WorldWideScience

Sample records for cost-effective high performance

  1. Silicon carbide high performance optics: a cost-effective, flexible fabrication process

    Science.gov (United States)

    Casstevens, John M.; Rashed, Abuagela; Plummer, Ronald; Bray, Don; Gates, Rob L.; Lara-Curzio, Edgar; Ferber, Matt K.; Kirkland, Tim

    2001-12-01

    Silicon carbide may well be the best known material for the manufacture of high performance optical components. This material offers many advantages over glasses and metals that have historically been used in high performance optical systems. A combination of extremely high specific stiffness (E/r), high thermal conductivity and outstanding dimensional stability make silicon carbide superior overall to beryllium and low-expansion glass ceramics. A major impediment to wide use of silicon carbide in optical systems has been the cost associated with preliminary shaping and final finishing of silicon carbide. Because silicon carbide is an extremely hard and strong material, precision machining can only be done with expensive diamond tooling on very stiff high quality machine tools. Near-net-shape slip casting of silicon carbide can greatly reduce the cost of silicon carbide mirror substrates but this process still requires significant diamond grinding of the cast components. The process described here begins by machining the component from all special type of graphite. This graphite can rapidly be machined with conventional multi-axis CNC machine tools to achieve any level of complexity and lightweighting required. The graphite is then directly converted completely to silicon carbide with very small and very predictable dimensional change. After conversion to silicon carbide the optical surface is coated with very fine grain CVD silicon carbide which is easily polished to extreme smoothness. Details of the fabrication process are described and photos and performance specifications of an eight-inch elliptical demonstration mirror are provided.

  2. A new approach to cost effective projects: High performance project teams

    Energy Technology Data Exchange (ETDEWEB)

    Chambers, N.C. [Brown and Root Energy Services (United Kingdom)

    1994-12-31

    In low oil price environment in which environmental conditions are more challenging, reservoir characteristics less favourable and political risk increasing, successful projects are required in such cases. The present paper deals with the visionary process of establishing high performance project teams. According to the author, such project teams embody dynamic recognition of holism. Holism is achieved as an output from the process of establishing the drivers and enablers for success on a project. They are given birth during the unfolding of the operators development plans and contracting strategy. The paper discusses the main drivers of project teams comprising purpose and performance goals, selection, common approach, commitment and accountability, and financial alignment

  3. Advanced Insulation for High Performance Cost-Effective Wall, Roof, and Foundation Systems Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Costeux, Stephane [Dow Chemical Company, Midland, MI (United States); Bunker, Shanon [Dow Chemical Company, Midland, MI (United States)

    2013-12-20

    The objective of this project was to explore and potentially develop high performing insulation with increased R/inch and low impact on climate change that would help design highly insulating building envelope systems with more durable performance and lower overall system cost than envelopes with equivalent performance made with materials available today. The proposed technical approach relied on insulation foams with nanoscale pores (about 100 nm in size) in which heat transfer will be decreased. Through the development of new foaming methods, of new polymer formulations and new analytical techniques, and by advancing the understanding of how cells nucleate, expand and stabilize at the nanoscale, Dow successfully invented and developed methods to produce foams with 100 nm cells and 80% porosity by batch foaming at the laboratory scale. Measurements of the gas conductivity on small nanofoam specimen confirmed quantitatively the benefit of nanoscale cells (Knudsen effect) to increase insulation value, which was the key technical hypotheses of the program. In order to bring this technology closer to a viable semi-continuous/continuous process, the project team modified an existing continuous extrusion foaming process as well as designed and built a custom system to produce 6" x 6" foam panels. Dow demonstrated for the first time that nanofoams can be produced in a both processes. However, due to technical delays, foam characteristics achieved so far fall short of the 100 nm target set for optimal insulation foams. In parallel with the technology development, effort was directed to the determination of most promising applications for nanocellular insulation foam. Voice of Customer (VOC) exercise confirmed that demand for high-R value product will rise due to building code increased requirements in the near future, but that acceptance for novel products by building industry may be slow. Partnerships with green builders, initial launches in smaller markets (e.g. EIFS

  4. A high performance cost-effective digital complex correlator for an X-band polarimetry survey.

    Science.gov (United States)

    Bergano, Miguel; Rocha, Armando; Cupido, Luís; Barbosa, Domingos; Villela, Thyrso; Boas, José Vilas; Rocha, Graça; Smoot, George F

    2016-01-01

    The detailed knowledge of the Milky Way radio emission is important to characterize galactic foregrounds masking extragalactic and cosmological signals. The update of the global sky models describing radio emissions over a very large spectral band requires high sensitivity experiments capable of observing large sky areas with long integration times. Here, we present the design of a new 10 GHz (X-band) polarimeter digital back-end to map the polarization components of the galactic synchrotron radiation field of the Northern Hemisphere sky. The design follows the digital processing trends in radio astronomy and implements a large bandwidth (1 GHz) digital complex cross-correlator to extract the Stokes parameters of the incoming synchrotron radiation field. The hardware constraints cover the implemented VLSI hardware description language code and the preliminary results. The implementation is based on the simultaneous digitized acquisition of the Cartesian components of the two linear receiver polarization channels. The design strategy involves a double data rate acquisition of the ADC interleaved parallel bus, and field programmable gate array device programming at the register transfer mode. The digital core of the back-end is capable of processing 32 Gbps and is built around an Altera field programmable gate array clocked at 250 MHz, 1 GSps analog to digital converters and a clock generator. The control of the field programmable gate array internal signal delays and a convenient use of its phase locked loops provide the timing requirements to achieve the target bandwidths and sensitivity. This solution is convenient for radio astronomy experiments requiring large bandwidth, high functionality, high volume availability and low cost. Of particular interest, this correlator was developed for the Galactic Emission Mapping project and is suitable for large sky area polarization continuum surveys. The solutions may also be adapted to be used at signal processing

  5. High-Performance Flexible Transparent Electrode with an Embedded Metal Mesh Fabricated by Cost-Effective Solution Process.

    Science.gov (United States)

    Khan, Arshad; Lee, Sangeon; Jang, Taehee; Xiong, Ze; Zhang, Cuiping; Tang, Jinyao; Guo, L Jay; Li, Wen-Di

    2016-06-01

    A new structure of flexible transparent electrodes is reported, featuring a metal mesh fully embedded and mechanically anchored in a flexible substrate, and a cost-effective solution-based fabrication strategy for this new transparent electrode. The embedded nature of the metal-mesh electrodes provides a series of advantages, including surface smoothness that is crucial for device fabrication, mechanical stability under high bending stress, strong adhesion to the substrate with excellent flexibility, and favorable resistance against moisture, oxygen, and chemicals. The novel fabrication process replaces vacuum-based metal deposition with an electrodeposition process and is potentially suitable for high-throughput, large-volume, and low-cost production. In particular, this strategy enables fabrication of a high-aspect-ratio (thickness to linewidth) metal mesh, substantially improving conductivity without considerably sacrificing transparency. Various prototype flexible transparent electrodes are demonstrated with transmittance higher than 90% and sheet resistance below 1 ohm sq(-1) , as well as extremely high figures of merit up to 1.5 × 10(4) , which are among the highest reported values in recent studies. Finally using our embedded metal-mesh electrode, a flexible transparent thin-film heater is demonstrated with a low power density requirement, rapid response time, and a low operating voltage.

  6. The CBS-The Most Cost Effective and High Performance Carbon Beam Source Dedicated for a New Generation Cancer Therapy

    CERN Document Server

    Kumada, Masayuki; Leivichev, E B; Parkhomchuk, Vasily; Podgorny, Fedor; Rastigeev, Sergey; Reva, Vladimir B; Skrinsky, Aleksander Nikolayevich; Vostrikov, Vladimir

    2005-01-01

    A Carbon ion beam is a superior tool to x-rays or a proton beam in both physical and biological doses in treating a cancer. A Carbon beam has an advantage in treating radiation resistant and deep-seated tumors. Its radiological effect is of a mitotic independent nature. These features improve hypofractionation, typically reducing the number of irradiations per patient from 35 to a few. It has been shown that a superior QOL(Quality Of Life) therapy is possible by a carbon beam.The only drawback is its high cost. Nevertheless, tens of Prefectures and organizations are eagerly considering the possibility of having a carbon ion therapy facility in Japan. Germany, Austria, Italy, China, Taiwan and Korea also desire to have one.A carbon beam accelerator of moderate cost is about 100 Million USD. With the "CBS" design philosophy, which will be described in this paper, the cost could be factor of 2 or 3 less, while improving its performance more than standard designs. Novel extraction techniques, a new approach to a ...

  7. Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion

    Science.gov (United States)

    Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara

    2014-01-01

    In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…

  8. High Performance and Cost-Effective Direct Methanol Fuel Cells: Fe-N-C Methanol-Tolerant Oxygen Reduction Reaction Catalysts.

    Science.gov (United States)

    Sebastián, David; Serov, Alexey; Artyushkova, Kateryna; Gordon, Jonathan; Atanassov, Plamen; Aricò, Antonino S; Baglio, Vincenzo

    2016-08-09

    Direct methanol fuel cells (DMFCs) offer great advantages for the supply of power with high efficiency and large energy density. The search for a cost-effective, active, stable and methanol-tolerant catalyst for the oxygen reduction reaction (ORR) is still a great challenge. In this work, platinum group metal-free (PGM-free) catalysts based on Fe-N-C are investigated in acidic medium. Post-treatment of the catalyst improves the ORR activity compared with previously published PGM-free formulations and shows an excellent tolerance to the presence of methanol. The feasibility for application in DMFC under a wide range of operating conditions is demonstrated, with a maximum power density of approximately 50 mW cm(-2) and a negligible methanol crossover effect on the performance. A review of the most recent PGM-free cathode formulations for DMFC indicates that this formulation leads to the highest performance at a low membrane-electrode assembly (MEA) cost. Moreover, a 100 h durability test in DMFC shows suitable applicability, with a similar performance-time behavior compared to common MEAs based on Pt cathodes.

  9. The Cost-Effectiveness of Investments to Meet the Guiding Principles for High-Performance Sustainable Buildings on the PNNL Campus

    Energy Technology Data Exchange (ETDEWEB)

    Cort, Katherine A.; Judd, Kathleen S.

    2014-08-29

    As part its campus sustainability efforts, Pacific Northwest National Laboratory (PNNL) has invested in eight new and existing buildings to ensure they meet the U.S. Department of Energy’s requirements for high performance sustainable buildings (HPSB) at DOE sites. These investments are expected to benefit PNNL by reducing the total life-cycle cost of facilities, improving energy efficiency and water conservation, and making buildings safer and healthier for the occupants. This study examines the cost-effectiveness of the implementing measures that meet the criteria for HPSBs in 3 different types of buildings on the PNNL campus: offices, scientific laboratories, and data centers. In each of the three case studies examined the investments made to achieve HPSB status demonstrated a high return on the HPSB investments that have taken place in these varied environments. Simple paybacks for total investments in the three case study buildings ranged from just 2 to 5 years; savings-to-investment ratios all exceeded the desirable threshold of 1; and the net present values associated with these investments were all positive.

  10. A simple cost-effective high performance liquid chromatographic assay of sulphadoxine in whole blood spotted on filter paper for field studies

    Directory of Open Access Journals (Sweden)

    Sijuade Abayomi O

    2009-10-01

    Full Text Available Abstract Background Artesunate plus sulphadoxine-pyrimethamine is one of the four artemisinin-based combination therapies currently recommended by WHO as first-line treatment for falciparum malaria. Sulphadoxine-pyrimethamine is also used for intermittent preventive treatment for malaria in pregnancy. Drug use patterns and drug pharmacokinetics are important factors impacting the spread of drug resistant parasites hence it is imperative to monitor the effect of pharmacokinetic variability on therapeutic efficacy. Unfortunately, information on the pharmacokinetics of sulphadoxine in children and pregnant women with malaria is very limited. Methods for the assay of sulphadoxine-pyrimethamine have been previously reported, but they are not cost-effective and practicable in analytical laboratories in low resource areas where malaria is endemic. Efforts in this study were thus devoted to development and evaluation of a simple, cost-effective and sensitive method for quantification of sulphadoxine in small capillary samples of whole blood dried on filter paper. Methods Sulphadoxine was determined in whole blood by reversed-phase high performance liquid chromatography with UV detection at 340 nm. Sulisoxazole (SLX was used as internal standard. Chromatographic separation was achieved using a Beckman Coulter ODS C18 and a mobile phase consisting of 0.05 M phosphate buffer-methanol-acetonitrile (70:17:13 V/V/V containing 1% triethylamine solution. Results Standard curves from sulphadoxine-spiked blood added to filter paper were linear over the concentration range studied. Linear regression analysis yielded correlation coefficient r2 > 0.99 (n = 6. Extraction recoveries were about 82-85%. The limit of quantification was 120 ng/ml while the within and between assay coefficient of variations were Conclusion The recovery and accuracy of determination of SDX from whole blood filter paper samples using the method described in this study is satisfactory, thus

  11. The High Value CVT Concept--Cost Effective and Powerful

    Institute of Scientific and Technical Information of China (English)

    A. Englisch,; A. Teubert; A. Gotz; E. Muller; E. Simon; B. Walter; A. Baumgartner

    2011-01-01

    Based on the comprehensive comparison of vehicle performance in economy,engine power,driving smoothness,and efficiency cost as well as pollutant emission etc,the paper discussed the high value CVT concept from an angle of the cost effective and powerful for vehicle.In the paper,it researched the related technical detail in CVT.By means of realizing the continuous change in transmission ratio,it could obtain the optimal matching between transmission system and engine operating mode,and enhance the characteristic of fuel oil in economy,and also improve the convenience in manipulation for driver and make passenger comfortable.For easy to understand the concept,the paper made the comparison analysis in many aspects such as performance,transmission specification,high value CVT hybrid,orifice torque sensor,hydraulic system,high value CVT em,new chain portfolio and assessment of the high value CVT on the NEDC.Finally it showed the potential advantages of CVT technology development,and proposed future developing trends to realize technical scheme of high value CVT.

  12. A High Performance, Cost-Effective, Open-Source Microscope for Scanning Two-Photon Microscopy that Is Modular and Readily Adaptable

    Science.gov (United States)

    Rosenegger, David G.; Tran, Cam Ha T.; LeDue, Jeffery; Zhou, Ning; Gordon, Grant R.

    2014-01-01

    Two-photon laser scanning microscopy has revolutionized the ability to delineate cellular and physiological function in acutely isolated tissue and in vivo. However, there exist barriers for many laboratories to acquire two-photon microscopes. Additionally, if owned, typical systems are difficult to modify to rapidly evolving methodologies. A potential solution to these problems is to enable scientists to build their own high-performance and adaptable system by overcoming a resource insufficiency. Here we present a detailed hardware resource and protocol for building an upright, highly modular and adaptable two-photon laser scanning fluorescence microscope that can be used for in vitro or in vivo applications. The microscope is comprised of high-end componentry on a skeleton of off-the-shelf compatible opto-mechanical parts. The dedicated design enabled imaging depths close to 1 mm into mouse brain tissue and a signal-to-noise ratio that exceeded all commercial two-photon systems tested. In addition to a detailed parts list, instructions for assembly, testing and troubleshooting, our plan includes complete three dimensional computer models that greatly reduce the knowledge base required for the non-expert user. This open-source resource lowers barriers in order to equip more laboratories with high-performance two-photon imaging and to help progress our understanding of the cellular and physiological function of living systems. PMID:25333934

  13. A high performance, cost-effective, open-source microscope for scanning two-photon microscopy that is modular and readily adaptable.

    Directory of Open Access Journals (Sweden)

    David G Rosenegger

    Full Text Available Two-photon laser scanning microscopy has revolutionized the ability to delineate cellular and physiological function in acutely isolated tissue and in vivo. However, there exist barriers for many laboratories to acquire two-photon microscopes. Additionally, if owned, typical systems are difficult to modify to rapidly evolving methodologies. A potential solution to these problems is to enable scientists to build their own high-performance and adaptable system by overcoming a resource insufficiency. Here we present a detailed hardware resource and protocol for building an upright, highly modular and adaptable two-photon laser scanning fluorescence microscope that can be used for in vitro or in vivo applications. The microscope is comprised of high-end componentry on a skeleton of off-the-shelf compatible opto-mechanical parts. The dedicated design enabled imaging depths close to 1 mm into mouse brain tissue and a signal-to-noise ratio that exceeded all commercial two-photon systems tested. In addition to a detailed parts list, instructions for assembly, testing and troubleshooting, our plan includes complete three dimensional computer models that greatly reduce the knowledge base required for the non-expert user. This open-source resource lowers barriers in order to equip more laboratories with high-performance two-photon imaging and to help progress our understanding of the cellular and physiological function of living systems.

  14. Hierarchical Ni-Co layered double hydroxide nanosheets entrapped on conductive textile fibers: a cost-effective and flexible electrode for high-performance pseudocapacitors

    Science.gov (United States)

    Nagaraju, Goli; Raju, G. Seeta Rama; Ko, Yeong Hwan; Yu, Jae Su

    2015-12-01

    Hierarchical three-dimensional (3D) porous nanonetworks of nickel-cobalt layered double hydroxide (Ni-Co LDH) nanosheets (NSs) are grown and decorated on flexible conductive textile substrate (CTs) via a simple two-electrode system based electrochemical deposition (ED) method. By applying a proper external cathodic voltage of -1.2 V for 15 min, the Ni-Co LDH NSs are densely deposited over the entire surface of the CTs with good adhesion. The flexible Ni-Co LDH NSs on CTs (Ni-Co LDH NSs/CTs) architecture with high porosity facilitates enhanced electrochemical performance in 1 M KOH electrolyte solution. The effect of growth concentration and external cathodic voltage on the electrochemical properties of Ni-Co LDH NSs/CTs is also investigated. The Ni10Co5 LDH NSs/CTs electrode exhibits a high specific capacitance of 2105 F g-1 at a current density of 2 A g-1 as well as an excellent cyclic stability as a pseudocapacitive electrode due to the advantageous properties of 3D interconnected porous frameworks of Ni10Co5 LDH NSs/CTs. This facile fabrication of bimetallic hydroxide nanostructures on CTs can provide a promising electrode for low-cost energy storage device applications.Hierarchical three-dimensional (3D) porous nanonetworks of nickel-cobalt layered double hydroxide (Ni-Co LDH) nanosheets (NSs) are grown and decorated on flexible conductive textile substrate (CTs) via a simple two-electrode system based electrochemical deposition (ED) method. By applying a proper external cathodic voltage of -1.2 V for 15 min, the Ni-Co LDH NSs are densely deposited over the entire surface of the CTs with good adhesion. The flexible Ni-Co LDH NSs on CTs (Ni-Co LDH NSs/CTs) architecture with high porosity facilitates enhanced electrochemical performance in 1 M KOH electrolyte solution. The effect of growth concentration and external cathodic voltage on the electrochemical properties of Ni-Co LDH NSs/CTs is also investigated. The Ni10Co5 LDH NSs/CTs electrode exhibits a high

  15. Cost-effectiveness analysis in markets with high fixed costs.

    Science.gov (United States)

    Cutler, David M; Ericson, Keith M Marzilli

    2010-01-01

    We consider how to conduct cost-effectiveness analysis when the social cost of a resource differs from the posted price. From the social perspective, the true cost of a medical intervention is the marginal cost of delivering another unit of a treatment, plus the social cost (deadweight loss) of raising the revenue to fund the treatment. We focus on pharmaceutical prices, which have high markups over marginal cost due to the monopoly power granted to pharmaceutical companies when drugs are under patent. We find that the social cost of a branded drug is approximately one-half the market price when the treatment is paid for by a public insurance plan and one-third the market price for mandated coverage by private insurance. We illustrate the importance of correctly accounting for social costs using two examples: coverage for statin drugs and approval for a drug to treat kidney cancer (sorafenib). In each case, we show that the correct social perspective for cost-effectiveness analysis would be more lenient than researcher recommendations.

  16. Investigate the Performance of LG 00 Mode in Cost Effective Hybrid Radio over Multimode Transmission System

    Directory of Open Access Journals (Sweden)

    Pardeep Kaur

    2014-05-01

    Full Text Available Radio over fiber (RoF technology composed for apprehension of future high performance integrated networks and future broadband networks. Multimode fiber links can offer a convenient approach for low cost and short Radio over Fiber (RoF systems. This work is based on the cost effective radio over multimode transmission system (Ro-MMF for long reach transmission. Error free transmission of 10 Gbps data with 10 GHz radio signal over multimode fiber link successfully demonstrated over 40 km. furthermore, The results are represented for Ro-MMF system by using LG (Laguerre-Gaussian 00 mode. The Performance of LG 00 mode in terms of SNR and Eye diagram investigated in proposed system.

  17. Performance management and cost effectiveness of public services : empirical evidence from Dutch municipalities

    NARCIS (Netherlands)

    Groot, de H.; Hulst, van B.L.

    2011-01-01

    The performance of public organizations is one of the key topics in public administration research. Cost-effectiveness as a dimension of performance has hardly been studied in this literature, however. Many governments currently are cutting budgets on an unprecedented scale after the world-wide fina

  18. Commissioning: A Highly Cost-Effective Building Energy Management Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Evan

    2011-01-06

    Quality assurance and optimization are essential elements of any serious technological endeavor, including efforts to improve energy efficiency. Commissioning is an important tool in this respect. The aim of commissioning new buildings is to ensure that they deliver-if not exceed-the performance and energy savings promised by their design. When applied to existing buildings, one-time or repeated commissioning (often called retrocommissioning) identifies the almost inevitable drift in energy performance and puts the building back on course, often surpassing the original design intent. In both contexts, commissioning is a systematic, forensic approach to improving performance, rather than a discrete technology.

  19. Simple, cost effective & result oriented framework for supplier performance measurement in sports goods manufacturing industry

    Directory of Open Access Journals (Sweden)

    2011-09-01

    Full Text Available The emergences of global markets have increased competition worldwide. For the Sports Goods Manufacturing Industry which is considered to be an intensive supplier base industry with limited resources to sustain in what is already a very competitive market there is a need for the entire supply chain viz. raw material and machinery suppliers and manufacturers to measure their supplier's performance to reduce business risks and revenue losses. How to design & execute a simple, cost effective & result oriented Framework for Supplier Performance Measurement for sports goods manufacturing small - medium enterprises is the main aim of this research paper.

  20. Cost-effective optoacoustic system based on the combination of high-power diode lasers

    Science.gov (United States)

    Sánchez, Miguel; Rodríguez, Sergio; Gawali, Sandeep B.; Leggio, Luca; Gallego, Daniel C.; Lamela, Horacio

    2017-03-01

    One of the main issues of the advances in optoacoustic (OA) applications is to reduce the high costs and the big sizes of solid state lasers. High-power diode lasers (HPDLs) have been demonstrated to be a valid alternative reducing enormously the expenses, besides other advantages such as smaller sizes and higher modulation frequencies. However, in some cases it is possible to furtherly reduce their costs. We present a cost-effective OA system based on the combination of several 905-nm HPDLs with direct coupling into a fiber bundle. These HPDLs have an internal pulse driver, based on an n-channel Mosfet and two charging capacitors, which needs an external Mosfet driver circuit and a voltage supply in order to improve the optical pulse shape and energy. We compare the performances and the prices of this OA system with another similar HPDL-based OA system built with commercial elements. Results indicate good OA signal generation ( 15.6 mVpp) with pulse energy of 12.3 μJ and, especially, a cost reduction by a factor of 15 if compared to the other HPDL-based system.

  1. The cost-effectiveness of intervening in low and high HIV prevalence areas in South Africa

    Directory of Open Access Journals (Sweden)

    Josue Mbonigaba

    2013-05-01

    Full Text Available This research compared the cost-effectiveness of a set of HIV/AIDS interventions in a low HIV prevalence area (LPA and in a high HIV prevalence area (HPA in South Africa. The rationale for this analysis was to assess the interaction dynamics between a specific HIV/AIDS intervention and an area of implementation and the effects of these dynamics on the cost-effectiveness of such an HIV/AIDS intervention. A pair of Markov models was evaluated for each intervention; one model for a HPA and another for an LPA and the cost-effectiveness of that intervention was compared across an LPA and a HPA. The baseline costs and health outcomes in each area were collected from the literature. To depict interaction dynamics between an HIV/AIDS intervention and an area of implementation, baseline health outcomes collected in each area, were adjusted over time based on the patterns of the projections observed in the AIDS model of the Actuarial Society of South Africa (ASSA2008. The study found that the VCT and treatment of STDs were equally cost-effective in an LPA and in a HPA while PMTCT and HAART were more cost-effective in an LPA than in a HPA. As a policy proposal, resources earmarked to non-ARV based interventions (VCT and treatment of STDs should  be equally shared across an LPA and a HPA while  more of the resources reserved for ARV-based interventions (PMTCT and HAART should go in an LPA in order to increase efficiency.

  2. Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Susanne Sjöström

    Full Text Available The objective of the present study is to calculate the cost-effectiveness of early medical abortion performed by nurse-midwifes in comparison to physicians in a high resource setting where ultrasound dating is part of the protocol. Non-physician health care professionals have previously been shown to provide medical abortion as effectively and safely as physicians, but the cost-effectiveness of such task shifting remains to be established.A cost effectiveness analysis was conducted based on data from a previously published randomized-controlled equivalence study including 1180 healthy women randomized to the standard procedure, early medical abortion provided by physicians, or the intervention, provision by nurse-midwifes. A 1.6% risk difference for efficacy defined as complete abortion without surgical interventions in favor of midwife provision was established which means that for every 100 procedures, the intervention treatment resulted in 1.6 fewer incomplete abortions needing surgical intervention than the standard treatment. The average direct and indirect costs and the incremental cost-effectiveness ratio (ICER were calculated. The study was conducted at a university hospital in Stockholm, Sweden.The average direct costs per procedure were EUR 45 for the intervention compared to EUR 58.3 for the standard procedure. Both the cost and the efficacy of the intervention were superior to the standard treatment resulting in a negative ICER at EUR -831 based on direct costs and EUR -1769 considering total costs per surgical intervention avoided.Early medical abortion provided by nurse-midwives is more cost-effective than provision by physicians. This evidence provides clinicians and decision makers with an important tool that may influence policy and clinical practice and eventually increase numbers of abortion providers and reduce one barrier to women's access to safe abortion.

  3. Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Sjöström, Susanne; Kopp Kallner, Helena; Simeonova, Emilia; Madestam, Andreas; Gemzell-Danielsson, Kristina

    2016-01-01

    The objective of the present study is to calculate the cost-effectiveness of early medical abortion performed by nurse-midwifes in comparison to physicians in a high resource setting where ultrasound dating is part of the protocol. Non-physician health care professionals have previously been shown to provide medical abortion as effectively and safely as physicians, but the cost-effectiveness of such task shifting remains to be established. A cost effectiveness analysis was conducted based on data from a previously published randomized-controlled equivalence study including 1180 healthy women randomized to the standard procedure, early medical abortion provided by physicians, or the intervention, provision by nurse-midwifes. A 1.6% risk difference for efficacy defined as complete abortion without surgical interventions in favor of midwife provision was established which means that for every 100 procedures, the intervention treatment resulted in 1.6 fewer incomplete abortions needing surgical intervention than the standard treatment. The average direct and indirect costs and the incremental cost-effectiveness ratio (ICER) were calculated. The study was conducted at a university hospital in Stockholm, Sweden. The average direct costs per procedure were EUR 45 for the intervention compared to EUR 58.3 for the standard procedure. Both the cost and the efficacy of the intervention were superior to the standard treatment resulting in a negative ICER at EUR -831 based on direct costs and EUR -1769 considering total costs per surgical intervention avoided. Early medical abortion provided by nurse-midwives is more cost-effective than provision by physicians. This evidence provides clinicians and decision makers with an important tool that may influence policy and clinical practice and eventually increase numbers of abortion providers and reduce one barrier to women's access to safe abortion.

  4. Simple and cost-effective fabrication of highly flexible, transparent superhydrophobic films with hierarchical surface design.

    Science.gov (United States)

    Kim, Tae-Hyun; Ha, Sung-Hun; Jang, Nam-Su; Kim, Jeonghyo; Kim, Ji Hoon; Park, Jong-Kweon; Lee, Deug-Woo; Lee, Jaebeom; Kim, Soo-Hyung; Kim, Jong-Man

    2015-03-11

    Optical transparency and mechanical flexibility are both of great importance for significantly expanding the applicability of superhydrophobic surfaces. Such features make it possible for functional surfaces to be applied to various glass-based products with different curvatures. In this work, we report on the simple and potentially cost-effective fabrication of highly flexible and transparent superhydrophobic films based on hierarchical surface design. The hierarchical surface morphology was easily fabricated by the simple transfer of a porous alumina membrane to the top surface of UV-imprinted polymeric micropillar arrays and subsequent chemical treatments. Through optimization of the hierarchical surface design, the resultant superhydrophobic films showed superior surface wetting properties (with a static contact angle of >170° and contact angle hysteresis of 82% at 550 nm wavelength). The superhydrophobic films were also experimentally found to be robust without significant degradation in the superhydrophobicity, even under repetitive bending and pressing for up to 2000 cycles. Finally, the practical usability of the proposed superhydorphobic films was clearly demonstrated by examining the antiwetting performance in real time while pouring water on the film and submerging the film in water.

  5. Cost-Effectiveness of Radiation and Chemotherapy for High-Risk Low-Grade Glioma.

    Science.gov (United States)

    Qian, Yushen; Maruyama, Satoshi; Kim, Haju; Pollom, Erqi L; Kumar, Kiran A; Chin, Alexander L; Harris, Jeremy P; Chang, Daniel T; Pitt, Allison; Bendavid, Eran; Owens, Douglas K; Durkee, Ben Y; Soltys, Scott G

    2017-06-28

    The addition of PCV (procarbazine, lomustine, vincristine) chemotherapy to radiotherapy (RT) for patients with high-risk (≥ 40 years old or sub-totally resected) low-grade glioma (LGG) results in an absolute median survival benefit of over 5 years. We evaluated the cost-effectiveness of this treatment strategy. A decision tree with an integrated three-state Markov model was created to follow patients with high risk LGG after surgery treated with RT vs. RT+PCV. Patients existed in one of 3 health states: stable, progressive, and dead. Survival and freedom from progression were modeled to reflect the results of RTOG 9802 using time-dependent transition probabilities. Health utility values and costs of care were derived from the literature and national registry databases. Analysis was conducted from the healthcare perspective. Deterministic and probabilistic sensitivity analysis explored uncertainty in model parameters. Modeled outcomes demonstrated agreement with clinical data in expected benefit of addition of PCV to RT. The addition of PCV to RT yielded an incremental benefit of 4.77 quality-adjusted life-years (QALYs) (9.94 for RT+PCV vs. 5.17 for RT alone) at an incremental cost of $48,635 ($188,234 for RT+PCV vs. $139,598 for RT alone), resulting in an incremental cost-effectiveness ratio of $10,186 per QALY gained. Probabilistic sensitivity analysis demonstrates that within modeled distributions of parameters, RT+PCV has 99.96% probability of being cost-effectiveness at a willingness-to-pay threshold of $100,000 per QALY. The addition of PCV to RT is a cost-effective treatment strategy for patients with high-risk LGG.

  6. High performance homes

    DEFF Research Database (Denmark)

    Beim, Anne; Vibæk, Kasper Sánchez

    2014-01-01

    Can prefabrication contribute to the development of high performance homes? To answer this question, this chapter defines high performance in more broadly inclusive terms, acknowledging the technical, architectural, social and economic conditions under which energy consumption and production occur....... Consideration of all these factors is a precondition for a truly integrated practice and as this chapter demonstrates, innovative project delivery methods founded on the manufacturing of prefabricated buildings contribute to the production of high performance homes that are cost effective to construct, energy...

  7. High performance homes

    DEFF Research Database (Denmark)

    Beim, Anne; Vibæk, Kasper Sánchez

    2014-01-01

    Can prefabrication contribute to the development of high performance homes? To answer this question, this chapter defines high performance in more broadly inclusive terms, acknowledging the technical, architectural, social and economic conditions under which energy consumption and production occur....... Consideration of all these factors is a precondition for a truly integrated practice and as this chapter demonstrates, innovative project delivery methods founded on the manufacturing of prefabricated buildings contribute to the production of high performance homes that are cost effective to construct, energy...

  8. Towards Scalable Cost-Effective Service and Survivability Provisioning in Ultra High Speed Networks

    Energy Technology Data Exchange (ETDEWEB)

    Bin Wang

    2006-12-01

    Optical transport networks based on wavelength division multiplexing (WDM) are considered to be the most appropriate choice for future Internet backbone. On the other hand, future DOE networks are expected to have the ability to dynamically provision on-demand survivable services to suit the needs of various high performance scientific applications and remote collaboration. Since a failure in aWDMnetwork such as a cable cut may result in a tremendous amount of data loss, efficient protection of data transport in WDM networks is therefore essential. As the backbone network is moving towards GMPLS/WDM optical networks, the unique requirement to support DOE’s science mission results in challenging issues that are not directly addressed by existing networking techniques and methodologies. The objectives of this project were to develop cost effective protection and restoration mechanisms based on dedicated path, shared path, preconfigured cycle (p-cycle), and so on, to deal with single failure, dual failure, and shared risk link group (SRLG) failure, under different traffic and resource requirement models; to devise efficient service provisioning algorithms that deal with application specific network resource requirements for both unicast and multicast; to study various aspects of traffic grooming in WDM ring and mesh networks to derive cost effective solutions while meeting application resource and QoS requirements; to design various diverse routing and multi-constrained routing algorithms, considering different traffic models and failure models, for protection and restoration, as well as for service provisioning; to propose and study new optical burst switched architectures and mechanisms for effectively supporting dynamic services; and to integrate research with graduate and undergraduate education. All objectives have been successfully met. This report summarizes the major accomplishments of this project. The impact of the project manifests in many aspects: First

  9. A Rapid and Cost-Effective Laser Based Synthesis of High Purity Cadmium Selenide Quantum Dots.

    Science.gov (United States)

    Gondall, M A; Qahtan, Talal F; Dastageer, M A; Yamani, Z H; Anjum, D H

    2016-01-01

    A rapid and cost effective method is developed to synthesize high purity cadmium Selenide (CdSe) quantum dots in acetone medium using second harmonic of Nd:YAG nanosecond pulsed laser of 532 nm wavelength. The thermal agglomeration due the nanosecond pulse duration of the laser was successfully eliminated by using unfocussed laser beam and thereby providing a favorable conditions for the synthesis of quantum dots having the grain size of 3 nm. The morphological and optical characterizations like XRD, HRTEM, optical absorption of the synthesized CdSe quantum dots, reveal that the material possesses the similar characteristics of the one synthesized through cumbersome wet chemical methods. Relative to the CdSe bulk material, the synthesized CdSe quantum dots showed a blue shift in the measured band gap energy from near infrared spectral region to visible region, making this material very attractive for many solar energy harvesting applications like photo-catalysis and solar cells.

  10. A cost-effective high-flux source of cold ytterbium atoms

    Science.gov (United States)

    Song, Bo; Zou, Yueyang; Zhang, Shanchao; Cho, Chang-woo; Jo, Gyu-Boong

    2016-10-01

    We report a cost-effective way to prepare high-flux slow ytterbium atoms with extremely low-power 399-nm light suitable for the production of quantum degenerate ytterbium gases. By collimating an atomic beam through an array of micro-capillary tubes, we obtain a bright atomic beam through the Zeeman slower operating at low light power of only 15 mW for the source. We achieve the loading rate of 2 × 107 s-1 into the intercombination magneto-optical trap (MOT) and a sufficient steady-state MOT atom number of 2 × 108 for 174Yb atoms. Our apparatus highlights an efficient method to obtain slow ytterbium atoms using a simple low-power 399-nm laser system.

  11. Fabrication of highly active and cost effective SERS plasmonic substrates by electrophoretic deposition of gold nanoparticles on a DVD template

    Energy Technology Data Exchange (ETDEWEB)

    Leordean, Cosmin; Marta, Bogdan; Gabudean, Ana-Maria; Focsan, Monica; Botiz, Ioan; Astilean, Simion, E-mail: simion.astilean@phys.ubbcluj.ro

    2015-09-15

    Highlights: • Simple and cost effective electrophoretic method to fabricate plasmonic substrates. • SERS performance at three different excitation laser lines. • Promising applicability in SERS based biosensing. - Abstract: In this work we present a simple, rapid and cost effective method to fabricate highly active SERS substrates. This method consists in an electrophoretic deposition of gold nanoparticles on a metallic nanostructured template of a commercial digital versatile disk (DVD). The negatively charged gold nanoparticles self-assemble on the positively charged DVD metallic film connected to a positive terminal of a battery, due to the influence of the electric field. When gold nanoparticles self-assembled on DVD metallic film, a 10-fold additional enhancement of Raman signal was observed when compared with the case of GNPs self-assembled on a polycarbonate DVD substrate only. Finite-difference time-domain simulations demonstrated that the additional electromagnetic field arising in the hot-spots created between gold nanoparticles and DVD metallic film induces an additional enhancement of the Raman signal. SERS efficiency of the fabricated plasmonic substrate was successfully demonstrated through detection of para-aminothiophenol molecule with three different excitation laser lines (532, 633 and 785 nm). The enhancement factor was calculated to be 10{sup 6} and indicates that plasmonic substrates fabricated through this method could be a promising platform for future SERS based sensors.

  12. [Can Topical Negative Pressure Therapy be Performed as a Cost-Effective General Surgery Procedure in the German DRG System?].

    Science.gov (United States)

    Hirche, Z; Xiong, L; Hirche, C; Willis, S

    2016-04-01

    Topical negative pressure therapy (TNPT) has been established for surgical wound therapy with different indications. Nevertheless, there is only sparse evidence regarding its therapeutic superiority or cost-effectiveness in the German DRG system (G-DRG). This study was designed to analyse the cost-effectiveness of TNPT in the G-DRG system with a focus on daily treatment costs and reimbursement in a general surgery care setting. In this retrospective study, we included 176 patients, who underwent TNPT between 2007 and 2011 for general surgery indications. Analysis of the cost-effectiveness involved 149 patients who underwent a simulation to calculate the reimbursement with or without TNPT by a virtual control group in which the TNP procedure was withdrawn for DRG calculation. This was followed by a calculation of costs for wound dressings and TNPT rent and material costs. Comparison between the "true" and the virtual group enabled calculation of the effective remaining surplus per case. Total reimbursement by included TNPT cases was 2,323 ,70.04 €. Costs for wound dressings and TNPT rent were 102,669.20 €. In 41 cases there was a cost-effectiveness (27.5%) with 607,422.03 € with TNP treatment, while the control group without TNP generated revenues of 442,015.10 €. Costs for wound dressings and TNPT rent were 47,376.68 €. In the final account we could generate a cost-effectiveness of 6759 € in 5 years per 149 patients by TNPT. In 108 cases there was no cost-effectiveness (72.5%). TNPT applied in a representative general surgery setting allows for wound therapy without a major financial burden. Based on the costs for wound dressings and TNPT rent, a primarily medically based decision when to use TNPT can be performed in a balanced product cost accounting. This study does not analyse the superiority of TNPT in wound care, so further prospective studies are required which focus on therapeutic superiority and cost-effectiveness. Georg Thieme

  13. Performance and Complexity Co-evaluation of the Advanced Video Coding Standard for Cost-Effective Multimedia Communications

    Directory of Open Access Journals (Sweden)

    Saponara Sergio

    2004-01-01

    Full Text Available The advanced video codec (AVC standard, recently defined by a joint video team (JVT of ITU-T and ISO/IEC, is introduced in this paper together with its performance and complexity co-evaluation. While the basic framework is similar to the motion-compensated hybrid scheme of previous video coding standards, additional tools improve the compression efficiency at the expense of an increased implementation cost. As a first step to bridge the gap between the algorithmic design of a complex multimedia system and its cost-effective realization, a high-level co-evaluation approach is proposed and applied to a real-life AVC design. An exhaustive analysis of the codec compression efficiency versus complexity (memory and computational costs project space is carried out at the early algorithmic design phase. If all new coding features are used, the improved AVC compression efficiency (up to 50% compared to current video coding technology comes with a complexity increase of a factor 2 for the decoder and larger than one order of magnitude for the encoder. This represents a challenge for resource-constrained multimedia systems such as wireless devices or high-volume consumer electronics. The analysis also highlights important properties of the AVC framework allowing for complexity reduction at the high system level: when combining the new coding features, the implementation complexity accumulates, while the global compression efficiency saturates. Thus, a proper use of the AVC tools maintains the same performance as the most complex configuration while considerably reducing complexity. The reported results provide inputs to assist the profile definition in the standard, highlight the AVC bottlenecks, and select optimal trade-offs between algorithmic performance and complexity.

  14. Analyzing the Cost-Effectiveness of Instruction Expenditures towards High School Completion among Oahu's Public School Districts

    Science.gov (United States)

    Ng, Larson S. W. M.

    2011-01-01

    The following study attempted to ascertain the instructional cost-effectiveness of public high school teachers towards high school completion through a financially based econometric analysis. Essentially, public high school instruction expenditures and completer data were collected from 2000 to 2007 and bivariate interaction analyzed through a…

  15. Performance Analysis of a Cost-Effective Electret Condenser Microphone Directional Array

    Science.gov (United States)

    Humphreys, William M., Jr.; Gerhold, Carl H.; Zuckerwar, Allan J.; Herring, Gregory C.; Bartram, Scott M.

    2003-01-01

    Microphone directional array technology continues to be a critical part of the overall instrumentation suite for experimental aeroacoustics. Unfortunately, high sensor cost remains one of the limiting factors in the construction of very high-density arrays (i.e., arrays containing several hundred channels or more) which could be used to implement advanced beamforming algorithms. In an effort to reduce the implementation cost of such arrays, the authors have undertaken a systematic performance analysis of a prototype 35-microphone array populated with commercial electret condenser microphones. An ensemble of microphones coupling commercially available electret cartridges with passive signal conditioning circuitry was fabricated for use with the Langley Large Aperture Directional Array (LADA). A performance analysis consisting of three phases was then performed: (1) characterize the acoustic response of the microphones via laboratory testing and calibration, (2) evaluate the beamforming capability of the electret-based LADA using a series of independently controlled point sources in an anechoic environment, and (3) demonstrate the utility of an electret-based directional array in a real-world application, in this case a cold flow jet operating at high subsonic velocities. The results of the investigation revealed a microphone frequency response suitable for directional array use over a range of 250 Hz - 40 kHz, a successful beamforming evaluation using the electret-populated LADA to measure simple point sources at frequencies up to 20 kHz, and a successful demonstration using the array to measure noise generated by the cold flow jet. This paper presents an overview of the tests conducted along with sample data obtained from those tests.

  16. Cost effectiveness of darunavir/ritonavir in highly treatment-experienced, HIV-1-infected adults in the USA.

    Science.gov (United States)

    Mauskopf, Josephine; Brogan, Anita; Martin, Silas; Smets, Erik

    2010-01-01

    Darunavir is a new protease inhibitor (PI) that is co-administered with low-dose ritonavir and has demonstrated substantial efficacy in clinical trials of highly treatment-experienced patients when combined with an optimized background regimen (with or without enfuvirtide). This study estimates the cost effectiveness of darunavir with ritonavir (DRV/r) in this population over 5-year and lifetime time horizons in the USA. A Markov model was used to follow a treatment-experienced HIV-1 cohort through six health states, based on CD4 cell count: greater than 500, 351-500, 201-350, 101-200, 51-100 and 0-50 cells/mm³, and death. The magnitude of the CD4 cell count increase and duration of increasing and stable periods were derived from week 48 DRV/r clinical trial results (POWER 1 and 2). The treatment pathway assumed one regimen switch following treatment failure on the initial regimen. The use of antiretroviral drugs was based on usage in DRV/r clinical trials. US daily wholesale acquisition costs were calculated using the recommended daily doses. For each CD4 cell count range, utility values, HIV-1-related mortality rates and costs for medical resources (other than antiretroviral drug costs) were obtained from published literature. Non-HIV-1-related mortality rates were calculated by applying a relative risk value to the US general population age and gender-specific mortality rates. Costs and outcomes were discounted at 3% per year. One-way and probabilistic sensitivity analyses and variability analysis were performed. In a 5-year analysis, patients receiving DRV/r experienced 3.80 quality-adjusted life-years (QALYs) and incurred total medical costs of US$217,288, while those receiving control PIs experienced 3.60 QALYs and incurred costs of US$218,962. DRV/r was both more effective and less costly than control PIs. For the lifetime analysis, the QALYs and lifetime medical costs with DRV/r were 10.03 and US$565,358, compared with 8.76 and US$527,287 with control PIs

  17. Is screening for pancreatic cancer in high-risk groups cost-effective?

    DEFF Research Database (Denmark)

    Jørgensen, Maiken Thyregod; Gerdes, Anne-Marie; Sørensen, Jan;

    2016-01-01

    OBJECTIVE: Pancreatic cancer (PC) is the fourth leading cause of cancer death worldwide, symptoms are few and diffuse, and when the diagnosis has been made only 10-15% would benefit from resection. Surgery is the only potentially curable treatment for pancreatic cancer, and the prognosis seems...... with Hereditary pancreatitis or with a disposition of HP and 40 first-degree relatives of patients with Familial Pancreatic Cancer (FPC) were screened for development of Pancreatic Ductal Adenocarcinoma (PDAC) with yearly endoscopic ultrasound. The cost-effectiveness of screening in comparison with no...

  18. Estimate of Cost-Effective Potential for Minimum Efficiency Performance Standards in 13 Major World Economies Energy Savings, Environmental and Financial Impacts

    Energy Technology Data Exchange (ETDEWEB)

    Letschert, Virginie E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bojda, Nicholas [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McNeil, Michael A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-07-01

    This study analyzes the financial impacts on consumers of minimum efficiency performance standards (MEPS) for appliances that could be implemented in 13 major economies around the world. We use the Bottom-Up Energy Analysis System (BUENAS), developed at Lawrence Berkeley National Laboratory (LBNL), to analyze various appliance efficiency target levels to estimate the net present value (NPV) of policies designed to provide maximum energy savings while not penalizing consumers financially. These policies constitute what we call the “cost-effective potential” (CEP) scenario. The CEP scenario is designed to answer the question: How high can we raise the efficiency bar in mandatory programs while still saving consumers money?

  19. Cost-Effectiveness of Highly Active Antiretroviral Therapy in South Africa.

    Directory of Open Access Journals (Sweden)

    2005-12-01

    for the HAART group for scenario 1 and 2, respectively, whereas the incremental cost per LYG was cost saving for both scenarios. In a sensitivity analysis based on the lower (25% and upper (75% interquartile range survival percentiles, the incremental cost per LYG ranged from $1,557 to $1,772 for the group without AIDS and from cost saving to $111 for patients with AIDS. CONCLUSION: HAART is a cost-effective intervention in South Africa, and cost saving when HAART prices are further reduced. Our estimates, however, were based on direct costs, and as such the actual cost saving might have been underestimated if indirect costs were also included.

  20. Cost-effectiveness of highly active antiretroviral therapy in South Africa.

    Science.gov (United States)

    Badri, Motasim; Maartens, Gary; Mandalia, Sundhiya; Bekker, Linda-Gail; Penrod, John R; Platt, Robert W; Wood, Robin; Beck, Eduard J

    2006-01-01

    2, respectively, whereas the incremental cost per LYG was cost saving for both scenarios. In a sensitivity analysis based on the lower (25%) and upper (75%) interquartile range survival percentiles, the incremental cost per LYG ranged from $1,557 to $1,772 for the group without AIDS and from cost saving to $111 for patients with AIDS. HAART is a cost-effective intervention in South Africa, and cost saving when HAART prices are further reduced. Our estimates, however, were based on direct costs, and as such the actual cost saving might have been underestimated if indirect costs were also included.

  1. Cost-effectiveness of highly active antiretroviral therapy in South Africa.

    Directory of Open Access Journals (Sweden)

    Motasim Badri

    2006-01-01

    and 2, respectively, whereas the incremental cost per LYG was cost saving for both scenarios. In a sensitivity analysis based on the lower (25% and upper (75% interquartile range survival percentiles, the incremental cost per LYG ranged from $1,557 to $1,772 for the group without AIDS and from cost saving to $111 for patients with AIDS.HAART is a cost-effective intervention in South Africa, and cost saving when HAART prices are further reduced. Our estimates, however, were based on direct costs, and as such the actual cost saving might have been underestimated if indirect costs were also included.

  2. Use of highly alkaline conditions to improve cost-effectiveness of algal biotechnology.

    Science.gov (United States)

    Canon-Rubio, Karen A; Sharp, Christine E; Bergerson, Joule; Strous, Marc; De la Hoz Siegler, Hector

    2016-02-01

    Phototrophic microorganisms have been proposed as an alternative to capture carbon dioxide (CO2) and to produce biofuels and other valuable products. Low CO2 absorption rates, low volumetric productivities, and inefficient downstream processing, however, currently make algal biotechnology highly energy intensive, expensive, and not economically competitive to produce biofuels. This mini-review summarizes advances made regarding the cultivation of phototrophic microorganisms at highly alkaline conditions, as well as other innovations oriented toward reducing the energy input into the cultivation and processing stages. An evaluation, in terms of energy requirements and energy return on energy invested, is performed for an integrated high-pH, high-alkalinity growth process that uses biofilms. Performance in terms of productivity and expected energy return on energy invested is presented for this process and is compared to previously reported life cycle assessments (LCAs) for systems at near-neutral pH. The cultivation of alkaliphilic phototrophic microorganisms in biofilms is shown to have a significant potential to reduce both energy requirements and capital costs.

  3. Cost effectiveness of high resolution computed tomography with interferon-gamma release assay for tuberculosis contact investigation

    Energy Technology Data Exchange (ETDEWEB)

    Kowada, Akiko, E-mail: kowadaa@gmail.com [Kojiya Haneda Healthcare Service, Ota City Public Health Office, Tokyo (Japan)

    2013-08-15

    Background: Tuberculosis contact investigation is one of the important public health strategies to control tuberculosis worldwide. Recently, high resolution computed tomography (HRCT) has been reported as a more accurate radiological method with higher sensitivity and specificity than chest X-ray (CXR) to detect active tuberculosis. In this study, we assessed the cost effectiveness of HRCT compared to CXR in combination with QuantiFERON{sup ®}-TB Gold In-Tube (QFT) or the tuberculin skin test (TST) for tuberculosis contact investigation. Methods: We constructed Markov models using a societal perspective on the lifetime horizon. The target population was a hypothetical cohort of immunocompetent 20-year-old contacts with smear-positive tuberculosis patients in developed countries. Six strategies; QFT followed by CXR, QFT followed by HRCT, TST followed by CXR, TST followed by HRCT, CXR alone and HRCT alone were modeled. All costs and clinical benefits were discounted at a fixed annual rate of 3%. Results: In the base-case analysis, QFT followed by HRCT strategy yielded the greatest benefit at the lowest cost ($US 6308.65; 27.56045 quality-adjusted life-years [QALYs])[year 2012 values]. Cost-effectiveness was sensitive to BCG vaccination rate. Conclusions: The QFT followed by HRCT strategy yielded the greatest benefits at the lowest cost. HRCT chest imaging, instead of CXR, is recommended as a cost effective addition to the evaluation and management of tuberculosis contacts in public health policy.

  4. Sintered pellets: A simple and cost effective method to predict the performance of GGAG:Ce single crystals

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Fang, E-mail: fmeng2@vols.utk.edu [Materials Science and Engineering, University of Tennessee, Knoxville, TN 37996 (United States); Scintillation Materials Research Center, University of Tennessee, Knoxville, TN 37996 (United States); Koschan, Merry [Scintillation Materials Research Center, University of Tennessee, Knoxville, TN 37996 (United States); Melcher, Charles L. [Materials Science and Engineering, University of Tennessee, Knoxville, TN 37996 (United States); Scintillation Materials Research Center, University of Tennessee, Knoxville, TN 37996 (United States); Cohen, Peter [Siemens Medical Solutions Molecular Imaging, Knoxville, TN 37932 (United States)

    2015-03-15

    Highlights: • Sintered pellets were firstly used to predict the performance of single crystals. • Similar properties between sintered pellets and single crystals were investigated. • B and Ba increase luminescence intensity in pellets and light yield in crystals. • Ca shortens photoluminescence decay in pellets and scintillation decay in crystals. - Abstract: Polycrystalline Gd{sub 3}Ga{sub 3}Al{sub 2}O{sub 12}:Ce (GGAG:Ce) pellets with various codopants were prepared via solid-state synthesis and characterized by X-ray diffraction, radioluminescence (RL), photoluminescence (PL), reflectivity and PL decay measurements. GGAG:Ce pellets codoped with B and Ba were found to have higher RL intensity than pellets with other codopants, while Ca codoping improved the decay time but reduced the RL intensity. These results were strongly correlated with the performance of these codopants in GGAG:Ce single crystals. The light yield of the single crystals codoped with B or Ba was ∼15% higher than the light yield of the GGAG:Ce crystal without codoping, while Ca codoping in single crystals resulted in lower light yield but shorter scintillation decay time (43 ns vs. 56 ns). The consistent performance of these codopants in both matrix forms indicates that sintering pellets may be used as a simple cost effective technique to evaluate compositions for likely single crystal scintillator performance.

  5. Cost-effectiveness of surveillance programs for families at high and moderate risk of hereditary non-polyposis colorectal cancer

    DEFF Research Database (Denmark)

    Rose Olsen, Kim; Bojesen, Stig E; Gerdes, Anne-Marie M

    2007-01-01

    and moderate risk of HNPCC are offered surveillance from age 25 and age 45, respectively. The model includes costs for all families referred to genetic counseling, including genetic risk assessment, mutation analysis, and surveillance in relevant families with or without known mutation, plus the costs related...... the moderate risk group is evaluated genetically but not offered surveillance. Sensitivity analysis showed these findings to be robust, although cost-effectiveness can be improved in cases of more conservative referrals to genetic counseling. CONCLUSIONS: The result for high risk families confirms the findings...

  6. Offering Lung Cancer Screening to High-Risk Medicare Beneficiaries Saves Lives and Is Cost-Effective: An Actuarial Analysis

    Science.gov (United States)

    Pyenson, Bruce S.; Henschke, Claudia I.; Yankelevitz, David F.; Yip, Rowena; Dec, Ellynne

    2014-01-01

    Background By a wide margin, lung cancer is the most significant cause of cancer death in the United States and worldwide. The incidence of lung cancer increases with age, and Medicare beneficiaries are often at increased risk. Because of its demonstrated effectiveness in reducing mortality, lung cancer screening with low-dose computed tomography (LDCT) imaging will be covered without cost-sharing starting January 1, 2015, by nongrandfathered commercial plans. Medicare is considering coverage for lung cancer screening. Objective To estimate the cost and cost-effectiveness (ie, cost per life-year saved) of LDCT lung cancer screening of the Medicare population at high risk for lung cancer. Methods Medicare costs, enrollment, and demographics were used for this study; they were derived from the 2012 Centers for Medicare & Medicaid Services (CMS) beneficiary files and were forecast to 2014 based on CMS and US Census Bureau projections. Standard life and health actuarial techniques were used to calculate the cost and cost-effectiveness of lung cancer screening. The cost, incidence rates, mortality rates, and other parameters chosen by the authors were taken from actual Medicare data, and the modeled screenings are consistent with Medicare processes and procedures. Results Approximately 4.9 million high-risk Medicare beneficiaries would meet criteria for lung cancer screening in 2014. Without screening, Medicare patients newly diagnosed with lung cancer have an average life expectancy of approximately 3 years. Based on our analysis, the average annual cost of LDCT lung cancer screening in Medicare is estimated to be $241 per person screened. LDCT screening for lung cancer in Medicare beneficiaries aged 55 to 80 years with a history of ≥30 pack-years of smoking and who had smoked within 15 years is low cost, at approximately $1 per member per month. This assumes that 50% of these patients were screened. Such screening is also highly cost-effective, at <$19,000 per life

  7. Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects.

    Science.gov (United States)

    Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

    2017-09-27

    To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades-while not inexpensive-contributed to greater system efficiency and modest savings. © Mwencha et al.

  8. Upgrading Supply Chain Management Systems to Improve Availability of Medicines in Tanzania: Evaluation of Performance and Cost Effects

    Science.gov (United States)

    Mwencha, Marasi; Rosen, James E; Spisak, Cary; Watson, Noel; Kisoka, Noela; Mberesero, Happiness

    2017-01-01

    ABSTRACT Background: To address challenges in public health supply chain performance, Tanzania invested in a national logistics management unit (LMU) and a national electronic logistics management information system (eLMIS). This evaluation examined the impact of those 2 key management upgrades approximately 1 year after they were introduced. Methods: We used a nonexperimental pre-post study design to compare the previous system with the upgraded management system. We collected baseline data from August to November 2013. We conducted round 1 of post-implementation data collection during April and May 2015, about 1 year after implementation of the upgrades. We evaluated key indicators of data use and reporting; supply chain management practices such as storage and supervision; supply chain performance including stock-out and expiry rates; and supply chain cost and savings. We analyzed the data using a range of techniques including statistical testing of baseline and round-1 results, and cost, cost-effectiveness, and return on investment analysis. Results: The upgrades were associated with improvements in data use, accessibility, visibility, and transparency; planning, control, and monitoring; support for quantification; stock-out rates; stock-out duration; commodity expiry; and forecast error. The upgraded system was more costly, but it was also more efficient, particularly when adjusting for the performance improvements. The upgrades also generated substantial savings that defrayed some, but not all, of the investment costs. Conclusion: Upgrades to Tanzania's supply chain management systems created multiple and complex pathways to impact. One year after implementation, the LMU and eLMIS brought about performance improvements through better data use and through improvements in some, but not all, management practices. Furthermore, the upgrades—while not inexpensive—contributed to greater system efficiency and modest savings. PMID:28877933

  9. Cost Effective Open Geometry HTS MRI System amended to BSCCO 2212 Wire for High Field Magnets

    Energy Technology Data Exchange (ETDEWEB)

    Kennth Marken

    2006-08-11

    The original goal of this Phase II Superconductivity Partnership Initiative project was to build and operate a prototype Magnetic Resonance Imaging (MRI) system using high temperature superconductor (HTS) coils wound from continuously processed dip-coated BSCCO 2212 tape conductor. Using dip-coated tape, the plan was for MRI magnet coils to be wound to fit an established commercial open geometry, 0.2 Tesla permanent magnet system. New electronics and imaging software for a prototype higher field superconducting system would have added significantly to the cost. However, the use of the 0.2 T platform would allow the technical feasibility and the cost issues for HTS systems to be fully established. Also it would establish the energy efficiency and savings of HTS open MRI compared with resistive and permanent magnet systems. The commercial goal was an open geometry HTS MRI running at 0.5 T and 20 K. This low field open magnet was using resistive normal metal conductor and its heat loss was rather high around 15 kolwatts. It was expected that an HTS magnet would dissipate around 1 watt, significantly reduce power consumption. The SPI team assembled to achieve this goal was led by Oxford Instruments, Superconducting Technology (OST), who developed the method of producing commercial dip coated tape. Superconductive Components Inc. (SCI), a leading US supplier of HTS powders, supported the conductor optimization through powder optimization, scaling, and cost reduction. Oxford Magnet Technology (OMT), a joint venture between Oxford Instruments and Siemens and the world’s leading supplier of MRI magnet systems, was involved to design and build the HTS MRI magnet and cryogenics. Siemens Magnetic Resonance Division, a leading developer and supplier of complete MRI imaging systems, was expected to integrate the final system and perform imaging trials. The original MRI demonstration project was ended in July 2004 by mutual consent of Oxford Instruments and Siemens. Between

  10. Cost Effective Open Geometry HTS MRI System amended to BSCCO 2212 Wire for High Field Magnets

    Energy Technology Data Exchange (ETDEWEB)

    Kennth Marken

    2006-08-11

    The original goal of this Phase II Superconductivity Partnership Initiative project was to build and operate a prototype Magnetic Resonance Imaging (MRI) system using high temperature superconductor (HTS) coils wound from continuously processed dip-coated BSCCO 2212 tape conductor. Using dip-coated tape, the plan was for MRI magnet coils to be wound to fit an established commercial open geometry, 0.2 Tesla permanent magnet system. New electronics and imaging software for a prototype higher field superconducting system would have added significantly to the cost. However, the use of the 0.2 T platform would allow the technical feasibility and the cost issues for HTS systems to be fully established. Also it would establish the energy efficiency and savings of HTS open MRI compared with resistive and permanent magnet systems. The commercial goal was an open geometry HTS MRI running at 0.5 T and 20 K. This low field open magnet was using resistive normal metal conductor and its heat loss was rather high around 15 kolwatts. It was expected that an HTS magnet would dissipate around 1 watt, significantly reduce power consumption. The SPI team assembled to achieve this goal was led by Oxford Instruments, Superconducting Technology (OST), who developed the method of producing commercial dip coated tape. Superconductive Components Inc. (SCI), a leading US supplier of HTS powders, supported the conductor optimization through powder optimization, scaling, and cost reduction. Oxford Magnet Technology (OMT), a joint venture between Oxford Instruments and Siemens and the world’s leading supplier of MRI magnet systems, was involved to design and build the HTS MRI magnet and cryogenics. Siemens Magnetic Resonance Division, a leading developer and supplier of complete MRI imaging systems, was expected to integrate the final system and perform imaging trials. The original MRI demonstration project was ended in July 2004 by mutual consent of Oxford Instruments and Siemens. Between

  11. Cost-Effectiveness of LDL-C Lowering With Evolocumab in Patients With High Cardiovascular Risk in the United States.

    Science.gov (United States)

    Gandra, Shravanthi R; Villa, Guillermo; Fonarow, Gregg C; Lothgren, Mickael; Lindgren, Peter; Somaratne, Ransi; van Hout, Ben

    2016-06-01

    Randomized trials have shown marked reductions in low-density lipoprotein cholesterol (LDL-C), a risk factor for cardiovascular disease (CVD), when evolocumab is administered. We hypothesized that evolocumab added to standard of care (SOC) vs SOC alone is cost-effective in the treatment of patients with heterozygous familial hypercholesterolemia (HeFH) or atherosclerotic CVD (ASCVD) with or without statin intolerance and LDL-C >100 mg/dL. Using a Markov cohort state transition model, primary and recurrent CVD event rates were predicted considering population-specific trial-based mean risk factors and calibrated against observed rates in the real world. The LDL-C-lowering effect from population-specific phase 3 randomized studies for evolocumab was used together with estimated LDL-C-lowering effect on CVD event rates per 38.67-mg/dL LDL-C lowering from a statin-trial meta-analysis. Costs and utilities were included from published sources. Evolocumab treatment was associated with both increased cost and improved quality-adjusted life-years (QALY): HeFH (incremental cost: US$153 289, incremental QALY: 2.02, incremental cost-effectiveness ratio: US$75 863/QALY); ASCVD (US$158 307, 1.12, US$141 699/QALY); and ASCVD with statin intolerance (US$136 903, 1.36, US$100 309/QALY). Evolocumab met both the American College of Cardiology/American Heart Association (ACC/AHA) and World Health Organization (WHO) thresholds in each population evaluated. Sensitivity and scenario analyses confirmed that model results were robust to changes in model parameters. Among patients with HeFH and ASCVD with or without statin intolerance, evolocumab added to SOC may provide a cost-effective treatment option for lowering LDL-C using ACC/AHA intermediate/high value and WHO cost-effectiveness thresholds. More definitive information on the clinical and economic value of evolocumab will be available from the forthcoming CVD outcomes study.

  12. Cost-effectiveness analysis of antiretroviral therapy in a cohort of HIV-infected patients starting first-line highly active antiretroviral therapy during 6 years of observation

    Directory of Open Access Journals (Sweden)

    Maggiolo F

    2015-02-01

    Full Text Available Franco Maggiolo,1 Giorgio L Colombo,2,3 Sergio Di Matteo,3 Giacomo M Bruno,3 Noemi Astuti,1 Elisa Di Filippo,1 Giulia Masini,1 Claudia Bernardini1 1Division of Infectious Diseases, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy; 2University of Pavia, Department of Drug Sciences, Pavia, Italy; 3SAVE Studi Analisi Valutazioni Economiche, Milan, Italy Objectives: Costs may play a role in deciding how and when to start highly active antiretroviral therapy (HAART in a naïve patient. The aim of the present study was to assess the cost- effectiveness of treatment with HAART in a large clinical cohort of naïve adults to determine the potential role of single-tablet regimens in the management of patients with human immunodeficiency virus (HIV. An incremental cost-effectiveness ratio analysis was performed, including a quality-adjusted life year approach. Results: In total, 741 patients (females comprising 25.5% were retrospectively included. The mean age was 39 years, the mean CD4 cell count was 266 cells/µL, and the mean viral load was 192,821 copies/mL. The most commonly used backbone was tenofovir + emtricitabine (77.6%; zidovudine + lamivudine was used in 10%, lamivudine + abacavir in 3%, and other nucleoside reverse transcriptase inhibitor (NRTI or NRTI-free regimens in 9.4% of patients. NNRTIs were used in 52.8% of cases, boosted protease inhibitors in 44.1%, and unboosted protease inhibitors and integrase inhibitors in 0.7% and 2.4%, respectively. Starting therapy at CD4 >500 cells/µL and CD4 351–500 cells/µL rather than at <201 cells/µL was the more cost-effective approach. The same consideration was not true comparing current indications with the possibility to start HAART at any CD4 value (eg, >500 cells per µL; in this case, the incremental cost-effectiveness ratio value was €199,130 per quality-adjusted life year gained, a higher value than the one suggested in guidelines. The single-tablet regimen (STR invariably

  13. Is a biomarker-based diagnostic strategy for invasive aspergillosis cost effective in high-risk haematology patients?

    Science.gov (United States)

    Macesic, N; Morrissey, C O; Liew, D; Bohensky, M A; Chen, S C-A; Gilroy, N M; Milliken, S T; Szer, J; Slavin, M A

    2017-01-27

    Empirical antifungal therapy is frequently used in hematology patients at high risk of invasive aspergillosis (IA), with substantial cost and toxicity. Biomarkers for IA aim for earlier and more accurate diagnosis and targeted treatment. However, data on the cost-effectiveness of a biomarker-based diagnostic strategy (BDS) are limited. We evaluated the cost effectiveness of BDS using results from a randomized controlled trial (RCT) and individual patient costing data. Data inputs derived from a published RCT were used to construct a decision-analytic model to compare BDS (Aspergillus galactomannan and PCR on blood) with standard diagnostic strategy (SDS) of culture and histology in terms of total costs, length of stay, IA incidence, mortality, and years of life saved. Costs were estimated for each patient using hospital costing data to day 180 and follow-up for survival was modeled to five years using a Gompertz survival model. Treatment costs were determined for 137 adults undergoing allogeneic hematopoietic stem cell transplant or receiving chemotherapy for acute leukemia in four Australian centers (2005-2009). Median total costs at 180 days were similar between groups (US[Formula: see text] for SDS [IQR US[Formula: see text

  14. Cost Effective Growth of High Temperature Piezoelectrics for Adaptive Flow Control Actuators Project

    Data.gov (United States)

    National Aeronautics and Space Administration — TRS Technologies, Inc. in collaboration with The Pennsylvania State University propose to develop new families of high temperature piezoelectric materials for...

  15. Carboplatin plus pemetrexed offers superior cost-effectiveness compared to pemetrexed in patients with advanced non-small cell lung cancer and performance status 2.

    Science.gov (United States)

    Schluckebier, Luciene; Garay, Osvaldo U; Zukin, Mauro; Ferreira, Carlos G

    2015-09-01

    Pemetrexed plus carboplatin offers survival advantage in first line treatment of advanced lung cancer patients with performance status of 2. We estimated the cost-effectiveness of this combined regimen compared to pemetrexed alone in a Brazilian population. A cost-effectiveness analysis was conducted based on a randomized phase III trial in patients with advanced non-small cell lung cancer (NSCLC) and ECOG performance status of 2 (PS2), comparing doublet regimen pemetrexed plus carboplatin with pemetrexed alone. The perspective adopted was the public health care sector over a three-year period. Direct medical costs and survival time were calculated from patient-level data and utility values were extracted from the literature. Sensitivity analyses were performed to evaluate uncertainties in the results. The combined regimen pemetrexed plus carboplatin yielded a gain of 0.16 life year (LY) and 0.12 quality-adjusted life year (QALY) compared to pemetrexed alone. The total cost was 17,674.31 USD for the combined regimen and 15,722.39 USD for pemetrexed alone. The incremental cost-effectiveness ratio (ICER) was $12,016.09 per LY gained and $15,732.05 per QALY gained. The factors with the greatest impact on the ICER are pemetrexed price and the time to progression utility value. The cost-effectiveness acceptability curve showed an upper 90% probability of pemetrexed plus carboplatin being cost-effective with a threshold between two and three GDP per capita. Our study suggests superiority of the combined pemetrexed plus carboplatin regimen in terms of efficacy as well as cost-effectiveness in advanced NSCLC patients with a poor performance status of 2. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Cost-effectiveness of caries-preventive fluoride varnish applications in clinic settings among patients of low, moderate and high risk.

    Science.gov (United States)

    Schwendicke, Falk; Splieth, Christian H; Thomson, William Murray; Reda, Seif; Stolpe, Michael; Foster Page, Lyndie

    2017-07-06

    The total body of evidence finds fluoride varnish effective to prevent caries. However, most trials were conducted in high-risk populations, with more recent trials on low-risk groups finding a lower efficacy. We aimed to assess the cost-effectiveness of fluoride varnish application in clinic setting in populations with different caries risk. A mixed public-private-payer perspective in the context of German health care was performed using a lifetime Markov model. Effectiveness data were derived from an update of the most recent systematic Cochrane review and synthesized in three different risk groups according to control group caries increment via random-effects meta-analysis. Varnish was assumed to be applied twice yearly between age 6 and 18 years. Teeth with carious defects would be treated restoratively and could experience further follow-up treatments. Costs were deduced from German fee item catalogues. Monte Carlo microsimulations were used for to analyse lifetime treatment costs and caries increment (Euro/Decayed, Missing, Filled Teeth (DMFT)). In low-risk groups, fluoride varnish was nearly twice as costly and minimally more effective (293 Euro, 8.1 DMFT) than no varnish (163 Euro, 8.5 DMFT). The incremental cost-effectiveness ratio (ICER) was 343 Euro spent per avoided DMFT. The ICER was lower in medium-risk (ICER 93 Euro/DMFT) and high-risk groups (8 Euro/DMFT). Application of fluoride varnish in the clinic setting is unlikely to be cost-effective in low-risk populations. There is the need to either target high-risk groups or to provide fluoride varnish at lower costs, possibly in nonclinic settings. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Critical parameters in cost-effective alkaline extraction for high protein yield from leaves

    NARCIS (Netherlands)

    Zhang, C.; Sanders, J.P.M.; Bruins, M.E.

    2014-01-01

    Leaves are potential resources for feed or food, but their applications are limited due to a high proportion of insoluble protein and inefficient processing. To overcome these problems, parameters of alkaline extraction were evaluated using green tea residue (GTR). Protein extraction could be maximi

  18. Photonic Integrated Circuits for Cost-Effective, High Port Density, and Higher Capacity Optical Communications Systems

    Science.gov (United States)

    Chiappa, Pierangelo

    Bandwidth-hungry services, such as higher speed Internet, voice over IP (VoIP), and IPTV, allow people to exchange and store huge amounts of data among worldwide locations. In the age of global communications, domestic users, companies, and organizations around the world generate new contents making bandwidth needs grow exponentially, along with the need for new services. These bandwidth and connectivity demands represent a concern for operators who require innovative technologies to be ready for scaling. To respond efficiently to these demands, Alcatel-Lucent is fast moving toward photonic integration circuits technologies as the key to address best performances at the lowest "bit per second" cost. This article describes Alcatel-Lucent's contribution in strategic directions or achievements, as well as possible new developments.

  19. Cost-Effective Pavement Performance Management of Indiana's Enhanced National Highway System through Strategic Modification of the Pavement Rehabilitation Treatment Trigger Values

    OpenAIRE

    Noureldin, Menna; Fricker, Jon D.; Sinha, Kumares C.

    2015-01-01

    Cost-Effective Pavement Performance Management of Indiana's Enhanced National Highway System through Strategic Modification of the Pavement Rehabilitation Treatment Trigger Values Presented during Session 3: Policy and Funding, moderated by Magdy Mikhail, at the 9th International Conference on Managing Pavement Assets (ICMPA9) in Alexandria, VA. Includes conference paper and PowerPoint slides.

  20. Cost-effective development of highly polymorphic microsatellite in Japanese quail facilitated by next-generation sequencing.

    Science.gov (United States)

    Tadano, R; Nunome, M; Mizutani, M; Kawahara-Miki, R; Fujiwara, A; Takahashi, S; Kawashima, T; Nirasawa, K; Ono, T; Kono, T; Matsuda, Y

    2014-12-01

    Next-generation sequencing technologies permit rapid and cost-effective identification of numerous putative microsatellite loci. Here, from the genome sequences of Japanese quail, we developed microsatellite markers containing dinucleotide repeats and employed these for characterisation of genetic diversity and population structure. A total of 385 individuals from 12 experimental and one wild-derived Japanese quail lines were genotyped with newly developed autosomal markers. The maximum number of alleles, expected heterozygosity and polymorphic information content (PIC) per locus were 10, 0.80 and 0.77 respectively. Approximately half of the markers were highly informative (PIC ≥ 0.50). The mean number of alleles per locus and observed heterozygosity within a line were in the range of 1.3-4.1 and 0.11-0.53 respectively. Compared with the wild-derived line, genetic diversity levels were low in the experimental lines. Genetic differentiation (FST ) between all pairs of the lines ranged from 0.13 to 0.83. Genetic clustering analyses based on multilocus genotypes of individuals showed that most individuals formed clearly defined clusters corresponding to the origins of the lines. These results suggest that Japanese quail experimental lines are highly structured. Microsatellite markers developed in this study may be effective for future genetic studies of Japanese quail.

  1. A safe, efficient and cost effective process for removing petroleum hydrocarbons from a highly heterogeneous and relatively inaccessible shoreline.

    Science.gov (United States)

    Guerin, Turlough F

    2015-10-01

    A rocky, intractable and highly heterogeneous, intertidal zone, was contaminated from a diesel fuel spill that occurred during refuelling of a grader used in road construction, on an operational mine's shiploading facility. A practical, cost-effective, and safer (to personnel by avoiding drilling and earthworks), and non-invasive sampling and remediation strategy was designed and implemented since the location and nature of the impacted geology (rock fill) and sediment, precluded conventional ex-situ and any in-situ treatment where drilling would be required. Enhanced biostimulation with surfactant, available N & P (which were highly constrained), and increased aeration, increased the degradation rate from no discernable change for 2 years post-spill, to 170 mg/kg/day; the maximum degradation rate after intervention. While natural attenuation was ineffective in this application, the low-cost, biostimulation intervention proved successful, allowing the site owner to meet their regulatory obligations. Petroleum hydrocarbons (aliphatic fraction) decreased from ∼20,000 mg/kg to <200 mg/kg at the completion of 180 weeks of treatment.

  2. Simple, rapid and cost-effective method for high quality nucleic acids extraction from different strains of Botryococcus braunii.

    Directory of Open Access Journals (Sweden)

    Byung-Hyuk Kim

    Full Text Available This study deals with an effective nucleic acids extraction method from various strains of Botryococcus braunii which possesses an extensive extracellular matrix. A method combining freeze/thaw and bead-beating with heterogeneous diameter of silica/zirconia beads was optimized to isolate DNA and RNA from microalgae, especially from B. braunii. Eukaryotic Microalgal Nucleic Acids Extraction (EMNE method developed in this study showed at least 300 times higher DNA yield in all strains of B. braunii with high integrity and 50 times reduced working volume compared to commercially available DNA extraction kits. High quality RNA was also extracted using this method and more than two times the yield compared to existing methods. Real-time experiments confirmed the quality and quantity of the input DNA and RNA extracted using EMNE method. The method was also applied to other eukaryotic microalgae, such as diatoms, Chlamydomonas sp., Chlorella sp., and Scenedesmus sp. resulting in higher efficiencies. Cost-effectiveness analysis of DNA extraction by various methods revealed that EMNE method was superior to commercial kits and other reported methods by >15%. This method would immensely contribute to area of microalgal genomics.

  3. Innovative Deep Throttling, High Performance Injector Concept Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Science and Technology Applications, LLC's (STA) vision for a versatile space propulsion system is a highly throttleable, high performance, and cost effective Liquid...

  4. Cost-effective alternative to nano-encapsulation: Amorphous curcumin-chitosan nanoparticle complex exhibiting high payload and supersaturation generation.

    Science.gov (United States)

    Nguyen, Minh Hiep; Yu, Hong; Kiew, Tie Yi; Hadinoto, Kunn

    2015-10-01

    While the wide-ranging therapeutic activities of curcumin have been well established, its successful delivery to realize its true therapeutic potentials faces a major challenge due to its low oral bioavailability. Even though nano-encapsulation has been widely demonstrated to be effective in enhancing the bioavailability of curcumin, it is not without drawbacks (i.e. low payload and costly preparation). Herein we present a cost-effective bioavailability enhancement strategy of curcumin in the form of amorphous curcumin-chitosan nanoparticle complex (or curcumin nanoplex in short) exhibiting a high payload (>80%). The curcumin nanoplex was prepared by a simple yet highly efficient drug-polysaccharide complexation method that required only mixing of the curcumin and chitosan solutions under ambient condition. The effects of (1) pH and (2) charge ratio of chitosan to curcumin on the (i) physical characteristics of the nanoplex (i.e. size, colloidal stability and payload), (ii) complexation efficiency, and (iii) production yield were investigated from which the optimal preparation condition was determined. The nanoplex formation was found to favor low acidic pH and charge ratio below unity. At the optimal condition (i.e. pH 4.4. and charge ratio=0.8), stable curcumin nanoplex (≈260nm) was prepared at >90% complexation efficiency and ≈50% production yield. The amorphous state stability, colloidal stability, and in vitro non-cytotoxicity of the nanoplex were successfully established. The curcumin nanoplex produced prolonged supersaturation (3h) in the presence of hydroxypropyl methylcellulose (HPMC) at five times of the saturation solubility of curcumin. In addition, curcumin released from the nanoplex exhibited improved chemical stability owed to the presence of chitosan. Both results (i.e. high supersaturation and improved chemical stability) bode well for the ability of the curcumin nanoplex to enhance the bioavailability of curcumin clinically. Copyright © 2015

  5. Implementation and Operational Research: A Cost-Effective, Clinically Actionable Strategy for Targeting HIV Preexposure Prophylaxis to High-Risk Men Who Have Sex With Men.

    Science.gov (United States)

    Ross, Eric L; Cinti, Sandro K; Hutton, David W

    2016-07-01

    Preexposure prophylaxis (PrEP) is effective at preventing HIV infection among men who have sex with men (MSM), but there is uncertainty about how to identify high-risk MSM who should receive PrEP. We used a mathematical model to assess the cost-effectiveness of using the HIV Incidence Risk Index for MSM (HIRI-MSM) questionnaire to target PrEP to high-risk MSM. We simulated strategies of no PrEP, PrEP available to all MSM, and eligibility thresholds set to HIRI-MSM scores between 5 and 45, in increments of 5 (where a higher score predicts greater HIV risk). Based on the iPrEx, IPERGAY, and PROUD trials, we evaluated PrEP efficacies from 44% to 86% and annual costs from $5900 to 8700. We designate strategies with incremental cost-effectiveness ratio (ICER) ≤$100,000/quality-adjusted life-year (QALY) as "cost-effective." Over 20 years, making PrEP available to all MSM is projected to prevent 33.5% of new HIV infections, with an ICER of $1,474,000/QALY. Increasing the HIRI-MSM score threshold reduces the prevented infections, but improves cost-effectiveness. A threshold score of 25 is projected to be optimal (most QALYs gained while still being cost-effective) over a wide range of realistic PrEP efficacies and costs. At low cost and high efficacy (IPERGAY), thresholds of 15 or 20 are optimal across a range of other input assumptions; at high cost and low efficacy (iPrEx), 25 or 30 are generally optimal. The HIRI-MSM provides a clinically actionable means of guiding PrEP use. Using a score of 25 to determine PrEP eligibility could facilitate cost-effective use of PrEP among high-risk MSM who will benefit from it most.

  6. Cost-effectiveness of posaconazole versus fluconazole or itraconazole in the prevention of invasive fungal infections among high-risk neutropenic patients in Spain

    Directory of Open Access Journals (Sweden)

    Grau Santiago

    2012-04-01

    Full Text Available Abstract Background We evaluated the cost-effectiveness of posaconazole compared with standard azole therapy (SAT; fluconazole or itraconazole for the prevention of invasive fungal infections (IFI and the reduction of overall mortality in high-risk neutropenic patients with acute myelogenous leukaemia (AML or myelodysplastic syndromes (MDS. The perspective was that of the Spanish National Health Service (NHS. Methods A decision-analytic model, based on a randomised phase III trial, was used to predict IFI avoided, life-years saved (LYS, total costs, and incremental cost-effectiveness ratio (ICER; incremental cost per LYS over patients' lifetime horizon. Data for the analyses included life expectancy, procedures, and costs associated with IFI and the drugs (in euros at November 2009 values which were obtained from the published literature and opinions of an expert committee. A probabilistic sensitivity analysis (PAS was performed. Results Posaconazole was associated with fewer IFI (0.05 versus 0.11, increased LYS (2.52 versus 2.43, and significantly lower costs excluding costs of the underlying condition (€6,121 versus €7,928 per patient relative to SAT. There is an 85% probability that posaconazole is a cost-saving strategy compared to SAT and a 97% probability that the ICER for posaconazole relative to SAT is below the cost per LYS threshold of €30,000 currently accepted in Spain. Conclusions Posaconazole is a cost-saving prophylactic strategy (lower costs and greater efficacy compared with fluconazole or itraconazole in high-risk neutropenic patients.

  7. The cost-effectiveness of using hepatitis A/B combined vaccine versus hepatitis B vaccine alone for high-risk heterosexuals.

    Science.gov (United States)

    Rein, David B; Weinbaum, Cindy M

    2008-10-01

    Previous studies estimated that vaccinating high-risk heterosexuals (HRH) with combination hepatitis A/B vaccine was a cost-effective alternative to vaccinating HRH against hepatitis B alone. Since then, the incidence of hepatitis A has declined dramatically in the United States. We re-estimate the cost-effectiveness of this policy accounting for modern declines in incidence. According to our estimates, vaccinating with combination vaccine resulted in a cost of $120,000 per quality adjusted life year gained (2.79 times the 2005 United States Gross Domestic Product per capita), a ratio that is less favorable than those for most other vaccination strategies.

  8. Cost-utility and cost-effectiveness analyses of a long-term, high-intensity exercise program compared with conventional physical therapy in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Hout, W.B. van den; Jong, Z. de; Munneke, M.; Hazes, J.M.W.; Breedveld, F.C.; Vliet Vlieland, T.P.M.

    2005-01-01

    OBJECTIVE: To estimate the cost utility and cost effectiveness of long-term, high-intensity exercise classes compared with usual care in rheumatoid arthritis (RA) patients. METHODS: RA patients (n = 300) were randomly assigned to either exercise classes or UC; followup lasted for 2 years. Outcome me

  9. Cost-utility and cost-effectiveness analyses of a long-term, high-intensity exercise program compared with conventional physical therapy in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Hout, W.B. van den; Jong, Z. de; Munneke, M.; Hazes, J.M.W.; Breedveld, F.C.; Vliet Vlieland, T.P.M.

    2005-01-01

    OBJECTIVE: To estimate the cost utility and cost effectiveness of long-term, high-intensity exercise classes compared with usual care in rheumatoid arthritis (RA) patients. METHODS: RA patients (n = 300) were randomly assigned to either exercise classes or UC; followup lasted for 2 years. Outcome me

  10. Project materials [Commercial High Performance Buildings Project

    Energy Technology Data Exchange (ETDEWEB)

    None

    2001-01-01

    The Consortium for High Performance Buildings (ChiPB) is an outgrowth of DOE'S Commercial Whole Buildings Roadmapping initiatives. It is a team-driven public/private partnership that seeks to enable and demonstrate the benefit of buildings that are designed, built and operated to be energy efficient, environmentally sustainable, superior quality, and cost effective.

  11. Inefficiencies and High-Value Improvements in U.S. Cervical Cancer Screening Practice: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Kim, Jane J; Campos, Nicole G; Sy, Stephen; Burger, Emily A; Cuzick, Jack; Castle, Philip E; Hunt, William C; Waxman, Alan; Wheeler, Cosette M

    2015-10-20

    Studies suggest that cervical cancer screening practice in the United States is inefficient. The cost and health implications of nonadherence in the screening process compared with recommended guidelines are uncertain. To estimate the benefits, costs, and cost-effectiveness of current cervical cancer screening practice and assess the value of screening improvements. Model-based cost-effectiveness analysis. New Mexico HPV Pap Registry; medical literature. Cohort of women eligible for routine screening. Lifetime. Societal. Current cervical cancer screening practice; improved adherence to guidelines-based screening interval, triage testing, diagnostic referrals, and precancer treatment referrals. Reductions in lifetime cervical cancer risk, quality-adjusted life-years (QALYs), lifetime costs, incremental cost-effectiveness ratios, and incremental net monetary benefits (INMBs). Current screening practice was associated with lower health benefit and was not cost-effective relative to guidelines-based strategies. Improvements in the screening process were associated with higher QALYs and small changes in costs. Perfect adherence to screening every 3 years with cytologic testing and adherence to colposcopy/biopsy referrals were associated with the highest INMBs ($759 and $741, respectively, at a willingness-to-pay threshold of $100,000 per QALY gained); together, the INMB increased to $1645. Current screening practice was inefficient in 100% of simulations. The rank ordering of screening improvements according to INMBs was stable over a range of screening inputs and willingness-to-pay thresholds. The effect of human papillomavirus vaccination was not considered. The added health benefit of improving adherence to guidelines, especially the 3-year interval for cytologic screening and diagnostic follow-up, may justify additional investments in interventions to improve U.S. cervical cancer screening practice. U.S. National Cancer Institute.

  12. ANALYSIS OF THE PERFORMANCE AND COST EFFECTIVENESS OF NINE SMALL WIND ENERGY CONVERSION SYSTEMS FUNDED BY THE DOE SMALL GRANTS PROGRAM

    Energy Technology Data Exchange (ETDEWEB)

    Kay, J.

    1982-04-01

    This report presents an analysis of the technical performance and cost effectiveness of nine small wind energy conversion systems (SWECS) funded during FY 1979 by the U.S. Department of Energy. Chapter 1 gives an analytic framework with which to evaluate the systems. Chapter 2 consists of a review of each of the nine projects, including project technical overviews, estimates of energy savings, and results of economic analysis. Chapter 3 summarizes technical, economic, and institutional barriers that are likely to inhibit widespread dissemination of SWECS technology.

  13. Prescribing high-dose lipid-lowering therapy early to avoid subsequent cardiovascular events: is this a cost-effective strategy?

    Science.gov (United States)

    Ara, R; Pandor, A; Stevens, J; Rafia, R; Ward, S E; Rees, A; Durrington, P N; Reynolds, T M; Wierzbicki, A S; Stevenson, M

    2012-06-01

    While evidence shows high-dose statins reduce cardiovascular events compared with moderate doses in individuals with acute coronary syndrome (ACS), many primary care trusts (PCT) advocate the use of generic simvastatin 40 mg/day for these patients. Data from 28 RCTs were synthesized using a mixed treatment comparison model. A Markov model was used to evaluate the cost-effectiveness of treatments taking into account adherence and the likely reduction in cost for atorvastatin when the patent expires. There is a clear dose-response: rosuvastatin 40 mg/day produces the greatest reduction in low-density lipoprotein cholesterol (56%) followed by atorvastatin 80 mg/day (52%), and simvastatin 40 mg/day (37%). Using a threshold of £20,000 per QALY, if adherence levels in general practice are similar to those observed in RCTs, all three higher dose statins would be considered cost-effective compared to simvastatin 40 mg/day. Using the net benefits of the treatments, rosuvastatin 40 mg/day is estimated to be the most cost-effective alternative. If the cost of atorvastatin reduces in line with that observed for simvastatin, atorvastatin 80 mg/day is estimated to be the most cost-effective alternative. Our analyses show that current PCT policies intended to minimize primary care drug acquisition costs result in suboptimal care.

  14. Should HIV testing for all pregnant women continue? Cost-effectiveness of universal antenatal testing compared to focused approaches across high to very low HIV prevalence settings

    OpenAIRE

    Ishikawa, Naoko; Dalal, Shona; Johnson, Cheryl; Hogan, Daniel R; Shimbo, Takuro; Shaffer, Nathan; Pendse, Razia N; Lo, Ying-Ru; Ghidinelli, Massimo N.; Baggaley, Rachel

    2016-01-01

    Introduction HIV testing is the entry point for the elimination of mother-to-child transmission of HIV. Decreasing external funding for the HIV response in some low- and middle-income countries has triggered the question of whether a focused approach to HIV testing targeting pregnant women in high-burden areas should be considered. This study aimed at determining and comparing the cost-effectiveness of universal and focused HIV testing approaches for pregnant women across high to very low HIV...

  15. Should HIV testing for all pregnant women continue? Cost-effectiveness of universal antenatal testing compared to focused approaches across high to very low HIV prevalence settings

    OpenAIRE

    Naoko Ishikawa; Shona Dalal; Cheryl Johnson; Hogan, Daniel R; Takuro Shimbo; Nathan Shaffer; Pendse, Razia N; Ying-Ru Lo; Ghidinelli, Massimo N.; Rachel Baggaley

    2016-01-01

    Introduction: HIV testing is the entry point for the elimination of mother-to-child transmission of HIV. Decreasing external funding for the HIV response in some low- and middle-income countries has triggered the question of whether a focused approach to HIV testing targeting pregnant women in high-burden areas should be considered. This study aimed at determining and comparing the cost-effectiveness of universal and focused HIV testing approaches for pregnant women across high to very low HI...

  16. A New, High Yield, Rapid, and Cost-Effective Protocol to Deprotection of Cysteine-Rich Conopeptide, Omega-Conotoxin MVIIA.

    Science.gov (United States)

    Eisapoor, Seyed Sahand; Jamili, Shahla; Shahbazzadeh, Delavar; Ghavam Mostafavi, Pargol; Pooshang Bagheri, Kamran

    2016-05-01

    Almost all conopeptides purified from Conus venoms are cysteine-rich peptides. Among them, omega-conotoxin MVIIA, FDA approved peptide drug (Prialt(®)), selected as a cysteine-rich model that its protection from oxidation is critical during solid phase synthesis. Deprotection of cysteines is a crucial step after peptide synthesis. The current study aimed to set up a new highly efficient deprotection protocol for omega-conotoxin MVIIA. Deprotection was performed based on mercury acetate with significant major modification. The protocol accomplished based on the best molar ratio of peptide/mercury/2-ME that adjusted to 0.2 mm/3 mm/10 mm (50 μg/1 mg/10 μL). The yield and purity of omega-conotoxin MVIIA obtained at 93 and 95%, respectively. The total time of protocol shortened to 90 min instead of 6-20 h in routine methods. In this study, omega-conotoxin MVIIA was recovered in high yield and in the shortest time. Despite of other known protocols, molar ratio adjusted to minimum amount. In conclusion, this protocol would be suggested to cost-effective deprotection of thiol groups for similar cysteine-rich peptides.

  17. The cost-effectiveness of directly observed highly-active antiretroviral therapy in the third trimester in HIV-infected pregnant women.

    Directory of Open Access Journals (Sweden)

    Caitlin J McCabe

    Full Text Available BACKGROUND: In HIV-infected pregnant women, viral suppression prevents mother-to-child HIV transmission. Directly observed highly-active antiretroviral therapy (HAART enhances virological suppression, and could prevent transmission. Our objective was to project the effectiveness and cost-effectiveness of directly observed administration of antiretroviral drugs in pregnancy. METHODS AND FINDINGS: A mathematical model was created to simulate cohorts of one million asymptomatic HIV-infected pregnant women on HAART, with women randomly assigned self-administered or directly observed antiretroviral therapy (DOT, or no HAART, in a series of Monte Carlo simulations. Our primary outcome was the quality-adjusted life expectancy in years (QALY of infants born to HIV-infected women, with the rates of Caesarean section and HIV-transmission after DOT use as intermediate outcomes. Both self-administered HAART and DOT were associated with decreased costs and increased life-expectancy relative to no HAART. The use of DOT was associated with a relative risk of HIV transmission of 0.39 relative to conventional HAART; was highly cost-effective in the cohort as a whole (cost-utility ratio $14,233 per QALY; and was cost-saving in women whose viral loads on self-administered HAART would have exceeded 1000 copies/ml. Results were stable in wide-ranging sensitivity analyses, with directly observed therapy cost-saving or highly cost-effective in almost all cases. CONCLUSIONS: Based on the best available data, programs that optimize adherence to HAART through direct observation in pregnancy have the potential to diminish mother-to-child HIV transmission in a highly cost-effective manner. Targeted use of DOT in pregnant women with high viral loads, who could otherwise receive self-administered HAART would be a cost-saving intervention. These projections should be tested with randomized clinical trials.

  18. High-throughput and automated diagnosis of antimicrobial resistance using a cost-effective cellphone-based micro-plate reader.

    Science.gov (United States)

    Feng, Steve; Tseng, Derek; Di Carlo, Dino; Garner, Omai B; Ozcan, Aydogan

    2016-12-15

    Routine antimicrobial susceptibility testing (AST) can prevent deaths due to bacteria and reduce the spread of multi-drug-resistance, but cannot be regularly performed in resource-limited-settings due to technological challenges, high-costs, and lack of trained professionals. We demonstrate an automated and cost-effective cellphone-based 96-well microtiter-plate (MTP) reader, capable of performing AST without the need for trained diagnosticians. Our system includes a 3D-printed smartphone attachment that holds and illuminates the MTP using a light-emitting-diode array. An inexpensive optical fiber-array enables the capture of the transmitted light of each well through the smartphone camera. A custom-designed application sends the captured image to a server to automatically determine well-turbidity, with results returned to the smartphone in ~1 minute. We tested this mobile-reader using MTPs prepared with 17 antibiotics targeting Gram-negative bacteria on clinical isolates of Klebsiella pneumoniae, containing highly-resistant antimicrobial profiles. Using 78 patient isolate test-plates, we demonstrated that our mobile-reader meets the FDA-defined AST criteria, with a well-turbidity detection accuracy of 98.21%, minimum-inhibitory-concentration accuracy of 95.12%, and a drug-susceptibility interpretation accuracy of 99.23%, with no very major errors. This mobile-reader could eliminate the need for trained diagnosticians to perform AST, reduce the cost-barrier for routine testing, and assist in spatio-temporal tracking of bacterial resistance.

  19. High-throughput and automated diagnosis of antimicrobial resistance using a cost-effective cellphone-based micro-plate reader

    Science.gov (United States)

    Feng, Steve; Tseng, Derek; di Carlo, Dino; Garner, Omai B.; Ozcan, Aydogan

    2016-12-01

    Routine antimicrobial susceptibility testing (AST) can prevent deaths due to bacteria and reduce the spread of multi-drug-resistance, but cannot be regularly performed in resource-limited-settings due to technological challenges, high-costs, and lack of trained professionals. We demonstrate an automated and cost-effective cellphone-based 96-well microtiter-plate (MTP) reader, capable of performing AST without the need for trained diagnosticians. Our system includes a 3D-printed smartphone attachment that holds and illuminates the MTP using a light-emitting-diode array. An inexpensive optical fiber-array enables the capture of the transmitted light of each well through the smartphone camera. A custom-designed application sends the captured image to a server to automatically determine well-turbidity, with results returned to the smartphone in ~1 minute. We tested this mobile-reader using MTPs prepared with 17 antibiotics targeting Gram-negative bacteria on clinical isolates of Klebsiella pneumoniae, containing highly-resistant antimicrobial profiles. Using 78 patient isolate test-plates, we demonstrated that our mobile-reader meets the FDA-defined AST criteria, with a well-turbidity detection accuracy of 98.21%, minimum-inhibitory-concentration accuracy of 95.12%, and a drug-susceptibility interpretation accuracy of 99.23%, with no very major errors. This mobile-reader could eliminate the need for trained diagnosticians to perform AST, reduce the cost-barrier for routine testing, and assist in spatio-temporal tracking of bacterial resistance.

  20. A Cost-effective High-resolution Melting Approach using the EvaGreen Dye for DNA Polymorphism Detection and Genotyping in Plants

    Institute of Scientific and Technical Information of China (English)

    Yi-Dan Li; Zhi-Zhan Chu; Xiang-Guo Liu; Hai-Chun Jing; Yao-Guang Liu; Dong-Yun Hao

    2010-01-01

    High-resolution melting (HRM) analysis relies on the use of fluorescent dyes, such as LCGreen,ResoLight, and SYTO9, which bind in a saturated manner to the double-stranded DNAs. These dyes are expensive in use and may not be affordable when dealing with a large quantity of samples. EvaGreen is a much cheaper DNA helix intercalating dye and has been used in quantitative real-time polymerase chain reaction (PCR) and post-PCR DNA melt curve analysis. Here we report on the development of an EvaGreen-based HRM analysis and its performance, in comparison with the popular LCGreen-based HRM analysis, in detection of DNA polymorphism in plants. We found that various polymorphisms ranged from single nucleotide polymorphisms (SNPs) to Indels were equally detected by using EvaGreen- or LCGreen-based HRM. EvaGreen dye was sensitive enough in discovery of SNPs in fivefold pooled samples.Using this economical dye we successfully identified multiple novel mutant alleles of Gln1-3 gene,which produces a cytosolic glutamine synthetase isoenzyme (GS1), in a maize ethyl methanesulfonate (EMS)-mutagenized library, and genotyped rice mapping populations with SNP markers. The current results suggest that EvaGreen is a promising dye for HRM analysis for its ease to use and cost effectiveness.

  1. The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model

    OpenAIRE

    Zomer, Ella; Owen, Alice; Magliano, Dianna J; Liew, Danny; Reid, Christopher M

    2012-01-01

    Objective To model the long term effectiveness and cost effectiveness of daily dark chocolate consumption in a population with metabolic syndrome at high risk of cardiovascular disease. Design Best case scenario analysis using a Markov model. Setting Australian Diabetes, Obesity and Lifestyle study. Participants 2013 people with hypertension who met the criteria for metabolic syndrome, with no history of cardiovascular disease and not receiving antihypertensive therapy. Main outcome measures ...

  2. The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model

    OpenAIRE

    Zomer, Ella; Owen, Alice; Magliano, Dianna J; Liew, Danny; Reid, Christopher M

    2012-01-01

    Objective To model the long term effectiveness and cost effectiveness of daily dark chocolate consumption in a population with metabolic syndrome at high risk of cardiovascular disease. Design Best case scenario analysis using a Markov model. Setting Australian Diabetes, Obesity and Lifestyle study. Participants 2013 people with hypertension who met the criteria for metabolic syndrome, with no history of cardiovascular disease and not receiving antihypertensive therapy. Main outcome measures ...

  3. Performance, Performance System, and High Performance System

    Science.gov (United States)

    Jang, Hwan Young

    2009-01-01

    This article proposes needed transitions in the field of human performance technology. The following three transitions are discussed: transitioning from training to performance, transitioning from performance to performance system, and transitioning from learning organization to high performance system. A proposed framework that comprises…

  4. Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    Rodrigo Antonini Ribeiro

    2015-01-01

    Full Text Available Background: Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. Objective: To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS perspective. Methods: We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg, intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg, high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$. A willingness-to-pay (WTP threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770 was applied. Results: Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Conclusions: Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

  5. Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Rodrigo Antonini, E-mail: rodrigo.ribeiro@htanalyze.com [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Duncan, Bruce Bartholow [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Ziegelmann, Patricia Klarmann [Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Departamento de Estatística da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Stella, Steffan Frosi [Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Vieira, Jose Luiz da Costa [Instituto de Cardiologia / Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Restelatto, Luciane Maria Fabian [Serviço de Medicina Interna do Hospital de Clínicas de Porto Alegre, Porto Alegre, RS (Brazil); Polanczyk, Carisi Anne [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil)

    2015-01-15

    Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS) perspective. We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs) of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk) of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg) were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg), intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg), high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$). A willingness-to-pay (WTP) threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770) was applied. Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

  6. Cost-effectiveness analysis of consolidation with brentuximab vedotin for high-risk Hodgkin lymphoma after autologous stem cell transplantation.

    Science.gov (United States)

    Hui, Lucy; von Keudell, Gottfried; Wang, Rong; Zeidan, Amer M; Gore, Steven D; Ma, Xiaomei; Davidoff, Amy J; Huntington, Scott F

    2017-10-01

    In a recent randomized, placebo-controlled trial, consolidation treatment with brentuximab vedotin (BV) decreased the risk of Hodgkin lymphoma (HL) progression after autologous stem cell transplantation (ASCT). However, the impact of BV consolidation on overall survival, quality of life, and health care costs remain unclear. A Markov decision-analytic model was constructed to measure the costs and clinical outcomes for BV consolidation therapy compared with active surveillance in a cohort of patients aged 33 years who were at risk for HL relapse after ASCT. Life-time costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for each post-ASCT strategy. After quality-of-life adjustments and standard discounting, upfront BV consolidation was associated with an improvement of 1.07 QALYs compared with active surveillance plus BV as salvage. However, the strategy of BV consolidation led to significantly higher health care costs ($378,832 vs $219,761), resulting in an ICER for BV consolidation compared with active surveillance of $148,664/QALY. If indication-specific pricing was implemented, then the model-estimated BV price reductions of 18% to 38% for the consolidative setting would translate into ICERs of $100,000 and $50,000 per QALY, respectively. These findings were consistent on 1-way and probabilistic sensitivity analyses. BV as consolidation therapy under current US pricing is unlikely to be cost effective at a willingness-to-pay threshold of $100,000 per QALY. However, indication-specific price reductions for the consolidative setting could reduce ICERs to widely acceptable values. Cancer 2017. © 2017 American Cancer Society. Cancer 2017;123:3763-3771. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. Detection Rate of High-Grade Cervical Neoplasia and Cost-Effectiveness of High-Risk Human Papillomavirus Genotyping with Reflex Liquid-based Cytology in Cervical Cancer Screening.

    Science.gov (United States)

    Tay, Sun Kuie; Lin, Lynette Eo; Goh, Ronald Ch

    2017-07-01

    This study aimed to determine the prevalence of cervical intraepithelial neoplasia grade 3 or worse (≥CIN3) and cost-effectiveness of human papillomavirus (HPV) genotyping with reflex liquid-based cytology (LBC) for cervical cancer screening in Singapore. Women who were ≥25 years old and undertook co-testing with LBC and HPV-genotyping (Cobas-4800, Roche, USA) for HPV-16, HPV-18 and 12 high-risk HPV types in a single institution were studied retrospectively. A single cervical smear in ThinPrep® PreservCyt® solution (Hologic, USA) was separated for tests in independent cytology and molecular pathology laboratories. The results were reviewed by a designated gynaecologist according to institutional clinical management protocols. Those who tested positive for HPV-16 and/or HPV-18 (regardless of cytology results), cytology showing low-grade squamous intraepithelial lesions (LSIL) or high-grade SIL (HSIL), or atypical squamous cells of undetermined significance (ASCUS) with positive 12 high-risk HPV types were referred for colposcopy. Colposcopy was performed by experienced colposcopists. Cervical biopsy, either directed punch biopsies or excisional biopsy, was determined by a colposcopist. The diagnosis of ≥CIN3 was reviewed by a gynaecologic pathologist. Cost-effectiveness of HPV-based screening in terms of disease and financial burden was analysed using epidemiological, clinical and financial input data from Singapore. Of 1866 women studied, 167 (8.9%) had abnormal cytology (≥ASCUS) and 171 (9.2%) tested positive for high-risk HPV. Twenty-three CIN were detected. Three of the 10 ≥CIN3 cases had negative cytology but positive HPV-16. Compared to cytology, HPV genotyping detected more ≥CIN3 (OR: 1.43). HPV+16/18 genotyping with reflex LBC was superior in terms of cost-effectiveness to LBC with reflex HPV, both for disease detection rate and cost per case of ≥CIN2 detected. Compared to cytology, HPV+16/18 genotyping with reflex LBC detected more ≥CIN3

  8. Cost-effectiveness analysis of cervical cancer prevention based on a rapid human papillomavirus screening test in a high-risk region of China.

    Science.gov (United States)

    Levin, Carol E; Sellors, John; Shi, Ju-Fang; Ma, Li; Qiao, You-lin; Ortendahl, Jesse; O'Shea, Meredith K H; Goldie, Sue J

    2010-09-01

    This study assessed the cost-effectiveness of a new, rapid human papillomavirus (HPV)-DNA screening test for cervical cancer prevention in the high-risk region of Shanxi, China. Using micro-costing methods, we estimated the resources needed to implement preventive strategies using cervical cytology or HPV-DNA testing, including the Hybrid Capture 2 (hc2) test (QIAGEN Corp., Gaithersburg, MD) and the rapid HPV-DNA careHPV test (QIAGEN). Data were used in a previously published model and empirically calibrated to country-specific epidemiological data. Strategies differed by initial test, targeted age, frequency of screening, number of clinic visits required (1, 2 or 3) and service delivery setting (national, county and township levels). Outcomes included lifetime risk of cancer, years of life saved (YLS), lifetime costs and incremental cost-effectiveness ratios (cost per YLS). For all screening frequencies, the most efficient strategy used 2-visit rapid HPV-DNA testing at the county level, including screening and diagnostics in the first visit, and treatment in the second visit. Screening at ages 35, 40 and 45 reduced cancer risk by 50% among women compliant with all 3 screening rounds, and was US$ 150 per YLS, compared with this same strategy applied twice per lifetime. This would be considered very cost-effective evaluated against China's per-capita gross domestic product (US$ 1,702). By enhancing the linkage between screening and treatment through a reduced number of visits, rapid HPV-DNA testing 3 times per lifetime is more effective than traditional cytology, and is likely to be cost-effective in high-risk regions of China.

  9. The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model

    Science.gov (United States)

    Zomer, Ella; Owen, Alice; Magliano, Dianna J; Liew, Danny

    2012-01-01

    Objective To model the long term effectiveness and cost effectiveness of daily dark chocolate consumption in a population with metabolic syndrome at high risk of cardiovascular disease. Design Best case scenario analysis using a Markov model. Setting Australian Diabetes, Obesity and Lifestyle study. Participants 2013 people with hypertension who met the criteria for metabolic syndrome, with no history of cardiovascular disease and not receiving antihypertensive therapy. Main outcome measures Treatment effects associated with dark chocolate consumption derived from published meta-analyses were used to determine the absolute number of cardiovascular events with and without treatment. Costs associated with cardiovascular events and treatments were applied to determine the potential amount of funding required for dark chocolate therapy to be considered cost effective. Results Daily consumption of dark chocolate (polyphenol content equivalent to 100 g of dark chocolate) can reduce cardiovascular events by 85 (95% confidence interval 60 to 105) per 10 000 population treated over 10 years. $A40 (£25; €31; $42) could be cost effectively spent per person per year on prevention strategies using dark chocolate. These results assume 100% compliance and represent a best case scenario. Conclusions The blood pressure and cholesterol lowering effects of dark chocolate consumption are beneficial in the prevention of cardiovascular events in a population with metabolic syndrome. Daily dark chocolate consumption could be an effective cardiovascular preventive strategy in this population. PMID:22653982

  10. Should HIV testing for all pregnant women continue? Cost-effectiveness of universal antenatal testing compared to focused approaches across high to very low HIV prevalence settings

    Directory of Open Access Journals (Sweden)

    Naoko Ishikawa

    2016-12-01

    Full Text Available Introduction: HIV testing is the entry point for the elimination of mother-to-child transmission of HIV. Decreasing external funding for the HIV response in some low- and middle-income countries has triggered the question of whether a focused approach to HIV testing targeting pregnant women in high-burden areas should be considered. This study aimed at determining and comparing the cost-effectiveness of universal and focused HIV testing approaches for pregnant women across high to very low HIV prevalence settings. Methods: We conducted a modelling analysis on health and cost outcomes of HIV testing for pregnant women using four country-based case scenarios (Namibia, Kenya, Haiti and Viet Nam to illustrate high, intermediate, low and very low HIV prevalence settings. We used subnational prevalence data to divide each country into high-, medium- and low-burden areas, and modelled different antenatal and testing coverage in each. Results: When HIV testing services were only focused in high-burden areas within a country, mother-to-child transmission rates remained high ranging from 18 to 23%, resulting in a 25 to 69% increase in new paediatric HIV infections and increased future treatment costs for children. Universal HIV testing was found to be dominant (i.e. more QALYs gained with less cost compared to focused approaches in the Namibia, Kenya and Haiti scenarios. The universal approach was also very cost-effective compared to focused approaches, with $ 125 per quality-adjusted life years gained in the Viet Nam-based scenario of very low HIV prevalence. Sensitivity analysis further supported the findings. Conclusions: Universal approach to antenatal HIV testing achieves the best health outcomes and is cost-saving or cost-effective in the long term across the range of HIV prevalence settings. It is further a prerequisite for quality maternal and child healthcare and for the elimination of mother-to-child transmission of HIV.

  11. Techno-Economic Feasibility of Highly Efficient Cost-Effective Thermoelectric-SOFC Hybrid Power Generation Systems

    Energy Technology Data Exchange (ETDEWEB)

    Jifeng Zhang; Jean Yamanis

    2007-09-30

    Solid oxide fuel cell (SOFC) systems have the potential to generate exhaust gas streams of high temperature, ranging from 400 to 800 C. These high temperature gas streams can be used for additional power generation with bottoming cycle technologies to achieve higher system power efficiency. One of the potential candidate bottoming cycles is power generation by means of thermoelectric (TE) devices, which have the inherent advantages of low noise, low maintenance and long life. This study was to analyze the feasibility of combining coal gas based SOFC and TE through system performance and cost techno-economic modeling in the context of multi-MW power plants, with 200 kW SOFC-TE module as building blocks. System and component concepts were generated for combining SOFC and TE covering electro-thermo-chemical system integration, power conditioning system (PCS) and component designs. SOFC cost and performance models previously developed at United Technologies Research Center were modified and used in overall system analysis. The TE model was validated and provided by BSST. The optimum system in terms of energy conversion efficiency was found to be a pressurized SOFC-TE, with system efficiency of 65.3% and cost of $390/kW of manufacturing cost. The pressurization ratio was approximately 4 and the assumed ZT of the TE was 2.5. System and component specifications were generated based on the modeling study. The major technology and cost barriers for maturing the system include pressurized SOFC stack using coal gas, the high temperature recycle blowers, and system control design. Finally, a 4-step development roadmap is proposed for future technology development, the first step being a 1 kW proof-of-concept demonstration unit.

  12. High Performance Perovskite Solar Cells.

    Science.gov (United States)

    Tong, Xin; Lin, Feng; Wu, Jiang; Wang, Zhiming M

    2016-05-01

    Perovskite solar cells fabricated from organometal halide light harvesters have captured significant attention due to their tremendously low device costs as well as unprecedented rapid progress on power conversion efficiency (PCE). A certified PCE of 20.1% was achieved in late 2014 following the first study of long-term stable all-solid-state perovskite solar cell with a PCE of 9.7% in 2012, showing their promising potential towards future cost-effective and high performance solar cells. Here, notable achievements of primary device configuration involving perovskite layer, hole-transporting materials (HTMs) and electron-transporting materials (ETMs) are reviewed. Numerous strategies for enhancing photovoltaic parameters of perovskite solar cells, including morphology and crystallization control of perovskite layer, HTMs design and ETMs modifications are discussed in detail. In addition, perovskite solar cells outside of HTMs and ETMs are mentioned as well, providing guidelines for further simplification of device processing and hence cost reduction.

  13. Performance and Cost-Effectiveness of Computed Tomography Lung Cancer Screening Scenarios in a Population-Based Setting: A Microsimulation Modeling Analysis in Ontario, Canada

    NARCIS (Netherlands)

    K. ten Haaf (Kevin); M.C. Tammemagi (Martin); Bondy, S.J. (Susan J.); C.M. van der Aalst (Carlijn); Gu, S. (Sumei); McGregor, S.E. (S. Elizabeth); Nicholas, G. (Garth); H.J. de Koning (Harry); L.F. Paszat (Lawrence F.)

    2017-01-01

    textabstractBackground: The National Lung Screening Trial (NLST) results indicate that computed tomography (CT) lung cancer screening for current and former smokers with three annual screens can be cost-effective in a trial setting. However, the cost-effectiveness in a population-based setting with

  14. High performance microsystem packaging: A perspective

    Energy Technology Data Exchange (ETDEWEB)

    Romig, A.D. Jr.; Dressendorfer, P.V.; Palmer, D.W.

    1997-10-01

    The second silicon revolution will be based on intelligent, integrated microsystems where multiple technologies (such as analog, digital, memory, sensor, micro-electro-mechanical, and communication devices) are integrated onto a single chip or within a multichip module. A necessary element for such systems is cost-effective, high-performance packaging. This paper examines many of the issues associated with the packaging of integrated microsystems, with an emphasis on the areas of packaging design, manufacturability, and reliability.

  15. Cost-effective conservation of an endangered frog under uncertainty.

    Science.gov (United States)

    Rose, Lucy E; Heard, Geoffrey W; Chee, Yung En; Wintle, Brendan A

    2016-04-01

    How should managers choose among conservation options when resources are scarce and there is uncertainty regarding the effectiveness of actions? Well-developed tools exist for prioritizing areas for one-time and binary actions (e.g., protect vs. not protect), but methods for prioritizing incremental or ongoing actions (such as habitat creation and maintenance) remain uncommon. We devised an approach that combines metapopulation viability and cost-effectiveness analyses to select among alternative conservation actions while accounting for uncertainty. In our study, cost-effectiveness is the ratio between the benefit of an action and its economic cost, where benefit is the change in metapopulation viability. We applied the approach to the case of the endangered growling grass frog (Litoria raniformis), which is threatened by urban development. We extended a Bayesian model to predict metapopulation viability under 9 urbanization and management scenarios and incorporated the full probability distribution of possible outcomes for each scenario into the cost-effectiveness analysis. This allowed us to discern between cost-effective alternatives that were robust to uncertainty and those with a relatively high risk of failure. We found a relatively high risk of extinction following urbanization if the only action was reservation of core habitat; habitat creation actions performed better than enhancement actions; and cost-effectiveness ranking changed depending on the consideration of uncertainty. Our results suggest that creation and maintenance of wetlands dedicated to L. raniformis is the only cost-effective action likely to result in a sufficiently low risk of extinction. To our knowledge we are the first study to use Bayesian metapopulation viability analysis to explicitly incorporate parametric and demographic uncertainty into a cost-effective evaluation of conservation actions. The approach offers guidance to decision makers aiming to achieve cost-effective

  16. A cost-effective 100-Gb/s transmitter with low-speed optoelectronic devices and high spectral efficiency

    Institute of Scientific and Technical Information of China (English)

    Junming Gao; Qingjiang Chang; Tao Wang; Yikai Su

    2008-01-01

    A 100-Gb/s high-speed optical transmitter is proposed and experimentally demonstrated. Based on frequency-quadrupling technique, two sub-channels with a fixed 50-GHz spacing are obtained from one laser source. Using return-to-zero differential quadrature phase-shift keying (RZ-DQPSK) modulation format and polarization multiplexing (PolMux), only low-speed electronic devices of 12.5 GHz are needed for the 100-Gb/s transmitter. This eliminates the need of ultrahigh-speed optoelectronic devices and thus greatly reduces the cost. The experimental results show that this transmitter can achieve good performance in dispersion tolerance of a 25-km single mode fiber (SMF).

  17. Rationale and design of the PREDICE project: cost-effectiveness of type 2 diabetes prevention among high-risk Spanish individuals following lifestyle intervention in real-life primary care setting

    Directory of Open Access Journals (Sweden)

    Bolíbar Bonaventura

    2011-08-01

    Full Text Available Abstract Background Type 2 diabetes is an important preventable disease and a growing public health problem. Based on information provided by clinical trials, we know that Type 2 diabetes can be prevented or delayed by lifestyle intervention. In view of translating the findings of diabetes prevention research into real-life it is necessary to carry out community-based evaluations so as to learn about the feasibility and effectiveness of locally designed and implemented programmes. The aim of this project was to assess the effectiveness of an active real-life primary care strategy in high-risk individuals for developing diabetes, and then evaluate its efficiency. Methods/Design Cost-Effectiveness analysis of the DE-PLAN (Diabetes in Europe - Prevention using Lifestyle, physical Activity and Nutritional intervention project when applied to a Mediterranean population in Catalonia (DE-PLAN-CAT. Multicenter, longitudinal cohort assessment (4 years conducted in 18 primary health-care centres (Catalan Health Institute. Individuals without diabetes aged 45-75 years were screened using the Finnish Diabetes Risk Score - FINDRISC - questionnaire and a 2-h oral glucose tolerance test. All high risk tested individuals were invited to participate in either a usual care intervention (information on diet and cardiovascular health without individualized programme, or the intensive DE-PLAN educational program (individualized or group periodically reinforced. Oral glucose tolerance test was repeated yearly to determine diabetes incidence. Besides measuring the accumulated incidence of diabetes, information was collected on economic impact of the interventions in both cohorts (using direct and indirect cost questionnaires and information on utility measures (Quality Adjusted Life Years. A cost-utility and a cost-effectiveness analysis will be performed and data will be modelled to predict long-term cost-effectiveness. Discussion The project was intended to evidence

  18. Cost-effective and highly sensitive cholesterol microsensors with fast response based on the enzyme-induced conductivity change of polyaniline

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Kuan-Chung; Chu, Chia-Ho; Hsu, Chen-Pin; Kang, Yen-Wen; Fang, Jung-Ying; Chen, Chih-Chen; Li, Sheng-Shian; Andrew Yeh, J.; Yao, Da-Jeng; Wang, Yu-Lin, E-mail: ylwang@mx.nthu.edu.tw [Institute of Nanoengineering and Microsystems, National Tsing Hua University, Hsinchu 300, Taiwan (China); Hsu, Chia-Hsien [Division of Medical Engineering, National Health Research Institutes, MiaoLi, Taiwan (China); Huang, Yu-Fen [Department of Biomedical Engineering and Environmental Science, National Tsing Hua University, Hsinchu 300, Taiwan (China)

    2014-09-15

    In this study, a cost-effective and highly sensitive cholesterol microsensor, which is consisted of cholesterol oxidase (ChOx), horseradish peroxidase (HRP), and polyaniline (PANI), was developed based on the enzyme-induced conductivity change of PANI with fast response. Hydrogen peroxide is produced via the reaction between cholesterol and ChOx, which was immobilized in a dialysis membrane. The produced hydrogen peroxide can oxidize HRP, which can be reduced by oxidizing PANI, thus resulting in decreased conductivity of the polyaniline thin film. The reduced HRP can be oxidized again by hydrogen peroxide and the cycle of the oxidation/reduction continues until all hydrogen peroxide are reacted, leading to the high sensitivity of the sensor due to the signal contributed from all hydrogen peroxide molecules. Cholesterol was detected near the physiological concentrations ranging from 100 mg/dl to 400 mg/dl with the cholesterol microsensors. The results show linear relation between cholesterol concentration and the conductivity change of the PANI. The microsensor showed no response to cholesterol when the PANI was standalone without cholesterol oxidase immobilized, indicating that the enzymatic reaction is required for cholesterol detection. The simple process of the sensor fabrication allows the sensor to be cost-effective and disposable usage. This electronic cholesterol microsensor is promising for point-of-care health monitoring in cholesterol level with low cost and fast response.

  19. Cost-Effective Stress Management Training.

    Science.gov (United States)

    Shea, Gordon F.

    1980-01-01

    Stress management training can be a cost effective way to improve productivity and job performance. Among many relaxation techniques, the most effective in terms of teachability, participant motivation, and profitability are self-hypnosis, progressive relaxation, and transcendental meditation. (SK)

  20. Bayesian cost-effectiveness analysis with the R package BCEA

    CERN Document Server

    Baio, Gianluca; Heath, Anna

    2017-01-01

    The book provides a description of the process of health economic evaluation and modelling for cost-effectiveness analysis, particularly from the perspective of a Bayesian statistical approach. Some relevant theory and introductory concepts are presented using practical examples and two running case studies. The book also describes in detail how to perform health economic evaluations using the R package BCEA (Bayesian Cost-Effectiveness Analysis). BCEA can be used to post-process the results of a Bayesian cost-effectiveness model and perform advanced analyses producing standardised and highly customisable outputs. It presents all the features of the package, including its many functions and their practical application, as well as its user-friendly web interface. The book is a valuable resource for statisticians and practitioners working in the field of health economics wanting to simplify and standardise their workflow, for example in the preparation of dossiers in support of marketing authorisation, or acade...

  1. 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-effectiveness

  2. High-sensitivity and cost-effective system for infrared imaging of concealed objects in dynamic mode

    Science.gov (United States)

    Gordiyenko, E.; Yefremenko, V.; Pearson, J.; Bader, S. D.; Novosad, V.

    2005-05-01

    Novel, cost-efficient, and highly-sensitive IR imaging systems play an important role in homeland security functions. Technical limitations in the areas of sensitivity, contrast ratio, bandwidth and cost continue to constrain imaging capabilities. We have designed and prototyped a compact computer-piloted high sensitivity infrared imaging system. The device consists of infrared optics, cryostat, low-noise pre-amplifier, Analog-to-Digital hardware, feedback electronics, and unique image processing software. Important advantages of the developed system are: (i) Eight electronic channels are available for simultaneous registration of IR and visible images in multiple spectral ranges, (ii) Capability of real-time analysis such as comparing the "sensed" image with "reference" images from a database, (iii) High accuracy temperature measurement of multiple points on the image by referencing the radiation intensity from the object to a black body model, (iv) Image generation by real-time integration of images from multiple sensors operating from the visible to the terahertz range. The device was tested with a liquid-nitrogen-cooled, single-pixel HgCdTe detector for imaging in 8-12 microns range. The demonstrated examples of infrared imaging of concealed objects in static and dynamic modes include a hammer (metal head and wooden handle), plastic imitator of handguns hidden under clothes, powder in an envelope, and revealing complex wall structures under decorative plaster.

  3. In situ high temperature XRD studies of ZnO nanopowder prepared via cost effective ultrasonic mist chemical vapour deposition

    Indian Academy of Sciences (India)

    Preetam Singh; Ashvani Kumar; Ajay Kaushal; Davinder Kaur; Ashish Pandey; R N Goyal

    2008-06-01

    Ultrasonic mist chemical vapour deposition (UM–CVD) system has been developed to prepare ZnO nanopowder. This is a promising method for large area deposition at low temperature inspite of being simple, inexpensive and safe. The particle size, lattice parameters and crystal structure of ZnO nanopowder are characterized by in situ high temperature X-ray diffraction (XRD). Surface morphology of powder was studied using transmission electron microscopy (TEM) and field emission electron microscope (FESEM). The optical properties are observed using UV-visible spectrophotometer. The influence of high temperature vacuum annealing on XRD pattern is systematically studied. Results of high temperature XRD showed prominent 100, 002 and 101 reflections among which 101 is of highest intensity. With increase in temperature, a systematic shift in peak positions towards lower 2 values has been observed, which may be due to change in lattice parameters. Temperature dependence of lattice constants under vacuum shows linear increase in their values. Diffraction patterns obtained from TEM are also in agreement with the XRD data. The synthesized powder exhibited the estimated direct bandgap (g) of 3.43 eV. The optical bandgap calculated from Tauc’s relation and the bandgap calculated from the particle size inferred from XRD were in agreement with each other.

  4. A colorimetric bioassay for high-throughput and cost-effectively assessing anti-foot-and-mouth disease virus activity.

    Science.gov (United States)

    Ramanathan, Palaniappan; Zhu, James J; Bishop, Elizabeth A; Puckette, Michael C; Hartwig, Ethan; Grubman, Marvin J; Rodriguez, Luis L

    2015-03-15

    Foot-and-mouth disease virus (FMDV) is one of the most contagious animal viruses. This virus is very sensitive to inhibition by type I interferons. Currently, a bioassay based on plaque reduction is used to measure anti-FMDV activity of porcine IFNs. The plaque reduction assay is tedious and difficult to utilize for high-throughput analysis. Using available FMDV susceptible bovine and porcine cells, we developed and tested a colorimetric assay based on cytopathic effect reduction for its ability to quantify FMDV-specific antiviral activity of bovine and porcine type I interferons. Our results show that this new method has significant advantages over other assays in terms of labor intensity, cost, high-throughput capability and/or anti-FMDV specific activity because of simpler procedures and direct measurement of antiviral activity. Several assay conditions were tested to optimize the procedures. The test results show that the assay can be standardized with fixed conditions and a standard or a reference for measuring antiviral activity as units. This is an excellent assay in terms of sensitivity and accuracy based on a statistical evaluation. The results obtained with this assay were highly correlated with a conventional virus titration method.

  5. Cost-effectiveness and value of information analysis of nutritional support for preventing pressure ulcers in high-risk patients: implement now, research later.

    Science.gov (United States)

    Tuffaha, Haitham W; Roberts, Shelley; Chaboyer, Wendy; Gordon, Louisa G; Scuffham, Paul A

    2015-04-01

    Pressure ulcers are a major cause of mortality, morbidity, and increased healthcare cost. Nutritional support may reduce the incidence of pressure ulcers in hospitalised patients who are at risk of pressure ulcer and malnutrition. To evaluate the cost-effectiveness of nutritional support in preventing pressure ulcers in high-risk hospitalised patients, and to assess the value of further research to inform the decision to implement this intervention using value of information analysis (VOI). The analysis was from the perspective of Queensland Health, Australia using a decision model with evidence derived from a systematic review and meta-analysis. Resources were valued using 2014 prices and the time horizon of the analysis was one year. Monte Carlo simulation was used to estimate net monetary benefits (NB) and to calculate VOI measures. Compared with standard hospital diet, nutritional support was cost saving at AU$425 per patient, and more effective with an average 0.005 quality-adjusted life years (QALY) gained. At a willingness-to-pay of AU$50,000 per QALY, the incremental NB was AU$675 per patient, with a probability of 87 % that nutritional support is cost-effective. The expected value of perfect information was AU$5 million and the expected value of perfect parameter information was highest for the relative risk of developing a pressure ulcer at AU$2.5 million. For a future trial investigating the relative effectiveness of the interventions, the expected net benefit of research would be maximised at AU$100,000 with 1,200 patients in each arm if nutritional support was perfectly implemented. The opportunity cost of withholding the decision to implement the intervention until the results of the future study are available would be AU$14 million. Nutritional support is cost-effective in preventing pressure ulcers in high-risk hospitalised patients compared with standard diet. Future research to reduce decision uncertainty is worthwhile; however, given the

  6. Octave-spanning supercontinuum generation in highly nonlinear silica fibres based on cost-effective fibre amplifiers

    Science.gov (United States)

    Saldaña-Díaz, J. E.; Jarabo, S.; Salgado-Remacha, F. J.

    2016-09-01

    We report a simple method for supercontinuum generation. The set-up consists of an Er-doped mode-locked fibre laser, used as seed, and a highly nonlinear fibre with zero dispersion at 1550 nm. Thus, all the components are easily attainable. With this novel system the requirements in terms of control of dispersion are reduced. In addition, the spectral width is optimized using fibres with positive and negative dispersion. The supercontinuum emission is characterized by means of an optical spectrum analyser and a PbS photodetector, showing an octave-spanning spectral width, with a flat profile from 1100 nm up to 2100 nm. Compared to other supercontinuum sources, this new proposal results in a very competitive and attainable system, particularly in the 1500-2100 nm region.

  7. Cost-effective reduced graphene oxide-coated polyurethane sponge as a highly efficient and reusable oil-absorbent.

    Science.gov (United States)

    Liu, Yue; Ma, Junkui; Wu, Tao; Wang, Xingrui; Huang, Guanbo; Liu, Yu; Qiu, Haixia; Li, Yi; Wang, Wei; Gao, Jianping

    2013-10-23

    Reduced graphene oxide coated polyurethane (rGPU) sponges were fabricated by a facile method. The structure and properties of these rGPU sponges were characterized by Fourier transform infrared spectroscopy, thermal gravimetric analysis, X-ray diffraction, and scanning electron microscopy. The rGPU sponges are hydrophobic and oleophilic and show extremely high absorption for organic liquids. For all the organic liquids tested, the absorption capacities were higher than 80 g g(-1) and 160 g g(-1) (the highest value) was achieved for chloroform. In addition, the absorption capacity of the rGPU sponge did not deteriorate after it was reused 50 times, so the rGPU sponge has excellent recyclability.

  8. Randomized controlled analysis-autogenous bone peg graft improved offset hemiarthroplasty in high risk patients: a novel cost effective technique

    Directory of Open Access Journals (Sweden)

    Hashmukh Shantilal Varma

    2016-06-01

    Results: In patients with novel technique value of X was 1 mm+/-0.8 SD, whereas value of X in conventional technique the value of X was significantly higher of about 7.2 mm+/-1.6 SD and this was associated with increased femoral off set 47.2+/-2.0 SD and the correlation was found to be statistically significant (p<0.05. Furthermore, in group B where graft was not used subsidence was found in 6 patients (24%. None was revised during the period of follow up. Conclusions: Our preliminary results indicate that the approach proposed is feasible and effective in the management of intracapsular fracture neck femur in high risk patients with unipolar prosthesis. [Int J Res Med Sci 2016; 4(6.000: 1897-1902

  9. Neurogaming Technology Meets Neuroscience Education: A Cost-Effective, Scalable, and Highly Portable Undergraduate Teaching Laboratory for Neuroscience.

    Science.gov (United States)

    de Wit, Bianca; Badcock, Nicholas A; Grootswagers, Tijl; Hardwick, Katherine; Teichmann, Lina; Wehrman, Jordan; Williams, Mark; Kaplan, David Michael

    2017-01-01

    Active research-driven approaches that successfully incorporate new technology are known to catalyze student learning. Yet achieving these objectives in neuroscience education is especially challenging due to the prohibitive costs and technical demands of research-grade equipment. Here we describe a method that circumvents these factors by leveraging consumer EEG-based neurogaming technology to create an affordable, scalable, and highly portable teaching laboratory for undergraduate courses in neuroscience. This laboratory is designed to give students hands-on research experience, consolidate their understanding of key neuroscience concepts, and provide a unique real-time window into the working brain. Survey results demonstrate that students found the lab sessions engaging. Students also reported the labs enhanced their knowledge about EEG, their course material, and neuroscience research in general.

  10. Cost-effective screening methods for various single gene defects in single cells using high magnesium and total ionic strength and restriction enzymes.

    Science.gov (United States)

    Tsai, Y H

    2000-12-01

    A reliable cost-effective protocol for the diagnosis of various defective genes in single blastomeres from preimplantation embryos has been established. Single cells were lysed in alkali buffer followed by neutralization and addition of a solution containing a high concentration of sulfhydryl reducing agents and MgCl(2) in relatively high ionic strength (0.45) (solution M) with or without restriction enzyme(s). The reaction mixture was incubated at 37 degrees C for 15 min followed by heat denaturation at 95 degrees C for 10 min. Respective polymerase chain reaction (PCR) mixture was then added to amplify each designated DNA region. The treatment of neutralized single cell lysate with adequate restriction enzyme(s) which do not cleave the target DNA sequences but shortens the genomic template DNA strands. This may facilitate primer-template annealing. The subsequent heat denaturation of the cell lysate in solution M indeed gave better signals of amplified DNA fragments on polyacrylamide gels. Defects in Tay Sachs exons 11 and 12, CF-DeltaF508 and CF-N1303K, and genomic sequences of ZFX/ZFY were successfully detected on gels after one-step PCR amplification, especially those cell lysates treated with restriction enzymes. In conclusion, a cost-effective one-step PCR method for amplifying various specific genomic regions containing a single gene defect in single cells has been established. This protocol may be applied to genetic screening for many single defective genes of biopsied single blastomeres from preimplantation in vitro fertilization (IVF) embryos.

  11. Next-generation phage display: integrating and comparing available molecular tools to enable cost-effective high-throughput analysis.

    Directory of Open Access Journals (Sweden)

    Emmanuel Dias-Neto

    Full Text Available BACKGROUND: Combinatorial phage display has been used in the last 20 years in the identification of protein-ligands and protein-protein interactions, uncovering relevant molecular recognition events. Rate-limiting steps of combinatorial phage display library selection are (i the counting of transducing units and (ii the sequencing of the encoded displayed ligands. Here, we adapted emerging genomic technologies to minimize such challenges. METHODOLOGY/PRINCIPAL FINDINGS: We gained efficiency by applying in tandem real-time PCR for rapid quantification to enable bacteria-free phage display library screening, and added phage DNA next-generation sequencing for large-scale ligand analysis, reporting a fully integrated set of high-throughput quantitative and analytical tools. The approach is far less labor-intensive and allows rigorous quantification; for medical applications, including selections in patients, it also represents an advance for quantitative distribution analysis and ligand identification of hundreds of thousands of targeted particles from patient-derived biopsy or autopsy in a longer timeframe post library administration. Additional advantages over current methods include increased sensitivity, less variability, enhanced linearity, scalability, and accuracy at much lower cost. Sequences obtained by qPhage plus pyrosequencing were similar to a dataset produced from conventional Sanger-sequenced transducing-units (TU, with no biases due to GC content, codon usage, and amino acid or peptide frequency. These tools allow phage display selection and ligand analysis at >1,000-fold faster rate, and reduce costs approximately 250-fold for generating 10(6 ligand sequences. CONCLUSIONS/SIGNIFICANCE: Our analyses demonstrates that whereas this approach correlates with the traditional colony-counting, it is also capable of a much larger sampling, allowing a faster, less expensive, more accurate and consistent analysis of phage enrichment. Overall

  12. Performance and Cost-Effectiveness of Computed Tomography Lung Cancer Screening Scenarios in a Population-Based Setting: A Microsimulation Modeling Analysis in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Kevin Ten Haaf

    2017-02-01

    Full Text Available The National Lung Screening Trial (NLST results indicate that computed tomography (CT lung cancer screening for current and former smokers with three annual screens can be cost-effective in a trial setting. However, the cost-effectiveness in a population-based setting with >3 screening rounds is uncertain. Therefore, the objective of this study was to estimate the cost-effectiveness of lung cancer screening in a population-based setting in Ontario, Canada, and evaluate the effects of screening eligibility criteria.This study used microsimulation modeling informed by various data sources, including the Ontario Health Insurance Plan (OHIP, Ontario Cancer Registry, smoking behavior surveys, and the NLST. Persons, born between 1940 and 1969, were examined from a third-party health care payer perspective across a lifetime horizon. Starting in 2015, 576 CT screening scenarios were examined, varying by age to start and end screening, smoking eligibility criteria, and screening interval. Among the examined outcome measures were lung cancer deaths averted, life-years gained, percentage ever screened, costs (in 2015 Canadian dollars, and overdiagnosis. The results of the base-case analysis indicated that annual screening was more cost-effective than biennial screening. Scenarios with eligibility criteria that required as few as 20 pack-years were dominated by scenarios that required higher numbers of accumulated pack-years. In general, scenarios that applied stringent smoking eligibility criteria (i.e., requiring higher levels of accumulated smoking exposure were more cost-effective than scenarios with less stringent smoking eligibility criteria, with modest differences in life-years gained. Annual screening between ages 55-75 for persons who smoked ≥40 pack-years and who currently smoke or quit ≤10 y ago yielded an incremental cost-effectiveness ratio of $41,136 Canadian dollars ($33,825 in May 1, 2015, United States dollars per life-year gained

  13. Cost effective solar Inverter

    Directory of Open Access Journals (Sweden)

    Nagarathna M

    2015-06-01

    Full Text Available Solar energy the most efficient, eco-friendly and abundantly available energy source in the nature. It can be converted into electrical energy in cost effective manner. In recent years, the interest in solar energy has risen due to surging oil prices and environmental concern. In many remote or underdeveloped areas, direct access to an electric grid is impossible and a photovoltaic inverter system would make life much simpler and more convenient. With this in mind, it is aimed to design, build, and test a solar panel inverter. This inverter system could be used as backup power during outages, battery charging, or for typical household applications. The main components of this solar system are solar cell, dc to dc boost converters, and inverter. Sine wave push pull inverter topology is used for inverter. In this topology only two MOSFETs are used and isolation requirement between control circuit and power circuit is also less which helps to decrease the cost of solar inverter.

  14. Cost-effectiveness of pre-exposure prophylaxis targeted to high-risk serodiscordant couples as a bridge to sustained ART use in Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Roger Ying

    2015-07-01

    Full Text Available Introduction: Despite scale-up of antiretroviral therapy (ART for treating HIV-positive persons, HIV incidence remains elevated among those at high risk such as persons in serodiscordant partnerships. Antiretrovirals taken by HIV-negative persons as pre-exposure prophylaxis (PrEP has the potential to avert infections in individuals in serodiscordant partnerships. Evaluating the cost-effectiveness of implementing time-limited PrEP as a short-term bridge during the first six months of ART for the HIV-positive partner to prevent HIV transmission compared to increasing ART coverage is crucial to informing policy-makers considering PrEP implementation. Methods: To estimate the real world delivery costs of PrEP, we conducted micro-costing and time and motion analyses in an open-label prospective study of PrEP and ART delivery targeted to high-risk serodiscordant couples in Uganda (the Partners Demonstration Project. The cost (in USD, in 2012 of PrEP and ART for serodiscordant couples was assessed, with and without research components, in the study setting. Using Ministry of Health costs, the cost of PrEP and ART provision within a government programme was estimated, as was the cost of providing PrEP in addition to ART. We parameterized an HIV transmission model to estimate the health and economic impacts of 1 PrEP and ART targeted to high-risk serodiscordant couples in the context of current ART use and 2 increasing ART coverage to 55% of HIV-positive persons with CD4 ≤500 cells/µL without PrEP. The incremental cost-effectiveness ratios (ICERs per HIV infection and disability-adjusted life year (DALY averted were calculated over 10 years. Results: The annual cost of PrEP and ART delivery for serodiscordant couples was $1058 per couple in the study setting and $453 in the government setting. The portion of the programme cost due to PrEP was $408 and $92 per couple per year in the study and government settings, respectively. Over 10 years, a

  15. Cost-effectiveness of heptavalent conjugate pneumococcal vaccine (Prevenar) in Germany: considering a high-risk population and herd immunity effects.

    Science.gov (United States)

    Lloyd, Adam; Patel, Nishma; Scott, David A; Runge, Claus; Claes, Christa; Rose, Markus

    2008-02-01

    In Germany, the seven-valent conjugate vaccine Prevenar is recommended for use in children at high risk of pneumococcal disease. Recent data suggest that giving conjugate vaccine to all children may lead to a decline in pneumococcal disease in unvaccinated adults, a phenomenon known as herd immunity. This analysis evaluated the cost and economic consequences in Germany of vaccinating (1) children at high risk, (2) all children when considering only benefits for vaccinated individuals and (3) all children when also considering herd immunity benefits. Costs in the model included vaccination, management of meningitis, bacteraemia, pneumonia and acute otitis media, insurance payments to parents and the costs of care for long-term disabilities. The model estimated that the cost-effectiveness of vaccination would be 38,222 euros per life year gained in children at high risk and 100,636 euros per life year gained in all children when not considering herd immunity. When considering herd immunity effects, the model estimated that offering vaccination for all children would reduce adult deaths by 3,027 per year, and vaccination would be broadly cost neutral. The findings are sensitive to the effect of conjugate vaccine on the rates of pneumonia and invasive disease in the elderly. If the herd immunity effect of conjugate vaccination in Germany is similar to that observed elsewhere, offering vaccine to all children will be more attractive than the current policy of restricting vaccination to children at high risk of pneumococcal disease.

  16. High Performance Marine Vessels

    CERN Document Server

    Yun, Liang

    2012-01-01

    High Performance Marine Vessels (HPMVs) range from the Fast Ferries to the latest high speed Navy Craft, including competition power boats and hydroplanes, hydrofoils, hovercraft, catamarans and other multi-hull craft. High Performance Marine Vessels covers the main concepts of HPMVs and discusses historical background, design features, services that have been successful and not so successful, and some sample data of the range of HPMVs to date. Included is a comparison of all HPMVs craft and the differences between them and descriptions of performance (hydrodynamics and aerodynamics). Readers will find a comprehensive overview of the design, development and building of HPMVs. In summary, this book: Focuses on technology at the aero-marine interface Covers the full range of high performance marine vessel concepts Explains the historical development of various HPMVs Discusses ferries, racing and pleasure craft, as well as utility and military missions High Performance Marine Vessels is an ideal book for student...

  17. High Efficiency, High Performance Clothes Dryer

    Energy Technology Data Exchange (ETDEWEB)

    Peter Pescatore; Phil Carbone

    2005-03-31

    gas dryer, significant time and energy savings, combined with dramatically reduced fabric temperatures, was achieved in a cost-effective manner. The key design factor lay in developing a system that matches the heat input to the dryer with the fabrics ability to absorb it. The development work done on the modulating gas dryer over the course of this program led to a demonstration dryer that delivered the following performance characteristics: (1) Up to 25% reduction in energy consumption for small and medium loads; (2) Up to 35% time savings for large loads with 10-15% energy reduction and no adverse effect on cloth temperatures; (3) Reduced fabric temperatures, dry times and 18% energy reduction for delicate loads; and, (4) Robust performance across a range of vent restrictions.

  18. High Efficiency, High Performance Clothes Dryer

    Energy Technology Data Exchange (ETDEWEB)

    Peter Pescatore; Phil Carbone

    2005-03-31

    gas dryer, significant time and energy savings, combined with dramatically reduced fabric temperatures, was achieved in a cost-effective manner. The key design factor lay in developing a system that matches the heat input to the dryer with the fabrics ability to absorb it. The development work done on the modulating gas dryer over the course of this program led to a demonstration dryer that delivered the following performance characteristics: (1) Up to 25% reduction in energy consumption for small and medium loads; (2) Up to 35% time savings for large loads with 10-15% energy reduction and no adverse effect on cloth temperatures; (3) Reduced fabric temperatures, dry times and 18% energy reduction for delicate loads; and, (4) Robust performance across a range of vent restrictions.

  19. A cost-effective high-throughput metabarcoding approach powerful enough to genotype ~44 000 year-old rodent remains from Northern Africa.

    Science.gov (United States)

    Guimaraes, S; Pruvost, M; Daligault, J; Stoetzel, E; Bennett, E A; Côté, N M-L; Nicolas, V; Lalis, A; Denys, C; Geigl, E-M; Grange, T

    2016-07-04

    We present a cost-effective metabarcoding approach, aMPlex Torrent, which relies on an improved multiplex PCR adapted to highly degraded DNA, combining barcoding and next-generation sequencing to simultaneously analyse many heterogeneous samples. We demonstrate the strength of these improvements by generating a phylochronology through the genotyping of ancient rodent remains from a Moroccan cave whose stratigraphy covers the last 120 000 years. Rodents are important for epidemiology, agronomy and ecological investigations and can act as bioindicators for human- and/or climate-induced environmental changes. Efficient and reliable genotyping of ancient rodent remains has the potential to deliver valuable phylogenetic and paleoecological information. The analysis of multiple ancient skeletal remains of very small size with poor DNA preservation, however, requires a sensitive high-throughput method to generate sufficient data. We show this approach to be particularly adapted at accessing this otherwise difficult taxonomic and genetic resource. As a highly scalable, lower cost and less labour-intensive alternative to targeted sequence capture approaches, we propose the aMPlex Torrent strategy to be a useful tool for the genetic analysis of multiple degraded samples in studies involving ecology, archaeology, conservation and evolutionary biology.

  20. High performance systems

    Energy Technology Data Exchange (ETDEWEB)

    Vigil, M.B. [comp.

    1995-03-01

    This document provides a written compilation of the presentations and viewgraphs from the 1994 Conference on High Speed Computing given at the High Speed Computing Conference, {open_quotes}High Performance Systems,{close_quotes} held at Gleneden Beach, Oregon, on April 18 through 21, 1994.

  1. The cost-effectiveness of removing television advertising of high-fat and/or high-sugar food and beverages to Australian children.

    Science.gov (United States)

    Magnus, A; Haby, M M; Carter, R; Swinburn, B

    2009-10-01

    To model the health benefits and cost-effectiveness of banning television (TV) advertisements in Australia for energy-dense, nutrient-poor food and beverages during children's peak viewing times. Benefits were modelled as changes in body mass index (BMI) and disability-adjusted life years (DALYs) saved. Intervention costs (AUD$) were compared with future health-care cost offsets from reduced prevalence of obesity-related health conditions. Changes in BMI were assumed to be maintained through to adulthood. The comparator was current practice, the reference year was 2001, and the discount rate for costs and benefits was 3%. The impact of the withdrawal of non-core food and beverage advertisements on children's actual food consumption was drawn from the best available evidence (a randomized controlled trial of advertisement exposure and food consumption). Supporting evidence was found in ecological relationships between TV advertising and childhood obesity, and from the effects of marketing bans on other products. A Working Group of stakeholders provided input into decisions surrounding the modelling assumptions and second-stage filters of 'strength of evidence', 'equity', 'acceptability to stakeholders', 'feasibility of implementation', 'sustainability' and 'side-effects'. The intervention had a gross incremental cost-effectiveness ratio of AUD$ 3.70 (95% uncertainty interval (UI) $2.40, $7.70) per DALY. Total DALYs saved were 37 000 (95% UI 16,000, 59,000). When the present value of potential savings in future health-care costs was considered (AUD$ 300m (95% UI $130m, $480m), the intervention was 'dominant', because it resulted in both a health gain and a cost offset compared with current practice. Although recognizing the limitations of the available evidence, restricting TV food advertising to children would be one of the most cost-effective population-based interventions available to governments today. Despite its economic credentials from a public health

  2. Effectiveness and cost effectiveness of screening immigrants schemes for tuberculosis (TB) on arrival from high TB endemic countries to low TB prevalent countries.

    Science.gov (United States)

    Sanneh, A F N S; Al-Shareef, A M

    2014-09-01

    Immigrants to developed countries are a major source of TB. Therefore amongst strategies adopted for TB control in developed countries include; 1) Screening immigrants at ports of entry referred to as "Port of Arrival Screening" (PoA) and 2) Passive screening (PS) for TB which means screening immigrants through general practices, hospitals, chest-clinics and emergency departments. Evidence of the effectiveness and cost effectiveness of these strategies is not consistent. Evaluate efficiency of active PoA TB screening for immigrants from TB endemic-regions compared with Passive Screening of immigrant-populations from TB endemic-regions. Major electronic-databases and reference lists of relevant studies were searched. Experts of immigrants' TB screening were contacted for additional studies published or unpublished. Systematic search of major databases identified only retrospective cohort-studies. Their qualities were assessed using Scottish Intercollegiate Guidelines Network (SIGN) methodological checklist for comparative cohort-studies. Systematic electronic searches identified 1443 citations. Of these 74 studies were retrieved for evaluation against the review's inclusion/exclusion criteria (see study inclusion/exclusion criteria). Four studies met the inclusion criteria (figure 2) which were low in the evidence hierarchy of primary effectiveness studies and had heterogeneities between them. Thus descriptive data-synthesis was performed. Proportionately PoA screening had the lowest percentage of receipt of tuberculin skin test (TST) and the highest percentage of non-attendance for TST reading (table 2). Active PoA screening reduced infectiousness by 34% compared to 30% by passive screening and new entrants screened at PoA were 80% less likely to be hospitalised Odds ratio (OR) = 0.2 (95% confidence interval (CI) 0.1 - 0.2). [Table: see text]. One cost effectiveness analysis was found that compared the costs of; active PoA screening, general practice screening and

  3. Using stool antigen to screen for Helicobacter pylori in immigrants and refugees from high prevalence countries is relatively cost effective in reducing the burden of gastric cancer and peptic ulceration.

    Directory of Open Access Journals (Sweden)

    Thomas R Schulz

    Full Text Available OBJECTIVES: Refugees and immigrants from developing countries settling in industrialised countries have a high prevalence of Helicobacter pylori (H. pylori. Screening these groups for H. pylori and use of eradication therapy to reduce the future burden of gastric cancer and peptic ulcer disease is not currently recommended in most countries. We investigated whether a screening and eradication approach would be cost effective in high prevalence populations. METHODS: Nine different screening and follow-up strategies for asymptomatic immigrants from high H. pylori prevalence areas were compared with the current approach of no screening. Cost effectiveness comparisons assumed population prevalence's of H. pylori of 25%, 50% or 75%. The main outcome measure was the net cost for each cancer prevented for each strategy. Total costs of each strategy and net costs including savings from reductions in ulcers and gastric cancer were also calculated. RESULTS: Stool antigen testing with repeat testing after treatment was the most cost effective approach relative to others, for each prevalence value. The net cost per cancer prevented with this strategy was US$111,800 (assuming 75% prevalence, $132,300 (50% and $193,900 (25%. A test and treat strategy using stool antigen remained relatively cost effective, even when the prevalence was 25%. CONCLUSIONS: H. pylori screening and eradication can be an effective strategy for reducing rates of gastric cancer and peptic ulcers in high prevalence populations and our data suggest that use of stool antigen testing is the most cost effective approach.

  4. Responsive design high performance

    CERN Document Server

    Els, Dewald

    2015-01-01

    This book is ideal for developers who have experience in developing websites or possess minor knowledge of how responsive websites work. No experience of high-level website development or performance tweaking is required.

  5. Prevention--a cost-effective way to fight the non-communicable disease epidemic: an academic perspective of the United Nations High-level NCD Meeting.

    Science.gov (United States)

    Probst-Hensch, Nicole; Tanner, Marcel; Kessler, Claudia; Burri, Christian; Künzli, Nino

    2011-09-07

    The United Nations General Assembly has convened a Summit on non-communicable diseases (NCDs), an historic moment in the global combat of these disorders. Lifestyles in increasingly urban and globalised environments have led to a steep surge in NCD incidence in low and middle income countries, where two thirds of all NCD deaths occur (most importantly from cancer, cardiovascular and respiratory disease as well as diabetes). Treatment of NCDs is usually long term and expensive, thus threatening patients' and nations' budgets and putting them at high risk for poverty. The NCD Summit offers an opportunity for strengthening and shaping primary prevention, the most cost-effective instrument to fight major risk factors such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy diet. From a Swiss perspective, we also emphasised the efforts for new laws on prevention and diagnosis registration, in accordance with the recommendations of the NCD summit in order to strengthen primary prevention and disease monitoring. In addition, the need for structural prevention across all policy sectors with leadership in environmental policy making to prevent NCDs as well as the need to adapt and strengthen primary health care are equally relevant for Switzerland. To compliment efforts in primary prevention, the field of NCDs requires special R&D platforms for affordable NCD drugs and diagnostics for neglected population segments in both Switzerland and low and middle income countries. Switzerland has a track record in research and development against diseases of poverty on a global scale that now needs to be applied to NCDs.

  6. Clojure high performance programming

    CERN Document Server

    Kumar, Shantanu

    2013-01-01

    This is a short, practical guide that will teach you everything you need to know to start writing high performance Clojure code.This book is ideal for intermediate Clojure developers who are looking to get a good grip on how to achieve optimum performance. You should already have some experience with Clojure and it would help if you already know a little bit of Java. Knowledge of performance analysis and engineering is not required. For hands-on practice, you should have access to Clojure REPL with Leiningen.

  7. High Performance Concrete

    OpenAIRE

    Traian Oneţ

    2009-01-01

    The paper presents the last studies and researches accomplished in Cluj-Napoca related to high performance concrete, high strength concrete and self compacting concrete. The purpose of this paper is to raid upon the advantages and inconveniences when a particular concrete type is used. Two concrete recipes are presented, namely for the concrete used in rigid pavement for roads and another one for self-compacting concrete.

  8. High Performance Concrete

    Directory of Open Access Journals (Sweden)

    Traian Oneţ

    2009-01-01

    Full Text Available The paper presents the last studies and researches accomplished in Cluj-Napoca related to high performance concrete, high strength concrete and self compacting concrete. The purpose of this paper is to raid upon the advantages and inconveniences when a particular concrete type is used. Two concrete recipes are presented, namely for the concrete used in rigid pavement for roads and another one for self-compacting concrete.

  9. Cost-effectiveness in reproductive medicine

    NARCIS (Netherlands)

    L.M. Moolenaar

    2013-01-01

    This thesis reports on cost-effectiveness in reproductive medicine. Firstly, we evaluated the methodologic quality of studies in reproductive medicine. Insight into the quality of economical analysis in reproductive medicine is important for valuing the performed studies and to assess whether these

  10. Cost-effectiveness of integrated collaborative care for comorbid major depression in patients with cancer☆

    Science.gov (United States)

    Duarte, A.; Walker, J.; Walker, S.; Richardson, G.; Holm Hansen, C.; Martin, P.; Murray, G.; Sculpher, M.; Sharpe, M.

    2015-01-01

    Objectives Comorbid major depression is associated with reduced quality of life and greater use of healthcare resources. A recent randomised trial (SMaRT, Symptom Management Research Trials, Oncology-2) found that a collaborative care treatment programme (Depression Care for People with Cancer, DCPC) was highly effective in treating depression in patients with cancer. This study aims to estimate the cost-effectiveness of DCPC compared with usual care from a health service perspective. Methods Costs were estimated using UK national unit cost estimates and health outcomes measured using quality-adjusted life-years (QALYs). Incremental cost-effectiveness of DCPC compared with usual care was calculated and scenario analyses performed to test alternative assumptions on costs and missing data. Uncertainty was characterised using cost-effectiveness acceptability curves. The probability of DCPC being cost-effective was determined using the UK National Institute for Health and Care Excellence's (NICE) cost-effectiveness threshold range of £20,000 to £30,000 per QALY gained. Results DCPC cost on average £631 more than usual care per patient, and resulted in a mean gain of 0.066 QALYs, yielding an incremental cost-effectiveness ratio of £9549 per QALY. The probability of DCPC being cost-effective was 0.9 or greater at cost-effectiveness thresholds above £20,000 per QALY for the base case and scenario analyses. Conclusions Compared with usual care, DCPC is likely to be cost-effective at the current thresholds used by NICE. This study adds to the weight of evidence that collaborative care treatment models are cost-effective for depression, and provides new evidence regarding their use in specialist medical settings. PMID:26652589

  11. Comparing the cost-effectiveness of simulation modalities: a case study of peripheral intravenous catheterization training.

    Science.gov (United States)

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-05-01

    While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three simulation-based programs. Medical students (n = 15 per group) practiced in one of three 2-h intravenous catheterization skills training programs: low-fidelity (virtual reality), high-fidelity (mannequin), or progressive (consisting of virtual reality, task trainer, and mannequin simulator). One week later, all performed a transfer test on a hybrid simulation (standardized patient with a task trainer). We used a net benefit regression model to identify the most cost-effective training program via paired comparisons. We also created a cost-effectiveness acceptability curve to visually represent the probability that one program is more cost-effective when compared to its comparator at various 'willingness-to-pay' values. We conducted separate analyses for implementation and total costs. The results showed that the progressive program had the highest total cost (p willingness-to-pay value, the progressive training program was generally most educationally- and cost-effective. Our analyses suggest that a progressive program that strategically combines simulation modalities provides a cost-effective solution. More generally, we have introduced how a cost-effectiveness analysis may be applied to simulation training; a method that medical educators may use to investment decisions (e.g., purchasing cost-effective and educationally sound simulators).

  12. Moving Beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America.

    Science.gov (United States)

    Emmett, Susan D; Tucci, Debara L; Bento, Ricardo F; Garcia, Juan M; Juman, Solaiman; Chiossone-Kerdel, Juan A; Liu, Ta J; de Muñoz, Patricia Castellanos; Ullauri, Alejandra; Letort, Jose J; Mansilla, Teresita; Urquijo, Diana P; Aparicio, Maria L; Gong, Wenfeng; Francis, Howard W; Saunders, James E

    2016-09-01

    Cochlear implantation (CI) and deaf education are cost effective management strategies of childhood profound sensorineural hearing loss in Latin America. CI has been widely established as cost effective in North America and Europe and is considered standard of care in those regions, yet cost effectiveness in other economic environments has not been explored. With 80% of the global hearing loss burden existing in low- and middle-income countries, developing cost effective management strategies in these settings is essential. This analysis represents the continuation of a global assessment of CI and deaf education cost effectiveness. Brazil, Colombia, Ecuador, Guatemala, Paraguay, Trinidad and Tobago, and Venezuela participated in the study. A Disability Adjusted Life Years model was applied with 3% discounting and 10-year length of analysis. Experts from each country supplied cost estimates from known costs and published data. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the World Health Organization standard of cost effectiveness ratio/gross domestic product per capita (CER/GDP)GDP 0.07-0.93). CI was cost effective in all countries (CER/GDP 0.69-2.96), with borderline cost effectiveness in the Guatemalan sensitivity analysis (Max CER/GDP 3.21). Both cochlear implantation and deaf education are widely cost effective in Latin America. In the lower-middle income economy of Guatemala, implant cost may have a larger impact. GDP is less influential in the middle- and high-income economies included in this study.

  13. Danish High Performance Concretes

    DEFF Research Database (Denmark)

    Nielsen, M. P.; Christoffersen, J.; Frederiksen, J.

    1994-01-01

    In this paper the main results obtained in the research program High Performance Concretes in the 90's are presented. This program was financed by the Danish government and was carried out in cooperation between The Technical University of Denmark, several private companies, and Aalborg University...

  14. High performance AC drives

    CERN Document Server

    Ahmad, Mukhtar

    2010-01-01

    This book presents a comprehensive view of high performance ac drives. It may be considered as both a text book for graduate students and as an up-to-date monograph. It may also be used by R & D professionals involved in the improvement of performance of drives in the industries. The book will also be beneficial to the researchers pursuing work on multiphase drives as well as sensorless and direct torque control of electric drives since up-to date references in these topics are provided. It will also provide few examples of modeling, analysis and control of electric drives using MATLAB/SIMULIN

  15. Cost-effectiveness of high-sensitive troponin assays for the early rule-out or diagnosis of acute myocardial infarction (AMI) in people with acute chest pain : A nice diagnostic assessment

    NARCIS (Netherlands)

    Ramaekers, B.L.T.; Armstrong, N.; Joore, M.A.; Westwood, M.; Whiting, P.; Thokala, P.; Ross, J.; Kleijnen, J.; Severens, J.; Van Asselt, A.

    2014-01-01

    Objectives: To assess cost-effectiveness of high sensitivity troponin (hs-cTn) assays for the management of adults presenting with acute chest pain at the emergency department. Methods: An economic model was constructed to estimate lifetime costs and QALYs of five hs-cTn strategies (differing accord

  16. Cost-effectiveness of Voriconasole in treatment of invasive aspregillosis

    Directory of Open Access Journals (Sweden)

    N. N. Climko

    2009-01-01

    Full Text Available Invasive aspergillosis (IA is widespread infectious implication in immunodeficient patients, characterized by severe clinical manifestations and high mortality. This article presents the first case of pharmacoeconomical analysis of Voriconasole in treatment of IA compared with alternative therapies in Russia. Using mathematic modeling methods, we evalued total costs (including costs of IA treatment, clinical effectiveness and IA-related mortality in each therapy group. Obtained results showed the dominating of Voriconasole because of its high effectiveness and lower costs compared with caspofungine or amphotericine B. Total costs of therapy with Voricinasole were up to 30% lower compared with caspofungine and up to 70% lower compared with amphotericine B. Performed univariate sensitivity analysis showed that cost-effectiveness of anti-IA treatment depends mostly on clinical effectiveness of antimycotics rather than drug costs. Thus, treatment with Voriconasole is cost-effective in IA patients.

  17. Soft-Etching Copper and Silver Electrodes for Significant Device Performance Improvement toward Facile, Cost-Effective, Bottom-Contacted, Organic Field-Effect Transistors.

    Science.gov (United States)

    Wang, Zongrui; Dong, Huanli; Zou, Ye; Zhao, Qiang; Tan, Jiahui; Liu, Jie; Lu, Xiuqiang; Xiao, Jinchong; Zhang, Qichun; Hu, Wenping

    2016-03-01

    Poor charge injection and transport at the electrode/semiconductor contacts has been so far a severe performance hurdle for bottom-contact bottom-gate (BCBG) organic field-effect transistors (OFETs). Here, we have developed a simple, economic, and effective method to improve the carrier injection efficiency and obtained high-performance devices with low cost and widely used source/drain (S/D) electrodes (Ag/Cu). Through the simple electrode etching process, the work function of the electrodes is more aligned with the semiconductors, which reduces the energy barrier and facilitates the charge injection. Besides, the formation of the thinned electrode edge with desirable micro/nanostructures not only leads to the enlarged contact side area beneficial for the carrier injection but also is in favor of the molecular self-organization for continuous crystal growth at the contact/active channel interface, which is better for the charge injection and transport. These effects give rise to the great reduction of contact resistance and the amazing improvement of the low-cost bottom-contact configuration OFETs performance.

  18. High Performance Liquid Chromatography

    Science.gov (United States)

    Talcott, Stephen

    High performance liquid chromatography (HPLC) has many applications in food chemistry. Food components that have been analyzed with HPLC include organic acids, vitamins, amino acids, sugars, nitrosamines, certain pesticides, metabolites, fatty acids, aflatoxins, pigments, and certain food additives. Unlike gas chromatography, it is not necessary for the compound being analyzed to be volatile. It is necessary, however, for the compounds to have some solubility in the mobile phase. It is important that the solubilized samples for injection be free from all particulate matter, so centrifugation and filtration are common procedures. Also, solid-phase extraction is used commonly in sample preparation to remove interfering compounds from the sample matrix prior to HPLC analysis.

  19. High Performance RAIT

    Institute of Scientific and Technical Information of China (English)

    JamesHughes; CharlesMilligan; 等

    2001-01-01

    The ability to move 10s of TeraBytes in reasonable amounts of time are critical to many of the High Energy Physics applications.This paper examines the issues of high performance,high reliability tape storage systems,and presents the results of a 2-year ASCI Path Forward program to be able to reliably move 1GB/s to an archive that can last 20 years.This paper will cover the requirements.approach,hardware,application software,interface descriptions,performance,measured reliability and predicted reliability.This paper will also touch on future directions for this research.The current research allows systems to sustain 80MB/s of uncompressable data per Fibre Channel interface which is striped out to 8 or more drives.This looks to the application as a single tape drive from both mout and data transfer perspectives .Striping 12 RAIT systems together will provide nearly 1GB/s to tape.The reliability is provided by a method of adding parity tapes to the data stripes.For example,adding 2 parity tapes to an 8-stripe group will allow any 2 of the 10 tapes to be lost or damaged without loss of information.The reliability of RAIT with 8 stripes and 2 parities exceeds that of mirrored tapes while RAIT uses 10 tapes instead of the 16 tapes that a mirror would require.The results of this paper is to be abloe to understand the applicability of RAIT and to be able to understand when it may be useful in High Energy Physics applications.

  20. Cost-effectiveness analysis and innovation.

    Science.gov (United States)

    Jena, Anupam B; Philipson, Tomas J

    2008-09-01

    While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency.

  1. High performance work practices, innovation and performance

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Newton, Cameron; Johnston, Kim

    2013-01-01

    Research spanning nearly 20 years has provided considerable empirical evidence for relationships between High Performance Work Practices (HPWPs) and various measures of performance including increased productivity, improved customer service, and reduced turnover. What stands out from...

  2. A Cost-Effectiveness Analysis of Tactical Satellites, High-Altitude Long-Endurance Airships, and High and Medium Altitude Unmanned Aerial Systems for ISR and Communication Missions

    Science.gov (United States)

    2008-09-01

    Accountability Office, 2008) 158, WorldCat . http://worldcat.org. 17 Predator, the Sky Warrior carries multiple payloads and has wing hard points to carry... WorldCat . http://worldcat.org. 20 communications and surveillance capabilities that will considerably improve force performance in the theater...Committee on Armed Services, U.S. Senate." U.S. Govt. Accountability Office. WorldCat . http://worldcat.org. August 26, 2008. "GPS III / GPS Block III

  3. High performance soft magnetic materials

    CERN Document Server

    2017-01-01

    This book provides comprehensive coverage of the current state-of-the-art in soft magnetic materials and related applications, with particular focus on amorphous and nanocrystalline magnetic wires and ribbons and sensor applications. Expert chapters cover preparation, processing, tuning of magnetic properties, modeling, and applications. Cost-effective soft magnetic materials are required in a range of industrial sectors, such as magnetic sensors and actuators, microelectronics, cell phones, security, automobiles, medicine, health monitoring, aerospace, informatics, and electrical engineering. This book presents both fundamentals and applications to enable academic and industry researchers to pursue further developments of these key materials. This highly interdisciplinary volume represents essential reading for researchers in materials science, magnetism, electrodynamics, and modeling who are interested in working with soft magnets. Covers magnetic microwires, sensor applications, amorphous and nanocrystalli...

  4. Highly cost-effective and sulfur/coking resistant VOx-grafted TiO2 nanoparticles as an efficient anode catalyst for direct conversion of dry sour methane in solid oxide fuel cells

    NARCIS (Netherlands)

    Garcia, A.; Yan, N.; Vincent, A.; Singh, A.; Hill, J.M.; Chuang, K. T.; Luo, J.L.

    2015-01-01

    In this work, we show that grafted metal oxide can be a highly cost-effective and active anode for solid oxide fuel cells for sour methane conversion. The developed electro-catalyst was composed of vanadium oxide grafted TiO2 nanoparticles (VOx/TiO2) infiltrated into a porous La0.4Sr0.5Ba0.1TiO3+δ e

  5. High Performance Work Systems and Firm Performance.

    Science.gov (United States)

    Kling, Jeffrey

    1995-01-01

    A review of 17 studies of high-performance work systems concludes that benefits of employee involvement, skill training, and other high-performance work practices tend to be greater when new methods are adopted as part of a consistent whole. (Author)

  6. An open, parallel, randomized, comparative, multicenter study to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (intervention) vs silver sulfadiazine cream.

    Science.gov (United States)

    Silverstein, Paul; Heimbach, David; Meites, Herbert; Latenser, Barbara; Mozingo, David; Mullins, Fred; Garner, Warren; Turkowski, Joseph; Shupp, Jeffrey; Glat, Paul; Purdue, Gary

    2011-01-01

    An open, parallel, randomized, comparative, multicenter study was implemented to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (Mepilex Ag) vs silver sulfadiazine cream (control) in the treatment of partial-thickness thermal burns. Individuals aged 5 years and older with partial-thickness thermal burns (2.5-20% BSA) were randomized into two groups and treated with the trial products for 21 days or until healed, whichever occurred first. Data were obtained and analyzed on cost (direct and indirect), healing rates, pain, comfort, ease of product use, and adverse events. A total of 101 subjects were recruited. There were no significant differences in burn area profiles within the groups. The cost of dressing-related analgesia was lower in the intervention group (P = .03) as was the cost of background analgesia (P = .07). The mean total cost of treatment was $309 vs $513 in the control (P < .001). The average cost-effectiveness per treatment regime was $381 lower in the intervention product, producing an incremental cost-effectiveness ratio of $1688 in favor of the soft silicone foam dressing. Mean healing rates were 71.7 vs 60.8% at final visit, and the number of dressing changes were 2.2 vs 12.4 in the treatment and control groups, respectively. Subjects reported significantly less pain at application (P = .02) and during wear (P = .048) of the Mepilex Ag dressing in the acute stages of wound healing. Clinicians reported the intervention dressing was significantly easier to use (P = .03) and flexible (P = .04). Both treatments were well tolerated; however, the total incidence of adverse events was higher in the control group. The silver-containing soft silicone foam dressing was as effective in the treatment of patients as the standard care (silver sulfadiazine). In addition, the group of patients treated with the soft silicone foam dressing demonstrated decreased pain and lower costs associated

  7. R high performance programming

    CERN Document Server

    Lim, Aloysius

    2015-01-01

    This book is for programmers and developers who want to improve the performance of their R programs by making them run faster with large data sets or who are trying to solve a pesky performance problem.

  8. Enhanced photovoltaic performance and time varied controllable growth of a CuS nanoplatelet structured thin film and its application as an efficient counter electrode for quantum dot-sensitized solar cells via a cost-effective chemical bath deposition.

    Science.gov (United States)

    Thulasi-Varma, Chebrolu Venkata; Rao, S Srinivasa; Kumar, Challa Shesha Sai Pavan; Gopi, Chandu V V M; Durga, I Kanaka; Kim, Soo-Kyoung; Punnoose, Dinah; Kim, Hee-Je

    2015-11-28

    For the first time we report a simple synthetic strategy to prepare copper sulfide counter electrodes on fluorine-doped tin oxide (FTO) substrates using the inexpensive chemical bath deposition method in the presence of hydrochloric acid (HCl) at different deposition times. CuS nanoplatelet structures were uniformly grown on the FTO substrate with a good dispersion and optimized conditions. The growth process of the CuS nanoplatelets can be controlled by changing the deposition time in the presence of HCl. HCl acts as a complexing agent as well as improving S(2-) concentration against S atoms in this one-step preparation. The photovoltaic performance was significantly improved in terms of the power conversion efficiency (PCE), short-circuit density (J(sc)), open-circuit voltage (V(oc)), and the fill factor (FF). The optimized deposition time of CuS 60 min resulted in a higher PCE of 4.06%, J(sc) of 12.92 mA cm(-2), V(oc) of 0.60 V, and a FF of 0.52 compared to CuS 50 min, CuS 70 min, and a Pt CE. The superior performance of the 60 min sample is due to the greater electrocatalytic activity and low charge transfer resistance at the interface of the CE and the polysulfide electrolyte. The concentration of Cu/S also had an important role in the formation of the CuS nanoplatelet structures. The optical bandgaps for the CuS with different morphologies were measured to be in the range of 1.98-2.28 eV. This improved photovoltaic performance is mainly attributed to the greater number of active reaction sites created by the CuS layer on the FTO substrate, which results large specific surface, superior electrical conductivity, low charge transfer resistance, and faster electron transport in the presence of HCl. Cyclic voltammetry, electrochemical impedance spectroscopy and Tafel-polarization measurements were used to investigate the electrocatalytic activity of the CuS and Pt CEs. This synthetic procedure not only provides high electrocatalytic activity for QDSSCs but could

  9. Cost-effectiveness of a hypertension management programme in an elderly population: a Markov model

    Directory of Open Access Journals (Sweden)

    Figar Silvana

    2011-04-01

    Full Text Available Abstract Background Mounting evidence shows that multi-intervention programmes for hypertension treatment are more effective than an isolated pharmacological strategy. Full economic evaluations of hypertension management programmes are scarce and contain methodological limitations. The aim of the study was to evaluate if a hypertension management programme for elderly patients is cost-effective compared to usual care from the perspective of a third-party payer. Methods We built a cost-effectiveness model using published evidence of effectiveness of a comprehensive hypertension programme vs. usual care for patients 65 years or older at a community hospital in Buenos Aires, Argentina. We explored incremental cost-effectiveness between groups. The model used a life-time framework adopting a third-party payer's perspective. Incremental cost-effectiveness ratio (ICER was calculated in International Dollars per life-year gained. We performed a probabilistic sensitivity analysis (PSA to explore variable uncertainty. Results The ICER for the base-case of the "Hypertension Programme" versus the "Usual care" approach was 1,124 International Dollars per life-year gained. PSA did not significantly influence results. The programme had a probability of 43% of being dominant (more effective and less costly and, overall, 95% chance of being cost-effective. Discussion Results showed that "Hypertension Programme" had high probabilities of being cost-effective under a wide range of scenarios. This is the first sound cost-effectiveness study to assess a comprehensive hypertension programme versus usual care. This study measures hard outcomes and explores robustness through a probabilistic sensitivity analysis. Conclusions The comprehensive hypertension programme had high probabilities of being cost-effective versus usual care. This study supports the idea that similar programmes could be the preferred strategy in countries and within health care systems where

  10. Cost-effectiveness of online positive psychology: Randomized controlled trial

    NARCIS (Netherlands)

    Bolier, Linda; Majo, Cristina; Smit, Filip; Westerhof, Gerben Johan; Haverman, Merel; Walburg, J.A.; Riper, Heleen; Bohlmeijer, Ernst Thomas

    2014-01-01

    As yet, no evidence is available about the cost-effectiveness of positive psychological interventions. When offered via the Internet, these interventions may be particularly cost-effective, because they are highly scalable and do not rely on scant resources such as therapists’ time. Alongside a rand

  11. Cost-effectiveness of Total Knee Arthroplasty in the United States

    Science.gov (United States)

    Losina, Elena; Walensky, Rochelle P.; Kessler, Courtenay L.; Emrani, Parastu S.; Reichmann, William M.; Wright, Elizabeth A.; Holt, Holly L.; Solomon, Daniel H.; Yelin, Edward; Paltiel, A. David; Katz, Jeffrey N.

    2009-01-01

    Background Total knee arthroplasty (TKA) relieves pain and improves quality of life for persons with advanced knee osteoarthritis. However, to our knowledge, the cost-effectiveness of TKA and the influences of hospital volume and patient risk on TKA cost-effectiveness have not been investigated in the United States. Methods We developed a Markov, state-transition, computer simulation model and populated it with Medicare claims data and cost and outcomes data from national and multinational sources. We projected lifetime costs and quality-adjusted life expectancy (QALE) for different risk populations and varied TKA intervention and hospital volume. Cost-effectiveness of TKA was estimated across all patient risk and hospital volume permutations. Finally, we conducted sensitivity analyses to determine various parameters’ influences on cost-effectiveness. Results Overall, TKA increased QALE from 6.822 to 7.957 quality-adjusted life years (QALYs). Lifetime costs rose from $37 100 (no TKA) to $57 900 after TKA, resulting in an incremental cost-effectiveness ratio of $18 300 per QALY. For high-risk patients, TKA increased QALE from 5.713 to 6.594 QALY, yielding a cost-effectiveness ratio of $28 100 per QALY. At all risk levels, TKA was more costly and less effective in low-volume centers than in high-volume centers. Results were insensitive to variations of key input parameters within policy-relevant, clinically plausible ranges. The greatest variations were seen for the quality of life gain after TKA and the cost of TKA. Conclusions Total knee arthroplasty appears to be cost-effective in the US Medicare-aged population, as currently practiced across all risk groups. Policy decisions should be made on the basis of available local options for TKA. However, when a high-volume hospital is available, TKAs performed in a high-volume hospital confer even greater value per dollar spent than TKAs performed in low-volume centers. PMID:19546411

  12. Cost-effectiveness of vaccination against herpes zoster.

    Science.gov (United States)

    de Boer, Pieter T; Wilschut, Jan C; Postma, Maarten J

    2014-01-01

    Herpes zoster (HZ) is a common disease among elderly, which may develop into a severe pain syndrome labeled postherpetic neuralgia (PHN). A live-attenuated varicella zoster virus vaccine has been shown to be effective in reducing the incidence and burden of illness of HZ and PHN, providing the opportunity to prevent significant health-related and financial consequences of HZ. In this review, we summarize the available literature on cost-effectiveness of HZ vaccination and discuss critical parameters for cost-effectiveness results. A search in PubMed and EMBASE was performed to identify full cost-effectiveness studies published before April 2013. Fourteen cost-effectiveness studies were included, all performed in western countries. All studies evaluated cost-effectiveness among elderly above 50 years and used costs per quality-adjusted life year (QALY) gained as primary outcome. The vast majority of studies showed vaccination of 60- to 75-year-old individuals to be cost-effective, when duration of vaccine efficacy was longer than 10 years. Duration of vaccine efficacy, vaccine price, HZ incidence, HZ incidence and discount rates were influential to the incremental cost-effectiveness ratio (ICER). HZ vaccination may be a worthwhile intervention from a cost-effectiveness point of view. More extensive reporting on methodology and more detailed results of sensitivity analyses would be desirable to address uncertainty and to guarantee optimal comparability between studies, for example regarding model structure, discounting, vaccine characteristics and loss of quality of life due to HZ and PHN.

  13. High-tech or field techs: Radio-telemetry is a cost-effective method for reducing bias in songbird nest searching

    Science.gov (United States)

    Peterson, Sean M.; Streby, Henry M.; Lehman, Justin A.; Kramer, Gunnar R.; Fish, Alexander C.; Andersen, David E.

    2015-01-01

    We compared the efficacy of standard nest-searching methods with finding nests via radio-tagged birds to assess how search technique influenced our determination of nest-site characteristics and nest success for Golden-winged Warblers (Vermivora chrysoptera). We also evaluated the cost-effectiveness of using radio-tagged birds to find nests. Using standard nest-searching techniques for 3 populations, we found 111 nests in locations with habitat characteristics similar to those described in previous studies: edges between forest and relatively open areas of early successional vegetation or shrubby wetlands, with 43% within 5 m of forest edge. The 83 nests found using telemetry were about half as likely (23%) to be within 5 m of forest edge. We spent little time searching >25 m into forest because published reports state that Golden-winged Warblers do not nest there. However, 14 nests found using telemetry (18%) were >25 m into forest. We modeled nest success using nest-searching method, nest age, and distance to forest edge as explanatory variables. Nest-searching method explained nest success better than nest age alone; we estimated that nests found using telemetry were 10% more likely to fledge young than nests found using standard nest-searching methods. Although radio-telemetry was more expensive than standard nest searching, the cost-effectiveness of both methods differed depending on searcher experience, amount of equipment owned, and bird population density. Our results demonstrate that telemetry can be an effective method for reducing bias in Golden-winged Warbler nest samples, can be cost competitive with standard nest-searching methods in some situations, and is likely to be a useful approach for finding nests of other forest-nesting songbirds.

  14. The efficacy, safety and cost-effectiveness of intra-operative cell salvage in high-bleeding-risk cardiac surgery with cardiopulmonary bypass: a prospective randomized and controlled trial.

    Science.gov (United States)

    Xie, Yihong; Shen, Sheliang; Zhang, Jun; Wang, Wenyuan; Zheng, Jiayin

    2015-01-01

    Intra-operative cell salvage (CS) was reported to be ineffective, safe and not cost-effective in low-bleeding-risk cardiac surgery with cardiopulmonary bypass (CPB), but studies in high-bleeding-risk cardiac surgery are limited. The objective of this study is to evaluate the efficacy, safety and cost-effectiveness of intra-operative CS in high-bleeding-risk cardiac surgery with CPB. One hundred and fifty patients were randomly assigned to either with intra-operative CS group (Group CS) or without intra-operative CS group (Group C). Study endpoints were defined as perioperative allogeneic red blood cell (RBC) transfusion, perioperative impairment of blood coagulative function, postoperative adverse events and costs of transfusion-related. Both the proportion and quantity of perioperative allogeneic RBC transfusion were significantly lower in Group CS than that in Group C (p=0.0002, after surgery, the incidence of postoperative excessive bleeding, were significantly higher in Group CS than that in Group C (p=0.018, 0.042, 0.034, respectively). Cost of both allogeneic RBC transfusion and total allogeneic blood transfusion were significantly lower in Group CS than that in Group C (pbleeding-risk cardiac surgery with CPB is effective, generally safe, and cost-effective in developed countries but not in China.

  15. Cost-effectiveness of the Norwegian breast cancer screening program.

    Science.gov (United States)

    van Luijt, P A; Heijnsdijk, E A M; de Koning, H J

    2017-02-15

    The Norwegian Breast Cancer Screening Programme (NBCSP) has a nation-wide coverage since 2005. All women aged 50-69 years are invited biennially for mammography screening. We evaluated breast cancer mortality reduction and performed a cost-effectiveness analysis, using our microsimulation model, calibrated to most recent data. The microsimulation model allows for the comparison of mortality and costs between a (hypothetical) situation without screening and a situation with screening. Breast cancer incidence in Norway had a steep increase in the early 1990s. We calibrated the model to simulate this increase and included recent costs for screening, diagnosis and treatment of breast cancer and travel and productivity loss. We estimate a 16% breast cancer mortality reduction for a cohort of women, invited to screening, followed over their complete lifetime. Cost-effectiveness is estimated at NOK 112,162 per QALY gained, when taking only direct medical costs into account (the cost of the buses, examinations, and invitations). We used a 3.5% annual discount rate. Cost-effectiveness estimates are substantially below the threshold of NOK 1,926,366 as recommended by the WHO guidelines. For the Norwegian population, which has been gradually exposed to screening, breast cancer mortality reduction for women exposed to screening is increasing and is estimated to rise to ∼30% in 2020 for women aged 55-80 years. The NBCSP is a highly cost-effective measure to reduce breast cancer specific mortality. We estimate a breast cancer specific mortality reduction of 16-30%, at the cost of 112,162 NOK per QALY gained. © 2016 UICC.

  16. Cost-effective lightweight mirrors for aerospace and defense

    Science.gov (United States)

    Woodard, Kenneth S.; Comstock, Lovell E.; Wamboldt, Leonard; Roy, Brian P.

    2015-05-01

    The demand for high performance, lightweight mirrors was historically driven by aerospace and defense (A&D) but now we are also seeing similar requirements for commercial applications. These applications range from aerospace-like platforms such as small unmanned aircraft for agricultural, mineral and pollutant aerial mapping to an eye tracking gimbaled mirror for optometry offices. While aerospace and defense businesses can often justify the high cost of exotic, low density materials, commercial products rarely can. Also, to obtain high performance with low overall optical system weight, aspheric surfaces are often prescribed. This may drive the manufacturing process to diamond machining thus requiring the reflective side of the mirror to be a diamond machinable material. This paper summarizes the diamond machined finishing and coating of some high performance, lightweight designs using non-exotic substrates to achieve cost effective mirrors. The results indicate that these processes can meet typical aerospace and defense requirements but may also be competitive in some commercial applications.

  17. Goal-Directed Fluid Therapy Guided by Cardiac Monitoring During High-Risk Abdominal Surgery in Adult Patients: Cost-Effectiveness Analysis of Esophageal Doppler and Arterial Pulse Pressure Waveform Analysis.

    Science.gov (United States)

    Legrand, Guillaume; Ruscio, Laura; Benhamou, Dan; Pelletier-Fleury, Nathalie

    2015-07-01

    Several minimally invasive techniques for cardiac output monitoring such as the esophageal Doppler (ED) and arterial pulse pressure waveform analysis (APPWA) have been shown to improve surgical outcomes compared with conventional clinical assessment (CCA). To evaluate the cost-effectiveness of these techniques in high-risk abdominal surgery from the perspective of the French public health insurance fund. An analytical decision model was constructed to compare the cost-effectiveness of ED, APPWA, and CCA. Effectiveness data were defined from meta-analyses of randomized clinical trials. The clinical end points were avoidance of hospital mortality and avoidance of major complications. Hospital costs were estimated by the cost of corresponding diagnosis-related groups. Both goal-directed therapy strategies evaluated were more effective and less costly than CCA. Perioperative mortality and the rate of major complications were reduced by the use of ED and APPWA. Cost reduction was mainly due to the decrease in the rate of major complications. APPWA was dominant compared with ED in 71.6% and 27.6% and dominated in 23.8% and 20.8% of the cases when the end point considered was "major complications avoided" and "death avoided," respectively. Regarding cost per death avoided, APPWA was more likely to be cost-effective than ED in a wide range of willingness to pay. Cardiac output monitoring during high-risk abdominal surgery is cost-effective and is associated with a reduced rate of hospital mortality and major complications, whatever the device used. The two devices evaluated had negligible costs compared with the observed reduction in hospital costs. Our comparative studies suggest a larger effect with APPWA that needs to be confirmed by further studies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. Cost-effective wound management: a survey of 1717 nurses.

    Science.gov (United States)

    Newton, Heather

    2017-06-22

    Delivering high-quality wound care requires a mix of knowledge and skills, which nurses aim to update by attending educational events such as conferences and study days. This article describes the data obtained from 30 educational study days, which took place across England, Scotland and Wales. It will explore nurses' knowledge in relation to the cost-effectiveness and clinical efficacy of current wound care practices, based on the answers of 1717 delegates that attended the events. It will also outline the results in relation to reducing expenditure on wound dressings and the importance of performing an accurate wound assessment.

  19. Cost-effective improvements of a rotating platform by integration of a high-accuracy inclinometer and encoders for attitude evaluation

    Science.gov (United States)

    Wen, Chenyang; He, Shengyang; Bu, Changgen; Hu, Peida

    2017-01-01

    Attitude heading reference systems (AHRSs) based on micro-electromechanical system (MEMS) inertial sensors are widely used because of their low cost, light weight, and low power. However, low-cost AHRSs suffer from large inertial sensor errors. Therefore, experimental performance evaluation of MEMS-based AHRSs after system implementation is necessary. High-accuracy turntables can be used to verify the performance of MEMS-based AHRSs indoors, but they are expensive and unsuitable for outdoor tests. This study developed a low-cost two-axis rotating platform for indoor and outdoor attitude determination. A high-accuracy inclinometer and encoders were integrated into the platform to improve the achievable attitude test accuracy. An attitude error compensation method was proposed to calibrate the initial attitude errors caused by the movements and misalignment angles of the platform. The proposed attitude error determination method was examined through rotating experiments, which showed that the standard deviations of the pitch and roll errors were 0.050° and 0.090°, respectively. The pitch and roll errors both decreased to 0.024° when the proposed attitude error determination method was used. This decrease validates the effectiveness of the compensation method. Experimental results demonstrated that the integration of the inclinometer and encoders improved the performance of the low-cost, two-axis, rotating platform in terms of attitude accuracy.

  20. High Performance Computing Today

    Energy Technology Data Exchange (ETDEWEB)

    Dongarra, Jack; Meuer,Hans; Simon,Horst D.; Strohmaier,Erich

    2000-04-01

    In last 50 years, the field of scientific computing has seen a rapid change of vendors, architectures, technologies and the usage of systems. Despite all these changes the evolution of performance on a large scale however seems to be a very steady and continuous process. Moore's Law is often cited in this context. If the authors plot the peak performance of various computers of the last 5 decades in Figure 1 that could have been called the supercomputers of their time they indeed see how well this law holds for almost the complete lifespan of modern computing. On average they see an increase in performance of two magnitudes of order every decade.

  1. Python high performance programming

    CERN Document Server

    Lanaro, Gabriele

    2013-01-01

    An exciting, easy-to-follow guide illustrating the techniques to boost the performance of Python code, and their applications with plenty of hands-on examples.If you are a programmer who likes the power and simplicity of Python and would like to use this language for performance-critical applications, this book is ideal for you. All that is required is a basic knowledge of the Python programming language. The book will cover basic and advanced topics so will be great for you whether you are a new or a seasoned Python developer.

  2. NGINX high performance

    CERN Document Server

    Sharma, Rahul

    2015-01-01

    System administrators, developers, and engineers looking for ways to achieve maximum performance from NGINX will find this book beneficial. If you are looking for solutions such as how to handle more users from the same system or load your website pages faster, then this is the book for you.

  3. High performance germanium MOSFETs

    Energy Technology Data Exchange (ETDEWEB)

    Saraswat, Krishna [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States)]. E-mail: saraswat@stanford.edu; Chui, Chi On [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States); Krishnamohan, Tejas [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States); Kim, Donghyun [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States); Nayfeh, Ammar [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States); Pethe, Abhijit [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States)

    2006-12-15

    Ge is a very promising material as future channel materials for nanoscale MOSFETs due to its high mobility and thus a higher source injection velocity, which translates into higher drive current and smaller gate delay. However, for Ge to become main-stream, surface passivation and heterogeneous integration of crystalline Ge layers on Si must be achieved. We have demonstrated growth of fully relaxed smooth single crystal Ge layers on Si using a novel multi-step growth and hydrogen anneal process without any graded buffer SiGe layer. Surface passivation of Ge has been achieved with its native oxynitride (GeO {sub x}N {sub y} ) and high-permittivity (high-k) metal oxides of Al, Zr and Hf. High mobility MOSFETs have been demonstrated in bulk Ge with high-k gate dielectrics and metal gates. However, due to their smaller bandgap and higher dielectric constant, most high mobility materials suffer from large band-to-band tunneling (BTBT) leakage currents and worse short channel effects. We present novel, Si and Ge based heterostructure MOSFETs, which can significantly reduce the BTBT leakage currents while retaining high channel mobility, making them suitable for scaling into the sub-15 nm regime. Through full band Monte-Carlo, Poisson-Schrodinger and detailed BTBT simulations we show a dramatic reduction in BTBT and excellent electrostatic control of the channel, while maintaining very high drive currents in these highly scaled heterostructure DGFETs. Heterostructure MOSFETs with varying strained-Ge or SiGe thickness, Si cap thickness and Ge percentage were fabricated on bulk Si and SOI substrates. The ultra-thin ({approx}2 nm) strained-Ge channel heterostructure MOSFETs exhibited >4x mobility enhancements over bulk Si devices and >10x BTBT reduction over surface channel strained SiGe devices.

  4. Cost effectiveness of surveillance for GI cancers.

    Science.gov (United States)

    Omidvari, Amir-Houshang; Meester, Reinier G S; Lansdorp-Vogelaar, Iris

    2016-12-01

    Gastrointestinal (GI) diseases are among the leading causes of death in the world. To reduce the burden of GI diseases, surveillance is recommended for some diseases, including for patients with inflammatory bowel diseases, Barrett's oesophagus, precancerous gastric lesions, colorectal adenoma, and pancreatic neoplasms. This review aims to provide an overview of the evidence on cost-effectiveness of surveillance of individuals with GI conditions predisposing them to cancer, specifically focussing on the aforementioned conditions. We searched the literature and reviewed 21 studies. Despite heterogeneity of studies in terms of settings, study populations, surveillance strategies and outcomes, most reviewed studies suggested at least some surveillance of patients with these GI conditions to be cost-effective. For some high-risk conditions frequent surveillance with 3-month intervals was warranted, while for other conditions, surveillance may only be cost-effective every 10 years. Further studies based on more robust effectiveness evidence are needed to inform and optimise surveillance programmes for GI cancers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Cost effectiveness of new roadway lighting systems

    Directory of Open Access Journals (Sweden)

    Yi Jiang

    2015-06-01

    Full Text Available Appropriate and adequate lighting at select locations on roadways is essential for roadway safety. As the lighting technologies advance, many types of new lighting devices have been developed for roadway lightings. The most promising new lighting technologies for roadway lighting include light emitting diode, induction, plasma, and metal halide lighting systems. A study was conducted to compare the new systems with the conventional high pressure sodium systems that are currently used on the Indiana roadway systems. In this study, the engineering issues, were analyzed such as illuminance, color rendering, power usage, cost effectiveness, and approval procedures for new roadway lighting systems. This paper, however, presents only the study findings related to cost effectiveness of the evaluated roadway lighting systems. Illustrated in this paper are the main features of the roadway lighting systems under evaluations, installations of the new lighting systems, measurements of power consumptions, and life cycle cost analyses of the lighting systems. Through this study, experience and knowledge have been obtained on the installations, power measurements, and cost effectiveness of the new types of the roadway lighting devices. The actual power values of various luminaires were obtained by measuring the electric current with a multi-meter. It was found that the differences between the rated and measured power values could be significant. The results of the life cycle cost analysis indicate that the lower life cycle costs of some of the alternative lighting devices are attributed to their relatively lower electricity usages and longer lamp/emitter replacement cycles.

  6. Development of a chamber system for rapid, high yield and cost-effective purification of deoxyribonucleic acid fragments from agarose gel

    Directory of Open Access Journals (Sweden)

    Gilda Eslami

    2014-01-01

    Full Text Available Background: There are several methods commonly practicing for deoxyribonucleic acid (DNA purification from agarose gel. In most laboratories, especially in developing countries, present methods for recovering of DNA fragments from the gel are mostly involved organic solvents. However, manual purification using organic solvents are toxic, labor intensive, time consuming and prone to contamination owing to several handling steps. The above mentioned burdens as well as cost and long time to import them, especially in developing countries, prompted us to design and develop a chamber system for rapid, non-toxic, cost-effective and user friendly device for polymerase chain reaction (PCR products purification from agarose gel. Materials and Methods: The device was made from plexiglass plates. After amplification of two fragments of 250 and 850 bp, PCR products were electrophoresed. Subsequently, the desired bands were excised and purified with three method: HiPer Mini chamber, phenol extraction method and spin column procedure. To assess the suitability of the purified DNAs, restriction digestion was applied. Results: Results showed that the yield of recovered DNA in our method was above 95%, whereas the yields obtained with conventional phenol extraction and spin column methods were around 60%. Conclusion: In conclusion, the current method for DNA elution is quick, inexpensive and robust and it does not require the use of toxic organic solvents. In addition, the purified DNA was well has suited for further manipulations such as restriction digestion, ligation, cloning, sequencing and hybridization.

  7. High performance collectors

    Science.gov (United States)

    Ogawa, H.; Hozumi, S.; Mitsumata, T.; Yoshino, K.; Aso, S.; Ebisu, K.

    1983-04-01

    Materials and structures used for flat plate solar collectors and evacuated tubular collectors were examined relative to their overall performance to project effectiveness for building heating and cooling and the feasibility of use for generating industrial process heat. Thermal efficiencies were calculated for black paint single glazed, selective surface single glazed, and selective surface double glazed flat plate collectors. The efficiencies of a single tube and central tube accompanied by two side tube collectors were also studied. Techniques for extending the lifetimes of the collectors were defined. The selective surface collectors proved to have a performance superior to other collectors in terms of the average annual energy delivered. Addition of a black chrome-coated fin system to the evacuated collectors produced significant collection efficiency increases.

  8. High Performance Magnets

    Science.gov (United States)

    2000-03-29

    Our efforts in this project were focused on three different materials, namely; interstitial Sm-Fe carbides and nitrides, high energy product Nd2Fe14B ...magnets with MgO addition, and nanocomposite Nd2Fe14B /alpha-Fe consisting of a fine mixture of hard and soft phases. In the Sm-Fe carbides and

  9. High Performance Biocomputation

    Science.gov (United States)

    2005-03-01

    ab initio calculation of a small protein has been reported (1PNH, a scorpion toxin with 31 residues and 500 atoms; [3]). Hybrid classical and first...challenge can be characterized as highly computationally-savvy and fully capable of effectively exploiting state-of-the-art capability. However, there...enilarrassingly parallel comlrltations, where little or no comnmiinication is required), capacity computing is an effective approac-h. A recent extension of

  10. Facile and cost effective synthesis of mesoporous spinel NiCo2O4 as an anode for high lithium storage capacity

    Science.gov (United States)

    Jadhav, Harsharaj S.; Kalubarme, Ramchandra S.; Park, Choong-Nyeon; Kim, Jaekook; Park, Chan-Jin

    2014-08-01

    To fulfill the high power and high energy density demands for Li-ion batteries (LIBs) new anode materials need to be explored to replace conventional graphite. Herein, we report the urea assisted facile co-precipitation synthesis of spinel NiCo2O4 and its application as an anode material for LIBs. The synthesized NiCo2O4 exhibited an urchin-like microstructure and polycrystalline and mesoporous nature. In addition, the mesoporous NiCo2O4 electrode exhibited an initial discharge capacity of 1095 mA h g-1 and maintained a reversible capacity of 1000 mA h g-1 for 400 cycles at 0.5 C-rate. The reversible capacity of NiCo2O4 could still be maintained at 718 mA h g-1, even at 10 C. The mesoporous NiCo2O4 exhibits great potential as an anode material for LIBs with the advantages of unique performance and facile preparation.To fulfill the high power and high energy density demands for Li-ion batteries (LIBs) new anode materials need to be explored to replace conventional graphite. Herein, we report the urea assisted facile co-precipitation synthesis of spinel NiCo2O4 and its application as an anode material for LIBs. The synthesized NiCo2O4 exhibited an urchin-like microstructure and polycrystalline and mesoporous nature. In addition, the mesoporous NiCo2O4 electrode exhibited an initial discharge capacity of 1095 mA h g-1 and maintained a reversible capacity of 1000 mA h g-1 for 400 cycles at 0.5 C-rate. The reversible capacity of NiCo2O4 could still be maintained at 718 mA h g-1, even at 10 C. The mesoporous NiCo2O4 exhibits great potential as an anode material for LIBs with the advantages of unique performance and facile preparation. Electronic supplementary information (ESI) available: Experimental details and additional experimental results. See DOI: 10.1039/c4nr02183e

  11. High performance steam development

    Energy Technology Data Exchange (ETDEWEB)

    Duffy, T.; Schneider, P. [Solar Turbines Inc., San Diego, CA (United States)

    1995-10-01

    Over 30 years ago U.S. industry introduced the world`s highest temperature (1200{degrees}F at 5000 psig) and most efficient power plant, the Eddystone coal-burning steam plant. The highest alloy material used in the plant was 316 stainless steel. Problems during the first few years of operation caused a reduction in operating temperature to 1100{degrees}F which has generally become the highest temperature used in plants around the world. Leadership in high temperature steam has moved to Japan and Europe over the last 30 years.

  12. HIGH-PERFORMANCE COATING MATERIALS

    Energy Technology Data Exchange (ETDEWEB)

    SUGAMA,T.

    2007-01-01

    Corrosion, erosion, oxidation, and fouling by scale deposits impose critical issues in selecting the metal components used at geothermal power plants operating at brine temperatures up to 300 C. Replacing these components is very costly and time consuming. Currently, components made of titanium alloy and stainless steel commonly are employed for dealing with these problems. However, another major consideration in using these metals is not only that they are considerably more expensive than carbon steel, but also the susceptibility of corrosion-preventing passive oxide layers that develop on their outermost surface sites to reactions with brine-induced scales, such as silicate, silica, and calcite. Such reactions lead to the formation of strong interfacial bonds between the scales and oxide layers, causing the accumulation of multiple layers of scales, and the impairment of the plant component's function and efficacy; furthermore, a substantial amount of time is entailed in removing them. This cleaning operation essential for reusing the components is one of the factors causing the increase in the plant's maintenance costs. If inexpensive carbon steel components could be coated and lined with cost-effective high-hydrothermal temperature stable, anti-corrosion, -oxidation, and -fouling materials, this would improve the power plant's economic factors by engendering a considerable reduction in capital investment, and a decrease in the costs of operations and maintenance through optimized maintenance schedules.

  13. High performance polymer concrete

    Directory of Open Access Journals (Sweden)

    Frías, M.

    2007-06-01

    Full Text Available This paper studies the performance of concrete whose chief components are natural aggregate and an organic binder —a thermosetting polyester resin— denominated polymer concrete or PC. The material was examined macro- and microscopically and its basic physical and mechanical properties were determined using mercury porosimetry, scanning electron microscopy (SEM-EDAX, X-ray diffraction (XRD and strength tests (modulus of elasticity, stress-strain curves and ultimate strengths. According to the results of these experimental studies, the PC exhibited a low density (4.8%, closed pore system and a concomitantly continuous internal microstructure. This would at least partially explain its mechanical out-performance of traditional concrete, with average compressive and flexural strength values of 100 MPa and over 20 MPa, respectively. In the absence of standard criteria, the bending test was found to be a useful supplement to compressive strength tests for establishing PC strength classes.Este trabajo de investigación aborda el estudio de un hormigón de altas prestaciones, formado por áridos naturales y un aglomerante orgánico constituido por una resina termoestable poliéster, denominado hormigón polimérico HP. Se describe el material a nivel microscópico y macroscópico, presentando sus propiedades físicas y mecánicas fundamentales, mediante diferentes técnicas experimentales, tales como: porosimetría de mercurio, microscopía electrónica (SEM-EDAX, difracción de rayos X (DRX y ensayos mecánicos (módulo de elasticidad, curvas tensión- deformación y resistencias últimas. Como consecuencia del estudio experimental llevado a cabo, se ha podido apreciar cómo el HP está formado por porosidad cerrada del 4,8%, proporcionando una elevada continuidad a su microestructura interna, lo que justifica, en parte, la mejora de propiedades mecánicas respecto al hormigón tradicional, con unos valores medios de resistencia a compresión de 100

  14. Cost-effectiveness of Barostim therapy for the treatment of resistant hypertension in European settings.

    Science.gov (United States)

    Borisenko, Oleg; Beige, Joachim; Lovett, Eric G; Hoppe, Uta C; Bjessmo, Staffan

    2014-03-01

    The purpose of this study is to simulate the cost-effectiveness and the long-term clinical performance of the Barostim neo System for the treatment of resistant hypertension when compared to optimal medical treatment. A decision analytic model with a combination of a decision tree and Markov process was used to evaluate the cost-effectiveness of Barostim. The clinical effectiveness of Barostim was based on the results of the randomized, placebo-controlled Rheos trial and the follow-up substudy of the DEBuT-HT trial. The cost-effectiveness was modelled from a German societal perspective over a lifetime horizon. Patients with high SBP levels have an increased risk of myocardial infarction, stroke, heart failure and end-stage renal disease. In a simulated cohort of 50-year-old patients at high risk of end-organ damage, Barostim therapy generated 1.66 additional life-years and 2.17 additional quality-adjusted life years with an incremental cost of &OV0556;16 891 when compared with continuation of medical management. Barostim was estimated to be cost-effective compared with optimal medical treatment with an incremental cost-effectiveness ratio of &OV0556;7 797/QALY. In the model, Barostim reduced over a lifetime the rates of myocardial infarction by 19%, stroke by 35%, heart failure by 12% and end-stage renal disease by 23%. The cost-effectiveness of Barostim can be greater in younger patients with resistant hypertension and in patients with significant risk factors for end-organ damage. Barostim may be a cost-effective treatment when compared with optimal medical management in patients with resistant hypertension.

  15. High Performance Commercial Fenestration Framing Systems

    Energy Technology Data Exchange (ETDEWEB)

    Mike Manteghi; Sneh Kumar; Joshua Early; Bhaskar Adusumalli

    2010-01-31

    A major objective of the U.S. Department of Energy is to have a zero energy commercial building by the year 2025. Windows have a major influence on the energy performance of the building envelope as they control over 55% of building energy load, and represent one important area where technologies can be developed to save energy. Aluminum framing systems are used in over 80% of commercial fenestration products (i.e. windows, curtain walls, store fronts, etc.). Aluminum framing systems are often required in commercial buildings because of their inherent good structural properties and long service life, which is required from commercial and architectural frames. At the same time, they are lightweight and durable, requiring very little maintenance, and offer design flexibility. An additional benefit of aluminum framing systems is their relatively low cost and easy manufacturability. Aluminum, being an easily recyclable material, also offers sustainable features. However, from energy efficiency point of view, aluminum frames have lower thermal performance due to the very high thermal conductivity of aluminum. Fenestration systems constructed of aluminum alloys therefore have lower performance in terms of being effective barrier to energy transfer (heat loss or gain). Despite the lower energy performance, aluminum is the choice material for commercial framing systems and dominates the commercial/architectural fenestration market because of the reasons mentioned above. In addition, there is no other cost effective and energy efficient replacement material available to take place of aluminum in the commercial/architectural market. Hence it is imperative to improve the performance of aluminum framing system to improve the energy performance of commercial fenestration system and in turn reduce the energy consumption of commercial building and achieve zero energy building by 2025. The objective of this project was to develop high performance, energy efficient commercial

  16. Clinical effectiveness and cost-effectiveness of quadrivalent human papillomavirus vaccination in HIV-negative men who have sex with men to prevent recurrent high-grade anal intraepithelial neoplasia.

    Science.gov (United States)

    Deshmukh, Ashish A; Chiao, Elizabeth Y; Das, Prajnan; Cantor, Scott B

    2014-12-05

    We examined the long-term clinical and economic benefits of quadrivalent human papillomavirus (qHPV) vaccine as a secondary/adjunct prevention strategy in the prevention of recurrent high-grade intraepithelial neoplasia (HGAIN) in HIV-negative men who have sex with men (MSM) and are 27 years or older. We constructed a Markov model to evaluate the clinical effectiveness and cost-effectiveness of two strategies: (1) no qHPV vaccine after treatment for HGAIN versus (2) qHPV vaccine after treatment for HGAIN. Model parameters, including natural history of anal cancer, vaccine efficacy measured in terms of hazard ratio (HR) (decrease in the risk of recurrent HGAIN), HGAIN treatment efficacy, utilities, and costs, were obtained from the literature. The outcomes were measured in terms of lifetime risk of anal cancer, lifetime cost, quality-adjusted life years, and incremental cost-effectiveness ratios (ICERs). Sensitivity analysis was conducted on all model parameters. We found that vaccinating HIV-negative MSM reduced the lifetime risk of anal cancer by 60.77% at an ICER of US$87,240 per quality-adjusted life-year. The results were highly sensitive to vaccine efficacy, transition of HGAIN to anal cancer, cost of treatment for HGAIN, vaccine degree of protection over time, and the vaccine duration of protection and less sensitive to HPV clearance, cost of qHPV vaccine, and the transitions from normal to low-grade anal intraepithelial neoplasia (LGAIN) and normal to HGAIN. With an HR of 0.3, the ICER was well below a $50,000 willingness-to-pay threshold; with an HR of 0.5, the ICER was still below a threshold of $100,000. The most critical disease-related factor influencing the cost-effectiveness was the progression of HGAIN to anal cancer. At an annual transition probability below 0.001, the ICER was below $50,000. Vaccinating HIV-negative MSM treated for HGAIN decreases the lifetime risk of anal cancer and is likely to be a cost-effective intervention.

  17. High-performance sports medicine

    National Research Council Canada - National Science Library

    Speed, Cathy

    2013-01-01

    High performance sports medicine involves the medical care of athletes, who are extraordinary individuals and who are exposed to intensive physical and psychological stresses during training and competition...

  18. Cost-effectiveness of Lung Cancer Screening in Canada.

    Science.gov (United States)

    Goffin, John R; Flanagan, William M; Miller, Anthony B; Fitzgerald, Natalie R; Memon, Saima; Wolfson, Michael C; Evans, William K

    2015-09-01

    The US National Lung Screening Trial supports screening for lung cancer among smokers using low-dose computed tomographic (LDCT) scans. The cost-effectiveness of screening in a publically funded health care system remains a concern. To assess the cost-effectiveness of LDCT scan screening for lung cancer within the Canadian health care system. The Cancer Risk Management Model (CRMM) simulated individual lives within the Canadian population from 2014 to 2034, incorporating cancer risk, disease management, outcome, and cost data. Smokers and former smokers eligible for lung cancer screening (30 pack-year smoking history, ages 55-74 years, for the reference scenario) were modeled, and performance parameters were calibrated to the National Lung Screening Trial (NLST). The reference screening scenario assumes annual scans to age 75 years, 60% participation by 10 years, 70% adherence to screening, and unchanged smoking rates. The CRMM outputs are aggregated, and costs (2008 Canadian dollars) and life-years are discounted 3% annually. The incremental cost-effectiveness ratio. Compared with no screening, the reference scenario saved 51,000 quality-adjusted life-years (QALY) and had an incremental cost-effectiveness ratio of CaD $52,000/QALY. If smoking history is modeled for 20 or 40 pack-years, incremental cost-effectiveness ratios of CaD $62,000 and CaD $43,000/QALY, respectively, were generated. Changes in participation rates altered life years saved but not the incremental cost-effectiveness ratio, while the incremental cost-effectiveness ratio is sensitive to changes in adherence. An adjunct smoking cessation program improving the quit rate by 22.5% improves the incremental cost-effectiveness ratio to CaD $24,000/QALY. Lung cancer screening with LDCT appears cost-effective in the publicly funded Canadian health care system. An adjunct smoking cessation program has the potential to improve outcomes.

  19. High Performance Space Pump Project

    Data.gov (United States)

    National Aeronautics and Space Administration — PDT is proposing a High Performance Space Pump based upon an innovative design using several technologies. The design will use a two-stage impeller, high temperature...

  20. An Alternative Vaccination Approach for The Prevention of Highly Pathogenic Avian Influenza Subtype H5N1 in The Red River Delta, Vietnam —A Geospatial-Based Cost-Effectiveness Analysis

    Directory of Open Access Journals (Sweden)

    Chinh C. Tran

    2016-02-01

    Full Text Available This study addresses the tradeoff between Vietnam’s national poultry vaccination program, which implemented an annual two-round HPAI H5N1 vaccination program for the entire geographical area of the Red River Delta during the period from 2005–2010, and an alternative vaccination program which would involve vaccination for every production cycle at the recommended poultry age in high risk areas within the Delta. The ex ante analysis framework was applied to identify the location of areas with high probability of HPAI H5N1 occurrence for the alternative vaccination program by using boosted regression trees (BRT models, followed by weighted overlay operations. Cost-effectiveness of the vaccination programs was then estimated to measure the tradeoff between the past national poultry vaccination program and the alternative vaccination program. Ex ante analysis showed that the focus areas for the alternative vaccination program included 1137 communes, corresponding to 50.6% of total communes in the Delta, and located primarily in the coastal areas to the east and south of Hanoi. The cost-effectiveness analysis suggested that the alternative vaccination program would have been more successful in reducing the rate of disease occurrence and the total cost of vaccinations, as compared to the national poultry vaccination program.

  1. High Performance Thin Layer Chromatography.

    Science.gov (United States)

    Costanzo, Samuel J.

    1984-01-01

    Clarifies where in the scheme of modern chromatography high performance thin layer chromatography (TLC) fits and why in some situations it is a viable alternative to gas and high performance liquid chromatography. New TLC plates, sample applications, plate development, and instrumental techniques are considered. (JN)

  2. High Performance Thin Layer Chromatography.

    Science.gov (United States)

    Costanzo, Samuel J.

    1984-01-01

    Clarifies where in the scheme of modern chromatography high performance thin layer chromatography (TLC) fits and why in some situations it is a viable alternative to gas and high performance liquid chromatography. New TLC plates, sample applications, plate development, and instrumental techniques are considered. (JN)

  3. High-Performance Data Converters

    DEFF Research Database (Denmark)

    Steensgaard-Madsen, Jesper

    Novel techniques for multi-bit oversampled data conversion are described. State-of-the-art oversampled data converters are analyzed, leading to the conclusion that their performance is limited mainly by low-resolution signal representation. To increase the resolution, high-performance, high...

  4. Scalable resource management in high performance computers.

    Energy Technology Data Exchange (ETDEWEB)

    Frachtenberg, E. (Eitan); Petrini, F. (Fabrizio); Fernandez Peinador, J. (Juan); Coll, S. (Salvador)

    2002-01-01

    Clusters of workstations have emerged as an important platform for building cost-effective, scalable and highly-available computers. Although many hardware solutions are available today, the largest challenge in making large-scale clusters usable lies in the system software. In this paper we present STORM, a resource management tool designed to provide scalability, low overhead and the flexibility necessary to efficiently support and analyze a wide range of job scheduling algorithms. STORM achieves these feats by closely integrating the management daemons with the low-level features that are common in state-of-the-art high-performance system area networks. The architecture of STORM is based on three main technical innovations. First, a sizable part of the scheduler runs in the thread processor located on the network interface. Second, we use hardware collectives that are highly scalable both for implementing control heartbeats and to distribute the binary of a parallel job in near-constant time, irrespective of job and machine sizes. Third, we use an I/O bypass protocol that allows fast data movements from the file system to the communication buffers in the network interface and vice versa. The experimental results show that STORM can launch a job with a binary of 12MB on a 64 processor/32 node cluster in less than 0.25 sec on an empty network, in less than 0.45 sec when all the processors are busy computing other jobs, and in less than 0.65 sec when the network is flooded with a background traffic. This paper provides experimental and analytical evidence that these results scale to a much larger number of nodes. To the best of our knowledge, STORM is at least two orders of magnitude faster than existing production schedulers in launching jobs, performing resource management tasks and gang scheduling.

  5. Cost-effectiveness of minimally invasive sacroiliac joint fusion

    Directory of Open Access Journals (Sweden)

    Cher DJ

    2015-12-01

    Full Text Available Daniel J Cher,1 Melissa A Frasco,2 Renée JG Arnold,2,3 David W Polly4,5 1Clinical Affairs, SI-BONE, Inc., San Jose, CA, USA; 2Division of Health Economics and Outcomes Research, Quorum Consulting, Inc., San Francisco, CA, USA; 3Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 4Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA; 5Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA Background: Sacroiliac joint (SIJ disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction. Objective: To determine the cost-effectiveness of minimally invasive SIJ fusion. Methods: Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed. Results: SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER <$26,000/QALY. Probabilistic analyses showed a high degree of certainty that the maximum ICER for SIJ fusion was less than commonly selected thresholds for acceptability (mean ICER =$13,687, 95% confidence interval $5,162–$28,085. SIJ fusion provided potential cost savings per QALY gained compared to non-surgical treatment after a treatment horizon of greater than 13 years. Conclusion: Compared to traditional non-surgical treatments

  6. Device Characterization of High Performance Quantum Dot Comb Laser

    KAUST Repository

    Rafi, Kazi

    2012-02-01

    The cost effective comb based laser sources are considered to be one of the prominent emitters used in optical communication (OC) and photonic integrated circuits (PIC). With the rising demand for delivering triple-play services (voice, data and video) in FTTH and FTTP-based WDM-PON networks, metropolitan area network (MAN), and short-reach rack-to-rack optical computer communications, a versatile and cost effective WDM transmitter design is required, where several DFB lasers can be replaced by a cost effective broadband comb laser to support on-chip optical signaling. Therefore, high performance quantum dot (Q.Dot) comb lasers need to satisfy several challenges before real system implementations. These challenges include a high uniform broadband gain spectrum from the active layer, small relative intensity noise with lower bit error rate (BER) and better temperature stability. Thus, such short wavelength comb lasers offering higher bandwidth can be a feasible solution to address these challenges. However, they still require thorough characterization before implementation. In this project, we briefly characterized the novel quantum dot comb laser using duty cycle based electrical injection and temperature variations where we have observed the presence of reduced thermal conductivity in the active layer. This phenomenon is responsible for the degradation of device performance. Hence, different performance trends, such as broadband emission and spectrum stability were studied with pulse and continuous electrical pumping. The tested comb laser is found to be an attractive solution for several applications but requires further experiments in order to be considered for photonic intergraded circuits and to support next generation computer-communications.

  7. High Performance Networks for High Impact Science

    Energy Technology Data Exchange (ETDEWEB)

    Scott, Mary A.; Bair, Raymond A.

    2003-02-13

    This workshop was the first major activity in developing a strategic plan for high-performance networking in the Office of Science. Held August 13 through 15, 2002, it brought together a selection of end users, especially representing the emerging, high-visibility initiatives, and network visionaries to identify opportunities and begin defining the path forward.

  8. Design and mechanism of cost-effective and highly efficient ultrathin (< 0.5 μm GaAs solar cells employing nano/micro-hemisphere surface texturing

    Directory of Open Access Journals (Sweden)

    J. S. Li

    2013-03-01

    Full Text Available Low aspect-ratio nano/micro-hemisphere surface texturing is introduced for improving light management in ultrathin GaAs solar cells. A 200 nm thick film textured by the optimal GaAs nano/micro-hemisphere array with both the hemisphere diameter and array periodicity of 500 nm can achieve >90% light absorption from 1.44 to 2.5 eV, lying in the high photon density energy regime of the solar spectrum for GaAs. The excellent light confinement and low aspect ratio, which is thus convenient for conformal deposition of electrodes for efficient photogenerated carrier collection of the proposed structure will facilitate realization of highly efficient and cost-effective ultrathin GaAs solar cells.

  9. Cost-effectiveness of opportunistic salpingectomy for ovarian cancer prevention.

    Science.gov (United States)

    Dilley, Sarah E; Havrilesky, Laura J; Bakkum-Gamez, Jamie; Cohn, David E; Michael Straughn, J; Caughey, Aaron B; Rodriguez, Maria I

    2017-08-01

    Data suggesting a link between the fallopian tube and ovarian cancer have led to an increase in rates of salpingectomy at the time of pelvic surgery, a practice known as opportunistic salpingectomy (OS). However, the potential benefits, risks and costs for this new practice are not well established. Our objective was to assess the cost-effectiveness of opportunistic salpingectomy at the time of laparoscopic permanent contraception or hysterectomy for benign indications. We created two models to compare the cost-effectiveness of salpingectomy versus usual care. The hypothetical study population is 50,000 women aged 45 undergoing laparoscopic hysterectomy with ovarian preservation for benign indications, and 300,000 women aged 35 undergoing laparoscopic permanent contraception. SEER data were used for probabilities of ovarian cancer cases and deaths. The ovarian cancer risk reduction, complication rates, utilities and associated costs were obtained from published literature. Sensitivity analyses and Monte Carlo simulation were performed, and incremental cost-effectiveness ratios (ICERs) were calculated to determine the cost per quality adjusted life year (QALY) gained. In the laparoscopic hysterectomy cohort, OS is cost saving and would yield $23.9 million in health care dollars saved. In the laparoscopic permanent contraception cohort, OS is cost-effective with an ICER of $31,432/QALY compared to tubal ligation, and remains cost-effective as long as it reduces ovarian cancer risk by 54%. Monte Carlo simulation demonstrated cost-effectiveness with hysterectomy and permanent contraception in 62.3% and 55% of trials, respectively. Opportunistic salpingectomy for low-risk women undergoing pelvic surgery may be a cost-effective strategy for decreasing ovarian cancer risk at time of hysterectomy or permanent contraception. In our model, salpingectomy was cost-effective with both procedures, but the advantage greater at time of hysterectomy. Copyright © 2017. Published by

  10. RTM: Cost-effective processing of composite structures

    Science.gov (United States)

    Hasko, Greg; Dexter, H. Benson

    1991-01-01

    Resin transfer molding (RTM) is a promising method for cost effective fabrication of high strength, low weight composite structures from textile preforms. In this process, dry fibers are placed in a mold, resin is introduced either by vacuum infusion or pressure, and the part is cured. RTM has been used in many industries, including automotive, recreation, and aerospace. Each of the industries has different requirements of material strength, weight, reliability, environmental resistance, cost, and production rate. These requirements drive the selection of fibers and resins, fiber volume fractions, fiber orientations, mold design, and processing equipment. Research is made into applying RTM to primary aircraft structures which require high strength and stiffness at low density. The material requirements are discussed of various industries, along with methods of orienting and distributing fibers, mold configurations, and processing parameters. Processing and material parameters such as resin viscosity, perform compaction and permeability, and tool design concepts are discussed. Experimental methods to measure preform compaction and permeability are presented.

  11. A quick, efficient, and cost-effective method for isolating high-quality total RNA from tomato fruits, suitable for molecular biology studies.

    Science.gov (United States)

    Sabzevari, Alireza Ghannad; Hosseini, Ramin

    2014-01-01

    Tomato (Solanum lycopersicum L.) is the primary model for the study of fleshy fruits, and research on this species has elucidated many aspects of fruit physiology, development, and metabolism. However, for advancing such studies at molecular biology levels, the RNA isolation from fruit tissues is often essential. The RNA isolation from tomato fruits is complicated because of the presence of high levels of polysaccharides, polyphenolics, pigments, and secondary metabolites and also the varying water content during development. Here, we present an optimized protocol for the isolation of total RNA from the fruit tissues at different developmental stages. In comparison to the previous methods described for the RNA isolation from tomato fruit, this method has the advantages that it does not involve the use of guanidine salts, lyophilizers, and commercial reagents, reduces the time and cost of extraction, overcomes the high water content problem, and promotes RNA quality by inhibiting RNA degradation and minimizing the gDNA, polyphenolic and polysaccharide contaminations. Using this method, high yields of high-purity and intact RNA samples were obtained as confirmed by the spectrophotometric readings and the electrophoresis on denaturing agarose gels. The isolated RNA was employed as a robust template for cDNA synthesis, reverse transcriptase-polymerase chain reaction (RT-PCR), and temporal gene expression analysis. The functionality of the isolated RNA was further demonstrated through cloning full-length cDNAs encoding β-galactosidase proteins by RT-PCR and sequencing.

  12. Cost-Effectiveness of Routine 18F-FDG PET/CT in High-Risk Patients with Gram-Positive Bacteremia

    NARCIS (Netherlands)

    Vos, F.J.; Bleeker-Rovers, C.P.; Kullberg, B.J.; Adang, E.M.M.; Oyen, W.J.G.

    2011-01-01

    Gram-positive bacteremia has a high morbidity and mortality rate of approximately 30%. Delayed diagnosis of clinically silent metastatic infectious foci is an important indicator for a complicated outcome. (18)F-FDG PET/CT allows detection of focal infection, resulting in lower relapse rates and mor

  13. RavenDB high performance

    CERN Document Server

    Ritchie, Brian

    2013-01-01

    RavenDB High Performance is comprehensive yet concise tutorial that developers can use to.This book is for developers & software architects who are designing systems in order to achieve high performance right from the start. A basic understanding of RavenDB is recommended, but not required. While the book focuses on advanced topics, it does not assume that the reader has a great deal of prior knowledge of working with RavenDB.

  14. High-Performance Operating Systems

    DEFF Research Database (Denmark)

    Sharp, Robin

    1999-01-01

    Notes prepared for the DTU course 49421 "High Performance Operating Systems". The notes deal with quantitative and qualitative techniques for use in the design and evaluation of operating systems in computer systems for which performance is an important parameter, such as real-time applications......, communication systems and multimedia systems....

  15. High-Performance Operating Systems

    DEFF Research Database (Denmark)

    Sharp, Robin

    1999-01-01

    Notes prepared for the DTU course 49421 "High Performance Operating Systems". The notes deal with quantitative and qualitative techniques for use in the design and evaluation of operating systems in computer systems for which performance is an important parameter, such as real-time applications......, communication systems and multimedia systems....

  16. Facile and Cost-Effective Synthesis and Deposition of a YBCO Superconductor on Copper Substrates by High-Energy Ball Milling

    Science.gov (United States)

    Alami, Abdul Hai; Assad, Mhd Adel; Aokal, Camilia

    2016-09-01

    The article investigates the synthesis and deposition of YBCO on a copper substrate for various functional purposes. The superconductor is first prepared by mechanically alloying elemental components (yttrium, barium, and copper) for 50 hours in a high-energy ball mill with subsequent protocol of heat treatment in an oxygen-rich atmosphere to arrive at stoichiometric ratios of YBa2Cu3O7. The material is then deposited on a thin copper substrate also by ball milling under various parameters of rotational speed and deposition time to select the best and most homogenous substrate coverage. Atomic force microscopy has confirmed the desired results, and other microstructural, thermal, and electrical techniques are used to characterize the obtained material. High-energy ball milling proved to be a versatile means to synthesize and deposit the material in a straightforward manner and controllable parameters for different deposit thicknesses and coverages.

  17. Facile and Cost-Effective Synthesis and Deposition of a YBCO Superconductor on Copper Substrates by High-Energy Ball Milling

    Science.gov (United States)

    Alami, Abdul Hai; Assad, Mhd Adel; Aokal, Camilia

    2016-12-01

    The article investigates the synthesis and deposition of YBCO on a copper substrate for various functional purposes. The superconductor is first prepared by mechanically alloying elemental components (yttrium, barium, and copper) for 50 hours in a high-energy ball mill with subsequent protocol of heat treatment in an oxygen-rich atmosphere to arrive at stoichiometric ratios of YBa2Cu3O7. The material is then deposited on a thin copper substrate also by ball milling under various parameters of rotational speed and deposition time to select the best and most homogenous substrate coverage. Atomic force microscopy has confirmed the desired results, and other microstructural, thermal, and electrical techniques are used to characterize the obtained material. High-energy ball milling proved to be a versatile means to synthesize and deposit the material in a straightforward manner and controllable parameters for different deposit thicknesses and coverages.

  18. Custom LSI plus hybrid equals cost effectiveness

    Science.gov (United States)

    Friedman, S. N.

    The possibility to combine various technologies, such as Bi-Polar linear and CMOS/Digital makes it feasible to create systems with a tailored performance not available on a single monolithic circuit. The custom LSI 'BLOCK', especially if it is universal in nature, is proving to be a cost effective way for the developer to improve his product. The custom LSI represents a low price part in contrast to the discrete components it will replace. In addition, the hybrid assembly can realize a savings in labor as a result of the reduced parts handling and associated wire bonds. The possibility of the use of automated system manufacturing techniques leads to greater reliability as the human factor is partly eliminated. Attention is given to reliability predictions, cost considerations, and a product comparison study.

  19. Cost-Effectiveness Analysis of Test-Based versus Presumptive Treatment of Uncomplicated Malaria in Children under Five Years in an Area of High Transmission in Central Ghana

    DEFF Research Database (Denmark)

    Tawiah, Theresa; Hansen, Kristian Schultz; Baiden, Frank

    2016-01-01

    ) or clinical judgement (control) was used to measure the effect of mRDTs on appropriate treatment: ‘a child with a positive reference diagnosis prescribed a course of ACT or a child with a negative reference diagnosis not given an ACT’. Cost data was collected from five purposively selected health centres...... and used to estimate the health sector costs of performing an mRDT and treat children for malaria and other common febrile illnesses. Costs of training healthcare personnel and supervision in the study period were also collected. A sample of caregivers to children participating in the trial was interviewed...... analyses were applied to assess the robustness of ICERs. Results: The availability of mRDTs for malaria diagnosis resulted in fewer ACT treatments compared to the clinical judgement approach (73% versus 81%) and more children appropriately treated (70% versus 57%). The introduction of mRDT-based diagnosis...

  20. The clinical and cost effectiveness of group art therapy for people with non-psychotic mental health disorders: a systematic review and cost-effectiveness analysis.

    Science.gov (United States)

    Uttley, Lesley; Stevenson, Matt; Scope, Alison; Rawdin, Andrew; Sutton, Anthea

    2015-07-07

    The majority of mental health problems are non-psychotic (e.g., depression, anxiety, and phobias). For some people, art therapy may be a more acceptable alternative form of psychological therapy than standard forms of treatment, such as talking therapies. This study was part of a health technology assessment commissioned by the National Institute for Health Research, UK and aimed to systematically appraise the clinical and cost-effective evidence for art therapy for people with non-psychotic mental health disorders. Comprehensive literature searches for studies examining art therapy in populations with non-psychotic mental health disorders were performed in May 2013. A quantitative systematic review of clinical effectiveness and a systematic review of studies evaluating the cost-effectiveness of group art therapy were conducted. Eleven randomised controlled trials were included (533 patients). Meta-analysis was not possible due to clinical heterogeneity and insufficient comparable data on outcome measures across studies. The control groups varied between studies but included: no treatment/wait-list, attention placebo controls and psychological therapy comparators. Art therapy was associated with significant positive changes relative to the control group in mental health symptoms in 7 of the 11 studies. A de novo model was constructed and populated with data identified from the clinical review. Scenario analyses were conducted allowing comparisons of group art therapy with wait-list control and group art therapy with group verbal therapy. Group art-therapy appeared cost-effective compared with wait-list control with high certainty although generalisability to the target population was unclear; group verbal therapy appeared more cost-effective than art therapy but there was considerable uncertainty and a sizeable probability that art therapy was more cost effective. From the limited available evidence art therapy was associated with positive effects compared with

  1. Systematic review of cost and cost-effectiveness of different TB-screening strategies

    Directory of Open Access Journals (Sweden)

    Costa José

    2011-09-01

    Full Text Available Abstract Background Interferon-γ release assays (IGRAs for TB have the potential to replace the tuberculin skin test (TST in screening for latent tuberculosis infection (LTBI. The higher per-test cost of IGRAs may be compensated for by lower post-screening costs (medical attention, chest x-rays and chemoprevention, given the higher specificity of the new tests as compared to that of the conventional TST. We conducted a systematic review of all publications that have addressed the cost or cost-effectiveness of IGRAs. The objective of this report was to undertake a structured review and critical appraisal of the methods used for the model-based cost-effectiveness analysis of TB screening programmes. Methods Using Medline and Embase, 75 publications that contained the terms "IGRA", "tuberculosis" and "cost" were identified. Of these, 13 were original studies on the costs or cost-effectiveness of IGRAs. Results The 13 relevant studies come from five low-to-medium TB-incidence countries. Five studies took only the costs of screening into consideration, while eight studies analysed the cost-effectiveness of different screening strategies. Screening was performed in high-risk groups: close contacts, immigrants from high-incidence countries and healthcare workers. Two studies used the T-SPOT.TB as an IGRA and the other studies used the QuantiFERON-TB Gold and/or Gold In-Tube test. All 13 studies observed a decrease in costs when the IGRAs were used. Six studies compared the use of an IGRA as a test to confirm a positive TST (TST/IGRA strategy to the use of an IGRA-only strategy. In four of these studies, the two-step strategy and in two the IGRA-only strategy was more cost-effective. Assumptions about TST specificity and progression risk after a positive test had the greatest influence on determining which IGRA strategy was more cost-effective. Conclusion The available studies on cost-effectiveness provide strong evidence in support of the use of IGRAs

  2. High-Performance Ball Bearing

    Science.gov (United States)

    Bursey, Roger W., Jr.; Haluck, David A.; Olinger, John B.; Owen, Samuel S.; Poole, William E.

    1995-01-01

    High-performance bearing features strong, lightweight, self-lubricating cage with self-lubricating liners in ball apertures. Designed to operate at high speed (tens of thousands of revolutions per minute) in cryogenic environment like liquid-oxygen or liquid-hydrogen turbopump. Includes inner race, outer race, and cage keeping bearing balls equally spaced.

  3. High-Performance Ball Bearing

    Science.gov (United States)

    Bursey, Roger W., Jr.; Haluck, David A.; Olinger, John B.; Owen, Samuel S.; Poole, William E.

    1995-01-01

    High-performance bearing features strong, lightweight, self-lubricating cage with self-lubricating liners in ball apertures. Designed to operate at high speed (tens of thousands of revolutions per minute) in cryogenic environment like liquid-oxygen or liquid-hydrogen turbopump. Includes inner race, outer race, and cage keeping bearing balls equally spaced.

  4. Optimization of Electrochemically Deposited Highly Doped ZnO Bilayers on Ga-Rich Chalcopyrite Selenide for Cost-Effective Photovoltaic Device Technology

    Directory of Open Access Journals (Sweden)

    Dimitra N. Papadimitriou

    2016-11-01

    Full Text Available High quality polycrystalline bilayers of aluminium doped ZnO (Al:ZnO were successively electrodeposited in the form of columnar structures preferentially oriented along the ( 10 1 ¯ 1 crystallographic direction from aqueous solution of zinc nitrate (Zn(NO32 at negative electrochemical potential of EC = (−0.8–(−1.2 V and moderate temperature of 80 °C on gallium rich (30% Ga chalcopyrite selenide Cu(In,GaSe2 (CIGS with chemically deposited ZnSe buffer (ZnSe/Cu(In,GaSe2/Mo/glass. The aluminium doped ZnO layer properties have initially been probed by deposition of Al:ZnO/i-ZnO bilayers directly on Mo/glass substrates. The band-gap energy of the Al:ZnO/i-ZnO reference layers was found to vary from 3.2 to 3.7 eV by varying the AlCl3 solute dopant concentration from 1 to 20 mM. The electrical resistivity of indium-pellet contacted highly doped Al:ZnO sheet of In/Al:ZnO/i-ZnO/Mo/glass reference samples was of the order ρ ~10−5 Ω·cm; the respective carrier concentration of the order 1022 cm−3 is commensurate with that of sputtered Al:ZnO layers. For crystal quality optimization of the bilayers by maintenance of the volatile selenium content of the chalcopyrite, they were subjected to 2-step annealing under successive temperature raise and N2 flux regulation. The hydrostatic compressive strain due to Al3+ incorporation in the ZnO lattice of bilayers processed successively with 5 and 12 mM AlCl3 dopant was εh = −0.046 and the respective stress σh = −20 GPa. The surface reflectivity of maximum 5% over the scanned region of 180–900 nm and the (optical band gap of Eg = 3.67 eV were indicative of the high optical quality of the electrochemically deposited (ECD Al:ZnO bilayers.

  5. A Power Compensated Novel Architecture of RM-OXC Based on T-FBG and OC: A High-speed and Cost-effective System

    Science.gov (United States)

    Singh, Manpreet; Dewra, Sanjeev

    2017-05-01

    This paper presents a high-speed, power-compensated novel architecture of N×N reconfigurable multiwavelength optical cross connect (RM-OXC) based on tunable fiber Bragg grating (T-FBG) and optical circulator (OC). FBG and OC-based OXCs are network elements that play a significant role in optical networks to offer more network survivability and reconfiguration flexibility. Optical signal-to-noise ratio of 71.05, 69.05 and 67.05 dB is achieved with acceptable quality factor of 7.54, 6.95 and 6.41, respectively, with 10 Gbps having input transmission power of -8 dBm at different transmission distances (40, 50, 60 km). It is found that the signal is communicated to a maximum distance of 60 km in the presence of fiber nonlinearities without optical amplifier at 0.8-nm channel spacing.

  6. Integrated microbial processes for biofuels and high value-added products: the way to improve the cost effectiveness of biofuel production.

    Science.gov (United States)

    da Silva, Teresa Lopes; Gouveia, Luísa; Reis, Alberto

    2014-02-01

    The production of microbial biofuels is currently under investigation, as they are alternative sources to fossil fuels, which are diminishing and their use has a negative impact on the environment. However, so far, biofuels derived from microbes are not economically competitive. One way to overcome this bottleneck is the use of microorganisms to transform substrates into biofuels and high value-added products, and simultaneously taking advantage of the various microbial biomass components to produce other products of interest, as an integrated process. In this way, it is possible to maximize the economic value of the whole process, with the desired reduction of the waste streams produced. It is expected that this integrated system makes the biofuel production economically sustainable and competitive in the near future. This review describes the investigation on integrated microbial processes (based on bacteria, yeast, and microalgal cultivations) that have been experimentally developed, highlighting the importance of this approach as a way to optimize microbial biofuel production process.

  7. A cost-effective strategy for the bio-prospecting of mixed microalgae with high carbohydrate content: diversity fluctuations in different growth media.

    Science.gov (United States)

    Cea-Barcia, Glenda; Buitrón, Germán; Moreno, Gloria; Kumar, Gopalakrishnan

    2014-07-01

    In recent years, widespread efforts have been directed towards decreasing the costs associated with microalgae culture systems for the production of biofuels. In this study, a simple and inexpensive strategy to bio-prospect and cultivate mixed indigenous chlorophytes with a high carbohydrate content for biomethane and biohydrogen production was developed. Mixed microalgae were collected from four different water-bodies in Queretaro, Mexico, and were grown in Bold's basal mineral medium and secondary effluent from a wastewater treatment plant using inexpensive photo-bioreactors. The results showed large fluctuations in microalgal genera diversity based on different culture media and nitrogen sources. In secondary effluent, Golenkinia sp. and Scenedesmus sp. proliferated. The carbohydrate content, for secondary effluent, varied between 12% and 57%, and the highest volumetric and areal productivity were 61 mg L(-1)d(-1) and 4.6 g m(-2)d(-1), respectively. These results indicate that mixed microalgae are a good feedstock for biomethane and biohydrogen production.

  8. Cost-effectiveness of thrombolysis within 4.5 hours of acute ischemic stroke in China.

    Directory of Open Access Journals (Sweden)

    Yuesong Pan

    Full Text Available BACKGROUND: Previous economic studies conducted in developed countries showed intravenous tissue-type plasminogen activator (tPA is cost-effective for acute ischemic stroke. The present study aimed to determine the cost-effectiveness of tPA treatment in China, the largest developing country. METHODS: A combination of decision tree and Markov model was developed to determine the cost-effectiveness of tPA treatment versus non-tPA treatment within 4.5 hours after stroke onset. Outcomes and costs data were derived from the database of Thrombolysis Implementation and Monitor of acute ischemic Stroke in China (TIMS-China study. Efficacy data were derived from a pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Costs and quality-adjusted life-years (QALYs were compared in both short term (2 years and long term (30 years. One-way and probabilistic sensitivity analyses were performed to test the robustness of the results. RESULTS: Comparing to non-tPA treatment, tPA treatment within 4.5 hours led to a short-term gain of 0.101 QALYs at an additional cost of CNY 9,520 (US$ 1,460, yielding an incremental cost-effectiveness ratio (ICER of CNY 94,300 (US$ 14,500 per QALY gained in 2 years; and to a long-term gain of 0.422 QALYs at an additional cost of CNY 6,530 (US$ 1,000, yielding an ICER of CNY 15,500 (US$ 2,380 per QALY gained in 30 years. Probabilistic sensitivity analysis showed that tPA treatment is cost-effective in 98.7% of the simulations at a willingness-to-pay threshold of CNY 105,000 (US$ 16,200 per QALY. CONCLUSIONS: Intravenous tPA treatment within 4.5 hours is highly cost-effective for acute ischemic strokes in China.

  9. Cost-Effectiveness Analysis of Different Genetic Testing Strategies for Lynch Syndrome in Taiwan.

    Science.gov (United States)

    Chen, Ying-Erh; Kao, Sung-Shuo; Chung, Ren-Hua

    2016-01-01

    Patients with Lynch syndrome (LS) have a significantly increased risk of developing colorectal cancer (CRC) and other cancers. Genetic screening for LS among patients with newly diagnosed CRC aims to identify mutations in the disease-causing genes (i.e., the DNA mismatch repair genes) in the patients, to offer genetic testing for relatives of the patients with the mutations, and then to provide early prevention for the relatives with the mutations. Several genetic tests are available for LS, such as DNA sequencing for MMR genes and tumor testing using microsatellite instability and immunohistochemical analyses. Cost-effectiveness analyses of different genetic testing strategies for LS have been performed in several studies from different countries such as the US and Germany. However, a cost-effectiveness analysis for the testing has not yet been performed in Taiwan. In this study, we evaluated the cost-effectiveness of four genetic testing strategies for LS described in previous studies, while population-specific parameters, such as the mutation rates of the DNA mismatch repair genes and treatment costs for CRC in Taiwan, were used. The incremental cost-effectiveness ratios based on discounted life years gained due to genetic screening were calculated for the strategies relative to no screening and to the previous strategy. Using the World Health Organization standard, which was defined based on Taiwan's Gross Domestic Product per capita, the strategy based on immunohistochemistry as a genetic test followed by BRAF mutation testing was considered to be highly cost-effective relative to no screening. Our probabilistic sensitivity analysis results also suggest that the strategy has a probability of 0.939 of being cost-effective relative to no screening based on the commonly used threshold of $50,000 to determine cost-effectiveness. To the best of our knowledge, this is the first cost-effectiveness analysis for evaluating different genetic testing strategies for LS in

  10. A risk-profiling approach for surveillance of inflammatory bowel disease-colorectal carcinoma is more cost-effective: a comparative cost-effectiveness analysis between international guidelines.

    Science.gov (United States)

    Lutgens, Maurice; van Oijen, Martijn; Mooiweer, Erik; van der Valk, Mirthe; Vleggaar, Frank; Siersema, Peter; Oldenburg, Bas

    2014-11-01

    Colonoscopic surveillance for neoplasia is recommended for patients with inflammatory bowel disease (IBD)-related colitis. However, data on cost-effectiveness predate current international guidelines. To compare cost-effectiveness based on contemporary data between the surveillance strategies of the American Gastroenterological Association (AGA) and British Society of Gastroenterology (BSG). We constructed a Markov decision model to simulate the clinical course of IBD patients. We compared the 2 surveillance strategies for a base case of a 40-year-old colitis patient who was followed for 40 years. AGA surveillance distinguishes 2 groups: a high-risk group with annual surveillance and an average-risk group with biannual surveillance. BSG surveillance distinguishes 3 risk groups with yearly, 3-year, or 5-year surveillance. Patients could move from a no-dysplasia state with colonoscopic surveillance to 1 of 3 states for which proctocolectomy was indicated: (1) dysplasia/local cancer, (2) regional/metastasized cancer, or (3) refractory disease. After proctocolectomy, a patient moved to a no-colon state without surveillance. Direct costs of medical care, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. BSG surveillance dominated AGA surveillance with $9846 per QALY. Both strategies were equally effective with 24.16 QALYs, but BSG surveillance was associated with lower costs because of fewer colonoscopies performed. Costs related to IBD, surgery, or cancer did not affect cost-effectiveness. The model depends on the accuracy of derived data, and the assumptions that were made to reflect real-life situations. Study conclusions may only apply to the U.S. health care system. The updated risk-profiling approach for surveillance of IBD colorectal carcinoma by the BSG guideline appears to be more cost-effective. Copyright © 2014. Published by Elsevier Inc.

  11. Cost-effectiveness thresholds: pros and cons.

    Science.gov (United States)

    Bertram, Melanie Y; Lauer, Jeremy A; De Joncheere, Kees; Edejer, Tessa; Hutubessy, Raymond; Kieny, Marie-Paule; Hill, Suzanne R

    2016-12-01

    Cost-effectiveness analysis is used to compare the costs and outcomes of alternative policy options. Each resulting cost-effectiveness ratio represents the magnitude of additional health gained per additional unit of resources spent. Cost-effectiveness thresholds allow cost-effectiveness ratios that represent good or very good value for money to be identified. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, in choosing which health interventions to fund and which not to fund, these thresholds have been used as decision rules. However, experience with the use of such GDP-based thresholds in decision-making processes at country level shows them to lack country specificity and this - in addition to uncertainty in the modelled cost-effectiveness ratios - can lead to the wrong decision on how to spend health-care resources. Cost-effectiveness information should be used alongside other considerations - e.g. budget impact and feasibility considerations - in a transparent decision-making process, rather than in isolation based on a single threshold value. Although cost-effectiveness ratios are undoubtedly informative in assessing value for money, countries should be encouraged to develop a context-specific process for decision-making that is supported by legislation, has stakeholder buy-in, for example the involvement of civil society organizations and patient groups, and is transparent, consistent and fair.

  12. A Departmental Cost-Effectiveness Model.

    Science.gov (United States)

    Holleman, Thomas, Jr.

    In establishing a departmental cost-effectiveness model, the traditional cost-effectiveness model was discussed and equipped with a distant and deflation equation for both benefits and costs. Next, the economics of costing was examined and program costing procedures developed. Then, the model construct was described as it was structured around the…

  13. Cost-effective ultrasound PACS solution

    Science.gov (United States)

    Honeyman-Buck, Janice C.; Frost, Meryll M.; Staab, Edward V.

    1995-05-01

    Picture archiving and communication systems (PACS) have been quite successful at the University of Florida in the areas of CT, MR, and nuclear medicine. In each case, although we have not always been able to provide the optimal level of performance, we have been able to solve a problem and the systems are used extensively. Ultrasound images are required in a number of locations and the multiformat camera print capability was no longer adequate for the growing volume in the ultrasound section. Although we were certain we could successfully implement PACS for ultrasound, new forces in health care dictate that we justify our system in terms of cost. We analyzed the feasibility of a PACS solution for ultrasound and designed a system that meets our needs and is cost effective. We evaluated the ultrasound operation in terms of image acquisition patterns and throughput requirements. An inventory of existing and PACS equipment was made to determine the feasibility of interfacing the two systems. Commercial systems were evaluated for functionality and cost and a system was designed to meet our needs. The only way to achieve our goal of installing a cost effective ultrasound PACS was to eliminate film and use the cost savings to offset the cost of new equipment and development. We designed a system that could be produced using inexpensive components and existing hardware and software to meet our needs. A commercial vendor was chosen to provide the ultrasound acquisition. The Radiology Information System interface used at the University provides the necessary data to build a DICOM header, and an existing DICOM server routes the images to the appropriate workstations, archives, and printers. Additional storage is added to an existing archive to accommodate the ultrasound images and two existing workstations are evaluated for use in ultrasound.

  14. High performance scalable image coding

    Institute of Scientific and Technical Information of China (English)

    Gan Tao; He Yanmin; Zhu Weile

    2007-01-01

    A high performance scalable image coding algorithm is proposed. The salient features of this algorithm are the ways to form and locate the significant clusters. Thanks to the list structure, the new coding algorithm achieves fine fractional bit-plane coding with negligible additional complexity. Experiments show that it performs comparably or better than the state-of-the-art coders. Furthermore, the flexible codec supports both quality and resolution scalability, which is very attractive in many network applications.

  15. [Cost-effectiveness of an organized breast cancer screening program in Southern Brazil].

    Science.gov (United States)

    Ribeiro, Rodrigo Antonini; Caleffi, Maira; Polanczyk, Carisi Anne

    2013-11-01

    The aim of this study was to evaluate the cost-effectiveness of an organized breast cancer mammographic screening program implemented in Porto Alegre (Núcleo Mama Porto Alegre - NMPOA), Rio Grande do Sul State, Brazil. A Markov model was constructed to estimate the incremental cost-effectiveness ratio of NMPOA compared to current BC diagnosis and care in the Brazilian public health system, in a hypothetical cohort of women aged 40-69 years at risk of developing breast cancer. Model parameters were collected from NMPOA and the national literature. In the NMPOA strategy, effectiveness was modeled taking into account the actual observed screening adherence. Effectiveness was measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio in the base case was R$ 13,426 per QALY. This result was not sensitive to variation in the main model parameters in sensitivity analyses. Considering the threshold usually suggested as highly attractive in Brazil, breast cancer screening as performed in NMPOA is cost-effective in cities with high incidence of breast cancer.

  16. INL High Performance Building Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Jennifer D. Morton

    2010-02-01

    High performance buildings, also known as sustainable buildings and green buildings, are resource efficient structures that minimize the impact on the environment by using less energy and water, reduce solid waste and pollutants, and limit the depletion of natural resources while also providing a thermally and visually comfortable working environment that increases productivity for building occupants. As Idaho National Laboratory (INL) becomes the nation’s premier nuclear energy research laboratory, the physical infrastructure will be established to help accomplish this mission. This infrastructure, particularly the buildings, should incorporate high performance sustainable design features in order to be environmentally responsible and reflect an image of progressiveness and innovation to the public and prospective employees. Additionally, INL is a large consumer of energy that contributes to both carbon emissions and resource inefficiency. In the current climate of rising energy prices and political pressure for carbon reduction, this guide will help new construction project teams to design facilities that are sustainable and reduce energy costs, thereby reducing carbon emissions. With these concerns in mind, the recommendations described in the INL High Performance Building Strategy (previously called the INL Green Building Strategy) are intended to form the INL foundation for high performance building standards. This revised strategy incorporates the latest federal and DOE orders (Executive Order [EO] 13514, “Federal Leadership in Environmental, Energy, and Economic Performance” [2009], EO 13423, “Strengthening Federal Environmental, Energy, and Transportation Management” [2007], and DOE Order 430.2B, “Departmental Energy, Renewable Energy, and Transportation Management” [2008]), the latest guidelines, trends, and observations in high performance building construction, and the latest changes to the Leadership in Energy and Environmental Design

  17. FUNDAMENTALS OF HIGH PERFORMANCE ORGANIZATIONS.

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Gili Massi

    2013-06-01

    Full Text Available The objective of this article is to verify whether organizations’ high performance rests on their culture, which adjusts their cultural values, strategy, and external environment. A strong organizational culture has been reported as determinant of organizations’ performance. These studies approach the influence of values guiding and adjusting the organization’s strategic actions regarding its external environment. The bibliographic research showed that there are other variables impacting of organizations’ performance and it was concluded that the objective of this study was partially achieved.

  18. Storage Area Networks and The High Performance Storage System

    Energy Technology Data Exchange (ETDEWEB)

    Hulen, H; Graf, O; Fitzgerald, K; Watson, R W

    2002-03-04

    The High Performance Storage System (HPSS) is a mature Hierarchical Storage Management (HSM) system that was developed around a network-centered architecture, with client access to storage provided through third-party controls. Because of this design, HPSS is able to leverage today's Storage Area Network (SAN) infrastructures to provide cost effective, large-scale storage systems and high performance global file access for clients. Key attributes of SAN file systems are found in HPSS today, and more complete SAN file system capabilities are being added. This paper traces the HPSS storage network architecture from the original implementation using HIPPI and IPI-3 technology, through today's local area network (LAN) capabilities, and to SAN file system capabilities now in development. At each stage, HPSS capabilities are compared with capabilities generally accepted today as characteristic of storage area networks and SAN file systems.

  19. Optimization and Performance Analysis of High Speed Mobile Access Networks

    CERN Document Server

    Weerawardane, Thushara

    2012-01-01

    The design and development of cost-effective mobile broadband wireless access networks is a key challenge for many mobile network operators. The over-dimensioning or under-dimensioning of an access network results in both additional costs and customer dissatisfaction.   Thushara Weerawardane introduces new transport technologies and features for High Speed Packet Access (HSPA) and Long-Term Evolution (LTE) networks. Using advanced scientific methods, he proposes new adaptive flow control and enhanced congestion control algorithms, then defends them with highly-developed analytical models derived from Markov chains. For faster analysis, compared to long-lasting detailed simulations, these models provide optimum network performance and ensure reliable quality standards for end users during transport network congestion. Further, the author investigates and analyzes LTE transport network performance by introducing novel traffic differentiation models and buffer management techniques during intra-LTE handovers.

  20. Annual Report, Fall 2016: Identifying Cost Effective Tank Waste Characterization Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Reboul, S. H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); DiPrete, D. P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-12-12

    This report documents the activities that were performed during the second year of a project undertaken to improve the cost effectiveness and timeliness of SRNL’s tank closure characterization practices. The activities performed during the first year of the project were previously reported in SRNL-STI-2015-00144. The scope of the second year activities was divided into the following three primary tasks: 1) develop a technical basis and strategy for improving the cost effectiveness and schedule of SRNL’s tank closure characterization program; 2) initiate the design and assembly of a new waste removal system for improving the throughput and reducing the personnel dose associated with extraction chromatography radiochemical separations; and 3) develop and perform feasibility testing of three alternative radiochemical separation protocols holding promise for improving high resource demand/time consuming tank closure sample analysis methods.

  1. High-Performance Polymeric Materials.

    Science.gov (United States)

    1987-12-07

    interactions, Chain packing, Polybenzobisoxazoles Electrical conductivity Polybenzobisthiazoles Ceramic particles Chain flexibility Elastomer reinforcement...structures for the polybenzobisoxazole (PBO) and polybenzobisthiazole (PBT) chains originally synthesized and much studied because of their utility as...high-performance fibers and films. For cts-PBO, trans-PBO. and trans-PBT chains in their coplanar conformations, the band gaps in the axial direction

  2. High performance rolling element bearing

    Science.gov (United States)

    Bursey, Jr., Roger W. (Inventor); Olinger, Jr., John B. (Inventor); Owen, Samuel S. (Inventor); Poole, William E. (Inventor); Haluck, David A. (Inventor)

    1993-01-01

    A high performance rolling element bearing (5) which is particularly suitable for use in a cryogenically cooled environment, comprises a composite cage (45) formed from glass fibers disposed in a solid lubricant matrix of a fluorocarbon polymer. The cage includes inserts (50) formed from a mixture of a soft metal and a solid lubricant such as a fluorocarbon polymer.

  3. High Performance Bulk Thermoelectric Materials

    Energy Technology Data Exchange (ETDEWEB)

    Ren, Zhifeng [Boston College, Chestnut Hill, MA (United States)

    2013-03-31

    Over 13 plus years, we have carried out research on electron pairing symmetry of superconductors, growth and their field emission property studies on carbon nanotubes and semiconducting nanowires, high performance thermoelectric materials and other interesting materials. As a result of the research, we have published 104 papers, have educated six undergraduate students, twenty graduate students, nine postdocs, nine visitors, and one technician.

  4. High performance in software development

    CERN Document Server

    CERN. Geneva; Haapio, Petri; Liukkonen, Juha-Matti

    2015-01-01

    What are the ingredients of high-performing software? Software development, especially for large high-performance systems, is one the most complex tasks mankind has ever tried. Technological change leads to huge opportunities but challenges our old ways of working. Processing large data sets, possibly in real time or with other tight computational constraints, requires an efficient solution architecture. Efficiency requirements span from the distributed storage and large-scale organization of computation and data onto the lowest level of processor and data bus behavior. Integrating performance behavior over these levels is especially important when the computation is resource-bounded, as it is in numerics: physical simulation, machine learning, estimation of statistical models, etc. For example, memory locality and utilization of vector processing are essential for harnessing the computing power of modern processor architectures due to the deep memory hierarchies of modern general-purpose computers. As a r...

  5. The 10-Year Cost-Effectiveness of Lifestyle Intervention or Metformin for Diabetes Prevention

    OpenAIRE

    ,

    2012-01-01

    OBJECTIVE The Diabetes Prevention Program (DPP) and its Outcomes Study (DPPOS) demonstrated that either intensive lifestyle intervention or metformin could prevent type 2 diabetes in high-risk adults for at least 10 years after randomization. We report the 10-year within-trial cost-effectiveness of the interventions. RESEARCH DESIGN AND METHODS Data on resource utilization, cost, and quality of life were collected prospectively. Economic analyses were performed from health system and societal...

  6. High Performance Tools And Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Collette, M R; Corey, I R; Johnson, J R

    2005-01-24

    This goal of this project was to evaluate the capability and limits of current scientific simulation development tools and technologies with specific focus on their suitability for use with the next generation of scientific parallel applications and High Performance Computing (HPC) platforms. The opinions expressed in this document are those of the authors, and reflect the authors' current understanding and functionality of the many tools investigated. As a deliverable for this effort, we are presenting this report describing our findings along with an associated spreadsheet outlining current capabilities and characteristics of leading and emerging tools in the high performance computing arena. This first chapter summarizes our findings (which are detailed in the other chapters) and presents our conclusions, remarks, and anticipations for the future. In the second chapter, we detail how various teams in our local high performance community utilize HPC tools and technologies, and mention some common concerns they have about them. In the third chapter, we review the platforms currently or potentially available to utilize these tools and technologies on to help in software development. Subsequent chapters attempt to provide an exhaustive overview of the available parallel software development tools and technologies, including their strong and weak points and future concerns. We categorize them as debuggers, memory checkers, performance analysis tools, communication libraries, data visualization programs, and other parallel development aides. The last chapter contains our closing information. Included with this paper at the end is a table of the discussed development tools and their operational environment.

  7. CT colonography and cost-effectiveness

    Energy Technology Data Exchange (ETDEWEB)

    Mavranezouli, Ifigeneia [University College London, National Collaborating Centre for Mental Health, Centre for Outcomes Research and Effectiveness, Sub-department of Clinical Health Psychology, London (United Kingdom); East, James E. [St Marks Hospital, Imperial College London, Wolfson Unit for Endoscopy, London (United Kingdom); Taylor, Stuart A. [University College Hospital, Specialist X-Ray, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom)

    2008-11-15

    CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

  8. Final report: Compiled MPI. Cost-Effective Exascale Application Development

    Energy Technology Data Exchange (ETDEWEB)

    Gropp, William Douglas [Univ. of Illinois, Urbana-Champaign, IL (United States)

    2015-12-21

    This is the final report on Compiled MPI: Cost-Effective Exascale Application Development, and summarizes the results under this project. The project investigated runtime enviroments that improve the performance of MPI (Message-Passing Interface) programs; work at Illinois in the last period of this project looked at optimizing data access optimizations expressed with MPI datatypes.

  9. Toward high performance graphene fibers.

    Science.gov (United States)

    Chen, Li; He, Yuling; Chai, Songgang; Qiang, Hong; Chen, Feng; Fu, Qiang

    2013-07-07

    Two-dimensional graphene and graphene-based materials have attracted tremendous interest, hence much attention has been drawn to exploring and applying their exceptional characteristics and properties. Integration of graphene sheets into macroscopic fibers is a very important way for their application and has received increasing interest. In this study, neat and macroscopic graphene fibers were continuously spun from graphene oxide (GO) suspensions followed by chemical reduction. By varying wet-spinning conditions, a series of graphene fibers were prepared, then, the structural features, mechanical and electrical performances of the fibers were investigated. We found the orientation of graphene sheets, the interaction between inter-fiber graphene sheets and the defects in the fibers have a pronounced effect on the properties of the fibers. Graphene fibers with excellent mechanical and electrical properties will yield great advances in high-tech applications. These findings provide guidance for the future production of high performance graphene fibers.

  10. Cost-effectiveness of HCV screening: a systematic review of the literature from 2007 to 2012

    Directory of Open Access Journals (Sweden)

    Alessandro Camera

    2013-07-01

    Full Text Available Background: currently, 123-170 million people in the world are infected with Hepatitis C Virus (HCV and 75% of them remain undiagnosed. HCV-positive individuals will develop Chronic Hepatitis C (CHC or hepatocellular carcinoma (HCC within 25 years in 20-30% of cases. Early detection of HCV has been demonstrated to increase quality-adjusted life years (QALY and to improve the behaviour of the infected population. Current national policies usually recommend regular screenings only for at-risk populations. A systematic review of the recent evidence on long-term cost-effectiveness of HCV screening in different populations was performed.Methods: resources were searched on publicly available databases (PubMed, ScienceDirect, NHS EED, Cochrane Library and Google®. Studies were considered eligible if published between 2007 and 2012 and if providing measures of incremental cost-effectiveness ratio (ICER or incremental cost utility ratio (ICUR of HCV screening in terms of cost/life years gained (LYG and cost/QALY. All the costs were converted into Euro (€ for 2011. A weighted version of the Drummond checklist was used to further assess the quality of the included studies.Results: six articles were selected and analysed. Three U.S. and one Japanese studies suggested a positive cost-effectiveness profile of broad birth-cohort and population screening. Other studies conducted in Italy and the UK demonstrated high variability in the cost-effectiveness in different study populations. All the studies were judged of medium-high quality.Conclusions: cost-effectiveness of HCV screening significantly varies among countries and study populations. Prevalence in the population should be one of the criteria for policy-makers for future decisions and recommendations. New Direct-Acting Antiviral agents might increase the costeffectiveness of early HCV screening. Future studies should also focus on migrants and men who have sex with men (MSM populations.

  11. Neo4j high performance

    CERN Document Server

    Raj, Sonal

    2015-01-01

    If you are a professional or enthusiast who has a basic understanding of graphs or has basic knowledge of Neo4j operations, this is the book for you. Although it is targeted at an advanced user base, this book can be used by beginners as it touches upon the basics. So, if you are passionate about taming complex data with the help of graphs and building high performance applications, you will be able to get valuable insights from this book.

  12. Green Infrastructure Siting and Cost Effectiveness Analysis

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Parcel scale green infrastructure siting and cost effectiveness analysis. You can find more details at the project's website.

  13. Cost-effectiveness of Intensive Blood Pressure Management

    DEFF Research Database (Denmark)

    Richman, Ilana B; Fairley, Michael; Jørgensen, Mads Emil

    2016-01-01

    . Objective: To evaluate the incremental cost-effectiveness of intensive blood pressure management compared with standard management. Design, Setting, and Participants: This cost-effectiveness analysis conducted from September 2015 to August 2016 used a Markov cohort model to estimate cost-effectiveness...... of intensive blood pressure management among 68-year-old high-risk adults with hypertension but not diabetes. We used the Systolic Blood Pressure Intervention Trial (SPRINT) to estimate treatment effects and adverse event rates. We used Centers for Disease Control and Prevention Life Tables to project age....... Interventions: Treatment of hypertension to a systolic blood pressure goal of 120 mm Hg (intensive management) or 140 mm Hg (standard management). Main Outcomes and Measures: Lifetime costs and quality-adjusted life-years (QALYs), discounted at 3% annually. Results: Standard management yielded 9.6 QALYs...

  14. Pursuing Photovoltaic Cost-Effectiveness

    DEFF Research Database (Denmark)

    Yang, Yongheng; Koutroulis, Eftichios; Sangwongwanich, Ariya

    2017-01-01

    Countries with considerable PhotoVoltaic (PV) installations are facing a challenge of overloading their power grid during peak-power production hours if the power infrastructure remains the same. To address this, regulations have been imposed on PV systems, where more active power control should...... be flexibly performed. As an advanced control strategy, the Absolute Active Power Control (AAPC) can effectively solve the overloading issues by limiting the maximum possible PV power to a certain level (i.e., the power limitation), and also benefit the inverter reliability due to the reduction in the thermal...... loading of the power devices. However, its feasibility is challenged by the associated energy losses. An increase of the inverter lifetime and a reduction of the energy yield can alter the cost of energy, demanding an optimization of the power limitation. Therefore, aiming at minimizing the Levelized Cost...

  15. High performance MEAs. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-15

    The aim of the present project is through modeling, material and process development to obtain significantly better MEA performance and to attain the technology necessary to fabricate stable catalyst materials thereby providing a viable alternative to current industry standard. This project primarily focused on the development and characterization of novel catalyst materials for the use in high temperature (HT) and low temperature (LT) proton-exchange membrane fuel cells (PEMFC). New catalysts are needed in order to improve fuel cell performance and reduce the cost of fuel cell systems. Additional tasks were the development of new, durable sealing materials to be used in PEMFC as well as the computational modeling of heat and mass transfer processes, predominantly in LT PEMFC, in order to improve fundamental understanding of the multi-phase flow issues and liquid water management in fuel cells. An improved fundamental understanding of these processes will lead to improved fuel cell performance and hence will also result in a reduced catalyst loading to achieve the same performance. The consortium have obtained significant research results and progress for new catalyst materials and substrates with promising enhanced performance and fabrication of the materials using novel methods. However, the new materials and synthesis methods explored are still in the early research and development phase. The project has contributed to improved MEA performance using less precious metal and has been demonstrated for both LT-PEM, DMFC and HT-PEM applications. New novel approach and progress of the modelling activities has been extremely satisfactory with numerous conference and journal publications along with two potential inventions concerning the catalyst layer. (LN)

  16. Cost-effectiveness analyses in orthopaedic sports medicine: a systematic review.

    Science.gov (United States)

    Nwachukwu, Benedict U; Schairer, William W; Bernstein, Jaime L; Dodwell, Emily R; Marx, Robert G; Allen, Answorth A

    2015-06-01

    As increasing attention is paid to the cost of health care delivered in the United States (US), cost-effectiveness analyses (CEAs) are gaining in popularity. Reviews of the CEA literature have been performed in other areas of medicine, including some subspecialties within orthopaedics. Demonstrating the value of medical procedures is of utmost importance, yet very little is known about the overall quality and findings of CEAs in sports medicine. To identify and summarize CEA studies in orthopaedic sports medicine and to grade the quality of the available literature. Systematic review. A systematic review of the literature was performed to compile findings and grade the methodological quality of US-based CEA studies in sports medicine. The Quality of Health Economic Studies (QHES) instrument and the checklist by the US Panel on Cost-effectiveness in Health and Medicine were used to assess study quality. One-sided Fisher exact testing was performed to analyze the predictors of high-quality CEAs. Twelve studies met inclusion criteria. Five studies examined anterior cruciate ligament reconstruction, 3 studies examined rotator cuff repair, 2 examined autologous chondrocyte implantation, 1 study examined hip arthroscopic surgery, and 1 study examined the operative management of shoulder dislocations. Based on study findings, operative intervention in sports medicine is highly cost-effective. The quality of published evidence is good, with a mean quality score of 81.8 (range, 70-94). There is a trend toward higher quality in more recent publications. No significant predictor of high-quality evidence was found. The CEA literature in sports medicine is good; however, there is a paucity of studies, and the available evidence is focused on a few procedures. More work needs to be conducted to quantify the cost-effectiveness of different techniques and procedures within sports medicine. The QHES tool may be useful for the evaluation of future CEAs. © 2014 The Author(s).

  17. Cost effectiveness of robotic mitral valve surgery

    Science.gov (United States)

    2017-01-01

    Significant technological advances have led to an impressive evolution in mitral valve surgery over the last two decades, allowing surgeons to safely perform less invasive operations through the right chest. Most new technology comes with an increased upfront cost that must be measured against postoperative savings and other advantages such as decreased perioperative complications, faster recovery, and earlier return to preoperative level of functioning. The Da Vinci robot is an example of such a technology, combining the significant benefits of minimally invasive surgery with a “gold standard” valve repair. Although some have reported that robotic surgery is associated with increased overall costs, there is literature suggesting that efficient perioperative care and shorter lengths of stay can offset the increased capital and intraoperative expenses. While data on current cost is important to consider, one must also take into account future potential value resulting from technological advancement when evaluating cost-effectiveness. Future refinements that will facilitate more effective surgery, coupled with declining cost of technology will further increase the value of robotic surgery compared to traditional approaches. PMID:28203539

  18. High Performance Proactive Digital Forensics

    Science.gov (United States)

    Alharbi, Soltan; Moa, Belaid; Weber-Jahnke, Jens; Traore, Issa

    2012-10-01

    With the increase in the number of digital crimes and in their sophistication, High Performance Computing (HPC) is becoming a must in Digital Forensics (DF). According to the FBI annual report, the size of data processed during the 2010 fiscal year reached 3,086 TB (compared to 2,334 TB in 2009) and the number of agencies that requested Regional Computer Forensics Laboratory assistance increasing from 689 in 2009 to 722 in 2010. Since most investigation tools are both I/O and CPU bound, the next-generation DF tools are required to be distributed and offer HPC capabilities. The need for HPC is even more evident in investigating crimes on clouds or when proactive DF analysis and on-site investigation, requiring semi-real time processing, are performed. Although overcoming the performance challenge is a major goal in DF, as far as we know, there is almost no research on HPC-DF except for few papers. As such, in this work, we extend our work on the need of a proactive system and present a high performance automated proactive digital forensic system. The most expensive phase of the system, namely proactive analysis and detection, uses a parallel extension of the iterative z algorithm. It also implements new parallel information-based outlier detection algorithms to proactively and forensically handle suspicious activities. To analyse a large number of targets and events and continuously do so (to capture the dynamics of the system), we rely on a multi-resolution approach to explore the digital forensic space. Data set from the Honeynet Forensic Challenge in 2001 is used to evaluate the system from DF and HPC perspectives.

  19. Is population screening for abdominal aortic aneurysm cost-effective?

    Directory of Open Access Journals (Sweden)

    Jensen Lotte

    2008-11-01

    Full Text Available Abstract Background Ruptured abdominal aortic aneurysm (AAA is responsible for 1–2% of all male deaths over the age of 65 years. Early detection of AAA and elective surgery can reduce the mortality risk associated with AAA. However, many patients will not be diagnosed with AAA and have therefore an increased death risk due to the untreated AAA. It has been suggested that population screening for AAA in elderly males is effective and cost-effective. The purpose of this study was to perform a systematic review of published cost-effectiveness analyses of screening elderly men for AAA. Methods We performed a systematic search for economic evaluations in NHSEED, EconLit, Medline, Cochrane, Embase, Cinahl and two Scandinavian HTA data bases (DACEHTA and SBU. All identified studies were read in full and each study was systematically assessed according to international guidelines for critical assessment of economic evaluations in health care. Results The search identified 16 cost-effectiveness studies. Most studies considered only short term cost consequences. The studies seemed to employ a number of "optimistic" assumptions in favour of AAA screening, and included only few sensitivity analyses that assessed less optimistic assumptions. Conclusion Further analyses of cost-effectiveness of AAA screening are recommended.

  20. Biosimilar medicines and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2011-02-01

    Full Text Available Steven SimoensResearch Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumAbstract: Given that biosimilars are agents that are similar but not identical to the reference biopharmaceutical, this study aims to introduce and describe specific issues related to the economic evaluation of biosimilars by focusing on the relative costs, relative effectiveness, and cost-effectiveness of biosimilars. Economic evaluation assesses the cost-effectiveness of a medicine by comparing the costs and outcomes of a medicine with those of a relevant comparator. The assessment of cost-effectiveness of a biosimilar is complicated by the fact that evidence needed to obtain marketing authorization from a registration authority does not always correspond to the data requirements of a reimbursement authority. In particular, this relates to the availability of adequately powered equivalence or noninferiority studies, the need for comparative data about the effectiveness in a real-world setting rather than the efficacy in a structured setting, and the use of health outcome measures instead of surrogate endpoints. As a biosimilar is likely to be less expensive than the comparator (eg, the reference biopharmaceutical, the assessment of the cost-effectiveness of a biosimilar depends on the relative effectiveness. If appropriately designed and powered clinical studies demonstrate equivalent effectiveness between a biosimilar and the comparator, then a cost-minimization analysis identifies the least expensive medicine. If there are differences in the effectiveness of a biosimilar and the comparator, other techniques of economic evaluation need to be employed, such as cost-effectiveness analysis or cost-utility analysis. Given that there may be uncertainty surrounding the long-term safety (ie, risk of immunogenicity and rare adverse events and effectiveness of a biosimilar, the cost-effectiveness

  1. A conceptual model to estimate cost effectiveness of the indoor environment improvements

    Energy Technology Data Exchange (ETDEWEB)

    Seppanen, Olli; Fisk, William J.

    2003-06-01

    Macroeconomic analyses indicate a high cost to society of a deteriorated indoor climate. The few example calculations performed to date indicate that measures taken to improve IEQ are highly cost-effective when health and productivity benefits are considered. We believe that cost-benefit analyses of building designs and operations should routinely incorporate health and productivity impacts. As an initial step, we developed a conceptual model that shows the links between improvements in IEQ and the financial gains from reductions in medical care and sick leave, improved work performance, lower employee turn over, and reduced maintenance due to fewer complaints.

  2. Presidential address. Endoscopic surgery, cost effectiveness, and the quality of life.

    Science.gov (United States)

    Hasson, H M

    1995-02-01

    One measure of mitigating escalating costs of health care is to create an economic market-based system that connects value to cost. Cost-effectiveness analysis compares treatments that produce different benefits and require different costs, and ranks them by the amount of net treatment benefit divided by cost. Evaluation of the impact of illness and treatment on the medical condition, quality of life, and productivity of individual patients is essential for capturing all dimensions of treatment outcome. When performed by efficient teams, laparoscopic surgery compared with conventional open surgery, adds value through reduced operative morbidity, earlier returns to work, and improved quality of life. These advantages have to be confirmed by cost-effectiveness analysis, however. Endoscopic surgery will be consistently more cost effective than conventional surgery only when performed by a dedicated team of surgeons, nurses, and technicians. The need for a specialized team arises from the fact that endoscopic surgery requires different skills, including the ability to develop a two-dimensional concept for tissue manipulation, perform major surgery through small incisions using a different type of hand-eye coordination, and operate and maintain highly sophisticated and sensitive equipment and instrumentation. Reusable instruments will contribute to lower costs.

  3. High-performance commercial building systems

    Energy Technology Data Exchange (ETDEWEB)

    Selkowitz, Stephen

    2003-10-01

    building owners and health and performance benefits to occupants. At the same time this program can strengthen the growing energy efficiency industry in California by providing new jobs and growth opportunities for companies providing the technology, systems, software, design, and building services to the commercial sector. The broad objectives across all five program elements were: (1) To develop and deploy an integrated set of tools and techniques to support the design and operation of energy-efficient commercial buildings; (2) To develop open software specifications for a building data model that will support the interoperability of these tools throughout the building life-cycle; (3) To create new technology options (hardware and controls) for substantially reducing controllable lighting, envelope, and cooling loads in buildings; (4) To create and implement a new generation of diagnostic techniques so that commissioning and efficient building operations can be accomplished reliably and cost effectively and provide sustained energy savings; (5) To enhance the health, comfort and performance of building occupants. (6) To provide the information technology infrastructure for owners to minimize their energy costs and manage their energy information in a manner that creates added value for their buildings as the commercial sector transitions to an era of deregulated utility markets, distributed generation, and changing business practices. Our ultimate goal is for our R&D effort to have measurable market impact. This requires that the research tasks be carried out with a variety of connections to key market actors or trends so that they are recognized as relevant and useful and can be adopted by expected users. While some of this activity is directly integrated into our research tasks, the handoff from ''market-connected R&D'' to ''field deployment'' is still an art as well as a science and in many areas requires resources and a

  4. The cost effectiveness of lung transplantation compared with that of heart and liver transplantation in the Netherlands

    NARCIS (Netherlands)

    Ouwens, JP; van Enckevort, PJ; TenVergert, EM; Bonsel, GJ; van der Bij, W; Haagsma, EB; Rutten, FFH; Slooff, MJH; Koeter, GH

    This study was performed to assess the main reasons for the unfavorable cost effectiveness of lung transplantation compared with that of heart and liver transplantation. Costs, effects, and cost-effectiveness ratios of Dutch lung, heart, and liver transplantation programs were compared. The data are

  5. A model-based cost-effectiveness analysis of osteoporosis screening and treatment strategy for postmenopausal Japanese women.

    Science.gov (United States)

    Yoshimura, M; Moriwaki, K; Noto, S; Takiguchi, T

    2017-02-01

    Although an osteoporosis screening program has been implemented as a health promotion project in Japan, its cost-effectiveness has yet to be elucidated fully. We performed a cost-effectiveness analysis and found that osteoporosis screening and treatment would be cost-effective for Japanese women over 60 years.

  6. Implementation of DSP Based Cost Effective Inverter Fed Induction Motor Drive with VisSim

    Science.gov (United States)

    Mohanty, Nalin K.; Muthu, Ranganath

    2012-03-01

    The implementation of a Digital Signal Processor (DSP) based high-performance cost effective fed Induction Motor drive with VisSim/Embedded Controls Developer (ECD) is presented in this paper. In the experimental work VisSim/ECD software automatically converts the in built block diagram to C code and compiles, links, and downloads the code to DSP processor TMS320F2812. The DSP processor generates the required PWM to a cost effective ie four switch 3-phase (FSTPI) inverter. The power circuit of FSTPI fed drive system consists of an IGBT based FSTPI bridge inverter module feeding to a 5 hp three-phase squirrel cage induction motor. In this work the speed of induction motor output is shown by the GUI of VisSim/ECD and SPWM pulses, line voltages and line current output curves are shown using digital storage oscilloscope to demonstrate the feasibility of the system.

  7. High performance solar Stirling system

    Science.gov (United States)

    Stearns, J. W.; Haglund, R.

    1981-01-01

    A full-scale Dish-Stirling system experiment, at a power level of 25 kWe, has been tested during 1981 on the Test Bed Concentrator No. 2 at the Parabolic Dish Test Site, Edwards, CA. Test components, designed and developed primarily by industrial contractors for the Department of Energy, include an advanced Stirling engine driving an induction alternator, a directly-coupled solar receiver with a natural gas combustor for hybrid operation and a breadboard control system based on a programmable controller and standard utility substation components. The experiment demonstrated practicality of the solar Stirling application and high system performance into a utility grid. This paper describes the design and its functions, and the test results obtained.

  8. High performance solar Stirling system

    Science.gov (United States)

    Stearns, J. W.; Haglund, R.

    1981-12-01

    A full-scale Dish-Stirling system experiment, at a power level of 25 kWe, has been tested during 1981 on the Test Bed Concentrator No. 2 at the Parabolic Dish Test Site, Edwards, CA. Test components, designed and developed primarily by industrial contractors for the Department of Energy, include an advanced Stirling engine driving an induction alternator, a directly-coupled solar receiver with a natural gas combustor for hybrid operation and a breadboard control system based on a programmable controller and standard utility substation components. The experiment demonstrated practicality of the solar Stirling application and high system performance into a utility grid. This paper describes the design and its functions, and the test results obtained.

  9. Cost-effectiveness of private umbilical cord blood banking.

    Science.gov (United States)

    Kaimal, Anjali J; Smith, Catherine C; Laros, Russell K; Caughey, Aaron B; Cheng, Yvonne W

    2009-10-01

    To investigate the cost-effectiveness of private umbilical cord blood banking. A decision-analytic model was designed comparing private umbilical cord blood banking with no umbilical cord blood banking. Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood. Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained. In sensitivity analysis, if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective. Currently, private umbilical cord blood banking is cost-effective only for children with a very high likelihood of needing a stem cell transplant. Patients considering private blood banking should be informed of the remote likelihood that a unit will be used for a child or another family member. III.

  10. Design of the EXercise Intervention after Stem cell Transplantation (EXIST study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of an individualized high intensity physical exercise program on fitness and fatigue in patients with multiple myeloma or (non- Hodgkin's lymphoma treated with high dose chemotherapy and autologous stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Burghout Heleen

    2010-12-01

    Full Text Available Abstract Background The use of high-dose chemotherapy combined with autologous stem cell transplantation has improved the outcome of hematologic malignancies. Nevertheless, this treatment can cause persistent fatigue and a reduced global quality of life, role and physical function. Physical exercise interventions may be beneficial for physical fitness, fatigue and quality of life. However, the trials conducted so far to test the effects of physical exercise interventions in this group of patients were of poor to moderate methodological quality and economic evaluations are lacking. Hence there is need for a rigorous, appropriately controlled assessment of the effectiveness of exercise programs in these patients. The aims of the present study are (1 to determine the effectiveness of an individualized high intensity strength and interval training program with respect to physiological and psychological health status in patients with multiple myeloma or (non-Hodgkin's lymphoma who have recently undergone high dose chemotherapy followed by autologous stem cell transplantation; and (2 to evaluate the cost-effectiveness of this program. Methods A multicenter, prospective, single blind randomized controlled trial will be performed. We aim to recruit 120 patients within an inclusion period of 2 years at 7 hospitals in the Netherlands. The patients will be randomly assigned to one of two groups: (1 intervention plus usual care; or (2 usual care. The intervention consists of an 18-week individualized supervised high-intensity exercise program and counselling. The primary outcomes (cardiorespiratory fitness, muscle strength and fatigue and secondary outcomes are assessed at baseline, at completion of the intervention and at 12 months follow-up. Discussion The strengths of this study include the solid trial design with clearly defined research groups and standardized outcome measures, the inclusion of an economic evaluation and the inclusion of both

  11. Cost-Effectiveness of Old and New Technologies for Aneuploidy Screening.

    Science.gov (United States)

    Sinkey, Rachel G; Odibo, Anthony O

    2016-06-01

    Cost-effectiveness analyses allow assessment of whether marginal gains from new technology are worth increased costs. Several studies have examined cost-effectiveness of Down syndrome (DS) screening and found it to be cost-effective. Noninvasive prenatal screening also appears to be cost-effective among high-risk women with respect to DS screening, but not for the general population. Chromosomal microarray (CMA) is a genetic sequencing method superior to but more expensive than karyotype. In light of CMAs greater ability to detect genetic abnormalities, it is cost-effective when used for prenatal diagnosis of an anomalous fetus. This article covers methodology and salient issues of cost-effectiveness. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . XXI PART ONE: METHODS COST-EFFECTIVENESS FOR GENERALIZED ANALYSIS 1. 2. What is Generalized Cost-Effectiveness Analysis? . . . . . . . . . . . . 3 Undertaking...

  13. Cost-effectiveness analysis in Chagas' disease vectors control interventions

    Directory of Open Access Journals (Sweden)

    A. M. Oliveira Filho

    1989-01-01

    Full Text Available After a large scale field trial performed in central Brazil envisaging the control of Chagas' disease vectors in an endemic area colonized by Triatoma infestans and T. sordida the cost-effectiveness analysis for each insecticide/formulation was performed. It considered the operational costs and the prices of insecticides and formulations, related to the activity and persistence of each one. The end point was considered to be less than 90% of domicilliary unitis (house + annexes free of infestation. The results showed good cost-effectiveness for a slow-release emulsifiable suspension (SRES based on PVA and containing malathion as active ingredient, as well as for the pyrethroids tested in this assay-cyfluthrin, cypermethrin, deltamethrin and permethrin.

  14. Living renal donors: optimizing the imaging strategy--decision- and cost-effectiveness analysis

    NARCIS (Netherlands)

    Y.S. Liem (Ylian Serina); M.C.J.M. Kock (Marc); W. Weimar (Willem); K. Visser (Karen); M.G.M. Hunink (Myriam); J.N.M. IJzermans (Jan)

    2003-01-01

    textabstractPURPOSE: To determine the most cost-effective strategy for preoperative imaging performed in potential living renal donors. MATERIALS AND METHODS: In a decision-analytic model, the societal cost-effectiveness of digital subtraction angiography (DSA), gadolinium-enhanced

  15. Electrochemical Journals, AIP's Scitation, Cost-Effectiveness

    OpenAIRE

    Roth, Dana L

    2004-01-01

    A review of the relative subscription costs, page & article counts of Electrochemical Society journals compared with commercial counterparts. A description of the AIP's Scitation database. The relative cost-effectiveness (normalized cost/article/Impact Factor) of society and commercial journals related to electrochemistry.

  16. Data Center Storage Cost-Effective Strategies, Implementation, and Management

    CERN Document Server

    Smith, Hubbert

    2011-01-01

    We overspend on data center storage ! yet, we fall short of business requirements. It's not about the technologies. It's about the proper application of technologies to deliver storage services efficiently and affordably. It's about meeting business requirements dependent on data center storage. Spend less, deliver more. Data Center Storage: Cost-Effective Strategies, Implementation, and Management provides an industry insider's insight on how to properly scope, plan, evaluate, and implement storage technologies to maximize performance, capacity, reliability, and power savings. It provides bus

  17. Cost-effectiveness of screening for lung cancer with low-dose computed tomography: a systematic literature review.

    Science.gov (United States)

    Puggina, Anna; Broumas, Athanasios; Ricciardi, Walter; Boccia, Stefania

    2016-02-01

    On 31 December 2013, the US Preventive Services Task Force rated low-dose computed tomography (LDCT) for lung cancer screening as level 'B' recommendation. Yet, lung cancer screening implementation remains controversial, particularly when considering its cost-effectiveness. The aim of this work is to investigate the cost-effectiveness of LDCT screening program for lung cancer by performing a systematic literature review. We reviewed the published economic evaluations of LDCT in lung cancer screening. MEDLINE, ISI Web of Science and Cochrane databases were searched for literature retrieval up to 31 March 2015. Inclusion criteria included: studies reporting an original full economic evaluation; reports presenting the outcomes as Quality-Adjusted Life Years (QALYs) gained or as Life Years Gained. Nine economic evaluations met the inclusion criteria. All the cost-effectiveness analyses included high risk populations for lung cancer and compared the use of annual LDCT screening with no screening. Seven studies reported an incremental cost-effectiveness ratio below the threshold of US$ 100 000 per QALY gained. Cost-effectiveness of LDCT screening for lung cancer is an highly debatable issue. Currently available economic evaluations suggest the cost-effectiveness of LDCT for lung cancer screening compared with no screening and indicate that the implementation of LDCT should be considered when planning a national lung cancer screening program. Additional economic evaluations, especially from a societal perspective and in an EU-setting, are needed. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  18. Cost-effectiveness of open partial fasciectomy, needle aponeurotomy, and collagenase injection for dupuytren contracture.

    Science.gov (United States)

    Chen, Neal C; Shauver, Melissa J; Chung, Kevin C

    2011-11-01

    We undertook a cost-utility analysis to compare traditional fasciectomy for Dupuytren with 2 new treatments, needle aponeurotomy and collagenase injection. We constructed an expected-value decision analysis model with an arm representing each treatment. A survey was administered to a cohort of 50 consecutive subjects to determine utilities of different interventions. We conducted multiple sensitivity analyses to assess the impact of varying the rate of disease recurrence in each arm of the analysis as well as the cost of the collagenase injection. The threshold for a cost-effective treatment is based on the traditional willingness-to-pay of $50,000 per quality-adjusted life years (QALY) gained. The cost of open partial fasciectomy was $820,114 per QALY gained over no treatment. The cost of needle aponeurotomy was $96,474 per QALY gained versus no treatment. When we performed a sensitivity analysis and set the success rate at 100%, the cost of needle aponeurotomy was $49,631. When needle aponeurotomy was performed without surgical center or anesthesia costs and with reduced hand therapy, the cost was $36,570. When a complete collagenase injection series was priced at $250, the cost was $31,856 per QALY gained. When the injection series was priced at $945, the cost was $49,995 per QALY gained. At the market price of $5,400 per injection, the cost was $166,268 per QALY gained. In the current model, open partial fasciectomy is not cost-effective. Needle aponeurotomy is cost-effective if the success rate is high. Collagenase injection is cost-effective when priced under $945. Economic and Decision Analysis II. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  19. Detectors with Improved Near-to-Mid IR Performance and Reduced Cooling Requirements Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This program will develop an ultra-high performance infrared detector manufacturing technology with improved performance and cost effectiveness, and reduced cooling...

  20. A Systematic Review on the Cost-Effectiveness of Genetic and Electrocardiogram Testing for Long QT Syndrome in Infants and Young Adults.

    Science.gov (United States)

    Gonzalez, Fernando Matias; Veneziano, Maria Assunta; Puggina, Anna; Boccia, Stefania

    2015-07-01

    Recent improvements in the identification of the genetic basis of long QT syndrome (LQTS) have led to significant changes in the diagnosis and management of this life-threatening condition. Genetic and electrocardiogram (ECG) tests are the most relevant examples among testing strategies for LQTS, yet their cost-effectiveness remains controversial. The aim of this work was to review the available evidence on the cost-effectiveness of genetic and ECG testing strategies for the diagnosis of LQTS. We performed a systematic review of the literature on the cost-effectiveness of genetic and ECG screening strategies for the early detection of LQTS using MEDLINE, EMBASE, and CRD databases between 2000 and 2013. A weighted version of Drummond checklist was instrumental in further assessing the quality of the included studies. We identified four eligible articles. Among them, genetic testing in the early detection of LQTS was cost-effective compared with no testing in symptomatic cases and not cost-effective when compared with watchful waiting in asymptomatic first-degree relatives of patients with established LQTS although it reached cost-effectiveness in higher risk subgroups, whereas ECG testing in neonates was highly cost-effective when compared with any screening strategy. LQTS profiling and patients' stratification have the potential to improve the disease management. Because of the limited current knowledge in this field, the present review recommends to perform further cost-effectiveness evaluations of the genetic and ECG screening alternatives, especially within European health care systems, which are still not available in the literature on genetic testing. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. Cost-effectiveness of a randomised trial of physical activity in Alzheimer's disease

    DEFF Research Database (Denmark)

    Sopina, Elizaveta; Sørensen, Jan; Beyer, Nina

    2017-01-01

    Objectives To explore the cost-effectiveness of a supervised moderate-To-high intensity aerobic exercise programme in people diagnosed with Alzheimer's disease (AD) and estimate incremental cost-effectiveness ratios (ICER) using participant-reported and proxy-reported measures of health...

  2. Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Johns Benjamin P

    2010-03-01

    Full Text Available Abstract Background Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented. Methods Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. Results In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others. In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario would not be cost effective. In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment. Conclusions From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage.

  3. Cost-effectiveness of HIV screening of blood donations in Accra (Ghana)

    NARCIS (Netherlands)

    van Hulst, Marinus; Sagoe, Kwamena W. C.; Vermande, Jacobien E.; van der Schaaf, Ido P.; Adriani, Willem P. A. van der Tuuk; Torpey, Kwasi; Ansah, Justina; Mingle, Julius A. A.; Sibinga, Cees Th. Smit; Postma, Maarten J.

    2008-01-01

    Objectives: Areas with high HIV-incidence rates compared to the developed world may benefit from additional testing in blood banks and may show more favorable cost-effectiveness ratios. We evaluated the cost-effectiveness of adding p24 antigen, mini pool nucleic acid amplification testing (MP-NAT),

  4. Cost-effectiveness of telemonitoring of diabetic foot ulcer patients

    DEFF Research Database (Denmark)

    Fasterholdt, Iben; Gerstrøm, Marie; Rasmussen, Benjamin Schnack Brandt

    2017-01-01

    This study compared the cost-effectiveness of telemonitoring with standard monitoring for patients with diabetic foot ulcers. The economic evaluation was nested within a pragmatic randomised controlled trial. A total of 374 patients were randomised to either telemonitoring or standard monitoring....... Telemonitoring consisted of two tele-consultations in the patient's own home and one consultation at the outpatient clinic; standard monitoring consisted of three outpatient clinic consultations. Total healthcare costs were estimated over a 6-month period at individual patient level, from a healthcare sector...... perspective. The bootstrap method was used to calculate the incremental cost-effectiveness ratio, and one-way sensitivity analyses were performed. Telemonitoring costs were found to be €2039 less per patient compared to standard monitoring; however, this difference was not statistically significant...

  5. Cost-effectiveness of telemonitoring of diabetic foot ulcer patients.

    Science.gov (United States)

    Fasterholdt, Iben; Gerstrøm, Marie; Rasmussen, Benjamin Schnack Brandt; Yderstræde, Knud Bonnet; Kidholm, Kristian; Pedersen, Kjeld Møller

    2016-09-16

    This study compared the cost-effectiveness of telemonitoring with standard monitoring for patients with diabetic foot ulcers. The economic evaluation was nested within a pragmatic randomised controlled trial. A total of 374 patients were randomised to either telemonitoring or standard monitoring. Telemonitoring consisted of two tele-consultations in the patient's own home and one consultation at the outpatient clinic; standard monitoring consisted of three outpatient clinic consultations. Total healthcare costs were estimated over a 6-month period at individual patient level, from a healthcare sector perspective. The bootstrap method was used to calculate the incremental cost-effectiveness ratio, and one-way sensitivity analyses were performed. Telemonitoring costs were found to be €2039 less per patient compared to standard monitoring; however, this difference was not statistically significant. Amputation rate was similar in the two groups. In conclusion, a telemonitoring service in this form had similar costs and effects as standard monitoring. © The Author(s) 2016.

  6. HPV testing for cervical cancer screening appears more cost-effective than Papanicolau cytology in Mexico.

    Science.gov (United States)

    Flores, Yvonne N; Bishai, David M; Lorincz, Attila; Shah, Keerti V; Lazcano-Ponce, Eduardo; Hernández, Mauricio; Granados-García, Víctor; Pérez, Ruth; Salmerón, Jorge

    2011-02-01

    To determine the incremental costs and effects of different HPV testing strategies, when compared to Papanicolau cytology (Pap), for cervical cancer screening in Mexico. A cost-effectiveness analysis (CEA) examined the specific costs and health outcomes associated with (1) no screening; (2) only the Pap test; (3) only self-administered HPV; (4) only clinician administered HPV; and (5) clinician administered HPV plus the Pap test. The costs of self- and clinician-HPV testing, as well as with the Pap test, were identified and quantified. Costs were reported in 2008 US dollars. The health outcome associated with these screening strategies was defined as the number of high-grade cervical intraepithelial neoplasia or cervical cancer cases detected. This CEA was performed using the perspective of the Mexican Institute of Social Security (IMSS) in Morelos, Mexico. Screening women between the ages of 30-80 for cervical cancer using clinical-HPV testing or the combination of clinical-HPV testing, and the Pap is always more cost-effective than using the Pap test alone. This CEA indicates that HPV testing could be a cost-effective screening alternative for a large health delivery organization such as IMSS. These results may help policy-makers implement HPV testing as part of the IMSS cervical cancer screening program.

  7. Cost-Effectiveness of Payments for Ecosystem Services with Dual Goals of Environment and Poverty Alleviation

    Science.gov (United States)

    Gauvin, Crystal; Uchida, Emi; Rozelle, Scott; Xu, Jintao; Zhan, Jinyan

    2010-03-01

    The goal of this article is to understand strategies by which both the environmental and poverty alleviation objectives of PES programs can be achieved cost effectively. To meet this goal, we first create a conceptual framework to understand the implications of alternative targeting when policy makers have both environmental and poverty alleviation goals. We then use the Grain for Green program in China, the largest PES program in the developing world, as a case study. We also use a data set from a survey that we designed and implemented to evaluate the program. Using the data set we first evaluate what factors determined selection of program areas for the Grain for Green program. We then demonstrate the heterogeneity of parcels and households and examine the correlations across households and their parcels in terms of their potential environmental benefits, opportunity costs of participating, and the asset levels of households as an indicator of poverty. Finally, we compare five alternative targeting criteria and simulate their performance in terms of cost effectiveness in meeting both the environmental and poverty alleviation goals when given a fixed budget. Based on our simulations, we find that there is a substantial gain in the cost effectiveness of the program by targeting parcels based on the “gold standard,” i.e., targeting parcels with low opportunity cost and high environmental benefit managed by poorer households.

  8. Cost/effectiveness analysis of atorvastatin in patients with acute coronary syndromes

    Directory of Open Access Journals (Sweden)

    Simona Cammarota

    2010-06-01

    Full Text Available Introduction: recent clinical trials found that high-dose statin therapy, compared with conventional-dose statin therapy, reduces the risk of cardiovascular events in patients with acute coronary syndromes (ACS and stable coronary artery disease (CAD. With the introduction of simvastatin and pravastatin generics and the next patent expiration of atorvastatin, projected for 2011 in Italy, it is natural to ask: what is the most cost-effective treatment for a rational use of resources?Aim: the aim of this study was to estimate the cost-effectiveness of high-dose atorvastatin versus conventional standard-dose statins based on the scenario of atovastatin price evolution.Methods: a cost-effectiveness analysis was conducted in the perspective of the Italian National Health Service over the 4.9 years time horizon. Clinical data were obtained from a pooled analyses of the 3 clinical trials that directly compared high-dose atorvastatin with conventional standard-dose statins in patients with either ACS or CAD. Hospitalizations were quantified based on the Italian National Health Service tariffs and drug costs according to the Italian National Therapeutic Formulary (2009. Assuming the cost of atorvastatin reduces in line with that observed for simvastatin when the patent expires, 3 scenarios were constructed: atorvastatin current price (scenario 1; 55% price discount (scenario 2; 65% price discount (scenario 3. Effects were measured in terms of primary composite endpoint (coronary death or any adverse cardiovascular event. All costs were discounted at 3% per annum. Sensitivity analyses were performed to assess the robustness of findings. Results: intensive therapy with atorvastatin provided a hospitalization cost saving of 245,519.36 € per 1,000 patients. Under the assumptions established for scenario 1 and scenario 2, the incremental cost-effectiveness of treatment with atorvastatin 80 mg was estimated to be 20,289.72 € and 917.05 € for patient free

  9. Cost effectiveness of routine duodenal biopsies in iron deficiency anemia

    Science.gov (United States)

    Broide, Efrat; Matalon, Shay; Kriger-Sharabi, Ofra; Richter, Vered; Shirin, Haim; Leshno, Moshe

    2016-01-01

    AIM To investigate the cost effectiveness of routine small bowel biopsies (SBBs) in patients with iron deficiency anemia (IDA) independent of their celiac disease (CD) serology test results. METHODS We used a state transition Markov model. Two strategies were compared: routine SBBs during esophagogastroduodenoscopy (EGD) in all patients with IDA regardless their celiac serology status (strategy A) vs SBBs only in IDA patients with positive serology (strategy B). The main outcomes were quality adjusted life years (QALY), average cost and the incremental cost effectiveness ratio (ICER). One way sensitivity analysis was performed on all variables and two way sensitivity analysis on selected variables were done. In order to validate the results, a Monte Carlo simulation of 100 sample trials with 10, and an acceptability curve were performed. RESULTS Strategy A of routine SBBs yielded 19.888 QALYs with a cost of $218.10 compared to 19.887 QALYs and $234.17 in strategy B. In terms of cost-effectiveness, strategy A was the dominant strategy, as long as the cost of SBBs stayed less than $67. In addition, the ICER of strategy A was preferable, providing the cost of biopsy stays under $77. Monte Carlo simulation demonstrated that strategy A yielded the same QALY but with lower costs than strategy B. CONCLUSION Our model suggests that EGD with routine SBBs is a cost-effective approach with improved QALYs in patients with IDA when the prevalence of CD is 5% or greater. SBBs should be a routine screening tool for CD among patients with IDA, regardless of their celiac antibody status. PMID:27678365

  10. Cost effectiveness of a medical digital library.

    Science.gov (United States)

    Roussel, F; Darmoni, S J; Thirion, B

    2001-01-01

    The rapid increase in the price of electronic journals has made the optimization of collection management an urgent task. As there is currently no standard procedure for the evaluation of this problem, we applied the Reading Factor (RF), an electronically computed indicator used for consultation of individual articles. The aim of our study was to assess the cost effective impact of modifications in our digital library (i.e. change of access from the Intranet to the Internet or change in editorial policy). The digital OVID library at Rouen University Hospital continues to be cost-effective in comparison with the interlibrary loan costs. Moreover, when electronic versions are offered alongside a limited amount of interlibrary loans, a reduction in library costs was observed.

  11. Sampling: Making Electronic Discovery More Cost Effective

    Directory of Open Access Journals (Sweden)

    Milton Luoma

    2011-06-01

    Full Text Available With the huge volumes of electronic data subject to discovery in virtually every instance of litigation, time and costs of conducting discovery have become exceedingly important when litigants plan their discovery strategies.  Rather than incurring the costs of having lawyers review every document produced in response to a discovery request in search of relevant evidence, a cost effective strategy for document review planning is to use statistical sampling of the database of documents to determine the likelihood of finding relevant evidence by reviewing additional documents.  This paper reviews and discusses how sampling can be used to make document review more cost effective by considering issues such as an appropriate sample size, how to develop a sampling strategy, and taking into account the potential value of the litigation in relation to the costs of additional discovery efforts. 

  12. Measure Guideline: Ventilation Guidance for Residential High-Performance New Construction - Multifamily

    Energy Technology Data Exchange (ETDEWEB)

    Lstiburek, Joseph [Building Science Corp., Westford, MA (United States)

    2017-01-01

    The measure guideline provides ventilation guidance for residential high performance multifamily construction that incorporates the requirements of the ASHRAE 62.2 ventilation and indoor air quality standard. The measure guideline focus is on the decision criteria for weighing cost and performance of various ventilation systems. The measure guideline is intended for contractors, builders, developers, designers and building code officials. The guide may also be helpful to building owners wishing to learn more about ventilation strategies available for their buildings. The measure guideline includes specific design and installation instructions for the most cost effective and performance effective solutions for ventilation in multifamily units that satisfies the requirements of ASHRAE 62.2-2016.

  13. 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

  14. Hip Fracture Prevention: Cost-Effective Strategies

    OpenAIRE

    Peter Vestergaard; Lars Rejnmark; Leif Mosekilde

    2001-01-01

    The available literature on cost benefit, cost effectiveness and cost utility of different drug and non-drug regimens in preventing hip fractures was reviewed. The cost of a hip fracture and of the different treatment regimens varied considerably from one country to another. In primary prevention, potential savings only exceeded costs in women over the age of 70 years treated with hormonal replacement therapy (HRT). In the case of HRT, treating those with low bone mineral density levels (seco...

  15. High Performance Torso Cooling Garment

    Science.gov (United States)

    Conger, Bruce; Makinen, Janice

    2016-01-01

    The concept proposed in this paper is to improve thermal efficiencies of the liquid cooling and ventilation garment (LCVG) in the torso area, which could facilitate removal of LCVG tubing from the arms and legs, thereby increasing suited crew member mobility. EVA space suit mobility in micro-gravity is challenging, and it becomes even more challenging in the gravity of Mars. By using shaped water tubes that greatly increase the contact area with the skin in the torso region of the body, the heat transfer efficiency can be increased. This increase in efficiency could provide the required liquid cooling via torso tubing only; no arm or leg LCVG tubing would be required. Benefits of this approach include increased crewmember mobility, enhanced evaporation cooling, increased comfort during Mars EVA tasks, and easing of the overly dry condition in the helmet associated with the Advanced Extravehicular Mobility Unit (EMU) ventilation loop currently under development. This report describes analysis and test activities performed to evaluate the potential improvements to the thermal performance of the LCVG. Analyses evaluated potential tube shapes for improving the thermal performance of the LCVG. The analysis results fed into the selection of flat flow strips to improve thermal contact with the skin of the suited test subject. Testing of small segments was performed to compare thermal performance of the tubing approach of the current LCVG to the flat flow strips proposed as the new concept. Results of the testing is presented along with recommendations for future development of this new concept.

  16. Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography only.

    Science.gov (United States)

    Vijgen, Sylvia M C; Westerhuis, Michelle E M H; Opmeer, Brent C; Visser, Gerard H A; Moons, Karl G M; Porath, Martina M; Oei, Guid S; Van Geijn, Herman P; Bolte, Antoinette C; Willekes, Christine; Nijhuis, Jan G; Van Beek, Erik; Graziosi, Giuseppe C M; Schuitemaker, Nico W E; Van Lith, Jan M M; Van Den Akker, Eline S A; Drogtrop, Addy P; Van Dessel, Hendrikus J H M; Rijnders, Robbert J P; Oosterbaan, Herman P; Mol, Ben Willem J; Kwee, Anneke

    2011-07-01

    To assess the cost-effectiveness of addition of ST analysis of the fetal electrocardiogram (ECG; STAN) to cardiotocography (CTG) for fetal surveillance during labor compared with CTG only. Cost-effectiveness analysis based on a randomized clinical trial on ST analysis of the fetal ECG. Obstetric departments of three academic and six general hospitals in The Netherlands. Population. Laboring women with a singleton high-risk pregnancy, a fetus in cephalic presentation, a gestational age >36 weeks and an indication for internal electronic fetal monitoring. A trial-based cost-effectiveness analysis was performed from a health-care provider perspective. Primary health outcome was the incidence of metabolic acidosis measured in the umbilical artery. Direct medical costs were estimated from start of labor to childbirth. Cost-effectiveness was expressed as costs to prevent one case of metabolic acidosis. The incidence of metabolic acidosis was 0.7% in the ST-analysis group and 1.0% in the CTG-only group (relative risk 0.70; 95% confidence interval 0.38-1.28). Per delivery, the mean costs per patient of CTG plus ST analysis (n= 2 827) were €1,345 vs. €1,316 for CTG only (n= 2 840), with a mean difference of €29 (95% confidence interval -€9 to €77) until childbirth. The incremental costs of ST analysis to prevent one case of metabolic acidosis were €9 667. The additional costs of monitoring by ST analysis of the fetal ECG are very limited when compared with monitoring by CTG only and very low compared with the total costs of delivery. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Cost-Effectiveness of Treating Hepatitis C with Sofosbuvir/Ledipasvir in Germany

    Science.gov (United States)

    Stahmeyer, Jona T.; Rossol, Siegbert; Liersch, Sebastian; Guerra, Ines; Krauth, Christian

    2017-01-01

    Background Infections with the hepatitis C virus (HCV) are a global public health problem. Long-term consequences are the development of liver cirrhosis and hepatocellular carcinoma. Newly introduced direct acting antivirals, especially interferon-free regimens, have improved rates of sustained viral response above 90% in most patient groups and allow treating patients who were ineligible for treatment in the past. These new regimens have replaced former treatment and are recommended by current guidelines. However, there is an ongoing discussion on high pharmaceutical prices. Our aim was to assess the long-term cost-effectiveness of treating hepatitis C genotype 1 patients with sofosbuvir/ledipasvir (SOF/LDV) treatment in Germany. Material and Methods We used a Markov cohort model to simulate disease progression and assess cost-effectiveness. The model calculates lifetime costs and outcomes (quality-adjusted life years, QALYs) of SOF/LDV and other strategies. Patients were stratified by treatment status (treatment-naive and treatment-experienced) and absence/presence of cirrhosis. Different treatment strategies were compared to prior standard of care. Sensitivity analyses were performed to evaluate model robustness. Results Base-case analyses results show that in treatment-naive non-cirrhotic patients treatment with SOF/LDV dominates the prior standard of care (is more effective and less costly). In cirrhotic patients an incremental cost-effectiveness ratio (ICER) of 3,383 €/QALY was estimated. In treatment-experienced patients ICERs were 26,426 €/QALY and 1,397 €/QALY for treatment-naive and treatment-experienced patients, respectively. Robustness of results was confirmed in sensitivity analyses. Conclusions Our analysis shows that treatment with SOF/LDV is cost-effective compared to prior standard of care in all patient groups considering international costs per QALY thresholds. PMID:28046099

  18. [Cost effectiveness and health sector reform].

    Science.gov (United States)

    Musgrove, P

    1995-01-01

    The cost-effectiveness of a health intervention is an estimate of the relation between what it costs to be provided, and the improvement in health which results from such intervention. Health may improve because the incidence of illness or injury is reduced, because death is avoided or delayed, or because the duration or severity of disability is limited. The calculation of this health benefit combines objective factors, such as the age at incidence and whether or not the outcome is death, with subjective factors such as the severity of disability, the judgement as to the value of life lived at different ages, and the rate at which the future is discounted. The construction and interpretation of the estimate are explained. Also, the paper examines whether the concept of cost-effectiveness is consistent with ethical norms such as equity, and concludes that they are not in conflict. Finally, it addresses the question of how to incorporate cost-effectiveness into a health sector reform, and possible ways to implement it.

  19. Learning Apache Solr high performance

    CERN Document Server

    Mohan, Surendra

    2014-01-01

    This book is an easy-to-follow guide, full of hands-on, real-world examples. Each topic is explained and demonstrated in a specific and user-friendly flow, from search optimization using Solr to Deployment of Zookeeper applications. This book is ideal for Apache Solr developers and want to learn different techniques to optimize Solr performance with utmost efficiency, along with effectively troubleshooting the problems that usually occur while trying to boost performance. Familiarity with search servers and database querying is expected.

  20. Power and sample size in cost-effectiveness analysis.

    Science.gov (United States)

    Laska, E M; Meisner, M; Siegel, C

    1999-01-01

    For resource allocation under a constrained budget, optimal decision rules for mutually exclusive programs require that the treatment with the highest incremental cost-effectiveness ratio (ICER) below a willingness-to-pay (WTP) criterion be funded. This is equivalent to determining the treatment with the smallest net health cost. The designer of a cost-effectiveness study needs to select a sample size so that the power to reject the null hypothesis, the equality of the net health costs of two treatments, is high. A recently published formula derived under normal distribution theory overstates sample-size requirements. Using net health costs, the authors present simple methods for power analysis based on conventional normal and on nonparametric statistical theory.

  1. High-Performance Composite Chocolate

    Science.gov (United States)

    Dean, Julian; Thomson, Katrin; Hollands, Lisa; Bates, Joanna; Carter, Melvyn; Freeman, Colin; Kapranos, Plato; Goodall, Russell

    2013-01-01

    The performance of any engineering component depends on and is limited by the properties of the material from which it is fabricated. It is crucial for engineering students to understand these material properties, interpret them and select the right material for the right application. In this paper we present a new method to engage students with…

  2. High-Performance Composite Chocolate

    Science.gov (United States)

    Dean, Julian; Thomson, Katrin; Hollands, Lisa; Bates, Joanna; Carter, Melvyn; Freeman, Colin; Kapranos, Plato; Goodall, Russell

    2013-01-01

    The performance of any engineering component depends on and is limited by the properties of the material from which it is fabricated. It is crucial for engineering students to understand these material properties, interpret them and select the right material for the right application. In this paper we present a new method to engage students with…

  3. High-performance electroabsorption modulator

    Science.gov (United States)

    Wei, Zhang; Jiaoqing, Pan; Hongliang, Zhu; Huan, Wang; Wei, Wang

    2009-09-01

    A 100-μm-long electroabsorption modulator monolithically integrated with passive waveguides at the input and output ports is fabricated through ion implantation induced quantum well intermixing, using only a two-step low-pressure metal-organic vapor phase epitaxial process. An InGaAsP/InGaAsP intra-step quantum well is introduced to the active region to improve the modulation properties. In the experiment high modulation speed and high extinction ratio are obtained simultaneously, the electrical-to-optical frequency response (E/O response) without any load termination reaches to 22 GHz, and extinction ration is as high as 16 dB.

  4. Cost-effectiveness of early treatment for retinopathy of prematurity.

    Science.gov (United States)

    Kamholz, Karen L; Cole, Cynthia H; Gray, James E; Zupancic, John A F

    2009-01-01

    The Early Treatment for Retinopathy of Prematurity trial demonstrated that peripheral retinal ablation of eyes with high-risk prethreshold retinopathy of prematurity (early treatment) is associated with improved visual outcomes at 9 months' corrected gestational age compared with treatment at threshold disease (conventional management). However, early treatment increased the frequency of laser therapy, anesthesia with intubation, treatment-related systemic complications, and the need for repeat treatments. To determine the cost-effectiveness of an early treatment strategy for retinopathy of prematurity compared with conventional management. We developed a stochastic decision analytic model to assess the incremental cost of early treatment per eye with severe visual impairment prevented. We derived resource-use and efficacy estimates from the Early Treatment for Retinopathy of Prematurity trial's published outcome data. We used a third-party payer perspective. Our primary analysis focused on outcomes from birth through 9 months' corrected gestational age. A secondary analysis used a lifetime horizon. Parameter uncertainty was quantified by using probabilistic and deterministic sensitivity analyses. The incremental cost-effectiveness of early treatment was $14,200 per eye with severe visual impairment prevented. There was a 90% probability that the cost-effectiveness of early treatment would be less than $40,000 per eye with severe visual impairment prevented and a 0.5% probability that early treatment would be cost-saving (less costly and more effective). Limiting early treatment to more severely affected eyes (eyes with "type 1 retinopathy of prematurity" as defined by the Early Treatment for Retinopathy of Prematurity trial) had a cost-effectiveness of $6,200 per eye with severe visual impairment prevented. Analyses that considered long-term costs and outcomes found that early treatment was cost-saving. Early treatment of retinopathy of prematurity is both

  5. Functional High Performance Financial IT

    DEFF Research Database (Denmark)

    Berthold, Jost; Filinski, Andrzej; Henglein, Fritz

    2011-01-01

    The world of finance faces the computational performance challenge of massively expanding data volumes, extreme response time requirements, and compute-intensive complex (risk) analyses. Simultaneously, new international regulatory rules require considerably more transparency and external...... auditability of financial institutions, including their software systems. To top it off, increased product variety and customisation necessitates shorter software development cycles and higher development productivity. In this paper, we report about HIPERFIT, a recently etablished strategic research center...... at the University of Copenhagen that attacks this triple challenge of increased performance, transparency and productivity in the financial sector by a novel integration of financial mathematics, domain-specific language technology, parallel functional programming, and emerging massively parallel hardware. HIPERFIT...

  6. High performance Mo adsorbent PZC

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1998-10-01

    We have developed Mo adsorbents for natural Mo(n, {gamma}){sup 99}Mo-{sup 99m}Tc generator. Among them, we called the highest performance adsorbent PZC that could adsorb about 250 mg-Mo/g. In this report, we will show the structure, adsorption mechanism of Mo, and the other useful properties of PZC when you carry out the examination of Mo adsorption and elution of {sup 99m}Tc. (author)

  7. Cost-effectiveness of asthma therapy: a comprehensive review.

    Science.gov (United States)

    Domínguez-Ortega, Javier; Phillips-Anglés, Elsa; Barranco, Pilar; Quirce, Santiago

    2015-01-01

    Asthma has an important impact in terms of both direct and indirect costs. In Europe, the disease costs € 19 000 million a year. Moreover, the cost is greater among patients with severe uncontrolled asthma and is even higher when the work productivity is also taken into account. Improved control of the disease results in cost savings. In this context, cost-effectiveness and cost-utility studies offer important information for clinicians in deciding the best treatment options for asthmatic patients and contribute to ensure an efficient use of the available healthcare resources. An English and Spanish literature search using electronic search engines (PubMed and EMBASE) was conducted in peer-review journals, from 2009 to June 2014. In order to perform the search for the most suitable and representative articles, key words were selected ("asthma", "cost-effectiveness", "cost-utility", "QALY", "cost-benefit", "economic impact of asthma" "healthcare cost", "asthma treatment" and "work productivity with asthma"). Two-hundred forty-three titles and abstracts were identified by the primary literature search. The full text of the potentially 76 eligible papers was reviewed, and 22 articles were qualified to be finally included. This article provides a comprehensive review on the evidence of cost-effectiveness of asthma treatments derived from the published literature and offers an overall summary of the socioeconomic burden of asthma and its relationship with the degree of disease control. Management alternatives, such as the use of combination therapy with ICS/LABA or omalizumab, when administered according to their current therapeutic indications, have been shown to be cost-effective.

  8. Cost-effectiveness of Family-Based Obesity Treatment.

    Science.gov (United States)

    Quattrin, Teresa; Cao, Ying; Paluch, Rocco A; Roemmich, James N; Ecker, Michelle A; Epstein, Leonard H

    2017-09-01

    We translated family-based behavioral treatment (FBT) to treat children with overweight and obesity and their parents in the patient-centered medical home. We reported greater reductions in child and parent weight at 6 and 24 months compared with an attention-controlled information control (IC) group. This article reports the cost-effectiveness of long-term weight change for FBT compared with IC. Ninety-six children 2 to 5 years of age with overweight or obesity and with parents who had a BMI ≥25 were randomly assigned to FBT or IC, and both received diet and activity education (12-month treatment and 12-month follow-up). Weight loss and cost-effectiveness were assessed at 24 months. Intention-to-treat, completers, and sensitivity analyses were performed. The average societal cost per family was $1629 for the FBT and $886 for the IC groups at 24 months. At 24 months, child percent over BMI (%OBMI) change decreased by 2.0 U in the FBT group versus an increase of 4.4 U in the IC group. Parents lost 6.0 vs 0.2 kg at 24 months in the FBT and IC groups, respectively. The incremental cost-effectiveness ratios (ICERs) for children and parents' %OBMI were $116.1 and $83.5 per U of %OBMI, respectively. Parental ICERs were also calculated for body weight and BMI and were $128.1 per 1, and $353.8/ per kilogram, respectively. ICER values for child %OBMI were similar in the intention-to-treat group ($116.1/1 U decrease) compared with completers ($114.3). For families consisting of children and parents with overweight, FBT presents a more cost-effective alternative than an IC group. Copyright © 2017 by the American Academy of Pediatrics.

  9. High-performance commercial building systems

    Energy Technology Data Exchange (ETDEWEB)

    Selkowitz, Stephen

    2003-10-01

    building owners and health and performance benefits to occupants. At the same time this program can strengthen the growing energy efficiency industry in California by providing new jobs and growth opportunities for companies providing the technology, systems, software, design, and building services to the commercial sector. The broad objectives across all five program elements were: (1) To develop and deploy an integrated set of tools and techniques to support the design and operation of energy-efficient commercial buildings; (2) To develop open software specifications for a building data model that will support the interoperability of these tools throughout the building life-cycle; (3) To create new technology options (hardware and controls) for substantially reducing controllable lighting, envelope, and cooling loads in buildings; (4) To create and implement a new generation of diagnostic techniques so that commissioning and efficient building operations can be accomplished reliably and cost effectively and provide sustained energy savings; (5) To enhance the health, comfort and performance of building occupants. (6) To provide the information technology infrastructure for owners to minimize their energy costs and manage their energy information in a manner that creates added value for their buildings as the commercial sector transitions to an era of deregulated utility markets, distributed generation, and changing business practices. Our ultimate goal is for our R&D effort to have measurable market impact. This requires that the research tasks be carried out with a variety of connections to key market actors or trends so that they are recognized as relevant and useful and can be adopted by expected users. While some of this activity is directly integrated into our research tasks, the handoff from ''market-connected R&D'' to ''field deployment'' is still an art as well as a science and in many areas requires resources and a

  10. Carpet Aids Learning in High Performance Schools

    Science.gov (United States)

    Hurd, Frank

    2009-01-01

    The Healthy and High Performance Schools Act of 2002 has set specific federal guidelines for school design, and developed a federal/state partnership program to assist local districts in their school planning. According to the Collaborative for High Performance Schools (CHPS), high-performance schools are, among other things, healthy, comfortable,…

  11. High-performance solar collector

    Science.gov (United States)

    Beekley, D. C.; Mather, G. R., Jr.

    1979-01-01

    Evacuated all-glass concentric tube collector using air or liquid transfer mediums is very efficient at high temperatures. Collector can directly drive existing heating systems that are presently driven by fossil fuel with relative ease of conversion and less expense than installation of complete solar heating systems.

  12. High Performance JavaScript

    CERN Document Server

    Zakas, Nicholas

    2010-01-01

    If you're like most developers, you rely heavily on JavaScript to build interactive and quick-responding web applications. The problem is that all of those lines of JavaScript code can slow down your apps. This book reveals techniques and strategies to help you eliminate performance bottlenecks during development. You'll learn how to improve execution time, downloading, interaction with the DOM, page life cycle, and more. Yahoo! frontend engineer Nicholas C. Zakas and five other JavaScript experts -- Ross Harmes, Julien Lecomte, Steven Levithan, Stoyan Stefanov, and Matt Sweeney -- demonstra

  13. High performance Vernier racetrack resonators.

    Science.gov (United States)

    Boeck, Robert; Flueckiger, Jonas; Yun, Han; Chrostowski, Lukas; Jaeger, Nicolas A F

    2012-12-15

    We demonstrate record performance of series-coupled silicon racetrack resonators exhibiting the Vernier effect. Our device has an interstitial peak suppression (IPS) of 25.5 dB, which is 14.5 dB larger than previously reported results. We also demonstrate the relationship between the inter-ring gap distance and the IPS as well as the 3 dB bandwidth (BW) both theoretically and experimentally. Namely, we show that as the inter-ring gap distance increases, the IPS increases and the 3 dB BW decreases.

  14. Male Circumcision at Different Ages in Rwanda: A Cost-Effectiveness Study

    Science.gov (United States)

    Binagwaho, Agnes; Pegurri, Elisabetta; Muita, Jane; Bertozzi, Stefano

    2010-01-01

    Background There is strong evidence showing that male circumcision (MC) reduces HIV infection and other sexually transmitted infections (STIs). In Rwanda, where adult HIV prevalence is 3%, MC is not a traditional practice. The Rwanda National AIDS Commission modelled cost and effects of MC at different ages to inform policy and programmatic decisions in relation to introducing MC. This study was necessary because the MC debate in Southern Africa has focused primarily on MC for adults. Further, this is the first time, to our knowledge, that a cost-effectiveness study on MC has been carried out in a country where HIV prevalence is below 5%. Methods and Findings A cost-effectiveness model was developed and applied to three hypothetical cohorts in Rwanda: newborns, adolescents, and adult men. Effectiveness was defined as the number of HIV infections averted, and was calculated as the product of the number of people susceptible to HIV infection in the cohort, the HIV incidence rate at different ages, and the protective effect of MC; discounted back to the year of circumcision and summed over the life expectancy of the circumcised person. Direct costs were based on interviews with experienced health care providers to determine inputs involved in the procedure (from consumables to staff time) and related prices. Other costs included training, patient counselling, treatment of adverse events, and promotion campaigns, and they were adjusted for the averted lifetime cost of health care (antiretroviral therapy [ART], opportunistic infection [OI], laboratory tests). One-way sensitivity analysis was performed by varying the main inputs of the model, and thresholds were calculated at which each intervention is no longer cost-saving and at which an intervention costs more than one gross domestic product (GDP) per capita per life-year gained. Results: Neonatal MC is less expensive than adolescent and adult MC (US$15 instead of US$59 per procedure) and is cost-saving (the cost-effectiveness

  15. Male circumcision at different ages in Rwanda: a cost-effectiveness study.

    Directory of Open Access Journals (Sweden)

    Agnes Binagwaho

    2010-01-01

    Full Text Available BACKGROUND: There is strong evidence showing that male circumcision (MC reduces HIV infection and other sexually transmitted infections (STIs. In Rwanda, where adult HIV prevalence is 3%, MC is not a traditional practice. The Rwanda National AIDS Commission modelled cost and effects of MC at different ages to inform policy and programmatic decisions in relation to introducing MC. This study was necessary because the MC debate in Southern Africa has focused primarily on MC for adults. Further, this is the first time, to our knowledge, that a cost-effectiveness study on MC has been carried out in a country where HIV prevalence is below 5%. METHODS AND FINDINGS: A cost-effectiveness model was developed and applied to three hypothetical cohorts in Rwanda: newborns, adolescents, and adult men. Effectiveness was defined as the number of HIV infections averted, and was calculated as the product of the number of people susceptible to HIV infection in the cohort, the HIV incidence rate at different ages, and the protective effect of MC; discounted back to the year of circumcision and summed over the life expectancy of the circumcised person. Direct costs were based on interviews with experienced health care providers to determine inputs involved in the procedure (from consumables to staff time and related prices. Other costs included training, patient counselling, treatment of adverse events, and promotion campaigns, and they were adjusted for the averted lifetime cost of health care (antiretroviral therapy [ART], opportunistic infection [OI], laboratory tests. One-way sensitivity analysis was performed by varying the main inputs of the model, and thresholds were calculated at which each intervention is no longer cost-saving and at which an intervention costs more than one gross domestic product (GDP per capita per life-year gained. RESULTS: Neonatal MC is less expensive than adolescent and adult MC (US$15 instead of US$59 per procedure and is cost

  16. Cost-effectiveness of sofosbuvir-based treatments for chronic hepatitis C in the US.

    Science.gov (United States)

    Zhang, Sai; Bastian, Nathaniel D; Griffin, Paul M

    2015-08-05

    The standard care of treatment of interferon plus ribavirin (plus protease inhibitor for genotype 1) are effective in 50 % to 70 % of patients with CHC. Several new treatments including Harvoni, Olysio + Sovaldi, Viekira Pak, Sofosbuvir-based regimens characterized with potent inhibitors have been approved by the Food and Drug Administration (FDA) providing more options for CHC patients. Trials have shown that the new treatments increased the rate to 80% to 95%, though with a substantial increase in cost. In particular, current market pricing of a 12-week course of sofosbuvir is approximately US$84,000. We determine the cost-effectiveness of new treatments in comparison with the standard care of treatments. A Markov simulation model of CHC disease progression is used to evaluate the cost-effectiveness of different treatment strategies based on genotype. The model calculates the expected lifetime medical costs and quality adjusted life years (QALYs) of hypothetical cohorts of identical patients receiving certain treatments. For genotype 1, we compare: (1) peginterferon + ribavirin + telaprevir for 12 weeks, followed by 12 or 24 weeks treatment of peginterferon + ribavirin dependent on HCV RNA level at week 12; (2) Harvoni treatment, 12 weeks; (3) Olysio + Sovaldi, 12 weeks for patients without cirrhosis, 24 weeks for patients with cirrhosis; (4) Viekira Pak + ribavirin, 12 weeks for patients without cirrhosis, 24 weeks for patients with cirrhosis; (5) sofosbuvir + peginterferon + ribavirin, 12 weeks for patients with or without cirrhosis. For genotypes 2 and 3, treatment strategies include: (1) peginterferon + ribavirin, 24 weeks for treatment-naïve patients; (2) sofosbuvir + ribavirin, 12 weeks for patients with genotype 2, 24 weeks for genotype 3; (3) peginterferon + ribavirin as initial treatment, 24 weeks for patients with genotype 2/3, follow-up treatment with sofosbuvir + ribavirin for 12/16 weeks are performed

  17. High performance polyethylene nanocomposite fibers

    Directory of Open Access Journals (Sweden)

    A. Dorigato

    2012-12-01

    Full Text Available A high density polyethylene (HDPE matrix was melt compounded with 2 vol% of dimethyldichlorosilane treated fumed silica nanoparticles. Nanocomposite fibers were prepared by melt spinning through a co-rotating twin screw extruder and drawing at 125°C in air. Thermo-mechanical and morphological properties of the resulting fibers were then investigated. The introduction of nanosilica improved the drawability of the fibers, allowing the achievement of higher draw ratios with respect to the neat matrix. The elastic modulus and creep stability of the fibers were remarkably improved upon nanofiller addition, with a retention of the pristine tensile properties at break. Transmission electronic microscope (TEM images evidenced that the original morphology of the silica aggregates was disrupted by the applied drawing.

  18. Cost-effectiveness of Acupuncture for Chronic Nonspecific Low Back Pain.

    Science.gov (United States)

    Taylor, Penny; Pezzullo, Lynne; Grant, Suzanne J; Bensoussan, Alan

    2014-09-01

    Cost-effectiveness is a major criterion underpinning decisions in mainstream health care. Acupuncture is increasingly used in patients with chronic lower back pain (LBP), but there is a lack of evidence on cost-effectiveness. The objective of this study was to assess the cost-effectiveness of acupuncture in alleviating chronic LBP either alone or in conjunction with standard care compared with patients receiving routine care, and/or sham. To determine effectiveness, we undertook meta-analyses which found a significant improvement in pain in those receiving acupuncture and standard care compared with those receiving standard care alone. For acupuncture and standard care vs. standard care and sham, a weak positive effect was found for weeks 12 to 16, but this was not significant. For acupuncture alone vs. standard care alone, a significant positive effect was found at week 8, but not at weeks 26 or 52. The main outcome parameters for our cost-effectiveness analysis were the incremental cost-effectiveness ratio (ICER) of acupuncture treatment presented as cost (A$) per disability-adjusted life-year (DALY) saved. The WHO benchmark for a very highly cost-effective intervention is one that costs less than gross domestic product per capita per quality-adjusted life-year (QALY) gained or DALY averted, or less than around $A52,000 in 2009 (the base year for the analysis). According to this threshold, acupuncture as a complement to standard care for relief of chronic LBP is highly cost-effective, costing around $48,562 per DALY avoided. When comorbid depression is alleviated at the same rate as pain, cost is around $18,960 per DALY avoided. Acupuncture as a substitute for standard care was not found to be cost-effective unless comorbid depression was included. According to the WHO cost-effectiveness threshold values, acupuncture is a cost-effective treatment strategy in patients with chronic LBP.

  19. Cost-effectiveness analysis of rotavirus vaccination in Argentina.

    Science.gov (United States)

    Urueña, Analía; Pippo, Tomás; Betelu, María Sol; Virgilio, Federico; Hernández, Laura; Giglio, Norberto; Gentile, Ángela; Diosque, Máximo; Vizzotti, Carla

    2015-05-07

    Rotavirus is a leading cause of severe diarrhea in children under 5. In Argentina, the most affected regions are the Northeast and Northwest, where hospitalizations and deaths are more frequent. This study estimated the cost-effectiveness of adding either of the two licensed rotavirus vaccines to the routine immunization schedule. The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (Version 2.0) was used to assess health benefits, costs savings, life-years gained (LYGs), DALYs averted, and cost/DALY averted of vaccinating 10 successive cohorts, from the health care system and societal perspectives. Two doses of monovalent (RV1) rotavirus vaccine and three doses of pentavalent (RV5) rotavirus vaccine were each compared to a scenario assuming no vaccination. The price/dose was US$ 7.50 and US$ 5.15 for RV1 and RV5, respectively. We ran both a national and sub-national analysis, discounting all costs and benefits 3% annually. Our base case results were compared to a range of alternative univariate and multivariate scenarios. The number of LYGs was 5962 and 6440 for RV1 and RV5, respectively. The cost/DALY averted when compared to no vaccination from the health care system and societal perspective was: US$ 3870 and US$ 1802 for RV1, and US$ 2414 and US$ 358 for RV5, respectively. Equivalent figures for the Northeast were US$ 1470 and US$ 636 for RV1, and US$ 913 and US$ 80 for RV5. Therefore, rotavirus vaccination was more cost-effective in the Northeast compared to the whole country; and, in the Northwest, health service's costs saved outweighed the cost of introducing the vaccine. Vaccination with either vaccine compared to no vaccination was highly cost-effective based on WHO guidelines and Argentina's 2011 per capita GDP of US$ 9090. Key variables influencing results were vaccine efficacy, annual loss of efficacy, relative coverage of deaths, vaccine price, and discount rate. Compared to no

  20. Acceptance of health technology assessment submissions with incremental cost-effectiveness ratios above the cost-effectiveness threshold

    Directory of Open Access Journals (Sweden)

    Griffiths EA

    2015-08-01

    Full Text Available Elizabeth A Griffiths, Janek K Hendrich, Samuel DR Stoddart, Sean CM Walsh HERON™ Commercialization, PAREXEL International, London, UK Objectives: In health technology assessment (HTA agencies where cost-effectiveness plays a role in decision-making, an incremental cost-effectiveness ratio (ICER threshold is often used to inform reimbursement decisions. The acceptance of submissions with ICERs higher than the threshold was assessed across different agencies and across indications, in order to inform future reimbursement submissions. Methods: All HTA appraisals from May 2000 to May 2014 from National Institute for Health and Care Excellence (NICE, Scottish Medicines Consortium (SMC, Pharmaceutical Benefits Advisory Committee (PBAC, and Canadian Agency for Drugs and Technologies in Health (CADTH were assessed. Multiple technology appraisals, resubmissions, vaccination programs, and requests for advice were excluded. Submissions not reporting an ICER, or for which an ICER could not be determined were also excluded. The remaining appraisals were reviewed, and the submitted ICER, recommendation, and reasoning behind the recommendation were extracted. Results: NICE recommended the highest proportion of submissions with ICERs higher than the threshold (34% accepted without restrictions; 20% with restrictions, followed by PBAC (16% accepted without restrictions; 4% with restrictions, SMC (11% accepted without restrictions; 14% accepted with restrictions, and CADTH (0% accepted without restrictions; 26% with restrictions. Overall, the majority of higher-than-threshold ICER submissions were classified into the "malignant disease and immunosuppression" therapeutic category; however, there was no notable variation in acceptance rates by disease area. Reasons for accepting submissions reporting ICERs above the threshold included high clinical benefit over the standard of care, and addressing an unmet therapeutic need. Conclusion: Acceptance of submissions

  1. Screening, prevention and treatment of cervical cancer -- a global and regional generalized cost-effectiveness analysis.

    Science.gov (United States)

    Ginsberg, Gary Michael; Edejer, Tessa Tan-Torres; Lauer, Jeremy A; Sepulveda, Cecilia

    2009-10-09

    The paper calculates regional generalized cost-effectiveness estimates of screening, prevention, treatment and combined interventions for cervical cancer. Using standardised WHO-CHOICE methodology, a cervical cancer model was employed to provide estimates of screening, vaccination and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. In regions characterized by high income, low mortality and high existing treatment coverage, the addition of any screening programme to the current high treatment levels is very cost-effective. However, based on projections of the future price per dose (representing the economic costs of the vaccination excluding monopolistic rents and vaccine development cost) vaccination is the most cost-effective intervention. In regions characterized by low income, low mortality and existing treatment coverage around 50%, expanding treatment with or without combining it with screening appears to be cost-effective or very cost-effective. Abandoning treatment in favour of screening in a no-treatment scenario would not be cost-effective. Vaccination is usually the most cost-effective intervention. Penta or tri-annual PAP smears appear to be cost-effective, though when combined with HPV-DNA testing they are not cost-effective. In regions characterized by low income, high mortality and low treatment levels, expanding treatment with or without adding screening would be very cost-effective. A one off vaccination plus expanding treatment was usually very cost-effective. One-off PAP or VIA screening at age 40 are more cost-effective than other interventions though less effective overall. From a cost-effectiveness perspective, consideration should be given to implementing

  2. Unusual High Oxygen Reduction Performance in All-Carbon Electrocatalysts

    Science.gov (United States)

    Wei, Wei; Tao, Ying; Lv, Wei; Su, Fang-Yuan; Ke, Lei; Li, Jia; Wang, Da-Wei; Li, Baohua; Kang, Feiyu; Yang, Quan-Hong

    2014-09-01

    Carbon-based electrocatalysts are more durable and cost-effective than noble materials for the oxygen reduction reaction (ORR), which is an important process in energy conversion technologies. Heteroatoms are considered responsible for the excellent ORR performance in many carbon-based electrocatalysts. But whether an all-carbon electrocatalyst can effectively reduce oxygen is unknown. We subtly engineered the interfaces between planar graphene sheets and curved carbon nanotubes (G-CNT) and gained a remarkable activity/selectivity for ORR (larger current, and n = 3.86, ~93% hydroxide + ~7% peroxide). This performance is close to that of Pt; and the durability is much better than Pt. We further demonstrate the application of this G-CNT hybrid as an all-carbon cathode catalyst for lithium oxygen batteries.We speculate that the high ORR activity of this G-CNT hybrid stems from the localized charge separation at the interface of the graphene and carbon nanotube, which results from the tunneling electron transfer due to the Fermi level mismatch on the planar and curved sp2 surfaces. Our result represents a conceptual breakthrough and pioneers the new avenues towards practical all-carbon electrocatalysis.

  3. A cost effective CO2 strategy

    DEFF Research Database (Denmark)

    by the Ministry of Transport, with the Technical University of Denmark as one of the main contributors. The CO2-strategy was to be based on the principle of cost-effectiveness. A model was set up to assist in the assessment. The model consists of a projection of CO2-emissions from road and rail modes from 2020...... are evaluated according to CO2 reduction potential and according to the ‘shadow price’ on a reduction of one ton CO2. The shadow price reflects the costs (and benefits) of the different measures. Comparing the measures it is possible to identify cost effective measures, but these measures are not necessarily......, a scenario-part and a cost-benefit part. Air and sea modes are not analyzed. The model adopts a bottom-up approach to allow a detailed assessment of transport policy measures. Four generic areas of intervention were identified and the likely effect on CO2 emissions, socioeconomic efficiency and other...

  4. Type 2 diabetes: cost-effectiveness of medication adherence and lifestyle interventions

    Directory of Open Access Journals (Sweden)

    Nerat T

    2016-10-01

    Full Text Available Tomaž Nerat, Igor Locatelli, Mitja Kos Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia Introduction: Type 2 diabetes is a major burden for the payer, however, with proper medication adherence, diet and exercise regime, complication occurrence rates, and consequently costs can be altered.Aims: The aim of this study was to conduct a cost-effectiveness analysis on real patient data and evaluate which medication adherence or lifestyle intervention is less cost demanding for the payer.Methods: Medline was searched systematically for published type 2 diabetes interventions regarding medication adherence and lifestyle in order to determine their efficacies, that were then used in the cost-effectiveness analysis. For cost-effectiveness analysis-required disease progression simulation, United Kingdom Prospective Diabetes Study Outcomes model 2.0 and Slovenian type 2 diabetes patient cohort were used. The intervention duration was set to 1, 2, 5, and 10 years. Complications and drug costs in euro (EUR were based on previously published type 2 diabetes costs from the Health Care payer perspective in Slovenia.Results: Literature search proved the following interventions to be effective in type 2 diabetes patients: medication adherence, the Mediterranean diet, aerobic, resistance, and combined exercise. The long-term simulation resulted in no payer net savings. The model predicted following quality-adjusted life-years (QALY gained and incremental costs for QALY gained (EUR/QALYg after 10 years of intervention: high-efficacy medication adherence (0.245 QALY; 9,984 EUR/QALYg, combined exercise (0.119 QALY; 46,411 EUR/QALYg, low-efficacy medication adherence (0.075 QALY; 30,967 EUR/QALYg, aerobic exercise (0.069 QALY; 80,798 EUR/QALYg, the Mediterranean diet (0.057 QALY; 27,246 EUR/QALYg, and resistance exercise (0.050 QALY; 111,847 EUR/QALYg.Conclusion: The results suggest that medication adherence intervention is, regarding cost-effectiveness

  5. The Cost-Effectiveness of Biologics for the Treatment of Rheumatoid Arthritis: A Systematic Review

    Science.gov (United States)

    Joensuu, Jaana T.; Huoponen, Saara; Aaltonen, Kalle J.; Konttinen, Yrjö T.; Nordström, Dan; Blom, Marja

    2015-01-01

    Background and Objectives Economic evaluations provide information to aid the optimal utilization of limited healthcare resources. Costs of biologics for Rheumatoid arthritis (RA) are remarkably high, which makes these agents an important target for economic evaluations. This systematic review aims to identify existing studies examining the cost-effectiveness of biologics for RA, assess their quality and report their results systematically. Methods A literature search covering Medline, Scopus, Cochrane library, ACP Journal club and Web of Science was performed in March 2013. The cost-utility analyses (CUAs) of one or more available biological drugs for the treatment of RA in adults were included. Two independent investigators systematically collected information and assessed the quality of the studies. To enable the comparison of the results, all costs were converted to 2013 euro. Results Of the 4890 references found in the literature search, 41 CUAs were included in the current systematic review. While considering only direct costs, the incremental cost-effectiveness ratio (ICER) of the tumor necrosis factor inhibitors (TNFi) ranged from 39,000 to 1 273,000 €/quality adjusted life year (QALY) gained in comparison to conventional disease-modifying antirheumatic drugs (cDMARDs) in cDMARD naïve patients. Among patients with an insufficient response to cDMARDs, biologics were associated with ICERs ranging from 12,000 to 708,000 €/QALY. Rituximab was found to be the most cost-effective alternative compared to other biologics among the patients with an insufficient response to TNFi. Conclusions When 35,000 €/QALY is considered as a threshold for the ICER, TNFis do not seem to be cost-effective among cDMARD naïve patients and patients with an insufficient response to cDMARDs. With thresholds of 50,000 to 100,000 €/QALY biologics might be cost-effective among patients with an inadequate response to cDMARDs. Standardization of multiattribute utility instruments

  6. The cost-effectiveness of biologics for the treatment of rheumatoid arthritis: a systematic review.

    Directory of Open Access Journals (Sweden)

    Jaana T Joensuu

    Full Text Available Economic evaluations provide information to aid the optimal utilization of limited healthcare resources. Costs of biologics for Rheumatoid arthritis (RA are remarkably high, which makes these agents an important target for economic evaluations. This systematic review aims to identify existing studies examining the cost-effectiveness of biologics for RA, assess their quality and report their results systematically.A literature search covering Medline, Scopus, Cochrane library, ACP Journal club and Web of Science was performed in March 2013. The cost-utility analyses (CUAs of one or more available biological drugs for the treatment of RA in adults were included. Two independent investigators systematically collected information and assessed the quality of the studies. To enable the comparison of the results, all costs were converted to 2013 euro.Of the 4890 references found in the literature search, 41 CUAs were included in the current systematic review. While considering only direct costs, the incremental cost-effectiveness ratio (ICER of the tumor necrosis factor inhibitors (TNFi ranged from 39,000 to 1,273,000 €/quality adjusted life year (QALY gained in comparison to conventional disease-modifying antirheumatic drugs (cDMARDs in cDMARD naïve patients. Among patients with an insufficient response to cDMARDs, biologics were associated with ICERs ranging from 12,000 to 708,000 €/QALY. Rituximab was found to be the most cost-effective alternative compared to other biologics among the patients with an insufficient response to TNFi.When 35,000 €/QALY is considered as a threshold for the ICER, TNFis do not seem to be cost-effective among cDMARD naïve patients and patients with an insufficient response to cDMARDs. With thresholds of 50,000 to 100,000 €/QALY biologics might be cost-effective among patients with an inadequate response to cDMARDs. Standardization of multiattribute utility instruments and a validated standard conversion method

  7. Dynamic modeling of cost-effectiveness of rotavirus vaccination, Kazakhstan.

    Science.gov (United States)

    Freiesleben de Blasio, Birgitte; Flem, Elmira; Latipov, Renat; Kuatbaeva, Ajnagul; Kristiansen, Ivar Sønbø

    2014-01-01

    The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children vaccine cost at vaccination program costs would be entirely offset. To further evaluate efficacy of a vaccine program, benefits of indirect protection conferred by vaccination warrant further study.

  8. Key aspects of cost effective collector and solar field design

    Science.gov (United States)

    von Reeken, Finn; Nicodemo, Dario; Keck, Thomas; Weinrebe, Gerhard; Balz, Markus

    2016-05-01

    A study has been performed where different key parameters influencing solar field cost are varied. By using levelised cost of energy as figure of merit it is shown that parameters like GoToStow wind speed, heliostat stiffness or tower height should be adapted to respective site conditions from an economical point of view. The benchmark site Redstone (Northern Cape Province, South Africa) has been compared to an alternate site close to Phoenix (AZ, USA) regarding site conditions and their effect on cost-effective collector and solar field design.

  9. Scheduling in high performance buffered crossbar switches

    NARCIS (Netherlands)

    Mhamdi, L.

    2007-01-01

    High performance routers are the basic building blocks of the Internet. Most high performance routers built today use crossbars and a centralized scheduler. Due to their high scheduling complexity, crossbar-based routers are not scalable and cannot keep pace with the explosive growth of the Internet

  10. Maximizing cost-effectiveness by adjusting treatment strategy according to glaucoma severity

    Science.gov (United States)

    Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta; Gomes, Carlos Eduardo de Mello; Chaoubah, Alfredo

    2016-01-01

    Abstract Background: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. Methods: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population. Different strategies were tested according to disease severity. For early glaucoma, we compared observation, laser and medications. For moderate glaucoma, medications, laser and surgery. For advanced glaucoma, medications and surgery. Main outcome measures were ICER (incremental cost-effectiveness ratio), medical direct costs and QALY (quality-adjusted life year). Results: In early glaucoma, both laser and medical treatment were cost-effective (ICERs of initial laser and initial medical treatment over observation only, were R$ 2,811.39/QALY and R$ 3,450.47/QALY). Compared to observation strategy, the two alternatives have provided significant gains in quality of life. In moderate glaucoma population, medical treatment presented the highest costs among treatment strategies. Both laser and surgery were highly cost-effective in this group. For advanced glaucoma, both tested strategies were cost-effective. Starting age had a great impact on results in all studied groups. Initiating glaucoma therapy using laser or surgery were more cost-effective, the younger the patient. Conclusion: All tested treatment strategies for glaucoma provided real gains in quality of life and were cost-effective. However, according to the disease severity, not all strategies provided the same cost-effectiveness profile. Based on our findings, there should be a

  11. High performance heat pump absorption cycles

    Energy Technology Data Exchange (ETDEWEB)

    Lazzarin, R.; Longo, G.; Rossetto, L.

    1988-10-01

    Absorption heat pumps can provide high performances when operating in suitable cycles with multiple effects. This report describes some multistage cycles and evaluates the coefficient of performance realistically obtainable both in winter and summer working conditions.

  12. High-performance image processing on the desktop

    Science.gov (United States)

    Jordan, Stephen D.

    1996-04-01

    The suitability of computers to the task of medical image visualization for the purposes of primary diagnosis and treatment planning depends on three factors: speed, image quality, and price. To be widely accepted the technology must increase the efficiency of the diagnostic and planning processes. This requires processing and displaying medical images of various modalities in real-time, with accuracy and clarity, on an affordable system. Our approach to meeting this challenge began with market research to understand customer image processing needs. These needs were translated into system-level requirements, which in turn were used to determine which image processing functions should be implemented in hardware. The result is a computer architecture for 2D image processing that is both high-speed and cost-effective. The architectural solution is based on the high-performance PA-RISC workstation with an HCRX graphics accelerator. The image processing enhancements are incorporated into the image visualization accelerator (IVX) which attaches to the HCRX graphics subsystem. The IVX includes a custom VLSI chip which has a programmable convolver, a window/level mapper, and an interpolator supporting nearest-neighbor, bi-linear, and bi-cubic modes. This combination of features can be used to enable simultaneous convolution, pan, zoom, rotate, and window/level control into 1 k by 1 k by 16-bit medical images at 40 frames/second.

  13. The Opportunity for High-Performance Biomaterials from Methane

    Science.gov (United States)

    Strong, Peter James; Laycock, Bronwyn; Mahamud, Syarifah Nuraqmar Syed; Jensen, Paul Douglas; Lant, Paul Andrew; Tyson, Gene; Pratt, Steven

    2016-01-01

    Polyhydroxyalkanoate (PHA) biopolymers are widely recognised as outstanding candidates to replace conventional petroleum-derived polymers. Their mechanical properties are good and can be tailored through copolymer composition, they are biodegradable, and unlike many alternatives, they do not rely on oil-based feedstocks. Further, they are the only commodity polymer that can be synthesised intracellularly, ensuring stereoregularity and high molecular weight. However, despite offering enormous potential for many years, they are still not making a significant impact. This is broadly because commercial uptake has been limited by variable performance (inconsistent polymer properties) and high production costs of the raw polymer. Additionally, the main type of PHA produced naturally is poly-3-hydroxybutyrate (PHB), which has limited scope due to its brittle nature and low thermal stability, as well as its tendency to embrittle over time. Production cost is strongly impacted by the type of the feedstock used. In this article we consider: the production of PHAs from methanotrophs using methane as a cost-effective substrate; the use of mixed cultures, as opposed to pure strains; and strategies to generate a poly(3-hydroxybutyrate-co-3-hydroxyvalerate) copolymer (PHBV), which has more desirable qualities such as toughness and elasticity. PMID:27681905

  14. High-Temperature-Short-Time Annealing Process for High-Performance Large-Area Perovskite Solar Cells.

    Science.gov (United States)

    Kim, Minjin; Kim, Gi-Hwan; Oh, Kyoung Suk; Jo, Yimhyun; Yoon, Hyun; Kim, Ka-Hyun; Lee, Heon; Kim, Jin Young; Kim, Dong Suk

    2017-06-27

    Organic-inorganic hybrid metal halide perovskite solar cells (PSCs) are attracting tremendous research interest due to their high solar-to-electric power conversion efficiency with a high possibility of cost-effective fabrication and certified power conversion efficiency now exceeding 22%. Although many effective methods for their application have been developed over the past decade, their practical transition to large-size devices has been restricted by difficulties in achieving high performance. Here we report on the development of a simple and cost-effective production method with high-temperature and short-time annealing processing to obtain uniform, smooth, and large-size grain domains of perovskite films over large areas. With high-temperature short-time annealing at 400 °C for 4 s, the perovskite film with an average domain size of 1 μm was obtained, which resulted in fast solvent evaporation. Solar cells fabricated using this processing technique had a maximum power conversion efficiency exceeding 20% over a 0.1 cm(2) active area and 18% over a 1 cm(2) active area. We believe our approach will enable the realization of highly efficient large-area PCSs for practical development with a very simple and short-time procedure. This simple method should lead the field toward the fabrication of uniform large-scale perovskite films, which are necessary for the production of high-efficiency solar cells that may also be applicable to several other material systems for more widespread practical deployment.

  15. Attaining High Performance Communications A Vertical Approach

    CERN Document Server

    Gavrilovska, Ada

    2009-01-01

    Technological Advances and Problems of High Performance Communications. An ecosystem of solutions along a stack of technology layers. Cohesively collecting state-of-the-art contributions from leading researchers in industry, national laboratories, and academia, Attaining High Performance Communications: A Vertical Approach discusses various issues pertaining to high performance communications in a particular layer of a vertical stack. It explores efficient interconnection hardware, the architectural aspects of network adapters and their integration with processor cores, the design of scalable

  16. OPCAB Surgery is cost-effective for elderly patients

    DEFF Research Database (Denmark)

    Holme, Susanne Juel; Jensen Beck, Søren; Houlind, Kim;

    2013-01-01

    To determine the cost-effective operative strategy for coronary artery bypass surgery in patients above 70 years.......To determine the cost-effective operative strategy for coronary artery bypass surgery in patients above 70 years....

  17. High Performance Spaceflight Computing (HPSC) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — In 2012, the NASA Game Changing Development Program (GCDP), residing in the NASA Space Technology Mission Directorate (STMD), commissioned a High Performance...

  18. High performance carbon nanocomposites for ultracapacitors

    Science.gov (United States)

    Lu, Wen

    2012-10-02

    The present invention relates to composite electrodes for electrochemical devices, particularly to carbon nanotube composite electrodes for high performance electrochemical devices, such as ultracapacitors.

  19. Cost-Effective Fuel Treatment Planning

    Science.gov (United States)

    Kreitler, J.; Thompson, M.; Vaillant, N.

    2014-12-01

    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  20. High Performance Work Systems, Performance and Innovativeness in Small Firms

    OpenAIRE

    Jan Kok; Deanne den Hartog

    2006-01-01

    The research presented in this paper focuses on the effectiveness of a high performance work system. This system is comprised of practices in the areas of extensiveness of staffing, performance based pay, pay level, job rotation, training and participation. In particular, this study focuses on the effects of such a system on the performance of small and medium-sized enterprises. Results of our study, among small and medium size enterprises in the Netherlands, show that firms with such a syste...

  1. The cost-effectiveness of health communication programs: what do we know?

    Science.gov (United States)

    Hutchinson, Paul; Wheeler, Jennifer

    2006-01-01

    While a considerable body of evidence has emerged supporting the effectiveness of communication programs in augmenting health, only a very small subset of studies has examined also whether these programs are cost-effective, that is, whether they achieve greater health gains for available financial resources than alternative interventions. In this article, we examine the available literature on the cost-effectiveness of health behavior change communication programs, focusing on communication interventions involving mass media, and, to a lesser extent, community mobilization and interpersonal communication or counseling. Our objective is to identify the state of past and current research efforts of the cost-effectiveness of behavior change communication programs. This review makes three principal conclusions. First, the analysis of the cost-effectiveness of health communication programs commonly has not been performed. Second, the studies reviewed here have utilized a considerable diversity of methods and have reflected varying levels of quality and adherence to standard cost-effectiveness methodologies. This leads to problems of transparency, comparability, and generalizability. Third, while the available studies generally are indicative of the cost-effectiveness of communication interventions relative to alternatives, the evidence base clearly needs to be expanded by additional rigorous cost-effectiveness analyses.

  2. [Intensified insulin treatment is cost-effective].

    Science.gov (United States)

    Reichard, P; Alm, C; Andersson, E; Wärn, I; Rosenqvist, U

    1999-01-20

    Both the Diabetes Control and Complications Trial (DCCT) in USA/Canada, and Stockholm Diabetes Intervention Study (SDIS) showed intensified insulin treatment and reduced glycaemia to prevent complications in patients with insulin-dependent (type I) diabetes mellitus. In the DCCT, the intensified treatment was considered cost-effective. In the SDIS, investigation of the direct increase in costs due to the intensified insulin treatment showed the saving in direct costs due to the reduction in photocoagulation requirements, and in the prevalence of renal insufficiency and of amputation, to correspond to 10 years' intensive insulin treatment. Thus, as intensified insulin treatment in type I diabetes reduces direct suffering at a low cost, it may be regarded as 'evidence-based' and mandatory.

  3. High Performance Grinding and Advanced Cutting Tools

    CERN Document Server

    Jackson, Mark J

    2013-01-01

    High Performance Grinding and Advanced Cutting Tools discusses the fundamentals and advances in high performance grinding processes, and provides a complete overview of newly-developing areas in the field. Topics covered are grinding tool formulation and structure, grinding wheel design and conditioning and applications using high performance grinding wheels. Also included are heat treatment strategies for grinding tools, using grinding tools for high speed applications, laser-based and diamond dressing techniques, high-efficiency deep grinding, VIPER grinding, and new grinding wheels.

  4. Strategy Guideline: High Performance Residential Lighting

    Energy Technology Data Exchange (ETDEWEB)

    Holton, J.

    2012-02-01

    The Strategy Guideline: High Performance Residential Lighting has been developed to provide a tool for the understanding and application of high performance lighting in the home. The high performance lighting strategies featured in this guide are drawn from recent advances in commercial lighting for application to typical spaces found in residential buildings. This guide offers strategies to greatly reduce lighting energy use through the application of high quality fluorescent and light emitting diode (LED) technologies. It is important to note that these strategies not only save energy in the home but also serve to satisfy the homeowner's expectations for high quality lighting.

  5. Cost-effectiveness of enhanced syphilis screening among HIV-positive men who have sex with men: a microsimulation model.

    Directory of Open Access Journals (Sweden)

    Ashleigh R Tuite

    Full Text Available Syphilis co-infection risk has increased substantially among HIV-infected men who have sex with men (MSM. Frequent screening for syphilis and treatment of men who test positive might be a practical means of controlling the risk of infection and disease sequelae in this population.We evaluated the cost-effectiveness of strategies that increased the frequency and population coverage of syphilis screening in HIV-infected MSM receiving HIV care, relative to current standard of care.We developed a state-transition microsimulation model of syphilis natural history and medical care in HIV-infected MSM receiving care for HIV. We performed Monte Carlo simulations using input data derived from a large observational cohort in Ontario, Canada, and from published biomedical literature. Simulations compared usual care (57% of the population screened annually to different combinations of more frequent (3- or 6-monthly screening and higher coverage (100% screened. We estimated expected disease-specific outcomes, quality-adjusted survival, costs, and cost-effectiveness associated with each strategy from the perspective of a public health care payer.Usual care was more costly and less effective than strategies with more frequent or higher coverage screening. Higher coverage strategies (with screening frequency of 3 or 6 months were expected to be cost-effective based on usually cited willingness-to-pay thresholds. These findings were robust in the face of probabilistic sensitivity analyses, alternate cost-effectiveness thresholds, and alternate assumptions about duration of risk, program characteristics, and management of underlying HIV.We project that higher coverage and more frequent syphilis screening of HIV-infected MSM would be a highly cost-effective health intervention, with many potentially viable screening strategies projected to both save costs and improve health when compared to usual care. The baseline requirement for regular blood testing in this

  6. Cost effectiveness of novel oral anticoagulants for stroke prevention in atrial fibrillation depending on the quality of warfarin anticoagulation control.

    Science.gov (United States)

    Janzic, Andrej; Kos, Mitja

    2015-04-01

    Vitamin K antagonists, such as warfarin, are standard treatments for stroke prophylaxis in patients with atrial fibrillation. Patient outcomes depend on quality of warfarin management, which includes regular monitoring and dose adjustments. Recently, novel oral anticoagulants (NOACs) that do not require regular monitoring offer an alternative to warfarin. The aim of this study was to evaluate whether cost effectiveness of NOACs for stroke prevention in atrial fibrillation depends on the quality of warfarin control. We developed a Markov decision model to simulate warfarin treatment outcomes in relation to the quality of anticoagulation control, expressed as percentage of time in the therapeutic range (TTR). Standard treatment with adjusted-dose warfarin and improved anticoagulation control by genotype-guided dosing were compared with dabigatran, rivaroxaban, apixaban and edoxaban. The analysis was performed from the Slovenian healthcare payer perspective using 2014 costs. In the base case, the incremental cost-effectiveness ratio for apixaban, dabigatran and edoxaban was below the threshold of €25,000 per quality-adjusted life-years compared with adjusted-dose warfarin with a TTR of 60%. The probability that warfarin was a cost-effective option was around 1%. This percentage rises as the quality of anticoagulation control improves. At a TTR of 70%, warfarin was the preferred treatment in half the iterations. The cost effectiveness of NOACs for stroke prevention in patients with nonvalvular atrial fibrillation who are at increased risk for stroke is highly sensitive to warfarin anticoagulation control. NOACs are more likely to be cost-effective options in settings with poor warfarin management than in settings with better anticoagulation control, where they may not represent good value for money.

  7. Cost effectiveness of cryptococcal antigen screening as a strategy to prevent HIV-associated cryptococcal meningitis in South Africa.

    Directory of Open Access Journals (Sweden)

    Joseph N Jarvis

    Full Text Available OBJECTIVES: Cryptococcal meningitis (CM-related mortality may be prevented by screening patients for sub-clinical cryptococcal antigenaemia (CRAG at antiretroviral-therapy (ART initiation and pre-emptively treating those testing positive. Prior to programmatic implementation in South Africa we performed a cost-effectiveness analysis of alternative preventive strategies for CM. DESIGN: Cost-effectiveness analysis. METHODS: Using South African data we modelled the cost-effectiveness of four strategies for patients with CD4 cell-counts <100 cells/µl starting ART 1 no screening or prophylaxis (standard of care, 2 universal primary fluconazole prophylaxis, 3 CRAG screening with fluconazole treatment if antigen-positive, 4 CRAG screening with lumbar puncture if antigen-positive and either amphotericin-B for those with CNS disease or fluconazole for those without. Analysis was limited to the first year of ART. RESULTS: The least costly strategy was CRAG screening followed by high-dose fluconazole treatment of all CRAG-positive individuals. This strategy dominated the standard of care at CRAG prevalence ≥0.6%. Although CRAG screening followed by lumbar puncture in all antigen-positive individuals was the most effective strategy clinically, the incremental benefit of LPs and amphotericin therapy for those with CNS disease was small and additional costs were large (US$158 versus US$51 per person year; incremental cost effectiveness ratio(ICER US$889,267 per life year gained. Both CRAG screening strategies are less costly and more clinically effective than current practice. Primary prophylaxis is more effective than current practice, but relatively cost-ineffective (ICER US$20,495. CONCLUSIONS: CRAG screening would be a cost-effective strategy to prevent CM-related mortality among patients initiating ART in South Africa. These findings provide further justification for programmatic implementation of CRAG screening.

  8. Cost Effective Polymer Solar Cells Research and Education

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Sam-Shajing [Norfolk State Univ, Norfolk, VA (United States)

    2015-10-13

    The technical or research objective of this project is to investigate and develop new polymers and polymer based optoelectronic devices for potentially cost effective (or cost competitive), durable, lightweight, flexible, and high efficiency solar energy conversion applications. The educational objective of this project includes training of future generation scientists, particularly young, under-represented minority scientists, working in the areas related to the emerging organic/polymer based solar energy technologies and related optoelectronic devices. Graduate and undergraduate students will be directly involved in scientific research addressing issues related to the development of polymer based solar cell technology.

  9. Cost-effectiveness studies as part of an ALARA program

    Energy Technology Data Exchange (ETDEWEB)

    Baum, J.W.

    1986-01-01

    Recent studies of cost effectiveness of engineering modifications for dose reduction at nuclear power plants conducted at BNL will be considered in this report. Since each of these items has the potential for a 50% to 60% reduction in collective dose, it appears there is large potential for dose reduction from engineering type modifications. The question that must be answered for each plant is ''which modifications or improvements are required for optimization (ALARA). The purpose of this paper is to illustrate that quantified optimization need not be costly and can often be highly beneficial.

  10. Unconventional High-Performance Laser Protection System Based on Dichroic Dye-Doped Cholesteric Liquid Crystals

    Science.gov (United States)

    Zhang, Wanshu; Zhang, Lanying; Liang, Xiao; Le Zhou; Xiao, Jiumei; Yu, Li; Li, Fasheng; Cao, Hui; Li, Kexuan; Yang, Zhou; Yang, Huai

    2017-01-01

    High-performance and cost-effective laser protection system is of crucial importance for the rapid advance of lasers in military and civilian fields leading to severe damages of human eyes and sensitive optical devices. However, it is crucially hindered by the angle-dependent protective effect and the complex preparation process. Here we demonstrate that angle-independence, good processibility, wavelength tunability, high optical density and good visibility can be effectuated simultaneously, by embedding dichroic anthraquinone dyes in a cholesteric liquid crystal matrix. More significantly, unconventional two-dimensional parabolic protection behavior is reported for the first time that in stark contrast to the existing protection systems, the overall parabolic protection behavior enables protective effect to increase with incident angles, hence providing omnibearing high-performance protection. The protective effect is controllable by dye concentration, LC cell thickness and CLC reflection efficiency, and the system can be made flexible enabling applications in flexible and even wearable protection devices. This research creates a promising avenue for the high-performance and cost-effective laser protection, and may foster the development of optical applications such as solar concentrators, car explosion-proof membrane, smart windows and polarizers. PMID:28230153

  11. Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa.

    Directory of Open Access Journals (Sweden)

    Alastair Heffernan

    Full Text Available Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC CD4 testing has been shown to be highly effective in increasing the proportion of HIV positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios (ICERs were estimated over one and three years. We estimated that POC CD4 testing introduced in the current South African care context can prevent 1.7% (95% CI: 0.4% - 4.3% of new HIV infections over 1 year. In that context, POC CD4 testing was cost-effective 99.8% of the time after 1 year with a median estimated ICER of US$4,468/DALY averted. In healthcare contexts with expanded HIV testing and improved retention in care, POC CD4 testing only became cost-effective after 3 years. The results were similar when, in addition, ART was offered irrespective of CD4 count, and CD4 testing was used for clinical assessment. Our findings suggest that even if ART is expanded to all HIV positive individuals and HIV testing efforts are increased in the near future, POC CD4 testing is a cost-effective tool, even within a short time horizon. Our study also illustrates the importance of evaluating the potential impact of such diagnostic technologies at the population level, so that indirect benefits and costs can be incorporated into estimations of cost-effectiveness.

  12. Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa.

    Science.gov (United States)

    Heffernan, Alastair; Barber, Ella; Thomas, Ranjeeta; Fraser, Christophe; Pickles, Michael; Cori, Anne

    2016-01-01

    Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC) CD4 testing has been shown to be highly effective in increasing the proportion of HIV positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios (ICERs) were estimated over one and three years. We estimated that POC CD4 testing introduced in the current South African care context can prevent 1.7% (95% CI: 0.4% - 4.3%) of new HIV infections over 1 year. In that context, POC CD4 testing was cost-effective 99.8% of the time after 1 year with a median estimated ICER of US$4,468/DALY averted. In healthcare contexts with expanded HIV testing and improved retention in care, POC CD4 testing only became cost-effective after 3 years. The results were similar when, in addition, ART was offered irrespective of CD4 count, and CD4 testing was used for clinical assessment. Our findings suggest that even if ART is expanded to all HIV positive individuals and HIV testing efforts are increased in the near future, POC CD4 testing is a cost-effective tool, even within a short time horizon. Our study also illustrates the importance of evaluating the potential impact of such diagnostic technologies at the population level, so that indirect benefits and costs can be incorporated into estimations of cost-effectiveness.

  13. Probabilistic performance-based design for high performance control systems

    Science.gov (United States)

    Micheli, Laura; Cao, Liang; Gong, Yongqiang; Cancelli, Alessandro; Laflamme, Simon; Alipour, Alice

    2017-04-01

    High performance control systems (HPCS) are advanced damping systems capable of high damping performance over a wide frequency bandwidth, ideal for mitigation of multi-hazards. They include active, semi-active, and hybrid damping systems. However, HPCS are more expensive than typical passive mitigation systems, rely on power and hardware (e.g., sensors, actuators) to operate, and require maintenance. In this paper, a life cycle cost analysis (LCA) approach is proposed to estimate the economic benefit these systems over the entire life of the structure. The novelty resides in the life cycle cost analysis in the performance based design (PBD) tailored to multi-level wind hazards. This yields a probabilistic performance-based design approach for HPCS. Numerical simulations are conducted on a building located in Boston, MA. LCA are conducted for passive control systems and HPCS, and the concept of controller robustness is demonstrated. Results highlight the promise of the proposed performance-based design procedure.

  14. China's High Performance Computer Standard Commission Established

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ China's High Performance Computer Standard Commission was established on March 28, 2007, under the guidance of the Science and Technology Bureau of the Ministry of Information Industry. It will prepare relevant professional standards on high performance computers to break through the monopoly in the field by foreign manufacturers and vendors.

  15. A High-performance Small Signal Amplifier

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    According to questions in the design of high quality small signal amplifier, this paper gave a new-type high performance small signal amplifier. The paper selected the operational amplifier of ICL Company and designed a new-type circuit with simple, low cost and excellent performance.

  16. GDP Matters: Cost Effectiveness of Cochlear Implantation and Deaf Education in Sub-Saharan Africa.

    Science.gov (United States)

    Emmett, Susan D; Tucci, Debara L; Smith, Magteld; Macharia, Isaac M; Ndegwa, Serah N; Nakku, Doreen; Mukara, Kaitesi B; Kaitesi, Mukara B; Ibekwe, Titus S; Mulwafu, Wakisa; Gong, Wenfeng; Francis, Howard W; Saunders, James E

    2015-09-01

    Cochlear implantation and deaf education are cost effective in Sub-Saharan Africa. Cost effectiveness of pediatric cochlear implantation has been well established in developed countries but is unknown in low resource settings, where access to the technology has traditionally been limited. With incidence of severe-to-profound congenital sensorineural hearing loss 5 to 6 times higher in low/middle-income countries than the United States and Europe, developing cost-effective management strategies in these settings is critical. Costs were obtained from experts in Nigeria, South Africa, Kenya, Rwanda, Uganda, and Malawi using known costs and published data, with estimation when necessary. A disability adjusted life years (DALY) model was applied using 3% discounting and 10-year length of analysis. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the WHO standard of cost-effectiveness ratio/gross domestic product per capita (CER/GDP) less than 3. Cochlear implantation was cost effective in South Africa and Nigeria, with CER/GDP of 1.03 and 2.05, respectively. Deaf education was cost effective in all countries investigated, with CER/GDP ranging from 0.55 to 1.56. The most influential factor in the sensitivity analysis was device cost, with the cost-effective threshold reached in all countries using discounted device costs that varied directly with GDP. Cochlear implantation and deaf education are equally cost effective in lower-middle and upper-middle income economies of Nigeria and South Africa. Device cost may have greater impact in the emerging economies of Kenya, Uganda, Rwanda, and Malawi.

  17. Failure analysis of high performance ballistic fibers

    OpenAIRE

    Spatola, Jennifer S

    2015-01-01

    High performance fibers have a high tensile strength and modulus, good wear resistance, and a low density, making them ideal for applications in ballistic impact resistance, such as body armor. However, the observed ballistic performance of these fibers is much lower than the predicted values. Since the predictions assume only tensile stress failure, it is safe to assume that the stress state is affecting fiber performance. The purpose of this research was to determine if there are failure mo...

  18. Failure analysis of high performance ballistic fibers

    OpenAIRE

    Spatola, Jennifer S

    2015-01-01

    High performance fibers have a high tensile strength and modulus, good wear resistance, and a low density, making them ideal for applications in ballistic impact resistance, such as body armor. However, the observed ballistic performance of these fibers is much lower than the predicted values. Since the predictions assume only tensile stress failure, it is safe to assume that the stress state is affecting fiber performance. The purpose of this research was to determine if there are failure mo...

  19. Using Cost-Effectiveness Tests to Design CHP Incentive Programs

    Energy Technology Data Exchange (ETDEWEB)

    Tidball, Rick [ICF International, Fairfax, VA (United States)

    2014-11-01

    This paper examines the structure of cost-effectiveness tests to illustrate how they can accurately reflect the costs and benefits of CHP systems. This paper begins with a general background discussion on cost-effectiveness analysis of DER and then describes how cost-effectiveness tests can be applied to CHP. Cost-effectiveness results are then calculated and analyzed for CHP projects in five states: Arkansas, Colorado, Iowa, Maryland, and North Carolina. Based on the results obtained for these five states, this paper offers four considerations to inform regulators in the application of cost-effectiveness tests in developing CHP programs.

  20. Hydrothermal synthesis of NiWO4 crystals for high performance non-enzymatic glucose biosensors

    Science.gov (United States)

    Mani, Sivakumar; Vediyappan, Veeramani; Chen, Shen-Ming; Madhu, Rajesh; Pitchaimani, Veerakumar; Chang, Jia-Yaw; Liu, Shang-Bin

    2016-01-01

    A facile hydrothermal route for the synthesis of ordered NiWO4 nanocrystals, which show promising applications as high performance non-enzymatic glucose sensor is reported. The NiWO4-modified electrodes showed excellent sensitivity (269.6 μA mM−1 cm−2) and low detection limit (0.18 μM) for detection of glucose with desirable selectivity, stability, and tolerance to interference, rendering their prospective applications as cost-effective, enzyme-free glucose sensors. PMID:27087561

  1. Cost-effectiveness of antiviral therapy during late pregnancy to prevent perinatal transmission of hepatitis B virus

    Directory of Open Access Journals (Sweden)

    Wenjun Wang

    2016-03-01

    Full Text Available Background. Hepatitis B virus (HBV infections are perinatally transmitted from chronically infected mothers. Supplemental antiviral therapy during late pregnancy with lamivudine (LAM, telbivudine (LdT, or tenofovir (TDF can substantially reduce perinatal HBV transmission compared to postnatal immunoprophylaxis (IP alone. However, the cost-effectiveness of these measures is not clear. Aim. This study evaluated the cost-effectiveness from a societal perspective of supplemental antiviral agents for preventing perinatal HBV transmission in mothers with high viral load (>6 log10 copies/mL. Methods. A systematic review and network meta-analysis were performed for the risk of perinatal HBV transmission with antiviral therapies. A decision analysis was conducted to evaluate the clinical and economic outcomes in China of four competing strategies: postnatal IP alone (strategy IP, or in combination with perinatal LAM (strategy LAM + IP, LdT (strategy LdT + IP, or TDF (strategy TDF + IP. Antiviral treatments were administered from week 28 of gestation to 4 weeks after birth. Outcomes included treatment-related costs, number of infections, and quality-adjusted life years (QALYs. One- and two-way sensitivity analyses were performed to identify influential clinical and cost-related variables. Probabilistic sensitivity analyses were used to estimate the probabilities of being cost-effective for each strategy. Results. LdT + IP and TDF + IP averted the most infections and HBV-related deaths, and gained the most QALYs. IP and TDF + IP were dominated as they resulted in less or equal QALYs with higher associated costs. LdT + IP had an incremental $2,891 per QALY gained (95% CI [$932–$20,372] compared to LAM + IP (GDP per capita for China in 2013 was $6,800. One-way sensitivity analyses showed that the cost-effectiveness of LdT + IP was only sensitive to the relative risk of HBV transmission comparing LdT + IP with LAM + IP. Probabilistic sensitivity analyses

  2. Cost-effectiveness of pharmacotherapy to reduce obesity.

    Directory of Open Access Journals (Sweden)

    J Lennert Veerman

    Full Text Available AIMS: Obesity causes a high disease burden in Australia and across the world. We aimed to analyse the cost-effectiveness of weight reduction with pharmacotherapy in Australia, and to assess its potential to reduce the disease burden due to excess body weight. METHODS: We constructed a multi-state life-table based Markov model in Excel in which body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. We use data on effectiveness identified from PubMed searches, on mortality from Australian Bureau of Statistics, on disease costs from the Australian Institute of Health and Welfare, and on drug costs from the Department of Health and Ageing. We evaluate 1-year pharmacological interventions with sibutramine and orlistat targeting obese Australian adults free of obesity-related disease. We use a lifetime horizon for costs and health outcomes and a health sector perspective for costs. Incremental Cost-Effectiveness Ratios (ICERs below A$50 000 per Disability Adjusted Life Year (DALY averted are considered good value for money. RESULTS: The ICERs are A$130 000/DALY (95% uncertainty interval [UI] 93 000-180 000 for sibutramine and A$230 000/DALY (170 000-340 000 for orlistat. The interventions reduce the body weight-related disease burden at the population level by 0.2% and 0.1%, respectively. Modest weight loss during the interventions, rapid post-intervention weight regain and low adherence limit the health benefits. CONCLUSIONS: Treatment with sibutramine or orlistat is not cost-effective from an Australian health sector perspective and has a negligible impact on the total body weight-related disease burden.

  3. Cost-effectiveness of HPV vaccination in Belize.

    Science.gov (United States)

    Walwyn, Leslie; Janusz, Cara Bess; Clark, Andrew David; Prieto, Elise; Waight, Eufemia; Largaespada, Natalia

    2015-05-07

    Among women in Belize, cervical cancer is both the leading cancer and the leading cause of cancer deaths. Both the quadrivalent and bivalent human papillomavirus (HPV) vaccines are licensed in Belize. The Ministry of Health of Belize convened a multidisciplinary team to estimate the costs, health benefits, and cost-effectiveness of adding an HPV vaccine to the national immunization schedule. The CERVIVAC cost-effectiveness model (Version 1.123) was used to assess the lifetime health and economic outcomes of vaccinating one cohort of girls aged 10 years against HPV. The comparator was no HPV vaccination. The PAHO Revolving Fund negotiated price of US$ 13.79 per dose was used (for the quadrivalent vaccine) and national data sources were used to define demography, cervical cancer incidence and mortality, cervical cancer treatment costs, and vaccine delivery costs. Estimates from international agencies were used in scenario analysis. In a cohort of ∼4000 Belizean girls tracked over a lifetime, HPV vaccination is estimated to prevent 69 new cases of cervical cancer (undiscounted), and 51 cervical cancer deaths (undiscounted). Considering the potential cervical cancer treatment costs and lost wages avoided by households (societal perspective), the cost per disability-adjusted life year (DALY) averted was estimated to be US$ 429. This increased to US$ 1320 when cervical cancer treatment costs and lost wages were excluded from the analysis. Both estimates are far below the gross domestic product (GDP) per capita of Belize (US$ 4795). The lifetime health care costs saved by the women and their families represent more than 60% of the investment cost needed by the Government for the vaccine. Routine HPV vaccination would be highly cost-effective in Belize. If affordable, efforts should be made to expedite the introduction of this vaccine into the Belizean national immunization program. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Comprehensive overview: efficacy, tolerability, and cost-effectiveness of irbesartan

    Directory of Open Access Journals (Sweden)

    Gialama F

    2013-10-01

    Full Text Available Fotini Gialama, Nikos ManiadakisHealth Services Organisation and Management, National School of Public Health, Athens, GreeceBackground: Hypertension represents a major health problem, affecting more than one billion adults worldwide. Irbesartan, an angiotensin II receptor blocker, is considered to be a highly effective treatment in the management of hypertension. The purpose of this review is to evaluate the efficacy, safety and tolerability profile, and cost-effectiveness of treatment with irbesartan in hypertension.Methods: A review of the literature was conducted using the electronic PubMed and Cochrane Library databases and the Health Economic Evaluations Database of search terms relating to irbesartan efficacy, tolerability, and cost-effectiveness, and the results were utilized.Results: Findings from the present analysis show that irbesartan either as monotherapy or in combination with other antihypertensive agents can achieve significant reductions in blood pressure, both systolic and diastolic, compared with alternative treatment options. Irbesartan was also found to have a renoprotective effect independent of its blood pressure-lowering in patients with type 2 diabetes and nephropathy. Furthermore, irbesartan demonstrated an excellent safety and tolerability profile, with either lower or equal adverse events compared with placebo and other alternative treatments. In terms of economic analyses, compared with other antihypertensive therapy alternatives, irbesartan was found to be a preferred option, that is less costly and more effective.Conclusion: The evidence indicates that treating patients with hypertension alone or with type 2 diabetes and nephropathy using irbesartan can control hypertension, prolong life, and reduce costs in relation to existing alternatives.Keywords: irbesartan, tolerability, safety, efficacy, cost-effectiveness, economic evaluation

  5. The cost-effectiveness of rotavirus vaccination in Armenia.

    Science.gov (United States)

    Jit, Mark; Yuzbashyan, Ruzanna; Sahakyan, Gayane; Avagyan, Tigran; Mosina, Liudmila

    2011-11-01

    The cost-effectiveness of introducing infant rotavirus vaccination in Armenia in 2012 using Rotarix(R) was evaluated using a multiple birth cohort model. The model considered the cost and health implications of hospitalisations, primary health care consultations and episodes not leading to medical care in children under five years old. Rotavirus vaccination is expected to cost the Ministry of Health $220,000 in 2012, rising to $830,000 in 2016 following termination of GAVI co-financing, then declining to $260,000 in 2025 due to vaccine price maturity. It may reduce health care costs by $34,000 in the first year, rising to $180,000 by 2019. By 2025, vaccination may be close to cost saving to the Ministry of Health if the vaccine purchase price declines as expected. Once coverage has reached high levels, vaccination may prevent 25,000 cases, 3000 primary care consultations, 1000 hospitalisations and 8 deaths per birth cohort vaccinated. The cost per disability-adjusted life year (DALY) saved is estimated to be about $650 from the perspective of the Ministry of Health, $850 including costs accrued to both the Ministry and to GAVI, $820 from a societal perspective excluding indirect costs and $44 from a societal perspective including indirect costs. Since the gross domestic product per capita of Armenia in 2008 was $3800, rotavirus vaccination is likely to be regarded as "very cost-effective" from a WHO standpoint. Vaccination may still be "very cost-effective" if less favourable assumptions are used regarding vaccine price and disease incidence, as long as DALYs are not age-weighted.

  6. Cost-effectiveness of pharmacotherapy to reduce obesity.

    Science.gov (United States)

    Veerman, J Lennert; Barendregt, Jan J; Forster, Megan; Vos, Theo

    2011-01-01

    Obesity causes a high disease burden in Australia and across the world. We aimed to analyse the cost-effectiveness of weight reduction with pharmacotherapy in Australia, and to assess its potential to reduce the disease burden due to excess body weight. We constructed a multi-state life-table based Markov model in Excel in which body weight influences the incidence of stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, post-menopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. We use data on effectiveness identified from PubMed searches, on mortality from Australian Bureau of Statistics, on disease costs from the Australian Institute of Health and Welfare, and on drug costs from the Department of Health and Ageing. We evaluate 1-year pharmacological interventions with sibutramine and orlistat targeting obese Australian adults free of obesity-related disease. We use a lifetime horizon for costs and health outcomes and a health sector perspective for costs. Incremental Cost-Effectiveness Ratios (ICERs) below A$50 000 per Disability Adjusted Life Year (DALY) averted are considered good value for money. The ICERs are A$130 000/DALY (95% uncertainty interval [UI] 93 000-180 000) for sibutramine and A$230 000/DALY (170 000-340 000) for orlistat. The interventions reduce the body weight-related disease burden at the population level by 0.2% and 0.1%, respectively. Modest weight loss during the interventions, rapid post-intervention weight regain and low adherence limit the health benefits. Treatment with sibutramine or orlistat is not cost-effective from an Australian health sector perspective and has a negligible impact on the total body weight-related disease burden.

  7. Strategy Guideline. Partnering for High Performance Homes

    Energy Technology Data Exchange (ETDEWEB)

    Prahl, Duncan [IBACOS, Inc., Pittsburgh, PA (United States)

    2013-01-01

    High performance houses require a high degree of coordination and have significant interdependencies between various systems in order to perform properly, meet customer expectations, and minimize risks for the builder. Responsibility for the key performance attributes is shared across the project team and can be well coordinated through advanced partnering strategies. For high performance homes, traditional partnerships need to be matured to the next level and be expanded to all members of the project team including trades, suppliers, manufacturers, HERS raters, designers, architects, and building officials as appropriate. This guide is intended for use by all parties associated in the design and construction of high performance homes. It serves as a starting point and features initial tools and resources for teams to collaborate to continually improve the energy efficiency and durability of new houses.

  8. Opportunities and challenges of high-performance computing in chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Guest, M.F.; Kendall, R.A.; Nichols, J.A. [eds.] [and others

    1995-06-01

    The field of high-performance computing is developing at an extremely rapid pace. Massively parallel computers offering orders of magnitude increase in performance are under development by all the major computer vendors. Many sites now have production facilities that include massively parallel hardware. Molecular modeling methodologies (both quantum and classical) are also advancing at a brisk pace. The transition of molecular modeling software to a massively parallel computing environment offers many exciting opportunities, such as the accurate treatment of larger, more complex molecular systems in routine fashion, and a viable, cost-effective route to study physical, biological, and chemical `grand challenge` problems that are impractical on traditional vector supercomputers. This will have a broad effect on all areas of basic chemical science at academic research institutions and chemical, petroleum, and pharmaceutical industries in the United States, as well as chemical waste and environmental remediation processes. But, this transition also poses significant challenges: architectural issues (SIMD, MIMD, local memory, global memory, etc.) remain poorly understood and software development tools (compilers, debuggers, performance monitors, etc.) are not well developed. In addition, researchers that understand and wish to pursue the benefits offered by massively parallel computing are often hindered by lack of expertise, hardware, and/or information at their site. A conference and workshop organized to focus on these issues was held at the National Institute of Health, Bethesda, Maryland (February 1993). This report is the culmination of the organized workshop. The main conclusion: a drastic acceleration in the present rate of progress is required for the chemistry community to be positioned to exploit fully the emerging class of Teraflop computers, even allowing for the significant work to date by the community in developing software for parallel architectures.

  9. Cost-effectiveness analyses of training: a manager?s guide

    OpenAIRE

    O?Malley, Gabrielle; Marseille, Elliot; Weaver, Marcia R

    2013-01-01

    The evidence on the cost and cost-effectiveness of global training programs is sparse. This manager?s guide to cost-effectiveness analysis (CEA) is for professionals who want to recognize and support high quality CEA. It focuses on CEA of training in the context of program implementation or rapid program expansion. Cost analysis provides cost per output and CEA provides cost per outcome. The distinction between these two analyses is essential for making good decisions about value. A hypotheti...

  10. Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Ferket, Bart S; Feldman, Zachary; Zhou, Jing; Oei, Edwin H; Bierma-Zeinstra, Sita M A; Mazumdar, Madhu

    2017-03-28

    Objectives To evaluate the impact of total knee replacement on quality of life in people with knee osteoarthritis and to estimate associated differences in lifetime costs and quality adjusted life years (QALYs) according to use by level of symptoms.Design Marginal structural modeling and cost effectiveness analysis based on lifetime predictions for total knee replacement and death from population based cohort data.Setting Data from two studies-Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study (MOST)-within the US health system.Participants 4498 participants with or at high risk for knee osteoarthritis aged 45-79 from the OAI with no previous knee replacement (confirmed by baseline radiography) followed up for nine years. Validation cohort comprised 2907 patients from MOST with two year follow-up.Intervention Scenarios ranging from current practice, defined as total knee replacement practice as performed in the OAI (with procedural rates estimated by a prediction model), to practice limited to patients with severe symptoms to no surgery.Main outcome measures Generic (SF-12) and osteoarthritis specific quality of life measured over 96 months, model based QALYs, costs, and incremental cost effectiveness ratios over a lifetime horizon.Results In the OAI, total knee replacement showed improvements in quality of life with small absolute changes when averaged across levels of confounding variables: 1.70 (95% uncertainty interval 0.26 to 3.57) for SF-12 physical component summary (PCS); -10.69 (-13.39 to -8.01) for Western Ontario and McMaster Universities arthritis index (WOMAC); and 9.16 (6.35 to 12.49) for knee injury and osteoarthritis outcome score (KOOS) quality of life subscale. These improvements became larger with decreasing functional status at baseline. Provision of total knee replacement to patients with SF-12 PCS scores osteoarthritis from the MOST cohort and were robust against various scenarios including increased rates of total

  11. PACS for Bhutan: a cost effective open source architecture for emerging countries

    Directory of Open Access Journals (Sweden)

    Osman Ratib

    2016-07-01

    Full Text Available Abstract This paper reports the design and implementation of an innovative and cost-effective imaging management infrastructure suitable for radiology centres in emerging countries. It was implemented in the main referring hospital of Bhutan equipped with a CT, an MRI, digital radiology, and a suite of several ultrasound units. They lacked the necessary informatics infrastructure for image archiving and interpretation and needed a system for distribution of images to clinical wards. The solution developed for this project combines several open source software platforms in a robust and versatile archiving and communication system connected to analysis workstations equipped with a FDA-certified version of the highly popular Open-Source software. The whole system was implemented on standard off-the-shelf hardware. The system was installed in three days, and training of the radiologists as well as the technical and IT staff was provided onsite to ensure full ownership of the system by the local team. Radiologists were rapidly capable of reading and interpreting studies on the diagnostic workstations, which had a significant benefit on their workflow and ability to perform diagnostic tasks more efficiently. Furthermore, images were also made available to several clinical units on standard desktop computers through a web-based viewer. Messages/teaching points • Open source imaging informatics platforms can provide cost-effective alternatives for PACS • Robust and cost-effective open architecture can provide adequate solutions for emerging countries • Imaging informatics is often lacking in hospitals equipped with digital modalities

  12. Cost-effectiveness of medical primary prevention strategies to reduce absolute risk of cardiovascular disease in Tanzania: a Markov modelling study.

    Science.gov (United States)

    Ngalesoni, Frida N; Ruhago, George M; Mori, Amani T; Robberstad, Bjarne; Norheim, Ole F

    2016-05-17

    Cardiovascular disease (CVD) is a growing cause of mortality and morbidity in Tanzania, but contextualized evidence on cost-effective medical strategies to prevent it is scarce. We aim to perform a cost-effectiveness analysis of medical interventions for primary prevention of CVD using the World Health Organization's (WHO) absolute risk approach for four risk levels. The cost-effectiveness analysis was performed from a societal perspective using two Markov decision models: CVD risk without diabetes and CVD risk with diabetes. Primary provider and patient costs were estimated using the ingredients approach and step-down methodologies. Epidemiological data and efficacy inputs were derived from systematic reviews and meta-analyses. We used disability- adjusted life years (DALYs) averted as the outcome measure. Sensitivity analyses were conducted to evaluate the robustness of the model results. For CVD low-risk patients without diabetes, medical management is not cost-effective unless willingness to pay (WTP) is higher than US$1327 per DALY averted. For moderate-risk patients, WTP must exceed US$164 per DALY before a combination of angiotensin converting enzyme inhibitor (ACEI) and diuretic (Diu) becomes cost-effective, while for high-risk and very high-risk patients the thresholds are US$349 (ACEI, calcium channel blocker (CCB) and Diu) and US$498 per DALY (ACEI, CCB, Diu and Aspirin (ASA)) respectively. For patients with CVD risk with diabetes, a combination of sulfonylureas (Sulf), ACEI and CCB for low and moderate risk (incremental cost-effectiveness ratio (ICER) US$608 and US$115 per DALY respectively), is the most cost-effective, while adding biguanide (Big) to this combination yielded the most favourable ICERs of US$309 and US$350 per DALY for high and very high risk respectively. For the latter, ASA is also part of the combination. Medical preventive cardiology is very cost-effective for all risk levels except low CVD risk. Budget impact analyses and

  13. Cost-effectiveness assessment in outpatient sinonasal surgery.

    Science.gov (United States)

    Mortuaire, G; Theis, D; Fackeure, R; Chevalier, D; Gengler, I

    2017-09-15

    To assess the cost-effectiveness of outpatient sinonasal surgery in terms of clinical efficacy and control of expenses. A retrospective study was conducted from January 2014 to January 2016. Patients scheduled for outpatient sinonasal surgery were systematically included. Clinical data were extracted from surgical and anesthesiology computer files. The cost accounting methods applied in our institution were used to evaluate logistic and technical costs. The standardized hospital fees rating system based on hospital stay and severity in diagnosis-related groups (Groupes homogènes de séjours: GHS) was used to estimate institutional revenue. Over 2years, 927 outpatient surgical procedures were performed. The crossover rate to conventional hospital admission was 2.9%. In a day-1 telephone interview, 85% of patients were very satisfied with the procedure. All outpatient cases showed significantly lower costs than estimated for conventional management with overnight admission, while hospital revenue did not differ between the two. This study confirmed the efficacy of outpatient surgery in this indication. Lower costs could allow savings for the health system by readjusting the rating for the procedure. More precise assessment of cost-effectiveness will require more fine-grained studies based on micro costing at hospital level and assessment of impact on conventional surgical activity and post-discharge community care. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. High Performance Methane Thrust Chamber (HPMTC) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — ORBITEC proposes to develop a High-Performance Methane Thrust Chamber (HPMRE) to meet the demands of advanced chemical propulsion systems for deep-space mission...

  15. Analog circuit design designing high performance amplifiers

    CERN Document Server

    Feucht, Dennis

    2010-01-01

    The third volume Designing High Performance Amplifiers applies the concepts from the first two volumes. It is an advanced treatment of amplifier design/analysis emphasizing both wideband and precision amplification.

  16. Radiation Hard High Performance Optoelectronic Devices Project

    Data.gov (United States)

    National Aeronautics and Space Administration — High-performance, radiation-hard, widely-tunable integrated laser/modulator chip and large-area avalanche photodetectors (APDs) are key components of optical...

  17. High-performance computing using FPGAs

    CERN Document Server

    Benkrid, Khaled

    2013-01-01

    This book is concerned with the emerging field of High Performance Reconfigurable Computing (HPRC), which aims to harness the high performance and relative low power of reconfigurable hardware–in the form Field Programmable Gate Arrays (FPGAs)–in High Performance Computing (HPC) applications. It presents the latest developments in this field from applications, architecture, and tools and methodologies points of view. We hope that this work will form a reference for existing researchers in the field, and entice new researchers and developers to join the HPRC community.  The book includes:  Thirteen application chapters which present the most important application areas tackled by high performance reconfigurable computers, namely: financial computing, bioinformatics and computational biology, data search and processing, stencil computation e.g. computational fluid dynamics and seismic modeling, cryptanalysis, astronomical N-body simulation, and circuit simulation.     Seven architecture chapters which...

  18. Architecture Analysis of High Performance Capacitors (POSTPRINT)

    Science.gov (United States)

    2009-07-01

    includes the measurement of heat dissipated from a recently developed fluorenyl polyester (FPE) capacitor under an AC excitation. II. Capacitor ...AFRL-RZ-WP-TP-2010-2100 ARCHITECTURE ANALYSIS OF HIGH PERFORMANCE CAPACITORS (POSTPRINT) Hiroyuki Kosai and Tyler Bixel UES, Inc...2009 4. TITLE AND SUBTITLE ARCHITECTURE ANALYSIS OF HIGH PERFORMANCE CAPACITORS (POSTPRINT) 5a. CONTRACT NUMBER In-house 5b. GRANT NUMBER 5c

  19. Introduction to High Performance Scientific Computing

    OpenAIRE

    2016-01-01

    The field of high performance scientific computing lies at the crossroads of a number of disciplines and skill sets, and correspondingly, for someone to be successful at using high performance computing in science requires at least elementary knowledge of and skills in all these areas. Computations stem from an application context, so some acquaintance with physics and engineering sciences is desirable. Then, problems in these application areas are typically translated into linear algebraic, ...

  20. Strip Casting of High Performance Structural Alloys

    Institute of Scientific and Technical Information of China (English)

    S S Park; J G Lee; Nack J Kim

    2004-01-01

    There exists a great need for the development of high performance alloys due to increasing demands for energy conservation and environmental protection. Application of strip casting shows a strong potential for the improvement of properties of existing alloys and also for the development of novel alloy systems with superior properties. The present paper reviews our Center's activities in the development of high performance alloys by strip casting. Examples include (1) Al alloys, (2) wrought Mg alloys, and (3) bulk metallic glass (BMG) alloys.

  1. Tackling obesity in areas of high social deprivation: clinical effectiveness and cost-effectiveness of a task-based weight management group programme - a randomised controlled trial and economic evaluation.

    Science.gov (United States)

    McRobbie, Hayden; Hajek, Peter; Peerbux, Sarrah; Kahan, Brennan C; Eldridge, Sandra; Trépel, Dominic; Parrott, Steve; Griffiths, Chris; Snuggs, Sarah; Myers Smith, Katie

    2016-10-01

    An increasing number of people require help to manage their weight. The NHS recommends weight loss advice by general practitioners and/or a referral to a practice nurse. Although this is helpful for some, more effective approaches that can be disseminated economically on a large scale are needed. To assess whether or not a task-based weight management programme [Weight Action Programme (WAP)] has better long-term effects than a 'best practice' intervention provided in primary care by practice nurses. Randomised controlled trial with cost-effectiveness analysis. General practices in east London, UK. Three hundred and thirty adults with a body mass index (BMI) of ≥ 30 kg/m(2) or a BMI of ≥ 28 kg/m(2) plus comorbidities were recruited from local general practices and via media publicity. Those who had a BMI of > 45 kg/m(2), had lost > 5% of their body weight in the previous 6 months, were currently pregnant or taking psychiatric medications were excluded. Participants were randomised (2 : 1) to the WAP or nurse arms. The WAP intervention was delivered in eight weekly group sessions that combined dietary and physical activity, advice and self-monitoring in a group-oriented intervention. The initial course was followed by 10 monthly group maintenance sessions open to all participants in this study arm. The practice nurse intervention (best usual care) consisted of four one-to-one sessions delivered over 8 weeks, and included standard advice on diet and physical activity based on NHS 'Change4Life' materials and motivational support. The primary outcome measure was weight change at 12 months. Secondary outcome measures included change in BMI, waist circumference and blood pressure, and proportion of participants losing at least 5% and 10% of baseline body weight. Staff collecting measurements at the 6- and 12-month follow-ups were blinded to treatment allocation. The primary outcome measure was analysed according to the intention-to-treat principle

  2. High-performance flat-panel solar thermoelectric generators with high thermal concentration.

    Science.gov (United States)

    Kraemer, Daniel; Poudel, Bed; Feng, Hsien-Ping; Caylor, J Christopher; Yu, Bo; Yan, Xiao; Ma, Yi; Wang, Xiaowei; Wang, Dezhi; Muto, Andrew; McEnaney, Kenneth; Chiesa, Matteo; Ren, Zhifeng; Chen, Gang

    2011-05-01

    The conversion of sunlight into electricity has been dominated by photovoltaic and solar thermal power generation. Photovoltaic cells are deployed widely, mostly as flat panels, whereas solar thermal electricity generation relying on optical concentrators and mechanical heat engines is only seen in large-scale power plants. Here we demonstrate a promising flat-panel solar thermal to electric power conversion technology based on the Seebeck effect and high thermal concentration, thus enabling wider applications. The developed solar thermoelectric generators (STEGs) achieved a peak efficiency of 4.6% under AM1.5G (1 kW m(-2)) conditions. The efficiency is 7-8 times higher than the previously reported best value for a flat-panel STEG, and is enabled by the use of high-performance nanostructured thermoelectric materials and spectrally-selective solar absorbers in an innovative design that exploits high thermal concentration in an evacuated environment. Our work opens up a promising new approach which has the potential to achieve cost-effective conversion of solar energy into electricity.

  3. Strengthening Cost-Effectiveness Analysis for Public Health Policy.

    Science.gov (United States)

    Russell, Louise B; Sinha, Anushua

    2016-05-01

    Although the U.S. spends more on medical care than any country in the world, Americans live shorter lives than the citizens of other high-income countries. Many important opportunities to improve this record lie outside the health sector and involve improving the conditions in which Americans live and work: safe design and maintenance of roads, bridges, train tracks, and airports; control of environmental pollutants; occupational safety; healthy buildings; a safe and healthy food supply; safe manufacture of consumer products; a healthy social environment; and others. Faced with the overwhelming array of possibilities, U.S. decision makers need help identifying those that can contribute the most to health. Cost-effectiveness analysis is designed to serve that purpose, but has mainly been used to assess interventions within the health sector. This paper briefly reviews the objective of cost-effectiveness analysis and its methodologic evolution and discusses the issues that arise when it is used to evaluate interventions that fall outside the health sector under three headings: structuring the analysis, quantifying/measuring benefits and costs, and valuing benefits and costs.

  4. Can aging in place be cost effective? A systematic review.

    Science.gov (United States)

    Graybill, Erin M; McMeekin, Peter; Wildman, John

    2014-01-01

    To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs) that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place. People aged 65+ and their live-in carers (where applicable), using an ALT to age in place at home opposed to a community-dwelling arrangement. Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style. Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered. The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.

  5. Can aging in place be cost effective? A systematic review.

    Directory of Open Access Journals (Sweden)

    Erin M Graybill

    Full Text Available PURPOSE OF THE STUDY: To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place. DESIGN: People aged 65+ and their live-in carers (where applicable, using an ALT to age in place at home opposed to a community-dwelling arrangement. METHODS: Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style. RESULTS: Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered. IMPLICATIONS: The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.

  6. Cost-effectiveness of Mohs micrographic surgery vs surgical excision for basal cell carcinoma of the face

    NARCIS (Netherlands)

    B.A.B. Essers (Brigitte); C.D. Dirksen (Carmen); F.H. Nieman (Fred); N.W.J. Smeets (Nicole W.); G.A.M. Krekels (Gertruud); M.H. Prins (Martin); H.A.M. Neumann (Martino)

    2006-01-01

    textabstractObjective: To assess the cost-effectiveness of Mohs micrographic surgery (MMS) compared with the surgical excision for both primary and recurrent basal cell carcinoma (BCC). Design: A cost-effectiveness study performed alongside a prospective randomized clinical trial in which MMS was co

  7. Cost-effectiveness of novel diagnostic tools for the diagnosis of tuberculosis.

    Science.gov (United States)

    Dowdy, D W; O'Brien, M A; Bishai, D

    2008-09-01

    The potential cost-effectiveness of improved diagnostic tests for tuberculosis (TB) in resource-limited settings is unknown. To estimate the incremental cost-effectiveness of a hypothetical new point-of-care TB diagnostic test in South Africa, Brazil and Kenya. Decision-analysis model, adding four diagnostic interventions (sputum smear microscopy, new test, smear plus new test and smear plus TB culture) to a baseline of existing infrastructure without smear. Adding sputum smear was estimated to be more cost-effective (incremental cost per disability-adjusted life year [DALY] of $86 [South Africa], $131 [Brazil], $38 (Kenya]) than a new TB diagnostic with 70% sensitivity, 95% specificity and price of $20 per test ($198 [South Africa], $275 [Brazil], $84 [Kenya]). However, compared to sputum smear, smear plus new test averted 46-49% more DALYs per 1000 TB suspects (321 vs. 215 [South Africa], 243 vs. 166 [Brazil], 790 vs. 531 [Kenya]), at an incremental cost of $170 (Kenya) to $625 (Brazil) per DALY averted. Cost-effectiveness was most sensitive to the specificity and price of the new test, the baseline TB case detection rate and the discount rate. Novel diagnostic tests for TB are potentially highly cost-effective. Cost-effectiveness is maximized by high-specificity, low-cost tests deployed to regions with poor infrastructure.

  8. The cost-effectiveness of adjuvant chemotherapy for early breast cancer: A comparison of no chemotherapy and first, second, and third generation regimens for patients with differing prognoses.

    Science.gov (United States)

    Campbell, H E; Epstein, D; Bloomfield, D; Griffin, S; Manca, A; Yarnold, J; Bliss, J; Johnson, L; Earl, H; Poole, C; Hiller, L; Dunn, J; Hopwood, P; Barrett-Lee, P; Ellis, P; Cameron, D; Harris, A L; Gray, A M; Sculpher, M J

    2011-11-01

    The risk of recurrence following surgery in women with early breast cancer varies, depending upon prognostic factors. Adjuvant chemotherapy reduces this risk; however, increasingly effective regimens are associated with higher costs and toxicity profiles, making it likely that different regimens may be cost-effective for women with differing prognoses. To investigate this we performed a cost-effectiveness analysis of four treatment strategies: (1) no chemotherapy, (2) chemotherapy using cyclophosphamide, methotrexate, and fluorouracil (CMF) (a first generation regimen), (3) chemotherapy using Epirubicin-CMF (E-CMF) or fluorouracil, epirubicin, and cyclophosphamide (FEC60) (a second generation regimens), and (4) chemotherapy with FEC60 followed by docetaxel (FEC-D) (a third generation regimen). These adjuvant chemotherapy regimens were used in three large UK-led randomised controlled trials (RCTs). A Markov model was used to simulate the natural progression of early breast cancer and the impact of chemotherapy on modifying this process. The probability of a first recurrent event within the model was estimated for women with different prognostic risk profiles using a parametric regression-based survival model incorporating established prognostic factors. Other probabilities, treatment effects, costs and quality of life weights were estimated primarily using data from the three UK-led RCTs, a meta-analysis of all relevant RCTs, and other published literature. The model predicted the lifetime costs, quality adjusted life years (QALYs) and cost-effectiveness of the four strategies for women with differing prognoses. Sensitivity analyses investigated the impact of uncertain parameters and model assumptions. For women with an average to high risk of recurrence (based upon prognostic factors and any other adjuvant therapies received), FEC-D appeared most cost-effective assuming a threshold of £20,000 per QALY for the National Health Service (NHS). For younger low risk

  9. Developing on-demand secure high-performance computing services for biomedical data analytics.

    Science.gov (United States)

    Robison, Nicholas; Anderson, Nick

    2013-01-01

    We propose a technical and process model to support biomedical researchers requiring on-demand high performance computing on potentially sensitive medical datasets. Our approach describes the use of cost-effective, secure and scalable techniques for processing medical information via protected and encrypted computing clusters within a model High Performance Computing (HPC) environment. The process model supports an investigator defined data analytics platform capable of accepting secure data migration from local clinical research data silos into a dedicated analytic environment, and secure environment cleanup upon completion. We define metrics to support the evaluation of this pilot model through performance and stability tests, and describe evaluation of its suitability towards enabling rapid deployment by individual investigators.

  10. Cost-effectiveness analysis of a low-cost bubble CPAP device in providing ventilatory support for neonates in Malawi - a preliminary report.

    Science.gov (United States)

    Chen, Ariel; Deshmukh, Ashish A; Richards-Kortum, Rebecca; Molyneux, Elizabeth; Kawaza, Kondwani; Cantor, Scott B

    2014-11-25

    A low-cost bubble continuous positive airway pressure (bCPAP) device has been shown to be an excellent clinical alternative to nasal oxygen for the care of neonates with respiratory difficulty. However, the delivery of bCPAP requires more resources than the current routine care using nasal oxygen. We performed an economic evaluation to determine the cost-effectiveness of a low-cost bCPAP device in providing ventilatory support for neonates in Malawi. We used patient-level clinical data from a previously published non-randomized controlled study. Economic data were based on the purchase price of supplies and equipment, adjusted for shelf life, as well as hospital cost data from the World Health Organization. Costs and benefits were discounted at 3%. The outcomes were measured in terms of cost, discounted life expectancy, cost/life year gained and net benefits of using bCPAP or nasal oxygen. The incremental cost-effectiveness ratio and incremental net benefits determined the value of one intervention compared to the other. Subgroup analysis on several parameters (birth weight categories, diagnosis of respiratory distress syndrome, and comorbidity of sepsis) was conducted to evaluate the effect of these parameters on the cost-effectiveness. Nasal oxygen therapy was less costly (US$29.29) than the low-cost bCPAP device ($57.78). Incremental effectiveness associated with bCPAP was 6.78 life years (LYs). In the base case analysis, the incremental cost-effectiveness ratio for bCPAP relative to nasal oxygen therapy was determined to be $4.20 (95% confidence interval, US$2.29-US$16.67) per LY gained. The results were highly sensitive for all tested subgroups, particularly for neonates with birth weight 1- cost effective. The bCPAP is a highly cost-effective strategy in providing ventilatory support for neonates in Malawi.

  11. CALiPER Report 21.3: Cost-Effectiveness of Linear (T8) LED Lamps

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Naomi J.; Perrin, Tess E.; Royer, Michael P.

    2014-05-27

    Meeting performance expectations is important for driving adoption of linear LED lamps, but cost-effectiveness may be an overriding factor in many cases. Linear LED lamps cost more initially than fluorescent lamps, but energy and maintenance savings may mean that the life-cycle cost is lower. This report details a series of life-cycle cost simulations that compared a two-lamp troffer using LED lamps (38 W total power draw) or fluorescent lamps (51 W total power draw) over a 10-year study period. Variables included LED system cost ($40, $80, or $120), annual operating hours (2,000 hours or 4,000 hours), LED installation time (15 minutes or 30 minutes), and melded electricity rate ($0.06/kWh, $0.12/kWh, $0.18/kWh, or $0.24/kWh). A full factorial of simulations allows users to interpolate between these values to aid in making rough estimates of economic feasibility for their own projects. In general, while their initial cost premium remains high, linear LED lamps are more likely to be cost-effective when electric utility rates are higher than average and hours of operation are long, and if their installation time is shorter.

  12. Cost-effectiveness of condom uterine balloon tamponade to control severe postpartum hemorrhage in Kenya.

    Science.gov (United States)

    Mvundura, Mercy; Kokonya, Donald; Abu-Haydar, Elizabeth; Okoth, Eunice; Herrick, Tara; Mukabi, James; Carlson, Lucas; Oguttu, Monica; Burke, Thomas

    2017-05-01

    To evaluate the cost-effectiveness of condom uterine balloon tamponade (UBT) for control of severe postpartum hemorrhage (PPH) due to uterine atony versus standard PPH care in Kenya. A cross-sectional analysis was conducted using cost data collected from 30 facilities in Western Kenya from April 15 to July 16, 2015. Effectiveness data were derived from the published literature. The modeling analysis was performed from the health-system perspective for a cohort of women who gave birth in 2015. Sensitivity analyses tested the robustness of model estimates. Costs were in 2015 US dollars. Compared with standard care with no uterine packing, condom UBT could prevent 1255 hospital transfers, 430 hysterectomies, and 44 maternal deaths. At $5 or $15 per UBT device, the incremental cost per disability-adjusted life year (DALY) averted was $26 or $40, respectively. If uterine packing was assumed to be done with standard care, the cost per DALY averted was $164 when the UBT price was $5 and $199 when the price was $15. Condom UBT was a highly cost-effective intervention for controlling severe PPH. This finding remained robust even when key model inputs were varied by wide margins. © 2017 International Federation of Gynecology and Obstetrics.

  13. Cost Effectiveness of the Earned Income Tax Credit as a Health Policy Investment.

    Science.gov (United States)

    Muennig, Peter A; Mohit, Babak; Wu, Jinjing; Jia, Haomiao; Rosen, Zohn

    2016-12-01

    Lower-income Americans are suffering from declines in income, health, and longevity over time. Income and employment policies have been proposed as a potential non-medical solution to this problem. An interrupted time series analysis of state-level incremental supplements to the Earned Income Tax Credit (EITC) program was performed using data from 1993 to 2010 Behavioral Risk Factor Surveillance System surveys and state-level life expectancy. The cost effectiveness of state EITC supplements was estimated using a microsimulation model, which was run in 2015. Supplemental EITC programs increased health-related quality of life and longevity among the poor. The program costs about $7,786/quality-adjusted life-year gained (95% CI=$4,100, $13,400) for the average recipient. This ratio increases with larger family sizes, costing roughly $14,261 (95% CI=$8,735, $19,716) for a family of three. State supplements to EITC appear to be highly cost effective, but randomized trials are needed to confirm these findings. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. CALiPER Report 21.3. Cost Effectiveness of Linear (T8) LED Lamps

    Energy Technology Data Exchange (ETDEWEB)

    None

    2014-05-01

    Meeting performance expectations is important for driving adoption of linear LED lamps, but cost-effectiveness may be an overriding factor in many cases. Linear LED lamps cost more initially than fluorescent lamps, but energy and maintenance savings may mean that the life-cycle cost is lower. This report details a series of life-cycle cost simulations that compared a two-lamp troffer using LED lamps (38 W total power draw) or fluorescent lamps (51 W total power draw) over a 10-year study period. Variables included LED system cost ($40, $80, or $120), annual operating hours (2,000 hours or 4,000 hours), LED installation time (15 minutes or 30 minutes), and melded electricity rate ($0.06/kWh, $0.12/kWh, $0.18/kWh, or $0.24/kWh). A full factorial of simulations allows users to interpolate between these values to aid in making rough estimates of economic feasibility for their own projects. In general, while their initial cost premium remains high, linear LED lamps are more likely to be cost-effective when electric utility rates are higher than average and hours of operation are long, and if their installation time is shorter.

  15. Cost-Effective Integration of Efficient Low-Lift Base Load Cooling Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Wei; Winiarski, David W.; Katipamula, Srinivas; Armstrong, Peter R.

    2008-01-14

    The long-term goal of DOE’s Commercial Buildings Integration subprogram is to develop cost-effective technologies and building practices that will enable the design and construction of net Zero Energy Buildings — commercial buildings that produce as much energy as they use on an annual basis — by 2025. To support this long-term goal, DOE further called for — as part of its FY07 Statement of Needs — the development by 2010 of “five cost-effective design technology option sets using highly efficient component technologies, integrated controls, improved construction practices, streamlined commissioning, maintenance and operating procedures that will make new and existing commercial buildings durable, healthy and safe for occupants.” In response, PNNL proposed and DOE funded a scoping study investigation of one such technology option set, low-lift cooling, that offers potentially exemplary HVAC energy performance relative to ASHRAE Standard 90.1-2004. The primary purpose of the scoping study was to estimate the national technical energy savings potential of this TOS.

  16. High Performance Work Systems for Online Education

    Science.gov (United States)

    Contacos-Sawyer, Jonna; Revels, Mark; Ciampa, Mark

    2010-01-01

    The purpose of this paper is to identify the key elements of a High Performance Work System (HPWS) and explore the possibility of implementation in an online institution of higher learning. With the projected rapid growth of the demand for online education and its importance in post-secondary education, providing high quality curriculum, excellent…

  17. Research on High Performance New Refractories

    Institute of Scientific and Technical Information of China (English)

    Zhong Xiangchong

    2007-01-01

    @@ At the age of 86,Prof.Zhong Xiangchong has his new book-"Research on High Performance New Refractories" published by Henan Science and Technology Publishing House to commemorate his 65 years service in the refractories science and technology including the recent 6 years at High Temperature Ceramics Institute which he founded in Zhengzhou University in 2001.

  18. Teacher Accountability at High Performing Charter Schools

    Science.gov (United States)

    Aguirre, Moises G.

    2016-01-01

    This study will examine the teacher accountability and evaluation policies and practices at three high performing charter schools located in San Diego County, California. Charter schools are exempted from many laws, rules, and regulations that apply to traditional school systems. By examining the teacher accountability systems at high performing…

  19. A cost-effect analysis of an intervention against radon in homes

    Directory of Open Access Journals (Sweden)

    Hein Stigum

    2009-10-01

    Full Text Available Background  Key words  : Radon exposure, lung cancer, cost-effect analysis, attributable risk, models-mathematical: Radon is a radioactive gas that may leak into buildings from the ground. Radon exposure is a risk factor for lung cancer. An intervention against radon exposure in homes may consist of locating homes with high radon exposure (above 200 Bq m-3 and improving these, and of protecting future houses. The purpose of this paper is to calculate the costs and the effects of this intervention. Methods: We performed a cost-effect analysis from the perspective of the society, followed by an uncertainty and sensitivity analysis. The distribution of radon levels in Norwegian homes is lognormal with mean=74.5 Bq/m3, and 7.6% above 200 Bq/m3. Results: The preventable attributable fraction of radon on lung cancer was 3.8% (95% uncertainty interval: 0.6%, 8.3%. In cumulative present values the intervention would cost $238 (145, 310 million and save 892 (133, 1981 lives, each life saved costs $0.27 (0.09, 0.9 million. The cost-effect ratio was sensitive to the radon risk, the radon exposure distribution, and the latency period of lung cancer. Together these three parameters explained 90% of the variation in the cost-effect ratio. Conclusions: Reducing the radon concentration in present and future homes to below 200 Bq/m3 will cost $0.27 (0.09, 0.9 million per life saved. The uncertainty in the estimated cost per life is large, mainly due to uncertainty in the risk of lung cancer from radon. Based on estimates from road construction, the Norwegian society has been willing to pay $1 million to save a life. We therefore conclude that the intervention against radon in homes is justifiable. The willingness to pay is also larger that the upper uncertainty limit of the cost per life. Our conclusion is therefore robust against the uncertainties in the parameters.

  20. Type 2 diabetes: cost-effectiveness of medication adherence and lifestyle interventions

    Science.gov (United States)

    Nerat, Tomaž; Locatelli, Igor; Kos, Mitja

    2016-01-01

    Introduction Type 2 diabetes is a major burden for the payer, however, with proper medication adherence, diet and exercise regime, complication occurrence rates, and consequently costs can be altered. Aims The aim of this study was to conduct a cost-effectiveness analysis on real patient data and evaluate which medication adherence or lifestyle intervention is less cost demanding for the payer. Methods Medline was searched systematically for published type 2 diabetes interventions regarding medication adherence and lifestyle in order to determine their efficacies, that were then used in the cost-effectiveness analysis. For cost-effectiveness analysis-required disease progression simulation, United Kingdom Prospective Diabetes Study Outcomes model 2.0 and Slovenian type 2 diabetes patient cohort were used. The intervention duration was set to 1, 2, 5, and 10 years. Complications and drug costs in euro (EUR) were based on previously published type 2 diabetes costs from the Health Care payer perspective in Slovenia. Results Literature search proved the following interventions to be effective in type 2 diabetes patients: medication adherence, the Mediterranean diet, aerobic, resistance, and combined exercise. The long-term simulation resulted in no payer net savings. The model predicted following quality-adjusted life-years (QALY) gained and incremental costs for QALY gained (EUR/QALYg) after 10 years of intervention: high-efficacy medication adherence (0.245 QALY; 9,984 EUR/QALYg), combined exercise (0.119 QALY; 46,411 EUR/QALYg), low-efficacy medication adherence (0.075 QALY; 30,967 EUR/QALYg), aerobic exercise (0.069 QALY; 80,798 EUR/QALYg), the Mediterranean diet (0.057 QALY; 27,246 EUR/QALYg), and resistance exercise (0.050 QALY; 111,847 EUR/QALYg). Conclusion The results suggest that medication adherence intervention is, regarding cost-effectiveness, superior to diet and exercise interventions from the payer perspective. However, the latter could also be utilized

  1. Nitrogen-rich graphene from small molecules as high performance anode material.

    Science.gov (United States)

    Gao, Weiwei; Huang, Hao; Shi, Hongyan; Feng, Xun; Song, Wenbo

    2014-10-17

    Nitrogen-rich graphene sheets were successfully achieved via facile thermal condensation of glucose and dicyandiamide at different temperatures during which dicyandiamide acts both as nitrogen source and sacrifice template. Devoid of surfactants or poisonous organic solvents, this small-molecule synthetic approach is a simple and cost-effective way to obtain nitrogen-rich graphene sheets (NRGS) with high specific surface area and large pore volume. Shown to be a promising anode material, the NRGS displayed high reversible capacity, excellent rate capability, and superior cycle performance. The superior lithium-storage performance is ascribed to the unique features of NRGS, including a large quantity of defects due to the high nitrogen doping level, favorable lithium ion transportation channels by virtue of the large surface area, and ultrahigh pore volume, as well as the crumpled two-dimensional structure.

  2. Cost effectiveness of ergonomic redesign of electronic motherboard.

    Science.gov (United States)

    Sen, Rabindra Nath; Yeow, Paul H P

    2003-09-01

    A case study to illustrate the cost effectiveness of ergonomic redesign of electronic motherboard was presented. The factory was running at a loss due to the high costs of rejects and poor quality and productivity. Subjective assessments and direct observations were made on the factory. Investigation revealed that due to motherboard design errors, the machine had difficulty in placing integrated circuits onto the pads, the operators had much difficulty in manual soldering certain components and much unproductive manual cleaning (MC) was required. Consequently, there were high rejects and occupational health and safety (OHS) problems, such as, boredom and work discomfort. Also, much labour and machine costs were spent on repairs. The motherboard was redesigned to correct the design errors, to allow more components to be machine soldered and to reduce MC. This eliminated rejects, reduced repairs, saved US dollars 581495/year and improved operators' OHS. The customer also saved US dollars 142105/year on loss of business.

  3. Performance and Costs of Ductless Heat Pumps in Marine-Climate High-Performance Homes -- Habitat for Humanity The Woods

    Energy Technology Data Exchange (ETDEWEB)

    Lubliner, Michael [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Howard, Luke [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Hales, David [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Kunkle, Rick [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Gordon, Andy [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Spencer, Melinda [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program

    2016-02-18

    The Woods is a Habitat for Humanity (HFH) community of ENERGY STAR Homes Northwest (ESHNW)-certified homes located in the marine climate of Tacoma/Pierce County, Washington. This research report builds on an earlier preliminary draft 2014 BA report, and includes significant billing analysis and cost effectiveness research from a collaborative, ongoing Ductless Heat Pump (DHP)research effort for Tacoma Public Utilities (TPU) and Bonneville Power Administration (BPA). This report focuses on the results of field testing, modeling, and monitoring of ductless mini-split heat pump hybrid heating systems in seven homes built and first occupied at various times between September 2013 and October 2014. The report also provides WSU documentation of high-performance home observations, lessons learned, and stakeholder recommendations for builders of affordable high-performance housing such as HFH. Tacoma Public Utilities (TPU) and Bonneville Power Administration (BPA). This report focuses on the results of field testing, modeling, and monitoring of ductless mini-split heat pump hybrid heating systems in seven homes built and first occupied at various times between September 2013 and October 2014. The report also provides WSU documentation of high-performance home observations, lessons learned, and stakeholder recommendations for builders of affordable high-performance housing such as HFH.

  4. Cost-effective nursing practice: cost-awareness and empowerment.

    Science.gov (United States)

    Fisher, P

    1993-12-01

    Cost-effective nursing practice is essential to succeed today as resources allocated to health care are declining. Realizing that any change poses a threat to our security, it is imperative that stakeholders be permitted to participate in decision-making processes affecting their work. An honest, open exchange of ideas towards cost-effective practices should be encouraged. Cost-effective behaviours are influenced significantly by negative attitudes with regard to loss of human resources, increased workload, and potential pay cuts. This article describes innovative strategies which could promote successful cost-effective nursing practice, including working smarter, not working harder. Topics addressed are attitude, awareness and empowerment.

  5. Cost-Effectiveness of Different Diagnostic Strategies in Suspected Stable Coronary Artery Disease in Portugal

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, António Miguel, E-mail: miguelferreira.md@sapo.pt [Hospital da Luz, Lisboa (Portugal); Hospital Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Lisboa (Portugal); Marques, Hugo [Hospital da Luz, Lisboa (Portugal); Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa (Portugal); Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa (Portugal); Gonçalves, Pedro Araújo [Hospital da Luz, Lisboa (Portugal); Hospital Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Lisboa (Portugal); Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa (Portugal); Cardim, Nuno [Hospital da Luz, Lisboa (Portugal); Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa (Portugal)

    2014-04-15

    Cost-effectiveness is an increasingly important factor in the choice of a test or therapy. To assess the cost-effectiveness of various methods routinely used for the diagnosis of stable coronary disease in Portugal. Seven diagnostic strategies were assessed. The cost-effectiveness of each strategy was defined as the cost per correct diagnosis (inclusion or exclusion of obstructive coronary artery disease) in a symptomatic patient. The cost and effectiveness of each method were assessed using Bayesian inference and decision-making tree analyses, with the pretest likelihood of disease ranging from 10% to 90%. The cost-effectiveness of diagnostic strategies was strongly dependent on the pretest likelihood of disease. In patients with a pretest likelihood of disease of ≤50%, the diagnostic algorithms, which include cardiac computed tomography angiography, were the most cost-effective. In these patients, depending on the pretest likelihood of disease and the willingness to pay for an additional correct diagnosis, computed tomography angiography may be used as a frontline test or reserved for patients with positive/inconclusive ergometric test results or a calcium score of >0. In patients with a pretest likelihood of disease of ≥ 60%, up-front invasive coronary angiography appears to be the most cost-effective strategy. Diagnostic algorithms that include cardiac computed tomography angiography are the most cost-effective in symptomatic patients with suspected stable coronary artery disease and a pretest likelihood of disease of ≤50%. In high-risk patients (pretest likelihood of disease ≥ 60%), up-front invasive coronary angiography appears to be the most cost-effective strategy. In all pretest likelihoods of disease, strategies based on ischemia appear to be more expensive and less effective compared with those based on anatomical tests.

  6. A Cost- Effective Design of Reversible Programmable Logic Array

    CERN Document Server

    Singla, Pradeep; 10.5120/5619-7911

    2012-01-01

    In the recent era, Reversible computing is a growing field having applications in nanotechnology, optical information processing, quantum networks etc. In this paper, the authors show the design of a cost effective reversible programmable logic array using VHDL. It is simulated on xilinx ISE 8.2i and results are shown. The proposed reversible Programming logic array called RPLA is designed by MUX gate [10] & Feynman gate for 3- inputs, which is able to perform any reversible 3- input logic function or Boolean function. Furthermore the quantized analysis with camparitive finding is shown for the realized RPLA against the existing one. The result shows improvement in the quantum cost and total logical caculation in proposed RPLA.

  7. An Improved, Efficient and Cost Effective Software Inspection Meeting Process

    Directory of Open Access Journals (Sweden)

    Dilawar Ali

    2013-02-01

    Full Text Available Normally, the inspection process is seemed to be just finding defects in software during software development process lifecycle. Software inspection is considered as a most cost effective technique, but if these defects are not properly corrected or handled it would cost you more than double later in the project. This paper focus on the last phase of inspection meeting process showing the importance of Follow-Up Stage in software inspection meeting process. This paper also suggests a set of activities that should be performed during the Rework and Follow-Up Stages so to get inspection meeting results productive and efficient. In this paper we focus on the over the shoulder reviews so to ensure the software quality having less impact on the total software cost.

  8. Cost-effectiveness of treatments reducing coronary heart disease mortality in Ireland, 2000 to 2010.

    LENUS (Irish Health Repository)

    Bennett, Kathleen

    2009-01-01

    OBJECTIVE: Coronary heart disease (CHD) is associated with a large burden of disease in Ireland and is responsible for more than 6000 deaths annually. This study examined the cost-effectiveness of specific CHD treatments in Ireland. METHODS: Irish epidemiological data on patient numbers and median survival in specific groups, plus the uptake, effectiveness, and costs of specific interventions, all stratified by age and sex, were incorporated into a previously validated CHD mortality model, the IMPACT model. This model calculates the number of life-years gained (LYGs) by specific cardiology interventions to generate incremental cost-effectiveness ratios (ICERs) per LYG for each intervention. RESULTS: In 2000, medical and surgical treatments together prevented or postponed approximately 1885 CHD deaths in patients aged 25 to 84 years, and thus generated approximately 14,505 extra life-years (minimum 7270, maximum 22,475). In general, all the cardiac interventions investigated were highly cost-effective in the Irish setting. Aspirin, beta-blockers, ACE inhibitors, spironolactone, and warfarin for specific conditions were the most cost-effective interventions (< euro 3000\\/LYG), followed by the statins for secondary prevention (< euro 6500\\/LYG). Revascularization for chronic angina and primary angioplasty for myocardial infarction, although still cost-effective, had the highest ICER (between euro 12,000 and euro 20,000\\/LYG). CONCLUSIONS: Using a comprehensive standardized methodology, cost-effectiveness ratios in this study clearly favored simple medical treatments for myocardial infarction, secondary prevention, angina, and heart failure.

  9. Cost-effectiveness of adding rituximab to fludarabine and cyclophosphamide for treatment of chronic lymphocytic leukemia in Ukraine

    Directory of Open Access Journals (Sweden)

    Mandrik O

    2015-08-01

    Full Text Available Olena Mandrik,1 Isaac Corro Ramos,2 Saskia Knies,1,3 Maiwenn Al,1,2 Johan L Severens1,2 1Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands; 2Institute of Medical Technology Assessment (iMTA, Erasmus University Rotterdam, Rotterdam, the Netherlands; 3National Health Care Institute, Diemen, the Netherlands Abstract: The aim of this study was to assess the cost-effectiveness, from a health care perspective, of adding rituximab to fludarabine and cyclophosphamide scheme (FCR versus FC for treatment-naïve and refractory/relapsed Ukrainian patients with chronic lymphocytic leukemia. A decision-analytic Markov cohort model with three health states and 1-month cycle time was developed and run within a life time horizon. Data from two multinational, prospective, open-label Phase 3 studies were used to assess patients' survival. While utilities were generalized from UK data, local resource utilization and disease-associated treatment, hospitalization, and side effect costs were applied. The alternative scenario was performed to assess the impact of lower life expectancy of the general population in Ukraine on the incremental cost-effectiveness ratio (ICER for treatment-naïve patients. One-way, two-way, and probabilistic sensitivity analyses were conducted to assess the robustness of the results. The ICER (in US dollars of treating chronic lymphocytic leukemia patients with FCR versus FC is US$8,704 per quality-adjusted life year gained for treatment-naïve patients and US$11,056 for refractory/relapsed patients. When survival data were modified to the lower life expectancy of the general population in Ukraine, the ICER for treatment-naïve patients was higher than US$13,000. This value is higher than three times the current gross domestic product per capita in Ukraine. Sensitivity analyses have shown a high impact of rituximab costs and a moderate impact of differences in utilities on the ICER

  10. Relative Cost-Effectiveness of Treatments for Adolescent Depression: 36-Week Results from the TADS Randomized Trial

    Science.gov (United States)

    Domino, Marisa Elena; Foster, E. Michael; Vitiello, Benedetto; Kratochvil, Christopher J.; Burns, Barbara J.; Silva, Susan G.; Reinecke, Mark A.; March, John S.

    2009-01-01

    Randomized controlled trials that involve 327 participants aged 12 to 18 who were diagnosed with major depression were given either fluoxetine alone, cognitive-behavioral therapy, or a combination of both. Cost-effectiveness acceptability curves suggest that combination treatment is highly likely to be the most cost-effective treatment than…

  11. Basic prinicipal of high performance liquid chromatography

    OpenAIRE

    Ivanova, Violeta

    2016-01-01

    High-performance liquid chromatography (HPLC) is an analytical technique based on the separation of molecules due to differences in their structure and/or composition. Separation is performed between two phases, mobile and stationary. The molecules in the sample have different affinities and interactions with the stationary support, leading to separation of molecules. Compounds which are longer retained at the stationary phase will elute later, compared to those which are distributed into the...

  12. vSphere high performance cookbook

    CERN Document Server

    Sarkar, Prasenjit

    2013-01-01

    vSphere High Performance Cookbook is written in a practical, helpful style with numerous recipes focusing on answering and providing solutions to common, and not-so common, performance issues and problems.The book is primarily written for technical professionals with system administration skills and some VMware experience who wish to learn about advanced optimization and the configuration features and functions for vSphere 5.1.

  13. Engineering high-performance vertical cavity lasers

    Energy Technology Data Exchange (ETDEWEB)

    Lear, K.L.; Hou, H.Q.; Hietala, V.M.; Choquette, K.D.; Schneider, R.P. Jr.

    1996-12-31

    The cw and high-speed performance of vertical cavity surface emitting laser diodes (VCSELs) are affected by both electrical and optical issues arising from the geometry and fabrication of these devices. Structures with low resistance semiconductor mirrors and Al-oxide confinement layers address these issues and have produced record performance including 50% power conversion efficiency and modulation bandwidths up to 20 GHz at small bias currents.

  14. High Performance Interconnect Network for Tianhe System

    Institute of Scientific and Technical Information of China (English)

    廖湘科; 庞征斌; 王克非; 卢宇彤; 谢旻; 夏军; 董德尊; 所光

    2015-01-01

    In this paper, we present the Tianhe-2 interconnect network and message passing services. We describe the architecture of the router and network interface chips, and highlight a set of hardware and software features effectively supporting high performance communications, ranging over remote direct memory access, collective optimization, hardware-enable reliable end-to-end communication, user-level message passing services, etc. Measured hardware performance results are also presented.

  15. Optimizations for High Performance Network Virtualization

    Institute of Scientific and Technical Information of China (English)

    Fan-Fu Zhou; Ru-Hui Ma; Jian Li; Li-Xia Chen; Wei-Dong Qiu; Hai-Bing Guan

    2016-01-01

    The increasing requirements of intensive interoperaterbility among the distributed nodes desiderate the high performance network connections, owing to the substantial growth of cloud computing and datacenters. Network I/O virtualization aggregates the network resource and separates it into manageable parts for particular servers or devices, which provides effective consolidation and elastic management with high agility, flexibility and scalability as well as reduced cost and cabling. However, both network I/O virtualization aggregation and the increasing network speed incur higher traffic density, which generates a heavy system stress for I/O data moving and I/O event processing. Consequently, many researchers have dedicated to enhancing the system performance and alleviating the system overhead for high performance networking virtualization. This paper first elaborates the mainstreaming I/O virtualization methodologies, including device emulation, split-driver model and hardware assisted model. Then, the paper discusses and compares their specific advantages in addition to performance bottlenecks in practical utilities. This paper mainly focuses on the comprehensive survey of state-of-the-art approaches for performance optimizations and improvements as well as the portability management for network I/O virtualization. The approaches include various novel data delivery schemes, overhead mitigations for interrupt processing and adequate resource allocations for dynamic network states. Finally, we highlight the diversity of I/O virtualization besides the performance improvements in network virtualization infrastructure.

  16. Are drug-coated balloons cost effective for femoropopliteal occlusive disease? A comparison of bare metal stents and uncoated balloons.

    Science.gov (United States)

    Poder, Thomas G; Fisette, Jean-François

    2016-07-01

    To perform a cost-effectiveness analysis to help hospital decision-makers with regard to the use of drug-coated balloons compared with bare metal stents and uncoated balloons for femoropopliteal occlusive disease. Clinical outcomes were extracted from the results of meta-analyses already published, and cost units are those used in the Quebec healthcare network. The literature review was limited to the last four years to obtain the most recent data. The cost-effectiveness analysis was based on a 2-year perspective, and risk factors of reintervention were considered. The cost-effectiveness analysis indicated that drug-coated balloons were generally more efficient than bare metal stents, particularly for patients with higher risk of reintervention (up to CAD$1686 per patient TASC II C or D). Compared with uncoated balloons, results indicated that drug-coated balloons were more efficient if the reintervention rate associated with uncoated balloons is very high and for patients with higher risk of reintervention (up to CAD$3301 per patient). The higher a patient's risk of reintervention, the higher the savings associated with the use of a drug-coated balloon will be. For patients at lower risk, the uncoated balloon strategy is still recommended as a first choice for endovascular intervention.

  17. Burden of rotavirus disease and cost-effectiveness of universal vaccination in the Province of Genoa (Northern Italy).

    Science.gov (United States)

    Panatto, D; Amicizia, D; Ansaldi, F; Marocco, A; Marchetti, F; Bamfi, F; Giacchino, R; Tacchella, A; Del Buono, S; Gasparini, R

    2009-05-26

    Rotavirus is acknowledged to be a major cause of acute gastroenteritis in infants and young children. As gastroenteritis due to rotavirus is a public health problem and two new vaccines are currently available, we investigated the rotavirus burden and developed a cost-effectiveness analysis, using data collected in the Province of Genoa (Italy), to evaluate the benefits of new borns vaccination. The cost-effectiveness of a rotavirus vaccination programme in the Province of Genoa was performed, in comparison with no vaccination, for both the regional healthcare system (RHS) and society (S). In 2006, admissions to the paediatric emergency department for gastroenteritis numbered 2338 (about 11% of total admissions); of these 33% were hospitalised. In 28% of cases, the children tested positive for rotavirus. During epidemics, paediatricians receive from 3 to 5 calls per day for gastroenteritis, carry out 1 or 2 ambulatory examinations and for children with a severe case history, make house visits. A rotavirus immunisation programme would have a great impact on disease burden, in that 90% coverage would reduce the number of severe cases by more than 85%. From the perspective of both the RHS and S, vaccination proved to be highly cost-effective.

  18. Achieving High Performance Perovskite Solar Cells

    Science.gov (United States)

    Yang, Yang

    2015-03-01

    Recently, metal halide perovskite based solar cell with the characteristics of rather low raw materials cost, great potential for simple process and scalable production, and extreme high power conversion efficiency (PCE), have been highlighted as one of the most competitive technologies for next generation thin film photovoltaic (PV). In UCLA, we have realized an efficient pathway to achieve high performance pervoskite solar cells, where the findings are beneficial to this unique materials/devices system. Our recent progress lies in perovskite film formation, defect passivation, transport materials design, interface engineering with respect to high performance solar cell, as well as the exploration of its applications beyond photovoltaics. These achievements include: 1) development of vapor assisted solution process (VASP) and moisture assisted solution process, which produces perovskite film with improved conformity, high crystallinity, reduced recombination rate, and the resulting high performance; 2) examination of the defects property of perovskite materials, and demonstration of a self-induced passivation approach to reduce carrier recombination; 3) interface engineering based on design of the carrier transport materials and the electrodes, in combination with high quality perovskite film, which delivers 15 ~ 20% PCEs; 4) a novel integration of bulk heterojunction to perovskite solar cell to achieve better light harvest; 5) fabrication of inverted solar cell device with high efficiency and flexibility and 6) exploration the application of perovskite materials to photodetector. Further development in film, device architecture, and interfaces will lead to continuous improved perovskite solar cells and other organic-inorganic hybrid optoelectronics.

  19. Dawning4000A high performance computer

    Institute of Scientific and Technical Information of China (English)

    SUN Ninghui; MENG Dan

    2007-01-01

    Dawning4000A is an AMD Opteron-based Linux Cluster with 11.2Tflops peak performance and 8.06Tflops Linpack performance.It was developed for the Shanghai Supercomputer Center (SSC)as one of the computing power stations of the China National Grid (CNGrid)project.The Massively Cluster Computer (MCC)architecture is proposed to put added-value on the industry standard system.Several grid-enabling components are developed to support the running environment of the CNGrid.It is an achievement for a high performance computer with the low-cost approach.

  20. High performance parallel I/O

    CERN Document Server

    Prabhat

    2014-01-01

    Gain Critical Insight into the Parallel I/O EcosystemParallel I/O is an integral component of modern high performance computing (HPC), especially in storing and processing very large datasets to facilitate scientific discovery. Revealing the state of the art in this field, High Performance Parallel I/O draws on insights from leading practitioners, researchers, software architects, developers, and scientists who shed light on the parallel I/O ecosystem.The first part of the book explains how large-scale HPC facilities scope, configure, and operate systems, with an emphasis on choices of I/O har

  1. Cost-effectiveness analysis of a quadrivalent human papilloma virus vaccine in Mexico.

    Science.gov (United States)

    Reynales-Shigematsu, Luz Myriam; Rodrigues, Eliane R; Lazcano-Ponce, Eduardo

    2009-08-01

    Cervical cancer is one of the main causes of death in women in low- and middle-income countries. Despite technological and scientific advances that allow an early detection of precancerous lesions and curative treatment of cervical cancer, Mexico and other Latin American countries have only been able to obtain a small decrease in the mortality rates for this kind of cancer. How to implement and sustain effective public health strategies for cervical cancer prevention, such as increasing cytology-based screening program coverage and implementing HPV-DNA testing and vaccination, are important questions. The aim of this study is to perform a cost-effectiveness analysis of the introduction of a quadrivalent (HPV 6/11/16/18) HPV vaccine into the public health system and evaluate the epidemiological and economic benefits on prevention of cervical cancer in Mexico. A Markov model is used to simulate the natural history of HPV infection in a cohort of Mexican women to evaluate the cost-effectiveness of the cervical cancer screening strategy used in Mexico as well as the benefits of other potential strategies such as 1) vaccination only, 2) conventional cytology-based screening program only and 3) vaccination followed by screening. For the strategies that involve screening we have chosen screening intervals of 3 and 5 years. The model produces results that are reasonably close to the epidemiological data related to HPV and cervical cancer in Mexico. The quadrivalent HPV vaccine could reduce the probability of persistent HPV-16/18 infection by at least 60%, which would result in a near-proportional reduction in HPV-16/18-associated invasive cervical cancer and CIN 3. The strategy of using only vaccination ($45 USD for three doses) as a preventive measure was a very cost-effective strategy in Mexico ($68USD/LYS). The strategy of vaccination with traditional screening of Pap test every 3 years produced higher cost by a lower performance of cervical cytology in Mexico, at a

  2. Energy-Performance-Based Design-Build Process: Strategies for Procuring High-Performance Buildings on Typical Construction Budgets: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Scheib, J.; Pless, S.; Torcellini, P.

    2014-08-01

    NREL experienced a significant increase in employees and facilities on our 327-acre main campus in Golden, Colorado over the past five years. To support this growth, researchers developed and demonstrated a new building acquisition method that successfully integrates energy efficiency requirements into the design-build requests for proposals and contracts. We piloted this energy performance based design-build process with our first new construction project in 2008. We have since replicated and evolved the process for large office buildings, a smart grid research laboratory, a supercomputer, a parking structure, and a cafeteria. Each project incorporated aggressive efficiency strategies using contractual energy use requirements in the design-build contracts, all on typical construction budgets. We have found that when energy efficiency is a core project requirement as defined at the beginning of a project, innovative design-build teams can integrate the most cost effective and high performance efficiency strategies on typical construction budgets. When the design-build contract includes measurable energy requirements and is set up to incentivize design-build teams to focus on achieving high performance in actual operations, owners can now expect their facilities to perform. As NREL completed the new construction in 2013, we have documented our best practices in training materials and a how-to guide so that other owners and owner's representatives can replicate our successes and learn from our experiences in attaining market viable, world-class energy performance in the built environment.

  3. Simple and cost-effective fluorescent labeling of 5-hydroxymethylcytosine

    Science.gov (United States)

    Shahal, Tamar; Green, Ori; Hananel, Uri; Michaeli, Yael; Shabat, Doron; Ebenstein, Yuval

    2016-12-01

    The nucleobase 5-hydroxymethylcytosine (5-hmC), a modified form of cytosine, is an important epigenetic mark related to regulation of gene expression. 5-hmC levels are highly dynamic during early development and are modulated during the progression of neurodegenerative disease and cancer. We describe a spectroscopic method for the global quantification of 5-hmC in genomic DNA. This method relies on the enzymatic glucosylation of 5-hmC, followed by a glucose oxidation step that results in the formation of aldehyde moieties that are covalently linked to a fluorescent reporter by oxime ligation. The fluorescence intensity of the labeled sample is directly proportional to its 5-hmC content. We show that this simple and cost-effective technique is suitable for quantification of 5-hmC content in different mouse tissues.

  4. DEVELOPMENT AND MANUFACTURE OF COST EFFECTIVE COMPOSITE DRILL PIPE

    Energy Technology Data Exchange (ETDEWEB)

    James C. Leslie; James C. Leslie II; Lee Truong; James T. Heard

    2003-03-30

    This technical report presents the engineering research and data accomplishments that have transpired to date in support of the development of Cost Effective Composite Drill Pipe (CDP). The report presents accomplishments made from October 1, 2002 through September 30, 2003. The following have been accomplished and are reported in detail herein: Metal-to-Composite Interface (MCI) redesign and testing; Successful demonstration of MCI connection for both SR and ER/DW CDP; Specifications for a 127mm (5 inch) ID by 152.4 mm (6 inch) OD composite drill pipe have been finalized for Extended Reach/Deep Water applications (ER/DW); Field testing of Short Radius CDP (SR); Sealing composite laminate to contain high pressure; Amendments; Amendment for ''Smart'' feature added to ER/DW development along with time and funding to complete battery of qualification tests with option for field demonstration; and Preparation of papers for publication and conference presentations.

  5. LIQUID ARGON CALORIMETER PERFORMANCE AT HIGH RATES

    CERN Document Server

    Kukhtin, V; The ATLAS collaboration

    2011-01-01

    The performance of the ATLAS liquid argon endcap and forward calorimeters has been projected at the planned high luminosity LHC option HL-LHC by exposing small calorimeter modules of the electromagnetic, hadronic, and forward calorimeters to high intensity proton beams at IHEP/Protvino accelerator. The results of HV current and of pulse shape analysis, and also the dependence of signal amplitude on beam intensity are presented.

  6. High Performance Binder for EMCDB Propellants

    Directory of Open Access Journals (Sweden)

    V. K. Bhat

    1995-01-01

    Full Text Available A novel block polymer has been synthesised from caprolactone using hydroxy terminated polybutadiene as ring opening initiator. Usefulness of this polymer as propellant binder has been studied by generating data on physico-chemical properties of the polymer. The polymer exhibited high miscibility with nitrate ester and high solid loading capability. Preliminary data generated on typical propellant formulation indicated higher performance as compared to composite propellant.

  7. Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, Tom [Building America Partnership for Improved Residential Construction (BA-PIRC), Corvallis, OR (United States); Peeks, Brady [Building America Partnership for Improved Residential Construction (BA-PIRC), Corvallis, OR (United States)

    2013-11-01

    The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in the manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50% over typical manufactured homes produced in the northwest.

  8. Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, T.; Peeks, B.

    2013-11-01

    The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in the manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50 percent over typical manufactured homes produced in the northwest.

  9. A scalable silicon photonic chip-scale optical switch for high performance computing systems.

    Science.gov (United States)

    Yu, Runxiang; Cheung, Stanley; Li, Yuliang; Okamoto, Katsunari; Proietti, Roberto; Yin, Yawei; Yoo, S J B

    2013-12-30

    This paper discusses the architecture and provides performance studies of a silicon photonic chip-scale optical switch for scalable interconnect network in high performance computing systems. The proposed switch exploits optical wavelength parallelism and wavelength routing characteristics of an Arrayed Waveguide Grating Router (AWGR) to allow contention resolution in the wavelength domain. Simulation results from a cycle-accurate network simulator indicate that, even with only two transmitter/receiver pairs per node, the switch exhibits lower end-to-end latency and higher throughput at high (>90%) input loads compared with electronic switches. On the device integration level, we propose to integrate all the components (ring modulators, photodetectors and AWGR) on a CMOS-compatible silicon photonic platform to ensure a compact, energy efficient and cost-effective device. We successfully demonstrate proof-of-concept routing functions on an 8 × 8 prototype fabricated using foundry services provided by OpSIS-IME.

  10. Guideline Standardisation, Cost Effectiveness, Industry Needs and Conflict of Interest

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2007-01-01

    Full Text Available 1. A Conference on Guideline Standardization (COGS was convened in April 2002 'to define a standard for guideline reporting that would promote guideline quality and facilitate implementation'. It includes items for standardization, conceptual issues, up gradation, conflict of interest, patient interest and systematization. Even items for individual preferences, choice or values are not neglected. Special mention must be made of items which specify disclosure of conflict of interest both in the Developer (including the organization that develops and the individuals involved in the guideline's formulation, as well as in the sponsor or funding source (and its role in developing and/or reporting the guideline. 2. Recommendations of CPGs and CDR panels are conflicting. One considers effectiveness, the other considers cost-effectiveness. However, CPGs do not adhere to established methodological standards, critical information that would attest to validity is regularly absent, explicit criteria to grade the scientific evidence that supports their recommendations is absent from 82% of guidelines, 87% are not in a position to report whether a systematic literature search was performed, 67% do not describe the type of professionals used in guidelines development, there is such marked variation in the quality of guidelines. Moreover, CPG guideline layers often are conflicted in their interests. The problem can be resolved to a large extent by taking a simple step: making CPG panelists go into cost effectiveness along with recommending Guidelines. What then happens is that they have to consider not only effectiveness but also costs. Now effectiveness can be fudged, cost cannot. Why? Because, what is the cost is well known. Therapies in Guidelines should be recommended and graded according to whether they are Most, Moderately or Least Cost Effective. For that CPGs will have to perform economic analysis as well. This will meet with resistance for obvious

  11. Cost-effectiveness of magnetic resonance imaging with a new contrast agent for the early diagnosis of Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Maria Biasutti

    Full Text Available BACKGROUND: Used as contrast agents for brain magnetic resonance imaging (MRI, markers for beta-amyloid deposits might allow early diagnosis of Alzheimer's disease (AD. We evaluated the cost-effectiveness of such a diagnostic test, MRI+CLP (contrastophore-linker-pharmacophore, should it become clinically available. METHODOLOGY/PRINCIPAL FINDINGS: We compared the cost-effectiveness of MRI+CLP to that of standard diagnosis using currently available cognition tests and of standard MRI, and investigated the impact of a hypothetical treatment efficient in early AD. The primary analysis was based on the current French context for 70-year-old patients with Mild Cognitive Impairment (MCI. In alternative "screen and treat" scenarios, we analyzed the consequences of systematic screenings of over-60 individuals (either population-wide or restricted to the ApoE4 genotype population. We used a Markov model of AD progression; model parameters, as well as incurred costs and quality-of-life weights in France were taken from the literature. We performed univariate and probabilistic multivariate sensitivity analyses. The base-case preferred strategy was the standard MRI diagnosis strategy. In the primary analysis however, MRI+CLP could become the preferred strategy under a wide array of scenarios involving lower cost and/or higher sensitivity or specificity. By contrast, in the "screen and treat" analyses, the probability of MRI+CLP becoming the preferred strategy remained lower than 5%. CONCLUSIONS/SIGNIFICANCE: It is thought that anti-beta-amyloid compounds might halt the development of dementia in early stage patients. This study suggests that, even should such treatments become available, systematically screening the over-60 population for AD would only become cost-effective with highly specific tests able to diagnose early stages of the disease. However, offering a new diagnostic test based on beta-amyloid markers to elderly patients with MCI might prove

  12. MRCP is not a cost-effective strategy in the management of silent common bile duct stones.

    Science.gov (United States)

    Epelboym, Irene; Winner, Megan; Allendorf, John D

    2013-05-01

    Few formal cost-effectiveness analyses simultaneously evaluate radiographic, endoscopic, and surgical approaches to the management of choledocholithiasis. Using the decision analytic software TreeAge, we modeled the initial clinical management of a patient presenting with symptomatic cholelithiasis without overt signs of choledocholithiasis. In this base case, we assumed a 10 % probability of concurrent asymptomatic choledocholithiasis. Our model evaluated four diagnostic/therapeutic strategies: universal magnetic resonance cholangiopancreatography (MRCP), universal endoscopic retrograde cholangiopancreatography (ERCP), laparoscopic cholecystectomy (LC), or laparoscopic cholecystectomy with universal intraoperative cholangiogram (LCIOC). All probabilities were estimated from a review of published literature. Procedure and intervention costs were equated with Medicare reimbursements. Costs of hospitalizations were derived from median hospitalization reimbursement for New York State using diagnosis-related groups (DRG). Sensitivity analyses were performed on all cost and probability variables. The most cost-effective strategy in the diagnosis and management of symptomatic cholelithiasis with a 10 % risk of asymptomatic choledocholithiasis was LCIOC. This was followed by LC alone, MRCP, and ERCP. LC was preferred only when the probability that a retained CBD stone would eventually become symptomatic fell below 15 % or if the probability of technical success of an intraoperative cholangiogram (IOC) was less than 35 %. Universal MRCP and ERCP were both more costly and less effective than surgical strategies, even at a high probability of asymptomatic choledocholithiasis. Within the tested range for both procedural and hospitalization-related costs for any of the surgical or endoscopic interventions, LCIOC and LC were always more cost-effective than universal MRCP or ERCP, irrespective of the presence or absence of complications. Varying the cost, sensitivity, and

  13. Cost-effectiveness analysis of sofosbuvir compared to current standard treatment in Swiss patients with chronic hepatitis C.

    Directory of Open Access Journals (Sweden)

    Alena M Pfeil

    Full Text Available In clinical trials, sofosbuvir showed high antiviral activity in patients infected with hepatitis C virus (HCV across all genotypes. We aimed to determine the cost-effectiveness of sofosbuvir-based treatment compared to current standard treatment in mono-infected patients with chronic hepatitis C (CHC genotypes 1-4 in Switzerland. Cost-effectiveness was modelled from the perspective of the Swiss health care system using a lifetime Markov model. Incremental cost-effectiveness ratios (ICERs used an endpoint of cost per quality-adjusted life year (QALY gained. Treatment characteristics, quality of life, and transition probabilities were obtained from published literature. Country-specific model inputs such as patient characteristics, mortality and costs were obtained from Swiss sources. We performed extensive sensitivity analyses. Costs and effects were discounted at 3% (range: 0-5% per year. Sofosbuvir-containing treatment in mixed cohorts of cirrhotic and non-cirrhotic patients with CHC genotypes 1-4 showed ICERs between CHF 10,337 and CHF 91,570 per QALY gained. In subgroup analyses, sofosbuvir dominated telaprevir- and boceprevir-containing treatment in treatment-naïve genotype 1 cirrhotic patients. ICERs of sofosbuvir were above CHF 100,000 per QALY in treatment-naïve, interferon eligible, non-cirrhotic patients infected with genotypes 2 or 3. In deterministic and probabilistic sensitivity analyses, results were generally robust. From a Swiss health care system perspective, treatment of mixed cohorts of cirrhotic and non-cirrhotic patients with CHC genotypes 1-4 with sofosbuvir-containing treatment versus standard treatment would be cost-effective if a threshold of CHF 100,000 per QALY was assumed.

  14. Potential cost-effectiveness of schistosomiasis treatment for reducing HIV transmission in Africa--the case of Zimbabwean women.

    Directory of Open Access Journals (Sweden)

    Martial L Ndeffo Mbah

    Full Text Available BACKGROUND: Epidemiological data from Zimbabwe suggests that genital infection with Schistosoma haematobium may increase the risk of HIV infection in young women. Therefore, the treatment of Schistosoma haematobium with praziquantel could be a potential strategy for reducing HIV infection. Here we assess the potential cost-effectiveness of praziquantel as a novel intervention strategy against HIV infection. METHODS: We developed a mathematical model of female genital schistosomiasis (FGS and HIV infections in Zimbabwe that we fitted to cross-sectional data of FGS and HIV prevalence of 1999. We validated our epidemic projections using antenatal clinic data on HIV prevalence. We simulated annual praziquantel administration to school-age children. We then used these model predictions to perform a cost-effectiveness analysis of annual administration of praziquantel as a potential measure to reduce the burden of HIV in sub-Saharan Africa. FINDINGS: We showed that for a variation of efficacy between 30-70% of mass praziquantel administration for reducing the enhanced risk of HIV transmission per sexual act due to FGS, annual administration of praziquantel to school-age children in Zimbabwe could result in net savings of US$16-101 million compared with no mass treatment of schistosomiasis over a ten-year period. For a variation in efficacy between 30-70% of mass praziquantel administration for reducing the acquisition of FGS, annual administration of praziquantel to school-age children could result in net savings of US$36-92 million over a ten-year period. CONCLUSIONS: In addition to reducing schistosomiasis burden, mass praziquantel administration may be a highly cost-effective way of reducing HIV infections in sub-Saharan Africa. Program costs per case of HIV averted are similar to, and under some conditions much better than, other interventions that are currently implemented in Africa to reduce HIV transmission. As a cost-saving strategy, mass

  15. Cost-effectiveness analysis of sofosbuvir compared to current standard treatment in Swiss patients with chronic hepatitis C.

    Science.gov (United States)

    Pfeil, Alena M; Reich, Oliver; Guerra, Ines M; Cure, Sandrine; Negro, Francesco; Müllhaupt, Beat; Lavanchy, Daniel; Schwenkglenks, Matthias

    2015-01-01

    In clinical trials, sofosbuvir showed high antiviral activity in patients infected with hepatitis C virus (HCV) across all genotypes. We aimed to determine the cost-effectiveness of sofosbuvir-based treatment compared to current standard treatment in mono-infected patients with chronic hepatitis C (CHC) genotypes 1-4 in Switzerland. Cost-effectiveness was modelled from the perspective of the Swiss health care system using a lifetime Markov model. Incremental cost-effectiveness ratios (ICERs) used an endpoint of cost per quality-adjusted life year (QALY) gained. Treatment characteristics, quality of life, and transition probabilities were obtained from published literature. Country-specific model inputs such as patient characteristics, mortality and costs were obtained from Swiss sources. We performed extensive sensitivity analyses. Costs and effects were discounted at 3% (range: 0-5%) per year. Sofosbuvir-containing treatment in mixed cohorts of cirrhotic and non-cirrhotic patients with CHC genotypes 1-4 showed ICERs between CHF 10,337 and CHF 91,570 per QALY gained. In subgroup analyses, sofosbuvir dominated telaprevir- and boceprevir-containing treatment in treatment-naïve genotype 1 cirrhotic patients. ICERs of sofosbuvir were above CHF 100,000 per QALY in treatment-naïve, interferon eligible, non-cirrhotic patients infected with genotypes 2 or 3. In deterministic and probabilistic sensitivity analyses, results were generally robust. From a Swiss health care system perspective, treatment of mixed cohorts of cirrhotic and non-cirrhotic patients with CHC genotypes 1-4 with sofosbuvir-containing treatment versus standard treatment would be cost-effective if a threshold of CHF 100,000 per QALY was assumed.

  16. Evaluation of a cost effective in-house method for HIV-1 drug resistance genotyping using plasma samples.

    Directory of Open Access Journals (Sweden)

    Devidas N Chaturbhuj

    Full Text Available OBJECTIVES: Validation of a cost effective in-house method for HIV-1 drug resistance genotyping using plasma samples. DESIGN: The validation includes the establishment of analytical performance characteristics such as accuracy, reproducibility, precision and sensitivity. METHODS: The accuracy was assessed by comparing 26 paired Virological Quality Assessment (VQA proficiency testing panel sequences generated by in-house and ViroSeq Genotyping System 2.0 (Celera Diagnostics, US as a gold standard. The reproducibility and precision were carried out on five samples with five replicates representing multiple HIV-1 subtypes (A, B, C and resistance patterns. The amplification sensitivity was evaluated on HIV-1 positive plasma samples (n = 88 with known viral loads ranges from 1000-1.8 million RNA copies/ml. RESULTS: Comparison of the nucleotide sequences generated by ViroSeq and in-house method showed 99.41±0.46 and 99.68±0.35% mean nucleotide and amino acid identity respectively. Out of 135 Stanford HIVdb listed HIV-1 drug resistance mutations, partial discordance was observed at 15 positions and complete discordance was absent. The reproducibility and precision study showed high nucleotide sequence identities i.e. 99.88±0.10 and 99.82±0.20 respectively. The in-house method showed 100% analytical sensitivity on the samples with HIV-1 viral load >1000 RNA copies/ml. The cost of running the in-house method is only 50% of that for ViroSeq method (112$ vs 300$, thus making it cost effective. CONCLUSIONS: The validated cost effective in-house method may be used to collect surveillance data on the emergence and transmission of HIV-1 drug resistance in resource limited countries. Moreover, the wide applications of a cost effective and validated in-house method for HIV-1 drug resistance testing will facilitate the decision making for the appropriate management of HIV infected patients.

  17. Cost-effectiveness analysis of paclitaxel + carboplatin vs. alternative combinations in the treatment of non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Mario Eandi

    2006-06-01

    Full Text Available Non-small cell lung cancer (NSCLC is the most common type of lung cancer and its medical and economical burden represents a serious matter in Europe and Usa, due to its high mortality rates and drug costs. Lung cancer is responsible for about 30% of cancer death in men and women; in Europe only about 8 per cent of people with lung cancer survive for 5 years. At present combination chemotherapy based on cisplatin or carboplatin associated with paclitaxel, vinorelbine or gemcitabine is the state of the art for the treatment in patients with stage IIIb or IV NSCLC. Aim of this study was to compare the cost-effectiveness of paclitaxel/carboplatin (PCb, gemcitabine/cisplatin (GC and vinorelbine/cisplatin (VC in the perspective of the Italian National Health Service. Therefore we perfomed a semi-Markov decision model mainly based on clinical results from the Italian Lung Cancer Project. The model included differential direct medical costs registered for two years from starting chemotherapy, using tariffs valid for 2005. Benefits was measured by years of life saved (YOLs. The model also allowed to estimate only costs accrued over the period of time, performing a cost-minimisation analysis. According to cost-effectiveness analysis, VC is dominated because it’s more costly and less effective than GC. On the contrary, combination chemotherapy with GC is more inexpensive but less effective than paclitaxel/carboplatin (PCb: in this case we compared the incremental cost-effectiveness ratio (ICER with a maximum acceptable willingness-to-pay (WTP value. In the base scenario the ICER of PCb over GC treatment is 52,326 euro/ YOLs, which is definitely lower than the maximum acceptable WTP value. Sensitivity analyses confirmed the robustness of the results from cost-effectiveness analysis in the base scenario.

  18. A cost-effective methodology for the design of massively-parallel VLSI functional units

    Science.gov (United States)

    Venkateswaran, N.; Sriram, G.; Desouza, J.

    1993-01-01

    In this paper we propose a generalized methodology for the design of cost-effective massively-parallel VLSI Functional Units. This methodology is based on a technique of generating and reducing a massive bit-array on the mask-programmable PAcube VLSI array. This methodology unifies (maintains identical data flow and control) the execution of complex arithmetic functions on PAcube arrays. It is highly regular, expandable and uniform with respect to problem-size and wordlength, thereby reducing the communication complexity. The memory-functional unit interface is regular and expandable. Using this technique functional units of dedicated processors can be mask-programmed on the naked PAcube arrays, reducing the turn-around time. The production cost of such dedicated processors can be drastically reduced since the naked PAcube arrays can be mass-produced. Analysis of the the performance of functional units designed by our method yields promising results.

  19. Cost-effective fiber multiplexing system based on low coherence interferometers and application to temperature measurement

    Science.gov (United States)

    Jiang, Meng; Zhao, Zhongze; Li, Kun; Wang, Zeming; Zhan, Yage; Zhou, Hongying; Yang, Fu

    2016-12-01

    Based on the low-coherence interferometric principles, a cost-effective all-fiber Mach-Zehnder multiplexing system is proposed and demonstrated. The system consists of two interferometers: sensing interferometer and demodulation interferometer. By scanning an optical tunable delay line back and forth constantly with a stable speed, sensing fibers with different optical paths can be temporal interrogated. The system is experimentally proved to have a high performance with a good stability and low system noises. The multiplexing capacity of the system is also investigated. An experiment of measuring the surrounding temperature is carried out. A sensitivity of 12 μm/°C is achieved within the range of 20°C to 80°C. This low cost fiber multiplexing system has a potential application in the remote monitoring of temperature and strain in building structures, such as bridges and towers.

  20. Strategy Guideline: Partnering for High Performance Homes

    Energy Technology Data Exchange (ETDEWEB)

    Prahl, D.

    2013-01-01

    High performance houses require a high degree of coordination and have significant interdependencies between various systems in order to perform properly, meet customer expectations, and minimize risks for the builder. Responsibility for the key performance attributes is shared across the project team and can be well coordinated through advanced partnering strategies. For high performance homes, traditional partnerships need to be matured to the next level and be expanded to all members of the project team including trades, suppliers, manufacturers, HERS raters, designers, architects, and building officials as appropriate. In an environment where the builder is the only source of communication between trades and consultants and where relationships are, in general, adversarial as opposed to cooperative, the chances of any one building system to fail are greater. Furthermore, it is much harder for the builder to identify and capitalize on synergistic opportunities. Partnering can help bridge the cross-functional aspects of the systems approach and achieve performance-based criteria. Critical success factors for partnering include support from top management, mutual trust, effective and open communication, effective coordination around common goals, team building, appropriate use of an outside facilitator, a partnering charter progress toward common goals, an effective problem-solving process, long-term commitment, continuous improvement, and a positive experience for all involved.

  1. The Cost-Effectiveness of NBPTS Teacher Certification

    Science.gov (United States)

    Yeh, Stuart S.

    2010-01-01

    A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of…

  2. Cost-effectiveness of malaria microscopy and rapid diagnostic tests versus presumptive diagnosis: implications for malaria control in Uganda

    Directory of Open Access Journals (Sweden)

    Batwala Vincent

    2011-12-01

    Full Text Available Abstract Background Current Uganda National Malaria treatment guidelines recommend parasitological confirmation either by microscopy or rapid diagnostic test (RDT before treatment with artemether-lumefantrine (AL. However, the cost-effectiveness of these strategies has not been assessed at rural operational primary care centres. Methods Three health centres (HCs were randomized to three diagnostic arms (microscopy, RDT and presumptive diagnosis in a district of low and another of high malaria transmission intensities in Uganda. Some 22,052 patients presenting with fever at outpatients departments were enrolled from March 2010 to February 2011. Of these, a random sample of 1,627 was selected to measure additional socio-economic characteristics. Costing was performed following the standard step-down cost allocation and the ingredients approach. Effectiveness was measured as the number and proportion of patients correctly diagnosed and treated. Incremental Cost-Effectiveness Ratios (ICERs were estimated from the societal perspective (http://Clinicaltrials.gov, NCT00565071. Results Overall RDT was most cost-effective with lowest ICER US$5.0 compared to microscopy US$9.61 per case correctly diagnosed and treated. In the high transmission setting, ICER was US$4.38 for RDT and US$12.98 for microscopy. The corresponding ICERs in the low transmission setting were US$5.85 and US$7.63 respectively. The difference in ICERs between RDT and microscopy was greater in the high transmission area (US$8.9 than in low transmission setting (US$1.78. At a willingness to pay of US$2.8, RDT remained cost effective up to a threshold value of the cost of treatment of US$4.7. Conclusion RDT was cost effective in both low and high transmission settings. With a global campaign to reduce the costs of AL and RDT, the Malaria Control Programme and stakeholders need a strategy for malaria diagnosis because as the cost of AL decreases, presumptive treatment is likely to become

  3. Commercial Buildings High Performance Rooftop Unit Challenge

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-12-16

    The U.S. Department of Energy (DOE) and the Commercial Building Energy Alliances (CBEAs) are releasing a new design specification for high performance rooftop air conditioning units (RTUs). Manufacturers who develop RTUs based on this new specification will find strong interest from the commercial sector due to the energy and financial savings.

  4. Miniaturized high-performance MEMS accelerometer detector

    Science.gov (United States)

    Gonseth, Stephan; Rudolf, Felix; Eichenberger, Christoph; Durrant, Dick; Airey, Phil

    2015-06-01

    In the framework of the demonstration of European capabilities for future space exploration mission, a high-performance miniaturized MEMS accelerometer detector is developed by Colibrys for incorporation into a compact inertial measurement unit (IMU). The envisaged missions where a miniaturized IMU is under development by SEA should cover: Aerobraking;

  5. High performance computing on vector systems

    CERN Document Server

    Roller, Sabine

    2008-01-01

    Presents the developments in high-performance computing and simulation on modern supercomputer architectures. This book covers trends in hardware and software development in general and specifically the vector-based systems and heterogeneous architectures. It presents innovative fields like coupled multi-physics or multi-scale simulations.

  6. High Performance Electronics on Flexible Silicon

    KAUST Repository

    Sevilla, Galo T.

    2016-09-01

    Over the last few years, flexible electronic systems have gained increased attention from researchers around the world because of their potential to create new applications such as flexible displays, flexible energy harvesters, artificial skin, and health monitoring systems that cannot be integrated with conventional wafer based complementary metal oxide semiconductor processes. Most of the current efforts to create flexible high performance devices are based on the use of organic semiconductors. However, inherent material\\'s limitations make them unsuitable for big data processing and high speed communications. The objective of my doctoral dissertation is to develop integration processes that allow the transformation of rigid high performance electronics into flexible ones while maintaining their performance and cost. In this work, two different techniques to transform inorganic complementary metal-oxide-semiconductor electronics into flexible ones have been developed using industry compatible processes. Furthermore, these techniques were used to realize flexible discrete devices and circuits which include metal-oxide-semiconductor field-effect-transistors, the first demonstration of flexible Fin-field-effect-transistors, and metal-oxide-semiconductors-based circuits. Finally, this thesis presents a new technique to package, integrate, and interconnect flexible high performance electronics using low cost additive manufacturing techniques such as 3D printing and inkjet printing. This thesis contains in depth studies on electrical, mechanical, and thermal properties of the fabricated devices.

  7. An Introduction to High Performance Fortran

    Directory of Open Access Journals (Sweden)

    John Merlin

    1995-01-01

    Full Text Available High Performance Fortran (HPF is an informal standard for extensions to Fortran 90 to assist its implementation on parallel architectures, particularly for data-parallel computation. Among other things, it includes directives for specifying data distribution across multiple memories, and concurrent execution features. This article provides a tutorial introduction to the main features of HPF.

  8. Debugging a high performance computing program

    Science.gov (United States)

    Gooding, Thomas M.

    2013-08-20

    Methods, apparatus, and computer program products are disclosed for debugging a high performance computing program by gathering lists of addresses of calling instructions for a plurality of threads of execution of the program, assigning the threads to groups in dependence upon the addresses, and displaying the groups to identify defective threads.

  9. Using LEADS to shift to high performance.

    Science.gov (United States)

    Fenwick, Shauna; Hagge, Erna

    2016-03-01

    Health systems across Canada are tasked to measure results of all their strategic initiatives. Included in most strategic plans is leadership development. How to measure leadership effectiveness in relation to organizational objectives is key in determining organizational effectiveness. The following findings offer considerations for a 21(st)-century approach to shifting to high-performance systems.

  10. Toward High Performance in Industrial Refrigeration Systems

    DEFF Research Database (Denmark)

    Thybo, C.; Izadi-Zamanabadi, Roozbeh; Niemann, H.

    2002-01-01

    Achieving high performance in complex industrial systems requires information manipulation at different system levels. The paper shows how different models of same subsystems, but using different quality of information/data, are used for fault diagnosis as well as robust control design in industr...... in industrial refrigeration systems....

  11. Towards High Performance in Industrial Refrigeration Systems

    DEFF Research Database (Denmark)

    Thybo, C.; Izadi-Zamanabadi, Roozbeh; Niemann, H.

    2002-01-01

    Achieving high performance in complex industrial systems requires information manipulation at different system levels. The paper shows how different models of same subsystems, but using different quality of information/data, are used for fault diagnosis as well as robust control design in industr...... in industrial refrigeration systems....

  12. High Performance Builder Spotlight: Imagine Homes

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-01-01

    Imagine Homes, working with the DOE's Building America research team member IBACOS, has developed a system that can be replicated by other contractors to build affordable, high-performance homes. Imagine Homes has used the system to produce more than 70 Builders Challenge-certified homes per year in San Antonio over the past five years.

  13. High-Performance, Low Environmental Impact Refrigerants

    Science.gov (United States)

    McCullough, E. T.; Dhooge, P. M.; Glass, S. M.; Nimitz, J. S.

    2001-01-01

    Refrigerants used in process and facilities systems in the US include R-12, R-22, R-123, R-134a, R-404A, R-410A, R-500, and R-502. All but R-134a, R-404A, and R-410A contain ozone-depleting substances that will be phased out under the Montreal Protocol. Some of the substitutes do not perform as well as the refrigerants they are replacing, require new equipment, and have relatively high global warming potentials (GWPs). New refrigerants are needed that addresses environmental, safety, and performance issues simultaneously. In efforts sponsored by Ikon Corporation, NASA Kennedy Space Center (KSC), and the US Environmental Protection Agency (EPA), ETEC has developed and tested a new class of refrigerants, the Ikon (registered) refrigerants, based on iodofluorocarbons (IFCs). These refrigerants are nonflammable, have essentially zero ozone-depletion potential (ODP), low GWP, high performance (energy efficiency and capacity), and can be dropped into much existing equipment.

  14. Strategy Guideline. High Performance Residential Lighting

    Energy Technology Data Exchange (ETDEWEB)

    Holton, J. [IBACOS, Inc., Pittsburgh, PA (United States)

    2012-02-01

    This report has been developed to provide a tool for the understanding and application of high performance lighting in the home. The strategies featured in this guide are drawn from recent advances in commercial lighting for application to typical spaces found in residential buildings. This guide offers strategies to greatly reduce lighting energy use through the application of high quality fluorescent and light emitting diode (LED) technologies. It is important to note that these strategies not only save energy in the home but also serve to satisfy the homeowner’s expectations for high quality lighting.

  15. Assessment of effectiveness and cost-effectiveness of HPV testing in primary screening for cervical

    Directory of Open Access Journals (Sweden)

    Willich, Stefan N.

    2007-09-01

    Full Text Available Introduction: The introduction of a screening programme for cervical carcinoma in Germany has led to a significant reduction in incidence of the disease. To date, however, diagnosis in Germany has been based solely on cervical cytology, which has been criticised because of a low sensitivity and consequently high rate of false negative results. Because an infection with the human papillomavirus (HPV previously was found to be a necessary aetiological factor in the development of cervical cancer, there has been some discussion that HPV testing should be included in cervical cancer screening. Objectives: How do HPV tests compare to cytological tests in terms of sensitivity and specificity, and what are the effects of screening for cervical carcinoma in Germany? Is there health economic evidence that may foster an inclusion of HPV testing into national screening programms? Methods: A systematic literature review was performed, including studies that compared the HPV test to cervical cytology in terms of sensitivity and specificity in the diagnosis of CIN 2+ (CIN=Cervical Intraepithelial Neoplasia. In addition, a systematic review of the relevant health economic literature was performed to analyze cost-effectiveness in the German setting. Results: A total of 24 studies fulfilled the inclusion criteria. One study consisted of three substudies. Hence, results of 26 comparisons of HPV and cytology are reported. In 25 of these, the HPV test was more sensitive than cytology, whereas cytology had better specificity in 21 studies. The combination of HPV test and cytology increased sensitivity. Variability in results was considerably larger for cytology than for HPV testing. Results of the economic meta-analysis suggest that in health care settings with already established PAP screening programms, cost-effectiveness strongly depends on screening intervals. In analyses comparing HPV screening to conventional PAP screening with two-yearly intervals, only 25

  16. NINJA: Java for High Performance Numerical Computing

    Directory of Open Access Journals (Sweden)

    José E. Moreira

    2002-01-01

    Full Text Available When Java was first introduced, there was a perception that its many benefits came at a significant performance cost. In the particularly performance-sensitive field of numerical computing, initial measurements indicated a hundred-fold performance disadvantage between Java and more established languages such as Fortran and C. Although much progress has been made, and Java now can be competitive with C/C++ in many important situations, significant performance challenges remain. Existing Java virtual machines are not yet capable of performing the advanced loop transformations and automatic parallelization that are now common in state-of-the-art Fortran compilers. Java also has difficulties in implementing complex arithmetic efficiently. These performance deficiencies can be attacked with a combination of class libraries (packages, in Java that implement truly multidimensional arrays and complex numbers, and new compiler techniques that exploit the properties of these class libraries to enable other, more conventional, optimizations. Two compiler techniques, versioning and semantic expansion, can be leveraged to allow fully automatic optimization and parallelization of Java code. Our measurements with the NINJA prototype Java environment show that Java can be competitive in performance with highly optimized and tuned Fortran code.

  17. High performance anode for advanced Li batteries

    Energy Technology Data Exchange (ETDEWEB)

    Lake, Carla [Applied Sciences, Inc., Cedarville, OH (United States)

    2015-11-02

    The overall objective of this Phase I SBIR effort was to advance the manufacturing technology for ASI’s Si-CNF high-performance anode by creating a framework for large volume production and utilization of low-cost Si-coated carbon nanofibers (Si-CNF) for the battery industry. This project explores the use of nano-structured silicon which is deposited on a nano-scale carbon filament to achieve the benefits of high cycle life and high charge capacity without the consequent fading of, or failure in the capacity resulting from stress-induced fracturing of the Si particles and de-coupling from the electrode. ASI’s patented coating process distinguishes itself from others, in that it is highly reproducible, readily scalable and results in a Si-CNF composite structure containing 25-30% silicon, with a compositionally graded interface at the Si-CNF interface that significantly improve cycling stability and enhances adhesion of silicon to the carbon fiber support. In Phase I, the team demonstrated the production of the Si-CNF anode material can successfully be transitioned from a static bench-scale reactor into a fluidized bed reactor. In addition, ASI made significant progress in the development of low cost, quick testing methods which can be performed on silicon coated CNFs as a means of quality control. To date, weight change, density, and cycling performance were the key metrics used to validate the high performance anode material. Under this effort, ASI made strides to establish a quality control protocol for the large volume production of Si-CNFs and has identified several key technical thrusts for future work. Using the results of this Phase I effort as a foundation, ASI has defined a path forward to commercialize and deliver high volume and low-cost production of SI-CNF material for anodes in Li-ion batteries.

  18. A Linux Workstation for High Performance Graphics

    Science.gov (United States)

    Geist, Robert; Westall, James

    2000-01-01

    The primary goal of this effort was to provide a low-cost method of obtaining high-performance 3-D graphics using an industry standard library (OpenGL) on PC class computers. Previously, users interested in doing substantial visualization or graphical manipulation were constrained to using specialized, custom hardware most often found in computers from Silicon Graphics (SGI). We provided an alternative to expensive SGI hardware by taking advantage of third-party, 3-D graphics accelerators that have now become available at very affordable prices. To make use of this hardware our goal was to provide a free, redistributable, and fully-compatible OpenGL work-alike library so that existing bodies of code could simply be recompiled. for PC class machines running a free version of Unix. This should allow substantial cost savings while greatly expanding the population of people with access to a serious graphics development and viewing environment. This should offer a means for NASA to provide a spectrum of graphics performance to its scientists, supplying high-end specialized SGI hardware for high-performance visualization while fulfilling the requirements of medium and lower performance applications with generic, off-the-shelf components and still maintaining compatibility between the two.

  19. The path toward HEP High Performance Computing

    CERN Document Server

    Apostolakis, John; Carminati, Federico; Gheata, Andrei; Wenzel, Sandro

    2014-01-01

    High Energy Physics code has been known for making poor use of high performance computing architectures. Efforts in optimising HEP code on vector and RISC architectures have yield limited results and recent studies have shown that, on modern architectures, it achieves a performance between 10% and 50% of the peak one. Although several successful attempts have been made to port selected codes on GPUs, no major HEP code suite has a 'High Performance' implementation. With LHC undergoing a major upgrade and a number of challenging experiments on the drawing board, HEP cannot any longer neglect the less-than-optimal performance of its code and it has to try making the best usage of the hardware. This activity is one of the foci of the SFT group at CERN, which hosts, among others, the Root and Geant4 project. The activity of the experiments is shared and coordinated via a Concurrency Forum, where the experience in optimising HEP code is presented and discussed. Another activity is the Geant-V project, centred on th...

  20. High performance HRM: NHS employee perspectives.

    Science.gov (United States)

    Hyde, Paula; Sparrow, Paul; Boaden, Ruth; Harris, Claire

    2013-01-01

    The purpose of this paper is to examine National Health Service (NHS) employee perspectives of how high performance human resource (HR) practices contribute to their performance. The paper draws on an extensive qualitative study of the NHS. A novel two-part method was used; the first part used focus group data from managers to identify high-performance HR practices specific to the NHS. Employees then conducted a card-sort exercise where they were asked how or whether the practices related to each other and how each practice affected their work. In total, 11 high performance HR practices relevant to the NHS were identified. Also identified were four reactions to a range of HR practices, which the authors developed into a typology according to anticipated beneficiaries (personal gain, organisation gain, both gain and no-one gains). Employees were able to form their own patterns (mental models) of performance contribution for a range of HR practices (60 interviewees produced 91 groupings). These groupings indicated three bundles particular to the NHS (professional development, employee contribution and NHS deal). These mental models indicate employee perceptions about how health services are organised and delivered in the NHS and illustrate the extant mental models of health care workers. As health services are rearranged and financial pressures begin to bite, these mental models will affect employee reactions to changes both positively and negatively. The novel method allows for identification of mental models that explain how NHS workers understand service delivery. It also delineates the complex and varied relationships between HR practices and individual performance.

  1. Cost effectiveness of intermittent screening followed by treatment versus intermittent preventive treatment during pregnancy in West Africa: analysis and modelling of results from a non-inferiority trial.

    Science.gov (United States)

    Fernandes, Silke; Sicuri, Elisa; Halimatou, Diawara; Akazili, James; Boiang, Kalifa; Chandramohan, Daniel; Coulibaly, Sheikh; Diawara, Sory Ibrahim; Kayentao, Kassoum; Ter Kuile, Feiko; Magnussen, Pascal; Tagbor, Harry; Williams, John; Woukeu, Arouna; Cairns, Matthew; Greenwood, Brian; Hanson, Kara

    2016-09-23

    Emergence of high-grade sulfadoxine-pyrimethamine (SP) resistance in parts of Africa has led to growing concerns about the efficacy of intermittent preventive treatment of malaria during pregnancy (IPTp) with SP. The incremental cost-effectiveness of intermittent screening and treatment (ISTp) with artemether-lumefantrine (AL) as an alternative strategy to IPTp-SP was estimated followed by a simulation of the effects on cost-effectiveness of decreasing efficacy of IPTp-SP due to SP resistance. The analysis was based on results from a multi-centre, non-inferiority trial conducted in West Africa. A decision tree model was analysed from a health provider perspective. Model parameters for all trial countries with appropriate ranges and distributions were used in a probabilistic sensitivity analysis. Simulations were performed in hypothetical cohorts of 1000 pregnant women who received either ISTp-AL or IPTp-SP. In addition a cost-consequences analysis was conducted. Trial estimates were used to calculate disability-adjusted-life-years (DALYs) for low birth weight and severe/moderate anaemia (both shown to be non-inferior for ISTp-AL) and clinical malaria (inferior for ISTp-AL). Cost estimates were obtained from observational studies, health facility costings and public procurement databases. Results were calculated as incremental cost per DALY averted. Finally, the cost-effectiveness changes with decreasing SP efficacy were explored by simulation. Relative to IPTp-SP, delivering ISTp-AL to 1000 pregnant women cost US$ 4966.25 more (95 % CI US$ 3703.53; 6376.83) and led to a small excess of 28.36 DALYs (95 % CI -75.78; 134.18), with LBW contributing 81.3 % of this difference. The incremental cost-effectiveness ratio was -175.12 (95 % CI -1166.29; 1267.71) US$/DALY averted. Simulations show that cost-effectiveness of ISTp-AL increases as the efficacy of IPTp-SP decreases, though the specific threshold at which ISTp-AL becomes cost-effective depends on assumptions

  2. Cost-Effectiveness Analysis of Second-Line Chemotherapy Agents for Advanced Gastric Cancer.

    Science.gov (United States)

    Lam, Simon W; Wai, Maya; Lau, Jessica E; McNamara, Michael; Earl, Marc; Udeh, Belinda

    2017-01-01

    Gastric cancer is the fifth most common malignancy and second leading cause of cancer-related mortality. Chemotherapy options for patients who fail first-line treatment are limited. Thus the objective of this study was to assess the cost-effectiveness of second-line treatment options for patients with advanced or metastatic gastric cancer. Cost-effectiveness analysis using a Markov model to compare the cost-effectiveness of six possible second-line treatment options for patients with advanced gastric cancer who have failed previous chemotherapy: irinotecan, docetaxel, paclitaxel, ramucirumab, paclitaxel plus ramucirumab, and palliative care. The model was performed from a third-party payer's perspective to compare lifetime costs and health benefits associated with studied second-line therapies. Costs included only relevant direct medical costs. The model assumed chemotherapy cycle lengths of 30 days and a maximum number of 24 cycles. Systematic review of literature was performed to identify clinical data sources and utility and cost data. Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated. The primary outcome measure for this analysis was the ICER between different therapies, where the incremental cost was divided by the number of QALYs saved. The ICER was compared with a willingness-to-pay (WTP) threshold that was set at $50,000/QALY gained, and an exploratory analysis using $160,000/QALY gained was also used. The model's robustness was tested by using 1-way sensitivity analyses and a 10,000 Monte Carlo simulation probabilistic sensitivity analysis (PSA). Irinotecan had the lowest lifetime cost and was associated with a QALY gain of 0.35 year. Docetaxel, ramucirumab alone, and palliative care were dominated strategies. Paclitaxel and the combination of paclitaxel plus ramucirumab led to higher QALYs gained, at an incremental cost of $86,815 and $1,056,125 per QALY gained, respectively. Based on our prespecified

  3. Can Water-Injected Turbomachines Provide Cost-Effective Emissions and Maintenance Reductions?

    Science.gov (United States)

    Hendricks, Robert C.; Daggett, David L.; Shouse, Dale T.; Roquemore, William M.; Brankovic, Andreja; Ryder, Robert C., Jr.

    2011-01-01

    An investigation has been performed to evaluate the effect of water injection on the performance of the Air Force Research Laboratory (AFRL, Wright-Patterson Air Force Base (WPAFB)) experimental trapped vortex combustor (TVC) over a range of fuel-to-air and water-to-fuel ratios. Performance is characterized by combustor exit quantities: temperature and emissions measurements using rakes, and overall pressure drop, from upstream plenum to combustor exit. Combustor visualization is performed using gray-scale and color still photographs and high-frame-rate videos. A parallel investigation evaluated the performance of a computational fluid dynamics (CFD) tool for the prediction of the reacting flow in a liquid fueled combustor (e.g., TVC) that uses water injection for control of pollutant emissions and turbine inlet temperature. Generally, reasonable agreement is found between data and NO(x) computations. Based on a study assessing the feasibility and performance impact of using water injection on a Boeing 747-400 aircraft to reduce NO(x) emissions during takeoff, retrofitting does not appear to be cost effective; however, an operator of a newly designed engine and airframe might be able to save up to 1.0 percent in operating costs. Other challenges of water injection will be discussed.

  4. Validity and cost-effectiveness of methods for screening of primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Fröschl, Barbara

    2007-02-01

    Full Text Available Health political background: About 950,000 people are affected by glaucoma in Germany, about 50% of which are undiagnosed. The German Ophthalmological Society and the German Association of Ophthalmologists recommend a screening for glaucoma according to their guidelines. The Federal Joint Committee disapproved a glaucoma-screening program on expense of the compulsory health insurance in 2004. Scientific background: Primary open angle glaucoma is diagnosed by evaluation of the optic disc, the retinal fibre layer and the visual field. The main examinations are ophthalmoscopy, scanning laser polarimetry, confocal scanning laser ophthalmoscopy, retinal thickness analysis and optical coherence tomography. Scotomas are diagnosed by perimetry (standard automated perimetry, short wavelength automated perimetry and frequency doubling perimetry. The intraocular pressure is the most important treatable risk factor and is measured by (contact or non-contact tonometry. Research questions: The aim of this HTA-report is to investigate the diagnostic validity and cost effectiveness of diagnostic techniques or combinations of these methods with respect to the use in a screening setting in Germany. Methods: A systematic literature research was performed in 35 international databases and yielded 2602 articles. Overall 57 publications were included for assessment, according to predefined selection criteria. Results: The 55 medical articles deal mainly with frequency doubling perimetry, confocal scanning laser ophthalmoscopy and scanning laser polarimetry. Few articles cover short wavelength automated perimetry, tonometry and ophalmocopic evaluations by ophthalmologists. The quality of the papers is generally low, as far as the evidence in respect of screening is concerned. No single method exists with both, high sensitivity and high specificity for screening purpose. Data are also not sufficient to recommend combinations of methods. Only two economic models on cost

  5. High performance forward swept wing aircraft

    Science.gov (United States)

    Koenig, David G. (Inventor); Aoyagi, Kiyoshi (Inventor); Dudley, Michael R. (Inventor); Schmidt, Susan B. (Inventor)

    1988-01-01

    A high performance aircraft capable of subsonic, transonic and supersonic speeds employs a forward swept wing planform and at least one first and second solution ejector located on the inboard section of the wing. A high degree of flow control on the inboard sections of the wing is achieved along with improved maneuverability and control of pitch, roll and yaw. Lift loss is delayed to higher angles of attack than in conventional aircraft. In one embodiment the ejectors may be advantageously positioned spanwise on the wing while the ductwork is kept to a minimum.

  6. Playa: High-Performance Programmable Linear Algebra

    Directory of Open Access Journals (Sweden)

    Victoria E. Howle

    2012-01-01

    Full Text Available This paper introduces Playa, a high-level user interface layer for composing algorithms for complex multiphysics problems out of objects from other Trilinos packages. Among other features, Playa provides very high-performance overloaded operators implemented through an expression template mechanism. In this paper, we give an overview of the central Playa objects from a user's perspective, show application to a sequence of increasingly complex solver algorithms, provide timing results for Playa's overloaded operators and other functions, and briefly survey some of the implementation issues involved.

  7. Heteroarenes as high performance organic semiconductors.

    Science.gov (United States)

    Jiang, Wei; Li, Yan; Wang, Zhaohui

    2013-07-21

    The design, synthesis, and characterization of new organic semiconductors (OSCs) are important aspects for the development of next-generation optoelectronic devices. Structurally, organic semiconductors based on π-conjugated molecules can be easily modified via rational synthesis to tune multi-level self-assembled structures and discover novel chemical, optical, and electronic properties. Heteroarenes, which contain chalcogens and nitrogens in fused aromatic rings, are being developed as promising semiconducting materials for applications in a variety of electronic devices due to their outstanding optoelectronic properties. We highlight recent approaches toward realizing high performance p-channel field effect transistors based on linear heteroacenes and heteroatom annulated polycyclic aromatics (PAHs) as key functional components. These comprehensive, but carefully orchestrated approaches simultaneously address (i) practical synthesis, (ii) tunable self-assembled packing arrangement as well as (iii) high electronic performance.

  8. High performance cloud auditing and applications

    CERN Document Server

    Choi, Baek-Young; Song, Sejun

    2014-01-01

    This book mainly focuses on cloud security and high performance computing for cloud auditing. The book discusses emerging challenges and techniques developed for high performance semantic cloud auditing, and presents the state of the art in cloud auditing, computing and security techniques with focus on technical aspects and feasibility of auditing issues in federated cloud computing environments.   In summer 2011, the United States Air Force Research Laboratory (AFRL) CyberBAT Cloud Security and Auditing Team initiated the exploration of the cloud security challenges and future cloud auditing research directions that are covered in this book. This work was supported by the United States government funds from the Air Force Office of Scientific Research (AFOSR), the AFOSR Summer Faculty Fellowship Program (SFFP), the Air Force Research Laboratory (AFRL) Visiting Faculty Research Program (VFRP), the National Science Foundation (NSF) and the National Institute of Health (NIH). All chapters were partially suppor...

  9. Evaluation of high-performance computing software

    Energy Technology Data Exchange (ETDEWEB)

    Browne, S.; Dongarra, J. [Univ. of Tennessee, Knoxville, TN (United States); Rowan, T. [Oak Ridge National Lab., TN (United States)

    1996-12-31

    The absence of unbiased and up to date comparative evaluations of high-performance computing software complicates a user`s search for the appropriate software package. The National HPCC Software Exchange (NHSE) is attacking this problem using an approach that includes independent evaluations of software, incorporation of author and user feedback into the evaluations, and Web access to the evaluations. We are applying this approach to the Parallel Tools Library (PTLIB), a new software repository for parallel systems software and tools, and HPC-Netlib, a high performance branch of the Netlib mathematical software repository. Updating the evaluations with feed-back and making it available via the Web helps ensure accuracy and timeliness, and using independent reviewers produces unbiased comparative evaluations difficult to find elsewhere.

  10. High-performance liquid chromatography of biopolymers

    Energy Technology Data Exchange (ETDEWEB)

    Regnier, F.E.

    1983-10-21

    The ability to separate biological macromolecules with good resolution on liquid chromatographic columns has depended on the development of suitable packing materials. In size exclusion chromatography, molecules are separated by size on the basis of differential permeation of the packing. Ion exchange, hydrophobic interaction (or reversed-phase), and affinity chromatography are all surface-mediated separation methods, although they depend on different retention mechanisms. High-performance liquid chromatographic columns designed for biopolymers offer major advantages over conventional columns in both speed and resolving power. The exponential growth of literature on the high-performance separation of peptides and proteins in particular indicates that the techniques will become the dominant form of column liquid chromatography. 92 refs., 4 figs.

  11. Evaluation of high-performance computing software

    Energy Technology Data Exchange (ETDEWEB)

    Browne, S.; Dongarra, J. [Univ. of Tennessee, Knoxville, TN (United States); Rowan, T. [Oak Ridge National Lab., TN (United States)

    1996-12-31

    The absence of unbiased and up to date comparative evaluations of high-performance computing software complicates a user`s search for the appropriate software package. The National HPCC Software Exchange (NHSE) is attacking this problem using an approach that includes independent evaluations of software, incorporation of author and user feedback into the evaluations, and Web access to the evaluations. We are applying this approach to the Parallel Tools Library (PTLIB), a new software repository for parallel systems software and tools, and HPC-Netlib, a high performance branch of the Netlib mathematical software repository. Updating the evaluations with feed-back and making it available via the Web helps ensure accuracy and timeliness, and using independent reviewers produces unbiased comparative evaluations difficult to find elsewhere.

  12. High-Power Wind Turbine: Performance Calculation

    Directory of Open Access Journals (Sweden)

    Goldaev Sergey V.

    2015-01-01

    Full Text Available The paper is devoted to high-power wind turbine performance calculation using Pearson’s chi-squared test the statistical hypothesis on distribution of general totality of air velocities by Weibull-Gnedenko. The distribution parameters are found by numerical solution of transcendental equation with the definition of the gamma function interpolation formula. Values of the operating characteristic of the incomplete gamma function are defined by numerical integration using Weddle’s rule. The comparison of the calculated results using the proposed methodology with those obtained by other authors found significant differences in the values of the sample variance and empirical Pearson. The analysis of the initial and maximum wind speed influence on performance of the high-power wind turbine is done

  13. Linear algebra on high-performance computers

    Energy Technology Data Exchange (ETDEWEB)

    Dongarra, J.J.; Sorensen, D.C.

    1986-01-01

    This paper surveys work recently done at Argonne National Laboratory in an attempt to discover ways to construct numerical software for high-performance computers. The numerical algorithms are taken from several areas of numerical linear algebra. We discuss certain architectural features of advanced-computer architectures that will affect the design of algorithms. The technique of restructuring algorithms in terms of certain modules is reviewed. This technique has proved successful in obtaining a high level of transportability without severe loss of performance on a wide variety of both vector and parallel computers. The module technique is demonstrably effective for dense linear algebra problems. However, in the case of sparse and structured problems it may be difficult to identify general modules that will be as effective. New algorithms have been devised for certain problems in this category. We present examples in three important areas: banded systems, sparse QR factorization, and symmetric eigenvalue problems. 32 refs., 10 figs., 6 tabs.

  14. Monitoring SLAC High Performance UNIX Computing Systems

    Energy Technology Data Exchange (ETDEWEB)

    Lettsome, Annette K.; /Bethune-Cookman Coll. /SLAC

    2005-12-15

    Knowledge of the effectiveness and efficiency of computers is important when working with high performance systems. The monitoring of such systems is advantageous in order to foresee possible misfortunes or system failures. Ganglia is a software system designed for high performance computing systems to retrieve specific monitoring information. An alternative storage facility for Ganglia's collected data is needed since its default storage system, the round-robin database (RRD), struggles with data integrity. The creation of a script-driven MySQL database solves this dilemma. This paper describes the process took in the creation and implementation of the MySQL database for use by Ganglia. Comparisons between data storage by both databases are made using gnuplot and Ganglia's real-time graphical user interface.

  15. Toward a theory of high performance.

    Science.gov (United States)

    Kirby, Julia

    2005-01-01

    What does it mean to be a high-performance company? The process of measuring relative performance across industries and eras, declaring top performers, and finding the common drivers of their success is such a difficult one that it might seem a fool's errand to attempt. In fact, no one did for the first thousand or so years of business history. The question didn't even occur to many scholars until Tom Peters and Bob Waterman released In Search of Excellence in 1982. Twenty-three years later, we've witnessed several more attempts--and, just maybe, we're getting closer to answers. In this reported piece, HBR senior editor Julia Kirby explores why it's so difficult to study high performance and how various research efforts--including those from John Kotter and Jim Heskett; Jim Collins and Jerry Porras; Bill Joyce, Nitin Nohria, and Bruce Roberson; and several others outlined in a summary chart-have attacked the problem. The challenge starts with deciding which companies to study closely. Are the stars the ones with the highest market caps, the ones with the greatest sales growth, or simply the ones that remain standing at the end of the game? (And when's the end of the game?) Each major study differs in how it defines success, which companies it therefore declares to be worthy of emulation, and the patterns of activity and attitude it finds in common among them. Yet, Kirby concludes, as each study's method incrementally solves problems others have faced, we are progressing toward a consensus theory of high performance.

  16. Cost Effectiveness of Screening Colonoscopy Depends on Adequate Bowel Preparation Rates – A Modeling Study

    Science.gov (United States)

    Kingsley, James; Karanth, Siddharth; Revere, Frances Lee

    2016-01-01

    Background Inadequate bowel preparation during screening colonoscopy necessitates repeating colonoscopy. Studies suggest inadequate bowel preparation rates of 20–60%. This increases the cost of colonoscopy for our society. Aim The aim of this study is to determine the impact of inadequate bowel preparation rate on the cost effectiveness of colonoscopy compared to other screening strategies for colorectal cancer (CRC). Methods A microsimulation model of CRC screening strategies for the general population at average risk for CRC. The strategies include fecal immunochemistry test (FIT) every year, colonoscopy every ten years, sigmoidoscopy every five years, or stool DNA test every 3 years. The screening could be performed at private practice offices, outpatient hospitals, and ambulatory surgical centers. Results At the current assumed inadequate bowel preparation rate of 25%, the cost of colonoscopy as a screening strategy is above society’s willingness to pay (<$50,000/QALY). Threshold analysis demonstrated that an inadequate bowel preparation rate of 13% or less is necessary before colonoscopy is considered more cost effective than FIT. At inadequate bowel preparation rates of 25%, colonoscopy is still more cost effective compared to sigmoidoscopy and stool DNA test. Sensitivity analysis of all inputs adjusted by ±10% showed incremental cost effectiveness ratio values were influenced most by the specificity, adherence, and sensitivity of FIT and colonoscopy. Conclusions Screening colonoscopy is not a cost effective strategy when compared with fecal immunochemical test, as long as the inadequate bowel preparation rate is greater than 13%. PMID:27936028

  17. Cost effectiveness of therapeutic interventions in ankylosing spondylitis: a critical and systematic review.

    Science.gov (United States)

    Gaujoux-Viala, Cécile; Fautrel, Bruno

    2012-12-01

    This report reviews the cost effectiveness of different therapeutic interventions used in the treatment of ankylosing spondylitis (AS). We performed a systematic search of the databases MEDLINE via PubMed, EMBASE and the Cochrane Library and used hand-searching to identify articles on cost effectiveness of therapies for adult patients with AS published up to November 2010. Of 135 articles, 13 studies were analysed. Two articles were on physical therapies, one article was on NSAIDs and ten articles were on tumour necrosis factor (TNF) inhibitors (infliximab = 6, etanercept = 2, infliximab and etanercept = 1 and adalimumab = 1). Of the latter, no article directly compared TNF inhibitors. Articles showed substantial heterogeneity in methodological approaches and thus results, which prevented us from any extensive comparison, data pooling or meta-analysis. The incremental cost-effectiveness ratio (ICER) for spa-exercise treatment was &U20AC;7465 (95% CI 3294, 14 686) per QALY. The ICERs for infliximab, etanercept and adalimumab were &U20AC;5307-237 010, &U20AC;29 815-123 761 and &U20AC;7344-33 303 per QALY, respectively. Modelling treatment strategies in chronic relapsing diseases such as AS presents specific challenges, as reflected in the variation in the cost-effectiveness results reported. Although quite variable, the cost-effectiveness ratios for AS therapies remain within an acceptable range.

  18. Cost-effectiveness of vaccination against herpes zoster and postherpetic neuralgia: a critical review.

    Science.gov (United States)

    Kawai, Kosuke; Preaud, Emmanuelle; Baron-Papillon, Florence; Largeron, Nathalie; Acosta, Camilo J

    2014-03-26

    The objective of this study was to systematically review cost-effectiveness studies of vaccination against herpes zoster (HZ) and postherpetic neuralgia (PHN). We searched MEDLINE and EMBASE databases for eligible studies published prior to November 2013. We extracted information regarding model structure, model input parameters, and study results. We compared the results across studies by projecting the health and economic impacts of vaccinating one million adults over their lifetimes. We identified 15 cost-effectiveness studies performed in North America and Europe. Results ranged from approximately US$10,000 to more than US$100,000 per quality-adjusted life years (QALY) gained. Most studies in Europe concluded that zoster vaccination is likely to be cost-effective. Differences in results among studies are largely due to differing assumptions regarding duration of vaccine protection and a loss in quality of life associated with HZ and to a larger extent, PHN. Moreover, vaccine efficacy against PHN, age at vaccination, and vaccine cost strongly influenced the results in sensitivity analyses. Most studies included in this review shows that vaccination against HZ is likely to be cost-effective. Future research addressing key model parameters and cost-effectiveness studies in other parts of the world are needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Cost-effectiveness of new oral anticoagulants in the treatment and secondary prevention of venous thromboembolism

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2015-01-01

    Full Text Available Aim. To assess the cost-effectiveness of apixaban in the treatment and secondary prevention of venous thromboembolism (VTE compared with low molecular weight heparin (LMWH/warfarin and other new oral anticoagulants (NOACs. Material and methods. Cost-effectiveness analysis was performed using a Markov model, developed on the basis of the results of AMPLIFY AMPLIFY-Ext trials, and network meta-analyzes on the use of antithrombotic drugs in acute VTE and long-term administration after VTE. Markov cycle duration was 3 months. The duration of therapy in the simulation was 6 and 12 months. The time horizon of the study was 5 years. Life expectancy and costs were discounted by 3.5% per year. The costs on drugs were estimated based on the registered marginal cost price. Besides, the analysis was performed to the weighted average auctions prices for NOACs. The costs of monitoring and treatment of complications were calculated on the basis of the collective agreement of compulsory health insurance system (St. Petersburg, 2015. Results. Apixaban provided significant cost savings compared with other modes of anticoagulant therapy for hospital treatment. Apixaban provided cost savings compared with other NOACs with a minimal increase in life expectancy with regard to quality in long-term analysis. Apixaban provided an increase in life expectancy compared with the appointment of LMWH/warfarin, but required some increase in costs. At therapy duration of 6 months, the costs per one additional year of life with regard to quality and to one additional calendar year of life were 309.8-403.7 and 481.6-627.4 thousand rubles, respectively; at therapy duration of 12 months – 1254.4-1476.9 and 649.0-764.1 thousand rubles, respectively. Conclusion. Apixaban provided a reduction in the incidence of bleeding compared with other NOACs and LMWH/warfarin with comparable efficacy in treatment and secondary prevention of VTE. Apixaban therapy costs were lower than these

  20. Cost-effectiveness of new oral anticoagulants in the treatment and secondary prevention of venous thromboembolism

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2015-11-01

    Full Text Available Aim. To assess the cost-effectiveness of apixaban in the treatment and secondary prevention of venous thromboembolism (VTE compared with low molecular weight heparin (LMWH/warfarin and other new oral anticoagulants (NOACs. Material and methods. Cost-effectiveness analysis was performed using a Markov model, developed on the basis of the results of AMPLIFY AMPLIFY-Ext trials, and network meta-analyzes on the use of antithrombotic drugs in acute VTE and long-term administration after VTE. Markov cycle duration was 3 months. The duration of therapy in the simulation was 6 and 12 months. The time horizon of the study was 5 years. Life expectancy and costs were discounted by 3.5% per year. The costs on drugs were estimated based on the registered marginal cost price. Besides, the analysis was performed to the weighted average auctions prices for NOACs. The costs of monitoring and treatment of complications were calculated on the basis of the collective agreement of compulsory health insurance system (St. Petersburg, 2015. Results. Apixaban provided significant cost savings compared with other modes of anticoagulant therapy for hospital treatment. Apixaban provided cost savings compared with other NOACs with a minimal increase in life expectancy with regard to quality in long-term analysis. Apixaban provided an increase in life expectancy compared with the appointment of LMWH/warfarin, but required some increase in costs. At therapy duration of 6 months, the costs per one additional year of life with regard to quality and to one additional calendar year of life were 309.8-403.7 and 481.6-627.4 thousand rubles, respectively; at therapy duration of 12 months – 1254.4-1476.9 and 649.0-764.1 thousand rubles, respectively. Conclusion. Apixaban provided a reduction in the incidence of bleeding compared with other NOACs and LMWH/warfarin with comparable efficacy in treatment and secondary prevention of VTE. Apixaban therapy costs were lower than these

  1. High-Performance Liquid Chromatography: An Overview

    OpenAIRE

    Tandia N; Singh SK1; Kumar N; Singh S

    2013-01-01

    Chromatography is considered extremely powerful separation technique for variety of samples. Thecommon feature of all these techniques is that the different components in a sample mixture aredistributed between two phases, one of which remains stationary while the other the mobile phase, runsthrough the interstices or over the surface of the fixed phase. The movement of the mobile phase resultsin differential migration of the sample components. High performance thin layer chromatography is an...

  2. Optics of high-performance electron microscopes*

    OpenAIRE

    H H Rose

    2016-01-01

    During recent years, the theory of charged particle optics together with advances in fabrication tolerances and experimental techniques has lead to very significant advances in high-performance electron microscopes. Here, we will describe which theoretical tools, inventions and designs have driven this development. We cover the basic theory of higher-order electron optics and of image formation in electron microscopes. This leads to a description of different methods to correct aberrations by...

  3. Domain Decomposition Based High Performance Parallel Computing

    CERN Document Server

    Raju, Mandhapati P

    2009-01-01

    The study deals with the parallelization of finite element based Navier-Stokes codes using domain decomposition and state-ofart sparse direct solvers. There has been significant improvement in the performance of sparse direct solvers. Parallel sparse direct solvers are not found to exhibit good scalability. Hence, the parallelization of sparse direct solvers is done using domain decomposition techniques. A highly efficient sparse direct solver PARDISO is used in this study. The scalability of both Newton and modified Newton algorithms are tested.

  4. High temperature furnace modeling and performance verifications

    Science.gov (United States)

    Smith, James E., Jr.

    1992-01-01

    Analytical, numerical, and experimental studies were performed on two classes of high temperature materials processing sources for their potential use as directional solidification furnaces. The research concentrated on a commercially available high temperature furnace using a zirconia ceramic tube as the heating element and an Arc Furnace based on a tube welder. The first objective was to assemble the zirconia furnace and construct parts needed to successfully perform experiments. The 2nd objective was to evaluate the zirconia furnace performance as a directional solidification furnace element. The 3rd objective was to establish a data base on materials used in the furnace construction, with particular emphasis on emissivities, transmissivities, and absorptivities as functions of wavelength and temperature. A 1-D and 2-D spectral radiation heat transfer model was developed for comparison with standard modeling techniques, and were used to predict wall and crucible temperatures. The 4th objective addressed the development of a SINDA model for the Arc Furnace and was used to design sample holders and to estimate cooling media temperatures for the steady state operation of the furnace. And, the 5th objective addressed the initial performance evaluation of the Arc Furnace and associated equipment for directional solidification. Results of these objectives are presented.

  5. Sacrificing power for more cost-effective treatment: A techno-economic approach for engineering microbial fuel cells.

    Science.gov (United States)

    Stoll, Zachary A; Ma, Zhaokun; Trivedi, Christopher B; Spear, John R; Xu, Pei

    2016-10-01

    Microbial fuel cells (MFCs) are a promising energy-positive wastewater treatment technology, however, the system's cost-effectiveness has been overlooked. In this study, two new anode materials - hard felt (HF) and carbon foam (CF) - were evaluated against the standard graphite brush (GB) to determine if using inexpensive materials with less than ideal properties can achieve more cost-effective treatment than high-cost, high-performing materials. Using domestic wastewater as the substrate, power densities for the GB, HF and CF-MFCs were 393, 339 and 291 mW m(-2) normalized by cathodic surface area, respectively. Higher power densities correlated with larger anodic surface areas and anodic current densities but not with electrical conductivity. Cyclic voltammetry revealed that redox systems used for extracellular electron transport in the GB, HF and CF-MFCs were similar (-0.143 ± 0.046, -0.158 ± 0.004 and -0.100 ± 0.014 V vs. Ag/AgCl) and that the electrochemical kinetics of the MFCs showed no correlation with their respective electrical conductivity. 16S rRNA sequencing showed the GB, HF and CF microbial community compositions were not statistically different while organic removal rates were nearly identical for all MFCs. The HF-MFC generated a power output to electrode cost (W $(-1)) 1.9 times greater than the GB-MFC, despite producing 14% less power and 15% less anodic current, while having 2.6 times less anodic surface area, 2.1 times larger charge transfer resistance and an electrical conductivity three orders of magnitude lower. The results demonstrate that inexpensive materials are capable of achieving more cost-effective treatment than high-performing materials despite generating lower power when treating real wastewater.

  6. Renal transplantation vs hemodialysis: Cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Perović Saša

    2009-01-01

    Full Text Available Background/Aim. Chronic renal insufficiency (CRI, diabetes, hypertension, autosomal dominant polycystic kidney disease (ADPKD are the main reasons for starting dialysis treatment in patients having kidney function failure. At present, dialysis treatments are performed in about 4,100 patients at 46 institutions in Serbia, out of which 90% are hemodialyses. At end-stage renal disease (ESRD the only correct selection is kidney transplatation. The basic aim of the planned research was to compare ratio of costs and effects (Cost Effectiveness Analysis - CEA of hemodialysis and kidney transplantation in patients at ESRD. Methods. As the main issue of treatment in patients from both groups the life quality measured by the validated McGill Questionary, was used. The study included 150 patients totally, divided into two groups. The study group consisted of 50 patients with kidney transplantation performed at the Clinical Center of Serbia and the control group consisted of 100 patients on hemodialysis at Clinical Center of Serbia, Clinical Hospital Center Zemun, Clinical Hospital Center 'Zvezdara', Clinical Center Kragujevac and Health Center 'Studenica', Kraljevo, comparable with respect to sex, age and length of treatment with the study group. Results. Effect of kidney transplantation in relation to hemodialysis being selection of treatment is expressed in the form of incremental ratio of costs and effects (Incremental Cost-Effectiveness Ratio - ICER. It is clear from the enclosed tables that the strategy of kidney transplantation is far more profitable considering the fact that it represents saving of EUR 132,256.25 per one year of contribution Quality Adjusted Life Years (QALY within the period of 10 years. According to all aspects of live quality (physical symptoms and problems, physical well-being, psychological symptoms, existential well-being and support, difference is statistically important in favor of transplant patents. Conclusion. The costs

  7. Computational Biology and High Performance Computing 2000

    Energy Technology Data Exchange (ETDEWEB)

    Simon, Horst D.; Zorn, Manfred D.; Spengler, Sylvia J.; Shoichet, Brian K.; Stewart, Craig; Dubchak, Inna L.; Arkin, Adam P.

    2000-10-19

    The pace of extraordinary advances in molecular biology has accelerated in the past decade due in large part to discoveries coming from genome projects on human and model organisms. The advances in the genome project so far, happening well ahead of schedule and under budget, have exceeded any dreams by its protagonists, let alone formal expectations. Biologists expect the next phase of the genome project to be even more startling in terms of dramatic breakthroughs in our understanding of human biology, the biology of health and of disease. Only today can biologists begin to envision the necessary experimental, computational and theoretical steps necessary to exploit genome sequence information for its medical impact, its contribution to biotechnology and economic competitiveness, and its ultimate contribution to environmental quality. High performance computing has become one of the critical enabling technologies, which will help to translate this vision of future advances in biology into reality. Biologists are increasingly becoming aware of the potential of high performance computing. The goal of this tutorial is to introduce the exciting new developments in computational biology and genomics to the high performance computing community.

  8. High performance pattern matching on heterogeneous platform.

    Science.gov (United States)

    Soroushnia, Shima; Daneshtalab, Masoud; Plosila, Juha; Pahikkala, Tapio; Liljeberg, Pasi

    2014-10-23

    Pattern discovery is one of the fundamental tasks in bioinformatics and pattern recognition is a powerful technique for searching sequence patterns in the biological sequence databases. Fast and high performance algorithms are highly demanded in many applications in bioinformatics and computational molecular biology since the significant increase in the number of DNA and protein sequences expand the need for raising the performance of pattern matching algorithms. For this purpose, heterogeneous architectures can be a good choice due to their potential for high performance and energy efficiency. In this paper we present an efficient implementation of Aho-Corasick (AC) which is a well known exact pattern matching algorithm with linear complexity, and Parallel Failureless Aho-Corasick (PFAC) algorithm which is the massively parallelized version of AC algorithm without failure transitions, on a heterogeneous CPU/GPU architecture. We progressively redesigned the algorithms and data structures to fit on the GPU architecture. Our results on different protein sequence data sets show that the new implementation runs 15 times faster compared to the original implementation of the PFAC algorithm.

  9. High performance computing and communications panel report

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-01

    In FY92, a presidential initiative entitled High Performance Computing and Communications (HPCC) was launched, aimed at securing U.S. preeminence in high performance computing and related communication technologies. The stated goal of the initiative is threefold: extend U.S. technological leadership in high performance computing and computer communications; provide wide dissemination and application of the technologies; and spur gains in U.S. productivity and industrial competitiveness, all within the context of the mission needs of federal agencies. Because of the importance of the HPCC program to the national well-being, especially its potential implication for industrial competitiveness, the Assistant to the President for Science and Technology has asked that the President's Council of Advisors in Science and Technology (PCAST) establish a panel to advise PCAST on the strengths and weaknesses of the HPCC program. The report presents a program analysis based on strategy, balance, management, and vision. Both constructive recommendations for program improvement and positive reinforcement of successful program elements are contained within the report.

  10. Novel emergency department registration kiosk for HIV screening is cost-effective.

    Science.gov (United States)

    Hsieh, Yu-Hsiang; Holtgrave, David R; Peterson, Stephen; Gaydos, Charlotte A; Rothman, Richard E

    2016-01-01

    High operating costs challenge sustainability of successful US emergency department (ED) HIV screening programs. Free-standing registration kiosks could potentially reduce the marginal costs of ED HIV screening. We investigated incremental cost-effectiveness ratio (CER) per new HIV diagnosis for a kiosk-based approach for offering screening at ED registration versus a testing staff-based approach to offer testing at the bedside. A rapid oral-fluid HIV screening program, instituted in a US ED since 2005, had a rate of new HIV diagnosis 0.16% in 2012. A two-phase quasi experimental design, including a testing staff-based approach to offer testing at the bedside (Phase I, August and September 2011) and a kiosk-based approach to offer testing at ED registration (Phase II, December 2011 and January 2012), was performed. CER per new HIV diagnosis was defined as total cost of the screening program divided by number of newly diagnosed cases. Costs included screening program personnel (study coordinator, testing staff, and kiosk helpers), diagnostic assays (rapid and confirmatory tests), and kiosks (2 kiosks, software, and IT consulting fees). Sensitivity analyses were performed. Data from our dedicated testing staff (DTS) program (Phase I) resulted in an estimated 5434 patients tested in one year and 9 newly diagnosed HIV-infected patients (95% CI: 3, 18). Data from the kiosk program (Phase II), resulted in a projected 4571 ED patients tested in one year and 21 newly diagnosed HIV-infected patients (95% CI: 4, 70). The overall cost was $ 201,433 for the DTS program, versus $292,008 for the kiosk program. Incremental CER per new HIV diagnosis for kiosk-based approach was $7523 (range: $1780-90,025 by sensitivity analysis). Our pilot data demonstrated that the use of kiosks for HIV screening was potentially more cost-effective than a testing staff-based bedside approach.

  11. From fundamental understanding to innovative developments of high-performance composites for aerospace application

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    In framework of the National Key Basic Research Program (973 Program) we focus our attention on R&D of (1) continuous enhancement of composites performance both for new generation and existing materials, (2) cost-effective manufacturing technologies, particularly resin transfer molding (RTM) in conjunction with textile technology, and (3) crashworthy composite structures in design, and manufacturing and simulation methodology for aircrafts composites. Many successful examples stories such as ex-situ concept have been demonstrated that the performance potential of composites could be enhanced and maximized by basically understandirg the complicated multi-scale and multi-dimensional structural characteristics in relation to properties. Based on the concept, graphite composites system with generally high impact damage resistance and balanced processing conditions has being developed consisting of base resins, modifiers and binders/tackifiers.

  12. Cost-Effectiveness Comparison of Coupler Designs of Wireless Power Transfer for Electric Vehicle Dynamic Charging

    Directory of Open Access Journals (Sweden)

    Weitong Chen

    2016-11-01

    Full Text Available This paper presents a cost-effectiveness comparison of coupler designs for wireless power transfer (WPT, meant for electric vehicle (EV dynamic charging. The design comparison of three common types of couplers is first based on the raw material cost, output power, transfer efficiency, tolerance of horizontal offset, and flux density. Then, the optimal cost-effectiveness combination is selected for EV dynamic charging. The corresponding performances of the proposed charging system are compared and analyzed by both simulation and experimentation. The results verify the validity of the proposed dynamic charging system for EVs.

  13. Cost-Effective Strategies for Developing Formative Assessments in Online Workplace Training

    Directory of Open Access Journals (Sweden)

    Terry Mackey

    2009-11-01

    Full Text Available In the context of asynchronous online learning, formative assessments can offer amazing flexibility and support a wide range of learning strategies. While some versions do involve a considerable investment in time and cost, effective formative assessments need not be expensive. Many cost-effective strategies for developing formative assessments exist, and these can be employed quickly and effectively in online workplace training. These strategies allow learners to assess their progress and accomplishments before the risks of decreased motivation, confidence and understanding become unfortunate realities that negatively impact instructional outcomes, on-the-job performance and online learning ROI.

  14. Innovative grinding wheel design for cost-effective machining of advanced ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Licht, R.H.; Kuo, P.; Liu, S.; Murphy, D.; Picone, J.W.; Ramanath, S.

    2000-05-01

    This Final Report covers the Phase II Innovative Grinding Wheel (IGW) program in which Norton Company successfully developed a novel grinding wheel for cost-effective cylindrical grinding of advanced ceramics. In 1995, Norton Company successfully completed the 16-month Phase I technical effort to define requirements, design, develop, and evaluate a next-generation grinding wheel for cost-effective cylindrical grinding of advanced ceramics using small prototype wheels. The Phase II program was initiated to scale-up the new superabrasive wheel specification to larger diameters, 305-mm to 406-mm, required for most production grinding of cylindrical ceramic parts, and to perform in-house and independent validation grinding tests.

  15. Cost-effectiveness analysis of introduction of rapid, alternative methods to identify multidrug-resistant tuberculosis in middle-income countries.

    Science.gov (United States)

    Acuna-Villaorduna, Carlos; Vassall, Anna; Henostroza, German; Seas, Carlos; Guerra, Humberto; Vasquez, Lucy; Morcillo, Nora; Saravia, Juan; O'Brien, Richard; Perkins, Mark D; Cunningham, Jane; Llanos-Zavalaga, Luis; Gotuzzo, Eduardo

    2008-08-15

    Resistance to commonly used antituberculosis drugs is emerging worldwide. Conventional drug-susceptibility testing (DST) methods are slow and demanding. Alternative, rapid DST methods would permit the early detection of drug resistance and, in turn, arrest tuberculosis transmission. A cost-effectiveness analysis of 5 DST methods was performed in the context of a clinical trial that compared rapid with conventional DST methods. The methods under investigation were direct phage-replication assay (FASTPlaque-Response; Biotech), direct amplification and reverse hybridization of the rpoB gene (INNO-LiPA; Innogenetics), indirect colorimetric minimum inhibitory concentration assay (MTT; ICN Biomedicals), and direct proportion method on Löwenstein-Jensen medium. These were compared with the widely used indirect proportion method on Löwenstein-Jensen medium. All alternative DST methods were found to be cost-effective, compared with other health care interventions. DST methods also generate substantial cost savings in settings of high prevalence of multidrug-resistant tuberculosis. Excluding the effects of transmission, the direct proportion method on Löwenstein-Jensen medium was the most cost-effective alternative DST method for patient groups with prevalences of multidrug-resistant tuberculosis of 2%, 5%, 20%, and 50% (cost in US$2004, $94, $36, $8, and $2 per disability-adjusted life year, respectively). Alternative, rapid methods for DST are cost-effective and should be considered for use by national tuberculosis programs in middle-income countries.

  16. Cost Effectiveness of Home Energy Retrofits in Pre-Code Vintage Homes in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Fairey, Philip [BA-PIRC/Florida Solar Energy Center, Cocoa, FL (United States); Parker, Danny [BA-PIRC/Florida Solar Energy Center, Cocoa, FL (United States)

    2012-11-01

    This analytical study examines the opportunities for cost-effective energy efficiency and renewable energy retrofits in residential archetypes constructed prior to 1980 (Pre-Code) in fourteen U.S. cities. These fourteen cities are representative of each of the International Energy Conservation Code (IECC) climate zones in the contiguous United States. The analysis is conducted using an in-house version of EnergyGauge USA v.2.8.05 named CostOpt that has been programmed to perform iterative, incremental economic optimization on a large list of residential energy efficiency and renewable energy retrofit measures. The principle objectives of the study are to determine the opportunities for cost effective source energy reductions in this large cohort of existing residential building stock as a function of local climate and energy costs; and to examine how retrofit financing alternatives impact the source energy reductions that are cost effectively achievable.

  17. Cost-effectiveness of alternative outpatient pelvic inflammatory disease treatment strategies.

    Science.gov (United States)

    Smith, Kenneth J; Ness, Roberta B; Wiesenfeld, Harold C; Roberts, Mark S

    2007-12-01

    Effectiveness differences between outpatient pelvic inflammatory disease (PID) treatment regimens are uncertain, but significant differences in cost exist. To examine the influence of antibiotic costs on PID therapy cost-effectiveness. The authors used a Markov decision model to estimate the cost-effectiveness of recommended antibiotic regimens for PID and performed a value of information analysis to guide future research. Antibiotic costs vary between USD 43 and USD188. Pairwise comparisons, assuming a hypothetical 1% relative risk reduction in PID complications with the more expensive regimen, showed economically reasonable cost-effectiveness ratios. Value of information and sample size considerations support further investigation to detect 10% PID complication rate differences between regimens with >or=USD 50 cost differences. Within the cost range of recommended regimens, use of more expensive antibiotics would be economically reasonable if relatively small decreases in PID complication rates exist. Further investigation of effectiveness differences between regimens is needed.

  18. Cost-effectiveness analysis of a statewide media campaign to promote adolescent physical activity.

    Science.gov (United States)

    Peterson, Michael; Chandlee, Margaret; Abraham, Avron

    2008-10-01

    A cost-effectiveness analysis of a statewide social marketing campaign was performed using a statewide surveillance survey distributed to 6th through 12th graders, media production and placement costs, and 2000 census data. Exposure to all three advertisements had the highest impact on both intent and behavior with 65.6% of the respondents considering becoming more active and 58.3% reporting becoming more active. Average cost of the entire campaign was $4.01 per person to see an ad, $7.35 per person to consider being more active, and $8.87 per person to actually become more active, with billboards yielding the most positive cost-effectiveness. Findings highlight market research as an essential part of social marketing campaigns and the importance of using multiple marketing modalities to enhance cost-effectiveness and impact.

  19. An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier.

    Science.gov (United States)

    Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D

    2016-01-01

    Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem.

  20. An Efficient, Non-iterative Method of Identifying the Cost-Effectiveness Frontier

    Science.gov (United States)

    Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D.

    2015-01-01

    Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we additionally provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. PMID:25926282

  1. COST EFFECTIVENESS OF SELECTED POST HARVEST POD

    African Journals Online (AJOL)

    and aflatoxin (AF) contamination of shelled groundnut. The study was conducted ... Constraints to groundnut production in Ghana ... mans and animals (Anon, 1995), the maximum permissible ... ever, mostly influenced by high kernel moisture.

  2. High-sensitivity troponin assays for the early rule-out or diagnosis of acute myocardial infarction in people eith acute chest pain: a systematic review and cost-effectiveness analysis

    NARCIS (Netherlands)

    M. Westwood (Marie); T. van Asselt (Thea); B. Ramaekers (Bram); P. Whiting (Penny); P. Tokala (Praveen); M.A. Joore (Manuela); N. Armstrong (Nigel); J. Ross (Janine); J.L. Severens (Hans); J. Kleijnen (Jos)

    2015-01-01

    textabstractBackground: Early diagnosis of acute myocardial infarction (AMI) can ensure quick and effective treatment but only 20% of adults with emergency admissions for chest pain have an AMI. High-sensitivity cardiac troponin (hs-cTn) assays may allow rapid rule-out of AMI and avoidance of unnece

  3. High-sensitivity troponin assays for the early rule-out or diagnosis of acute myocardial infarction in people with acute chest pain : a systematic review and cost-effectiveness analysis

    NARCIS (Netherlands)

    Westwood, Marie; van Asselt, Thea; Ramaekers, Bram; Whiting, Penny; Thokala, Praveen; Joore, Manuela; Armstrong, Nigel; Ross, Janine; Severens, Johan; Kleijnen, Jos

    2015-01-01

    BACKGROUND: Early diagnosis of acute myocardial infarction (AMI) can ensure quick and effective treatment but only 20% of adults with emergency admissions for chest pain have an AMI. High-sensitivity cardiac troponin (hs-cTn) assays may allow rapid rule-out of AMI and avoidance of unnecessary hospit

  4. Cost-effectiveness of diagnostic for malaria in Extra-Amazon Region, Brazil

    Directory of Open Access Journals (Sweden)

    de Oliveira Maria Regina F

    2012-11-01

    Full Text Available Abstract Background Rapid diagnostic tests (RDT for malaria have been demonstrated to be effective and they should replace microscopy in certain areas. Method The cost-effectiveness of five RDT and thick smear microscopy was estimated and compared. Data were collected on Brazilian Extra-Amazon Region. Data sources included the National Malaria Control Programme of the Ministry of Health, the National Healthcare System reimbursement table, laboratory suppliers and scientific literature. The perspective was that of the Brazilian public health system, the analytical horizon was from the start of fever until the diagnostic results provided to patient and the temporal reference was that of year 2010. Two costing methods were produced, based on exclusive-use microscopy or shared-use microscopy. The results were expressed in costs per adequately diagnosed cases in 2010 U.S. dollars. One-way sensitivity analysis was performed considering key model parameters. Results In the cost-effectiveness analysis with exclusive-use microscopy, the RDT CareStart™ was the most cost-effective diagnostic strategy. Microscopy was the most expensive and most effective, with an additional case adequately diagnosed by microscopy costing US$ 35,550.00 in relation to CareStart™. In opposite, in the cost-effectiveness analysis with shared-use microscopy, the thick smear was extremely cost-effective. Introducing into the analytic model with shared-use microscopy a probability for individual access to the diagnosis, assuming a probability of 100% of access for a public health system user to any RDT and, hypothetically, of 85% of access to microscopy, this test saw its effectiveness reduced and was dominated by the RDT CareStart™. Conclusion The analysis of cost-effectiveness of malaria diagnosis technologies in the Brazilian Extra-Amazon Region depends on the exclusive or shared use of the microscopy. Following the assumptions of this study, shared-use microscopy would be

  5. Construction Guide to Next-Generation High-Performance Walls in Climate Zones 3-5 - Part 1: 2x6 Walls

    Energy Technology Data Exchange (ETDEWEB)

    V. Kochkin and J. Wiehagen

    2017-08-31

    Part 1 of this Construction Guide to High-Performance Walls in Climate Zones 3-5 provides time-proven, practical, and cost-effective strategies for constructing durable, energy-efficient walls. It addresses walls constructed with 2x6 wood frame studs, wood structural panel (WSP) exterior sheathing, and a cladding system installed over WSP sheathing in low-rise residential buildings up to three stories high.

  6. THE EARLY BIRD CATCHES THE WORM : EARLY COST-EFFECTIVENESS ANALYSIS OF NEW MEDICAL TESTS

    NARCIS (Netherlands)

    Buisman, Leander R; Rutten-van Mölken, Maureen P M H; Postmus, Douwe; Luime, Jolanda J; Uyl-de Groot, Carin A; Redekop, William K

    2016-01-01

    OBJECTIVES: There is little specific guidance on performing an early cost-effectiveness analysis (CEA) of medical tests. We developed a framework with general steps and applied it to two cases. METHODS: Step 1 is to narrow down the scope of analysis by defining the test's application, target populat

  7. Cost-effectiveness analyses of pharmacologic maintenance treatment for chronic obstructive pulmonary disease : A systematic review

    NARCIS (Netherlands)

    Van Der Schans, S.; Goossens, L.M.; Boland, M.R.; Kocks, J.; Postma, M.J.; Van Boven, J.F.; Rutten-van Mölken, M.P.

    2016-01-01

    Objectives: We aimed to systematically review recently published articles that reported the cost-effectiveness of COPD maintenance treatments, with a focus on key findings, quality, and methodological issues. Methods: A systematic literature search was performed in EMBASE, Pubmed, UK-NHS (NHS-EED) a

  8. A cost-effective retractor and heart stabilizer for minimal-access coronary bypass.

    Science.gov (United States)

    Rousou, J A; Engelman, R M; Flack, J E; Deaton, D W

    1998-05-01

    Exposure for internal mammary artery harvesting and immobilization of the coronary artery during the performance of minimally invasive direct coronary artery bypass grafting requires the use of appropriate retractors and instruments. We have successfully used existing retractors and instruments, modified for such use, which are reusable and cost effective. The use of such a retractor and cardiac stabilizer is described.

  9. The path toward HEP High Performance Computing

    Science.gov (United States)

    Apostolakis, John; Brun, René; Carminati, Federico; Gheata, Andrei; Wenzel, Sandro

    2014-06-01

    High Energy Physics code has been known for making poor use of high performance computing architectures. Efforts in optimising HEP code on vector and RISC architectures have yield limited results and recent studies have shown that, on modern architectures, it achieves a performance between 10% and 50% of the peak one. Although several successful attempts have been made to port selected codes on GPUs, no major HEP code suite has a "High Performance" implementation. With LHC undergoing a major upgrade and a number of challenging experiments on the drawing board, HEP cannot any longer neglect the less-than-optimal performance of its code and it has to try making the best usage of the hardware. This activity is one of the foci of the SFT group at CERN, which hosts, among others, the Root and Geant4 project. The activity of the experiments is shared and coordinated via a Concurrency Forum, where the experience in optimising HEP code is presented and discussed. Another activity is the Geant-V project, centred on the development of a highperformance prototype for particle transport. Achieving a good concurrency level on the emerging parallel architectures without a complete redesign of the framework can only be done by parallelizing at event level, or with a much larger effort at track level. Apart the shareable data structures, this typically implies a multiplication factor in terms of memory consumption compared to the single threaded version, together with sub-optimal handling of event processing tails. Besides this, the low level instruction pipelining of modern processors cannot be used efficiently to speedup the program. We have implemented a framework that allows scheduling vectors of particles to an arbitrary number of computing resources in a fine grain parallel approach. The talk will review the current optimisation activities within the SFT group with a particular emphasis on the development perspectives towards a simulation framework able to profit best from

  10. [High-performance society and doping].

    Science.gov (United States)

    Gallien, C L

    2002-09-01

    Doping is not limited to high-level athletes. Likewise it is not limited to the field of sports activities. The doping phenomenon observed in sports actually reveals an underlying question concerning the notion of sports itself, and more widely, the society's conception of sports. In a high-performance society, which is also a high-risk society, doping behavior is observed in a large number of persons who may or may not participate in sports activities. The motivation is the search for individual success or profit. The fight against doping must therefore focus on individual responsibility and prevention in order to preserve athlete's health and maintain the ethical and educational value of sports activities.

  11. High Performance OLED Panel and Luminaire

    Energy Technology Data Exchange (ETDEWEB)

    Spindler, Jeffrey [OLEDWorks LLC, Rochester, NY (United States)

    2017-02-20

    In this project, OLEDWorks developed and demonstrated the technology required to produce OLED lighting panels with high energy efficiency and excellent light quality. OLED panels developed in this program produce high quality warm white light with CRI greater than 85 and efficacy up to 80 lumens per watt (LPW). An OLED luminaire employing 24 of the high performance panels produces practical levels of illumination for general lighting, with a flux of over 2200 lumens at 60 LPW. This is a significant advance in the state of the art for OLED solid-state lighting (SSL), which is expected to be a complementary light source to the more advanced LED SSL technology that is rapidly replacing all other traditional forms of lighting.

  12. High Performance Database Management for Earth Sciences

    Science.gov (United States)

    Rishe, Naphtali; Barton, David; Urban, Frank; Chekmasov, Maxim; Martinez, Maria; Alvarez, Elms; Gutierrez, Martha; Pardo, Philippe

    1998-01-01

    The High Performance Database Research Center at Florida International University is completing the development of a highly parallel database system based on the semantic/object-oriented approach. This system provides exceptional usability and flexibility. It allows shorter application design and programming cycles and gives the user control via an intuitive information structure. It empowers the end-user to pose complex ad hoc decision support queries. Superior efficiency is provided through a high level of optimization, which is transparent to the user. Manifold reduction in storage size is allowed for many applications. This system allows for operability via internet browsers. The system will be used for the NASA Applications Center program to store remote sensing data, as well as for Earth Science applications.

  13. High Performance Photocathodes based on Molecular Beam Epitaxy Deposition for Next Generation Photo Detectors and Light Sources

    CERN Document Server

    Xie, Junqi; Wagner, Robert

    2013-01-01

    The development of high-performance photocathodes is a key challenge for future accelerator and particle physics applications. In this paper photocathode growth through molecular beam epitaxy is introduced as a promising technique to obtain robust, highly efficient alkali-antimonide based photocathodes. Recent research shows that the quantum efficiency of photocathodes can be significantly enhanced through control of the photocathode crystallinity. Molecular beam epitaxy allows for cost-effective growth of large-area photocathodes with excellent control of the stoichiometry and crystallinity, making photocathodes with peak quantum efficiencies exceeding 35% routine.

  14. Cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry meat food supply.

    Science.gov (United States)

    Lake, Robin J; Horn, Beverley J; Dunn, Alex H; Parris, Ruth; Green, F Terri; McNickle, Don C

    2013-07-01

    An analysis of the cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry supply examined a series of interventions. Effectiveness was evaluated in terms of reduced health burden measured by disability-adjusted life years (DALYs). Costs of implementation were estimated from the value of cost elements, determined by discussions with industry. Benefits were estimated by changing the inputs to a poultry food chain quantitative risk model. Proportional reductions in the number of predicted Campylobacter infections were converted into reductions in the burden of disease measured in DALYs. Cost-effectiveness ratios were calculated for each intervention, as cost per DALY reduction and the ratios compared. The results suggest that the most cost-effective interventions (lowest ratios) are at the primary processing stage. Potential phage-based controls in broiler houses were also highly cost-effective. This study is limited by the ability to quantify costs of implementation and assumptions required to estimate health benefits, but it supports the implementation of interventions at the primary processing stage as providing the greatest quantum of benefit and lowest cost-effectiveness ratios.

  15. High Performance Building Facade Solutions - PIER Final Project Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eleanor; Selkowitz, Stephen

    2009-12-31

    Building facades directly influence heating and cooling loads and indirectly influence lighting loads when daylighting is considered, and are therefore a major determinant of annual energy use and peak electric demand. Facades also significantly influence occupant comfort and satisfaction, making the design optimization challenge more complex than many other building systems.This work focused on addressing significant near-term opportunities to reduce energy use in California commercial building stock by a) targeting voluntary, design-based opportunities derived from the use of better design guidelines and tools, and b) developing and deploying more efficient glazings, shading systems, daylighting systems, facade systems and integrated controls. This two-year project, supported by the California Energy Commission PIER program and the US Department of Energy, initiated a collaborative effort between The Lawrence Berkeley National Laboratory (LBNL) and major stakeholders in the facades industry to develop, evaluate, and accelerate market deployment of emerging, high-performance, integrated facade solutions. The LBNL Windows Testbed Facility acted as the primary catalyst and mediator on both sides of the building industry supply-user business transaction by a) aiding component suppliers to create and optimize cost effective, integrated systems that work, and b) demonstrating and verifying to the owner, designer, and specifier community that these integrated systems reliably deliver required energy performance. An industry consortium was initiated amongst approximately seventy disparate stakeholders, who unlike the HVAC or lighting industry, has no single representative, multi-disciplinary body or organized means of communicating and collaborating. The consortium provided guidance on the project and more importantly, began to mutually work out and agree on the goals, criteria, and pathways needed to attain the ambitious net zero energy goals defined by California and

  16. Hybrid Microscopy: Enabling Inexpensive High-Performance Imaging through Combined Physical and Optical Magnifications

    Science.gov (United States)

    Zhang, Yu Shrike; Chang, Jae-Byum; Alvarez, Mario Moisés; Trujillo-de Santiago, Grissel; Aleman, Julio; Batzaya, Byambaa; Krishnadoss, Vaishali; Ramanujam, Aishwarya Aravamudhan; Kazemzadeh-Narbat, Mehdi; Chen, Fei; Tillberg, Paul W.; Dokmeci, Mehmet Remzi; Boyden, Edward S.; Khademhosseini, Ali

    2016-03-01

    To date, much effort has been expended on making high-performance microscopes through better instrumentation. Recently, it was discovered that physical magnification of specimens was possible, through a technique called expansion microscopy (ExM), raising the question of whether physical magnification, coupled to inexpensive optics, could together match the performance of high-end optical equipment, at a tiny fraction of the price. Here we show that such “hybrid microscopy” methods—combining physical and optical magnifications—can indeed achieve high performance at low cost. By physically magnifying objects, then imaging them on cheap miniature fluorescence microscopes (“mini-microscopes”), it is possible to image at a resolution comparable to that previously attainable only with benchtop microscopes that present costs orders of magnitude higher. We believe that this unprecedented hybrid technology that combines expansion microscopy, based on physical magnification, and mini-microscopy, relying on conventional optics—a process we refer to as Expansion Mini-Microscopy (ExMM)—is a highly promising alternative method for performing cost-effective, high-resolution imaging of biological samples. With further advancement of the technology, we believe that ExMM will find widespread applications for high-resolution imaging particularly in research and healthcare scenarios in undeveloped countries or remote places.

  17. Hybrid Microscopy: Enabling Inexpensive High-Performance Imaging through Combined Physical and Optical Magnifications.

    Science.gov (United States)

    Zhang, Yu Shrike; Chang, Jae-Byum; Alvarez, Mario Moisés; Trujillo-de Santiago, Grissel; Aleman, Julio; Batzaya, Byambaa; Krishnadoss, Vaishali; Ramanujam, Aishwarya Aravamudhan; Kazemzadeh-Narbat, Mehdi; Chen, Fei; Tillberg, Paul W; Dokmeci, Mehmet Remzi; Boyden, Edward S; Khademhosseini, Ali

    2016-03-15

    To date, much effort has been expended on making high-performance microscopes through better instrumentation. Recently, it was discovered that physical magnification of specimens was possible, through a technique called expansion microscopy (ExM), raising the question of whether physical magnification, coupled to inexpensive optics, could together match the performance of high-end optical equipment, at a tiny fraction of the price. Here we show that such "hybrid microscopy" methods--combining physical and optical magnifications--can indeed achieve high performance at low cost. By physically magnifying objects, then imaging them on cheap miniature fluorescence microscopes ("mini-microscopes"), it is possible to image at a resolution comparable to that previously attainable only with benchtop microscopes that present costs orders of magnitude higher. We believe that this unprecedented hybrid technology that combines expansion microscopy, based on physical magnification, and mini-microscopy, relying on conventional optics--a process we refer to as Expansion Mini-Microscopy (ExMM)--is a highly promising alternative method for performing cost-effective, high-resolution imaging of biological samples. With further advancement of the technology, we believe that ExMM will find widespread applications for high-resolution imaging particularly in research and healthcare scenarios in undeveloped countries or remote places.

  18. Hybrid ventilation systems and high performance buildings

    Energy Technology Data Exchange (ETDEWEB)

    Utzinger, D.M. [Wisconsin Univ., Milwaukee, WI (United States). School of Architecture and Urban Planning

    2009-07-01

    This paper described hybrid ventilation design strategies and their impact on 3 high performance buildings located in southern Wisconsin. The Hybrid ventilation systems combined occupant controlled natural ventilation with mechanical ventilation systems. Natural ventilation was shown to provide adequate ventilation when appropriately designed. Proper control integration of natural ventilation into hybrid systems was shown to reduce energy consumption in high performance buildings. This paper also described the lessons learned from the 3 buildings. The author served as energy consultant on all three projects and had the responsibility of designing and integrating the natural ventilation systems into the HVAC control strategy. A post occupancy evaluation of building energy performance has provided learning material for architecture students. The 3 buildings included the Schlitz Audubon Nature Center completed in 2003; the Urban Ecology Center completed in 2004; and the Aldo Leopold Legacy Center completed in 2007. This paper included the size, measured energy utilization intensity and percentage of energy supplied by renewable solar power and bio-fuels on site for each building. 6 refs., 2 tabs., 6 figs.

  19. The challenge of paying for cost-effective cures.

    Science.gov (United States)

    Zettler, Patricia J; Fuse Brown, Erin C

    2017-01-01

    In this article, we consider the problem of financing highly effective and cost-effective prescription drugs within a value-based pricing system. Precisely because these drugs are highly effective, their value-based prices may be quite expensive; and moreover, the value-based price of a cure ought to be set high enough to create incentives for innovation, otherwise these beneficial therapies may be underdeveloped. However, in our fragmented health insurance system, where patients move frequently between payers, these payers generally lack the incentives to pay value-based prices for cures because they cannot ensure that they will reap the long-term economic benefits. Therefore, we argue that there is a need for mechanisms to spread the burden of financing of cures across payers to maximize patient access and the public good. We suggest that risk adjustment, reinsurance, and risk corridors are familiar policy options that merit consideration to address the problem and create incentives for value-based pricing.

  20. Automatic Energy Schemes for High Performance Applications

    Energy Technology Data Exchange (ETDEWEB)

    Sundriyal, Vaibhav [Iowa State Univ., Ames, IA (United States)

    2013-01-01

    Although high-performance computing traditionally focuses on the efficient execution of large-scale applications, both energy and power have become critical concerns when approaching exascale. Drastic increases in the power consumption of supercomputers affect significantly their operating costs and failure rates. In modern microprocessor architectures, equipped with dynamic voltage and frequency scaling (DVFS) and CPU clock modulation (throttling), the power consumption may be controlled in software. Additionally, network interconnect, such as Infiniband, may be exploited to maximize energy savings while the application performance loss and frequency switching overheads must be carefully balanced. This work first studies two important collective communication operations, all-to-all and allgather and proposes energy saving strategies on the per-call basis. Next, it targets point-to-point communications to group them into phases and apply frequency scaling to them to save energy by exploiting the architectural and communication stalls. Finally, it proposes an automatic runtime system which combines both collective and point-to-point communications into phases, and applies throttling to them apart from DVFS to maximize energy savings. The experimental results are presented for NAS parallel benchmark problems as well as for the realistic parallel electronic structure calculations performed by the widely used quantum chemistry package GAMESS. Close to the maximum energy savings were obtained with a substantially low performance loss on the given platform.