. We find that the port congestion has significantly increased the transport costs from East Asia to the United States. Our analysis suggests that increase in port capacity by 10 percent could cut transport cost in East Asia by up to three percent. This translates into a 0.3 to 0.5 percent across-the-board tariff cut.

[Profitability of a day hospital: analysis of activity, cost and effectiveness].

Science.gov (United States)

Hernando Ortiz, Lili; Hinojosa Mena-Bernal, Carmen; González Sarmiento, Enrique; González Guilabert, Isabel; Arana Ruiz, Jorge; Muñoz Moreno, M Fe

2012-01-01

Day hospitals are an alternative to conventional hospital care. We analyzed the functioning and profitability of the day hospital of Hospital Clínico de Valladolid, Spain, in 2009. Profitability is expressed as the provision of identical health coverage at a lower cost than that generated by conventional hospital care and with adequate quality indicators. We performed a retrospective, observational and descriptive study of the information obtained on each patient attended in the day hospital from January 1 to December 31, 2009. We studied four quality indicators: cancellation of meetings, the rate of transfusion reactions, the out-patient rate and the satisfaction index. The estimated savings for each process was calculated as the difference in the average cost of hospitalization minus the average cost of the process in the day hospital. The most frequent diseases were systemic and connective tissue diseases, accounting for 25.4% of the processes treated; of these, 17.1% corresponded to rheumatoid arthritis. Patient satisfaction was 93%. Meetings cancellations and the rate of transfusion reactions were 0%. The out-patient rate was 26%. Day hospital costs were 8.6% of conventional hospital costs, with savings of 78,390.69 euros. The day hospital is cost effective due to savings compared with conventional hospitalization and has a satisfactory quality index. Copyright © 2011 SESPAS. Published by Elsevier España, S.L. All rights reserved.

Plant and equipment division laboratory services series: a ten-year building-maintenance cost history

International Nuclear Information System (INIS)

Keesee, H.F.

1976-09-01

Maintaining a multifacility national laboratory in a safe, reliable condition is a complex management responsibility in terms of budgets, costs, and proper utilization of personnel and material resources. Increasing wage rates and material costs, combined with decreased budgets and aging facilities, create unusual challenges to maintenance managers. A ten-year history of building-maintenance costs, a brief description of the maintenance program, analyses of personnel requirements, cost increase indexes, unit costs, cost controls, procedures, and a brief discussion of alterations and improvements are presented

A spatio-temporal index for aerial full waveform laser scanning data

Science.gov (United States)

Laefer, Debra F.; Vo, Anh-Vu; Bertolotto, Michela

2018-04-01

behaviours of the hybrid indexing for AA and NAA clipping windows are attributable to the different proportion of the local-index-related overheads with respect to the total querying costs. When temporal constraints were added, generally the number of costly spatial checks were reduced, thereby shortening the querying times.

A cohort analysis of nuclear generation cost data

International Nuclear Information System (INIS)

Ono, Kenji; Nakamura, Takashi

2002-01-01

At the Nuclear Energy Information Center of the Central Research Institute of Electric Power Industry, Ltd., cost analysis of nuclear power generation has been carried out. In general, it is frequently carried out to analyze timely changing trends on various indexes on management of power stations such as annual O and M (operation and management) costs, apparatus using ratio, and so on, in nuclear power stations. Main aims of such analyses are to obtain knowledge useful for future policies and management decision making by grasping factors causing such changes to evaluate effects based on them as quantitatively as possible. Effects of the timely changing factors on various indexes on management of power stations can consider by dividing them to three types shown as follows; (1) effects of every years, (2) effects of every elapsed years, and (3) effects of operation beginning year. By separating these three effects to evaluate them, grasping of factors at background of the changes and their quantitative evaluations can be carried out more correctly, to be expected to obtain more useful knowledge. Here were described results applied on engineering method called by the 'Bayes type Cohort model' developed at a field of social science to trend analysis on indexes of such power stations. (G.K.)

Analysis of Cost of Rework on Time and Cost Performance of Building Construction Projects in Abuja, Nigeria

Directory of Open Access Journals (Sweden)

Emmanuel Chidiebere Eze

2018-01-01

Full Text Available Rework is a menace that leads to undesired and unnecessary loss of efforts, it degrades project cost and schedule performance of construction projects, both at design and construction phases. This study therefore, analyzed the impact of cost of rework on time and cost performance of building construction projects in Nigerian, using selected commercial building project within the country’s capital. A pro forma was adopted for gathering data on rework cost, project cost and time of selected building projects, while structured questionnaire was used to collect information on the likely measures for reducing rework incidences from construction professionals that were involved in the delivery of the identified projects. Regression analysis, relative importance index and Kruskal-Walis test were employed for data analysis. The study revealed a significant relationship between the cost of rework and initial and final project cost of delivering commercial buildings, as an average of 3.53% impact on the initial project cost, 46.60% contribution to cost overrun, and p-value of 0.000 was observed on all assessed projects. For the project delivery time, a significant relationship between the cost of rework and initial and final project duration, as an average of 7.35% impact on the initial delivery time, extra 19 days and p-value of 0.000 was observed on all assessed projects. Team building and education, management commitment, employee involvement, were some of the best possible measures to minimized rework problems.

Indirect costs of teaching in Canadian hospitals.

Science.gov (United States)

MacKenzie, T A; Willan, A R; Cox, M A; Green, A

1991-01-01

We sought to determine whether there are indirect costs of teaching in Canadian hospitals. To examine cost differences between teaching and nonteaching hospitals we estimated two cost functions: cost per case and cost per patient-day (dependent variables). The independent variables were number of beds, occupancy rate, teaching ratio (number of residents and interns per 100 beds), province, urbanicity (the population density of the county in which the hospital was situated) and wage index. Within each hospital we categorized a random sample of patient discharges according to case mix and severity of illness using age and standard diagnosis and procedure codes. Teaching ratio and case severity were each highly correlated positively with the dependent variables. The other variables that led to higher costs in teaching hospitals were wage rates and number of beds. Our regression model could serve as the basis of a reimbursement system, adjusted for severity and teaching status, particularly in provinces moving toward introducing case-weighting mechanisms into their payment model. Even if teaching hospitals were paid more than nonteaching hospitals because of the difference in the severity of illness there should be an additional allowance to cover the indirect costs of teaching. PMID:1898870

Impact of initiation of asenapine on patterns of utilization and cost of healthcare resources associated with the treatment of bipolar I disorder.

Science.gov (United States)

Chitnis, Abhishek; Wang, Rosa; Sun, Shawn X; Dixit, Shailja; Tawah, Alie; Boulanger, Luke

2015-01-01

To assess the impact of initiation of asenapine on "real-world" levels of utilization and cost of healthcare services for the treatment of bipolar I disorder (BPD) in the US. Using two large US healthcare claims databases that collectively included commercially insured patients aged a BPD diagnosis, plus psychiatric medications and the costs thereof (2012 dollars) were deemed 'BPD-related'. Differences in BPD-related utilization and cost of healthcare services were compared between the pre- and post-index periods. A total of 1403 patients met all selection criteria; the mean age was 42.8 years and 70.6% were women. Relative to pre-index, significant decreases were noted in post-index use of BPD-related healthcare services, most notably admissions (from 24.0% to 12.3% during the post-index period) and emergency department visits (from 4.6% to 2.6%) (both p levels of utilization of BPD-related healthcare services and costs decreased during the 6-month period immediately following initiation of asenapine therapy.

A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted.

Directory of Open Access Journals (Sweden)

Peter J Neumann

Full Text Available Calculating the cost per disability-adjusted life years (DALYs averted associated with interventions is an increasing popular means of assessing the cost-effectiveness of strategies to improve population health. However, there has been no systematic attempt to characterize the literature and its evolution.We conducted a systematic review of cost-effectiveness studies reporting cost-per-DALY averted from 2000 through 2015. We developed the Global Health Cost-Effectiveness Analysis (GHCEA Registry, a repository of English-language cost-per-DALY averted studies indexed in PubMed. To identify candidate studies, we searched PubMed for articles with titles or abstracts containing the phrases "disability-adjusted" or "DALY". Two reviewers with training in health economics independently reviewed each article selected in our abstract review, gathering information using a standardized data collection form. We summarized descriptive characteristics on study methodology: e.g., intervention type, country of study, study funder, study perspective, along with methodological and reporting practices over two time periods: 2000-2009 and 2010-2015. We analyzed the types of costs included in analyses, the study quality on a scale from 1 (low to 7 (high, and examined the correlation between diseases researched and the burden of disease in different world regions.We identified 479 cost-per-DALY averted studies published from 2000 through 2015. Studies from Sub-Saharan Africa comprised the largest portion of published studies. The disease areas most commonly studied were communicable, maternal, neonatal, and nutritional disorders (67%, followed by non-communicable diseases (28%. A high proportion of studies evaluated primary prevention strategies (59%. Pharmaceutical interventions were commonly assessed (32% followed by immunizations (28%. Adherence to good practices for conducting and reporting cost-effectiveness analysis varied considerably. Studies mainly included

I Evolution of Environmental Costs Discolsur: A Study in Cellulose and Paper Companies - Members of Corporate Sustainability Index - CSI

Directory of Open Access Journals (Sweden)

Daniel Fonseca

2016-07-01

Full Text Available This research aimed to analyse, in relation to previous studies, the evolution of classification and disclosure of environmental costs on cellulose and paper companies listed on the CSI. The research, of a descriptive, documentary and qualitative nature, was based on content analysis of financial statements, accompanying notes, management reports and sustainability reports in the fiscal years 2010 to 2014. The results indicate that companies show environmental costs mainly in a qualitative way and of the positive type. The most part of this information is contained in the sustainability report. As to the classification, the highlighted environmental costs are of these types, (a prevention costs; (b internal failure costs; (c indirect costs; (d internal costs; (e costs for contingencies; (f potentially hidden costs; (g image and relationship costs, though not by these names. These results demonstrate a change, compared to previous studies on the quality and quantity of disclosure of environmental costs. It is suggested for future research the broadening of samples for other organizational activity sectors, with the aim of possible understanding of the Brazilian environment.

Genotype-covariate interaction effects and the heritability of adult body mass index

NARCIS (Netherlands)

Robinson, Matthew R.; English, Geoffrey; Moser, Gerhard; Lloyd-Jones, Luke R; Triplett, Marcus A; Zhu, Zhihong; Nolte, Ilja M; van Vliet-Ostaptchouk, Jana V; Snieder, Harold; Esko, Tonu; Milani, Lili; Mägi, Reedik; Metspalu, Andres; Magnusson, Patrik K. E.; Pedersen, Nancy L.; Ingelsson, Erik; Johannesson, Magnus; Yang, Jian; Cesarini, David; Visscher, Peter M.

Obesity is a worldwide epidemic, with major health and economic costs. Here we estimate heritability for body mass index (BMI) in 172,000 sibling pairs and 150,832 unrelated individuals and explore the contribution of genotype-covariate interaction effects at common SNP loci. We find evidence for

The Non-Linear Relationship between BMI and Health Care Costs and the Resulting Cost Fraction Attributable to Obesity.

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Laxy, Michael; Stark, Renée; Peters, Annette; Hauner, Hans; Holle, Rolf; Teuner, Christina M

2017-08-30

This study aims to analyse the non-linear relationship between Body Mass Index (BMI) and direct health care costs, and to quantify the resulting cost fraction attributable to obesity in Germany. Five cross-sectional surveys of cohort studies in southern Germany were pooled, resulting in data of 6757 individuals (31-96 years old). Self-reported information on health care utilisation was used to estimate direct health care costs for the year 2011. The relationship between measured BMI and annual costs was analysed using generalised additive models, and the cost fraction attributable to obesity was calculated. We found a non-linear association of BMI and health care costs with a continuously increasing slope for increasing BMI without any clear threshold. Under the consideration of the non-linear BMI-cost relationship, a shift in the BMI distribution so that the BMI of each individual is lowered by one point is associated with a 2.1% reduction of mean direct costs in the population. If obesity was eliminated, and the BMI of all obese individuals were lowered to 29.9 kg/m², this would reduce the mean direct costs by 4.0% in the population. Results show a non-linear relationship between BMI and health care costs, with very high costs for a few individuals with high BMI. This indicates that population-based interventions in combination with selective measures for very obese individuals might be the preferred strategy.

What can we learn from international comparisons of costs by DRG?

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Pirson, M; Schenker, L; Martins, D; Dung, Duong; Chalé, J J; Leclercq, P

2013-02-01

The objective of this study was to compare costs data by diagnosis related group (DRG) between Belgium and Switzerland. Our hypotheses were that differences between countries can probably be explained by methodological differences in cost calculations, by differences in medical practices and by differences in cost structures within the two countries. Classifications of DRG used in the two countries differ (AP-DRGs version 1.7 in Switzerland and APR-DRGs version 15.0 in Belgium). The first step of this study was to transform Belgian summaries into Swiss AP-DRGs. Belgian and Swiss data were calculated with a clinical costing methodology (full costing). Belgian and Swiss costs were converted into US$ PPP (purchasing power parity) in order to neutralize differences in purchasing power between countries. The results of this study showed higher costs in Switzerland despite standardization of cost data according to PPP. The difference is not explained by the case-mix index because this was similar for inliers between the two countries. The length of stay (LOS) was also quite similar for inliers between the two countries. The case-mix index was, however, higher for high outliers in Belgium, as reflected in a higher LOS for these patients. Higher costs in Switzerland are thus probably explained mainly by the higher number of agency staff by service in this country or because of differences in medical practices. It is possible to make international comparisons but only if there is standardization of the case-mix between countries and only if comparable accountancy methodologies are used. Harmonization of DRGs groups, nomenclature and accountancy is thus required.

Low-cost multispectral imaging for remote sensing of lettuce health

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Ren, David D. W.; Tripathi, Siddhant; Li, Larry K. B.

2017-01-01

In agricultural remote sensing, unmanned aerial vehicle (UAV) platforms offer many advantages over conventional satellite and full-scale airborne platforms. One of the most important advantages is their ability to capture high spatial resolution images (1-10 cm) on-demand and at different viewing angles. However, UAV platforms typically rely on the use of multiple cameras, which can be costly and difficult to operate. We present the development of a simple low-cost imaging system for remote sensing of crop health and demonstrate it on lettuce (Lactuca sativa) grown in Hong Kong. To identify the optimal vegetation index, we recorded images of both healthy and unhealthy lettuce, and used them as input in an expectation maximization cluster analysis with a Gaussian mixture model. Results from unsupervised and supervised clustering show that, among four widely used vegetation indices, the blue wide-dynamic range vegetation index is the most accurate. This study shows that it is readily possible to design and build a remote sensing system capable of determining the health status of lettuce at a reasonably low cost (lettuce growers.

A Study to Compare the Cost of Operation and Maintenance in Green Building Index (GBI and Non-Green Building Index (Non-GBI Rated Building in Malaysia

Directory of Open Access Journals (Sweden)

Ping Lee Zheng

2016-01-01

Full Text Available Urges for sustainable development had pushed the government and professional bodies to respond and react by implementing regulations where possible to direct development in that manner. However, the outcome in most financial conferences and dialogues on sustainable buildings flagged on high construction and maintenance cost. Thus, this study is conducted to collect and analyze actual building operation and maintenance cost between GBI and Non-GBI rated buildings in Malaysia which are more than 2 years fully operated buildings. There are two categories of selected buildings which are residential and non-residential type of building. Each category of the building consists of similar building’s characteristic such as geographic location, mode of operation, building heights, total numbers of floors and units. The scope of building’s maintenance for this study is mainly on wear and tear of the wall painting, electrical light fittings, ceiling panels, roofing system and mechanical services like water pump system are recorded for their replacement frequency of service and the cost involved within a consistent period of 12 months operation at cost percentage saving of 78.9% and 40.4% for residential and non-residential buildings respectively compare against Non-GBI rated buildings. Electricity consumption for GBI rated buildings are lower than Non-GBI rated buildings which recorded at the cost variance of 23.8% and 6.3% and water consumption at 35.9% and 44.0% for the above mentioned two main categories of selected case study buildings. Results from this study conclude major savings on residential buildings category in term of maintenance cost and electricity consumption for GBI rated buildings. Whereby, non-residential category of buildings, GBI rated building had been proven to obtain significant savings in terms of maintenance cost and water consumption.

Cost and consequences of noncompliance with osteoporosis treatment among women initiating therapy.

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Modi, Ankita; Siris, Ethel S; Tang, Jackson; Sen, Shuvayu

2015-04-01

The objective was to evaluate compliance with osteoporosis (OP) treatments and determine the fracture and healthcare burden associated with noncompliance. This retrospective analysis of a US claims database identified women initiating an OP medication from 1 January 2002 to 30 June 2009. Patients were ≥55 years and had ≥1 pharmacy claim for a bisphosphonate or non-bisphosphonate (raloxifene, calcitonin, teriparatide); the index date was the first pharmacy claim. There were three study periods: baseline (12 months pre-index); compliance period (0-12 months post-index); and follow-up period (12-24 months post-index). Medication possession ratio (MPR) was calculated during the compliance period to differentiate two cohorts: compliant (MPR ≥ 80%) and noncompliant (MPR costs), all adjusted for patient demographic and clinical characteristics. Overall, 685,505 women initiating OP therapy were identified and 57,913 (8.4%) met the inclusion criteria: only 23,430 (40.5%) were compliant and 34,483 (59.5%) were noncompliant. Mean age was 64 years. Noncompliance was associated with a 20% higher risk of any fracture (odds ratio: 1.20, 95% CI = 1.07-1.35), a higher incidence rate ratio (IRR) for inpatient utilization (IRR: 1.26, 95% CI = 1.19-1.34) and a lower rate of outpatient utilization (IRR: 0.97, 95% CI = 0.95-0.98). Noncompliant patients had 13% higher medical costs (cost ratio: 1.13, 95% CI = 1.06-1.21) than compliant patients. Inclusion in this study required 36 months of continuous healthcare coverage. Thus, the results are primarily applicable to a stable, managed care population and may not be generalizable to other populations. Noncompliance with OP therapy was associated with a higher risk of fracture, higher all-cause medical costs and a higher frequency of inpatient service utilization. Additional research is needed to identify barriers to compliance with OP therapy.

The environmental cost of a reference withdrawal from surface waters: Definition and geography

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Soligno, Irene; Ridolfi, Luca; Laio, Francesco

2017-12-01

World freshwater ecosystems are significantly deteriorating at a faster rate than other ecosystems. Water withdrawals are recognized as one of the main drivers of growing water stress in river basins worldwide. Over the years, much effort has been devoted to quantify water withdrawals at a global scale; however, comparisons are not simple because the uneven spatiotemporal distribution of surface water resources entails that the same amount of consumed water does not have the same environmental cost in different times or places. In order to account for this spatiotemporal heterogeneity, this work proposes a novel index to assess the environmental cost of a withdrawal from a generic river section. The index depends on (i) the environmental relevance of the impacted fluvial ecosystem (e.g., bed-load transport capacity, width of the riparian belt, biodiversity richness) and (ii) the downstream river network affected by the water withdrawal. The environmental cost has been estimated in each and every river section worldwide considering a reference withdrawal. Being referred to a unitary reference withdrawal that can occur in any river section worldwide, our results can be suitably arranged for describing any scenario of surface water consumption (i.e., as the superposition of the actual pattern of withdrawals). The index aims to support the interpretation of the volumetric measure of surface water withdrawal with a perspective that takes into account the fluvial system where the withdrawal actually occurs. The application of the index highlights the river regions where withdrawals can cause higher environmental costs, with the challenge of weighting each water withdrawal considering the responsibilities that it has on downstream freshwater ecosystems.

Health care costs of adults treated for attention-deficit/hyperactivity disorder who received alternative drug therapies.

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Wu, Eric Q; Birnbaum, Howard G; Zhang, Huabin F; Ivanova, Jasmina I; Yang, Elaine; Mallet, David

2007-09-01

Many therapies exist for treating adult attention-deficit/hyperactivity disorder (ADHD), also referred to as attention-deficit disorder (ADD), but there is no research regarding cost differences associated with initiating alternative ADD/ADHD drug therapies in adults. To compare from the perspective of a large self-insured employer the risk-adjusted direct health care costs associated with 3 alternative drug therapies for ADD in newly treated patients: extended-release methylphenidate (osmotic release oral system-MPH), mixed amphetamine salts extended release (MAS-XR), or atomoxetine. We analyzed data from a US claims database of 5 million beneficiaries from 31 large self-insured employers (1999-2004). Analysis was restricted to adults aged 18 to 64 years with at least 1 diagnosis of ADD/ADHD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 314.0x--attention deficit disorder; 314.00--attention deficit disorder without hyperactivity; or 314.01--attention-deficit disorder with hyperactivity) and at least 1 pharmacy claim for OROS-MPH, MAS-XR, or atomoxetine identified using National Drug Codes. In preliminary analysis, we calculated the duration of index ADHD drug therapy as time from index therapy initiation to a minimum 60-day gap. Because the median duration of index ADHD drug therapy was found to be approximately 90 days, the primary measures were total direct medical plus drug costs and medical-only costs computed over 6 months following therapy initiation. Adults were required to have continuous eligibility 6 months before and 6 months after their latest drug therapy initiation and no ADHD therapy during the previous 6 months. Cost was measured as the payment amount made by the health plan to the provider rather than billed charges, and it excluded patient copayments and deductibles. Medical costs included costs incurred for all-cause inpatient and outpatient/other services. Costs were adjusted for inflation to

Monetary Diet Cost, Diet Quality, and Parental Socioeconomic Status in Spanish Youth.

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Helmut Schröder

Full Text Available Using a food-based analysis, healthy dietary patterns in adults are more expensive than less healthy ones; studies are needed in youth. Therefore, the objective of the present study was to determine relationships between monetary daily diet cost, diet quality, and parental socioeconomic status.Data were obtained from a representative national sample of 3534 children and young people in Spain, aged 2 to 24 years. Dietary assessment was performed with a 24-hour recall. Mediterranean diet adherence was measured by the KIDMED questionnaire. Average food cost was calculated from official Spanish government data. Monetary daily diet cost was expressed as euros per day (€/d and euros per day standardized to a 1000kcal diet (€/1000kcal/d.Mean monetary daily diet cost was 3.16±1.57€/d (1.56±0.72€/1000kcal/d. Socioeconomic status was positively associated with monetary daily diet cost and diet quality measured by the KIDMED index (€/d and €/1000kcal/d, p<0.019. High Mediterranean diet adherence (KIDMED score 8-12 was 0.71 €/d (0.28€/1000kcal/d more expensive than low compliance (KIDMED score 0-3. Analysis for nonlinear association between the KIDMED index and monetary daily diet cost per1000kcal showed no further cost increases beyond a KIDMED score of 8 (linear p<0.001; nonlinear p = 0.010.Higher monetary daily diet cost is associated with healthy eating in Spanish youth. Higher socioeconomic status is a determinant for higher monetary daily diet cost and quality.

Monetary Diet Cost, Diet Quality, and Parental Socioeconomic Status in Spanish Youth

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Ribas-Barba, Lourdes; Pérez-Rodrigo, Carmen; Bawaked, Rowaedh Ahmed; Fíto, Montserrat; Serra-Majem, Lluis

2016-01-01

Background Using a food-based analysis, healthy dietary patterns in adults are more expensive than less healthy ones; studies are needed in youth. Therefore, the objective of the present study was to determine relationships between monetary daily diet cost, diet quality, and parental socioeconomic status. Design and Methods Data were obtained from a representative national sample of 3534 children and young people in Spain, aged 2 to 24 years. Dietary assessment was performed with a 24-hour recall. Mediterranean diet adherence was measured by the KIDMED questionnaire. Average food cost was calculated from official Spanish government data. Monetary daily diet cost was expressed as euros per day (€/d) and euros per day standardized to a 1000kcal diet (€/1000kcal/d). Results Mean monetary daily diet cost was 3.16±1.57€/d (1.56±0.72€/1000kcal/d). Socioeconomic status was positively associated with monetary daily diet cost and diet quality measured by the KIDMED index (€/d and €/1000kcal/d, pdiet adherence (KIDMED score 8–12) was 0.71 €/d (0.28€/1000kcal/d) more expensive than low compliance (KIDMED score 0–3). Analysis for nonlinear association between the KIDMED index and monetary daily diet cost per1000kcal showed no further cost increases beyond a KIDMED score of 8 (linear pdiet cost is associated with healthy eating in Spanish youth. Higher socioeconomic status is a determinant for higher monetary daily diet cost and quality. PMID:27622518

Valuation of Index-Linked Cash Flows in a Heath–Jarrow–Morton Framework

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Jonas Alm

2015-09-01

Full Text Available In this paper, we study the valuation of stochastic cash flows that exhibit dependence on interest rates. We focus on insurance liability cash flows linked to an index, such as a consumer price index or wage index, where changes in the index value can be partially understood in terms of changes in the term structure of interest rates. Insurance liability cash flows that are not explicitly linked to an index may still be valued in our framework by interpreting index returns as so-called claims inflation, i.e., an increase in claims cost per sold insurance contract. We focus primarily on the case when a deep and liquid market for index-linked contracts is absent or when the market price data are unreliable. Firstly, we present an approach for assigning a monetary value to a stochastic cash flow that does not require full knowledge of the joint dynamics of the cash flow and the term structure of interest rates. Secondly, we investigate in detail model selection, estimation and validation in a Heath–Jarrow–Morton framework. Finally, we analyze the effects of model uncertainty on the valuation of the cash flows and how forecasts of cash flows and interest rates translate into model parameters and affect the valuation.

Rural Hospital Wages and the Area Wage Index

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Dalton, Kathleen; Slifkin, Rebecca T.; Howard, Hilda A.

2002-01-01

We examined data on hospital hourly wages and the prospective payment system (PPS) wage index from 1990 to 1997, to determine if incremental changes to the index have improved its precision and equity as a regional cost adjuster. The differential between average rural and urban PPS hourly wages has declined by almost one-fourth over the 8-year study period. Nearly one-half of the decrease is attributable to regulatory and reporting changes in the annual hospital wage survey. Patterns of within-market wage variation across rural-urban continuum codes identify three separate sub-markets within the State-level aggregates defining rural labor markets. Geographic reclassification decisions appear to eliminate one of the three. Remaining systematic within-market rural wage differences work to the reimbursement advantage of hospitals in the smaller and more isolated communities. PMID:12545604

Is expanding Medicare coverage cost-effective?

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Muennig Peter

2005-03-01

Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

Indexes of large genome collections on a PC.

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Agnieszka Danek

Full Text Available The availability of thousands of individual genomes of one species should boost rapid progress in personalized medicine or understanding of the interaction between genotype and phenotype, to name a few applications. A key operation useful in such analyses is aligning sequencing reads against a collection of genomes, which is costly with the use of existing algorithms due to their large memory requirements. We present MuGI, Multiple Genome Index, which reports all occurrences of a given pattern, in exact and approximate matching model, against a collection of thousand(s genomes. Its unique feature is the small index size, which is customisable. It fits in a standard computer with 16-32 GB, or even 8 GB, of RAM, for the 1000GP collection of 1092 diploid human genomes. The solution is also fast. For example, the exact matching queries (of average length 150 bp are handled in average time of 39 µs and with up to 3 mismatches in 373 µs on the test PC with the index size of 13.4 GB. For a smaller index, occupying 7.4 GB in memory, the respective times grow to 76 µs and 917 µs. Software is available at http://sun.aei.polsl.pl/mugi under a free license. Data S1 is available at PLOS One online.

42 CFR 413.40 - Ceiling on the rate of increase in hospital inpatient costs.

Science.gov (United States)

2010-10-01

... October 1, 2002, is the percentage increase projected by the hospital market basket index. (4) Target... target amount for the previous cost reporting period, updated by the market basket percentage increase... each cost reporting period, the ceiling is determined by multiplying the updated target amount, as...

Population-based rare variant detection via pooled exome or custom hybridization capture with or without individual indexing.

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Ramos, Enrique; Levinson, Benjamin T; Chasnoff, Sara; Hughes, Andrew; Young, Andrew L; Thornton, Katherine; Li, Allie; Vallania, Francesco L M; Province, Michael; Druley, Todd E

2012-12-06

Rare genetic variation in the human population is a major source of pathophysiological variability and has been implicated in a host of complex phenotypes and diseases. Finding disease-related genes harboring disparate functional rare variants requires sequencing of many individuals across many genomic regions and comparing against unaffected cohorts. However, despite persistent declines in sequencing costs, population-based rare variant detection across large genomic target regions remains cost prohibitive for most investigators. In addition, DNA samples are often precious and hybridization methods typically require large amounts of input DNA. Pooled sample DNA sequencing is a cost and time-efficient strategy for surveying populations of individuals for rare variants. We set out to 1) create a scalable, multiplexing method for custom capture with or without individual DNA indexing that was amenable to low amounts of input DNA and 2) expand the functionality of the SPLINTER algorithm for calling substitutions, insertions and deletions across either candidate genes or the entire exome by integrating the variant calling algorithm with the dynamic programming aligner, Novoalign. We report methodology for pooled hybridization capture with pre-enrichment, indexed multiplexing of up to 48 individuals or non-indexed pooled sequencing of up to 92 individuals with as little as 70 ng of DNA per person. Modified solid phase reversible immobilization bead purification strategies enable no sample transfers from sonication in 96-well plates through adapter ligation, resulting in 50% less library preparation reagent consumption. Custom Y-shaped adapters containing novel 7 base pair index sequences with a Hamming distance of ≥2 were directly ligated onto fragmented source DNA eliminating the need for PCR to incorporate indexes, and was followed by a custom blocking strategy using a single oligonucleotide regardless of index sequence. These results were obtained aligning raw

Population-based rare variant detection via pooled exome or custom hybridization capture with or without individual indexing

Directory of Open Access Journals (Sweden)

Ramos Enrique

2012-12-01

Full Text Available Abstract Background Rare genetic variation in the human population is a major source of pathophysiological variability and has been implicated in a host of complex phenotypes and diseases. Finding disease-related genes harboring disparate functional rare variants requires sequencing of many individuals across many genomic regions and comparing against unaffected cohorts. However, despite persistent declines in sequencing costs, population-based rare variant detection across large genomic target regions remains cost prohibitive for most investigators. In addition, DNA samples are often precious and hybridization methods typically require large amounts of input DNA. Pooled sample DNA sequencing is a cost and time-efficient strategy for surveying populations of individuals for rare variants. We set out to 1 create a scalable, multiplexing method for custom capture with or without individual DNA indexing that was amenable to low amounts of input DNA and 2 expand the functionality of the SPLINTER algorithm for calling substitutions, insertions and deletions across either candidate genes or the entire exome by integrating the variant calling algorithm with the dynamic programming aligner, Novoalign. Results We report methodology for pooled hybridization capture with pre-enrichment, indexed multiplexing of up to 48 individuals or non-indexed pooled sequencing of up to 92 individuals with as little as 70 ng of DNA per person. Modified solid phase reversible immobilization bead purification strategies enable no sample transfers from sonication in 96-well plates through adapter ligation, resulting in 50% less library preparation reagent consumption. Custom Y-shaped adapters containing novel 7 base pair index sequences with a Hamming distance of ≥2 were directly ligated onto fragmented source DNA eliminating the need for PCR to incorporate indexes, and was followed by a custom blocking strategy using a single oligonucleotide regardless of index sequence

Pengaruh Pengungkapan Corporate Social Responsibility terhadap Cost Of Equity Perusahaan

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Mitta Ariyani

2016-06-01

The purpose of this study is to investigate the effect of Corporate Social Responsibility (CSR Disclosure on Cost of Equity Capital. CSR disclosure index is measured based on Global Reporting Initiative standards, while Cost of Equity Capital is measured by Capital Asset Pricing Model (CAPM. This study uses manufacturing companies which is listed on Indonesia Stock Exchange (IDX in 2010. By purposive sampling, this research obtained 72 companies as a samples. The control variables used are financial leverage and firm size. Multiple regression analysis by SPSS 16 was run for testing the hypothesis. The result show that CSR disclosure and financial leverage have no effect to Cost of Equity. Then, firm size have positive effect to Cost of Equity.

Acute pediatric stroke: contributors to institutional cost.

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Turney, Colin M; Wang, Wei; Seiber, Eric; Lo, Warren

2011-11-01

Recent studies examined the overall cost of pediatric stroke, but there are little data regarding the sources of these costs. We examined an administrative database that collected charges from 24 US children's hospitals to determine the sources of costs for acute hospital care of stroke. We used International Classification of Diseases, 9th Revision codes to search the Pediatric Health Information System. From 2003 to 2009 there were 1667 patients who had a primary diagnosis of stroke, 703 of which were hemorrhagic and 964 were ischemic. Individual costs, excluding physician charges, were gathered under 7 categories that were ranked to determine which contributed the most to total cost. Individual costs were ranked within their categories. We analyzed costs based on stroke type. Total costs were adjusted using the US Consumer Price Index to compare increases with the rate of inflation. Median total cost for any stroke was $19,548 (interquartile range, $10,764-$40,721). The category "other/nursing" contributed the most to hospital costs followed by imaging, laboratory, and pharmacy. Brain MRI and CT contributed the most to imaging costs. Hemorrhagic strokes (median $24,843) were more expensive than ischemic strokes (median $16,954). Total cost increased from 2003 to 2009, but no overall annual trend emerged after controlling for gender, age, race, and hospital. This is the first in-depth analysis of cost for pediatric stroke care. The highest cost categories are potential targets for cost containment but are also crucial for effective diagnosis and treatment. Necessary yet prudent use of imaging technologies and inpatient stays may be strategies for cost containment.

A new approach to process control using Instability Index

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Weintraub, Jeffrey; Warrick, Scott

2016-03-01

The merits of a robust Statistical Process Control (SPC) methodology have long been established. In response to the numerous SPC rule combinations, processes, and the high cost of containment, the Instability Index (ISTAB) is presented as a tool for managing these complexities. ISTAB focuses limited resources on key issues and provides a window into the stability of manufacturing operations. ISTAB takes advantage of the statistical nature of processes by comparing the observed average run length (OARL) to the expected run length (ARL), resulting in a gap value called the ISTAB index. The ISTAB index has three characteristic behaviors that are indicative of defects in an SPC instance. Case 1: The observed average run length is excessively long relative to expectation. ISTAB > 0 is indicating the possibility that the limits are too wide. Case 2: The observed average run length is consistent with expectation. ISTAB near zero is indicating that the process is stable. Case 3: The observed average run length is inordinately short relative to expectation. ISTAB system based on ISTAB as an enhancement to more traditional SPC approaches.

Economic values and expected effect of selection index for pathogen-specific mastitis under Danish conditions

DEFF Research Database (Denmark)

Sørensen, Lars Peter; Mark, Thomas; Sørensen, M.K.

2010-01-01

The objectives of this study were 1) to estimate costs related to 5 different pathogen-specific mastitis traits (susceptibility to different pathogens causing mastitis in dairy cattle) and unspecific mastitis, and 2) to compare selection differentials for an udder health index consisting of 5...... different pathogen-specific mastitis traits and lactation average somatic cell count from 5 to 170 d after first calving (LASCC170) with another index consisting of 1 unspecific mastitis trait and LASCC170. Economic values were estimated for mastitis caused by Staphylococcus aureus, Streptococcus...... dysgalactiae, Escherichia coli, coagulase-negative staphylococci, and Streptococcus uberis using a stochastic simulation model (SimHerd IV). Mastitis incidences for SimHerd IV were from incidences of mastitis treatments in primiparous Danish Holstein cows calving in 2007. Estimated costs ranged from 149 euro...

Cost of skeletal complications from bone metastases in six European countries.

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Pereira, J; Body, J-J; Gunther, O; Sleeboom, H; Hechmati, G; Maniadakis, N; Terpos, E; Acklin, Y P; Finek, J; von Moos, R

2016-06-01

Objective Patients with bone metastases or lesions secondary to solid tumors or multiple myeloma often experience bone complications (skeletal-related events [SREs]-radiation to bone, pathologic fracture, surgery to bone, and spinal cord compression); however, recent data that can be used to assess the value of treatments to prevent SREs across European countries are limited. This study aimed to provide estimates of health resource utilization (HRU) and cost associated with all SRE types in Europe. HRU data were reported previously; cost data are reported herein. Methods Eligible patients from 49 centers across Austria (n = 57), the Czech Republic (n = 59), Finland (n = 60), Greece (n = 59), Portugal (n = 59), and Sweden (n = 62) had bone metastases or lesions secondary to breast, lung, or prostate cancer, or multiple myeloma, and ≥1 index SRE (a SRE preceded by a SRE-free period of ≥ 6.5 months). SRE-related costs were estimated from a payer perspective using health resource utilization data from patient charts (before and after the index SRE diagnosis). Country-specific unit costs were from 2010 and local currencies were converted to 2010 euros. Results The mean costs across countries were €7043, €5242, €11,101, and €11,509 per radiation to bone, pathologic fracture, surgery to bone, and spinal cord compression event, respectively. Purchasing power parity (PPP)-adjusted mean cost ratios were similar in most countries, with the exception of radiation to bone. Limitations The overall burden of SREs may have been under-estimated owing to home visits and evaluations outside the hospital setting not being reported here. Conclusions All SREs were associated with substantial costs. Variation in SRE-associated costs between countries was most likely driven by differences in treatment practices and unit costs.

Direct and indirect healthcare costs of rheumatoid arthritis patients in Turkey.

Science.gov (United States)

Hamuryudan, Vedat; Direskeneli, Haner; Ertenli, Ihsan; Inanc, Murat; Karaaslan, Yasar; Oksel, Fahrettin; Ozbek, Suleyman; Pay, Salih; Terzioglu, Ender; Balkan Tezer, Dilara; Hacibedel, Basak; Akkoc, Nurullah

2016-01-01

To estimate the annual cost of rheumatoid arthritis (RA) in Turkey by obtaining real-world data directly from patients. In this cross-sectional study, RA patients from the rheumatology outpatient clinics of 10 university hospitals were interviewed with a standardised questionnaire on RA-related healthcare care costs. The study included 689 RA patients (565 females) with a mean age of 51.2±13.2 years and mean disease duration of 9.4±7.8 years. The mean scores of the Routine Assessment of Patient Index Data 3 and the Health Assessment Questionnaire-Disability Index (5.08±2.34 and 1.08±0.68, respectively) indicated moderate disease activity and severity for the whole group. One-third of the patients were on biologic agents and 12% had co-morbid conditions. The mean number of annual outpatient visits was 11.7±9.6 per patient. Of the patients, 15% required hospitalisation and 4% underwent surgery. The mean annual direct cost was € 4,954 (median, € 1,805), whereas the mean annual indirect cost was € 2,802 (median, € 608). Pharmacy costs accounted for the highest expenditure (mean, € 2,777; median, € 791), followed by the RA-related consultations and expenses (mean, € 1,600; median, € 696). RA has a substantial economic burden in Turkey, direct costs being higher than indirect costs. Although both direct and indirect costs are lower in Turkey than in Europe with respect to nominal Euro terms, they are higher from the perspectives of purchasing power parity and gross domestic product. Early diagnosis and treatment of RA may positively affect the national economy considering the positive correlation between health care utilisations and increased cost with disease severity.

Costs and compensation of work‐related injuries in British Columbia sawmills

Science.gov (United States)

Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

2007-01-01

Objective To estimate the costs of work‐related injury in a cohort of sawmill workers in British Columbia from the perspective of the workers' compensation system. Methods Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5786 actively employed sawmill workers. A total of 173 work‐related injury cases were identified from these records using the International classification of diseases—ninth revision (ICD‐9) external cause of injury codes and the responsibility of payment schedule. Workers' compensation records were extracted and matched with hospital records by dates and ICD‐9 diagnosis codes. All costs were converted into 1995 constant Canadian dollars using the Provincial General Consumer Price Index for the non‐healthcare costs and Medical Consumer Price Index for the healthcare costs. A 5% discounting rate was applied to adjust for the time value of money. For the uncompensated cases, costs were imputed from the compensated cases using the median cost for a similar nature of injury. Results 370 hospitalisation events due to injury were captured, and by either of the two indicators (E Codes or payment schedules), 173 (47%) hospitalisation events due to injury, were identified as work related. The median healthcare cost was $4377 and the median non‐healthcare cost was $16 559 for a work‐related injury. The median non‐healthcare and healthcare costs by injury were falls, $19 978 and $5185; struck by falling object, $32 398 and $8625; struck against, $12 667 and $5741; machinery related, $26 480 and $6643; caught in or between, $24 130 and $4389; and overexertion, $7801 and $2710. The total cost was $10 374 115 for non‐healthcare and $1 764 137 for healthcare. The compensation agency did not compensate $874 871 (8.4%) of the non‐healthcare costs and $200 588 (11.4%) of the healthcare costs. Conclusion Eliminating avoidable work‐related injury events can save valuable resources. PMID:17053018

Costs and compensation of work-related injuries in British Columbia sawmills.

Science.gov (United States)

Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

2007-03-01

To estimate the costs of work-related injury in a cohort of sawmill workers in British Columbia from the perspective of the workers' compensation system. Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5786 actively employed sawmill workers. A total of 173 work-related injury cases were identified from these records using the International classification of diseases-ninth revision (ICD-9) external cause of injury codes and the responsibility of payment schedule. Workers' compensation records were extracted and matched with hospital records by dates and ICD-9 diagnosis codes. All costs were converted into 1995 constant Canadian dollars using the Provincial General Consumer Price Index for the non-healthcare costs and Medical Consumer Price Index for the healthcare costs. A 5% discounting rate was applied to adjust for the time value of money. For the uncompensated cases, costs were imputed from the compensated cases using the median cost for a similar nature of injury. 370 hospitalisation events due to injury were captured, and by either of the two indicators (E Codes or payment schedules), 173 (47%) hospitalisation events due to injury, were identified as work related. The median healthcare cost was 4377 dollars and the median non-healthcare cost was 16,559 dollars for a work-related injury. The median non-healthcare and healthcare costs by injury were falls, 19,978 dollars and 5185 dollars; struck by falling object, 32,398 dollars and 8625 dollars; struck against, 12,667 dollars and 5741 dollars; machinery related, 26,480 dollars and 6643 dollars; caught in or between, 24,130 dollars and 4389 dollars; and overexertion, 7801 dollars and 2710 dollars. The total cost was 10,374,115 dollars for non-healthcare and 1,764,137 dollars for healthcare. The compensation agency did not compensate 874,871 dollars (8.4%) of the non-healthcare costs and 200,588 dollars (11.4%) of the healthcare costs. Eliminating avoidable work-related injury events

Nitrous Oxide and Nitrous Oxide-Free Low-Flow Anesthesia Using Bispectral Index Monitoring: Effects on Hemodynamics, Recovery Times, Volatile Anesthetic Consumption and Costs

Directory of Open Access Journals (Sweden)

Bengü Gülhan Köksal

2010-12-01

Full Text Available Aim: In this study, we aimed to compare the effects of desfluraneN2O and desflurane-fentanyl combinations on hemodynamics, recovery times, volatile anesthetic consumption and costs in low-flow desflurane anesthesia by bispectral index (BIS monitoring of depth of anesthesia. Methods: After approval of ethics committee and obtaining patient consents, 60 patients were divided into two equal groups randomly. Non-invasive blood pressure measurement, ECG, SpO2 and BIS were monitored. All patients received 10 L .min-1 100% oxygen with mask for 5 minute before intubation. 2 mg.kg-1 propofol, 2 μg.kg-1 fentanyl and 0.6 mg.kg-1 rocuronium bromide were administered at induction in both groups. Desfluran 6% was chosen for anesthesia maintenance. Group 1 received 50% O2-N2O mixture in 6 L.min-1 and Group 2 received 50% O2-air mixture in 6 L.min-1 as carrier gas. Low-flow anesthesia (1 L.min-1 was started after a 10-min period of initial high flow (6 L.min-1. In Group 2, infusion of fentanyl was begun in 1 μg.kg.hour-1 rate. Desflurane level was adjusted at a main BIS value of 40-60. Blood pressure, heart rate, FiO2, etO2, FiN22, EtN2O, FiCO2, EtCO2, Fidesfluran and Etdesflurane were recorded. Results: There were no significant differences between the two groups in terms of heart rate, arterial blood pressure, settings of desfluran and recovery time. BIS values (p<0.001 and anesthetic agent costs (p<0.001 were higher in Group 2. Conclusion: Using fentanyl infusion instead of nitrous oxide in low flow-anesthesia with desflurane did not alter the hemodynamic parameters. Fentanyl infusion with medical air-oxygen as carrier gas is an alternative technique, but increases BIS values and anesthetic agent costs. (The Medical Bulletin of Haseki 2010; 48: 132-8

Moderation of the Relation of County-Level Cost of Living to Nutrition by the Supplemental Nutrition Assistance Program.

Science.gov (United States)

Basu, Sanjay; Wimer, Christopher; Seligman, Hilary

2016-11-01

To examine the association of county-level cost of living with nutrition among low-income Americans. We used the National Household Food Acquisition and Purchase Survey (2012-2013; n = 14 313; including 5414 persons in households participating in the Supplemental Nutrition Assistance Program [SNAP]) to examine associations between county-level cost-of-living metrics and both food acquisitions and the Healthy Eating Index, with control for individual-, household-, and county-level covariates and accounting for unmeasured confounders influencing both area of living and food acquisition. Living in a higher-cost county-particularly one with high rent costs-was associated with significantly lower volume of acquired vegetables, fruits, and whole grains; greater volume of acquired refined grains, fats and oils, and added sugars; and an 11% lower Healthy Eating Index score. Participation in SNAP was associated with nutritional improvements among persons living in higher-cost counties. Living in a higher-cost county (particularly with high rent costs) is associated with poorer nutrition among low-income Americans, and SNAP may mitigate the negative nutritional impact of high cost of living.

Interferometric measurement of refractive index modification in a single mode microfiber

Science.gov (United States)

Ahmed, Farid; Ahsani, Vahid; Jun, Martin B. G.

2017-02-01

Efficient and cost effective measurement of the refractive index profile in an optical fiber is a significant technical job to design and manufacture in-fiber photonic devices and communication systems. For instance, to design fiber gratings, it is required to estimate the refractive index modulation to be inscribed by the fabrication apparatus such as ultraviolet or infrared lasers. Mach-Zehnder interferometer (MZI) based quantification of refractive index change written in single mode microfiber by femtosecond laser radiation is presented in this study. The MZI is constructed by splicing a microfiber (core diameter: 3.75 μm, cladding diameter: 40 μm) between standard single mode fibers. To measure the RI inscribed by infrared femtosecond laser, 200 μm length of the core within the MZI was scanned with laser radiation. As the higher index was written within 200 μm length of the core, the transmission spectrum of the interferometer displayed a corresponding red shift. The observed spectral shift was used to calculate the amount of refractive index change inscribed by the femtosecond irradiation. For the MZI length of 3.25 mm, and spectral shift of 0.8 nm, the calculated refractive index was found to be 0.00022. The reported results display excellent agreement between theory and experimental findings. Demonstrated method provides simple yet very effective on-site measurement of index change in optical fibers. Since the MZI can be constructed in diverse fiber types, this technique offers flexibility to quantify index change in various optical fibers.

Replacement versus Historical Cost Profit Rates: What is the difference? When does it matter?

OpenAIRE

Basu, Deepankar

2012-01-01

This paper explains the BEA methodology for computing historical cost and replacement cost measures of the net stock of capital in the U.S. economy. It is demonstrated that there exists a threshold rate of inflation in the price of capital goods that keeps the percentage difference between the two capital stock measures constant. Hence, over periods when average inflation in the price index for capital goods is equal to the threshold value, historical cost and replacement cost profit rates wo...

Health care costs associated with hospital acquired complications in patients with chronic kidney disease.

Science.gov (United States)

Bohlouli, Babak; Jackson, Terri; Tonelli, Marcello; Hemmelgarn, Brenda; Klarenbach, Scott

2017-12-28

Patients with CKD are at increased risk of potentially preventable hospital acquired complications (HACs). Understanding the economic consequences of preventable HACs, may define the scope and investment of initiatives aimed at prevention. Adult patients hospitalized from April, 2003 to March, 2008 in Alberta, Canada comprised the study cohort. Healthcare costs were determined and categorized into 'index hospitalization' including hospital cost and in-hospital physician claims, and 'post discharge' including ambulatory care cost, physician claims, and readmission costs from discharge to 90 days. Multivariable regression was used to estimate the incremental healthcare costs associated with potentially preventable HACs. In fully adjusted models, the median incremental index hospitalization cost was CAN-$6169 (95% CI; 6003-6336) in CKD patients with ≥1 potentially preventable HACs, compared with those without. Post-discharge incremental costs were 1471(95% CI; 844-2099) in those patients with CKD who developed potentially preventable HACs within 90 days after discharge compared with patients without potentially preventable HACs. Additionally, the incremental costs associated with ≥1 potentially preventable HACs within 90 days from admission in patients with CKD were $7522 (95% CI; 7219-7824). A graded relation of the incremental costs was noted with the increasing number of complications. In patients without CKD but with ≥1 preventable HACs incremental costs within 90 days from hospital admission was $6688 (95% CI: 6612-6723). Potentially preventable HACs are associated with substantial increases in healthcare costs in people with CKD. Investment in implementing targeted strategies to reduce HACs may have a significant benefit for patient and health system outcomes.

The relationship between cost estimates reliability and BIM adoption: SEM analysis

Science.gov (United States)

Ismail, N. A. A.; Idris, N. H.; Ramli, H.; Rooshdi, R. R. Raja Muhammad; Sahamir, S. R.

2018-02-01

This paper presents the usage of Structural Equation Modelling (SEM) approach in analysing the effects of Building Information Modelling (BIM) technology adoption in improving the reliability of cost estimates. Based on the questionnaire survey results, SEM analysis using SPSS-AMOS application examined the relationships between BIM-improved information and cost estimates reliability factors, leading to BIM technology adoption. Six hypotheses were established prior to SEM analysis employing two types of SEM models, namely the Confirmatory Factor Analysis (CFA) model and full structural model. The SEM models were then validated through the assessment on their uni-dimensionality, validity, reliability, and fitness index, in line with the hypotheses tested. The final SEM model fit measures are: P-value=0.000, RMSEA=0.0790.90, TLI=0.956>0.90, NFI=0.935>0.90 and ChiSq/df=2.259; indicating that the overall index values achieved the required level of model fitness. The model supports all the hypotheses evaluated, confirming that all relationship exists amongst the constructs are positive and significant. Ultimately, the analysis verified that most of the respondents foresee better understanding of project input information through BIM visualization, its reliable database and coordinated data, in developing more reliable cost estimates. They also perceive to accelerate their cost estimating task through BIM adoption.

Risk factors and direct medical cost of early versus late unplanned readmissions among diabetes patients at a tertiary hospital in Singapore.

Science.gov (United States)

Png, May Ee; Yoong, Joanne; Chen, Cynthia; Tan, Chuen Seng; Tai, E Shyong; Khoo, Eric Y H; Wee, Hwee Lin

2018-02-20

To examine the risk factors and direct medical costs associated with early (≤30 days) versus late (31-180 days) unplanned readmissions among patients with type 2 diabetes in Singapore. Risk factors and associated costs among diabetes patients were investigated using electronic medical records from a local tertiary care hospital from 2010 to 2012. Multivariable logistic regression was used to identify risk factors associated with early and late unplanned readmissions while a generalized linear model was used to estimate the direct medical cost. Sensitivity analysis was also performed. A total of 1729 diabetes patients had unplanned readmissions within 180 days of an index discharge. Length of index stay (a marker of acute illness burden) was one of the risk factors associated with early unplanned readmission while patient behavior-related factors, like diabetes-related medication adherence, were associated with late unplanned readmission. Adjusted mean cost of index admission was higher among patients with unplanned readmission. Sensitivity analysis yielded similar results. Existing routinely captured data can be used to develop prediction models that flag high risk patients during their index admission, potentially helping to support clinical decisions and prevent such readmissions.

Humidity insensitive step-index polymer optical fibre Bragg grating sensors

DEFF Research Database (Denmark)

Woyessa, Getinet; Fasano, Andrea; Stefani, Alessio

2015-01-01

We have fabricated and characterised a humidity insensitive step index(SI) polymer optical fibre(POF) Bragg grating sensors. The fibre was made based on the injection molding technique, which is an efficient method for fast, flexible and cost effective preparation of the fibre preform. The fabric...... poly-methyl-methacrylate (PMMA) based SIPOFs. The fibre has a minimum loss of similar to 6dB/m at 770nm....

Walkability Index

Science.gov (United States)

The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of the built environment that influence the likelihood of walking being used as a mode of travel. The Walkability Index is based on the EPA's previous data product, the Smart Location Database (SLD). Block group data from the SLD was the only input into the Walkability Index, and consisted of four variables from the SLD weighted in a formula to create the new Walkability Index. This dataset shares the SLD's block group boundary definitions from Census 2010. The methodology describing the process of creating the Walkability Index can be found in the documents located at ftp://newftp.epa.gov/EPADataCommons/OP/WalkabilityIndex.zip. You can also learn more about the Smart Location Database at https://edg.epa.gov/data/Public/OP/Smart_Location_DB_v02b.zip.

The development of a value based pricing index for new drugs in metastatic colorectal cancer.

Science.gov (United States)

Dranitsaris, George; Truter, Ilse; Lubbe, Martie S

2011-06-01

Worldwide, prices for cancer drugs have been under downward pressure where several governments have mandated price cuts of branded products. A better alternative to government mandated price cuts would be to estimate a final price based on drug performance, cost effectiveness and a country's ability to pay. We developed a global pricing index for new cancer drugs in patients with metastatic colorectal cancer (mCRC) that encompasses all of these attributes. A pharmacoeconomic model was developed to simulate mCRC patients receiving chemotherapy plus a 'new drug' that improves survival by 1.4, 3 and 6months, respectively. Cost and utility data were obtained from cancer centres and oncology nurses (n=112) in Canada, Spain, India, South Africa and Malaysia. Multivariable analysis was then used to develop the pricing index, which considers survival benefit, per capita GDP and income dispersion (as measured by the Gini coefficient) as predictor variables. Higher survival benefits were associated with elevated drug prices, especially in higher income countries such as Canada. For Argentina with a per capita GDP of $15,000 and a Gini coefficient of 51, the index estimated that for a drug which provides a 4month survival benefit in mCRC, the value based price would be $US 630 per dose. In contrast, the same drug in a wealthier country like Norway (per capita GDP=$50,000) could command a price of $US 2,775 per dose. The application of this index to estimate a price based on cost effectiveness and the wealth of a nation would be important for opening dialogue between the key stakeholders and a better alternative to government mandated price cuts. Copyright © 2011 Elsevier Ltd. All rights reserved.

Estimating Drug Costs: How do Manufacturer Net Prices Compare with Other Common US Price References?

Science.gov (United States)

Mattingly, T Joseph; Levy, Joseph F; Slejko, Julia F; Onwudiwe, Nneka C; Perfetto, Eleanor M

2018-05-12

Drug costs are frequently estimated in economic analyses using wholesale acquisition cost (WAC), but what is the best approach to develop these estimates? Pharmaceutical manufacturers recently released transparency reports disclosing net price increases after accounting for rebates and other discounts. Our objective was to determine whether manufacturer net prices (MNPs) could approximate the discounted prices observed by the U.S. Department of Veterans Affairs (VA). We compared the annual, average price discounts voluntarily reported by three pharmaceutical manufacturers with the VA price for specific products from each company. The top 10 drugs by total sales reported from company tax filings for 2016 were included. The discount observed by the VA was determined from each drug's list price, reported as WAC, in 2016. Descriptive statistics were calculated for the VA discount observed and a weighted price index was calculated using the lowest price to the VA (Weighted VA Index), which was compared with the manufacturer index. The discounted price as a percentage of the WAC ranged from 9 to 74%. All three indexes estimated by the average discount to the VA were at or below the manufacturer indexes (42 vs. 50% for Eli Lilly, 56 vs. 65% for Johnson & Johnson, and 59 vs. 59% for Merck). Manufacturer-reported average net prices may provide a close approximation of the average discounted price granted to the VA, suggesting they may be a useful proxy for the true pharmacy benefits manager (PBM) or payer cost. However, individual discounts for products have wide variation, making a standard discount adjustment across multiple products less acceptable.

Comparative treatment patterns, healthcare resource utilization and costs of atomoxetine and long-acting methylphenidate among children and adolescents with attention-deficit/hyperactivity disorder in Germany.

Science.gov (United States)

Greven, Peter; Sikirica, Vanja; Chen, Yaozhu J; Curtice, Tammy G; Makin, Charles

2017-09-01

Attention-deficit/hyperactivity disorder (ADHD) imposes a substantial burden on patients and their families. A retrospective, propensity score-matched cohort study compared treatment patterns, healthcare resource utilization (HRU) and costs among children/adolescents with ADHD aged 6-17 years at treatment initiation (index) in Germany who received atomoxetine (ATX) or long-acting methylphenidate (LA-MPH) monotherapy. Patients received at least one prescription for their index medication (ATX/LA-MPH) during 2006-2010; the first prescription marked the index date. ATX- and LA-MPH-indexed cohorts were matched 1:1 (n = 737); a patient subset was identified that had not received ADHD-indicated medications in 12 months prior to index (novel initiators: ATX, n = 486; LA-MPH, n = 488). Treatment patterns were evaluated among novel initiators, and HRU and costs among the matched cohorts in the 12 months after index. No significant differences in baseline characteristics were found between the novel initiator patient subsets. ATX-indexed novel initiators had significantly longer persistence to index medication [mean (standard deviation; SD) days: 222.0 (133.9) vs 203.2 (135.0), P = 0.029) but higher switching rates (8.8 vs 5.5 %, P = 0.045) than LA-MPH-indexed novel initiators. The total ATX-indexed cohort required more prescriptions [any medication; mean (SD): 20.9 (11.5) vs 15.7 (9.0), P < 0.001] and outpatient visits [mean (SD): 10.1 (6.3) vs 8.3 (5.3), P < 0.001], and incurred significantly higher total median healthcare costs (€1144 vs €541, P < 0.001) versus matched LA-MPH patients. These real-world data indicate that, among children/adolescents with ADHD in Germany, ATX-indexed patients may require more prescriptions and physician visits, and incur higher total healthcare costs, than matched LA-MPH patients.

Comparing cost of indwelling pleural catheter vs talc pleurodesis for malignant pleural effusion.

Science.gov (United States)

Penz, Erika D; Mishra, Eleanor K; Davies, Helen E; Manns, Braden J; Miller, Robert F; Rahman, Najib M

2014-10-01

Malignant pleural effusion is associated with short life expectancy and significant morbidity. A randomized controlled trial comparing indwelling pleural catheters (IPCs) with talc pleurodesis found that IPCs reduced in-hospital time and the need for additional procedures but were associated with excess adverse events. Using data from the clinical trial, we compared costs associated with use of IPCs and with talc pleurodesis. Resource use and adverse events were captured through case report forms over the 1-year trial follow-up. Costs for outpatient and inpatient visits, diagnostic imaging, nursing, and doctor time were obtained from the UK National Health Service reference costs and University of Kent's Unit Costs of Health and Social Care 2011 and inflated to 2013 using the UK Consumer Price Index. Procedure supply costs were obtained from the manufacturer. Difference in mean costs was compared using nonparametric bootstrapping. All costs were converted to US dollars using the Organisation for Economic Co-operation and Development Purchasing Power Parity Index. Overall mean cost (SD) for managing patients with IPCs and talc pleurodesis was $4,993 ($5,529) and $4,581 ($4,359), respectively. The incremental mean cost difference was $401, with 95% CI of -$1,387 to $2,261. The mean cost related to ongoing drainage in the IPC group was $1,011 ($732) vs $57 ($213) in the talc pleurodesis group (P = .001). This included the cost of drainage bottles, dressing changes in the first month, and catheter removal. There was no significant difference in cost of the initial intervention or adverse events between the groups. For patients with survival < 14 weeks, IPC is significantly less costly than talc pleurodesis, with mean cost difference of -$1,719 (95% CI, -$3,376 to -$85). There is no significant difference in the mean cost of managing patients with IPCs compared with talc pleurodesis. For patients with limited survival, IPC appears less costly. isrctn.org; No.: ISRCTN

Construction delays causing risks on time and cost - a critical review

Directory of Open Access Journals (Sweden)

Chidambaram Ramanathan

2012-02-01

Full Text Available There is an increase in the number of construction projects experiencing extensive delays leading to exceeding initial time and cost budget.  This paper reviews 41 studies around the world which surveyed the delay factors and classified them into Groups.  The main purpose of this paper is to review literature, each of which have categorized the causes that are responsible for time delays and cost overrun in projects. The collected list has 113 causes for delays categorized in to 18 different groups.  Most of the researches have analysed the responses from the Questionnaire survey.    The collected data are used to rank the problem.  The data are further used to investigate and analyse Important Index, Frequency Index, Severity Index, Relative Important Index, Relative Importance Weight, Weighted Average, Mean, Standard Deviation and Variance.  The collective comparison has revealed that the ranking given by all the researchers is not the same.  Further each and every study has different rank ratings for the different group of the delays.  This review paper attempts to provide an updated compilation of the earlier studies on ranking of the delay causers, which are never similar and constant for universal projects.  It is concluded that a separate study is required for identifying the factors causing delay for projects operated in Sabah, East Malaysia.

Modification of Low Refractive Index Polycarbonate for High Refractive Index Applications

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Gunjan Suri

2009-01-01

Full Text Available Polycarbonates and polythiourethanes are the most popular materials in use today, for optical applications. Polycarbonates are of two types which fall in the category of low refractive index and medium refractive index. The present paper describes the conversion of low refractive index polycarbonates into high refractive index material by the use of a high refractive index monomer, polythiol, as an additive. Novel polycarbonates, where the properties of refractive index and Abbe number can be tailor made, have been obtained. Thermal studies and refractive index determination indicate the formation of a new polymer with improved properties and suitable for optical applications.

Theoretical and methodological aspects of assessing economic effectiveness of nuclear power plant construction using cost-benefit analysis

International Nuclear Information System (INIS)

Moravcik, A.

1984-01-01

The cost benefit of investments is devided into social and economic benefits. The postulates are discussed for the assessment of the cost benefit of capital costs of nuclear power plants. The relations are given for total cost benefit of capital costs expressed by the total profit rate of capital costs, and the absolute effectiveness exoressed by the socio-economic benefit of capital costs. The absolute cost benefit of capital costs is characterized by several complex indexes. Comparable capital cost benefit is used for assessing the effectiveness of interchangeable variants of solution. The minimum calculated costs serve as the criterion for selecting the optimal variant. (E.S.)

Near-infrared multispectral photoacoustic microscopy using a graded-index fiber amplifier

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Takashi Buma

2016-09-01

Full Text Available We demonstrate optical resolution photoacoustic microscopy (OR-PAM of lipid-rich tissue using a multi-wavelength pulsed laser based on nonlinear fiber optics. 1047 nm laser pulses are converted to 1098, 1153, 1215, and 1270 nm pulses via stimulated Raman scattering in a graded-index multimode fiber. Multispectral PAM of a lipid phantom is demonstrated with our low-cost and simple technique.

Uptake, outcomes, and costs of antenatal, well-baby, and prevention of mother-to-child transmission of HIV services under routine care conditions in Zambia.

Directory of Open Access Journals (Sweden)

Callie A Scott

Full Text Available BACKGROUND: Zambia adopted Option A for prevention of mother-to-child transmission of HIV (PMTCT in 2010 and announced a move to Option B+ in 2013. We evaluated the uptake, outcomes, and costs of antenatal, well-baby, and PMTCT services under routine care conditions in Zambia after the adoption of Option A. METHODS: We enrolled 99 HIV-infected/HIV-exposed (index mother/baby pairs with a first antenatal visit in April-September 2011 at four study sites and 99 HIV-uninfected/HIV-unexposed (comparison mother/baby pairs matched on site, gestational age, and calendar month at first visit. Data on patient outcomes and resources utilized from the first antenatal visit through six months postpartum were extracted from site registers. Costs in 2011 USD were estimated from the provider's perspective. RESULTS: Index mothers presented for antenatal care at a mean 23.6 weeks gestation; 55% were considered to have initiated triple-drug antiretroviral therapy (ART based on information recorded in site registers. Six months postpartum, 62% of index and 30% of comparison mother/baby pairs were retained in care; 67% of index babies retained had an unknown HIV status. Comparison and index mother/baby pairs utilized fewer resources than under fully guideline-concordant care; index babies utilized more well-baby resources than comparison babies. The average cost per comparison pair retained in care six months postpartum was $52 for antenatal and well-baby services. The average cost per index pair retained was $88 for antenatal, well-baby, and PMTCT services and increased to $185 when costs of triple-drug ART services were included. CONCLUSIONS: HIV-infected mothers present to care late in pregnancy and many are lost to follow up by six months postpartum. HIV-exposed babies are more likely to remain in care and receive non-HIV, well-baby care than HIV-unexposed babies. Improving retention in care, guideline concordance, and moving to Option B+ will result in

The e-index, complementing the h-index for excess citations.

Directory of Open Access Journals (Sweden)

Chun-Ting Zhang

Full Text Available BACKGROUND: The h-index has already been used by major citation databases to evaluate the academic performance of individual scientists. Although effective and simple, the h-index suffers from some drawbacks that limit its use in accurately and fairly comparing the scientific output of different researchers. These drawbacks include information loss and low resolution: the former refers to the fact that in addition to h(2 citations for papers in the h-core, excess citations are completely ignored, whereas the latter means that it is common for a group of researchers to have an identical h-index. METHODOLOGY/PRINCIPAL FINDINGS: To solve these problems, I here propose the e-index, where e(2 represents the ignored excess citations, in addition to the h(2 citations for h-core papers. Citation information can be completely depicted by using the h-index together with the e-index, which are independent of each other. Some other h-type indices, such as a and R, are h-dependent, have information redundancy with h, and therefore, when used together with h, mask the real differences in excess citations of different researchers. CONCLUSIONS/SIGNIFICANCE: Although simple, the e-index is a necessary h-index complement, especially for evaluating highly cited scientists or for precisely comparing the scientific output of a group of scientists having an identical h-index.

The Effect of Severity of Illness on Spine Surgery Costs Across New York State Hospitals: An Analysis of 69,831 Cases.

Science.gov (United States)

Kaye, I David; Adrados, Murillo; Karia, Raj J; Protopsaltis, Themistocles S; Bosco, Joseph A

2017-11-01

Observational database review. To determine the effect of patient severity of illness (SOI) on the cost of spine surgery among New York state hospitals. National health care spending has risen at an unsustainable rate with musculoskeletal care, and spine surgery in particular, accounting for a significant portion of this expenditure. In an effort towards cost-containment, health care payers are exploring novel payment models some of which reward cost savings but penalize excessive spending. To mitigate risk to health care institutions, accurate cost forecasting is essential. No studies have evaluated the effect of SOI on costs within spine surgery. The New York State Hospital Inpatient Cost Transparency Database was reviewed to determine the costs of 69,831 hospital discharges between 2009 and 2011 comprising the 3 most commonly performed spine surgeries in the state. These costs were then analyzed in the context of the specific all patient refined diagnosis-related group (DRG) SOI modifier to determine this index's effect on overall costs. Overall, hospital-reported cost increases with the patient's SOI class and patients with worse baseline health incur greater hospital costs (Pcosts are increasingly variable for each worsening SOI class (Pcosts is persistent for all 3 DRGs across all 3 years studied (2009-2011), within each of the 7 New York state regions, and occurs irrespective of the hospital's teaching status or size. Using the 3M all patient refined-DRG SOI index as a measure of patient's health status, a significant increase in cost for spine surgery for patients with higher SOI index was found. This study confirms the greater cost and variability of spine surgery for sicker patients and illustrates the inherent unpredictability in cost forecasting and budgeting for these same patients.

Autonomous hip exoskeleton saves metabolic cost of walking uphill.

Science.gov (United States)

Seo, Keehong; Lee, Jusuk; Park, Young Jin

2017-07-01

We have developed a hip joint exoskeleton to boost gait function in the elderly and rehabilitation of post-stroke patients. To quantitatively evaluate the impact of the power and mass of the exoskeleton, we measured the metabolic cost of walking on slopes of 0, 5, and 10% grade, once not wearing the exoskeleton and then wearing it. The exoskeleton reduced the metabolic cost by 13.5,15.5 and 9.8% (31.9, 51.6 and 45.6 W) at 0, 5, and 10% grade, respectively. The exoskeleton performance index was computed as 0.97, 1.24, and 1.24 at each grade, implicating that the hip exoskeleton was more effective on slopes than level ground in saving the metabolic cost.

Determining the optimal index of heat stress in foundry, die casting and road construction industries using FAHP_Topsis

Directory of Open Access Journals (Sweden)

Maryam Dehghanipoor

2016-12-01

Full Text Available Introduction: Heat stress is one of the harmful risks in casting and die casting industries, which can not only cause work-related diseases but also can impair the performance and safety of workers. Since the indicators that are used to evaluate heat stress are very different, it is very difficult to choose a suitable index. The aim of this study was to determine the optimum heat stress index in foundry, die-cast, and road construction industries using FAHP and Topsis methods. Material and Method: In order to determine optimum heat stress index in foundry, die-cast, and road construction industries, first, the prioritization criteria were defined by experts (including ease of measurement, measurement accuracy, comprehensiveness, time, cost, and correlation. Then, considering these criteria, the best heat stress index was determined based on experts’ opinions and using FAHP and Topsis methods. Result: The results of this study suggest that given the current conditions and criteria, WBGT and P4SR is the best indices for foundry, die casting and construction. Conclusion: The results showed that according to comprehensiveness, accuracy and correlation criteria, the WBGT index is considered as the best indicator of heat stress assessment in foundry, die-cast and road construction industries. Moreover, the HSI ranked in the last place due to the complexity and cost of its calculation.

Web-based automation of green building rating index and life cycle cost analysis

Science.gov (United States)

Shahzaib Khan, Jam; Zakaria, Rozana; Aminuddin, Eeydzah; IzieAdiana Abidin, Nur; Sahamir, Shaza Rina; Ahmad, Rosli; Nafis Abas, Darul

2018-04-01

Sudden decline in financial markets and economic meltdown has slow down adaptation and lowered interest of investors towards green certified buildings due to their higher initial costs. Similarly, it is essential to fetch investor’s attention towards more development of green buildings through automated tools for the construction projects. Though, historical dearth is found on the automation of green building rating tools that brings up an essential gap to develop an automated analog computerized programming tool. This paper present a proposed research aim to develop an integrated web-based automated analog computerized programming that applies green building rating assessment tool, green technology and life cycle cost analysis. It also emphasizes to identify variables of MyCrest and LCC to be integrated and developed in a framework then transformed into automated analog computerized programming. A mix methodology of qualitative and quantitative survey and its development portray the planned to carry MyCrest-LCC integration to an automated level. In this study, the preliminary literature review enriches better understanding of Green Building Rating Tools (GBRT) integration to LCC. The outcome of this research is a pave way for future researchers to integrate other efficient tool and parameters that contributes towards green buildings and future agendas.

Modified complementary ensemble empirical mode decomposition and intrinsic mode functions evaluation index for high-speed train gearbox fault diagnosis

Science.gov (United States)

Chen, Dongyue; Lin, Jianhui; Li, Yanping

2018-06-01

Complementary ensemble empirical mode decomposition (CEEMD) has been developed for the mode-mixing problem in Empirical Mode Decomposition (EMD) method. Compared to the ensemble empirical mode decomposition (EEMD), the CEEMD method reduces residue noise in the signal reconstruction. Both CEEMD and EEMD need enough ensemble number to reduce the residue noise, and hence it would be too much computation cost. Moreover, the selection of intrinsic mode functions (IMFs) for further analysis usually depends on experience. A modified CEEMD method and IMFs evaluation index are proposed with the aim of reducing the computational cost and select IMFs automatically. A simulated signal and in-service high-speed train gearbox vibration signals are employed to validate the proposed method in this paper. The results demonstrate that the modified CEEMD can decompose the signal efficiently with less computation cost, and the IMFs evaluation index can select the meaningful IMFs automatically.

Triglycerides/glucose index is a useful surrogate marker of insulin resistance among adolescents.

Science.gov (United States)

Kang, B; Yang, Y; Lee, E Y; Yang, H K; Kim, H-S; Lim, S-Y; Lee, J-H; Lee, S-S; Suh, B-K; Yoon, K-H

2017-05-01

Our aim was to investigate the association between the triglycerides/glucose index (TyG index) and the homeostasis model assessment-estimated insulin resistance (HOMA-IR) in the prediction of insulin resistance (IR) among adolescents. We conducted a cross-sectional study among 221 Korean adolescents (168 males and 53 females aged 9-13 years) from May to June 2014 in Chung-ju city. The TyG index was calculated as ln [triglycerides (mg dl -1 ) × fasting glucose (mg dl -1 )/2]. IR was defined using HOMA-IR >95th percentile for age and sex. In the IR group, weight, body mass index (BMI), waist circumference, body fat, fasting insulin, fasting plasma glucose, triglyceride levels and triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) were significantly higher than that in the non-IR group. The TG index was significantly different between the IR group (n=22) and non-IR group (n=199), at 8.43±0.45 and 8.05±0.41, respectively (Pindex was well correlated with HOMA-IR (r=0.41; Pindex for diagnosis of insulin resistance was 8.18. The TyG index is a simple, cost-effective surrogate marker of insulin resistance among adolescents compared with HOMA-IR.

Historical Cost Curves for Hydrogen Masers and Cesium Beam Frequency and Timing Standards

Science.gov (United States)

Remer, D. S.; Moore, R. C.

1985-01-01

Historical cost curves were developed for hydrogen masers and cesium beam standards used for frequency and timing calibration in the Deep Space Network. These curves may be used to calculate the cost of future hydrogen masers or cesium beam standards in either future or current dollars. The cesium beam standards are decreasing in cost by about 2.3% per year since 1966, and hydrogen masers are decreasing by about 0.8% per year since 1978 relative to the National Aeronautics and Space Administration inflation index.

Healthcare costs attributable to the treatment of patients with spinal metastases

DEFF Research Database (Denmark)

Tipsmark, Line Stjernholm; Bünger, Cody Eric; Wang, Miao

2015-01-01

for 65% and outpatient services for 31% of the healthcare costs followed by hospice placements 3% and primary care 1%. Lifetime healthcare costs accounted for €36,616 (95% CI 33,835-39,583) per T1 patients, €49,632 (95% CI 42,287-57,767) per T2 patient, €70997 (95% CI 62,244-82,354) per T3 patient...... with an average of 71% for inpatient hospitalisation and 25% for outpatient services. CONCLUSION: The index treatment accounts for almost half of lifetime health care costs from treatment initiation until death. As expected, lifetime healthcare costs are positively association with invasiveness of treatment.......BACKGROUND: Cancer treatment, and in particular end-of-life treatment, is associated with substantial healthcare costs. The purpose of this study was to analyse healthcare costs attributable to the treatment of patients with spinal metastases. METHODS: The study population (n = 629) was identified...

Breakeven costs for embryo transfer in a commercial dairy herd.

Science.gov (United States)

Ferris, T A; Troyer, B W

1987-11-01

Differences in Estimated Breeding Values expressed in dollars were compared by simulation of two, 100-cow, closed herds. One herd practiced normal intensity of female selection. The other herd generated various herd replacements by embryo transfer by varying 1) selection rate of embryo transfer dams and 2) numbers of daughters per dam from which embryos were transferred, while varying the merit of mates of embryo transfer dams. Estimated Breeding Value dollars were compounded each generation and regressed to remove age adjustments and added feed and health costs. Beginning values in both herds included a standard deviation of 55 Cow Index dollars, herd average of -23 Cow Index dollars, and a 120 Predicted Difference dollars for mates of dams not embryo transferred. Average merit of all sires used increased $12 per year. Herd calving rate (.70), proportion females (.5), calf loss (.15), and heifer survival rate (.83) were used. Breakeven cost per embryo transfer cow entering the milking herd was computed by Net Present Value analysis using a 10% discount rate over 10 and 20 yr. Breakeven cost or the maximum expense that would allow a 10% return on the expenditure ranged from $135 to $510 per surviving cow, $24 to $125 per transfer, $47 to $178 per pregnancy, and $81 to $357 per female calf born. As the number of replacements resulting from embryo transfer increased, breakeven cost per embryo transfer cow decreased due to diminishing return.

20 CFR 416.405 - Cost-of-living adjustments in benefits.

Science.gov (United States)

2010-04-01

... which the title II benefits are being increased based on the Consumer Price Index, or, if greater, the... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Cost-of-living adjustments in benefits. 416.405 Section 416.405 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME...

Prospects of renewable energy sources in India: Prioritization of alternative sources in terms of Energy Index

International Nuclear Information System (INIS)

Jha, Shibani K.; Puppala, Harish

2017-01-01

The growing energy demand in progressing civilization governs the exploitation of various renewable sources over the conventional sources. Wind, Solar, Hydro, Biomass, and waste & Bagasse are the various available renewable sources in India. A reliable nonconventional geothermal source is also available in India but it is restricted to direct heat applications. This study archives the status of renewable alternatives in India. The techno economic factors and environmental aspects associated with each of these alternatives are discussed. This study focusses on prioritizing the renewable sources based on a parameter introduced as Energy Index. This index is evaluated using cumulative scores obtained for each of the alternatives. The cumulative score is obtained by evaluating each alternative over a range of eleven environmental and techno economic criteria following Fuzzy Analytical Hierarchy Process. The eleven criteria's considered in the study are Carbon dioxide emissions (CO 2 ), Sulphur dioxide emissions (SO 2 ), Nitrogen oxide emissions (NO x ), Land requirement, Current energy cost, Potential future energy cost, Turnkey investment, Capacity factor, Energy efficiency, Design period and Water consumption. It is concluded from the study that the geothermal source is the most preferable alternative with highest Energy Index. Hydro, Wind, Biomass and Solar sources are subsequently preferred alternatives. - Highlights: • FAH process is used to obtain cumulative score for each renewable alternative. • Cumulative score is normalized by highest score of ideal source. • Energy Index shows how best a renewable alternative is. • Priority order is obtained for alternatives based on Energy Index. • Geothermal is most preferable source followed by Hydro, Wind, Biomass and Solar.

Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people.

Science.gov (United States)

Yu, Doris S F

2010-10-01

This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin's model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Cronbach's alpha of the Chinese version of the Insomnia Severity Index was 0.81, with item-to-total correlations in the range of 0.34-0.67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese community-dwelling older people. Nurses can use this tool to assess older people's perceptions of insomnia. © 2010 The

Counting the costs of overweight and obesity: modeling clinical and cost outcomes.

Science.gov (United States)

Tucker, Daniel M D; Palmer, Andrew J; Valentine, William J; Roze, Stéphane; Ray, Joshua A

2006-03-01

To quantify changes in clinical and cost outcomes associated with increasing levels of body mass index (BMI) in a US setting. A semi-Markov model was developed to project and compare life expectancy (LE), quality-adjusted life expectancy (QALE) and direct medical costs associated with distinct levels of BMI in simulated adult cohorts over a lifetime horizon. Cohort definitions included age (20-65 years), gender, race, and BMI (24-45 kg m(-2)). Cohorts were exclusively male or female and either Caucasian or African-American. Mortality rates were adjusted according to these factors using published data. BMI progression over time was modeled. BMI-dependent US direct medical costs were derived from published sources and inflated to year 2004 values. A third party reimbursement perspective was taken. QALE and costs were discounted at 3% per annum. In young Caucasian cohorts LE decreased as BMI increased. However, in older Caucasian cohorts the BMI associated with greatest longevity was higher than 25 kg m(-2). A similar pattern was observed in young adult African-American cohorts. A survival paradox was projected in older African-American cohorts, with some BMI levels in the obese category associated with greatest longevity. QALE in all four race/gender cohorts followed similar patterns to LE. Sensitivity analyses demonstrated that simulating BMI progression over time had an important impact on results. Direct costs in all four cohorts increased with BMI, with a few exceptions. Optimal BMI, in terms of longevity, varied between race/gender cohorts and within these cohorts, according to age, contributing to the debate over what BMI level or distribution should be considered ideal in terms of mortality risk. Simulating BMI progression over time had a substantial impact on health outcomes and should be modeled in future health economic analyses of overweight and obesity.

Survey of Swiss nuclear's cost study 2016; Pruefung der Kostenstudie 2016 von swissnuclear

Energy Technology Data Exchange (ETDEWEB)

Alt, Stefan; Ustohalova, Veronika [Oeko-Institut e.V. - Institut fuer Angewandte Oekologie, Freiburg im Breisgau (Germany)

2017-04-26

The report discusses the Swiss nuclear cost study 2016 concerning the following issues: evaluation of the aspects of the cost study: cost structure, cost classification and risk provision, additional payment liability, option of lifetime extension for Swiss nuclear power plants; specific indications on the report ''cost study 2016 (KS16) - estimation of the decommissioning cost of Swiss nuclear power plants'': decommissioning costs in Germany, France and the USA, indexing the Swiss cost estimation for decommissioning cost, impact factors on the decommissioning costs; specific indications on the report ''cost study 2016 (KS16) - estimation of the disposal cost - interim storage, transport, containers and reprocessing''; specific indications on the report ''cost studies (KS16) - estimation of disposal costs - geological deep disposal'': time scale and costs incurred, political/social risks, retrievability, comparison with other mining costs.

Understanding Costs of Care in the Operating Room.

Science.gov (United States)

Childers, Christopher P; Maggard-Gibbons, Melinda

2018-04-18

.40; ambulatory, $14.35 of $20.90), with nonbillable supplies accounting for less than 10% of total expenses (inpatient, $2.55 of $37.37; ambulatory, $3.33 of $35.39). From FY2005 to FY2014, expenses in the OR have increased faster than the consumer price index and medical consumer price index. Teaching hospitals had slower growth in costs than nonteaching hospitals. Over time, the proportion of expenses dedicated to indirect costs has increased, while the proportion attributable to salary and supplies has decreased. The mean cost of OR time is $36 to $37 per minute, using financial data from California's short-term general and specialty hospitals in FY2014. These statewide data provide a generalizable benchmark for the value of OR time. Furthermore, understanding the composition of costs will allow those interested in value improvement to identify high-yield targets.

Needs-based sewerage prioritization: alternative to conventional cost-benefit analysis.

Science.gov (United States)

Rashid, Md M; Hayes, Donald F

2011-10-01

This paper presents an empirical approach to select and prioritize sewerage projects within set budgetary limitations. The methodology includes a model which quantifies benefits of a sewerage project as an index or dimensionless number. The index considers need and urgency of sewerage and other project goals. Benefit is defined as the difference in anticipated impact between the current condition (without the project) and the expected condition with the project. Anticipated benefits primarily include reduction in environmental pollution, reduction of human diseases and morbidity, and other tangible and intangible improvement. This approach is a powerful decision tool for sewerage prioritization and an effective alternative to conventional cost-benefit analysis. Unlike conventional analysis, this approach makes no attempt to convert project benefits and other impacts into a monetary measure. This work recognizes that the decision to provide sewerage based solely on net benefits is not practical. Instead, benefit-cost ratios (B/C) are calculated utilizing cost-effectiveness approach. Using these ratios, 16 unserviced areas of Ensenada, Mexico are ranked. The prioritization rankings produced by this method must be further scrutinized and carefully reviewed for logic, accuracy of input data, and practicality of implementation. A similar framework may also be useful for prioritizing other public works projects. Copyright © 2011 Elsevier Ltd. All rights reserved.

Bounds and inequalities relating h-index, g-index, e-index and generalized impact factor: an improvement over existing models.

Science.gov (United States)

Abbas, Ash Mohammad

2012-01-01

In this paper, we describe some bounds and inequalities relating h-index, g-index, e-index, and generalized impact factor. We derive the bounds and inequalities relating these indexing parameters from their basic definitions and without assuming any continuous model to be followed by any of them. We verify the theorems using citation data for five Price Medalists. We observe that the lower bound for h-index given by Theorem 2, [formula: see text], g ≥ 1, comes out to be more accurate as compared to Schubert-Glanzel relation h is proportional to C(2/3)P(-1/3) for a proportionality constant of 1, where C is the number of citations and P is the number of papers referenced. Also, the values of h-index obtained using Theorem 2 outperform those obtained using Egghe-Liang-Rousseau power law model for the given citation data of Price Medalists. Further, we computed the values of upper bound on g-index given by Theorem 3, g ≤ (h + e), where e denotes the value of e-index. We observe that the upper bound on g-index given by Theorem 3 is reasonably tight for the given citation record of Price Medalists.

Profile of medical care costs in patients with amyotrophic lateral sclerosis in the Medicare programme and under commercial insurance.

Science.gov (United States)

Meng, Lisa; Bian, Amy; Jordan, Scott; Wolff, Andrew; Shefner, Jeremy M; Andrews, Jinsy

2018-02-01

To determine amyotrophic lateral sclerosis (ALS)-associated costs incurred by patients covered by Medicare and/or commercial insurance before, during and after diagnosis and provide cost details. Costs were calculated from the Medicare Standard Analytical File 5% sample claims data from Parts A and B from 2009, 2010 and 2011 for ALS Medicare patients aged ≥70 years (monthly costs) and ≥65 years (costs associated with disability milestones). Commercial insurance patients aged 18-63 years were selected based on the data provided in the Coordination of Benefits field from Truven MarketScan® in 2008-2010. Monthly costs increased nine months before diagnosis, peaked during the index month (Medicare: $10,398; commercial: $9354) and decreased but remained high post-index. Costs generally shifted from outpatient to inpatient and private nursing after diagnosis; prescriptions and durable medical equipment costs were much higher for commercial patients post-diagnosis. Patients appeared to progress to disability milestones more rapidly as their disease progressed in severity (14.4 months to non-invasive ventilation [NIV] vs. 16.6 months to hospice), and their costs increased accordingly (NIV: $58,973 vs. hospice: $76,179). For newly diagnosed ALS patients in the U.S., medical costs are substantial and increase rapidly and substantially with each disability milestone.

A benefit-cost methodology for developing environmental standards for uranium mill tailings disposal

International Nuclear Information System (INIS)

Leiter, A.J.

1982-01-01

This paper describes a method for using benefit-cost analysis in developing generally applicable environmental standards for uranium mill tailings disposal. Several disposal alternatives were selected which consist of different combinations of control measures. The resulting cost and benefit estimations allow the calculation of the incremental cost of obtaining incremental benefits of radiation protection. The overall benefit of a disposal alternative is expressed in terms of an index which is based on weighting factors assigned to individual benefits. The results show that some disposal alternatives have higher costs while providing no additional benefit than other alternatives. These alternatives should be eliminated from consideration in developing standards

Vocal activity as a low cost and scalable index of seabird colony size.

Science.gov (United States)

Borker, Abraham L; McKown, Matthew W; Ackerman, Joshua T; Eagles-Smith, Collin A; Tershy, Bernie R; Croll, Donald A

2014-08-01

Although wildlife conservation actions have increased globally in number and complexity, the lack of scalable, cost-effective monitoring methods limits adaptive management and the evaluation of conservation efficacy. Automated sensors and computer-aided analyses provide a scalable and increasingly cost-effective tool for conservation monitoring. A key assumption of automated acoustic monitoring of birds is that measures of acoustic activity at colony sites are correlated with the relative abundance of nesting birds. We tested this assumption for nesting Forster's terns (Sterna forsteri) in San Francisco Bay for 2 breeding seasons. Sensors recorded ambient sound at 7 colonies that had 15-111 nests in 2009 and 2010. Colonies were spaced at least 250 m apart and ranged from 36 to 2,571 m(2) . We used spectrogram cross-correlation to automate the detection of tern calls from recordings. We calculated mean seasonal call rate and compared it with mean active nest count at each colony. Acoustic activity explained 71% of the variation in nest abundance between breeding sites and 88% of the change in colony size between years. These results validate a primary assumption of acoustic indices; that is, for terns, acoustic activity is correlated to relative abundance, a fundamental step toward designing rigorous and scalable acoustic monitoring programs to measure the effectiveness of conservation actions for colonial birds and other acoustically active wildlife. © 2014 Society for Conservation Biology.

Resource costing for multinational neurologic clinical trials: methods and results.

Science.gov (United States)

Schulman, K; Burke, J; Drummond, M; Davies, L; Carlsson, P; Gruger, J; Harris, A; Lucioni, C; Gisbert, R; Llana, T; Tom, E; Bloom, B; Willke, R; Glick, H

1998-11-01

We present the results of a multinational resource costing study for a prospective economic evaluation of a new medical technology for treatment of subarachnoid hemorrhage within a clinical trial. The study describes a framework for the collection and analysis of international resource cost data that can contribute to a consistent and accurate intercountry estimation of cost. Of the 15 countries that participated in the clinical trial, we collected cost information in the following seven: Australia, France, Germany, the UK, Italy, Spain, and Sweden. The collection of cost data in these countries was structured through the use of worksheets to provide accurate and efficient cost reporting. We converted total average costs to average variable costs and then aggregated the data to develop study unit costs. When unit costs were unavailable, we developed an index table, based on a market-basket approach, to estimate unit costs. To estimate the cost of a given procedure, the market-basket estimation process required that cost information be available for at least one country. When cost information was unavailable in all countries for a given procedure, we estimated costs using a method based on physician-work and practice-expense resource-based relative value units. Finally, we converted study unit costs to a common currency using purchasing power parity measures. Through this costing exercise we developed a set of unit costs for patient services and per diem hospital services. We conclude by discussing the implications of our costing exercise and suggest guidelines to facilitate more effective multinational costing exercises.

The cost of obesity for nonbariatric inpatient operative procedures in the United States: national cost estimates obese versus nonobese patients.

Science.gov (United States)

Mason, Rodney J; Moroney, Jolene R; Berne, Thomas V

2013-10-01

To evaluate the economic impact of obesity on hospital costs associated with the commonest nonbariatric, nonobstetrical surgical procedures. Health care costs and obesity are both rising. Nonsurgical costs associated with obesity are well documented but surgical costs are not. National cost estimates were calculated from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database, 2005-2009, for the highest volume nonbariatric nonobstetric procedures. Obesity was identified from the HCUP-NIS severity data file comorbidity index. Costs for obese patients were compared with those for nonobese patients. To control for medical complexity, each obese patient was matched one-to-one with a nonobese patient using age, sex, race, and 28 comorbid defined elements. Of 2,309,699 procedures, 439,8129 (19%) were successfully matched into 2 medically equal groups (obese vs nonobese). Adjusted total hospital costs incurred by obese patients were 3.7% higher with a significantly (P cost of $648 (95% confidence interval [CI]: $556-$736) compared with nonobese patients. Of the 2 major components of hospital costs, length of stay was significantly increased in obese patients (mean difference = 0.0253 days, 95% CI: 0.0225-0.0282) and resource utilization determined by costs per day were greater in obese patients due to an increased number of diagnostic and therapeutic procedures needed postoperatively (odds ratio [OR] = 0.94, 95% CI: 0.93-0.96). Postoperative complications were equivalent in both groups (OR = 0.97, 95% CI: 0.93-1.02). Annual national hospital expenditures for the largest volume surgical procedures is an estimated $160 million higher in obese than in a comparative group of nonobese patients.

The effect of inflation rate on the cost of medical waste management system

Science.gov (United States)

Jolanta Walery, Maria

2017-11-01

This paper describes the optimization study aimed to analyse the impact of the parameter describing the inflation rate on the cost of the system and its structure. The study was conducted on the example of the analysis of medical waste management system in north-eastern Poland, in the Podlaskie Province. The scope of operational research carried out under the optimization study was divided into two stages of optimization calculations with assumed technical and economic parameters of the system. In the first stage, the lowest cost of functioning of the analysed system was generated, whereas in the second one the influence of the input parameter of the system, i.e. the inflation rate on the economic efficiency index (E) and the spatial structure of the system was determined. With the assumed inflation rate in the range of 1.00 to 1.12, the highest cost of the system was achieved at the level of PLN 2022.20/t (increase of economic efficiency index E by ca. 27% in comparison with run 1, with inflation rate = 1.12).

A Refractive Index Sensor Based on the Resonant Coupling to Cladding Modes in a Fiber Loop

Science.gov (United States)

Reyes, Mauricio; Monzón-Hernández, David; Martínez-Ríos, Alejandro; Silvestre, Enrique; Díez, Antonio; Cruz, José Luis; Andrés, Miguel V.

2013-01-01

We report an easy-to-build, compact, and low-cost optical fiber refractive index sensor. It consists of a single fiber loop whose transmission spectra exhibit a series of notches produced by the resonant coupling between the fundamental mode and the cladding modes in a uniformly bent fiber. The wavelength of the notches, distributed in a wavelength span from 1,400 to 1,700 nm, can be tuned by adjusting the diameter of the fiber loop and are sensitive to refractive index changes of the external medium. Sensitivities of 170 and 800 nm per refractive index unit for water solutions and for the refractive index interval 1.40–1.442, respectively, are demonstrated. We estimate a long range resolution of 3 × 10−4 and a short range resolution of 2 × 10−5 for water solutions. PMID:23979478

Review of the cost of venous thromboembolism

Science.gov (United States)

Fernandez, Maria M; Hogue, Susan; Preblick, Ronald; Kwong, Winghan Jacqueline

2015-01-01

Background Venous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion Costs for VTE treatment are considerable and increasing faster than general inflation for medical care services, with hospitalization costs being the primary cost driver. Readmissions for VTE are generally more costly than the initial VTE admission. Further studies evaluating the economic impact of new

Diversified Investments, Market Returns and Low Transaction Costs: Which is the Best Combination of these Factors?

Directory of Open Access Journals (Sweden)

Jose M. Ventura

2000-08-01

Full Text Available The article presents a way to build a diversified portfolio at a cost lower than what most investment service firms and advisors can provide through active fund management. The investment strategy presented consists of selecting the Index that is appropriate for the investment aims and investing the portfolio based on the mix of different indexes that reflect the investor's goal. Since index investing by definition does not select any other security than the one in the index and has to be purchased in the proportion reflected in the index, stock selection is straightforward and management fees are at a low level or even beat the minimum, if competition works.

Examination of the Cost-of-Carry Formula for Futures Contracts on WIG20. Wavelet and Nonlinear Cointegration Analysis

Science.gov (United States)

Bruzda, Joanna

The instantaneous and non-instantaneous dependences between spot and futures index prices has been subject of numerous empirical investigations. The theoretical background of these studies is the cost-ofcarry model introduced by [15]. The cost-of-carry model is an arbitrage relationship based on comparison between two alternative methods of acquiring an asset at some future date. In the first method an asset is purchased now and held until this future date. In the second case a futures contract with maturity on the required date is bought. The present value of the futures contract is invested at the risk free interest rate until delivery of the underlying asset at the maturity date. Arbitrage should ensure that the difference between the current asset price and the futures contract price is the cost of carrying the asset, which involves dividend yields and interest rates. The cost-of-carry formula gives the fair price of the futures contract: F_{t,T} = S_t e^{left( {r_t - d_t } right)left( {T - t} right)} where St is the security index price at time t, F t,T is the index futures price at time t with maturity T, r t is the risk free interest rate, d t is the dividend yield on the security index, and (T — t) is the time to maturity of the futures contract. Taking logarithms of both sides of equation (1) we get: f_{t,T} = s_t + left( {r_t - d_t } right)left( {T - t} right)

Complete cumulative index (1963-1983)

International Nuclear Information System (INIS)

1983-01-01

This complete cumulative index covers all regular and special issues and supplements published by Atomic Energy Review (AER) during its lifetime (1963-1983). The complete cumulative index consists of six Indexes: the Index of Abstracts, the Subject Index, the Title Index, the Author Index, the Country Index and the Table of Elements Index. The complete cumulative index supersedes the Cumulative Indexes for Volumes 1-7: 1963-1969 (1970), and for Volumes 1-10: 1963-1972 (1972); this Index also finalizes Atomic Energy Review, the publication of which has recently been terminated by the IAEA

Negative index effects from a homogeneous positive index prism

Science.gov (United States)

Marcus, Sherman W.; Epstein, Ariel

2017-12-01

Cellular structured negative index metamaterials in the form of a right triangular prism have often been tested by observing the refraction of a beam across the prism hypotenuse which is serrated in order to conform to the cell walls. We show that not only can this negative index effect be obtained from a homogeneous dielectric prism having a positive index of refraction, but in addition, for sampling at the walls of the cellular structure, the phase in the material has the illusory appearance of moving in a negative direction. Although many previous reports relied on refraction direction and phase velocity of prism structures to verify negative index design, our investigation indicates that to unambiguously demonstrate material negativity additional empirical evidence is required.

Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation.

Science.gov (United States)

Elsamadicy, Aladine A; Yang, Siyun; Sergesketter, Amanda R; Ashraf, Bilal; Charalambous, Lefko; Kemeny, Hanna; Ejikeme, Tiffany; Ren, Xinru; Pagadala, Promila; Parente, Beth; Xie, Jichun; Lad, Shivanand P

2017-09-29

The diagnosis and treatment of complex regional pain syndrome (CRPS) is challenging and there is a paucity of data describing its overall cost burden and quantifying its impact on the US healthcare system. The aim of this study was to assess the prevalence and healthcare utilization costs associated with CRPS. A retrospective longitudinal study was performed using the Truven MarketScan® database to identify patients with a new indexed diagnosis of CRPS (Type I, II, or both) from 2001 to 2012. We collected total, outpatient, and pain prescription costs three years prior to CRPS diagnosis (baseline), at year of CRPS diagnosis, and eight-year post-CRPS diagnosis. A longitudinal multivariate analysis was used to model the estimated total and pain prescription cost ratios comparing patients diagnosed before and after CRPS. We included 35,316 patients with a newly indexed diagnosis of CRPS (Type I: n = 18,703, Type II: n = 14,599, Unspecified: n = 2014). Baseline characteristics were similar between the CRPS cohorts. Compared to two- and three-year baseline costs, one-year prior to diagnosis for all CRPS patients yielded the highest interquartile median [IQR] costs: total costs $7904[$3469, $16,084]; outpatient costs $6706[$3119, $12,715]; and pain prescription costs $1862[$147, $7649]. At the year of CRPS diagnosis, the median [IQR] costs were significantly higher than baseline costs: total costs $8508[$3943, $16,666]; outpatient costs $7251[$3527, $13,568]; and pain prescription costs $2077[$140, $8856]. Over the eight-year period after CRPS diagnosis, costs between all the years were similar, ranging from the highest (one-year) to lowest (seven-years), $4845 to $3888. The median total cumulative cost 8-years after CRPS diagnosis was $43,026 and $12,037 for pain prescription costs. [Correction added on 06 November 2017 after first online publication: the preceding sentence has been updated to demonstrate the median cumulative cost in replacement of the

Development of Dimensionless Index Assessing Low Impact Development in Urban Areas

Science.gov (United States)

Jun, S. H.; Lee, E. H.; Kim, J. H.

2017-12-01

Because the rapid urbanization and industrialization have increased the impervious area of watersheds, inundation in urban area and water pollution of river by non-point pollutants have caused serious problems for a long time. Low Impact Development (LID) techniques have been implemented for the solution of these problems due to its cost effectiveness for mitigating the water quality and quantity impact on urban areas. There have been many studies about the effectiveness of LID, but there is a lack of research on developing an index for the assessment of LID performance. In this study, the dimensionless reliability index of LID is proposed. The index is developed using Distance Measure Method (DMM). DMM is used to consider the parameters that have different units. The parameters for reliability of LID are the amount of pollutant at the outfall and the flooding volume. Both parameters become dimensionless index by DMM. Weighted factors in dimensionless index are considered to realize the behavior of reliability for the variation of importance to the parameters. LID is applied to an actual area called Gasan city in Seoul, South Korea where inundation is frequently occurred. The reliability is estimated for 16 different rainfall events. For each rainfall event, the parameters with LID installation are compared with those of no LID installation. Depending on which parameter is considered more important, the results showed difference. In conclusion, the optimal locations of LID are suggested as the weighted factors change.

COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

Directory of Open Access Journals (Sweden)

Moisello Anna Maria

2012-07-01

Full Text Available Firms are coping with a competitive scenario characterized by quick changes produced by internationalization, concentration, restructuring, technological innovation processes and financial market crisis. On the one hand market enlargement have increased the number and the segmentation of customers and have raised the number of competitors, on the other hand technological innovation has reduced product life cycle. So firms have to adjust their management models to this scenario, pursuing customer satisfaction and respecting cost constraints. In a context where price is a variable fixed by the market, firms have to switch from the cost measurement logic to the cost management one, adopting target costing methodology. The target costing process is a price driven, customer oriented profit planning and cost management system. It works, in a cross functional way, from the design stage throughout all the product life cycle and it involves the entire value chain. The process implementation needs a costing methodology consistent with the cost management logic. The aim of the paper is to focus on Activity Based Costing (ABC application to target costing process. So: -it analyzes target costing logic and phases, basing on a literary review, in order to highlight the costing needs related to this process; -it shows, through a numerical example, how to structure a flexible ABC model – characterized by the separation between variable, fixed in the short and fixed costs - that effectively supports target costing process in the cost measurement phase (drifting cost determination and in the target cost alignment; -it points out the effectiveness of the Activity Based Costing as a model of cost measurement applicable to the supplier choice and as a support for supply cost management which have an important role in target costing process. The activity based information allows a firm to optimize the supplier choice by following the method of minimizing the

The effect of chain membership on hospital costs.

Science.gov (United States)

Menke, T J

1997-06-01

To compare the cost structures of hospitals in multihospital systems and independently owned hospitals. The American Hospital Association's Annual Survey from 1990 for data on hospital costs and attributes. Area characteristics came from the Area Resource File, and the Medicare case-mix index came from the Health Care Financing Administration. Data on wages are from the Bureau of the Census' State and Metropolitan Area Data Book. The Guide to Hospital Performance from HCIA, Inc. provided data on quality of care. Separate cost functions were estimated for chain and independent hospitals. Hybrid translog cost functions included measures of outputs, input prices, and hospital and area characteristics. The estimation method accounted for the simultaneous determination of costs and chain membership, and for any nonrandom selection of hospitals into chains. Several economic cost measures were calculated to compare the cost structures of the two types of hospitals. Data from all sources were merged at the hospital level to form the study sample. Hospitals in multihospital systems were less costly than independently owned hospitals. Among independent hospitals, for-profits had the highest costs. There were no statistically significant differences in costs by ownership among chain members. Economies of scale were enjoyed in both types of hospitals only at high volumes of output, while economies of scope occurred at all volumes for chain hospitals, but only at low and medium volumes for independent hospitals. This study provides support for the idea that growth of the multihospital system sector can provide a market solution to the problem of constraining costs. It does not, however, support the property rights theory that proprietary hospitals are more efficient than nonprofit hospitals.

IndexCat

Data.gov (United States)

U.S. Department of Health & Human Services — IndexCat provides access to the digitized version of the printed Index-Catalogue of the Library of the Surgeon General's Office; eTK for medieval Latin texts; and...

Substantiating the Expediency of Costs on Introduction of the System of Economic Security of Enterprise

Directory of Open Access Journals (Sweden)

Melikhova Tetiana O.

2018-01-01

Full Text Available The article substantiates expediency of introduction of the system of economic security of enterprise on the basis of money flows. The methods proposed in the long-term period stipulate the use as sources of financing: accumulated conditional economic costs, accumulated conditional gross and net money flow; and as costs: cumulative advanced costs and the advanced value of fixed assets. The article suggests methods for calculation of: gross index of conditional yield; gross conditional income of project; gross conditional profitability; gross conditional profitability of money flow. The managerial decision on introduction of the system of economic security of enterprise in the short-term production period has been substantiated on the basis of calculations of the following indicators: gross profitability of annual depreciation; annual gross economic effect; index of conditional yield of the gross money flow; differences between the conditional gross cash flow and the depreciation deductions associated with the implementation of the enterprise’s economic security system.

External risk factors affecting construction costs

Science.gov (United States)

Mubarak, Husin, Saiful; Oktaviati, Mutia

2017-11-01

Some risk factors can have impacts on the cost, time, and performance. Results of previous studies indicated that the external conditions are among the factors which give effect to the contractor in the completion of the project. The analysis in the study carried out by considering the conditions of the project in the last 15 years in Aceh province, divided into military conflict phase (2000-2004), post tsunami disaster rehabilitation and reconstruction phase (2005-2009), and post-rehabilitation and reconstruction phase (2010-present). This study intended to analyze the impact of external risk factors, primarily related to the impact on project costs and to investigate the influence of the risk factors and construction phases impacted the project cost. Data was collected by using a questionnaire distributed in 15 large companies qualification contractors in Aceh province. Factors analyzed consisted of socio-political, government policies, natural disasters, and monetary conditions. Data were analyzed using statistical application of severity index to measure the level of risk impact. The analysis results presented the tendency of impact on cost can generally be classified as low. There is only one variable classified as high-impact, variable `fuel price increases', which appear on the military conflict and post tsunami disaster rehabilitation and reconstruction periods. The risk impact on costs from the factors and variables classified with high intensity needs a serious attention, especially when the high level impact is followed by the high frequency of occurrences.

AP Index

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Planetary Amplitude index - Bartels 1951. The a-index ranges from 0 to 400 and represents a K-value converted to a linear scale in gammas (nanoTeslas)--a scale that...

Public synthesis of the reference costs study of the electric power production

International Nuclear Information System (INIS)

2008-01-01

Every 3 or 5 years, the DGEC published the reference costs study of the electric power production which evaluates, in a theoretical framework, the total cost of an electrical MWh, from different production ways. These studies bring information for the definition of the energy policy and the elaboration of the investments program. because of the great competition of the market, it was decided not to publish the absolute value of the hypothesis and the results but under indexed form. (A.L.B.)

Introducing a conditional 'Willingness to Pay' index as a quantifier for environmental impact assessment

Science.gov (United States)

Batzias, Fragiskos; Kopsidas, Odysseas

2012-12-01

The optimal concentration Copt of a pollutant in the environment can be determined as an equilibrium point in the trade off between (i) environmental cost, due to impact on man/ecosystem/economy, and (ii) economic cost for environmental protection, as it can be expressed by Pigouvian tax. These two conflict variables are internalized within the same techno-economic objective function of total cost, which is minimized. In this work, the first conflict variable is represented by a Willingness To Pay (WTP) index. A methodology is developed for the estimation of this index by using fuzzy sets to count for uncertainty. Implementation of this methodology is presented, concerning odor pollution of air round an olive pomace oil mill. The ASTM E544-99 (2004) 'Standard Practice for Referencing Suprathreshold Odor Intensity' has been modified to serve as a basis for testing, while a network of the quality standards, required for the realization/application of this 'Practice', is also presented. Last, sensitivity analysis of Copt as regards the impact of (i) the increase of environmental information/sensitization and (ii) the decrease of interest rate reveals a shifting of Copt to lower and higher values, respectively; certain positive and negative implications (i.e., shifting of Copt to lower and higher values, respectively) caused by socio-economic parameters are also discussed.

Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

Directory of Open Access Journals (Sweden)

Hong J. Kan

2013-01-01

Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

7 CFR 5.1 - Parity index and index of prices received by farmers.

Science.gov (United States)

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Parity index and index of prices received by farmers... § 5.1 Parity index and index of prices received by farmers. (a) The parity index and related indices... farmers, interest, taxes, and farm wage rates, as revised May 1976 and published in the May 28, 1976, and...

Indexes to Nuclear Regulatory Commission issuances, January--June 1995. Volume 41, Index 2

International Nuclear Information System (INIS)

1995-09-01

Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and Licensing Board Panel (LBP), the Administrative Law Judges (ALJ), the directors' Decisions (DD), and the Denials of Petitions for rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. The information elements are displayed in one or more of five separate formats arranged as follows: Case name index; digests and headers; legal citations index; subject index; and facility index

Indexes to Nuclear Regulatory Commission issuances, January-March 1984. Volume 19, Index 1

International Nuclear Information System (INIS)

1984-01-01

Digests and indexes for issuances of the Commission, the Atomic Safety and Licensing Appeal Panel, the Atomic Safety and Licensing Board Panel, the Administrative Law Judge, the Directors' Decisions, and the Denials of Petitions of Rulemaking are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. Information elements are displayed in one or more of five separate formats: Case Name Index, Digests and Headers, Legal Citations Index, Subject Index, and Facility Index

Indexes to Nuclear Regulatory Commission Issuances, July--December 1993. Volume 38, Index 2

Energy Technology Data Exchange (ETDEWEB)

1994-04-01

Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and Licensing Board Panel (LBP), the Administrative Law Judges (ALJ), the Directors` Decisions (DD), and the Denials of Petitions for Rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. These information elements are displayed in one or more of five separate formats arranged as follows: Case Name Index; Digests and Headers; Legal Citations Index; Subject Index, and Facility Index.

Indexes to Nuclear Regulatory Commission issuances, January--June 1995. Volume 41, Index 2

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and Licensing Board Panel (LBP), the Administrative Law Judges (ALJ), the directors` Decisions (DD), and the Denials of Petitions for rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. The information elements are displayed in one or more of five separate formats arranged as follows: Case name index; digests and headers; legal citations index; subject index; and facility index.

(Super Variable Costing-Throughput Costing)

OpenAIRE

Çakıcı, Cemal

2006-01-01

(Super Variable Costing-Throughput Costing) The aim of this study is to explain the super-variable costing method which is a new subject in cost and management accounting and to show it’s working practicly.Shortly, super-variable costing can be defined as a costing method which is use only direct material costs in calculate of product costs and treats all costs except these (direct labor and overhead) as periad costs or operating costs.By using super-variable costing method, product costs ar...

Quality indexes for selecting control materials of the nuclear reactors

International Nuclear Information System (INIS)

Martinez-Val, J.M.; Pena, J.; Esteban Naudin, A.

1981-01-01

Quality indexes are established and valued for selecting control materials, The requirements for accomplishing such purposes are explained with detailed analysis: absortion cross section must be as high as possible, adequate reactivity evolution versus depletion, good resistance to radiation, appropiate thermal stability, mechanical resistance and ductility, chemical compatibility with the environment, good heat transfer properties, abundant in the nature and low costs. At present Westinghouse desire to commercialize hafnium as control material shows the exciting task of looking for new materials controlling nuclear reactors. (auth.)

Investigation on the Factors Influencing Construction Time and Cost Overrun for High-Rise Building Projects In Penang

Science.gov (United States)

Nor Haslinda, A.; Xian, T. Wei; Norfarahayu, K.; Muhamad Hanafi, R.; Fikri, H. Muhammad

2018-04-01

Time and cost overruns have become one prominent issue for most construction projects around the world. Project costing and timeframe extension had been causing a lot of wastage and loss of opportunity for many parties involved. Therefore, this research was carried out to investigate the factors influencing time and cost overruns for high-rise construction projects in Penang, Malaysia. A set of questionnaires survey was distributed to the project managers who had been or currently involved in the high-rise building projects in Penang to get their input and perceptions for each factor identified as well as its frequency of occurrence. In order to rank all the factors gathered, the mean index of the most distinguishing factors and its frequency of occurrence were multiplied to get the severity index. The results revealed that for time overrun, the most predominant causes were due to design changes, inadequate planning and scheduling and poor labor productivity. Meanwhile, the predominant causes of cost overrun were poor pre-construction budget and material cost planning, inaccurate quantity take-off and materials cost increased by inflation. The significance of establishing the issues related to time and cost overruns for the high-rise building construction project is to provide a greater insight and understanding on the causes of delays, particularly among the main project players: contractors, client, and consultants.

The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis.

Science.gov (United States)

Malinowski, Krzysztof Piotr; Kawalec, Paweł

2015-04-01

The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions.

21 CFR 516.157 - Publication of the index and content of an index listing.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Publication of the index and content of an index... MINOR SPECIES Index of Legally Marketed Unapproved New Animal Drugs for Minor Species § 516.157 Publication of the index and content of an index listing. (a) FDA will make the list of indexed drugs...

Understanding the direct and indirect costs of patients with schizophrenia [v2; ref status: indexed, http://f1000r.es/5ow

Directory of Open Access Journals (Sweden)

Kazuhiro Tajima-Pozo

2015-08-01

Full Text Available Background: Schizophrenia is a disabling mental disorder with high prevalence and that usually  requires long-term follow-up and expensive lifelong treatment. The cost of schizophrenia treatment consumes a significant amount of the health services' budget in western countries. Objective: The aim of the study was to find out about the costs related to schizophrenia across different european countries and compare them. Results: Schizophrenia treatment costs an estimated 18 billion euros annually worldwide. The direct costs associated with medical help are only part of the total expenditure. The indirect costs are an equally (or even moreimportant part of the total cost. These expenses are related to the lack of productivity of schizophrenic patients and the cost that relatives have to bear as a result of taking care of their affected relatives. Conclusions: Although data on the cost of schizophrenia may vary slightly between different european countries, the general conclusion that can be drawn is that schizophrenia is a very costly disorder. Not only because of direct costs related to medical procedures, but also due to the non-medical (indirect costs. Together this suggests the need to investigate cost-efficient strategies that could provide a better outcome for schizophrenic patients, as well as the people who care for them.

Review of the cost of venous thromboembolism

Directory of Open Access Journals (Sweden)

Fernandez MM

2015-08-01

Full Text Available Maria M Fernandez,1 Susan Hogue,1 Ronald Preblick,2 Winghan Jacqueline Kwong2 1RTI-Health Solutions, Market Access and Outcomes Strategy, Research Triangle Park, NC, 2Daiichi Sankyo, Inc., Health Economics & Outcomes Research, Parsippany, NJ, USA Background: Venous thromboembolism (VTE is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods: Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results: Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion: Costs for VTE treatment are

Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis

Directory of Open Access Journals (Sweden)

Mohammad M. H. Abdullah

2017-07-01

Full Text Available Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D and incidence of cardiovascular disease (CVD following a low glycemic index (GI or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1 estimate the proportions of individuals who are likely to consume pulses; (2 evaluate the reductions in established risk factors for T2D and CVD; (3 assess the percent reduction in incidences or complications of the diseases of interest; and (4 calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9 to Can$62.4 (95% CI $26–$98.8 and Can$31.6 (95% CI $11.1–$52 to Can$315.5 (95% CI $110.6–$520.4 million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term.

Cost effectiveness of drug eluting coronary artery stenting in a UK setting: cost-utility study.

Science.gov (United States)

Bagust, A; Grayson, A D; Palmer, N D; Perry, R A; Walley, T

2006-01-01

To assess the cost effectiveness of drug eluting stents (DES) compared with conventional stents for treatment of symptomatic coronary artery disease in the UK. Cost-utility analysis of audit based patient subgroups by means of a simple economic model. Tertiary care. 12 month audit data for 2884 patients receiving percutaneous coronary intervention with stenting at the Cardiothoracic Centre Liverpool between January 2000 and December 2002. Risk of repeat revascularisation within 12 months of index procedure and reduction in risk from use of DES. Economic modelling was used to estimate the cost-utility ratio and threshold price premium. Four factors were identified for patients undergoing elective surgery (n = 1951) and two for non-elective surgery (n = 933) to predict risk of repeat revascularisation within 12 months. Most patients fell within the subgroup with lowest risk (57% of the elective surgery group with 5.6% risk and 91% of the non-elective surgery group with 9.9% risk). Modelled cost-utility ratios were acceptable for only one group of high risk patients undergoing non-elective surgery (only one patient in audit data). Restricting the number of DES for each patient improved results marginally: 4% of stents could then be drug eluting on economic grounds. The threshold price premium justifying 90% substitution of conventional stents was estimated to be 112 pound sterling (212 USD, 162 pound sterling) (sirolimus stents) or 89 pound sterling (167 USD, 130 pound sterling) (paclitaxel stents). At current UK prices, DES are not cost effective compared with conventional stents except for a small minority of patients. Although the technology is clearly effective, general substitution is not justified unless the price premium falls substantially.

Price control in contracts of heat supply. May no more index be used in automatic price escalator clauses?; Preiskontrolle in Waermeliefervertraegen.. Darf in automatischen Preisgleitklauseln kein Index mehr genutzt werden?

Energy Technology Data Exchange (ETDEWEB)

Legler, Dirk [Guenther Heidel Wollenteit Hack Goldmann, Hamburg (Germany)

2010-03-15

Automatic price escalator clauses using a price index are AGB legally permissible in heat supply contracts. The fact that such price indices necessarily compound and orient themselves only at its own development of delivery costs is so long innocuous since the selection of these indices essentially can be justified on the basis of objective criteria. However, if the heat supplier as a user of the AGB uses no indices, but passes its costs of acquisition in its price escalator clause simply to 100 %, this evenly can be inadmissible according to paragraph 24 sect. 3, sentence 1 of AVB district heating regulation. This is valid if such a 'servile' passing signifies a neglect of conditions on the market.

Hospital costs for treatment of acute heart failure: economic analysis of the REVIVE II study.

Science.gov (United States)

de Lissovoy, Greg; Fraeman, Kathy; Teerlink, John R; Mullahy, John; Salon, Jeff; Sterz, Raimund; Durtschi, Amy; Padley, Robert J

2010-04-01

Acute heart failure (AHF) is the leading cause of hospital admission among older Americans. The Randomized EValuation of Intravenous Levosimendan Efficacy (REVIVE II) trial compared patients randomly assigned to a single infusion of levosimendan (levo) or placebo (SOC), each in addition to local standard treatments for AHF. We report an economic analysis of REVIVE II from the hospital perspective. REVIVE II enrolled patients (N = 600) hospitalized for treatment of acute decompensated heart failure (ADHF) who remained dyspneic at rest despite treatment with intravenous diuretics. Case report forms documented index hospital treatment (drug administration, procedures, days of treatment by care unit), as well as subsequent hospital and emergency department admissions during follow-up ending 90 days from date of randomization. These data were used to impute cost of admission based on an econometric cost function derived from >100,000 ADHF hospital billing records selected per REVIVE II inclusion criteria. Index admission mean length of stay (LOS) was shorter for the levo group compared with standard of care (SOC) (7.03 vs 8.96 days, P = 0.008) although intensive care unit (ICU)/cardiac care unit (CCU) days were similar (levo 2.88, SOC 3.22, P = 0.63). Excluding cost for levo, predicted mean (median) cost for the index admission was levo US $13,590 (9,458), SOC $19,021 (10,692) with a difference of $5,431 (1,234) favoring levo (P = 0.04). During follow-up through end of study day 90, no significant differences were observed in numbers of hospital admissions (P = 0.67), inpatient days (P = 0.81) or emergency department visits (P = 0.41). Cost-effectiveness was performed with a REVIVE-II sub-set conforming to current labeling, which excluded patients with low baseline blood pressure. Assuming an average price for levo in countries where currently approved, there was better than 50% likelihood that levo was both cost-saving and improved survival. Likelihood that levo would

Indexes to Nuclear Regulatory Commission issuances, January-June 1986. Volume 23, Index 2

International Nuclear Information System (INIS)

1986-01-01

Digests and indexes for issuances of the Commission, the Atomic Safety and Licensing Appeal Panel, the Atomic Safety and Licensing Board Panel, the Administrative Law Judge, the Directors' Decisions, and the Denials of Petitions of Rulemaking are presented in this document. The information elements are displayed in one or more of five separate formats. These formats are case name index, digests and headers, legal citations index, subject index, and facility index

Virginia ESI: INDEX (Index Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

Predictors of mental health-related acute service utilisation and treatment costs in the 12 months following an acute psychiatric admission.

Science.gov (United States)

Siskind, Dan; Harris, Meredith; Diminic, Sandra; Carstensen, Georgia; Robinson, Gail; Whiteford, Harvey

2014-11-01

A key step in informing mental health resource allocation is to identify the predictors of service utilisation and costs. This project aims to identify the predictors of mental health-related acute service utilisation and treatment costs in the year following an acute public psychiatric hospital admission. A dataset containing administrative and routinely measured outcome data for 1 year before and after an acute psychiatric admission for 1757 public mental health patients was analysed. Multivariate regression models were developed to identify patient- and treatment-related predictors of four measures of service utilisation or cost: (a) duration of index admission; and, in the year after discharge from the index admission (b) acute psychiatric inpatient bed-days; (c) emergency department (ED) presentations; and (d) total acute mental health service costs. Split-sample cross-validation was used. A diagnosis of psychosis, problems with living conditions and prior acute psychiatric inpatient bed-days predicted a longer duration of index admission, while prior ED presentations and self-harm predicted a shorter duration. A greater number of acute psychiatric inpatient bed-days in the year post-discharge were predicted by psychosis diagnosis, problems with living conditions and prior acute psychiatric inpatient admissions. The number of future ED presentations was predicted by past ED presentations. For total acute care costs, diagnosis of psychosis was the strongest predictor. Illness acuity and prior acute psychiatric inpatient admission also predicted higher costs, while self-harm predicted lower costs. The development of effective models for predicting acute mental health treatment costs using existing administrative data is an essential step towards a workable activity-based funding model for mental health. Future studies would benefit from the inclusion of a wider range of variables, including ethnicity, clinical complexity, cognition, mental health legal status

Comparative analysis of the cost and effectiveness of generic and brand-name antibiotics: the case of uncomplicated urinary tract infection.

Science.gov (United States)

Lin, Yu-Shiuan; Jan, I-Shiow; Cheng, Shou-Hsia

2017-03-01

Generic medications used for chronic diseases are beneficial in containing healthcare costs and improving drug accessibility. However, the effects of generic drugs in acute and severe illness remain controversial. This study aims to investigate treatment costs and outcomes of generic antibiotics prescribed for adults with a urinary tract infection in outpatient settings. The data source was the Longitudinal Health Insurance Database of Taiwan. We included outpatients aged 20 years and above with a urinary tract infection who required one oral antibiotic for which brand-name and generic products were simultaneously available. Drug cost and overall healthcare expense of the index consultation, healthcare cost during a 42-day follow-up period, and treatment failure rates were the main dependent variables. Data were compared between brand-name and generic users from the entire cohort and a propensity score-matched samples. Results from the entire cohort and propensity score-matched samples were similar. Daily antibiotic cost was significantly lower among generic users than brand-name users. Significant lower total drug claims of the index consultation only existed in patients receiving the investigated antibiotics, while the drug price between brand-name and generic versions were relatively large (e.g., >50%). The overall healthcare cost of the index consultation, healthcare expenditure during a 42-day follow-up period, and treatment failure rates were similar between the two groups. Compared with those treated with brand-name antibiotics, outpatients who received generic antibiotics had equivalent treatment outcomes with lower drug costs. Generic antibiotics are effective and worthy of adoption among outpatients with simple infections indicating oral antibiotic treatment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Professor Jeffery on the real cost of nuclear electricity in the UK: a note; and reply

International Nuclear Information System (INIS)

McGuire, A.; Barclay, R.S.; Jeffery, J.W.

1982-01-01

Two letters published in reply to an earlier article on the real cost of nuclear electricity in the U.K. criticize the use of the Retail Price Index as a price deflator and the attempts to convert capital charges from historical to a current cost basis. Corrections are made to the corresponding results. The author of the original article replies. (U.K.)

Indexes to Nuclear Regulatory Commission issuances, January-June 1984. Vol. 19, Index 2

International Nuclear Information System (INIS)

1984-11-01

Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and Licensing Appeal Panel (ALAB), the Atomic Safety and Licensing Board Panel (LBP), the Administrative Law Judge (ALJ), the Directors' Decisions (DD), and the Denials of Petitions of Rulemaking are presented in this document. The information elements are displayed in one or more of five separate formats: case name index, digests and headers, legal citations index, subject index, and facility index

Complete daVinci versus laparoscopic pyeloplasty: cost analysis.

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Bhayani, Sam B; Link, Richard E; Varkarakis, John M; Kavoussi, Louis R

2005-04-01

Computer-assisted pyeloplasty with the daVinci system is an emerging technique to treat ureteropelvic junction (UPJ) obstruction. A relative cost analysis was performed assessing this technology in comparison with purely laparoscopic pyeloplasty. Eight patients underwent computer-assisted (daVinci) dismembered pyeloplasty (CP) via a transperitoneal four-port approach. They were compared with 13 patients who underwent purely laparoscopic pyeloplasty (LP). All patients had a primary UPJ obstruction and were matched for age, sex, and body mass index. The cost of equipment and capital depreciation for both procedures, as well as assessment of room set-up time, takedown time, and personnel were analyzed. Surgeons and nursing staff for both groups were experienced in both laparoscopy and daVinci procedures. One- and two-way financial analysis was performed to assess relative costs. The mean set-up and takedown time was 71 minutes for CP and 49 minutes for LP. The mean length of stay was 2.3 days for CP and 2.5 days for LP. The mean operating room (OR) times for CP and LP were 176 and 210 minutes, respectively. There were no complications in either group. One-way cost analysis with an economic model showed that LP is more cost effective than CP at our hospital if LP OR time is cost effective as LP. Two-way sensitivity analysis shows that in-room time must still be 500 to obtain cost equivalence for CP. Perioperative parameters for CP are encouraging. However, the costs are a clear disadvantage. In our hospital, it is more cost effective to teach and perform LP than to perform CP.

Análise custo-efetividade e índice de qualidade da refeição aplicados à Estratégia Global da OMS Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy

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Flávia Mori Sarti Machado

2008-02-01

menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost. Health benefits were estimated based on adaptation of the Diet Quality Index (DQI. Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. RESULTS: The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58 as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72 compared to the others (DQI2=48 / DQI4=58. CONCLUSIONS: The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

Flood Victims Quality of Life Index 2017 (FVQoL-Index'17: scale ...

African Journals Online (AJOL)

Flood Victims Quality of Life Index 2017 (FVQoL-Index'17: scale development ... constructed (adapted and modified) based on the previous standardized instruments. The findings from this study reveal that FVQoL-Index'17 allowed to measure ...

The cost of ignoring acute cholecystectomy.

Science.gov (United States)

Garner, J P; Sood, S K; Robinson, J; Barber, W; Ravi, K

2009-01-01

Biliary symptoms whilst awaiting elective cholecystectomy are common, resulting in hospital admission, further investigation and increased hospital costs. Immediate cholecystectomy during the first admission is safe and effective, even when performed laparoscopically, but acute laparoscopic cholecystectomy has only recently become increasingly commonplace in the UK. This study was designed to quantify this problem in our hospital and its cost implications. The case notes of all patients undergoing laparoscopic cholecystectomy in our hospital between January 2004 and June 2005 were examined for details of hospital admissions with biliary symptoms or complications whilst waiting for elective cholecystectomy. Additional bed occupancy and radiological investigations were recorded and these costs to the trust calculated. We compared the potential tariff income to the hospital trust for the actual management of these patients and if a policy of acute laparoscopic cholecystectomy on first admission were in place. In the 18-month study period, 259 patients (202 females) underwent laparoscopic cholecystectomy. Of these, 147 presented as out-patients and only 11% required hospital admission because of biliary symptoms whilst waiting for elective surgery. There were 112 patients who initially presented acutely and were managed conservatively. Twenty-four patients were re-admitted 37 times, which utilised 231 hospital bed-days and repeat investigations costing over 40,000 pounds. There would have been a marginal increase in tariff income if a policy of acute laparoscopic cholecystectomy had been in place. Adoption of a policy of acute laparoscopic cholecystectomy on the index admission would result in substantial cost savings to the trust, reduce elective cholecystectomy waiting times and increase tariff income.

Predicting fiber refractive index from a measured preform index profile

Science.gov (United States)

Kiiveri, P.; Koponen, J.; Harra, J.; Novotny, S.; Husu, H.; Ihalainen, H.; Kokki, T.; Aallos, V.; Kimmelma, O.; Paul, J.

2018-02-01

When producing fiber lasers and amplifiers, silica glass compositions consisting of three to six different materials are needed. Due to the varying needs of different applications, substantial number of different glass compositions are used in the active fiber structures. Often it is not possible to find material parameters for theoretical models to estimate thermal and mechanical properties of those glass compositions. This makes it challenging to predict accurately fiber core refractive index values, even if the preform index profile is measured. Usually the desired fiber refractive index value is achieved experimentally, which is expensive. To overcome this problem, we analyzed statistically the changes between the measured preform and fiber index values. We searched for correlations that would help to predict the Δn-value change from preform to fiber in a situation where we don't know the values of the glass material parameters that define the change. Our index change models were built using the data collected from preforms and fibers made by the Direct Nanoparticle Deposition (DND) technology.

Sediment acoustic index method for computing continuous suspended-sediment concentrations

Science.gov (United States)

Landers, Mark N.; Straub, Timothy D.; Wood, Molly S.; Domanski, Marian M.

2016-07-11

Suspended-sediment characteristics can be computed using acoustic indices derived from acoustic Doppler velocity meter (ADVM) backscatter data. The sediment acoustic index method applied in these types of studies can be used to more accurately and cost-effectively provide time-series estimates of suspended-sediment concentration and load, which is essential for informed solutions to many sediment-related environmental, engineering, and agricultural concerns. Advantages of this approach over other sediment surrogate methods include: (1) better representation of cross-sectional conditions from large measurement volumes, compared to other surrogate instruments that measure data at a single point; (2) high temporal resolution of collected data; (3) data integrity when biofouling is present; and (4) less rating curve hysteresis compared to streamflow as a surrogate. An additional advantage of this technique is the potential expansion of monitoring suspended-sediment concentrations at sites with existing ADVMs used in streamflow velocity monitoring. This report provides much-needed standard techniques for sediment acoustic index methods to help ensure accurate and comparable documented results.

Modified Optimization Water Index (mowi) for LANDSAT-8 Oli/tirs

Science.gov (United States)

Moradi, M.; Sahebi, M.; Shokri, M.

2017-09-01

Water is one of the most important resources that essential need for human life. Due to population growth and increasing need of human to water, proper management of water resources will be one of the serious challenges of next decades. Remote sensing data is the best way to the management of water resources due time and cost effectiveness over a greater range of temporal and spatial scales. Between many kinds of satellite data, from SAR to optic or from high resolution to low resolution, Landsat imagery is more interesting data for water detection and management of earth surface water. Landsat8 OLI/TIRS is the newest version of Landsat satellite series. In this paper, we investigated the full spectral potential of Landsat8 for water detection. It is developed many kinds of methods for this purpose that index based methods have some advantages than other methods. Pervious indices just use a limited number of spectral band. In this paper, Modified Optimization Water Index (MOWI) defined by consideration of a linear combination of bands that each coefficient of bands calculated by particle swarm algorithm. The result shows that modified optimization water index (MOWI) has a proper performance on different condition like cloud, cloud shadow and mountain shadow.

An evaluation of the impact of patient cost sharing for antihypertensive medications on adherence, medication and health care utilization, and expenditures

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Pesa JA

2012-01-01

Full Text Available Jacqueline A Pesa1, Jill Van Den Bos2, Travis Gray2, Colleen Hartsig2, Robert Brett McQueen3, Joseph J Saseen3, Kavita V Nair31Janssen Scientific Affairs, LLC, Louisville, CO, USA; 2Milliman, Inc, Denver, CO, USA; 3University of Colorado Anschutz Medical Campus, Aurora, CO, USAObjective: To assess the impact of patient cost-sharing for antihypertensive medications on the proportion of days covered (PDC by antihypertensive medications, medical utilization, and health care expenditures among commercially insured individuals assigned to different risk categories.Methods: Participants were identified from the Consolidated Health Cost Guidelines (CHCG database (January 1, 2006–December 31, 2008 based on a diagnosis (index claim for hypertension, continuous enrollment ≥12 months pre- and post-index, and no prior claims for antihypertensive medications. Participants were assigned to: low-risk group (no comorbidities, high-risk group (1+ selected comorbidities, or very high-risk group (prior hospitalization for 1+ selected comorbidities. The relationship between patient cost sharing and PDC by antihypertensive medications was assessed using standard linear regression models, controlling for risk group membership, and various demographic and clinical factors. The relationship between PDC and health care service utilization was subsequently examined using negative binomial regression models.Results: Of the 28,688 study patients, 66% were low risk. The multivariate regression model supported a relationship between patient cost sharing per 30-day fill and PDC in the following year. For every US$1.00 increase in cost sharing, PDC decreased by 1.1 days (P < 0.0001. Significant predictors of PDC included high risk, older age, gender, Charlson Comorbidity Index score, geography, and total post-index insurer- and patient-paid costs. An increase in PDC was associated with a decrease in all-cause and hypertension-related inpatient, outpatient, and emergency

Real world cost of human epidermal receptor 2-positive metastatic breast cancer patients: a longitudinal incidence-based observational costing study in the Netherlands and Belgium.

Science.gov (United States)

Frederix, G W J; Severens, J L; Hövels, A M; van Hasselt, J G C; Hooiveld, M J J; Neven, P; Raaijmakers, J A M; Schellens, J H M

2015-05-01

Currently, no country-specific metastatic breast cancer (MBC) observational costing data are available for the Netherlands and Belgium. Our aim is to describe country-specific resource use and costs of human epidermal receptor 2 (HER-2)-positive MBC in the Netherlands and Belgium, making use of real-world data. The eligibility period for patient selection was from April 2004 to April 2010. Inclusion and retrospective data collection begins at the time of first diagnosis of HER-2-positive MBC during the eligibility period and ends 24 months post-index diagnosis of MBC or at patient death. We identified 88 eligible patients in the Netherlands and 44 patients in Belgium. The total costs of medical treatment and other resource use utilisation per patient was €48,301 in the Netherlands and €37,431 in Belgium. Majority of costs was related to the use of trastuzumab in both countries, which was 50% of the total costs in the Netherlands and 56% in Belgium respectively. Our study provides estimates of resource use and costs for HER-2-positive MBC in the Netherlands and Belgium. We noticed various differences in resource use patterns between both countries demonstrating caution is needed when transferring cost estimates between countries. © 2014 John Wiley & Sons Ltd.

Neighborhood walkability and hospital treatment costs: A first assessment.

Science.gov (United States)

Yu, Yan; Davey, Rachel; Cochrane, Tom; Learnihan, Vincent; Hanigan, Ivan C; Bagheri, Nasser

2017-06-01

Health system expenditure is a global concern, with hospital cost a major component. Built environment has been found to affect physical activity and health outcomes. The purpose of the study was a first assessment of the relationship between neighborhood walkability and hospital treatment costs. For 88 neighborhoods in the Australian Capital Territory (ACT), 2011-2013, a total of 30,690 public hospital admissions for the treatment of four diagnostic groups (cancers, endocrine, nutritional and metabolic diseases, circulatory diseases and respiratory diseases) were extracted from the ACT admitted patient care database and analyzed in relation to the Walk Score® index as a measure of walkability. Hospital cost was calculated according to the cost weight of the diagnosis related group assigned to each admission. Linear regressions were used to analyze the associations of walkability with hospital cost per person, admissions per person and cost per admission at the neighborhood level. An inverse association with neighborhood walkability was found for cost per person and admissions per person, but not cost per admission. After adjusting for age, sex and socioeconomic status, a 20-unit increase in walkability was associated with 12.1% (95% CI: 7.1-17.0%) lower cost and 12.5% (8.1-17.0%) fewer admissions. These associations did not vary by neighborhood socioeconomic status. This exploratory analysis suggests the potential for improved population health and reduced hospital cost with greater neighborhood walkability. Further research should replicate the analysis with data from other urban settings, and focus on the behavioral mechanisms underlying the inverse walkability-hospital cost association. Copyright © 2017 Elsevier Inc. All rights reserved.

Viva the h-index

OpenAIRE

Waaijers, Leo

2011-01-01

In their article 'The inconsistency of the h-index' Ludo Waltman and Nees Jan van Neck give three examples to demonstrate the inconsistency of the h-index. As will be explained, a little extension of their examples just illustrate the opposite, a stable feature of the h-index. For starting authors it, the h-index that is, focusses on the number of articles; for experienced authors its focus shifts towards the citation scores. This feature may be liked or not but does not make the h-index an i...

Implementation of Secondary Index on Cloud Computing NoSQL Database in Big Data Environment

Directory of Open Access Journals (Sweden)

Bao Rong Chang

2015-01-01

Full Text Available This paper introduces the combination of NoSQL database HBase and enterprise search platform Solr so as to tackle the problem of the secondary index function with fast query. In order to verify the effectiveness and efficiency of the proposed approach, the assessment using Cost-Performance ratio has been done for several competitive benchmark databases and the proposed one. As a result, our proposed approach outperforms the other databases and fulfills secondary index function with fast query in NoSQL database. Moreover, according to the cross-sectional analysis, the proposed combination of HBase and Solr database is capable of performing an excellent query/response in a big data environment.

Sprache und Sozio-Oekonomischer Index (Speech and Socioeconomic Index)

Science.gov (United States)

Bluhme, Hermann

1976-01-01

A comparison of the socioeconomic index of 77 speakers of Dutch, recorded in 40 places, revealed certain correlations between index and individual linguistic behavior, particularly in regard to the speed of articulation, quantity quotient (low vowels/short vowels), pitch modulation, number of relative clauses and passive construction. (Text is in…

Direct healthcare cost of obesity in brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011.

Science.gov (United States)

de Oliveira, Michele Lessa; Santos, Leonor Maria Pacheco; da Silva, Everton Nunes

2015-01-01

Obesity is a global public health problem and a risk factor for several diseases that financially impact healthcare systems. To estimate the direct costs attributable to obesity (body mass index {BMI} ≥ 30 kg/m2) and morbid obesity (BMI ≥ 40 kg/m2) in adults aged ≥ 20 incurred by the Brazilian public health system in 2011. Public hospitals and outpatient care. A cost-of-illness method was adopted using a top-down approach based on prevalence. The proportion of the cost of each obesity-associated comorbidity was calculated and obesity prevalence was used to calculate attributable risk. Direct healthcare cost data (inpatient care, bariatric surgery, outpatient care, medications and diagnostic procedures) were extracted from the Ministry of Health information systems, available on the web. Direct costs attributable to obesity totaled US$ 269.6 million (1.86% of all expenditures on medium- and high-complexity health care). The cost of morbid obesity accounted for 23.8% (US$ 64.2 million) of all obesity-related costs despite being 18 times less prevalent than obesity. Bariatric surgery costs in Brazil totaled US$ 17.4 million in 2011. The cost of morbid obesity in women was five times higher than it was in men. The cost of morbid obesity was found to be proportionally higher than the cost of obesity. If the current epidemic were not reversed, the prevalence of obesity in Brazil will increase gradually in the coming years, as well as its costs, having serious implications for the financial sustainability of the Brazilian public health system.

Formation of decontamination cost calculation model for severe accident consequence assessment

International Nuclear Information System (INIS)

Silva, Kampanart; Promping, Jiraporn; Okamoto, Koji; Ishiwatari, Yuki

2014-01-01

In previous studies, the authors developed an index “cost per severe accident” to perform a severe accident consequence assessment that can cover various kinds of accident consequences, namely health effects, economic, social and environmental impacts. Though decontamination cost was identified as a major component, it was taken into account using simple and conservative assumptions, which make it difficult to have further discussions. The decontamination cost calculation model was therefore reconsidered. 99 parameters were selected to take into account all decontamination-related issues, and the decontamination cost calculation model was formed. The distributions of all parameters were determined. A sensitivity analysis using the Morris method was performed in order to identify important parameters that have large influence on the cost per severe accident and large extent of interactions with other parameters. We identified 25 important parameters, and fixed most negligible parameters to the median of their distributions to form a simplified decontamination cost calculation model. Calculations of cost per severe accident with the full model (all parameters distributed), and with the simplified model were performed and compared. The differences of the cost per severe accident and its components were not significant, which ensure the validity of the simplified model. The simplified model is used to perform a full scope calculation of the cost per severe accident and compared with the previous study. The decontamination cost increased its importance significantly. (author)

Efficiency and Cost Analysis of Cell Saver Auto Transfusion System in Total Knee Arthroplasty

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Mustafa Gökhan Bilgili

2014-06-01

Full Text Available Background: Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability. Aims: Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system in the total knee arthroplasty procedure. Study Design: Retrospective comparative study. Methods: Those patients who were operated on by unilateral, cemented total knee arthroplasty (TKA were retrospectively evaluated. Group 1 included 37 patients who were treated using the cell saver system, and Group 2 involved 39 patients who were treated by allogenic blood transfusion. The groups were compared in terms of preoperative haemoglobin and haematocrit levels, blood loss and transfusion amount, whether allogenic transfusion was made, degree of deformity, body mass index and cost. Results: No significant results could be obtained in the statistical comparisons made in terms of the demographic properties, deformity properties, preoperative laboratory values, transfusion amount and length of hospital stay of the groups. Average blood loss was calculated to be less in Group 1 (p<0.05 and cost was higher in Group 1 (p<0.05. Conclusion: Cell saver systems do not decrease the amount of allogenic blood transfusion and costs more. Therefore, the routine usage of the auto-transfusion systems is a controversial issue. Cell saver system usage does not affect allogenic blood transfusion incidence or allogenic blood transfusion volume. It was found that preoperative haemoglobin and body mass index rates may affect allogenic blood transfusion. Therefore, it is foreseen that auto-transfusion systems could be useful in patients with low haemoglobin level and body mass index.

EJSCREEN Indexes 2015 Public

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U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eight EJ Indexes in EJSCREEN reflecting the 8 environmental indicators. The EJ Index names are:...

EJSCREEN Indexes 2016 Public

Data.gov (United States)

U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eleven EJ Indexes in EJSCREEN reflecting the 11 environmental indicators. The EJ Index names are:...

A practical approach for calculating reliable cost estimates from observational data: application to cost analyses in maternal and child health.

Science.gov (United States)

Salemi, Jason L; Comins, Meg M; Chandler, Kristen; Mogos, Mulubrhan F; Salihu, Hamisu M

2013-08-01

Comparative effectiveness research (CER) and cost-effectiveness analysis are valuable tools for informing health policy and clinical care decisions. Despite the increased availability of rich observational databases with economic measures, few researchers have the skills needed to conduct valid and reliable cost analyses for CER. The objectives of this paper are to (i) describe a practical approach for calculating cost estimates from hospital charges in discharge data using publicly available hospital cost reports, and (ii) assess the impact of using different methods for cost estimation in maternal and child health (MCH) studies by conducting economic analyses on gestational diabetes (GDM) and pre-pregnancy overweight/obesity. In Florida, we have constructed a clinically enhanced, longitudinal, encounter-level MCH database covering over 2.3 million infants (and their mothers) born alive from 1998 to 2009. Using this as a template, we describe a detailed methodology to use publicly available data to calculate hospital-wide and department-specific cost-to-charge ratios (CCRs), link them to the master database, and convert reported hospital charges to refined cost estimates. We then conduct an economic analysis as a case study on women by GDM and pre-pregnancy body mass index (BMI) status to compare the impact of using different methods on cost estimation. Over 60 % of inpatient charges for birth hospitalizations came from the nursery/labor/delivery units, which have very different cost-to-charge markups (CCR = 0.70) than the commonly substituted hospital average (CCR = 0.29). Using estimated mean, per-person maternal hospitalization costs for women with GDM as an example, unadjusted charges ($US14,696) grossly overestimated actual cost, compared with hospital-wide ($US3,498) and department-level ($US4,986) CCR adjustments. However, the refined cost estimation method, although more accurate, did not alter our conclusions that infant/maternal hospitalization costs

Treatment Patterns and Associated Health Care Costs Before and After Treatment Initiation Among Pulmonary Arterial Hypertension Patients in the United States.

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Burger, Charles D; Ozbay, A Burak; Lazarus, Howard M; Riehle, Ellen; Montejano, Leslie B; Lenhart, Gregory; White, R James

2018-02-13

Despite multiple treatment options, the prognosis of pulmonary arterial hypertension (PAH) remains poor. PAH patients experience a high economic burden due to comorbidities, hospitalizations, and medication costs. Although combination therapy has been shown to reduce hospitalizations, the relationship between treatment, health care utilization, and costs remains unclear. To provide a characterization of health care utilization and costs in real-world settings by comparing periods before and after initiating PAH-specific treatment. This retrospective study identified PAH patients in the Truven Health MarketScan Commercial and Medicare Supplemental Databases between 2010 and 2014 who initiated treatment with endothelin receptor antagonists (ERAs), phosphodiesterase-5 inhibitors (PDE-5Is), or soluble guanylate cyclase (sGC) stimulators. The index date was the date of the first PAH pharmacy claim. We included patients with ≥ 2 medical claims with diagnoses for PAH (ICD-9-CM: 416.0, 416.8) or PAH-related conditions and continuous enrollment in medical and pharmacy benefits for the 6 months before and after the index date. Treatment patterns were assessed at the drug class level (ERAs, PDE-5Is, sGC stimulators, and prostacyclins) from outpatient pharmacy claims during the 6-month post-index period. All-cause and PAH-related utilization and costs were measured. McNemar's and paired t-tests were used to compare patients' health care resource utilization and costs in the 6-month pre- and posttreatment periods. A total of 3,908 patients met the selection criteria. The study sample was 63% female with a mean age of 63 ± 15 years. Only 5% of patients began initial combination therapy for PAH, defined as claims for ≥ 2 medication classes within the first 30 days of treatment. Treatment interruption (≥ 30-day gap in days supply) of any PAH-specific medication was observed in 38% of patients. Compared with the 6-month pre-index period, the proportion of patients in the 6

Reducing Production Basis Risk through Rainfall Intensity Frequency (RIF) Indexes: Global Sensitivity Analysis' Implication on Policy Design

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Muneepeerakul, Chitsomanus; Huffaker, Ray; Munoz-Carpena, Rafael

2016-04-01

The weather index insurance promises financial resilience to farmers struck by harsh weather conditions with swift compensation at affordable premium thanks to its minimal adverse selection and moral hazard. Despite these advantages, the very nature of indexing causes the presence of "production basis risk" that the selected weather indexes and their thresholds do not correspond to actual damages. To reduce basis risk without additional data collection cost, we propose the use of rain intensity and frequency as indexes as it could offer better protection at the lower premium by avoiding basis risk-strike trade-off inherent in the total rainfall index. We present empirical evidences and modeling results that even under the similar cumulative rainfall and temperature environment, yield can significantly differ especially for drought sensitive crops. We further show that deriving the trigger level and payoff function from regression between historical yield and total rainfall data may pose significant basis risk owing to their non-unique relationship in the insured range of rainfall. Lastly, we discuss the design of index insurance in terms of contract specifications based on the results from global sensitivity analysis.

Automatic design of basin-specific drought indexes for highly regulated water systems

Science.gov (United States)

Zaniolo, Marta; Giuliani, Matteo; Castelletti, Andrea Francesco; Pulido-Velazquez, Manuel

2018-04-01

Socio-economic costs of drought are progressively increasing worldwide due to undergoing alterations of hydro-meteorological regimes induced by climate change. Although drought management is largely studied in the literature, traditional drought indexes often fail at detecting critical events in highly regulated systems, where natural water availability is conditioned by the operation of water infrastructures such as dams, diversions, and pumping wells. Here, ad hoc index formulations are usually adopted based on empirical combinations of several, supposed-to-be significant, hydro-meteorological variables. These customized formulations, however, while effective in the design basin, can hardly be generalized and transferred to different contexts. In this study, we contribute FRIDA (FRamework for Index-based Drought Analysis), a novel framework for the automatic design of basin-customized drought indexes. In contrast to ad hoc empirical approaches, FRIDA is fully automated, generalizable, and portable across different basins. FRIDA builds an index representing a surrogate of the drought conditions of the basin, computed by combining all the relevant available information about the water circulating in the system identified by means of a feature extraction algorithm. We used the Wrapper for Quasi-Equally Informative Subset Selection (W-QEISS), which features a multi-objective evolutionary algorithm to find Pareto-efficient subsets of variables by maximizing the wrapper accuracy, minimizing the number of selected variables, and optimizing relevance and redundancy of the subset. The preferred variable subset is selected among the efficient solutions and used to formulate the final index according to alternative model structures. We apply FRIDA to the case study of the Jucar river basin (Spain), a drought-prone and highly regulated Mediterranean water resource system, where an advanced drought management plan relying on the formulation of an ad hoc state index is used

Insourcing as a Stratagy for Cost Reduction: a Methodology to Identifiy and Mensurate the Supporting Decition Factors

Directory of Open Access Journals (Sweden)

Geraldo Magela Ribeiro dos Santos

2015-08-01

Full Text Available The 2008, market crisis made the national siderurgy industry reconsider its cost structure in order to maintain its competitiveness. Among the adopted strategies, insourcing was used in order to reduce costs and improve its productive capacity from its people and equipments resulting from declining sales. This research has been developed within this context and has as its objective to quantify the results of this choice. In order to achieve this objective, an insourcing case study of mechanical maintenance at ArcelorMittal Tubarão (AMT was used. Among the main advantages of insourcing at AMT are: the reduction of 24, 41% in maintenance services costs; a reduction in the level of rework and the level of lost time injuries (LTI; increased productivity and the index for available time fulfillment on shutdown. The factors that most contributed for the services insourcing are: collective bargaining agreements of the contractors higher than those of contracting and the incidence of profit, management fees (rates administration and taxes on the cost of labor and benefits to employees. This research also concludes that if the service prices of third parties were only adjusted based upon the inflation index (INPC over the last ten years, the insourcing of services, if viewed from the costs standpoint, would have been unfeasible.

Cost Differences Between Open and Minimally Invasive Surgery.

Science.gov (United States)

Fitch, Kathryn; Engel, Tyler; Bochner, Andrew

2015-09-01

To analyze the cost difference between minimally invasive surgery (MIS) and open surgery from a commercial payer perspective for colectomy, ventral hernia repair, thoracic resection (resection of the lung), and hysterectomy. A retrospective claims data analysis was conducted using the 2011 and 2012 Truven Health Analytics MarketScan Commercial Claims and Encounter Database. Study eligibility criteria included age 18-64 years, pharmacy coverage, ≥ 1 month of eligibility in 2012, and a claim coded with 1 of the 4 surgical procedures of interest; the index year was 2012. Average allowed facility and professional costs were calculated during inpatient stay (or day of surgery for outpatient hysterectomy) and the 30 days after discharge for MIS vs open surgery. Cost difference was compared after adjusting for presence of cancer, geographic region, and risk profile (age, gender, and comorbidities). In total, 46,386 cases in the 2012 MarketScan database represented one of the surgeries of interest. The difference in average allowed surgical procedure cost (facility and professional) between open surgery vs adjusted MIS was $10,204 for colectomy; $3,721, ventral hernia repair; $12,989, thoracic resection; and $1,174, noncancer hysterectomy (P average allowed cost in the 30 days after surgery between open surgery vs adjusted MIS was $1,494 for colectomy, $1,320 for ventral hernia repair, negative $711 for thoracic resection, and negative $425 for noncancer hysterectomy (P costs than open surgery for all 4 analyzed surgeries.

The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation

Science.gov (United States)

Doran, Tim; Cookson, Richard

2016-01-01

Background There are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course. Methods Hospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs. Results A steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31 298/100 000 population in the most affluent fifth of areas to 43 385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was £4.8 billion. A social gradient was also observed in the modelled lifetime costs where the lower life expectancy was not sufficient to outweigh the higher average costs in the more deprived populations. Lifetime costs for women were 14% greater than for men, due to higher costs in the reproductive years and greater life expectancy. Conclusions Socioeconomic inequalities result in increased morbidity and decreased life expectancy. Interventions to reduce inequality and improve health in more deprived neighbourhoods have the potential to save money for health systems not only within years but across peoples’ entire lifetimes, despite increased costs due to longer life expectancies. PMID:27189975

Exploring nutritional status, physical activity and body mass index of Pakistani teens

OpenAIRE

Kiran Khan; Nazia Jameel; Rehana Khalil; Saadia Gul

2016-01-01

Background: Obesity is becoming an increasingly prevalent problem in Pakistan, as it has in other developing countries. Childhood obesity poses high cost to the well-being and negatively affects children's health, causes chronic disease as children grow older. The aim of this study was to explore nutritional status, physical activity and body mass index (BMI) of school and college going students of mid and late adolescence age (14 to 19 years) studying in multi-ethnic city of Karachi, Pakista...

PR-Index: Using the h-Index and PageRank for Determining True Impact.

Science.gov (United States)

Gao, Chao; Wang, Zhen; Li, Xianghua; Zhang, Zili; Zeng, Wei

2016-01-01

Several technical indicators have been proposed to assess the impact of authors and institutions. Here, we combine the h-index and the PageRank algorithm to do away with some of the individual limitations of these two indices. Most importantly, we aim to take into account value differences between citations-evaluating the citation sources by defining the h-index using the PageRank score rather than with citations. The resulting PR-index is then constructed by evaluating source popularity as well as the source publication authority. Extensive tests on available collections data (i.e., Microsoft Academic Search and benchmarks on the SIGKDD innovation award) show that the PR-index provides a more balanced impact measure than many existing indices. Due to its simplicity and similarity to the popular h-index, the PR-index may thus become a welcome addition to the technical indices already in use. Moreover, growth dynamics prior to the SIGKDD innovation award indicate that the PR-index might have notable predictive power.

The cost of first-ever stroke in Valle d’Aosta, Italy: linking clinical registries and administrative data

Directory of Open Access Journals (Sweden)

Bottacchi Edo

2012-10-01

Full Text Available Abstract Background Stroke is one of the most relevant reasons of death and disability worldwide. Many cost of illness studies have been performed to evaluate direct and indirect costs of ischaemic stroke, especially within the first year after the acute episode, using different methodologies. Methods We conducted a longitudinal, retrospective, bottom-up cost of illness study, to evaluate clinical and economic outcomes of a cohort of patients affected by a first cerebrovascular event, including subjects with ischaemic, haemorrhagic or transient episodes. The analysis intended to detect direct costs, within 1, 2 and 3 years from the index event. Clinical patient data collected in regional disease registry were integrated and linked to regional administrative databases to perform the analysis. Results The analysis of costs within the first year from the index event included 800 patients. The majority of patients (71.5% were affected by ischaemic stroke. Overall, per patient costs were €7,079. Overall costs significantly differ according to the type of stroke, with costs for haemorrhagic stroke and ischaemic stroke amounting to €9,044 and €7,289. Hospital costs, including inpatient rehabilitation, were driver of expenditure, accounting for 89.5% of total costs. The multiple regression model showed that sex, level of physical disability and level of neurological deficit predict direct healthcare costs within 1 year. The analysis at 2 and 3 years (per patient costs: €7,901 and €8,874, respectively showed that majority of costs are concentrated in the first months after the acute event. Conclusions This cost analysis highlights the importance to set up significant prevention programs to reduce the economic burden of stroke, which is mostly attributable to hospital and inpatient rehabilitation costs immediately after the acute episode. Although some limitation typical of retrospective analyses the approach of linking clinical and

Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people: Results of a cluster randomized trial.

Science.gov (United States)

Suijker, Jacqueline J; MacNeil-Vroomen, Janet L; van Rijn, Marjon; Buurman, Bianca M; de Rooij, Sophia E; Moll van Charante, Eric P; Bosmans, Judith E

2017-01-01

To evaluate the cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people in comparison with usual care. We conducted cost-effectiveness and cost-utility analyses alongside a cluster randomized trial with one-year follow-up. Participants were aged ≥ 70 years and at increased risk of functional decline. Participants in the intervention group (n = 1209) received a comprehensive geriatric assessment and individually tailored multifactorial interventions coordinated by a community-care registered nurse with multiple follow-up visits. The control group (n = 1074) received usual care. Costs were assessed from a healthcare perspective. Outcome measures included disability (modified Katz-Activities of Daily Living (ADL) index score), and quality-adjusted life-years (QALYs). Statistical uncertainty surrounding Incremental Cost-Effectiveness Ratios (ICERs) was estimated using bootstrapped bivariate regression models while adjusting for confounders. There were no statistically significant differences in Katz-ADL index score and QALYs between the two groups. Total mean costs were significantly higher in the intervention group (EUR 6518 (SE 472) compared with usual care (EUR 5214 (SE 338); adjusted mean difference €1457 (95% CI: 572; 2537). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective was 0.14 at a willingness to pay (WTP) of EUR 50,000 per one point improvement on the Katz-ADL index score and 0.04 at a WTP of EUR 50,000 per QALY gained. The current intervention was not cost-effective compared to usual care to prevent or postpone new disabilities over a one-year period. Based on these findings, implementation of the evaluated multifactorial nurse-led care model is not to be recommended.

Hospital cost of Clostridium difficile infection including the contribution of recurrences in French acute-care hospitals.

Science.gov (United States)

Le Monnier, A; Duburcq, A; Zahar, J-R; Corvec, S; Guillard, T; Cattoir, V; Woerther, P-L; Fihman, V; Lalande, V; Jacquier, H; Mizrahi, A; Farfour, E; Morand, P; Marcadé, G; Coulomb, S; Torreton, E; Fagnani, F; Barbut, F

2015-10-01

The impact of Clostridium difficile infection (CDI) on healthcare costs is significant due to the extra costs of associated inpatient care. However, the specific contribution of recurrences has rarely been studied. The aim of this study was to estimate the hospital costs of CDI and the fraction attributable to recurrences in French acute-care hospitals. A retrospective study was performed for 2011 on a sample of 12 large acute-care hospitals. CDI costs were estimated from both hospital and public insurance perspectives. For each stay, CDI additional costs were estimated by comparison to controls without CDI extracted from the national DRG (diagnosis-related group) database and matched on DRG, age and sex. When CDI was the primary diagnosis, the full cost of stay was used. A total of 1067 bacteriological cases of CDI were identified corresponding to 979 stays involving 906 different patients. Recurrence(s) were identified in 118 (12%) of these stays with 51.7% of them having occurred within the same stay as the index episode. Their mean length of stay was 63.8 days compared to 25.1 days for stays with an index case only. The mean extra cost per stay with CDI was estimated at €9,575 (median: €7,514). The extra cost of CDI in public acute-care hospitals was extrapolated to €163.1 million at the national level, of which 12.5% was attributable to recurrences. The economic burden of CDI is substantial and directly impacts healthcare systems in France. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Validation of the What Matters Index: A brief, patient-reported index that guides care for chronic conditions and can substitute for computer-generated risk models.

Science.gov (United States)

Wasson, John H; Ho, Lynn; Soloway, Laura; Moore, L Gordon

2018-01-01

Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models. Five measures with well-documented impacts on the use of health services are summed to create a "What Matters Index." These measures are: 1) insufficient confidence to self-manage health problems, 2) pain, 3) bothersome emotions, 4) polypharmacy, and 5) adverse medication effects. We compare the sensitivity and predictive values of this index with two representative risk models in a population of 8619 Medicaid recipients. The patient-reported "What Matters Index" and the conventional risk models are found to exhibit similar sensitivities and predictive values for subsequent hospital or emergency room use. The "What Matters Index" is also reliable: akin to its performance during development, for patients with index scores of 1, 2, and ≥3, the odds ratios (with 95% confidence intervals) for subsequent hospitalization within 1 year, relative to patients with a score of 0, are 1.3 (1.1-1.6), 2.0 (1.6-2.4), and 3.4 (2.9-4.0), respectively; for emergency room use, the corresponding odds ratios are 1.3 (1.1-1.4), 1.9 (1.6-2.1), and 2.9 (2.6-3.3). Similar findings were replicated among smaller populations of 1061 mostly older patients from nine private practices and 4428 Medicaid patients without chronic conditions. In contrast to complex computer-generated risk models, the brief patient-reported "What Matters Index" immediately and unambiguously identifies fundamental, remediable needs for each patient and more sensibly directs the delivery of services to patient categories based on

EJSCREEN Supplementary Indexes 2015 Public

Data.gov (United States)

U.S. Environmental Protection Agency — There are 40 supplementary EJSCREEN indexes that are divided into 5 categories: EJ Index with supplementary demographic index, Supplementary EJ Index 1 with...

A Cost-Constrained Sampling Strategy in Support of LAI Product Validation in Mountainous Areas

Directory of Open Access Journals (Sweden)

Gaofei Yin

2016-08-01

Full Text Available Increasing attention is being paid on leaf area index (LAI retrieval in mountainous areas. Mountainous areas present extreme topographic variability, and are characterized by more spatial heterogeneity and inaccessibility compared with flat terrain. It is difficult to collect representative ground-truth measurements, and the validation of LAI in mountainous areas is still problematic. A cost-constrained sampling strategy (CSS in support of LAI validation was presented in this study. To account for the influence of rugged terrain on implementation cost, a cost-objective function was incorporated to traditional conditioned Latin hypercube (CLH sampling strategy. A case study in Hailuogou, Sichuan province, China was used to assess the efficiency of CSS. Normalized difference vegetation index (NDVI, land cover type, and slope were selected as auxiliary variables to present the variability of LAI in the study area. Results show that CSS can satisfactorily capture the variability across the site extent, while minimizing field efforts. One appealing feature of CSS is that the compromise between representativeness and implementation cost can be regulated according to actual surface heterogeneity and budget constraints, and this makes CSS flexible. Although the proposed method was only validated for the auxiliary variables rather than the LAI measurements, it serves as a starting point for establishing the locations of field plots and facilitates the preparation of field campaigns in mountainous areas.

Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa--a systematic review.

Science.gov (United States)

Barter, Devra M; Agboola, Stephen O; Murray, Megan B; Bärnighausen, Till

2012-11-14

Tuberculosis (TB) is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$). Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. TB patients and households in sub-Saharan Africa often incurred high costs when utilizing TB treatment and care, both within and outside of

The cost of dysphagia in geriatric patients

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Westmark S

2018-06-01

Full Text Available Signe Westmark,1 Dorte Melgaard,1,2 Line O Rethmeier,3 Lars Holger Ehlers3 1Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark; 2Department of Physiotherapy and Occupational Therapy, North Denmark Regional Hospital, Hjørring, Denmark; 3Danish Center for Healthcare Improvements, Aalborg University, Aalborg, Denmark Objectives: To estimate the annual cost at the hospital and in the municipality (social care due to dysphagia in geriatric patients.Design: Retrospective cost analysis of geriatric patients with dysphagia versus geriatric patients without dysphagia 1 year before hospitalization.Setting: North Denmark Regional Hospital, Hjørring Municipality, Frederikshavn Municipality, and Brønderslev Municipality.Subjects: A total of 258 hospitalized patients, 60 years or older, acute hospitalized in the geriatric department.Materials and methods: Volume-viscosity swallow test and the Minimal Eating Observation Form-II were conducted for data collection. A Charlson Comorbidity Index score measured comorbidity, and functional status was measured by Barthel-100. To investigate the cost of dysphagia, patient-specific data on health care consumption at the hospital and in the municipality (nursing, home care, and training were collected from medical registers and records 1 year before hospitalization including the hospitalization for screening for dysphagia. Multiple linear regression analyses were conducted to determine the relationship between dysphagia and hospital and municipality costs, respectively, adjusting for age, gender, and comorbidity.Results: Patients with dysphagia were significantly costlier than patients without dysphagia in both hospital (p=0.013 and municipality costs (p=0.028 compared to patients without dysphagia. Adjusted annual hospital costs in patients with dysphagia were 27,347 DKK (3,677 EUR, 4,282 USD higher than patients without dysphagia at the hospital, and annual health care costs in the

Costs and indices for domestic oil and gas field equipment and production operations, 1992--1995

International Nuclear Information System (INIS)

1996-08-01

This report presents estimated costs and cost indices for domestic oil and natural gas field equipment and production operations for 1992, 1993, 1994, and 1995. The costs of all equipment and services are those in effect during June of each year. The sum (aggregates) of the costs for representative leases by region, depth, and production rate were averaged and indexed. This provides a general measure of the increased or decreased costs from year to year for lease equipment and operations. These general measured do not capture changes in industry-wide costs exactly because of annual variations in the ratio of the total number of oil wells to the total number of gas wells. The detail provided in this report is unavailable elsewhere. The body of this report contains summary tables, and the appendices contain detailed tables

[Evaluating cost/equity in the Colombian health system, 1998-2005].

Science.gov (United States)

Eslava-Schmalbach, Javier; Barón, Gilberto; Gaitán-Duarte, Hernando; Alfonso, Helman; Agudelo, Carlos; Sánchez, Carolina

2008-01-01

An economic analysis of cost-equity (from society's viewpoint) for evaluating the impact of Law 100/93 in Colombia between 1998 and 2005. An economic analysis compared costs and equity in health in Colombia between 1998 and 2005. Data was taken from the Colombian Statistics' Administration Department ( Departamento Administrativo Nacional de Estadistica - DANE) and from national demographic and health surveys carried out in 2000 and 2005. Information regarding costs was taken from the National Health Accounts' System. Inequity in Health was considered in line with the Inequity in Health Index (IHI). Incremental and average cost-equity analysis covered three sub-periods; 1998-1999 (during which time per capita gross internal product became reduced in Colombia ), 2000-2001 (during which time total health expense became reduced) and 2001 -2005. An unstable tendency for inequity in health becoming reduced during the period was revealed. There was an inverse relationship between IHI and public health spending and a direct relationship between out-of-pocket spending on health and equity in health (Spearman, p<0.05). The second period had the best incremental cost-equity ratio. Fluctuations in IHI and marginal cost-equity during the periods being analysed suggested that health spending depended on equity in health in Colombia during the period being studied.

Economic selection index development for Beefmaster cattle II: General-purpose breeding objective.

Science.gov (United States)

Ochsner, K P; MacNeil, M D; Lewis, R M; Spangler, M L

2017-05-01

An economic selection index was developed for Beefmaster cattle in a general-purpose production system in which bulls are mated to a combination of heifers and mature cows, with resulting progeny retained as replacements or sold at weaning. National average prices from 2010 to 2014 were used to establish income and expenses for the system. Genetic parameters were obtained from the literature. Economic values were estimated by simulating 100,000 animals and approximating the partial derivatives of the profit function by perturbing traits 1 at a time, by 1 unit, while holding the other traits constant at their respective means. Relative economic values for the objective traits calving difficultly direct (CDd), calving difficulty maternal (CDm), weaning weight direct (WWd), weaning weight maternal (WWm), mature cow weight (MW), and heifer pregnancy (HP) were -2.11, -1.53, 18.49, 11.28, -33.46, and 1.19, respectively. Consequently, under the scenario assumed herein, the greatest improvements in profitability could be made by decreasing maintenance energy costs associated with MW followed by improvements in weaning weight. The accuracy of the index lies between 0.218 (phenotypic-based index selection) and 0.428 (breeding values known without error). Implementation of this index would facilitate genetic improvement and increase profitability of Beefmaster cattle operations with a general-purpose breeding objective when replacement females are retained and with weaned calves as the sale end point.

Costs involved in using a cochlear implant in South Africa

Directory of Open Access Journals (Sweden)

Gillian Robyn Kerr

2012-12-01

Full Text Available Cochlear implantation is an expensive but effective lifelong intervention for individuals with a severe-to-profound hearing loss. The primary aim of this study was to survey the short- and long-term costs of cochlear implantation. Individuals (N=154 using cochlear implants obtained from the University of Stellenbosch-Tygerberg Hospital Cochlear Implant Unit in Cape Town, South Africa were surveyed using a questionnaire and patient record review. The questionnaire used a combination of closed and open-ended questions to gather both quantitative and qualitative information. Costs were categorised as short- and long-term costs. All costs were converted to constant rands (June 2010 using the Consumer Price Index to allow for comparison in real terms over time. In the first 10 years of implantation the average estimated costs incurred by adults totalled R379 626, and by children R455 225. The initial purchase of the implant system was the most substantial cost, followed by upgrading of the processor. Travel and accommodation costs peaked in the first 2 years. On average the participants spent R2 550 per year on batteries and spares. Rehabilitation for children cost an average of R7 200. Insurance costs averaged R4 040 per year, and processor repairs R3 000 each. In addition to the upfront expense of obtaining the cochlear implant system, individuals using a cochlear implant in South Africa should be prepared for the long-term costs of maintenance, accessing the unit, support services and additional costs associated with use. Knowledge of these costs is important to ensure that individuals are successful users of their cochlear implants in the long term.

Risk factors and acute in-hospital costs for infected pressure ulcers among gunshot-spinal cord injury victims in southeastern Michigan.

Science.gov (United States)

Chopra, Teena; Marchaim, Dror; Awali, Reda A; Levine, Miriam; Sathyaprakash, Smitha; Chalana, Indu K; Ahmed, Farah; Martin, Emily T; Sieggreen, Mary; Sobel, Jack D; Kaye, Keith S

2016-03-01

Management of pressure ulcers (PrUs) in patients with gunshot-spinal cord injuries (SCIs) presents unique medical and economic challenges for practitioners. A retrospective chart review was conducted at 3 acute care hospitals in metropolitan Detroit for patients admitted with PrUs due to gunshot-SCIs between January 2004 and December 2008. Multivariate analysis using logistic regression was conducted to choose for the independent predictors of infected PrUs. Mean adjusted in-hospital costs per patient and per hospitalization were calculated and compared between infected and noninfected PrUs. The study cohort included 201 gunshot-SCI patients with PrUs contributing to 395 admissions, including readmissions, between 2004 and 2008. Seventy-six patients (38%) had infected PrUs at time of the index admission. Independent predictors of infected PrUs on index admission included Charlson Comorbidity Index ≥2 (odds ratio, 2.18, P = .026) and stage III/IV PrU (odds ratio, 4.82; P cost of $19,969 ± $6639 per patient. The mean adjusted cost per hospitalization for patients with infected PrUs was significantly higher than that for patients with noninfected PrUs ($16,735 ± $8310 vs $12,356 ± $7007; P costs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Human Use Index

Data.gov (United States)

U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

Multi-index Monte Carlo: when sparsity meets sampling

KAUST Repository

Haji Ali, Abdul Lateef

2015-06-27

We propose and analyze a novel multi-index Monte Carlo (MIMC) method for weak approximation of stochastic models that are described in terms of differential equations either driven by random measures or with random coefficients. The MIMC method is both a stochastic version of the combination technique introduced by Zenger, Griebel and collaborators and an extension of the multilevel Monte Carlo (MLMC) method first described by Heinrich and Giles. Inspired by Giles’s seminal work, we use in MIMC high-order mixed differences instead of using first-order differences as in MLMC to reduce the variance of the hierarchical differences dramatically. This in turn yields new and improved complexity results, which are natural generalizations of Giles’s MLMC analysis and which increase the domain of the problem parameters for which we achieve the optimal convergence, O(TOL−2). Moreover, in MIMC, the rate of increase of required memory with respect to TOL is independent of the number of directions up to a logarithmic term which allows far more accurate solutions to be calculated for higher dimensions than what is possible when using MLMC. We motivate the setting of MIMC by first focusing on a simple full tensor index set. We then propose a systematic construction of optimal sets of indices for MIMC based on properly defined profits that in turn depend on the average cost per sample and the corresponding weak error and variance. Under standard assumptions on the convergence rates of the weak error, variance and work per sample, the optimal index set turns out to be the total degree type. In some cases, using optimal index sets, MIMC achieves a better rate for the computational complexity than the corresponding rate when using full tensor index sets. We also show the asymptotic normality of the statistical error in the resulting MIMC estimator and justify in this way our error estimate, which allows both the required accuracy and the confidence level in our computational

A novel structural risk index for primary spontaneous pneumothorax: Ankara Numune Risk Index.

Science.gov (United States)

Akkas, Yucel; Peri, Neslihan Gulay; Kocer, Bulent; Kaplan, Tevfik; Alhan, Aslihan

2017-07-01

In this study, we aimed to reveal a novel risk index as a structural risk marker for primary spontanoeus pneumothorax using body mass index and chest height, structural risk factors for pneumothorax development. Records of 86 cases admitted between February 2014 and January 2015 with or without primary spontaneous pneumothorax were analysed retrospectively. The patients were allocated to two groups as Group I and Group II. The patients were evaluated with regard to age, gender, pneumothorax side, duration of hospital stay, treatment type, recurrence, chest height and transverse diameter on posteroanterior chest graphy and body mass index. Body mass index ratio per cm of chest height was calculated by dividing body mass index with chest height. We named this risk index ratio which is defined first as 'Ankara Numune Risk Index'. Diagnostic value of Ankara Numune Risk Index value for prediction of primary spontaneous pneumothorax development was analysed with Receiver Operating Characteristics curver. Of 86 patients, 69 (80.2%) were male and 17 (19.8%) were female. Each group was composed of 43 (50%) patients. When Receiver Operating Characteristics curve analysis was done for optimal limit value 0.74 of Ankara Numune Risk Index determined for prediction of pneumothorax development risk, area under the curve was 0.925 (95% Cl, 0.872-0.977, p pneumothorax development however it is insufficient for determining recurrence. Copyright © 2015. Published by Elsevier Taiwan.

Climate Risk and Production Shocks: Using Index Insurance to Link Climate Science to Policy for Sustainable Development

Science.gov (United States)

McCarney, G. R.; Osgood, D. E.

2011-12-01

Smallholder farmers in developing countries are often severely impacted by droughts and other climate related events. However, agricultural insurance programs are largely unavailable in lower-income countries because of limitations in traditional loss-based indemnity insurance. As a result, it is often the case that farmers who are the most vulnerable to climate shocks lack access to the insurance tools that could help to reduce their production risk. Index insurance, a recent financial innovation, has the potential to increase access to insurance for smallholder farmers (Barrett et al. 2007). Index insurance allows farmers to insure their production risk based on a weather index (such as total seasonal rainfall) rather than on crop yields. The use of a weather index addresses many of the perverse incentive problems found in traditional crop insurance, and greatly reduces the costs of insuring smallholder farmers. The trade-off in index insurance, however, is limited accuracy in calibrating payouts to actual losses, a phenomenon commonly known as basis risk. While index insurance has promise as a risk-smoothing instrument, many argue it has greater promise as a mechanism for improving access to credit for smallholder farmers in developing countries (e.g. Barnett, Barrett & Skees 2008). In these areas, farmers are often fully exposed to climate shocks, which greatly affect their willingness to borrow. By smoothing the uncertainty in climate shocks, insurance may allow farmers to take credit for productive risks. There has been much discussion as to the optimal strategy for combining index insurance with credit, specifically if the financial institutions or the individual farmers themselves should hold the insurance policy. Many existing insurance implementations insure the farmer directly. However, since a weather index is a proxy for yield loss based on regional data, there is basis risk due to uninsured idiosyncratic differences between farmers. As a response to

Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

Science.gov (United States)

Kawalec, Paweł; Mossakowska, Małgorzata; Pilc, Andrzej

2016-01-01

Background and Aims Evidence on indirect cost of Crohn’s disease (CD) is available but typically provides information on the loss of productivity at paid work of patients. In the present study, the quality of life and indirect costs of CD patients were assessed (overall and by disease severity). Methods A self-report questionnaire-based study among adult Polish patients with CD was performed. We collected data on patients’ characteristics, quality of life, loss of productivity, consumption of medical resources, and out-of-pocket expenses. The disease severity was determined using the patient’s version of the Harvey-Bradshaw index. Productivity costs were assessed from the social perspective, using a human capital approach. The cost of absenteeism, presenteeism and permanent work disability was valuated using the gross domestic product per worker. The patients’ productivity loss at unpaid work was measured by time inputs of others to assist patients. The productivity loss among informal caregivers and patients’ productivity loss at unpaid work were valuated with the average wage in Poland. The results were adjusted for confounders. Results The responses from 200 patients (47% in remission) were analysed. The mean utility index was 0.839 (SD 0.171). The total indirect cost was estimated at €462.47 per patient per month (24.0%, absenteeism; 35.0%, work disability; 30.4%, presenteeism; 0.4%, productivity loss at unpaid work; and 10.4%, informal care). A significant correlation of the quality of life and productivity losses with disease severity was observed. Compared with active disease, the remission subgroup had a higher utility index by 16% (pabsenteeism, 41% (p = 0.030) for presenteeism, 76% (pproductivity loss at unpaid work, and 75% (p<0.001) for informal care. Conclusions Our study revealed the social burden of CD and high dependency of indirect costs and quality of life on the severity of CD in Poland. PMID:27992531

Efficiency and cost analysis of cell saver auto transfusion system in total knee arthroplasty.

Science.gov (United States)

Bilgili, Mustafa Gökhan; Erçin, Ersin; Peker, Gökhan; Kural, Cemal; Başaran, Serdar Hakan; Duramaz, Altuğ; Avkan, Cevdet

2014-06-01

Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS) were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability. Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system in the total knee arthroplasty procedure. Retrospective comparative study. Those patients who were operated on by unilateral, cemented total knee arthroplasty (TKA) were retrospectively evaluated. Group 1 included 37 patients who were treated using the cell saver system, and Group 2 involved 39 patients who were treated by allogenic blood transfusion. The groups were compared in terms of preoperative haemoglobin and haematocrit levels, blood loss and transfusion amount, whether allogenic transfusion was made, degree of deformity, body mass index and cost. No significant results could be obtained in the statistical comparisons made in terms of the demographic properties, deformity properties, preoperative laboratory values, transfusion amount and length of hospital stay of the groups. Average blood loss was calculated to be less in Group 1 (pblood transfusion and costs more. Therefore, the routine usage of the auto-transfusion systems is a controversial issue. Cell saver system usage does not affect allogenic blood transfusion incidence or allogenic blood transfusion volume. It was found that preoperative haemoglobin and body mass index rates may affect allogenic blood transfusion. Therefore, it is foreseen that auto-transfusion systems could be useful in patients with low haemoglobin level and body mass index.

PR-Index: Using the h-Index and PageRank for Determining True Impact.

Directory of Open Access Journals (Sweden)

Chao Gao

Full Text Available Several technical indicators have been proposed to assess the impact of authors and institutions. Here, we combine the h-index and the PageRank algorithm to do away with some of the individual limitations of these two indices. Most importantly, we aim to take into account value differences between citations-evaluating the citation sources by defining the h-index using the PageRank score rather than with citations. The resulting PR-index is then constructed by evaluating source popularity as well as the source publication authority. Extensive tests on available collections data (i.e., Microsoft Academic Search and benchmarks on the SIGKDD innovation award show that the PR-index provides a more balanced impact measure than many existing indices. Due to its simplicity and similarity to the popular h-index, the PR-index may thus become a welcome addition to the technical indices already in use. Moreover, growth dynamics prior to the SIGKDD innovation award indicate that the PR-index might have notable predictive power.

INDEXABILITY AND OPTIMAL INDEX POLICIES FOR A CLASS OF REINITIALISING RESTLESS BANDITS.

Science.gov (United States)

Villar, Sofía S

2016-01-01

Motivated by a class of Partially Observable Markov Decision Processes with application in surveillance systems in which a set of imperfectly observed state processes is to be inferred from a subset of available observations through a Bayesian approach, we formulate and analyze a special family of multi-armed restless bandit problems. We consider the problem of finding an optimal policy for observing the processes that maximizes the total expected net rewards over an infinite time horizon subject to the resource availability. From the Lagrangian relaxation of the original problem, an index policy can be derived, as long as the existence of the Whittle index is ensured. We demonstrate that such a class of reinitializing bandits in which the projects' state deteriorates while active and resets to its initial state when passive until its completion possesses the structural property of indexability and we further show how to compute the index in closed form. In general, the Whittle index rule for restless bandit problems does not achieve optimality. However, we show that the proposed Whittle index rule is optimal for the problem under study in the case of stochastically heterogenous arms under the expected total criterion, and it is further recovered by a simple tractable rule referred to as the 1-limited Round Robin rule. Moreover, we illustrate the significant suboptimality of other widely used heuristic: the Myopic index rule, by computing in closed form its suboptimality gap. We present numerical studies which illustrate for the more general instances the performance advantages of the Whittle index rule over other simple heuristics.

Investigating the performance and cost-effectiveness of the simple ultrasound-based rules compared to the risk of malignancy index in the diagnosis of ovarian cancer (SUBSONiC-study): protocol of a prospective multicenter cohort study in the Netherlands

International Nuclear Information System (INIS)

Meys, Evelyne MJ; Rutten, Iris JG; Kruitwagen, Roy FPM; Slangen, Brigitte F; Bergmans, Martin GM; Mertens, Helen JMM; Nolting, Ernst; Boskamp, Dieuwke; Beets-Tan, Regina GH; Gorp, Toon van

2015-01-01

Estimating the risk of malignancy is essential in the management of adnexal masses. An accurate differential diagnosis between benign and malignant masses will reduce morbidity and costs due to unnecessary operations, and will improve referral to a gynecologic oncologist for specialized cancer care, which improves outcome and overall survival. The Risk of Malignancy Index is currently the most commonly used method in clinical practice, but has a relatively low diagnostic accuracy (sensitivity 75–80 % and specificity 85–90 %). Recent reports show that other methods, such as simple ultrasound-based rules, subjective assessment and (Diffusion Weighted) Magnetic Resonance Imaging might be superior to the RMI in the pre-operative differentiation of adnexal masses. A prospective multicenter cohort study will be performed in the south of The Netherlands. A total of 270 women diagnosed with at least one pelvic mass that is suspected to be of ovarian origin who will undergo surgery, will be enrolled. We will apply the Risk of Malignancy Index with a cut-off value of 200 and a two-step triage test consisting of simple ultrasound-based rules supplemented -if necessary- with either subjective assessment by an expert sonographer or Magnetic Resonance Imaging with diffusion weighted sequences, to characterize the adnexal masses. The histological diagnosis will be the reference standard. Diagnostic performances will be expressed as sensitivity, specificity, positive and negative predictive values and likelihood ratios. We hypothesize that this two-step triage test, including the simple ultrasound-based rules, will have better diagnostic accuracy than the Risk of Malignancy Index and therefore will improve the management of women with adnexal masses. Furthermore, we expect this two-step test to be more cost-effective. If the hypothesis is confirmed, the results of this study could have major effects on current guidelines and implementation of the triage test in daily clinical

Morse Set Classification and Hierarchical Refinement Using Conley Index

KAUST Repository

Guoning Chen,; Qingqing Deng,; Szymczak, A.; Laramee, R. S.; Zhang, E.

2012-01-01

Morse decomposition provides a numerically stable topological representation of vector fields that is crucial for their rigorous interpretation. However, Morse decomposition is not unique, and its granularity directly impacts its computational cost. In this paper, we propose an automatic refinement scheme to construct the Morse Connection Graph (MCG) of a given vector field in a hierarchical fashion. Our framework allows a Morse set to be refined through a local update of the flow combinatorialization graph, as well as the connection regions between Morse sets. The computation is fast because the most expensive computation is concentrated on a small portion of the domain. Furthermore, the present work allows the generation of a topologically consistent hierarchy of MCGs, which cannot be obtained using a global method. The classification of the extracted Morse sets is a crucial step for the construction of the MCG, for which the Poincar index is inadequate. We make use of an upper bound for the Conley index, provided by the Betti numbers of an index pair for a translation along the flow, to classify the Morse sets. This upper bound is sufficiently accurate for Morse set classification and provides supportive information for the automatic refinement process. An improved visualization technique for MCG is developed to incorporate the Conley indices. Finally, we apply the proposed techniques to a number of synthetic and real-world simulation data to demonstrate their utility. © 2006 IEEE.

Morse Set Classification and Hierarchical Refinement Using Conley Index

KAUST Repository

Guoning Chen,

2012-05-01

Morse decomposition provides a numerically stable topological representation of vector fields that is crucial for their rigorous interpretation. However, Morse decomposition is not unique, and its granularity directly impacts its computational cost. In this paper, we propose an automatic refinement scheme to construct the Morse Connection Graph (MCG) of a given vector field in a hierarchical fashion. Our framework allows a Morse set to be refined through a local update of the flow combinatorialization graph, as well as the connection regions between Morse sets. The computation is fast because the most expensive computation is concentrated on a small portion of the domain. Furthermore, the present work allows the generation of a topologically consistent hierarchy of MCGs, which cannot be obtained using a global method. The classification of the extracted Morse sets is a crucial step for the construction of the MCG, for which the Poincar index is inadequate. We make use of an upper bound for the Conley index, provided by the Betti numbers of an index pair for a translation along the flow, to classify the Morse sets. This upper bound is sufficiently accurate for Morse set classification and provides supportive information for the automatic refinement process. An improved visualization technique for MCG is developed to incorporate the Conley indices. Finally, we apply the proposed techniques to a number of synthetic and real-world simulation data to demonstrate their utility. © 2006 IEEE.

Indexing mergers and acquisitions

OpenAIRE

Gang, Jianhua; Guo, Jie (Michael); Hu, Nan; Li, Xi

2017-01-01

We measure the efficiency of mergers and acquisitions by putting forward an index (the ‘M&A Index’) based on stochastic frontier analysis. The M&A Index is calculated for each takeover deal and is standardized between 0 and 1. An acquisition with a higher index encompasses higher efficiency. We find that takeover bids with higher M&A Indices are more likely to succeed. Moreover, the M&A Index shows a strong and positive relation with the acquirers’ post-acquisition stock perfo...

Simultaneous measurement of group refractive index and thickness of optical samples using optical coherence tomography

International Nuclear Information System (INIS)

Cheng, Hsu-Chih; Liu, Yi-Cheng

2010-01-01

Optical coherence tomography (OCT), based on a Michelson interferometer and utilizing low coherence light as the optical source, is a novel technique for the noninvasive imaging of optical scattering media. A simple OCT scheme based on a 3x3 fiber coupler is presented for the simultaneous measurement of the refractive index and thickness of optical samples. The proposed system enables the refractive index and thickness to be determined without any prior knowledge of the sample parameters and is characterized by a simple and compact configuration, a straightforward measurement procedure, and a low cost. The feasibility of the proposed approach is demonstrated experimentally using BK7 and B270 optical glass samples.

Western Alaska ESI: INDEX (Index Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

Refractive index sensor based on lateral-offset of coreless silica interferometer

Science.gov (United States)

Baharin, Nur Faizzah; Azmi, Asrul Izam; Abdullah, Ahmad Sharmi; Mohd Noor, Muhammad Yusof

2018-02-01

A compact, cost-effective and high sensitivity fiber interferometer refractive index (RI) sensor based on symmetrical offset coreless silica fiber (CSF) configuration is proposed, optimized and demonstrated. The sensor is formed by splicing a section of CSF between two CSF sections in an offset manner. Thus, two distinct optical paths are created with large index difference, the first path through the connecting CSF sections and the second path is outside the CSF through the surrounding media. RI sensing is established from direct interaction of light with surrounding media, hence high sensitivity can be achieved with a relatively compact sensor length. In the experimental work, a 1.5 mm sensor demonstrates RI sensitivity of 750 nm/RIU for RI range between 1.33 and 1.345. With the main attributes of high sensitivity and compact size, the proposed sensor can be further developed for related applications including blood diagnosis, water quality control and food industries.

Cost-of-illness in patients with moderate to severe psoriasis: a cross-sectional survey in Hungarian dermatological centres.

Science.gov (United States)

Balogh, Orsolya; Brodszky, Valentin; Gulácsi, László; Herédi, Emese; Herszényi, Krisztina; Jókai, Hajnalka; Kárpáti, Sarolta; Baji, Petra; Remenyik, Éva; Szegedi, Andrea; Holló, Péter

2014-05-01

Despite the widespread availability of biological drugs in psoriasis, there is a shortage of disease burden studies. To assess the cost-of-illness and quality of life of patients with moderate to severe psoriasis in Hungary. Consecutive patients with Psoriasis Area and Severity Index (PASI) > 10 and Dermatology Life Quality Index (DLQI) > 10, or treated with traditional systemic (TST) or biological systemic treatment (BST) were included. Demographic data, clinical characteristics, psoriasis related medication, health care utilizations and employment status in the previous 12 months were recorded. Costing was performed from the societal perspective applying the human capital approach. Quality of life was assessed using DLQI and EQ-5D measures. Two-hundred patients were involved (females 32%) with a mean age of 51 (SD 13) years, 103 (52%) patients were on BST. Mean PASI, DLQI and EQ-5D scores were 8 (SD 10), 6 (SD 7) and 0.69 (SD 0.3), respectively. The mean total cost was €9,254/patient/year (SD 8,502) with direct costs accounting for 86%. The main cost driver was BST (mean €7,339/patient/year). Total costs differed significantly across treatment subgroups, mean (SD): no systemic therapy €2,186 (4,165), TST €2,388 (4,106) and BST €15,790 (6,016) (p costs than patients with or without traditional systemic treatment. Our study is the largest in Europe and the first in the CEE region that provides cost-of-illness data in psoriasis involving patients with BST.

Development of Malaysian women fertility index: Evidence from Shannon's entropy

Science.gov (United States)

Jalil, Wan Aznie Fatihah Wan Abd; Sharif, Shamshuritawati

2017-11-01

A fertility rate is a measure of the average number of children a woman will have during her childbearing years. Malaysia is now facing a population crisis and the fertility rate continues to decline. This situation will have implications for the age structure of the population where percentages of senior citizens are higher than percentages of people aged below 5 years old. Malaysia is expected to reach aging population status by the year 2035. As the aging population has a very long average life expectancy, the government needs to spend a lot on medical costs for senior citizens and need to increase budgets for pensions. The government may be required to increase tax revenues to support the growing older population. The falling fertility rate requires proper control by relevant authorities, especially through planning and implementation of strategic and effective measures. Hence, this paper aims to develop a fertility index using Shannon's entropy method. The results show that Selangor, Johor, and Sarawak are among the states with the highest values of the fertility index. On the other end of the spectrum, Terengganu, W.P. Labuan, and Perlis are ranked in the last positions according to the fertility index. The information generated from the results in this study can be used as a primary source for the government to design appropriate policies to mitigate dwindling fertility rates among Malaysian women.

Cerebral state index during propofol anesthesia : A Comparison with the Bispectral Index and the A-Line ARX Index

NARCIS (Netherlands)

Jensen, EW; Litvan, H; Revuelta, M; Rodriguez, BE; Caminal, P; Martinez, P; Vereecke, H; Struys, Michel MRF

Background: The objective of this study was to prospectively test the Cerebral State Index designed for measuring the depth of anesthesia. The Cerebral State Index is calculated using a fuzzy logic combination of four subparameters of the electroencephalographic signal. The performance of the

Computer-assisted indexing for the INIS database

International Nuclear Information System (INIS)

Nevyjel, A.

2006-01-01

INIS has identified computer-assisted indexing as areas where information technology could assist best in maintaining database quality and indexing consistency, while containing production costs. Subject analysis is a very important but also very expensive process in the production of the INIS database. Given the current necessity to process an increased number of records, including subject analysis, without additional staff, INIS as well as the member states need improvements in their processing efficiency. Computer assisted subject analysis is a promising way to achieve this. The quality of the INIS database is defined by its inputting rules. The Thesaurus is a terminological control device used in translating from the natural language of documents, indexers or users into a more constrained system language. It is a controlled and dynamic vocabulary of semantically and generically related terms. It is the essential tool for subject analysis as well as for advanced search engines. To support the identification of descriptors in the free text (title, abstract, free keywords) 'hidden terms' have been introduced as extension of the Thesaurus, which identify phrases or character strings of free text and point to the valid descriptor, which should be suggested. In the process of computer-assisted subject analysis the bibliographic records (including title and abstract) are analyzed by the software, resulting in a list of suggested descriptors. Within the working platform (graphical user interface) the suggested descriptors are sorted by importance (by their relevance for the content of the document) and the subject specialist clearly sees the highlighted context from which the terms were selected. The system allows the subject specialist to accept or reject descriptors from the suggested list and to assign additional descriptors when necessary. First experiences show that a performance enhancement of about 80-100% can be achieved in the subject analysis process. (author)

Prediction of massive bleeding. Shock index and modified shock index.

Science.gov (United States)

Terceros-Almanza, L J; García-Fuentes, C; Bermejo-Aznárez, S; Prieto-Del Portillo, I J; Mudarra-Reche, C; Sáez-de la Fuente, I; Chico-Fernández, M

2017-12-01

To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. Retrospective cohort. Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015. We studied the sensitivity (Se), specificity (Sp), positive and negative predictive value (PV+ and PV-), positive and negative likelihood ratio (LR+ and LR-), ROC curves (Receiver Operating Characteristics) and the area under the same (AUROC) for prediction of massive hemorrhage. 287 patients were included, 76.31% (219) were male, mean age was 43,36 (±17.71) years and ISS was 26 (interquartile range [IQR]: 21-34). The overall frequency of massive bleeding was 8.71% (25). For Shock Index: AUROC was 0.89 (95% confidence intervals [CI] 0.84 to 0.94), with an optimal cutoff at 1.11, Se was 91.3% (95% CI: 73.2 to 97.58) and Sp was 79.69% (95% CI: 74.34 to 84.16). For the Modified Shock Index: AUROC was 0.90 (95% CI: 0.86 to 0.95), with an optimal cutoff at 1.46, Se was 95.65% (95% CI: 79.01 to 99.23) and Sp was 75.78% (95% CI: 70.18 to 80.62). Shock Index and Modified Shock Index are good predictors of massive bleeding and could be easily incorporated to the initial workup of patients with severe trauma. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Integrating the Carbon and Water Footprints’ Costs in the Water Framework Directive 2000/60/EC Full Water Cost Recovery Concept: Basic Principles Towards Their Reliable Calculation and Socially Just Allocation

Directory of Open Access Journals (Sweden)

Anastasia Papadopoulou

2012-01-01

Full Text Available This paper presents the basic principles for the integration of the water and carbon footprints cost into the resource and environmental costs respectively, taking the suggestions set by the Water Framework Directive (WFD 2000/60/EC one step forward. WFD states that full water cost recovery (FWCR should be based on the estimation of the three sub-costs related: direct; environmental; and resource cost. It also strongly suggests the EU Member States develop and apply effective water pricing policies to achieve FWCR. These policies must be socially just to avoid any social injustice phenomena. This is a very delicate task to handle, especially within the fragile economic conditions that the EU is facing today. Water losses play a crucial role for the FWC estimation. Water losses should not be neglected since they are one of the major “water uses” in any water supply network. A methodology is suggested to reduce water losses and the related Non Revenue Water (NRW index. An Expert Decision Support System is proposed to assess the FWC incorporating the Water and Carbon Footprint costs.

Cost-effectiveness of a pressure ulcer quality collaborative

Directory of Open Access Journals (Sweden)

Bal Roland

2010-06-01

Full Text Available Abstract Background A quality improvement collaborative (QIC in the Dutch long-term care sector (nursing homes, assisted living facilities, home care used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs. The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. Methods We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials. Quality of life (Qol weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1 not sustained, (2 partially sustained, and (3 completely sustained. Results Incidence of PUs decreased from 15% to 4.5% for the 88 patients. Prevalence decreased from 38.6% to 22.7%. Average Quality of Life (Qol of patients increased by 0.02 Quality Adjusted Life Years (QALYs in two years; healthcare costs increased by €2000 per patient; the Incremental Cost-effectiveness Ratio (ICER was between 78,500 and 131,000 depending on whether the changes in incidence and prevalence of PU were sustained. Conclusions During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care, the QIC was probably more costly and more effective in the short run, but its long-term cost-effectiveness is questionable. The QIC can only be cost-effective if the changes in incidence and prevalence of PU are sustained.

Cost-effectiveness of a pressure ulcer quality collaborative.

Science.gov (United States)

Makai, Peter; Koopmanschap, Marc; Bal, Roland; Nieboer, Anna P

2010-06-01

A quality improvement collaborative (QIC) in the Dutch long-term care sector (nursing homes, assisted living facilities, home care) used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs). The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials). Quality of life (Qol) weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1) not sustained, (2) partially sustained, and (3) completely sustained. Incidence of PUs decreased from 15% to 4.5% for the 88 patients. Prevalence decreased from 38.6% to 22.7%. Average Quality of Life (Qol) of patients increased by 0.02 Quality Adjusted Life Years (QALY)s in two years; healthcare costs increased by euro2000 per patient; the Incremental Cost-effectiveness Ratio (ICER) was between 78,500 and 131,000 depending on whether the changes in incidence and prevalence of PU were sustained. During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care, the QIC was probably more costly and more effective in the short run, but its long-term cost-effectiveness is questionable. The QIC can only be cost-effective if the changes in incidence and prevalence of PU are sustained.

Cost-effectiveness of implant-supported mandibular removable partial dentures.

Science.gov (United States)

Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L; Raghoebar, Gerry M; Speksnijder, Caroline; Meijer, Henny J A; Cune, Marco S

2017-05-01

The aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Thirty subjects were included. A new RPD was made and implant support was provided 3 months later. Treatment costs (opportunity costs and costs based on tariffs) were calculated. Treatment effect was expressed by means of the Dutch Oral Health Impact Profile questionnaire (OHIP-NL49), a chewing ability test (Mixing Ability Index, MAI) and a short-form health survey measuring perceived general health (SF-36), which was subsequently converted into quality-adjusted-life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was the primary outcome measure of cost-effectiveness, comparing both treatment strategies. The mean total opportunity costs were €981 (95% CI €971-€991) for the RPD treatment and €2.480 (95% CI €2.461-€2.500) for the ISRPD treatment. The total costs derived from the national tariff structure were €850 for the RPD treatment and €2.610 for the ISRPD treatment. The ICER for OHIP-NL49 and MAI using the opportunity costs was €80 and €786, respectively. When using the tariff structure, corresponding ICERs were €94 and €921. The effect of supporting an RPD with implants when expressed in QALYs was negligible; hence an ICER was not determined. It is concluded that depending on the choice of outcome measure and monetary threshold, supporting an RPD with implants is cost-effective when payers are willing to pay more than €80 per OHIP point gained. Per MAI point gained, an additional €786 has to be invested. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Malaysian Education Index (MEI): An Online Indexing and Repository System

Science.gov (United States)

Kabilan, Muhammad Kamarul; Ismail, Hairul Nizam; Yaakub, Rohizani; Yusof, Najeemah Mohd; Idros, Sharifah Noraidah Syed; Umar, Irfan Naufal; Arshad, Muhammad Rafie Mohd.; Idrus, Rosnah; Rahman, Habsah Abdul

2010-01-01

This "Project Sheet" describes an on-going project that is being carried out by a group of educational researchers, computer science researchers and librarians from Universiti Sains Malaysia, Penang. The Malaysian Education Index (MEI) has two main functions--(1) Online Indexing System, and (2) Online Repository System. In this brief…

The impact of hydro-biofuel-wind energy consumption on environmental cost of doing business in a panel of BRICS countries: evidence from three-stage least squares estimator.

Science.gov (United States)

Zaman, Khalid

2018-02-01

The renewable energy sources are considered the vital factor to promote global green business. The environmental cost of doing business is the pre-requisite to analyze sustainable policies that facilitate the eco-minded entrepreneurs to produce healthier goods. This study examines the impact of renewable energy sources (i.e., hydro energy, biofuel energy, and wind energy) on the environmental cost of doing business in a panel of BRICS (Brazil, Russian Federation, India, China, and South Africa) countries, for the period of 1995-2015. The study employed principal component analysis to construct an "integrated environmental index" by using three alternative and plausible factors including carbon dioxide emissions, fossil fuel energy consumption, and chemicals used in the manufacturing process. The environmental index is used as an interactive term with the three cost of doing business indicators including business disclosure index, the cost of business start-up procedures, and logistics performance index to form environmental cost of doing business (ECDB) indicators. The results of three-stage least squares (3SLS) estimator show that foreign direct investment (FDI) inflows supported the green business while trade openness deteriorates the environment, which partially validates the "pollution haven hypotheses (PHH)" in a panel of countries. There is no evidence for environmental Kuznets curve (EKC) hypothesis; however, there is a monotonic decreasing relationship between per capita income and ECDB indicators. The hydro energy supports the sustainable business environment, while biofuel consumption deteriorates the environmental impact on the cost of business start-up procedures. Finally, wind energy subsequently affected the ECDB indicators in a panel of BRICS countries. The overall results conclude that growth factors and energy sources both have a considerable impact on the cost of doing business; therefore, there is a momentous need to formulate sustainable policy

Predicting pavement condition index using international roughness index in Washington DC.

Science.gov (United States)

2014-09-01

A number of pavement condition indices are used to conduct pavement management assessments, two of which are the : International Roughness Index (IRI) and Pavement Condition Index (PCI). The IRI is typically measured using specialized : equipment tha...

Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury.

Science.gov (United States)

Badke, Guilherme Lellis; Araujo, João Luiz Vitorino; Miura, Flávio Key; Guirado, Vinicius Monteiro de Paula; Saade, Nelson; Paiva, Aline Lariessy Campos; Avelar, Tiago Marques; Pedrozo, Charles Alfred Grander; Veiga, José Carlos Esteves

2018-04-01

Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile. A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost. Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44). Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority.

Treatment persistence & health care costs of adult MDD patients treated with escitalopram vs. citalopram in a medicaid population.

Science.gov (United States)

Wu, Eric Q; Ben-Hamadi, Rym; Lu, Mei; Beaulieu, Nicolas; Yu, Andrew P; Erder, M Haim

2012-01-01

Compare treatment persistence and health care costs of major depressive disorder (MDD) Medicaid patients treated with escitalopram versus citalopram. Retrospective analysis of Medicaid administrative claims data. Analyzed administrative claims data from the Florida Medicaid program (07/2002-06/2006) for patients ages 18-64 years with 21 inpatient claim or 2 independent medical claims for MDD. Outcomes included discontinuation and switching rates and prescription drug, medical, and total health care costs, all-cause and related to mental disorder. Contingency table analysis and survival analysis were used to compare outcomes between treatment groups, using both unadjusted analysis and multivariate analysis adjusting for baseline characteristics. The study included 2,650 patients initiated on escitalopram and 630 patients initiated on citalopram. Patients treated with escitalopram were less likely to discontinue the index drug (63.7% vs. 68.9%, P=0.015) or to switch to another second-generation antidepressant (14.9% vs. 18.4%, P=0.029) over the six months post-index date. Patients treated with escitalopram had $1,014 lower total health care costs (P=0.032) and $519 lower health care costs related to mental disorder (P=0.023). More than half of the total cost difference was attributable to savings in inpatient hospitalizations related to mental disorder ($571, P=0.003) and to outpatient costs ($53, PEscitalopram therapy was also associated with $736 lower medical costs related to mental disorder (P=0.009). In the Florida Medicaid program, compared to adult MDD patients initiated on citalopram, escitalopram patients have better treatment persistence and lower total health care costs due to any cause and due to mental disorder, mostly driven by lower hospitalization costs related to mental disorder.

Cost-effectiveness of a ROPS social marketing campaign.

Science.gov (United States)

Sorensen, J A; Jenkins, P; Bayes, B; Clark, S; May, J J

2010-01-01

Tractor rollovers are the most frequent cause of death in the farm community. Rollover protection structures (ROPS) can prevent the injuries and fatalities associated with these events; however, almost half of U.S. farms lack these essential devices. One promising strategy for increasing ROPS use is social marketing. The purpose of this study was to assess the costs associated with the New York ROPS Social Marketing Campaign in relation to the cost of fatalities and injuries averted as a result of the campaign to determine whether cost savings could be demonstrated in the initial years of program implementation. A total of 524 farmers who had retrofitted a tractor through the program were mailed a survey to assess the number of rollovers or close calls that occurred since ROPS installation. Responses were obtained from 382 farmers, two of whom indicated that they had a potential fatality/injury scenario since retrofitting their tractor through the program. The cost savings associated with the intervention was estimated using a decision-tree analysis adapted from Myers and Pana-Cryan with appropriate consumer price index adjustments. The data were compared to the cost of the New York ROPS Social Marketing Campaign to arrive at an associated cost-savings estimate relative to the intervention. This study indicates that a net savings will likely be demonstrated within the third year of the New York ROPS Social Marketing initiative. These data may provide evidence for researchers hoping to generate support from state and private agencies for similar initiatives.

Intelligent indexing

International Nuclear Information System (INIS)

Farkas, J.

1992-01-01

In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space ι 2 to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs

Intelligent indexing

Energy Technology Data Exchange (ETDEWEB)

Farkas, J

1993-12-31

In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space {iota}{sup 2} to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs.

Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

Science.gov (United States)

2012-01-01

Background Tuberculosis (TB) is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$). Results Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion TB patients and households in sub-Saharan Africa often incurred high costs when utilizing TB treatment

Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

Directory of Open Access Journals (Sweden)

Barter Devra M

2012-11-01

Full Text Available Abstract Background Tuberculosis (TB is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$. Results Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion TB patients and households in sub-Saharan Africa often incurred high costs

Costs and indices for domestic oil and gas field equipment and production operations 1990 through 1993

Energy Technology Data Exchange (ETDEWEB)

1994-07-08

This report presents estimated costs and indice for domestic oil and gas field equipment and production operations for 1990, 1991, 1992, and 1993. The costs of all equipment and serives were those in effect during June of each year. The sums (aggregates) of the costs for representative leases by region, depth, and production rate were averaged and indexed. This provides a general measure of the increased or decreased costs from year to year for lease equipment and operations. These general measures do not capture changes in industry-wide costs exactly because of annual variations in the ratio of oil wells to gas wells. The body of the report contains summary tables, and the appendices contain detailed tables. Price changes for oil and gas, changes in taxes on oil and gas revenues, and environmental factors (costs and lease availability) have significant impact on the number and cost of oil and gas wells drilled. These changes also impact the cost of oil and gas production equipment and operations.

Costs and indices for domestic oil and gas field equipment and production operations 1990 through 1993

International Nuclear Information System (INIS)

1994-01-01

This report presents estimated costs and indice for domestic oil and gas field equipment and production operations for 1990, 1991, 1992, and 1993. The costs of all equipment and serives were those in effect during June of each year. The sums (aggregates) of the costs for representative leases by region, depth, and production rate were averaged and indexed. This provides a general measure of the increased or decreased costs from year to year for lease equipment and operations. These general measures do not capture changes in industry-wide costs exactly because of annual variations in the ratio of oil wells to gas wells. The body of the report contains summary tables, and the appendices contain detailed tables. Price changes for oil and gas, changes in taxes on oil and gas revenues, and environmental factors (costs and lease availability) have significant impact on the number and cost of oil and gas wells drilled. These changes also impact the cost of oil and gas production equipment and operations

Design and Application of Drought Indexes in Highly Regulated Mediterranean Water Systems

Science.gov (United States)

Castelletti, A.; Zaniolo, M.; Giuliani, M.

2017-12-01

Costs of drought are progressively increasing due to the undergoing alteration of hydro-meteorological regimes induced by climate change. Although drought management is largely studied in the literature, most of the traditional drought indexes fail in detecting critical events in highly regulated systems, which generally rely on ad-hoc formulations and cannot be generalized to different context. In this study, we contribute a novel framework for the design of a basin-customized drought index. This index represents a surrogate of the state of the basin and is computed by combining the available information about the water available in the system to reproduce a representative target variable for the drought condition of the basin (e.g., water deficit). To select the relevant variables and combinatione thereof, we use an advanced feature extraction algorithm called Wrapper for Quasi Equally Informative Subset Selection (W-QEISS). W-QEISS relies on a multi-objective evolutionary algorithm to find Pareto-efficient subsets of variables by maximizing the wrapper accuracy, minimizing the number of selected variables, and optimizing relevance and redundancy of the subset. The accuracy objective is evaluated trough the calibration of an extreme learning machine of the water deficit for each candidate subset of variables, with the index selected from the resulting solutions identifying a suitable compromise between accuracy, cardinality, relevance, and redundancy. The approach is tested on Lake Como, Italy, a regulated lake mainly operated for irrigation supply. In the absence of an institutional drought monitoring system, we constructed the combined index using all the hydrological variables from the existing monitoring system as well as common drought indicators at multiple time aggregations. The soil moisture deficit in the root zone computed by a distributed-parameter water balance model of the agricultural districts is used as target variable. Numerical results show that

Is Accelerated Partner Therapy (APT) a cost-effective alternative to routine patient referral partner notification in the UK? Preliminary cost-consequence analysis of an exploratory trial.

Science.gov (United States)

Roberts, Tracy E; Tsourapas, Angelos; Sutcliffe, Lorna; Cassell, Jackie; Estcourt, Claudia

2012-02-01

To undertake a cost-consequence analysis to assess two new models of partner notification (PN), known as Accelerated Partner Therapy (APT Hotline and APT Pharmacy), as compared with routine patient referral PN, for sex partners of people with chlamydia, gonorrhoea and non-gonococcal urethritis. Comparison of costs and outcomes alongside an exploratory trial involving two genitourinary medicine clinics and six community pharmacies. Index patients selected the PN method (APT Hotline, APT Pharmacy or routine PN) for their partners. Clinics and pharmacies recorded cost and resource use data including duration of consultation and uptake of treatment pack. Cost data were collected prospectively for two out of three interventions, and data were synthesised and compared in terms of effectiveness and costs. Routine PN had the lowest average cost per partner treated (approximately £46) compared with either APT Hotline (approximately £54) or APT Pharmacy (approximately £53) strategies. The cost-consequence analysis revealed that APT strategies were more costly but also more effective at treating partners compared to routine PN. The hotline strategy costs more than both the alternative PN strategies. If we accept that strategies which identify and treat partners the fastest are likely to be the most effective in reducing reinfection and onward transmission, then APT Hotline appears an effective PN strategy by treating the highest number of partners in the shortest duration. Whether the additional benefit is worth the additional cost cannot be determined in this preliminary analysis. These data will be useful for informing development of future randomised controlled trials of APT.

Single mode step-index polymer optical fiber for humidity insensitive high temperature fiber Bragg grating sensors

DEFF Research Database (Denmark)

Woyessa, Getinet; Fasano, Andrea; Stefani, Alessio

2016-01-01

We have fabricated the first single-mode step-index and humidity insensitive polymer optical fiber operating in the 850 nm wavelength ranges. The step-index preform is fabricated using injection molding, which is an efficient method for cost effective, flexible and fast preparation of the fiber...... preform. The fabricated single-mode step-index (SI) polymer optical fiber (POF) has a 4.8µm core made from TOPAS grade 5013S-04 with a glass transition temperature of 134°C and a 150 µm cladding made from ZEONEX grade 480R with a glass transition temperature of 138°C. The key advantages of the proposed...... SIPOF are low water absorption, high operating temperature and chemical inertness to acids and bases and many polar solvents as compared to the conventional poly-methyl-methacrylate (PMMA) and polystyrene based POFs. In addition, the fiber Bragg grating writing time is short compared to microstructured...

Cost of practice in a tertiary/quaternary referral center: is it sustainable?

Science.gov (United States)

Cologne, K G; Hwang, G S; Senagore, A J

2014-11-01

Third-party payers are moving toward a bundled care payment system. This means that there will need to be a warranty cost of care-where the cost of complexity and complication rates is built into the bundled payment. The theoretical benefit of this system is that providers with lower complication rates will be able to provide care with lower warranty costs and lower overall costs. This may also result in referring riskier patients to tertiary or quaternary referral centers. Unless the payment model truly covers the higher cost of managing such referred cases, the economic risk may be unsustainable for these centers. We took the last seven patients that were referred by other surgeons as "too high risk" for colectomy at other centers. A contribution margin was calculated using standard Medicare reimbursement rates at our institution and cost of care based on our administrative database. We then recalculated a contribution margin assuming a 3 % reduction in payment for a higher than average readmission rate, like that which will take effect in 2014. Finally, we took into account the cost of any readmissions. Seven patients with diagnosis related group (DRG) 330 were reviewed with an average age of 66.8 ± 16 years, American Society of Anesthesiologists score 2.3 ± 1.0, body mass index 31.6 ± 9.8 kg/m(2) (range 22-51 kg/m(2)). There was a 57 % readmission rate, 29 % reoperation rate, 10.8 ± 7.7 day average initial length of stay with 14 ± 8.6 day average readmission length of stay. Forty-two percent were discharged to a location other than home. Seventy-one percent of these patients had Medicare insurance. The case mix index was 2.45. Average reimbursement for DRG 330 was $17,084 (based on Medicare data) for our facility in 2012, with the national average being $12,520. The total contribution margin among all cases collectively was -$19,122 ± 13,285 (average per patient -$2,731, range -$21,905-$12,029). Assuming a 3 % reimbursement reduction made the overall

Characteristic features of determining the labor input and estimated cost of the development and manufacture of equipment

Science.gov (United States)

Kurmanaliyev, T. I.; Breslavets, A. V.

1974-01-01

The difficulties in obtaining exact calculation data for the labor input and estimated cost are noted. The method of calculating the labor cost of the design work using the provisional normative indexes with respect to individual forms of operations is proposed. Values of certain coefficients recommended for use in the practical calculations of the labor input for the development of new scientific equipment for space research are presented.

CLUSTERING OF THE COUNTRIES ACCORDING TO CONSUMER CONFIDENCE INDEX AND EVALUATING WITH HUMAN DEVELOPMENT INDEX

Directory of Open Access Journals (Sweden)

Seda BAĞDATLI KALKAN

2018-01-01

Full Text Available Consumer confidence index is a national indicator that suggest about current and future expectations of the economic conditions. With consumer confidence index, it is aimed to determine the trends and expectations of consumers according to their general economic situation, employment opportunities, their financial situations and developments in the markets. Another parameter is also the Human Development Index (HDI. This index is an indicator that examines the development of countries both economically and socially. Countries are sorted by these two indices and are considered as basic parameters in international platforms. The purpose of this study is to group the selected countries according to the consumer confidence index and reveal the features of the groups and then determine the position of the grouped countries with the Human Development Index. According to the results of cluster analysis, it is shown that India, China, Sweden and USA have the highest total consumer confidence index, employment, expectation and investment index

Wildfire Suppression Costs for Canada under a Changing Climate.

Directory of Open Access Journals (Sweden)

Emily S Hope

Full Text Available Climate-influenced changes in fire regimes in northern temperate and boreal regions will have both ecological and economic ramifications. We examine possible future wildfire area burned and suppression costs using a recently compiled historical (i.e., 1980-2009 fire management cost database for Canada and several Intergovernmental Panel on Climate Change (IPCC climate projections. Area burned was modelled as a function of a climate moisture index (CMI, and fire suppression costs then estimated as a function of area burned. Future estimates of area burned were generated from projections of the CMI under two emissions pathways for four General Circulation Models (GCMs; these estimates were constrained to ecologically reasonable values by incorporating a minimum fire return interval of 20 years. Total average annual national fire management costs are projected to increase to just under $1 billion (a 60% real increase from the 1980-2009 period under the low greenhouse gas emissions pathway and $1.4 billion (119% real increase from the base period under the high emissions pathway by the end of the century. For many provinces, annual costs that are currently considered extreme (i.e., occur once every ten years are projected to become commonplace (i.e., occur once every two years or more often as the century progresses. It is highly likely that evaluations of current wildland fire management paradigms will be necessary to avoid drastic and untenable cost increases as the century progresses.

The Effects Of International Integration On Cost Of Equity: Application Of Turkey’s Tourism Sector

OpenAIRE

Demir, Sezgin; Kaderli, Yasemin Coşkun

2015-01-01

In this paper, the cost of equities of the companies listed in the BISTTRZM index in BORSAİSTANBUL were computed by using models which are based on the Capital Asset Pricing Model (CAPM). The results of models using local data were compared with the results of models using global data. Thus the effect of Turkey’s integration of international capital market on the cost of equity was measured. Local and Global Capital Asset Pricing Model (CAPM), Multifactor Global CAPM, Bekaert – Harvey Mixtur...

CSF free light chain identification of demyelinating disease: comparison with oligoclonal banding and other CSF indexes.

Science.gov (United States)

Gurtner, Kari M; Shosha, Eslam; Bryant, Sandra C; Andreguetto, Bruna D; Murray, David L; Pittock, Sean J; Willrich, Maria Alice V

2018-02-19

Cerebrospinal fluid (CSF) used in immunoglobulin gamma (IgG) index testing and oligoclonal bands (OCBs) are common laboratory tests used in the diagnosis of multiple sclerosis. The measurement of CSF free light chains (FLC) could pose as an alternative to the labor-intensive isoelectric-focusing (IEF) gels used for OCBs. A total of 325 residual paired CSF and serum specimens were obtained after physician-ordered OCB IEF testing. CSF kappa (cKFLC) and lambda FLC (cLFLC), albumin and total IgG were measured. Calculations were performed based on combinations of analytes: CSF sum of kappa and lambda ([cKFLC+cLFLC]), kappa-index (K-index) ([cKFLC/sKFLC]/[CSF albumin/serum albumin]), kappa intrathecal fraction (KFLCIF) {([cKFLC/sKFLC]-[0.9358×CSF albumin/serum albumin]^[0.6687×sKFLC]/cKFLC)} and IgG-index ([CSF IgG/CSF albumin]/[serum IgG/serum albumin]). Patients were categorized as: demyelination (n=67), autoimmunity (n=53), non-inflammatory (n=50), inflammation (n=38), degeneration (n=28), peripheral neuropathy (n=24), infection (n=13), cancer (n=11), neuromyelitis optica (n=10) and others (n=31). cKFLC measurement used alone at a cutoff of 0.0611 mg/dL showed >90% agreement to OCBs, similar or better performance than all other calculations, reducing the number of analytes and variables. When cases of demyelinating disease were reviewed, cKFLC measurements showed 86% clinical sensitivity/77% specificity. cKFLC alone demonstrates comparable performance to OCBs along with increased sensitivity for demyelinating diseases. Replacing OCB with cKFLC would alleviate the need for serum and CSF IgG and albumin and calculated conversions. cKFLC can overcome challenges associated with performance, interpretation, and cost of traditional OCBs, reducing costs and maintaining sensitivity and specificity supporting MS diagnosis.

Analyses of Blood Bank Efficiency, Cost-Effectiveness and Quality

Science.gov (United States)

Lam, Hwai-Tai Chen

In view of the increasing costs of hospital care, it is essential to investigate methods to improve the labor efficiency and the cost-effectiveness of the hospital technical core in order to control costs while maintaining the quality of care. This study was conducted to develop indices to measure efficiency, cost-effectiveness, and the quality of blood banks; to identify factors associated with efficiency, cost-effectiveness, and quality; and to generate strategies to improve blood bank labor efficiency and cost-effectiveness. Indices developed in this study for labor efficiency and cost-effectiveness were not affected by patient case mix and illness severity. Factors that were associated with labor efficiency were identified as managerial styles, and organizational designs that balance workload and labor resources. Medical directors' managerial involvement was not associated with labor efficiency, but their continuing education and specialty in blood bank were found to reduce the performance of unnecessary tests. Surprisingly, performing unnecessary tests had no association with labor efficiency. This suggested the existence of labor slack in blood banks. Cost -effectiveness was associated with workers' benefits, wages, and the production of high-end transfusion products by hospital-based donor rooms. Quality indices used in this study included autologous transfusion rates, platelet transfusion rates, and the check points available in an error-control system. Because the autologous transfusion rate was related to patient case mix, severity of illness, and possible inappropriate transfusion, it was not recommended to be used for quality index. Platelet-pheresis transfusion rates were associated with the transfusion preferences of the blood bank medical directors. The total number of check points in an error -control system was negatively associated with government ownership and workers' experience. Recommendations for improving labor efficiency and cost

White matter microstructure within the superior longitudinal fasciculus modulates the degree of response conflict indexed by N2 in healthy adults.

Science.gov (United States)

Gao, Shudan; Liu, Peng; Guo, Jialu; Zhu, Yuanqiang; Liu, Peng; Sun, Jinbo; Yang, Xuejuan; Qin, Wei

2017-12-01

Response conflict can be induced by priming multiple responses competing for control of action in trials. The N2 is one functionally-related cognitive control index for response conflict. And yet the underlying whiter matter neural substrates of inter-individual difference in conflict N2 remain unclear. So the aim of present study was to address the white matter microstructure of the N2 responsible for conflict by directly relating the amplitude cost of the event-related potential (ERP) N2 component to diffusion tensor imaging (DTI) indices in healthy subjects. Thirty healthy subjects underwent DTI scanning and electrophysiology recording during a modified Flanker task. N2 was a stimulus-locked negative ERP component. Fractional anisotropy (FA) was calculated based on DTI measures and was assumed to reflect the integrity of myelinate fiber bundles. Therefore, we tested the relationship between N2 amplitude and FA in brain white matter. Results showed that FA, an index for white matter characteristics, in the right superior longitudinal fasciculus (SLF) was significantly positively associated with N2 amplitude cost. The N2 amplitude cost also predicted response time (RT) cost in the Flanker task. Higher FA was associated with larger N2 amplitude cost, suggesting that changes in white matter integrity in the SLF may account for changes in efficient transmission of fronto-parietal modulatory conflict signals. Copyright © 2017 Elsevier B.V. All rights reserved.

Indexed

CERN Document Server

Hagy, Jessica

2008-01-01

Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

Payment schemes and cost efficiency: evidence from Swiss public hospitals.

Science.gov (United States)

Meyer, Stefan

2015-03-01

This paper aims at analysing the impact of prospective payment schemes on cost efficiency of acute care hospitals in Switzerland. We study a panel of 121 public hospitals subject to one of four payment schemes. While several hospitals are still reimbursed on a per diem basis for the treatment of patients, most face flat per-case rates-or mixed schemes, which combine both elements of reimbursement. Thus, unlike previous studies, we are able to simultaneously analyse and isolate the cost-efficiency effects of different payment schemes. By means of stochastic frontier analysis, we first estimate a hospital cost frontier. Using the two-stage approach proposed by Battese and Coelli (Empir Econ 20:325-332, 1995), we then analyse the impact of these payment schemes on the cost efficiency of hospitals. Controlling for hospital characteristics, local market conditions in the 26 Swiss states (cantons), and a time trend, we show that, compared to per diem, hospitals which are reimbursed by flat payment schemes perform better in terms of cost efficiency. Our results suggest that mixed schemes create incentives for cost containment as well, although to a lesser extent. In addition, our findings indicate that cost-efficient hospitals are primarily located in cantons with competitive markets, as measured by the Herfindahl-Hirschman index in inpatient care. Furthermore, our econometric model shows that we obtain biased estimates from frontier analysis if we do not account for heteroscedasticity in the inefficiency term.

Social/economic costs and health-related quality of life in patients with Duchenne muscular dystrophy in Europe.

Science.gov (United States)

Cavazza, Marianna; Kodra, Yllka; Armeni, Patrizio; De Santis, Marta; López-Bastida, Julio; Linertová, Renata; Oliva-Moreno, Juan; Serrano-Aguilar, Pedro; Posada-de-la-Paz, Manuel; Taruscio, Domenica; Schieppati, Arrigo; Iskrov, Georgi; Péntek, Márta; von der Schulenburg, Johann Matthias Graf; Kanavos, Panos; Chevreul, Karine; Persson, Ulf; Fattore, Giovanni

2016-04-01

The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with Duchenne muscular dystrophy (DMD) in Europe. We conducted a cross-sectional study of patients with DMD from Bulgaria, France, Germany, Hungary, Italy, Spain, Sweden, and the UK. Data on demographic characteristics, healthcare resource utilization, informal care, labor productivity losses, and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D) questionnaire. Costs have been estimated from a societal perspective adopting a bottom-up approach. A total of 422 questionnaires were included in the study; 268 of which were collected from patients with DMD and 154 from caregivers. The average annual cost per person in 2012 ranged from €7657 in Hungary to €58,704 in France. Direct non-healthcare costs are the main component of whole costs and informal care is the main driver of non-healthcare costs. Costs are also shown to differ between children and adults. With regard to HRQOL of adult patients, the EQ-5D VAS score and EQ-5D index scores were 50.5 and 0.24, respectively. The corresponding EQ-5D VAS and EQ-5D index scores for caregivers were 74.7 and 0.71, respectively. We have estimated the average annual cost per patient with DMD in eight European countries adopting a social perspective, and to our knowledge this is the first study with such a wide perspective. The results on costs show a considerable gap between Eastern and Western European countries. Non-healthcare costs range from 64 to 89 % of overall costs and informal care is to a great extent the main driver of this cost category. The HRQOL of people with DMD is much lower than that of the general population.

Cost-effectiveness of a Nutrition Education Curriculum Intervention in Elementary Schools.

Science.gov (United States)

Graziose, Matthew M; Koch, Pamela A; Wang, Y Claire; Lee Gray, Heewon; Contento, Isobel R

2017-09-01

To estimate the long-term cost-effectiveness of an obesity prevention nutrition education curriculum (Food, Health, & Choices) as delivered to all New York City fifth-grade public school students over 1 year. This study is a standard cost-effectiveness analysis from a societal perspective, with a 3% discount rate and a no-intervention comparator, as recommended by the US Panel on Cost-effectiveness in Health and Medicine. Costs of implementation, administration, and future obesity-related medical costs were included. Effectiveness was based on a cluster-randomized, controlled trial in 20 public schools during the 2012-2013 school year and linked to published estimates of childhood-to-adulthood body mass index trajectories using a decision analytic model. The Food, Health, & Choices intervention was estimated to cost $8,537,900 and result in 289 fewer males and 350 fewer females becoming obese (0.8% of New York City fifth-grade public school students), saving 1,599 quality-adjusted life-years (QALYs) and $8,098,600 in direct medical costs. Food, Health, & Choices is predicted to be cost-effective at $275/QALY (95% confidence interval, -$2,576/QALY to $2,084/QALY) with estimates up to $6,029/QALY in sensitivity analyses. This cost-effectiveness model suggests that a nutrition education curriculum in public schools is effective and cost-effective in reducing childhood obesity, consistent with the authors' hypothesis and previous literature. Future research should assess the feasibility and sustainability of scale-up. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Trends in medical care cost--revisited.

Science.gov (United States)

Vincenzino, J V

1997-01-01

Market forces have had a greater influence on the health care sector than anticipated. The increased use of managed care, particularly HMOs, has been largely responsible for a sharp deceleration in the rise of medical care costs. After recording double-digit growth for much of the post-Medicare/Medicaid period, national health expenditures rose just 5.1 percent and 5.5 percent in 1994 and 1995, respectively. The medical care Consumer Price Index (CPI) rose 3.5 percent in 1996-just 0.5 percent above the overall CPI. The delivery and financing of health care continues to evolve within a framework of cost constraints. As such, mergers, acquisitions and provider alliance groups will remain an integral part of the health industry landscape. However, cost savings are likely to become more difficult to achieve, especially if the "quality of care" issue becomes more pronounced. National health expenditures, which surpassed the $1 trillion mark in 1996, are projected to rise to $1.4 trillion by the year 2000--representing a 7.2 percent growth rate from 1995. In any event, demographics and technological advances suggest that the health sector will demand a rising share of economic resources. The ratio of health care expenditures to gross domestic product is forecast to rise from 13.6 percent in 1995 to 15 percent by the year 2000.

High index glass thin film processing for photonics and photovoltaic (PV) applications

Science.gov (United States)

Ogbuu, Okechukwu Anthony

To favorably compete with fossil-fuel technology, the greatest challenge for thin film solar-cells is to improve efficiency and reduce material cost. Thickness scaling to thin film reduces material cost but affects the light absorption in the cells; therefore a concept that traps incident photons and increases its optical path length is needed to boost absorption in thin film solar cells. One approach is the integration of low symmetric gratings (LSG), using high index material, on either the front-side or backside of 30 um thin c-Si cells. In this study, Multicomponent TeO2--Bi2O 3--ZnO (TBZ) glass thin films were prepared using RF magnetron sputtering under different oxygen flow rates. The influences of oxygen flow rate on the structural and optical properties of the resulting thin films were investigated. The structural origin of the optical property variation was studied using X-ray diffraction, X-ray photoelectron spectroscopy, Raman Spectroscopy, and transmission electron microscopy. The results indicate that TBZ glass thin film is a suitable material for front side LSG material photovoltaic and photonics applications due to their amorphous nature, high refractive index (n > 2), broad band optical transparency window, low processing temperature. We developed a simple maskless method to pattern sputtered tellurite based glass thin films using unconventional agarose hydrogel mediated wet etching. Conventional wet etching process, while claiming low cost and high throughput, suffers from reproducibility and pattern fidelity issues due to the isotropic nature of wet chemical etching when applied to glasses and polymers. This method overcomes these challenges by using an agarose hydrogel stamp to mediate a conformal etching process. In our maskless method, agarose hydrogel stamps are patterned following a standard soft lithography and replica molding process from micropatterned masters and soaked in a chemical etchant. The micro-scale features on the stamp are

The lead-lag relationship between stock index and stock index futures: A thermal optimal path method

Science.gov (United States)

Gong, Chen-Chen; Ji, Shen-Dan; Su, Li-Ling; Li, Sai-Ping; Ren, Fei

2016-02-01

The study of lead-lag relationship between stock index and stock index futures is of great importance for its wide application in hedging and portfolio investments. Previous works mainly use conventional methods like Granger causality test, GARCH model and error correction model, and focus on the causality relation between the index and futures in a certain period. By using a non-parametric approach-thermal optimal path (TOP) method, we study the lead-lag relationship between China Securities Index 300 (CSI 300), Hang Seng Index (HSI), Standard and Poor 500 (S&P 500) Index and their associated futures to reveal the variance of their relationship over time. Our finding shows evidence of pronounced futures leadership for well established index futures, namely HSI and S&P 500 index futures, while index of developing market like CSI 300 has pronounced leadership. We offer an explanation based on the measure of an indicator which quantifies the differences between spot and futures prices for the surge of lead-lag function. Our results provide new perspectives for the understanding of the dynamical evolution of lead-lag relationship between stock index and stock index futures, which is valuable for the study of market efficiency and its applications.

Index Bioclimatic "Wind-Chill"

Directory of Open Access Journals (Sweden)

Teodoreanu Elena

2015-05-01

Full Text Available This paper presents an important bioclimatic index which shows the influence of wind on the human body thermoregulation. When the air temperature is high, the wind increases thermal comfort. But more important for the body is the wind when the air temperature is low. When the air temperature is lower and wind speed higher, the human body is threatening to freeze faster. Cold wind index is used in Canada, USA, Russia (temperature "equivalent" to the facial skin etc., in the weather forecast every day in the cold season. The index can be used and for bioclimatic regionalization, in the form of skin temperature index.

12 CFR 34.22 - Index.

Science.gov (United States)

2010-01-01

... an index or combination of indices to which changes in the interest rate will be linked. This index... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Index. 34.22 Section 34.22 Banks and Banking... Mortgages § 34.22 Index. (a) In general. If a national bank makes an ARM loan to which 12 CFR 226.19(b...

Lifetime cost effectiveness of a through-school nutrition and physical programme: Project Energize.

Science.gov (United States)

Rush, Elaine; Obolonkin, Victor; McLennan, Stephanie; Graham, David; Harris, James D; Mernagh, Paul; Weston, Adéle R

2014-01-01

Project Energize, a multicomponent through-school physical activity and nutrition programme, is delivered to all primary school children in the Waikato region. The programme aim is to improve the overall health and reduce the rate of weight gain of all Waikato primary school children. An existing economic model was used to extrapolate the programme effects, initial costs, lifetime health treatment cost structures, quality-adjusted-life-years gained and increased life expectancy to the general and Māori child population of New Zealand. In March 2011, a sample of 2474 younger (7.58 ± 0.57 years, mean ± SD) and 2330 older (10.30 ± 0.51 years) children (36% Māori) attending Energize schools had body mass index measured and compared using mixed effect modelling with unEnergized comparison children from 2004 and 2006 from the same region. In 2011 the median body mass index reduction compared with the comparison younger children was -0.504 (90% CI -0.435 to -0.663) kg/m(2) and in the older children -0.551 (-0.456 to -0.789) kg/m(2). In 2010 there were 42,067 children attending Energize schools and in the same year NZ$1,891,175 was spent to deliver the programme; a cost of $44.96/child/year. Compared to the comparison children the increment in cost/quality-adjusted-life-year gained was $30,438 for the younger and $24,690 for the older children, and lower for Māori (younger $28,241, older $22,151) and for the middle socioeconomic status schools ($23,211, $17,891). Project Energize would improve quality and length of life and when compared with other obesity prevention programmes previously assessed with this model, it would be relatively cost-effective from the health treatment payer's perspective.

Evaluation of the indexes of income yield capacity of energetic projects

International Nuclear Information System (INIS)

Villanueva M, C.

2008-01-01

An economic-financial model to evaluate in the class living room those indexes of profitability of projects of productive infrastructure of the energy sector was developed, as for example: generation projects, transmission and electric energy distribution; projects of transport and distribution of natural gas; projects of cogeneration of vapor and electricity; projects of refinement of petroleum; and other industrial projects. It is described the structure and operation of the pattern, which has been implemented in an Excel calculation sheet that the students use in their personal computers to apply it to the evaluation of the indexes of profitability, specified by the Secretaria de Hacienda y Credito Publico (SHCP) in their limits for the elaboration and presentation of the cost and benefit analysis of the programs and projects of investment of the public sector. The indicators are: present net value VPN, quotient benefits cost B/C, return internal rate TIR, and equivalent annual cost CAE, which should be calculated with methodological rigor according to the SHCP lineaments. The pattern uses the pre-programmed financial functions in the Excel calculation sheet to carry out the compute of the indicators starting from the effective flow of the projects. It is described the technician-economic configuration and the effective flows during the useful life of three power stations of electric power generation that are designed, builds and operated to sell electric power to the national interconnected system in a nodal marginal prices market: a hydroelectric one, a combined cycle power station that uses natural gas, and a nucleo electric. The effective flows are developed and the central profitability of three centrals are evaluated and they are also carried out the corresponding sensitivity analyses and indifference required by the SHCP in their lineaments. Finally, the conditions in that the projects should operate and the prices in those that should sell their

An Analytical Study on an Orthodontic Index: Index of Complexity, Outcome and Need (ICON)

Science.gov (United States)

Torkan, Sepide; Pakshir, Hamid Reza; Fattahi, Hamid Reza; Oshagh, Morteza; Momeni Danaei, Shahla; Salehi, Parisa; Hedayati, Zohreh

2015-01-01

Statement of the Problem The validity of the Index of Complexity, Outcome and Need (ICON) which is an orthodontic index developed and introduced in 2000 should be studied in different ethnic groups. Purpose The aim of this study was to perform an analysis on the ICON and to verify whether this index is valid for assessing both the need and complexity of orthodontic treatment in Iran. Materials and Method Five orthodontists were asked to score pre-treatment diagnostic records of 100 patients with a uniform distribution of different types of malocclusions determined by Dental Health Component of the Index of Treatment Need. A calibrated examiner also assessed the need for orthodontic treatment and complexity of the cases based on the ICON index as well as the Index of Orthodontic Treatment Need (IOTN). 10 days later, 25% of the cases were re-scored by the panel of experts and the calibrated orthodontist. Results The weighted kappa revealed the inter-examiner reliability of the experts to be 0.63 and 0.51 for the need and complexity components, respectively. ROC curve was used to assess the validity of the index. A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point. This cut-off point showed the highest level of sensitivity and specificity in our society for orthodontic treatment need (0.77 and 0.78, respectively), but it failed to define definite ranges for the complexity of treatment. Conclusion ICON is a valid index in assessing the need for treatment in Iran when the cut-off point is adjusted to 35. As for complexity of treatment, the index is not validated for our society. It seems that ICON is a well-suited substitute for the IOTN index. PMID:26331142

Rethinking image indexing?

DEFF Research Database (Denmark)

Christensen, Hans Dam

2017-01-01

Hans Dam Christensen, ”Rethinking image indexing?”, in: Journal of the Association for Information Science and Technology, vol. 68, no. 7, 2017, 1782-1785......Hans Dam Christensen, ”Rethinking image indexing?”, in: Journal of the Association for Information Science and Technology, vol. 68, no. 7, 2017, 1782-1785...

The indirect costs of psoriatic arthritis: systematic review and meta-analysis.

Science.gov (United States)

Kawalec, Paweł; Malinowski, Krzysztof Piotr

2015-02-01

The aim of this systematic review is to collect all current data on the indirect costs (IC) related to psoriatic arthritis (PsA). The search was conducted using MEDLINE (via PubMed), Embase and Centre for Reviews and Dissemination databases. We considered original studies, systematic reviews, economic evaluations, conference abstracts and posters. All collected data were recalculated to average annual cost per patient, expressed using the consumer price index for 2013 and converted to US dollars using purchasing power parity. Eight of the identified publications presented IC of PsA. Average annual IC per patient calculated using the friction cost approach range from US$1693.83 to $12,318.45, while using the human capital approach they range from US$1750.68 to $50,270.52. Result of the meta-analysis was a basis for calculating cost of work disability equaled US$10,754.04 per patient per year in 2013 prices. This systematic review revealed a great economic burden of the disease to the society. A small number of studies on IC in PsA justify further investigations.

The ZJU index is a powerful index for identifying NAFLD in the general Chinese population.

Science.gov (United States)

Li, Linman; You, Wenyi; Ren, Wei

2017-10-01

The ZJU index is a novel model for detecting non-alcoholic fatty liver disease (NAFLD) that it is calculated based on combination of the body mass index, fasting plasma glucose, triglycerides, and the serum alanine aminotransferase-to-aspartate transaminase ratio. We aimed to evaluate the diagnostic accuracy of the ZJU index in detecting NAFLD in the Chinese population. This was a cross-sectional study. Anthropometric measurements, laboratory data, and ultrasonography features were collected through a standard protocol. The ZJU index, fatty liver index, hepatic steatosis index, lipid accumulation product, and visceral adiposity index were calculated. Then the predictive values of the five indices were compared according to the area under receiver-operating characteristic curve (AUROC) values. A total of 19,804 participants were recruited, of whom 7324 participants were diagnosed with NFALD and 12,480 subjects were regarded as controls. The AUROC value for NAFLD identification by the ZJU index was 0.925 (95% confidence interval [CI]: 0.919-0.931), which was significantly higher than the values for the other four models (P 60 years, the AUROC for the ZJU increased from 87.1 to 95.4%, values which were also greater than those for the other four indices. Analysis by sex also showed that the performance of the ZJU index in males and females was better than that of the other four indices. The ZJU index is an accurate and easy to employ tool for identifying NAFLD in the general Chinese population.

Embedded plasmonic nanoparticles in high refractive index TiOx matrix for photovoltaics applications

DEFF Research Database (Denmark)

Pastorelli, Francesco

Resume: More frequently high refractive index dielectric matrix are used in thin film photovoltaics as transporting layers with good optical proprieties. Doping such matrix with plasmonic resonant scatterers is a promising way to further increase energy conversion efficiencies by trapping incoming...... light in ultrathin solar cells. Colloidal plasmonic oligomers are obtained following a cost-effective selfassembly strategy and incorporated in organic based cells produced using spincoating techniques in ambient air conditions. An interesting increase is observed of both external quantum efficiency...

A neurite quality index and machine vision software for improved quantification of neurodegeneration.

Science.gov (United States)

Romero, Peggy; Miller, Ted; Garakani, Arman

2009-12-01

Current methods to assess neurodegradation in dorsal root ganglion cultures as a model for neurodegenerative diseases are imprecise and time-consuming. Here we describe two new methods to quantify neuroprotection in these cultures. The neurite quality index (NQI) builds upon earlier manual methods, incorporating additional morphological events to increase detection sensitivity for the detection of early degeneration events. Neurosight is a machine vision-based method that recapitulates many of the strengths of NQI while enabling high-throughput screening applications with decreased costs.

Author Index, From > 1988-1992

International Nuclear Information System (INIS)

1992-01-01

In 1988-1992, 824 papers were published in >. The papers were contributed by 1497 authors. The author index of the papers is annexed. The author index is divided into contained two parts: the first part is chinese author index, and the second part is foreign author index. The former is arranged according to the chinese phonetic alphabet. The latter is arranged according to the English alphabet

Analysis in indexing

DEFF Research Database (Denmark)

Mai, Jens Erik

2005-01-01

is presented as an alternative and the paper discusses how this approach includes a broader range of analyses and how it requires a new set of actions from using this approach; analysis of the domain, users and indexers. The paper concludes that the two-step procedure to indexing is insufficient to explain...

2016 GRI Index

OpenAIRE

World Bank

2016-01-01

This 2016 World Bank Global Reporting Initiative (GRI) Index provides an overview of sustainability considerations within the World Bank’s lending and analytical services as well as its corporate activities. This index of sustainability indicators has been prepared in accordance with the internationally recognized standard for sustainability reporting GRI guidelines (https://www.globalrepo...

Harmonization of sound insulation descriptors and classification schemes in Europe: COST Action TU0901

DEFF Research Database (Denmark)

Rasmussen, Birgit

-in-Chief. Handbook of noise and vibration control, USA: Wiley and Son; 2007 [Ch. 114]. [4] COST Action TU0901 “Integrating and Harmonizing Sound Insulation Aspects in Sustainable Urban Housing Constructions”, 2009-2013, www.cost.eu/index.php?id=240&action_number=tu0901 (public information at COST website) or http...... insulation requirements seems unrealistic. However, by preparing a harmonized European classification scheme with a number of quality classes, member states could select a "harmonized" class fitting the national needs and conditions. A joint European Action, COST Action TU0901 "Integrating and Harmonizing...... on good workmanship. The paper will summarize the background, discuss the present situation in Europe and describe the joint efforts to reduce the diversity in Europe, thus supporting and initiating – where needed – improvement of sound insulation of new and existing dwellings in Europe to the benefit...

Potential Association of Triglyceride Glucose Index with Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus Patients.

Science.gov (United States)

Akbar, Md; Bhandari, Uma; Habib, Anwar; Ahmad, Razi

2017-07-01

Cardiac autonomic neuropathy (CAN) is a common and most neglected complication of diabetes, estimated to be roughly 8% in recently diagnosed patients and greater than 50% in patients with chronic disease history. The insulin resistance (IR) itself is bidirectionally associated with increased risk of type 2 diabetes mellitus (T2DM) and CAN is a predisposing factor. The primary objective of the present study was aimed to find a correlation of triglyceride glucose index (TyG index) in CAN patients along with the prevalence of CAN in T2DM patients as a secondary objective. This prevalence study was conducted on 202 patients visiting the diabetic clinic of Hamdard Institute of Medical Sciences and Research, Jamia Hamdard (HIMSR) teaching hospital in New Delhi, India who fulfilled the inclusion criteria. The Ewings autonomic function test was used for diagnosis of CAN. TyG index was calculated for patients based on fasting levels of glucose and triglyceride. The CAN was diagnosed in 62 participants out of 202 T2DM patients (overall prevalence 30.7%). The mean ± standard deviation (SD) for TyG index was 10.3 ± 0.2 and 9.5 ± 0.2 in CAN positive, T2DM patients, respectively. The difference of TyG index, in CAN positive and T2DM patients, was highly significant (P index, duration, and age with patient groups. TyG index showed a positive correlation with heart rate during deep breathing (HRD), heart rate variation during standing (HRS), blood pressure (BP) response to handgrip and BP response to standing. Our finding highlights the TyG index, low-cost IR index, might be useful as an alternative tool for the early screening of patients at a high risk of diabetic neuropathy. © 2017 The Korean Academy of Medical Sciences.

Survey cost of electric power generation from renewable resources in the state of Goias, Brazil

International Nuclear Information System (INIS)

Almeida, Ronaldo Pereira de; Bortoni, Edson da Costa; Haddad, Jamil

2010-01-01

The work presents a developed study to obtain the investment index costs for renewable based distributed generation in Goias state. A set of renewable resources was selected, along with their availability in each city of the state. Therefore, a rank of investments could be developed. (author)

The effect of simulating weight gain on the energy cost of walking in unimpaired children and children with cerebral palsy.

Science.gov (United States)

Plasschaert, Frank; Jones, Kim; Forward, Malcolm

2008-12-01

To examine the effect of simulating weight gain on the energy cost of walking in children with cerebral palsy (CP) compared with unimpaired children. Repeated measures, matched subjects, controlled. University hospital clinical gait and movement analysis laboratory. Children (n=42) with CP and unimpaired children (n=42). Addition of 10% of body mass in weight belt. Energy cost of walking parameters consisting of walking speed, Physiological Cost Index, Total Heart Beat Index, oxygen uptake (VO2), gross oxygen cost, nondimensional net oxygen cost, and net oxygen cost with speed normalized to height were measured by using a breath-by-breath gas analysis system (K4b2) and a light beam timing gate system arranged around a figure 8 track. Two walking trials were performed in random order, with and the other without wearing a weighted belt. Children with CP and their unimpaired counterparts responded in fundamentally different ways to weight gain. The unimpaired population maintained speed and VO2 but the children with CP trended toward a drop in their speed and an increase in their VO2. The oxygen consumption of children with CP showed a greater dependence on mass than the unimpaired group (P=.043). An increase of a relatively small percentage in body mass began to significantly impact the energy cost of walking in children with CP. This result highlights the need for weight control to sustain the level of functional walking in these children.

The Effect of 12 Weeks Individualized Combined Exercise Rehabilitation Training on Physiological Cost Index (PCI and Walking Speed in Patients with Multiple Sclerosis at all Levels of Physical Disability

Directory of Open Access Journals (Sweden)

M Narimani

2016-11-01

Full Text Available Background & aim: Most research on the effects of exercise on people with MS rehabilitation exercises sclerosis (MS  have been carried out on patients with low to moderate disability, but research on patients with different severity of disability (physical disability scale of zero to 10 still has to be carefully considered. The aim of this study was to investigate the effects of twelve weeks of rehabilitation exercises personalized compound exercise on physiological cost index (PCI and average speed walking in patients with MS at various levels of disability. Methods: The present research was a semi-experimental practical study. Thus among female patients admitted to the MS Association of Shahrekord city, 96 people were chosen on the basis of physical disability scores and divided into three groups. The first group consisted of less than 5/4 a total of 44 people, the second group between 5/65 and 5/6 up third of each 26 patients were then randomly assigned to an experimental group and a control group. Afterwards each group was divided randomly into an experimental group and a control group. The first group (the scale of disability less than 4.5, N= 44. The second group (the scale of disability 5 - 6.5, N=26. Also 26 patients were in the third group (the scale of disability 6.5 and above. In addition, they were divided into 6 experimental and control groups. Training programs for experimental groups were 12 weeks, three sessions per week and one hour for each session. Factors such as physiological cost index and walking speed were measured with the appropriate tools before and after training. The experimental groups of 1, 2 and 3 each did their own intervention, while the control groups received only stretching exercises. Analysis of data obtained from 96 patients studied was done using descriptive statistics and the analysis of covariance and paired comparing of the adjusted means (P<0.05. ‌‌‌ Results: A significant difference in walking

Louisiana ESI: LG_INDEX (Large Index Polygons)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

GRI Index 2017

OpenAIRE

World Bank

2017-01-01

This World Bank GRI Index 2017 provides an overview of sustainability considerations within the World Bank’s lending and analytical services as well as its corporate activities. This index of sustainability indicators has been prepared in accordance with the internationally recognized standard for sustainability reporting, the GRI Standards: Core option (https://www.globalreporting.org). T...

Photonuclear data index 1986-1990

Energy Technology Data Exchange (ETDEWEB)

Varlamov, V A; Stepanov, M E; Sapunenko, V V [Moscow State University, Institute of Nuclear Physics, Centre for Photonuclear Experimental Data, Moscow (Russian Federation)

1992-07-01

This issue presents a bibliographic index to experimental photonuclear data published in periodical scientific literature during the years 1986-1990. The main tabulation is sorted by nucleus and reaction. It is supplemented by a reference index, an author index, explanatory tables of terms and abbreviations used, and a table of isotopic abundances and nucleon separation energies. The index is in English with an introduction in Russian and English. (author)

Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

Science.gov (United States)

Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

2018-01-01

Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

Calculate Your Body Mass Index

Science.gov (United States)

... Can! ) Health Professional Resources Calculate Your Body Mass Index Body mass index (BMI) is a measure of body fat based ... Health Information Email Alerts Jobs and Careers Site Index About NHLBI National Institute of Health Department of ...

The variation of acute treatment costs of trauma in high-income countries.

Science.gov (United States)

Willenberg, Lynsey; Curtis, Kate; Taylor, Colman; Jan, Stephen; Glass, Parisa; Myburgh, John

2012-08-21

In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS), per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1%) or charge estimate (25.9%) for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701). However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS), surgical intervention, hospital and intensive care, length of stay, polytrauma and age. The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied and the cost methods employed are the primary drivers for the

The variation of acute treatment costs of trauma in high-income countries

Directory of Open Access Journals (Sweden)

Willenberg Lynsey

2012-08-01

Full Text Available Abstract Background In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. Methods A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS, per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. Results A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1% or charge estimate (25.9% for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701. However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS, surgical intervention, hospital and intensive care, length of stay, polytrauma and age. Conclusion The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied

Turning the Big Mac Index into the Medical MAC Index | Wilson ...

African Journals Online (AJOL)

Objective: The purpose of this study was to create a global medical earnings index, called the Medical MAC Index, to enable a comparison of what medical specialists earn in the countries included in the study. Design: The study gathered data on the earnings of specialist anaesthetists employed in state hospitals with five ...

On the refractive index of sodium iodide solutions for index matching in PIV

Science.gov (United States)

Bai, Kunlun; Katz, Joseph

2014-04-01

Refractive index matching has become a popular technique for facilitating applications of modern optical diagnostic techniques, such as particle image velocimetry, in complex systems. By matching the refractive index of solid boundaries with that of the liquid, unobstructed optical paths can be achieved for illumination and image acquisition. In this research note, we extend previously provided data for the refractive index of aqueous solutions of sodium iodide (NaI) for concentrations reaching the temperature-dependent solubility limit. Results are fitted onto a quadratic empirical expression relating the concentration to the refractive index. Temperature effects are also measured. The present range of indices, 1.333-1.51, covers that of typical transparent solids, from silicone elastomers to several recently introduced materials that could be manufactured using rapid prototyping. We also review briefly previous measurements of the refractive index, viscosity, and density of NaI solutions, as well as prior research that has utilized this fluid.

Export into EFTA and transportation costs

Directory of Open Access Journals (Sweden)

Khúlová Lucia

2016-12-01

Full Text Available The Member States of the European Free Trade Association are the considerable opportunity for export, especially for countries of the European Union. The European Economic Area unites the Member States of European Union and Norway, Liechtenstein and Iceland (the three EFTA countries into an Internal Market. The paper deals with comparison the basic data of EFTA Member States such as geography, infrastructure, GDP. Due to Logistics Performance Index, it is possible to compare the level of logistics and transportation conditions in selected countries. The export costs and delivery time from a one Member State of European Union to capital cities of EFTA Member States are identified by using online calculator of chosen integrators.

Indexes to Nuclear Regulatory Commission Issuances

International Nuclear Information System (INIS)

1996-01-01

Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and licensing Board Panel (LBP), the Administrative Law Judges (ALJ) the Directors' Decisions (DD), and the Decisions on Petitions for Rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. Information elements are displayed in one or more of five separate formats arranged as follows: Case Name Index; Headers and Digests; Legal Citations Index; Subject Index; and Facility Index

Indexes to Nuclear Regulatory Commission Issuances

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-12-31

Digests and indexes for issuances of the Commission (CLI), the Atomic Safety and licensing Board Panel (LBP), the Administrative Law Judges (ALJ) the Directors` Decisions (DD), and the Decisions on Petitions for Rulemaking (DPRM) are presented in this document. These digests and indexes are intended to serve as a guide to the issuances. Information elements are displayed in one or more of five separate formats arranged as follows: Case Name Index; Headers and Digests; Legal Citations Index; Subject Index; and Facility Index.

The Relationship between Schools' Costs per Pupil and Nevada School Performance Framework Index Scores in Clark County School District

Science.gov (United States)

Rice, John; Huang, Min

2015-01-01

Clark County School District (CCSD) asked the Western Regional Education Laboratory (REL West) to examine the relationship between spending per pupil and Nevada School Performance Framework (NSPF) index scores in the district's schools. Data were examined from three school years (2011/12, 2012/13, 2013/14) and for three types of schools…

Changes in healthcare utilization and costs associated with sildenafil therapy for pulmonary arterial hypertension: a retrospective cohort study

Directory of Open Access Journals (Sweden)

Berger Ariel

2012-12-01

Full Text Available Abstract Background Little is known concerning the degree to which initiation of sildenafil for pulmonary arterial hypertension (PAH impacts patterns of healthcare utilization and costs. Methods Using a large US health insurance claims database, we identified all patients with evidence of PAH (ICD-9-CM diagnosis codes 416.0, 416.8 who received sildenafil between 1/1/2005 and 9/30/2008. Date of the first-noted prescription for sildenafil was designated the “index date,” and claims data were compiled for all study subjects for 6 months prior to their index date (“pretreatment” and 6 months thereafter (“follow-up”; patients with incomplete data during either of these periods were excluded. Healthcare utilization and costs were then compared between pretreatment and follow-up for all study subjects. Results A total of 567 PAH patients were identified who began therapy with sildenafil and met all other study entry criteria. Mean (SD age was 52 (10 years; 73% were women. Healthcare utilization was largely unchanged between pretreatment and follow-up, the only exceptions being decreases in the mean number of emergency department visits (from 0.7 to 0.5 per patient; p  Conclusions The cost of sildenafil therapy may be partially offset by reductions in other healthcare costs.

Innovation in drought risk management: exploring the potential of weather index insurance

Science.gov (United States)

Iglesias, E.; Baez, K.

2012-04-01

Many family farming and indigenous communities depend on grazing livestock activities and are particularly prone to drought risks. Vulnerability to drought limits the ability of these households to exit poverty and in many cases leads to environmental degradation. It is well known that uninsured exposure exacerbates income inequality in farming systems and eventually results in welfare losses for rural families. The advantages of farmers who have access to financial tools have been widely acknowledged. However, high administrative costs of traditional insurance hinder small farmers' access to risk management tools. One of the main problems in insurance design relates to the lack of quality data to estimate the risk premium. In rural areas where there are no historical records of farm production data on adverse events such as drought. New technologies such as remote sensing help to overcome this problem and generate information from these areas that otherwise would be impossible or too expensive to obtain. In this paper, we use a satellite based vegetation index (NDVI) and develop a stochastic model to analyse the potential of index insurance to address the risk of drought in Chilean grazing lands. Our results suggest that contract design is a key issue to improve the correlation of the index with individual farm losses, thus reducing basis risk. In particular, we find that the definition of homogeneous areas and the selection of the triggering index threshold are critical issues and show the incidence of different contract designs on (i) the probability that the farmer experience losses but does not receive compensation (false negative) and (ii) the probability that the index triggers compensation but the farmer does not experience drought losses (false negative). Both aspects are key issues to offer the farmer an adequate protection against droughts and guarantee the affordability of the risk premium.

Cost of Cardiac Surgery in Frail Compared With Nonfrail Older Adults.

Science.gov (United States)

Goldfarb, Michael; Bendayan, Melissa; Rudski, Lawrence G; Morin, Jean-Francois; Langlois, Yves; Ma, Felix; Lachapelle, Kevin; Cecere, Renzo; DeVarennes, Benoit; Tchervenkov, Christo I; Brophy, James M; Afilalo, Jonathan

2017-08-01

Frailty is a risk factor for mortality, morbidity, and prolonged length of stay after cardiac surgery, all of which are major drivers of hospitalization costs. The incremental hospitalization costs incurred in frail patients have yet to be elucidated. Patients aged ≥ 60 years were evaluated for frailty before coronary artery bypass grafting or heart valve surgery at 2 academic centres between 2013 and 2015 as part of the McGill Frailty Registry. Total costs were summed from the date of the index surgery to the date of hospital discharge. Mutivariable linear regression was used to determine the association between preoperative frailty status and total costs after adjusting for conventional surgical risk factors. Among 235 patients included in the analysis, the median age was 73.0 years (interquartile range [IQR], 70.0-78.0 years) and 68 (29%) were women. The median cost was $32,742 (IQR, $23,221-$49,627) in 91 frail patients compared with $23,370 (IQR, $19,977-$29,705) in 144 nonfrail patients. Seven extreme-cost cases > $100,000 were identified, and all of the patients in these cases exhibited baseline frailty. In the multivariable model, total costs were independently associated with frailty (adjusted additional cost, $21,245; 95% confidence interval [CI], $12,418-$30,073; P cost, $20,600; 95% CI, $9,661-$31,539; P costs after cardiac surgery, an effect that persists after adjusting for age, sex, surgery type, and surgical risk score. Further efforts are needed to optimize care and resource use in this vulnerable population. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Is the Carli index flawed?: assessing the case for the new retail price index RPIJ.

Science.gov (United States)

Levell, Peter

2015-02-01

The paper discusses the recent decision of the UK's Office for National Statistics to replace the controversial Carli index with the Jevons index in a new version of the retail price index-RPIJ. In doing so we make three contributions to the way that price indices should be selected for measures of consumer price inflation when quantity information is not available (i.e. at the 'elementary' level). Firstly, we introduce a new price bouncing test under the test approach for choosing index numbers. Secondly, we provide empirical evidence on the performance of the Carli and Jevons indices in different contexts under the statistical approach. Thirdly, applying something analogous to the principle of insufficient reason, we argue contrary to received wisdom in the literature, that the economic approach can be used to choose indices at the elementary level, and moreover that it favours the use of the Jevons index. Overall, we conclude that there is a case against the Carli index and that the Jevons index is to be preferred.

Experimental comparison between speech transmission index, rapid speech transmission index, and speech intelligibility index.

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Larm, Petra; Hongisto, Valtteri

2006-02-01

During the acoustical design of, e.g., auditoria or open-plan offices, it is important to know how speech can be perceived in various parts of the room. Different objective methods have been developed to measure and predict speech intelligibility, and these have been extensively used in various spaces. In this study, two such methods were compared, the speech transmission index (STI) and the speech intelligibility index (SII). Also the simplification of the STI, the room acoustics speech transmission index (RASTI), was considered. These quantities are all based on determining an apparent speech-to-noise ratio on selected frequency bands and summing them using a specific weighting. For comparison, some data were needed on the possible differences of these methods resulting from the calculation scheme and also measuring equipment. Their prediction accuracy was also of interest. Measurements were made in a laboratory having adjustable noise level and absorption, and in a real auditorium. It was found that the measurement equipment, especially the selection of the loudspeaker, can greatly affect the accuracy of the results. The prediction accuracy of the RASTI was found acceptable, if the input values for the prediction are accurately known, even though the studied space was not ideally diffuse.

Risk-Assessment Score and Patient Optimization as Cost Predictors for Ventral Hernia Repair.

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Saleh, Sherif; Plymale, Margaret A; Davenport, Daniel L; Roth, John Scott

2018-04-01

Ventral hernia repair (VHR) is associated with complications that significantly increase healthcare costs. This study explores the associations between hospital costs for VHR and surgical complication risk-assessment scores, need for cardiac or pulmonary evaluation, and smoking or obesity counseling. An IRB-approved retrospective study of patients having undergone open VHR over 3 years was performed. Ventral Hernia Risk Score (VHRS) for surgical site occurrence and surgical site infection, and the Ventral Hernia Working Group grade were calculated for each case. Also recorded were preoperative cardiology or pulmonary evaluations, smoking cessation and weight reduction counseling, and patient goal achievement. Hospital costs were obtained from the cost accounting system for the VHR hospitalization stratified by major clinical cost drivers. Univariate regression analyses were used to compare the predictive power of the risk scores. Multivariable analysis was performed to develop a cost prediction model. The mean cost of index VHR hospitalization was $20,700. Total and operating room costs correlated with increasing CDC wound class, VHRS surgical site infection score, VHRS surgical site occurrence score, American Society of Anesthesiologists class, and Ventral Hernia Working Group (all p variance in costs (p optimization significantly reduced direct and operating room costs (p < 0.05). Cardiac evaluation was associated with increased costs. Ventral hernia repair hospital costs are more accurately predicted by CDC wound class than VHR risk scores. A straightforward 6-factor model predicted most cost variation for VHR. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Master Veteran Index (MVI)

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Department of Veterans Affairs — As of June 28, 2010, the Master Veteran Index (MVI) database based on the enhanced Master Patient Index (MPI) is the authoritative identity service within the VA,...

Costs and cost-effectiveness of periviable care.

Science.gov (United States)

Caughey, Aaron B; Burchfield, David J

2014-02-01

With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

An Insight Into the Two Costing Technique: Absorption Costing and Marginal Costing

Directory of Open Access Journals (Sweden)

Mariam Nawaz

2013-02-01

Full Text Available This paper will investigate the controversy that is innate between the two costing techniques; Absorption Costing and Marginal Costing and would throw light on which costing technique better serves its purpose in helping management for decision making process and if Marginal Costing technique is concluded as better technique then why it should not be used for external reporting purpose. This paper will only crystallize and highlight the issues descriptively and will not resolve the issues that are inherent between the two costing techniques. The unique thing about this paper is that it is in favor of treating fixed cost as product cost that is it is supporting the advocates of Absorption Costing Technique but it is against to consider profit as a function of production rather it believes that profit should only be considered as function of sales for stock valuation and to help management in decision making process that is, regarding this point it is supporting advocates of Marginal Costing.

Human Use Index (Future)

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U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

Kmerind: A Flexible Parallel Library for K-mer Indexing of Biological Sequences on Distributed Memory Systems.

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Pan, Tony; Flick, Patrick; Jain, Chirag; Liu, Yongchao; Aluru, Srinivas

2017-10-09

Counting and indexing fixed length substrings, or k-mers, in biological sequences is a key step in many bioinformatics tasks including genome alignment and mapping, genome assembly, and error correction. While advances in next generation sequencing technologies have dramatically reduced the cost and improved latency and throughput, few bioinformatics tools can efficiently process the datasets at the current generation rate of 1.8 terabases every 3 days. We present Kmerind, a high performance parallel k-mer indexing library for distributed memory environments. The Kmerind library provides a set of simple and consistent APIs with sequential semantics and parallel implementations that are designed to be flexible and extensible. Kmerind's k-mer counter performs similarly or better than the best existing k-mer counting tools even on shared memory systems. In a distributed memory environment, Kmerind counts k-mers in a 120 GB sequence read dataset in less than 13 seconds on 1024 Xeon CPU cores, and fully indexes their positions in approximately 17 seconds. Querying for 1% of the k-mers in these indices can be completed in 0.23 seconds and 28 seconds, respectively. Kmerind is the first k-mer indexing library for distributed memory environments, and the first extensible library for general k-mer indexing and counting. Kmerind is available at https://github.com/ParBLiSS/kmerind.

Cost-effectiveness analysis of orbital atherectomy plus balloon angioplasty vs balloon angioplasty alone in subjects with calcified femoropopliteal lesions.

Science.gov (United States)

Weinstock, Barry; Dattilo, Raymond; Diage, Tiffini

2014-01-01

As cost considerations become increasingly critical when selecting optimal endovascular treatment strategies, a cost-benefit analysis was conducted comparing the Diamondback 360°® Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc., St Paul, MN, USA) and balloon angioplasty (BA) vs BA alone for treatment of calcified femoropopliteal lesions. The clinical outcomes from COMPLIANCE 360°, a prospective, multicenter, randomized study comparing OAS+BA vs BA alone for treatment of calcified femoropopliteal lesions, were correlated with cost data and previously published quality of life data. Site of service, hospital charges, and associated medical resource utilization were obtained from Uniform Billing statements for index treatments and associated revascularizations out to 1 year. Hospital costs were estimated using hospital-specific, procedure-specific cost-to-charge ratios. Length of stay and procedural data were collected from participating study sites. Twenty-five subjects with 38 lesions and 25 subjects with 27 lesions were randomized to the OAS+BA and BA-alone groups, respectively. Mean hospital charges (US$51,755 vs US$39,922) and estimated hospital costs (US$15,100 vs US$11,016) were higher for OAS+BA compared with BA alone (not statistically significant). Stent utilization was statistically significantly higher with BA-alone treatment for all subjects (1.1 vs 0.1, P=0.001) and in the subset of subjects with one lesion (1.0 vs 0.1, Pcost for single-lesion versus multiple-lesion treatment. Using costs and quality-adjusted life years (QALYs) for the single-lesion cohort, the 1-year incremental cost of OAS+BA vs BA alone was US$549, and incremental QALY was 0.16. This results in an incremental cost-effectiveness ratio of US$3,441, well below the US$50,000 threshold. One-year index procedure cost and cost-effectiveness were comparable for OAS+BA vs BA alone. This study provides compelling cost-effectiveness data for using atherectomy for treatment of