Cost comparison of re-usable and single-use fibrescopes in a large English teaching hospital.

Science.gov (United States)

McCahon, R A; Whynes, D K

2015-06-01

A number of studies in the U.S.A. and mainland Europe have described the costs of fibreoptic tracheal intubation. However, no such data from the UK appear available. We performed a cost assessment of fibreoptic intubation, using re-usable (various devices from Olympus, Acutronic and Karl Storz) and single-use (Ambu aScope) fibrescopes, at the Queens Medical Centre, Nottingham, U.K., between 1 January 2009 and 31 March 2014. The total annual cost of fibreoptic intubation with re-usable fibrescopes was £46,385. Based on 141 fibreoptic intubations per year, this equated to £329 per use, an average dominated by repair/maintenance costs (43%) and capital depreciation costs (42%). In comparison, the total annual cost of using single-use fibrescopes for the same work would have been around £200 per use. The analysis enabled us to develop a generic model, wherein we were able to describe the relationship between total cost of use vs number of uses for a fibrescope. An 'isopleth' was identified for this relationship: a line that joined all the points where the cost of re-usable vs single-use fibrescopes was equal. It appears cheaper to use single-use fibrescopes at up to 200 fibreoptic intubations per year (a range commensurate with normal practice) even when the repair rate for re-usable fibrescopes is low. Any centre, knowing its fibrescope use and repair rate, can plot its data similarly to help ascertain which of the re-usable or single-use fibrescope represents better value. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

Reusable single-port access device shortens operative time and reduces operative costs.

Science.gov (United States)

Shussman, Noam; Kedar, Asaf; Elazary, Ram; Abu Gazala, Mahmoud; Rivkind, Avraham I; Mintz, Yoav

2014-06-01

In recent years, single-port laparoscopy (SPL) has become an attractive approach for performing surgical procedures. The pitfalls of this approach are technical and financial. Financial concerns are due to the increased cost of dedicated devices and prolonged operating room time. Our aim was to calculate the cost of SPL using a reusable port and instruments in order to evaluate the cost difference between this approach to SPL using the available disposable ports and standard laparoscopy. We performed 22 laparoscopic procedures via the SPL approach using a reusable single-port access system and reusable laparoscopic instruments. These included 17 cholecystectomies and five other procedures. Operative time, postoperative length of stay (LOS) and complications were prospectively recorded and were compared with similar data from our SPL database. Student's t test was used for statistical analysis. SPL was successfully performed in all cases. Mean operative time for cholecystectomy was 72 min (range 40-116). Postoperative LOS was not changed from our standard protocols and was 1.1 days for cholecystectomy. The postoperative course was within normal limits for all patients and perioperative morbidity was recorded. Both operative time and length of hospital stay were shorter for the 17 patients who underwent cholecystectomy using a reusable port than for the matched previous 17 SPL cholecystectomies we performed (p cost difference. Operating with a reusable port ended up with an average cost savings of US$388 compared with using disposable ports, and US$240 compared with standard laparoscopy. Single-port laparoscopic surgery is a technically challenging and expensive surgical approach. Financial concerns among others have been advocated against this approach; however, we demonstrate herein that using a reusable port and instruments reduces operative time and overall operative costs, even beyond the cost of standard laparoscopy.

Clinical outcomes and costs of reusable and single-use flexible ureterorenoscopes: a prospective cohort study.

Science.gov (United States)

Mager, R; Kurosch, M; Höfner, T; Frees, S; Haferkamp, A; Neisius, A

2018-01-22

The purpose of this study is to analyze clinical outcomes and costs of single-use flexible ureterorenoscopes in comparison with reusable flexible ureterorenoscopes in a tertiary referral center. Prospectively, 68 flexible ureterorenoscopies utilizing reusable (Flex-X2S, Flex-X C , Karl Storz) and 68 applying single-use flexible ureterorenoscopes (LithoVue, Boston Scientific) were collected. Clinical outcome parameters such as overall success rate, complication rates according to Clavien-Dindo, operation time and radiation exposure time were measured. Cost analysis was based on purchase costs and recurrent costs for repair and reprocessing divided by number of procedures. In each group 68 procedures were available for evaluation. In 91% of reusable and 88% of single-use ureterorenoscopies stone disease was treated with a mean stone burden of 101 ± 226 and 90 ± 244 mm 2 and lower pole involvement in 47 and 41%, respectively (p > 0.05). Comparing clinical outcomes of reusable vs. single-use instruments revealed no significant difference for overall success rates (81 vs. 87%), stone-free rates (82 vs. 85%), operation time (76.2 ± 46.8 vs. 76.8 ± 40.2 min), radiation exposure time (3.83 ± 3.15 vs. 3.93 ± 4.43 min) and complication rates (7 vs. 17%) (p > 0.05). A wide range of repair and purchase costs resulted in total to $1212-$1743 per procedure for reusable ureterorenoscopy whereas price of single-use ureterorenoscopy was $1300-$3180 per procedure. The current work provided evidence for equal clinical effectiveness of reusable and single-use flexible ureterorenoscopes. Partially overlapping ranges of costs for single-use and reusable scopes stress the importance to precisely know the expenses and caseload when negotiating purchase prices, repair prices and warranty conditions.

Cost-effectiveness of single versus double embryo transfer in IVF in relation to female age

NARCIS (Netherlands)

van Loendersloot, Laura L.; Moolenaar, Lobke M.; van Wely, Madelon; Repping, Sjoerd; Bossuyt, Patrick M.; Hompes, Peter G. A.; van der Veen, Fulco; Mol, Ben Willem J.

2017-01-01

Objective: To evaluate the cost-effectiveness of single embryo transfer followed by an additional frozen thawed single embryo transfer, if more embryos are available, as compared to double embryo transfer in relation to female age. Study design: We used a decision tree model to evaluate the costs

PET/CT and contrast enhanced CT in single vs. two separate sessions: a cost analysis study.

Science.gov (United States)

Picchio, M; Mansueto, M; Crivellaro, C; Guerra, L; Marcelli, S; Arosio, M; Sironi, S; Gianolli, L; Grimaldi, A; Messa, C

2012-06-01

Aim of the study was to quantify the economic impact of PET/CT and contrast enhanced (c.e.) CT performed in a single session examination vs. stand-alone modalities in oncological patients. One-hundred-forty-five cancer patients referred to both PET/CT and c.e. CT, to either stage (N.=46) or re-stage (N.=99) the disease, were included. Seventy-two/145 performed both studies in a single session (innovative method) and 73/145 in two different sessions (traditional method). The cost-minimization analysis was performed by evaluating: 1) institutional costs, data obtained by hospital accountability (staff, medical materials, equipment maintenance and depreciation, departments utilities); 2) patients costs, data obtained by a specific survey provided to patients (travel, food, accommodation costs, productivity loss). Economic data analysis showed that the costs for innovative method was lower than those of traditional method, both for Institution (106 € less per test) and for patient (21 € less per patient). The loss of productivity for patient and caregivers resulted lower for the innovative method than the traditional method (3 work-hour less per person). PET/CT and c.e. CT performed in a single session is more cost-effective than stand-alone modalities, by reducing both Institutional and patients costs. These advantages are mainly due to lower Institutional cost (single procedure) and to lower cost related to travel and housing.

Single-Phase Hybrid Switched Reluctance Motor for Low-Power Low-Cost Applications

DEFF Research Database (Denmark)

Lu, Kaiyuan; Rasmussen, Peter Omand; Jakobsen, Uffe

2011-01-01

This paper presents a new single-phase, Hybrid Switched Reluctance (HSR) motor for low-cost, low-power, pump or fan drive systems. Its single-phase configuration allows use of a simple converter to reduce the system cost. Cheap ferrite magnets are used and arranged in a special flux concentration...... manner to increase effectively the torque density and efficiency of this machine. The efficiency of this machine is comparable to the efficiency of a traditional permanent magnet machine in the similar power range. The cogging torque, due to the existence of the permanent magnetic field, is beneficially...

Availability and costs of single cigarettes in Guatemala.

Science.gov (United States)

de Ojeda, Ana; Barnoya, Joaquin; Thrasher, James F

2013-01-01

Single-cigarette sales have been associated with increased cigarette accessibility to less educated, lower-income populations, and minors; lower immediate cost, and increased smoking cues. Since 1997, Guatemalan Law bans the sale of single cigarettes and packs with fewer than 20 cigarettes. In 2005, Guatemala ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC); it is therefore obliged to "prohibit sale of cigarettes individually or in small packets." Blocks were numbered and randomly selected in Guatemala City and 3 neighboring towns. All stores in each block were surveyed. Single-cigarette and fewer than 20-cigarette pack sales were assessed by observation and purchase attempts. Cigarette brands and manufacturers (Philip Morris, PM or British American Tobacco, BAT) were also recorded. Percentages and means were used to describe data. Analyses were done using STATA 11.0. Of 398 stores and street vendors surveyed, 75.6% (301) sold cigarettes. Of these, 91% (275) sold single cigarettes and none sold fewer than 20-cigarette packs. Only informal economic sectors sold singles. There was no difference on sales between Guatemala City and neighboring towns and by store type. Buying 20 single cigarettes was US$ 0.83 more expensive than buying a 20-cigarette pack. The most prevalent brands were Rubios (PM), Marlboro (PM), Payasos (BAT), and After Hours (BAT). Single-cigarettes sales are highly prevalent among informal economic sectors in Guatemala City and its neighboring towns. Our data should prove useful to advocate for FCTC Article 16 enforcement in Guatemala.

Cost Optimal Design of a Single-Phase Dry Power Transformer

Directory of Open Access Journals (Sweden)

Raju Basak

2015-08-01

Full Text Available The Dry type transformers are preferred to their oil-immersed counterparts for various reasons, particularly because their operation is hazardless. The application of dry transformers was limited to small ratings in the earlier days. But now these are being used for considerably higher ratings.  Therefore, their cost-optimal design has gained importance. This paper deals with the design procedure for achieving cost optimal design of a dry type single-phase power transformer of small rating, subject to usual design constraints on efficiency and voltage regulation. The selling cost for the transformer has been taken as the objective function. Only two key variables have been chosen, the turns/volt and the height: width ratio of window, which affects the cost function to high degrees. Other variables have been chosen on the basis of designers’ experience. Copper has been used as conductor material and CRGOS as core material to achieve higher efficiency, lower running cost and compact design. The electrical and magnetic loadings have been kept at their maximum values without violating the design constraints. The optimal solution has been obtained by the method of exhaustive search using nested loops.

Cost-effectiveness of a chemoprophylactic intervention with single dose rifampicin in contacts of new leprosy patients.

Directory of Open Access Journals (Sweden)

Willemijn J Idema

Full Text Available BACKGROUND: With 249,007 new leprosy patients detected globally in 2008, it remains necessary to develop new and effective interventions to interrupt the transmission of M. leprae. We assessed the economic benefits of single dose rifampicin (SDR for contacts as chemoprophylactic intervention in the control of leprosy. METHODS: We conducted a single centre, double blind, cluster randomised, placebo controlled trial in northwest Bangladesh between 2002 and 2007, including 21,711 close contacts of 1,037 patients with newly diagnosed leprosy. We gave a single dose of rifampicin or placebo to close contacts, with follow-up for four years. The main outcome measure was the development of clinical leprosy. We assessed the cost effectiveness by calculating the incremental cost effectiveness ratio (ICER between the standard multidrug therapy (MDT program with the additional chemoprophylaxis intervention versus the standard MDT program only. The ICER was expressed in US dollars per prevented leprosy case. FINDINGS: Chemoprophylaxis with SDR for preventing leprosy among contacts of leprosy patients is cost-effective at all contact levels and thereby a cost-effective prevention strategy. In total, $6,009 incremental cost was invested and 38 incremental leprosy cases were prevented, resulting in an ICER of $158 per one additional prevented leprosy case. It was the most cost-effective in neighbours of neighbours and social contacts (ICER $214, slightly less cost-effective in next door neighbours (ICER $497 and least cost-effective among household contacts (ICER $856. CONCLUSION: Chemoprophylaxis with single dose rifampicin given to contacts of newly diagnosed leprosy patients is a cost-effective intervention strategy. Implementation studies are necessary to establish whether this intervention is acceptable and feasible in other leprosy endemic areas of the world.

Individual single-site travel cost model for Czech paradise geopark

Directory of Open Access Journals (Sweden)

Jan Špaček

2013-01-01

Full Text Available Geotourism is a new phenomenon, which has emerged in the tourism literature during the past two decades, and whose meaning suffered from global census. Geotourism is still a new discipline and relatively little has been written about its demand side, demonstrated by a lack of studies in the literature This article studies the recreational value of geotourism areas, and focuses on the first geopark in the Czech Republic, namely the Czech Paradise Geopark. To assess the recreational value the travel cost method is applied, specifically the individual travel cost model. The necessary research data was gathered through intensive tourist surveys conducted in the study area. Data gathered in the respondents’ survey served to determine the consumer surplus as a measure of recreational value and to develop the single site travel cost model. The dependent variable in the conducted model is the number of visits in the area and among the independent variables, studied age, education, travel cost, family status, economic activity and income. The results were subsequently compared to findings in the available literature, research works and case studies.

Single-stage-to-orbit versus two-stage-two-orbit: A cost perspective

Science.gov (United States)

Hamaker, Joseph W.

1996-03-01

This paper considers the possible life-cycle costs of single-stage-to-orbit (SSTO) and two-stage-to-orbit (TSTO) reusable launch vehicles (RLV's). The analysis parametrically addresses the issue such that the preferred economic choice comes down to the relative complexity of the TSTO compared to the SSTO. The analysis defines the boundary complexity conditions at which the two configurations have equal life-cycle costs, and finally, makes a case for the economic preference of SSTO over TSTO.

Double versus single reading of mammograms in a breast cancer screening programme: a cost-consequence analysis.

Science.gov (United States)

Posso, Margarita C; Puig, Teresa; Quintana, Ma Jesus; Solà-Roca, Judit; Bonfill, Xavier

2016-09-01

To assess the costs and health-related outcomes of double versus single reading of digital mammograms in a breast cancer screening programme. Based on data from 57,157 digital screening mammograms from women aged 50-69 years, we compared costs, false-positive results, positive predictive value and cancer detection rate using four reading strategies: double reading with and without consensus and arbitration, and single reading with first reader only and second reader only. Four highly trained radiologists read the mammograms. Double reading with consensus and arbitration was 15 % (Euro 334,341) more expensive than single reading with first reader only. False-positive results were more frequent at double reading with consensus and arbitration than at single reading with first reader only (4.5 % and 4.2 %, respectively; p cancer detection rate were similar for both reading strategies (4.6 and 4.2 per 1000 screens; p = 0.283). Our results suggest that changing to single reading of mammograms could produce savings in breast cancer screening. Single reading could reduce the frequency of false-positive results without changing the cancer detection rate. These results are not conclusive and cannot be generalized to other contexts with less trained radiologists. • Double reading of digital mammograms is more expensive than single reading. • Compared to single reading, double reading yields a higher proportion of false-positive results. • The cancer detection rate was similar for double and single readings. • Single reading may be a cost-effective strategy in breast cancer screening programmes.

Characterization of the Ecosole HCPV tracker and single module inverter

Science.gov (United States)

Carpanelli, Maurizio; Borelli, Gianni; Verdilio, Daniele; De Nardis, Davide; Migali, Fabrizio; Cancro, Carmine; Graditi, Giorgio

2015-09-01

BECAR, the Beghelli group's R&D company, is leading ECOSOLE (Elevated COncentration SOlar Energy), one of the largest European Demonstration projects in solar photovoltaic. ECOSOLE, started in 2012, is focused on the study, design, and realization of new HCPV generator made of high efficiency PV modules equipped with SoG (Silicone on Glass) fresnel lenses and III-V solar cells, and a low cost matched solar tracker with distributed inverters approach. The project also regards the study and demonstration of new high throughput methods for the industrial large scale productions, at very low manufacturing costs. This work reports the description of the characterization of the tracker and single module.

Loy Yang A - Australia's largest privatisation

International Nuclear Information System (INIS)

Yenckin, C.

1997-01-01

The recent A$4,746 million privatisation of the 2000MW Loy Yang A power station and the Loy Yang coal mine by the Victorian Government is Australia's largest privatisation and one of 1997's largest project financing deals. (author)

Costs of achieving live birth from assisted reproductive technology: a comparison of sequential single and double embryo transfer approaches.

Science.gov (United States)

Crawford, Sara; Boulet, Sheree L; Mneimneh, Allison S; Perkins, Kiran M; Jamieson, Denise J; Zhang, Yujia; Kissin, Dmitry M

2016-02-01

To assess treatment and pregnancy/infant-associated medical costs and birth outcomes for assisted reproductive technology (ART) cycles in a subset of patients using elective double embryo (ET) and to project the difference in costs and outcomes had the cycles instead been sequential single ETs (fresh followed by frozen if the fresh ET did not result in live birth). Retrospective cohort study using 2012 and 2013 data from the National ART Surveillance System. Infertility treatment centers. Fresh, autologous double ETs performed in 2012 among ART patients younger than 35 years of age with no prior ART use who cryopreserved at least one embryo. Sequential single and double ETs. Actual live birth rates and estimated ART treatment and pregnancy/infant-associated medical costs for double ET cycles started in 2012 and projected ART treatment and pregnancy/infant-associated medical costs if the double ET cycles had been performed as sequential single ETs. The estimated total ART treatment and pregnancy/infant-associated medical costs were $580.9 million for 10,001 double ETs started in 2012. If performed as sequential single ETs, estimated costs would have decreased by $195.0 million to $386.0 million, and live birth rates would have increased from 57.7%-68.0%. Sequential single ETs, when clinically appropriate, can reduce total ART treatment and pregnancy/infant-associated medical costs by reducing multiple births without lowering live birth rates. Published by Elsevier Inc.

Using Telepresence to Connect and Engage Classes and the Public in the Exploration of Tamu Massif, the World's Largest Single Volcano

Science.gov (United States)

Nanez-James, S. E.; Sager, W.

2016-02-01

Research published in 2013 showed that TAMU Massif, the largest mountain in the Shatsky Rise oceanic plateau, located approximately 1500 kilometers east of Japan, is the "World's Largest Single Volcano." This claim garnered widespread public interest and wonder concerning how something so big could remain so mysterious in the 21st century. This disconnect highlights the fact that oceans are still widely unexplored, especially the middle of the deep ocean. Because there is so much interest in TAMU Massif, a diverse outreach team lead by chief scientist Dr. William Sager from the University of Houston in partnership with the Texas State Aquarium and the Schmidt Ocean Institute (SOI) conducted a multifaceted ship-to-shore outreach project that included secondary school students, formal and informal educators, university students and professors, the aquarium and museum audience, and the general public. The objective was to work in conjunction with SOI and various other partners, including the Texas Regional Collaborative, the Aquarium of the Pacific, and the Houston Museum of Natural Science, to promote science and ocean literacy while inspiring future scientists - especially those from underserved and underrepresented groups - through ocean connections. Participants were connected through live ship-to-shore distance learning broadcasts of ongoing marine research and discovery of TAMU Massif aboard the R/V Falkor, allowing audiences to participate in real-time research and apply real world science to curriculum in the classrooms. These ship-to-shore presentations connected to existing curriculums and standards, lessons, and career interests of the students and educators with special teacher events and professional development workshops conducted from aboard the R/V Falkor.

Largest case series of Latin American eyelid tumors over 13-Years from a single center in Sao Paulo, Brazil

Directory of Open Access Journals (Sweden)

Jéssica Carolinne Damasceno

Full Text Available ABSTRACT Purpose: Malignant lesions of the eyelid are the most common eye cancers. Although rarely lethal, late diagnosis can lead to serious visual morbidity. Definitive diagnosis of neoplastic lesions is pathological. Indications and types of eyelid lesions in a single high-volume ophthalmic reference center in Sao Paulo, Brazil, were analyzed. Methods: The surgical pathological reports of patients who underwent eye removal procedures between January 2000 and December 2012 were retrieved from the electronic database of the Ophthalmology Department and retrospectively reviewed. Data regarding the final anatomopathological diagnosis, sex, and age were analyzed via the χ2 test with Yates' correction. Results: Of the 1,113 eyelid tumors resected over the 13-year study period, 324 (29% lesions were malignant. The most prevalent lesions were basal cell, squamous cell, and sebaceous gland carcinomas. The median ages of patients (females, n=165, 51%; males, n=159, 49% with a diagnosis of basal cell, squamous cell, and sebaceous gland carcinomas were 65, 75, and 70 years, respectively. Conclusion: This is the largest retrospective cohort analysis of eyelid tumors in a Latin American population. These findings are in agreement with those from large centers in other countries and regions.

Capital costs of light water reactors: the USA

International Nuclear Information System (INIS)

MacKerron, G.

1979-10-01

The cost of building a modern nuclear power plant is greater than that of almost any other single civilian project - costs of individual plants are reckoned in hundreds of millions of pounds in the UK, and up to a billion dollars or more in the USA. Hence, depending on the size of nuclear programmes and their funding, escalation of nuclear capital costs may have important economic and social consequences through its effects on overall resource allocation. It is therefore important to analyse the extent and, as far as possible, the sources of cost increases and escalation, in order to see if the experience yields implications for technology policy. The USA has much the greatest experience in nuclear construction: it also has by far the largest amount of published information on the subject of capital costs. As all other countries lack either sufficient experience and/or adequate published cost information, it is impossible to conduct a genuine international comparison, and this paper is confined to an examination of US experience. This paper therefore assembles and evaluates currently available data on light water reactor (PWR and BWR) capital costs in the USA. (author)

Haven't We Been Here Before? Some Comments on Steve Coffman's Proposal for "Earth's Largest Library".

Science.gov (United States)

McGervey, Teresa

2000-01-01

Discusses the concept of Earth's Largest Library (ELL), a mega-virtual library based on the Amazon.com model. Topics include who will be included; privacy; censorship; scope of the collection; costs; legal aspects; collection development; personnel management; access; the concept of community; public service; lending policies; technical…

The Effects of Forage Policy on Feed Costs in Korea

Directory of Open Access Journals (Sweden)

Jae Bong Chang

2018-05-01

Full Text Available Feeding operations are substantial on livestock farms, besides being potentially expensive. Feeding efficiency has been considered a major influence on profits in the livestock industry. Indeed, feed costs are shown to be the largest single item of production cost in Korea. To promote production and use of domestic forage, the Korean government has enforced the forage base expansion program that strengthens the competitiveness of the livestock industry by reducing the production cost. The forage base expansion program includes three main policies: subsidized forage production, support for processing and distribution, and expanding land for forage production. This paper investigates the influence of the government’s policies often conjectured to have pronounced effects on forage production. To evaluate the forage policies, this paper uses a path-analysis approach linking government spending on forage base expansion programs and feed costs. Results indicate that the Korean government’s spending on supporting domestic forage production results in a decrease in the ratio of forage expenses to total feed cost.

Spinal Surgeon Variation in Single-Level Cervical Fusion Procedures: A Cost and Hospital Resource Utilization Analysis.

Science.gov (United States)

Hijji, Fady Y; Massel, Dustin H; Mayo, Benjamin C; Narain, Ankur S; Long, William W; Modi, Krishna D; Burke, Rory M; Canar, Jeff; Singh, Kern

2017-07-01

Retrospective analysis. To compare perioperative costs and outcomes of patients undergoing single-level anterior cervical discectomy and fusions (ACDF) at both a service (orthopedic vs. neurosurgical) and individual surgeon level. Hospital systems are experiencing significant pressure to increase value of care by reducing costs while maintaining or improving patient-centered outcomes. Few studies have examined the cost-effectiveness cervical arthrodesis at a service level. A retrospective review of patients who underwent a primary 1-level ACDF by eight surgeons (four orthopedic and four neurosurgical) at a single academic institution between 2013 and 2015 was performed. Patients were identified by Diagnosis-Related Group and procedural codes. Patients with the ninth revision of the International Classification of Diseases coding for degenerative cervical pathology were included. Patients were excluded if they exhibited preoperative diagnoses or postoperative social work issues affecting their length of stay. Comparisons of preoperative demographics were performed using Student t tests and chi-squared analysis. Perioperative outcomes and costs for hospital services were compared using multivariate regression adjusted for preoperative characteristics. A total of 137 patients diagnosed with cervical degeneration underwent single-level ACDF; 44 and 93 were performed by orthopedic surgeons and neurosurgeons, respectively. There was no difference in patient demographics. ACDF procedures performed by orthopedic surgeons demonstrated shorter operative times (89.1 ± 25.5 vs. 96.0 ± 25.5 min; P = 0.002) and higher laboratory costs (Δ+$6.53 ± $5.52 USD; P = 0.041). There were significant differences in operative time (P = 0.014) and labor costs (P = 0.034) between individual surgeons. There was no difference in total costs between specialties or individual surgeons. Surgical subspecialty training does not significantly affect total costs of

Determinants of the property damage costs of tanker accidents

International Nuclear Information System (INIS)

Talley, W.K.

1999-01-01

This study investigates determinants of the vessel, oil cargo spillage, and other-property damage costs of tanker accidents. Tobit estimation of a three-equation recursive model suggests that, among types of tanker accidents, fire/explosion accidents incur the largest vessel damage costs, but the smallest oil cargo spillage costs. Alternatively, grounding accidents incur the smallest vessel damage costs, but the largest oil cargo spillage costs, reflecting the difficulty of controlling oil cargo spillage subsequent to such accidents. Also, oil cargo spillage costs are lower for US flag tanker accidents. A dollar of vessel damage cost increases other-property damage cost by 0.06 dollars, whereas a dollar of oil cargo spillage increases this cost by 1.55 dollars

Single versus double embryo transfer: cost-effectiveness analysis alongside a randomized clinical trial.

Science.gov (United States)

Fiddelers, Audrey A A; van Montfoort, Aafke P A; Dirksen, Carmen D; Dumoulin, John C M; Land, Jolande A; Dunselman, Gerard A J; Janssen, J Marij; Severens, Johan L; Evers, Johannes L H

2006-08-01

Twin pregnancies after IVF are still frequent and are considered high-risk pregnancies leading to high costs. Transferring one embryo can reduce the twin pregnancy rate. We compared cost-effectiveness of one fresh cycle elective single embryo transfer (eSET) versus one fresh cycle double embryo transfer (DET) in an unselected patient population. Patients starting their first IVF cycle were randomized between eSET and DET. Societal costs per couple were determined empirically, from hormonal stimulation up to 42 weeks after embryo transfer. An incremental cost-effectiveness ratio (ICER) was calculated, representing additional costs per successful pregnancy. Successful pregnancy rates were 20.8% for eSET and 39.6% for DET. Societal costs per couple were significantly lower after eSET (7334 euro) compared with DET (10,924 euro). The ICER of DET compared with eSET was 19,096 euro, meaning that each additional successful pregnancy in the DET group will cost 19,096 euro extra. One cycle eSET was less expensive, but also less effective compared to one cycle DET. It depends on the society's willingness to pay for one extra successful pregnancy, whether one cycle DET is preferred from a cost-effectiveness point of view.

Selected cost considerations for geothermal district heating in existing single-family residential areas

Energy Technology Data Exchange (ETDEWEB)

Rafferty, Kevin

1996-06-01

In the past, district heating (geothermal or conventionally fueled) has not been widely applied to the single-family residential sector. Low-heat load density is the commonly cited reason for this. Although it's true that load density in these areas is much lower than for downtown business districts, other frequently overlooked factors may compensate for load density. In particular, costs for distribution system installation can be substantially lower in some residential areas due to a variety of factors. This reduced development cost may partially compensate for the reduced revenue resulting from low-load density. This report examines cost associated with the overall design of the system (direct or indirect system design), distribution piping installation, and customer branch lines. It concludes with a comparison of the costs for system development and the revenue from an example residential area.

A Probability Analysis of the Generating Cost for EU-APR1400 Single Unit

International Nuclear Information System (INIS)

Ha, Gak Hyeon; Kim, Sung Hwan

2014-01-01

The nuclear power plant market is expected to grow rapidly in order to address issues of global warming, reducing CO 2 emissions and securing stable electricity supplies. Under these circumstances, the main primary goal of the EU-APR100 development is to ensure export competitiveness in the European countries. To this end, EU-APR1400 have been developed based one te APR1400 (Advanced Power Reactor, GEN Type) The EU-APR1400 adds many advanced design features to its predecessor, as outlined below in Table 1. In this simulation, the results of the generating cost of the EU-APR1400 single unit were determined using the probability cost analysis technique, the generating cost range was shown to be 56.16 ∼ 70.92 won/kWh.

A Probability Analysis of the Generating Cost for EU-APR1400 Single Unit

Energy Technology Data Exchange (ETDEWEB)

Ha, Gak Hyeon; Kim, Sung Hwan [KHNP CRI, Seoul (Korea, Republic of)

2014-10-15

The nuclear power plant market is expected to grow rapidly in order to address issues of global warming, reducing CO{sub 2} emissions and securing stable electricity supplies. Under these circumstances, the main primary goal of the EU-APR100 development is to ensure export competitiveness in the European countries. To this end, EU-APR1400 have been developed based one te APR1400 (Advanced Power Reactor, GEN Type) The EU-APR1400 adds many advanced design features to its predecessor, as outlined below in Table 1. In this simulation, the results of the generating cost of the EU-APR1400 single unit were determined using the probability cost analysis technique, the generating cost range was shown to be 56.16 ∼ 70.92 won/kWh.

Design optimization of single-main-amplifier KrF laser-fusion systems

International Nuclear Information System (INIS)

Harris, D.B.; Pendergrass, J.H.

1985-01-01

KrF lasers appear to be a very promising laser fusion driver for commercial applications. The Large Amplifier Module for the Aurora Laser System at Los Alamos is the largest KrF laser in the world and is currently operating at 5 kJ with 10 to 15 kJ eventually expected. The next generation system is anticipated to be a single-main-amplifier system that generates approximately 100 kJ. This paper examines the cost and efficiency tradeoffs for a complete single-main-amplifier KrF laser fusion experimental facility. It has been found that a 7% efficient $310/joule complete laser-fusion system is possible by using large amplifier modules and high optical fluences

Randomized single versus double embryo transfer: obstetric and paediatric outcome and a cost-effectiveness analysis.

Science.gov (United States)

Kjellberg, Ann Thurin; Carlsson, Per; Bergh, Christina

2006-01-01

Transfer of several embryos after IVF results in a high multiple birth rate associated with increased morbidity and high costs for the neonatal care. In a previous randomized trial we demonstrated that a single embryo transfer (SET) strategy, including one fresh single embryo transfer and, if no live birth, one additional frozen-thawed SET, resulted in a live-birth rate that was not substantially lower than after double embryo transfer (DET) but markedly reduced the multiple birth rate. We compared costs for maternal health care and productivity losses and paediatric costs for the SET and DET strategies. In addition, maternal and paediatric outcomes between the two groups were compared. The SET strategy resulted in lower average total costs from treatment until 6 months after delivery. There were a few more deliveries with at least one live-born child in the DET group. The incremental cost per extra delivery in the DET alternative was high, 71 940. The rates of prematurely born and low birthweight children were significantly lower with the SET strategy. There were also markedly fewer maternal and paediatric complications in the SET group. The SET strategy is superior to the DET strategy, when number of deliveries with at least one live-born child, incremental cost-effectiveness ratio and maternal and paediatric complications are taken into consideration. The findings do not support continuing transfers of two embryos in this group of patients.

Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

Directory of Open Access Journals (Sweden)

Jukes Matthew CH

2008-09-01

Full Text Available Abstract Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly. Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year. The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This

Rehabilitation of the 6 largest hydropower plants in the Republic of Macedonia

International Nuclear Information System (INIS)

Chingoski, Vlatko; Savevski, Vasil

2004-01-01

In 1998, ESM (Electric Power Co. of Macedonia) received a loan from the International Bank for Reconstruction and Development (IBRD - The World bank) for the cost of the Power System Improvement Project, major part of which is the partial rehabilitation of the six largest HPPs in the Republic of Macedonia. Rehabilitation and life extension of these six largest hydro power plants is given the highest priority in the whole Power System Improvement Project mainly because these HPPs are, in general, fairly old, older than most of the thermal generation capacity and because a significant part of their equipment is wearing out, or is now obsolete with spare parts difficult to obtain. Furthermore, these plants play a vital role in the Macedonian Power System, providing peaking capacity, reserve capacity and frequency control. With the realization of this project, greater hydropower production is expected. It is also expected that HPPs will become a more vital part of the Macedonian Power System, which is also beneficial from an environmental aspect, due to greater usage of renewable energy resources in the country. (Original)

Cost-effective conservation planning: lessons from economics.

Science.gov (United States)

Duke, Joshua M; Dundas, Steven J; Messer, Kent D

2013-08-15

Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.

Market impact costs of institutional equity trades

NARCIS (Netherlands)

Bikker, Jacob A.; Spierdijk, Laura; van der Sluis, Pieter Jelle

2007-01-01

This article analyzes market impact costs of equity trading by one of the world's largest pension funds. We find that, on average, these costs are small in terms of market disruption, but substantial in terms of costs for the pension fund. Average market impact costs equal 20 basis points for buys

Market Impact Costs of Institutional Equity Trades

NARCIS (Netherlands)

Bikker, J.A.; Spierdijk, L.; van der Sluis, P.J.

2008-01-01

This article analyzes market impact costs of equity trading by one of the world's largest pension funds. We find that, on average, these costs are small in terms of market disruption, but substantial in terms of costs for the pension fund. Average market impact costs equal 20 basis points for buys

Market Impact Costs of Institutional Equity Trades

NARCIS (Netherlands)

van der Sluis, P.J.; Bikker, J.A.; Spierdijk, L.

2007-01-01

This article analyzes market impact costs of equity trading by one of the world's largest pension funds. We find that, on average, these costs are small in terms of market disruption, but substantial in terms of costs for the pension fund. Average market impact costs equal 20 basis points for buys

Estimating the recreational value of Pakistan's largest freshwater lake to support sustainable tourism management using a travel cost model

NARCIS (Netherlands)

Mangan, T.; Brouwer, R.; Lohano, H.; Nagraj, G.M.

2013-01-01

Keenjhar Lake, Pakistan's largest freshwater lake and an important Ramsar site, provides habitat for internationally important water birds. Annually, 385,000 people visit the lake. The lake is threatened by a variety of causes, including industrial and agricultural pollution. To support its

Low-cost coherent receiver for long-reach optical access network using single-ended detection.

Science.gov (United States)

Zhang, Xuebing; Li, Zhaohui; Li, Jianping; Yu, Changyuan; Lau, Alan Pak Tao; Lu, Chao

2014-09-15

A low-cost coherent receiver using two 2×3 optical hybrids and single-ended detection is proposed for long-reach optical access network. This structure can detect the two polarization components of polarization division multiplexing (PDM) signals. Polarization de-multiplexing and signal-to-signal beat interference (SSBI) cancellation are realized by using only three photodiodes. Simulation results for 40 Gb/s PDM-OFDM transmissions indicate that the low-cost coherent receiver has 3.2 dB optical signal-to-noise ratio difference compared with the theoretical value.

Largest College Endowments, 2011

Science.gov (United States)

Chronicle of Higher Education, 2012

2012-01-01

Of all endowments valued at more than $250-million, the UCLA Foundation had the highest rate of growth over the previous year, at 49 percent. This article presents a table of the largest college endowments in 2011. The table covers the "rank," "institution," "market value as of June 30, 2011," and "1-year change" of institutions participating in…

NLP modeling for the optimization of LiBr-H_2O absorption refrigeration systems with exergy loss rate, heat transfer area, and cost as single objective functions

International Nuclear Information System (INIS)

Mussati, Sergio F.; Gernaey, Krist V.; Morosuk, Tatiana; Mussati, Miguel C.

2016-01-01

Highlights: • A NLP model is used for simultaneous optimization of sizes and operating conditions. • Total exergy loss rate and transfer area are optimized as single objective functions. • Theoretical and practical bounds for cost optimization problems are computed. • A systematic solution strategy is proposed for total annual cost optimization. • Relevance of components is ranked by heat transfer area, exergy loss rate, and cost. - Abstract: Based on a nonlinear mathematical programming model, the sizes and operating conditions of the process units of single-effect absorption refrigeration systems operating with a LiBr–H_2O solution are optimized for a specified cooling capacity by minimizing three single objective functions: the total exergy loss rate, the total heat transfer area, and the total annual cost of the system. It was found that the optimal solution obtained by minimization of the total exergy loss rate provides “theoretical” upper bounds not only for the total heat transfer area of the system but also for each process unit and all stream temperatures, while the optimal solution obtained by minimization of the total heat transfer area provides the lower bounds for these model variables, to solve a cost optimization problem. The minimization of the total exergy loss rate by varying parametrically the available total heat transfer area between these bounds was also performed, allowing to see how the optimal distribution of the available total heat transfer area among the system components, as well as the operating conditions (stream temperature, pressure, composition, and mass flow rate) and heat loads, vary qualitatively and quantitatively with increasing available total heat transfer area. These optimization results allowed to find a “practical” value of the total heat transfer area, i.e. no benefits can be obtained by increasing the available total heat transfer area above this value since the minimal total exergy loss value cannot

A Low Cost Single Chip VDL Compatible Transceiver ASIC

Science.gov (United States)

Becker, Robert

2004-01-01

Recent trends in commercial communications system components have focussed almost exclusively on cellular telephone technology. As many of the traditional sources of receiver components have discontinued non-cellular telephone products, the designers of avionics and other low volume radio applications find themselves increasingly unable to find highly integrated components. This is particularly true for low power, low cost applications which cannot afford the lavish current consumption of the software defined radio approach increasingly taken by certified device manufacturers. In this paper, we describe a low power transceiver chip targeting applications from low VHF to low UHF frequencies typical of avionics systems. The chip encompasses a selectable single or double conversion design for the receiver and a low power IF upconversion transmitter. All local oscillators are synthesized and integrated into the chip. An on-chip I-Q modulator and demodulator provide baseband modulation and demodulation capability allowing the use of low power, fixed point signal processing components for signal demodulation. The goal of this program is to demonstrate a low cost VDL mode-3 transceiver using this chip to receive text weather information sent using 4-slot TDMA with no support for voice. The data will be sent from an experimental ground station. This work is funded by NASA Glenn Research Center.

One size fits all? Mixed methods evaluation of the impact of 100% single-room accommodation on staff and patient experience, safety and costs

Science.gov (United States)

Maben, Jill; Penfold, Clarissa; Simon, Michael; Anderson, Janet E; Robert, Glenn; Pizzo, Elena; Hughes, Jane; Murrells, Trevor; Barlow, James

2016-01-01

Background and objectives There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore the impact of all single rooms on staff and patient experience; safety outcomes; and costs. Methods Mixed methods pre/post ‘move’ comparison within four nested case study wards in a single acute hospital with 100% single rooms; quasi-experimental before-and-after study with two control hospitals; analysis of capital and operational costs associated with single rooms. Results Two-thirds of patients expressed a preference for single rooms with comfort and control outweighing any disadvantages (sense of isolation) felt by some. Patients appreciated privacy, confidentiality and flexibility for visitors afforded by single rooms. Staff perceived improvements (patient comfort and confidentiality), but single rooms were worse for visibility, surveillance, teamwork, monitoring and keeping patients safe. Staff walking distances increased significantly post move. A temporary increase of falls and medication errors in one ward was likely to be associated with the need to adjust work patterns rather than associated with single rooms per se. We found no evidence that single rooms reduced infection rates. Building an all single-room hospital can cost 5% more with higher housekeeping and cleaning costs but the difference is marginal over time. Conclusions Staff needed to adapt their working practices significantly and felt unprepared for new ways of working with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms. PMID:26408568

Single visit surgery for pediatric ambulatory surgical procedures: a satisfaction and cost analysis.

Science.gov (United States)

Olson, Jacob K; Deming, Lisa A; King, Denis R; Rager, Terrence M; Gartner, Sarah; Huibregtse, Natalie; Moss, R Lawrence; Besner, Gail E

2017-10-10

Single visit surgery (SVS) consists of same-day pre-operative assessment and operation with telephone post-operative follow-up. This reduces family time commitment to 1 hospital trip rather than 2-3. We began SVS for ambulatory patients with clear surgical indications in 2013. We sought to determine family satisfaction, cost savings to families, and institutional financial feasibility of SVS. SVS patients were compared to age/case matched conventional surgery (CS) patients. Satisfaction was assessed by post-operative telephone survey. Family costs were calculated as the sum of lost revenue (based on median income) and transportation costs ($0.50/mile). Satisfaction was high in both groups (98% for SVS vs. 93% for CS; p=0.27). 40% of CS families indicated that they would have preferred SVS, whereas no SVS families indicated preference for the CS option (p<0.001). Distance from the hospital did not correlate with satisfaction. Estimated cost savings for an SVS family was $188. Reimbursement, hospital and physician charges, and day-of-surgery cancellation rates were similar. SVS provides substantial cost savings to families while maintaining patient satisfaction and equivalent institutional reimbursement. SVS is an effective approach to low-risk ambulatory surgical procedures that is less disruptive to families, facilitates access to pediatric surgical care, and reduces resource utilization. Cost Effectiveness Study. Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

Investigation of a new low cost and low consumption single poly-silicon memory

Directory of Open Access Journals (Sweden)

Patrick Calenzo

2010-10-01

Full Text Available In this paper is presented an investigation on a new low cost and voltage consumption single poly-silicon memory cell for passive RFID (Radio Frequency IDentificationapplications. This structure is low cost due to its single poly-silicon design. This memory cell has two particularities : the first one is that no deported capacitor is necessary to program this cell which allows to reduce the structure size to 1.1μm². The second one is the way the cell is erased. A Zener diode is used to generate carriers in order to be injected into the floating gate. This Zener diode is one of the key points for the functionality that has to be validated with some electrical trials. These trials permit to integrate and use the Zener diodes measured in simulations of the complete memory cell. This is done to validate the best candidate between the Zener diodes used for the cell and highlight the efficiency in consumption and rapidity to erase the cell. Besides, the writing and the reading cases are simulated in order to show the low consumption required by the cell during these phases.

Largest particle detector nearing completion

CERN Multimedia

2006-01-01

"Construction of another part of the Large Hadron Collider (LHC), the worl's largest particle accelerator at CERN in Switzerland, is nearing completion. The Compact Muon Solenoid (CMS) is oner of the LHC project's four large particle detectors. (1/2 page)

Life cycle cost analysis of single slope hybrid (PV/T) active solar still

International Nuclear Information System (INIS)

Kumar, Shiv; Tiwari, G.N.

2009-01-01

This paper presents the life cycle cost analysis of the single slope passive and hybrid photovoltaic (PV/T) active solar stills, based on the annual performance at 0.05 m water depth. Effects of various parameters, namely interest rate, life of the system and the maintenance cost have been taken into account. The comparative cost of distilled water produced from passive solar still (Rs. 0.70/kg) is found to be less than hybrid (PV/T) active solar still (Rs. 1.93/kg) for 30 years life time of the systems. The payback periods of the passive and hybrid (PV/T) active solar still are estimated to be in the range of 1.1-6.2 years and 3.3-23.9 years, respectively, based on selling price of distilled water in the range of Rs. 10/kg to Rs. 2/kg. The energy payback time (EPBT) has been estimated as 2.9 and 4.7 years, respectively. (author)

Canada's largest co-gen project

International Nuclear Information System (INIS)

Salaff, S.

2000-01-01

In November 2000, the TransAlta Energy Corp. began construction on its $400 million natural gas fuelled cogeneration project in Sarnia Ontario. The Sarnia Regional Cogeneration Project (SRCP) is designed to integrate a new 440 MW cogeneration facility to be built at the Sarnia Division of Dow Chemicals Canada Inc. with nearby existing generators totaling 210 MW at Dow and Bayer Inc. At 650 MW, the new facility will rank as Canada's largest cogeneration installation. Commercial operation is scheduled for October 2002. TransAlta owns three natural gas fuelled cogeneration facilities in Ontario (in Ottawa, Mississauga and Windsor) totaling 250 MW. The cost of electric power in Ontario is currently controlled by rising natural gas prices and the supply demand imbalance. This balance will be significantly affected by the possible return to service of 2000 MW of nuclear generating capacity. The SRCP project was announced just prior to the Ontario Energy Competition Act of October 1998 which committed the province to introduce competition to the electricity sector and which created major uncertainties in the electricity market. Some of the small, 25 MW projects which survived the market uncertainty included the Toronto-based Toromont Energy Ltd. project involving gas fuelled cogeneration and methane gas generation from landfill projects in Sudbury and Waterloo. It was emphasized that cogeneration and combined heat and power projects have significant environmental advantages over large combined cycle facilities. The Ontario Energy Board is currently considering an application from TransAlta to link the SRCP facility to Ontario's Hydro One Network Inc.'s transmission grid. 1 fig

Single Particle Entropy in Heated Nuclei

International Nuclear Information System (INIS)

Guttormsen, M.; Chankova, R.; Hjorth-Jensen, M.; Rekstad, J.; Siem, S.; Sunde, A. C.; Syed, N. U. H.; Agvaanluvsan, U.; Schiller, A.; Voinov, A.

2006-01-01

The thermal motion of single particles represents the largest contribution to level density (or entropy) in atomic nuclei. The concept of single particle entropy is presented and shown to be an approximate extensive (additive) quantity for mid-shell nuclei. A few applications of single particle entropy are demonstrated

A low-cost single-board solution for real-time, unsupervised waveform classification of multineuron recordings.

Science.gov (United States)

Kreiter, A K; Aertsen, A M; Gerstein, G L

1989-10-01

We describe a low-cost single-board system for unsupervised, real-time spike sorting of recordings from a number of neurons on a single microelectrode. The maximum number of spike classes depends on the quality of the recording; it will typically be between 2 and 5. The spike sorter communicates with a conventional microcomputer through a standard serial port (RS232). For typical firing rates as measured in the mammalian central nervous system, this set-up will accommodate up to some 10 parallel spike sorters for as many separate microelectrodes.

Cost-Utility of a Single-Injection Combined Corticosteroid-Hyaluronic Acid Formulation vs a 2-Injection Regimen of Sequential Corticosteroid and Hyaluronic Acid Injections.

Science.gov (United States)

Belzile, Etienne L; Deakon, Robert T; Vannabouathong, Christopher; Bhandari, Mohit; Lamontagne, Martin; McCormack, Robert

2017-01-01

Research has shown early and sustained relief with a combination therapy of a corticosteroid (CS) and hyaluronic acid (HA) in knee osteoarthritis (OA) patients. This can be administered via a single injection containing both products or as separate injections. The former may be more expensive when considering only product cost, but the latter incurs the additional costs and time of a second procedure. The purpose of this study was to compare the cost-utility of the single injection with the 2-injection regimen. The results of this analysis revealed that the single-injection formulation of a CS and HA may be cost-effective, assuming a willingness-to-pay of $50 000 per quality-adjusted life year gained, for symptomatic relief of OA symptoms. This treatment may also be more desirable to patients who find injections to be inconvenient or unpleasant.

The cost of insulin-dependent diabetes mellitus (IDDM) in England and Wales.

Science.gov (United States)

Gray, A; Fenn, P; McGuire, A

1995-12-01

This study estimates the direct health and social care costs of insulin-dependent diabetes mellitus (IDDM) in England and Wales in 1992 to be 96 million pounds, or 1021 pounds per person in a population with IDDM estimated at 94,000 individuals. These costs include insulin maintenance, hospitalization, GP and out-patient consultations, renal replacement therapy, and payments to informal carers. Expenditure is concentrated on younger age groups, with one-third of the total expended on those aged 0-24. Around one-half of the total costs can be directly attributed to IDDM, with the remainder associated with a range of complications of the disease. The single largest area of service expenditure is renal replacement therapy. The cost estimates are most sensitive to incidence rates of IDDM, numbers on dialysis and average duration of dialysis. A further 113 million pounds may be lost each year due to premature deaths resulting in lost productive contributions to the economy. The direct and indirect costs of IDDM are therefore significant. The cost of illness framework presented here should facilitate the economic evaluation of new and existing treatment regimens, which may improve value for money by reducing costs and/or increasing the quality or quantity of life for people with IDDM.

Development of a practical costing method for hospitals.

Science.gov (United States)

Cao, Pengyu; Toyabe, Shin-Ichi; Akazawa, Kouhei

2006-03-01

To realize an effective cost control, a practical and accurate cost accounting system is indispensable in hospitals. In traditional cost accounting systems, the volume-based costing (VBC) is the most popular cost accounting method. In this method, the indirect costs are allocated to each cost object (services or units of a hospital) using a single indicator named a cost driver (e.g., Labor hours, revenues or the number of patients). However, this method often results in rough and inaccurate results. The activity based costing (ABC) method introduced in the mid 1990s can prove more accurate results. With the ABC method, all events or transactions that cause costs are recognized as "activities", and a specific cost driver is prepared for each activity. Finally, the costs of activities are allocated to cost objects by the corresponding cost driver. However, it is much more complex and costly than other traditional cost accounting methods because the data collection for cost drivers is not always easy. In this study, we developed a simplified ABC (S-ABC) costing method to reduce the workload of ABC costing by reducing the number of cost drivers used in the ABC method. Using the S-ABC method, we estimated the cost of the laboratory tests, and as a result, similarly accurate results were obtained with the ABC method (largest difference was 2.64%). Simultaneously, this new method reduces the seven cost drivers used in the ABC method to four. Moreover, we performed an evaluation using other sample data from physiological laboratory department to certify the effectiveness of this new method. In conclusion, the S-ABC method provides two advantages in comparison to the VBC and ABC methods: (1) it can obtain accurate results, and (2) it is simpler to perform. Once we reduce the number of cost drivers by applying the proposed S-ABC method to the data for the ABC method, we can easily perform the cost accounting using few cost drivers after the second round of costing.

Adding bevacizumab to single agent chemotherapy for the treatment of platinum-resistant recurrent ovarian cancer: A cost effectiveness analysis of the AURELIA trial.

Science.gov (United States)

Wysham, Weiya Z; Schaffer, Elisabeth M; Coles, Theresa; Roque, Dario R; Wheeler, Stephanie B; Kim, Kenneth H

2017-05-01

AURELIA, a randomized phase III trial of adding bevacizumab (B) to single agent chemotherapy (CT) for the treatment of platinum-resistant recurrent ovarian cancer, demonstrated improved progression free survival (PFS) in the B+CT arm compared to CT alone. We aimed to evaluate the cost effectiveness of adding B to CT in the treatment of platinum-resistant recurrent ovarian cancer. A decision tree model was constructed to evaluate the cost effectiveness of adding bevacizumab (B) to single agent chemotherapy (CT) based on the arms of the AURELIA trial. Costs, quality-adjusted life years (QALYs), and progression free survival (PFS) were modeled over fifteen months. Model inputs were extracted from published literature and public sources. Incremental cost effectiveness ratios (ICERs) per QALY gained and ICERs per progression free life year saved (PF-LYS) were calculated. One-way sensitivity analyses were performed to evaluate the robustness of results. The ICER associated with B+CT is $410,455 per QALY gained and $217,080 per PF-LYS. At a willingness to pay (WTP) threshold of $50,000/QALY, adding B to single agent CT is not cost effective for this patient population. Even at a WTP threshold of $100,000/QALY, B+CT is not cost effective. These findings are robust to sensitivity analyses. Despite gains in QALY and PFS, the addition of B to single agent CT for treatment of platinum-resistant recurrent ovarian cancer is not cost effective. Benefits, risks, and costs associated with treatment should be taken into consideration when prescribing chemotherapy for this patient population. Copyright © 2017 Elsevier Inc. All rights reserved.

Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

Energy Technology Data Exchange (ETDEWEB)

Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

2015-03-01

Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

International Nuclear Information System (INIS)

Kim, Hayeon; Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful; Smith, Kenneth J.

2015-01-01

Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

A retrospective review comparing two-year patient-reported outcomes, costs, and healthcare resource utilization for TLIF vs. PLF for single-level degenerative spondylolisthesis.

Science.gov (United States)

Kim, Elliott; Chotai, Silky; Stonko, David; Wick, Joseph; Sielatycki, Alex; Devin, Clinton J

2018-03-01

The purpose of this study was to compare patient-reported outcomes (PROs), morbidity, and costs of TLIF vs PLF to determine whether one treatment was superior in the setting of single-level degenerative spondylolisthesis. Patients undergoing TLIF or PLF for single-level spondylolisthesis were included for retrospective analysis. EQ-5D, ODI, SF-12 MCS/PCS, NRS-BP/LP scores were collected at baseline and 24 months after surgery. 90-day post-operative complications, revision surgery rates, and satisfaction scores were also collected. Two-year resource use was multiplied by unit costs based on Medicare payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Total cost was used to assess mean total 2-year cost per QALYs gained after surgery. 62 and 37 patients underwent TLIF and PLF, respectively. Patients in the PLF group were older (p differences were seen in baseline or 24-month PROs between the two groups. There was a significant improvement in all PROs from baseline to 24 months after surgery (p difference in 24-month direct, indirect, and total cost. Overall costs and health care utilization were similar in both the groups. Both TLIF and PLF for single-level degenerative spondylolisthesis provide improvement in disability, pain, quality of life, and general health.

76 FR 77533 - Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single...

Science.gov (United States)

2011-12-13

..., regarding FHFA's adoption of an Order revising FHFA's Public Use Database matrices to include certain data... FEDERAL HOUSING FINANCE AGENCY [No. 2011-N-13] Notice of Order: Revisions to Enterprise Public Use Database Incorporating High-Cost Single-Family Securitized Loan Data Fields and Technical Data Field...

Productivity and cost of marking activities for single-tree selection and thinning treatments in Arkansas

Science.gov (United States)

Tymur Sydor; Richard A. Kluender; Rodney L. Busby; Matthew Pelkki

2004-01-01

An activity algorithm was developed for standard marking methods for natural pine stands in Arkansas. For the two types of marking methods examined, thinning (selection from below) and single-tree selection (selection from above), cycle time and cost models were developed. Basal area (BA) removed was the major influencing factor in both models. Marking method was...

Estimating Power Outage Cost based on a Survey for Industrial Customers

Science.gov (United States)

Yoshida, Yoshikuni; Matsuhashi, Ryuji

A survey was conducted on power outage cost for industrial customers. 5139 factories, which are designated energy management factories in Japan, answered their power consumption and the loss of production value due to the power outage in an hour in summer weekday. The median of unit cost of power outage of whole sectors is estimated as 672 yen/kWh. The sector of services for amusement and hobbies and the sector of manufacture of information and communication electronics equipment relatively have higher unit cost of power outage. Direct damage cost from power outage in whole sectors reaches 77 billion yen. Then utilizing input-output analysis, we estimated indirect damage cost that is caused by the repercussion of production halt. Indirect damage cost in whole sectors reaches 91 billion yen. The sector of wholesale and retail trade has the largest direct damage cost. The sector of manufacture of transportation equipment has the largest indirect damage cost.

Alternative Fuels Data Center: America's Largest Home Runs on Biodiesel in

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North Carolina America's Largest Home Runs on Biodiesel in North Carolina to someone by E-mail Share Alternative Fuels Data Center: America's Largest Home Runs on Biodiesel in North Carolina on Facebook Tweet about Alternative Fuels Data Center: America's Largest Home Runs on Biodiesel in North

Is dibotermin alfa a cost-effective substitute for autologous iliac crest bone graft in single level lumbar interbody spine fusion?

Science.gov (United States)

Svedbom, Axel; Paech, Daniel; Leonard, Catherine; Donnell, David; Song, Fujian; Boszcyk, Bronek; Rothenfluh, Dominique A; Lloyd, Andrew; Borgman, Benny

2015-11-01

To evaluate the cost-effectiveness of dibotermin alfa compared with autologous iliac crest bone graft (ICBG) for patients undergoing single level lumbar interbody spinal fusion in a UK hospital setting. An individual patient data (IPD) meta-analysis of six randomized controlled clinical trials and two single arm trials compared dibotermin alfa on an absorbable collagen implantation matrix (ACIM) (n = 456) and ICBG (n = 244) on resource use, re-operation rates, and SF-6D (Short form 6-dimension) health utility (total N = 700). Failure-related second surgery, operating time, post-operative hospital stay, and quality-adjusted life years (QALYs) derived from the IPD meta-analysis were included as inputs in an economic evaluation undertaken to assess the cost-effectiveness of dibotermin alfa/ACIM versus ICBG for patients undergoing single level lumbar interbody spinal fusion. A four year time horizon and the United Kingdom (UK) National Health Service (NHS) and Personal Social Services (PSS) perspective was adopted in the base case, with sensitivity analyses performed to gauge parameter uncertainty. In the base case analysis, patients treated using dibotermin alfa/ACIM (12 mg pack) accrued 0.055 incremental QALYs at an incremental cost of £ 737, compared with patients treated with ICBG. This resulted in an incremental cost-effectiveness ratio (ICER) of £ 13,523, indicating that at a willingness-to-pay threshold of £ 20,000, dibotermin alfa/ACIM is a cost-effective intervention relative to ICBG from the NHS and PSS perspective. In a UK hospital setting, dibotermin alfa/ACIM is a cost-effective substitute for ICBG for patients who require lumbar interbody arthrodesis.

Opportunities for biodiversity gains under the world's largest reforestation programme

Science.gov (United States)

Hua, Fangyuan; Wang, Xiaoyang; Zheng, Xinlei; Fisher, Brendan; Wang, Lin; Zhu, Jianguo; Tang, Ya; Yu, Douglas W.; Wilcove, David S.

2016-01-01

Reforestation is a critical means of addressing the environmental and social problems of deforestation. China's Grain-for-Green Program (GFGP) is the world's largest reforestation scheme. Here we provide the first nationwide assessment of the tree composition of GFGP forests and the first combined ecological and economic study aimed at understanding GFGP's biodiversity implications. Across China, GFGP forests are overwhelmingly monocultures or compositionally simple mixed forests. Focusing on birds and bees in Sichuan Province, we find that GFGP reforestation results in modest gains (via mixed forest) and losses (via monocultures) of bird diversity, along with major losses of bee diversity. Moreover, all current modes of GFGP reforestation fall short of restoring biodiversity to levels approximating native forests. However, even within existing modes of reforestation, GFGP can achieve greater biodiversity gains by promoting mixed forests over monocultures; doing so is unlikely to entail major opportunity costs or pose unforeseen economic risks to households. PMID:27598524

Identifying the node spreading influence with largest k-core values

International Nuclear Information System (INIS)

Lin, Jian-Hong; Guo, Qiang; Dong, Wen-Zhao; Tang, Li-Ying; Liu, Jian-Guo

2014-01-01

Identifying the nodes with largest spreading influence of complex networks is one of the most promising domains. By taking into account the neighbors' k-core values, we present an improved neighbors' k-core (INK) method which is the sum of the neighbors' k-core values with a tunable parameter α to evaluate the node spreading influence with largest k-core values. Comparing with the Susceptible–Infected–Recovered (SIR) results for four real networks, the INK method could identify the node spreading influence with largest k-core values more accurately than the ones generated by the degree k, closeness C, betweenness B and coreness centrality method. - Highlights: • We present an improved neighbors' k-core (INK) method to evaluate the node spreading influence with largest k-core values. • The INK method could identify the node spreading influence with largest k-core values more accurately. • Kendall's tau τ of INK method with α=1 are highly identical to rank the node influence

Cost-effectiveness of single-dose tamsulosin and dutasteride combination therapy compared with tamsulosin monotherapy in patients with benign prostatic hyperplasia in the UK.

Science.gov (United States)

Walker, Anna; Doyle, Scott; Posnett, John; Hunjan, Manjit

2013-09-01

To estimate the long-term cost-effectiveness of single-dose dutasteride/tamsulosin combination therapy as a first-line treatment for benign prostatic hyperplasia (BPH) from the perspective of the UK National Health Service (NHS). A Markov state transition model was developed to estimate healthcare costs and patient outcomes, measured by quality-adjusted life years (QALYs), for patients aged ≥50 years with diagnosed BPH and moderate to severe symptoms. Costs and outcomes were estimated for two treatment comparators: oral, daily, single-dose combination therapy (dutasteride 0.5 mg + tamsulosin 0.4 mg), and oral daily tamsulosin (0.4 mg) over a period up to 25 years. The efficacy of comparators was taken from results of the Combination of Avodart and Tamsulosin (CombAT) trial. Cumulative discounted costs per patient were higher with combination therapy than with tamsulosin, but QALYs were also higher. After 25 years, the incremental cost-effectiveness ratio for combination therapy was £12,219, well within the threshold range (£20,000-£30,000 per QALY) typically applied in the NHS. Probabilistic sensitivity analysis showed that the probability of combination therapy being cost-effective given the threshold range is between 78% and 88%. Single-dose combination dutasteride/tamsulosin therapy has a high probability of being cost-effective in comparison to tamsulosin monotherapy in the UK's NHS. © 2013 BJU International.

Cost variation in a laparoscopic cholecystectomy and the association with outcomes across a single health system: implications for standardization and improved resource utilization

Science.gov (United States)

Brauer, David G; Hawkins, William G; Strasberg, Steven M; Brunt, L Michael; Jaques, David P; Mercurio, Nicholas R; Hall, Bruce L; Fields, Ryan C

2015-01-01

Background Payers and regulatory bodies are increasingly placing emphasis on cost containment, quality/outcome measurement and transparent reporting. Significant cost variation occurs in many operative procedures without a clear relationship with outcomes. Clear cost-benefit associations will be necessary to justify expenditures in the era of bundled payment structures. Methods All laparoscopic cholecystectomies (LCCKs) performed within a single health system over a 1-year period were analysed for operating room (OR) supply cost. The cost was correlated with American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) outcomes. Results From July 2013 to June 2014, 2178 LCCKs were performed by 55 surgeons at seven hospitals. The median case OR supply cost was $513 ± 156. There was variation in cost between individual surgeons and within an individual surgeon's practice. There was no correlation between cost and ACS NSQIP outcomes. The majority of cost variation was explained by selection of trocar and clip applier constructs. Conclusions Significant case OR cost variation is present in LCCK across a single health system, and there is no clear association between increased cost and NSQIP outcomes. Placed within the larger context of overall cost, the opportunity exists for improved resource utilization with no obvious risk for a reduction in the quality of care. PMID:26345351

CERN tests largest superconducting solenoid magnet

CERN Multimedia

2006-01-01

"CERN's Compacts Muon Solenoid (CMS) - the world's largest superconducting solenoid magnet - has reached full field in testing. The instrument is part of the proton-proton Large Hadron Collider (LHC) project, located in a giant subterranean chamber at Cessy on the Franco-Swiss border." (1 page)

Cost per remission and cost per response with infliximab, adalimumab, and golimumab for the treatment of moderately-to-severely active ulcerative colitis.

Science.gov (United States)

Toor, Kabirraaj; Druyts, Eric; Jansen, Jeroen P; Thorlund, Kristian

2015-06-01

To determine the short-term costs per sustained remission and sustained response of three tumor necrosis factor inhibitors (infliximab, adalimumab, and golimumab) in comparison to conventional therapy for the treatment of moderately-to-severely active ulcerative colitis. A probabilistic Markov model was developed. This included an 8-week induction period, and 22 subsequent 2-week cycles (up to 1 year). The model included three disease states: remission, response, and relapse. Costs were from a Canadian public payer perspective. Estimates for the additional cost per 1 year of sustained remission and sustained response were obtained. Golimumab 100 mg provided the lowest cost per additional remission ($935) and cost per additional response ($701) compared with conventional therapy. Golimumab 50 mg yielded slightly higher costs than golimumab 100 mg. Infliximab was associated with the largest additional number of estimated remissions and responses, but also higher cost at $1975 per remission and $1311 per response. Adalimumab was associated with the largest cost per remission ($7430) and cost per response ($2361). The cost per additional remission and cost per additional response associated with infliximab vs golimumab 100 mg was $14,659 and $4753, respectively. The results suggest that the additional cost of 1 full year of remission and response are lowest with golimumab 100 mg, followed by golimumab 50 mg. Although infliximab has the highest efficacy, it did not exhibit the lowest cost per additional remission or response. Adalimumab produced the highest cost per additional remission and response.

Forecasting market impact costs and identifying expensive trades

NARCIS (Netherlands)

Bikker, J.A.; Spierdijk, L.; Hoevenaars, R.P.M.M.; van der Sluis, P.J.

Often, a relatively small group of trades causes the major part of the trading costs on an investment portfolio. For the equity trades studied in this paper, executed by the world's second largest pension fund, we find that only 10% of all trades determines 75% of total market impact costs.

Quantifying the cognitive cost of laparo-endoscopic single-site surgeries: Gaze-based indices.

Science.gov (United States)

Di Stasi, Leandro L; Díaz-Piedra, Carolina; Ruiz-Rabelo, Juan Francisco; Rieiro, Héctor; Sanchez Carrion, Jose M; Catena, Andrés

2017-11-01

Despite the growing interest concerning the laparo-endoscopic single-site surgery (LESS) procedure, LESS presents multiple difficulties and challenges that are likely to increase the surgeon's cognitive cost, in terms of both cognitive load and performance. Nevertheless, there is currently no objective index capable of assessing the surgeon cognitive cost while performing LESS. We assessed if gaze-based indices might offer unique and unbiased measures to quantify LESS complexity and its cognitive cost. We expect that the assessment of surgeon's cognitive cost to improve patient safety by measuring fitness-for-duty and reducing surgeons overload. Using a wearable eye tracker device, we measured gaze entropy and velocity of surgical trainees and attending surgeons during two surgical procedures (LESS vs. multiport laparoscopy surgery [MPS]). None of the participants had previous experience with LESS. They performed two exercises with different complexity levels (Low: Pattern Cut vs. High: Peg Transfer). We also collected performance and subjective data. LESS caused higher cognitive demand than MPS, as indicated by increased gaze entropy in both surgical trainees and attending surgeons (exploration pattern became more random). Furthermore, gaze velocity was higher (exploration pattern became more rapid) for the LESS procedure independently of the surgeon's expertise. Perceived task complexity and laparoscopic accuracy confirmed gaze-based results. Gaze-based indices have great potential as objective and non-intrusive measures to assess surgeons' cognitive cost and fitness-for-duty. Furthermore, gaze-based indices might play a relevant role in defining future guidelines on surgeons' examinations to mark their achievements during the entire training (e.g. analyzing surgical learning curves). Copyright © 2017 Elsevier Ltd. All rights reserved.

Analysis of Human Standing Balance by Largest Lyapunov Exponent

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Kun Liu

2015-01-01

Full Text Available The purpose of this research is to analyse the relationship between nonlinear dynamic character and individuals’ standing balance by the largest Lyapunov exponent, which is regarded as a metric for assessing standing balance. According to previous study, the largest Lyapunov exponent from centre of pressure time series could not well quantify the human balance ability. In this research, two improvements were made. Firstly, an external stimulus was applied to feet in the form of continuous horizontal sinusoidal motion by a moving platform. Secondly, a multiaccelerometer subsystem was adopted. Twenty healthy volunteers participated in this experiment. A new metric, coordinated largest Lyapunov exponent was proposed, which reflected the relationship of body segments by integrating multidimensional largest Lyapunov exponent values. By using this metric in actual standing performance under sinusoidal stimulus, an obvious relationship between the new metric and the actual balance ability was found in the majority of the subjects. These results show that the sinusoidal stimulus can make human balance characteristics more obvious, which is beneficial to assess balance, and balance is determined by the ability of coordinating all body segments.

Lifetime costs of cerebral palsy

DEFF Research Database (Denmark)

Kruse, Marie; Michelsen, Susan Ishøy; Flachs, Esben Meulengracht

2009-01-01

This study quantified the lifetime costs of cerebral palsy (CP) in a register-based setting. It was the first study outside the US to assess the lifetime costs of CP. The lifetime costs attributable to CP were divided into three categories: health care costs, productivity costs, and social costs....... social care costs and productivity costs associated with CP point to a potential gain from labour market interventions that benefit individuals with CP.......This study quantified the lifetime costs of cerebral palsy (CP) in a register-based setting. It was the first study outside the US to assess the lifetime costs of CP. The lifetime costs attributable to CP were divided into three categories: health care costs, productivity costs, and social costs...... in 2000. The prevalence of CP in eastern Denmark was approximately 1.7 per 1000. Information on productivity and the use of health care was retrieved from registers. The lifetime cost of CP was about euro860 000 for men and about euro800 000 for women. The largest component was social care costs...

Cheap versus expensive trades: Assessing the determinants of market impact costs

NARCIS (Netherlands)

Bikker, J.A.; Spierdijk, L.; van der Sluis, P.J.

2005-01-01

This paper assesses the determinants of market impact costs of institutional equity trades, using unique data from the world's second largest pension fund. We allow the impact of trade characteristics and market conditions on trading costs to depend on the level of trading costs itself and establish

Low-cost, portable, robust and high-resolution single-camera stereo-DIC system and its application in high-temperature deformation measurements

Science.gov (United States)

Chi, Yuxi; Yu, Liping; Pan, Bing

2018-05-01

A low-cost, portable, robust and high-resolution single-camera stereo-digital image correlation (stereo-DIC) system for accurate surface three-dimensional (3D) shape and deformation measurements is described. This system adopts a single consumer-grade high-resolution digital Single Lens Reflex (SLR) camera and a four-mirror adaptor, rather than two synchronized industrial digital cameras, for stereo image acquisition. In addition, monochromatic blue light illumination and coupled bandpass filter imaging are integrated to ensure the robustness of the system against ambient light variations. In contrast to conventional binocular stereo-DIC systems, the developed pseudo-stereo-DIC system offers the advantages of low cost, portability, robustness against ambient light variations, and high resolution. The accuracy and precision of the developed single SLR camera-based stereo-DIC system were validated by measuring the 3D shape of a stationary sphere along with in-plane and out-of-plane displacements of a translated planar plate. Application of the established system to thermal deformation measurement of an alumina ceramic plate and a stainless-steel plate subjected to radiation heating was also demonstrated.

Improving the thermal integrity of new single-family detached residential buildings: Documentation for a regional database of capital costs and space conditioning load savings

International Nuclear Information System (INIS)

Koomey, J.G.; McMahon, J.E.; Wodley, C.

1991-07-01

This report summarizes the costs and space-conditioning load savings from improving new single-family building shells. It relies on survey data from the National Association of Home-builders (NAHB) to assess current insulation practices for these new buildings, and NAHB cost data (aggregated to the Federal region level) to estimate the costs of improving new single-family buildings beyond current practice. Space-conditioning load savings are estimated using a database of loads for prototype buildings developed at Lawrence Berkeley Laboratory, adjusted to reflect population-weighted average weather in each of the ten federal regions and for the nation as a whole

Allocation base of general production costs as optimization of prime costs

Directory of Open Access Journals (Sweden)

Levytska I.O.

2017-03-01

Full Text Available Qualified management aimed at optimizing financial results is the key factor in today's society. Effective management decisions depend on the necessary information about the costs of production process in all its aspects – their structure, types, accounting policies of reflecting costs. General production costs, the so-called indirect costs that are not directly related to the production process, but provide its functioning in terms of supporting structural divisions and create the necessary conditions of production, play a significant role in calculating prime costs of goods (works, services. However, the accurate estimate of prime costs of goods (works, services should be determined with the value of indirect costs (in other words, general production costs, and properly determined with the base of their allocation. The choice of allocation base of general production costs is the significant moment, depending on the nature of business, which must guarantee fair distribution regarding to the largest share of direct expenses in the total structure of production costs. The study finds the essence of general production costs based on the analysis of key definitions of leading Ukrainian economists. The optimal allocation approach of general production costs is to calculate these costs as direct production costs within each subsidiary division (department separately without selecting a base as the main one to the their total amount.

Estimating the cost of epilepsy in Europe: a review with economic modeling.

Science.gov (United States)

Pugliatti, Maura; Beghi, Ettore; Forsgren, Lars; Ekman, Mattias; Sobocki, Patrik

2007-12-01

Based on available epidemiologic, health economic, and international population statistics literature, the cost of epilepsy in Europe was estimated. Europe was defined as the 25 European Union member countries, Iceland, Norway, and Switzerland. Guidelines for epidemiological studies on epilepsy were used for a case definition. A bottom-up prevalence-based cost-of-illness approach, the societal perspective for including the cost items, and the human capital approach as valuation principle for indirect costs were used. The cost estimates were based on selected studies with common methodology and valuation principles. The estimated prevalence of epilepsy in Europe in 2004 was 4.3-7.8 per 1,000. The estimated total cost of the disease in Europe was euro15.5 billion in 2004, indirect cost being the single most dominant cost category (euro8.6 billion). Direct health care costs were euro2.8 billion, outpatient care comprising the largest part (euro1.3 billion). Direct nonmedical cost was euro4.2 billion. That of antiepileptic drugs was euro400 million. The total cost per case was euro2,000-11,500 and the estimated cost per European inhabitant was euro33. Epilepsy is a relevant socioeconomic burden at individual, family, health services, and societal level in Europe. The greater proportion of such burden is outside the formal health care sector, antiepileptic drugs representing a smaller proportion. Lack of economic data from several European countries and other methodological limitations make this report an initial estimate of the cost of epilepsy in Europe. Prospective incidence cost-of-illness studies from well-defined populations and common methodology are encouraged.

Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.

Science.gov (United States)

Lalloo, Ratilal; Kroon, Jeroen; Tut, Ohnmar; Kularatna, Sanjeewa; Jamieson, Lisa M; Wallace, Valda; Boase, Robyn; Fernando, Surani; Cadet-James, Yvonne; Scuffham, Paul A; Johnson, Newell W

2015-08-29

The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.

broken magnet highlights largest collider's engineering challenges

CERN Multimedia

Inman, Mason

2007-01-01

"Even at the world's soon-to-be largest particle accelerator - a device that promises to push the boundaries of physics - scientists need to be mindful of one of the most fundamental laws in the universe: Murphy's Law. (2 pages)

Asset Management Costs and Financial Performance of Dutch Pension Funds in 2011-2014

NARCIS (Netherlands)

Hollanders, David

2016-01-01

The costs of Dutch pension funds have increased in the last decades. The costs, as a percentage of assets invested, doubled between 1992-2009. In 2014 total costs equalled 6.3 billion euro, or 19.6% of annual contributions. Asset management is the largest component of costs. Pension funds claim that

Cost-Effectiveness of Single- Versus Generic Multiple-Tablet Regimens for Treatment of HIV-1 Infection in the United States.

Directory of Open Access Journals (Sweden)

Donna E Sweet

Full Text Available The possibility of incorporating generics into combination antiretroviral therapy and breaking apart once-daily single-tablet regimens (STRs, may result in less efficacious medications and/or more complex regimens with the expectation of marked monetary savings. A modeling approach that assesses the merits of such policies in terms of lifelong costs and health outcomes using adherence and effectiveness data from real-world U.S. settings.A comprehensive computer-based microsimulation model was developed to assess the lifetime health (life expectancy and quality adjusted life-years--QALYs and economic outcomes in HIV-1 infected patients initiating STRs compared with multiple-table regimens including generic medications where possible (gMTRs. The STRs considered included tenofovir disoproxil fumarate/emtricitabine and efavirenz or rilpivirine or elvitegravir/cobicistat. gMTRs substitutions included each counterpart to STRs, including generic lamivudine for emtricitabine and generic versus branded efavirenz.Life expectancy is estimated to be 1.301 years higher (discounted 0.619 QALY gain in HIV-1 patients initiating a single-tablet regimen in comparison to a generic-based multiple-table regimen. STRs were associated with an average increment of $26,547.43 per patient in medication and $1,824.09 in other medical costs due to longer survival which were partially offset by higher inpatients costs ($12,035.61 with gMTRs treatment. Overall, STRs presented incremental lifetime costs of $16,335.91 compared with gMTRs, resulting in an incremental cost-effectiveness ratio of $26,383.82 per QALY gained.STRs continue to represent good value for money under contemporary cost-effectiveness thresholds despite substantial price reductions of generic medications in the U. S.

Cost-effective reduction of fine primary particulate matter emissions in Finland

International Nuclear Information System (INIS)

Karvosenoja, Niko; Klimont, Zbigniew; Tohka, Antti; Johansson, Matti

2007-01-01

Policies to reduce adverse health impacts of fine particulate matter (PM 2.5 ) require information on costs of abatement and associated costs. This paper explores the potential for cost-efficient control of anthropogenic primary PM 2.5 emissions in Finland. Based on a Kyoto-compliant energy projection, two emission control scenarios for 2020 were developed. 'Baseline' assumes implementation of PM controls in compliance with existing legislation. 'Reduction' assumes ambitious further reductions. Emissions for 2020 were estimated at 26 and 18.6 Gg a -1 for 'Baseline' and 'Reduction', respectively. The largest abatement potential, 3.0 Gg a -1 , was calculated for power plants and industrial combustion. The largest potential with marginal costs below 5000 Euro MG(PM 2.5 ) -1 was for domestic wood combustion, 1.7 Gg a -1 . For traffic the potential was estimated at 1.0 Gg a -1 , but was associated with high costs. The results from this paper are used in the policy-driven national integrated assessment modeling that explores cost-efficient reductions of the health impacts of PM

Are renewables portfolio standards cost-effective emission abatement policy?

Science.gov (United States)

Dobesova, Katerina; Apt, Jay; Lave, Lester B

2005-11-15

Renewables portfolio standards (RPS) could be an important policy instrument for 3P and 4P control. We examine the costs of renewable power, accounting for the federal production tax credit, the market value of a renewable credit, and the value of producing electricity without emissions of SO2, NOx, mercury, and CO2. We focus on Texas, which has a large RPS and is the largest U.S. electricity producer and one of the largest emitters of pollutants and CO2. We estimate the private and social costs of wind generation in an RPS compared with the current cost of fossil generation, accounting for the pollution and CO2 emissions. We find that society paid about 5.7 cent/kWh more for wind power, counting the additional generation, transmission, intermittency, and other costs. The higher cost includes credits amounting to 1.1 cent/kWh in reduced SO2, NOx, and Hg emissions. These pollution reductions and lower CO2 emissions could be attained at about the same cost using pulverized coal (PC) or natural gas combined cycle (NGCC) plants with carbon capture and sequestration (CCS); the reductions could be obtained more cheaply with an integrated coal gasification combined cycle (IGCC) plant with CCS.

Estimated cost of overactive bladder in Thailand.

Science.gov (United States)

Prasopsanti, Kriangsak; Santi-Ngamkun, Apirak; Pornprasit, Kanokwan

2007-11-01

To estimate the annual direct and indirect costs of overactive bladder (OAB) in indigenous Thai people aged 18 years and over in the year 2005. Economically based models using diagnostic and treatment algorithms from clinical practice guidelines and current disease prevalence data were used to estimate direct and indirect costs of OAB. Prevalence and event probability estimates were obtained from the literature, national data sets, and expert opinion. Costs were estimated from a small survey using a cost questionnaire and from unit costs of King Chulalongkorn Memorial Hospital. The annual cost of OAB in Thailand is estimated as 1.9 billion USD. It is estimated to consume 1.14% of national GDP The cost includes 0.33 billion USD for direct medical costs, 1.3 billion USD for direct, nonmedical costs and 0.29 billion USD for indirect costs of lost productivity. The largest costs category was direct treatment costs of comorbidities associated with OAB. Costs of OAB medication accountedfor 14% of the total costs ofOAB.

The axiom about the market (cadastral cost of the reproducible factors of a single propert

Directory of Open Access Journals (Sweden)

A. D. Vlasov

2017-01-01

Full Text Available The purpose of the study. To prove the methodological error of the calculation of the market (cadastral value of capital construction objects, as a result of a violation of the Federal law of the Russian Federation of 29.07.1998 No. 135-FZ “On valuation activities in the Russian Federation”, article 3, in determining the market value of the property. To show that the theory and practice of measuring the value of real estate is necessary to delimit the elements of the market value formation of reproducible and not reproducible factors single property. Materials and methods. The objectives of the article are: the rules of law in assessment activities; the results of the cadastral valuation of real estate in settlements of Russia; comparative analysis of the factors determining the market (cadastral value of real estate. Results. Formulated the axiom about the market (cadastral cost of the reproducible factors of a single property. It is shown that in the theory and practice of measurement in market (cadastral value of real estate of Russia violated article 3 of the law 135-FZ of 29.07.1998. As a consequence, the market (cadastral cost of the capital construction objects 2-5 times overestimated, and the market (cadastral value of land in the 2-15 times underestimated. This is the basis of corruption, challenging the results of cadastral assessment of problems of formation of budgets of all levels, reduction in the rate of economic development of Russia. According to our results of the cadastral assessment of land plots of various categories of land in the regions of Russia there is a technology of determining the economic norms of rational use of real estate. Conclusion. Regardless of technology assessment of the property market value of reproducible improvements of the land may not exceed their replacement cost. 

The lifetime cost of a magnetic refrigerator

DEFF Research Database (Denmark)

Bjørk, Rasmus; Bahl, Christian R.H.; Nielsen, Kaspar Kirstein

2016-01-01

The total cost of a 25 W average load magnetic refrigerator using commercial grade Gd is calculated using a numerical model. The price of magnetocaloric material, magnet material and cost of operation are considered, and all influence the total cost. The lowest combined total cost with a device...... lifetime of 15 years is found to be in the range $150-$400 depending on the price of the magnetocaloric and magnet material. The cost of the magnet is largest, followed closely by the cost of operation, while the cost of the magnetocaloric material is almost negligible. For the lowest cost device...... characteristics are based on the performance of a conventional A+++ refrigeration unit. In a rough life time cost comparison between the AMR device and such a unit we find similar costs, the AMR being slightly cheaper, assuming the cost of the magnet can be recuperated at end of life....

Joint Asymptotic Distributions of Smallest and Largest Insurance Claims

Directory of Open Access Journals (Sweden)

Hansjörg Albrecher

2014-07-01

Full Text Available Assume that claims in a portfolio of insurance contracts are described by independent and identically distributed random variables with regularly varying tails and occur according to a near mixed Poisson process. We provide a collection of results pertaining to the joint asymptotic Laplace transforms of the normalised sums of the smallest and largest claims, when the length of the considered time interval tends to infinity. The results crucially depend on the value of the tail index of the claim distribution, as well as on the number of largest claims under consideration.

Activity-based costing evaluation of a [(18)F]-fludeoxyglucose positron emission tomography study.

Science.gov (United States)

Krug, Bruno; Van Zanten, Annie; Pirson, Anne-Sophie; Crott, Ralph; Borght, Thierry Vander

2009-10-01

The aim of the study is to use the activity-based costing approach to give a better insight in the actual cost structure of a positron emission tomography procedure (FDG-PET) by defining the constituting components and by simulating the impact of possible resource or practice changes. The cost data were obtained from the hospital administration, personnel and vendor interviews as well as from structured questionnaires. A process map separates the process in 16 patient- and non-patient-related activities, to which the detailed cost data are related. One-way sensitivity analyses shows to which degree of uncertainty the different parameters affect the individual cost and evaluate the impact of possible resource or practice changes like the acquisition of a hybrid PET/CT device, the patient throughput or the sales price of a 370MBq (18)F-FDG patient dose. The PET centre spends 73% of time in clinical activities and the resting time after injection of the tracer (42%) is the single largest departmental cost element. The tracer cost and the operational time have the most influence on cost per procedure. The analysis shows a total cost per FDG-PET ranging from 859 Euro for a BGO PET camera to 1142 Euro for a 16 slices PET-CT system, with a distribution of the resource costs in decreasing order: materials (44%), equipment (24%), wage (16%), space (6%) and hospital overhead (10%). The cost of FDG-PET is mainly influenced by the cost of the radiopharmaceutical. Therefore, the latter rather than the operational time should be reduced in order to improve its cost-effectiveness.

Advanced steam power plant concepts with optimized life-cycle costs: A new approach for maximum customer benefit

Energy Technology Data Exchange (ETDEWEB)

Seiter, C.

1998-07-01

The use of coal power generation applications is currently enjoying a renaissance. New highly efficient and cost-effective plant concepts together with environmental protection technologies are the main factors in this development. In addition, coal is available on the world market at attractive prices and in many places it is more readily available than gas. At the economical leading edge, standard power plant concepts have been developed to meet the requirements of emerging power markets. These concepts incorporate the high technological state-of-the-art and are designed to achieve lowest life-cycle costs. Low capital cost, fuel costs and operating costs in combination with shortest lead times are the main assets that make these plants attractive especially for IPPs and Developers. Other aspects of these comprehensive concepts include turnkey construction and the willingness to participate in BOO/BOT projects. One of the various examples of such a concept, the 2 x 610-MW Paiton Private Power Project Phase II in Indonesia, is described in this paper. At the technological leading edge, Siemens has always made a major contribution and was pacemaker for new developments in steam power plant technology. Modern coal-fired steam power plants use computer-optimized process and plant design as well as advanced materials, and achieve efficiencies exceeding 45%. One excellent example of this high technology is the world's largest lignite-fired steam power plant Schwarze Pumpe in Germany, which is equipped with two 800 MW Siemens steam turbine generators with supercritical steam parameters. The world's largest 50-Hz single-shaft turbine generator with supercritical steam parameters rated at 1025 MW for the Niederaussem lignite-fired steam power plant in Germany is a further example of the sophisticated Siemens steam turbine technology and sets a new benchmark in this field.

Preventing Obesity in the USA: Impact on Health Service Utilization and Costs.

Science.gov (United States)

Cecchini, Michele; Sassi, Franco

2015-07-01

With more than two-thirds of the US population overweight or obese, the obesity epidemic is a major threat for population health and the financial sustainability of the healthcare service. Whether, and to what extent, effective prevention interventions may offer the opportunity to 'bend the curve' of rising healthcare costs is still an object of debate. This study evaluates the potential economic impact of a set of prevention programmes, including education, counselling, long-term drug treatment, regulation (e.g. of advertising or labelling) and fiscal measures, on national healthcare expenditure and use of healthcare services in the USA. The study was carried out as a retrospective evaluation of alternative scenarios compared with a 'business as usual' scenario. An advanced econometric approach involving the use of logistic regression and generalized linear models was used to calculate the number of contacts with key healthcare services (inpatient, outpatient, drug prescriptions) and the associated cost. Analyses were carried out on the Medical Expenditure Panel Survey (1997-2010). In 2010, prevention interventions had the potential to decrease total healthcare expenditure by up to $US2 billion. This estimate does not include the implementation costs. The largest share of savings is produced by reduced use and costs of inpatient care, followed by reduced use of drugs. Reduction in expenditure for outpatient care would be more limited. Private insurance schemes benefit from the largest savings in absolute terms; however, public insurance schemes benefit from the largest cost reduction per patient. People in the lowest income groups show the largest economic benefits. Prevention interventions aimed at tackling obesity and associated risk factors may produce a significant decrease in the use of healthcare services and expenditure. Savings become substantial when a long-term perspective is taken.

A Model of Batch Scheduling for a Single Batch Processor with Additional Setups to Minimize Total Inventory Holding Cost of Parts of a Single Item Requested at Multi-due-date

Science.gov (United States)

Hakim Halim, Abdul; Ernawati; Hidayat, Nita P. A.

2018-03-01

This paper deals with a model of batch scheduling for a single batch processor on which a number of parts of a single items are to be processed. The process needs two kinds of setups, i. e., main setups required before processing any batches, and additional setups required repeatedly after the batch processor completes a certain number of batches. The parts to be processed arrive at the shop floor at the times coinciding with their respective starting times of processing, and the completed parts are to be delivered at multiple due dates. The objective adopted for the model is that of minimizing total inventory holding cost consisting of holding cost per unit time for a part in completed batches, and that in in-process batches. The formulation of total inventory holding cost is derived from the so-called actual flow time defined as the interval between arrival times of parts at the production line and delivery times of the completed parts. The actual flow time satisfies not only minimum inventory but also arrival and delivery just in times. An algorithm to solve the model is proposed and a numerical example is shown.

Long term costs and effects of reducing the number of twin pregnancies in IVF by single embryo transfer: the TwinSing study.

Science.gov (United States)

van Heesch, Mirjam M J; Bonsel, Gouke J; Dumoulin, John C M; Evers, Johannes L H; van der Hoeven, Mark Ahbm; Severens, Johan L; Dykgraaf, Ramon H M; van der Veen, Fulco; Tonch, Nino; Nelen, Willianne L D M; van Zonneveld, Piet; van Goudoever, Johannes B; Tamminga, Pieter; Steiner, Katerina; Koopman-Esseboom, Corine; van Beijsterveldt, Catharina E M; Boomsma, Dorret I; Snellen, Diana; Dirksen, Carmen D

2010-10-20

Pregnancies induced by in vitro fertilisation (IVF) often result in twin gestations, which are associated with both maternal and perinatal complications. An effective way to reduce the number of IVF twin pregnancies is to decrease the number of embryos transferred from two to one. The interpretation of current studies is limited because they used live birth as outcome measure and because they applied limited time horizons. So far, research on long-term outcomes of IVF twins and singletons is scarce and inconclusive. The objective of this study is to investigate the short (1-year) and long-term (5 and 18-year) costs and health outcomes of IVF singleton and twin children and to consider these in estimating the cost-effectiveness of single embryo transfer compared with double embryo transfer, from a societal and a healthcare perspective. A multi-centre cohort study will be performed, in which IVF singletons and IVF twin children born between 2003 and 2005 of whom parents received IVF treatment in one of the five participating Dutch IVF centres, will be compared. Data collection will focus on children at risk of health problems and children in whom health problems actually occurred. First year of life data will be collected in approximately 1,278 children (619 singletons and 659 twin children). Data up to the fifth year of life will be collected in approximately 488 children (200 singletons and 288 twin children). Outcome measures are health status, health-related quality of life and costs. Data will be obtained from hospital information systems, a parent questionnaire and existing registries. Furthermore, a prognostic model will be developed that reflects the short and long-term costs and health outcomes of IVF singleton and twin children. This model will be linked to a Markov model of the short-term cost-effectiveness of single embryo transfer strategies versus double embryo transfer strategies to enable the calculation of the long-term cost-effectiveness. This is

Long term costs and effects of reducing the number of twin pregnancies in IVF by single embryo transfer: the TwinSing study

Directory of Open Access Journals (Sweden)

van Goudoever Johannes B

2010-10-01

Full Text Available Abstract Background Pregnancies induced by in vitro fertilisation (IVF often result in twin gestations, which are associated with both maternal and perinatal complications. An effective way to reduce the number of IVF twin pregnancies is to decrease the number of embryos transferred from two to one. The interpretation of current studies is limited because they used live birth as outcome measure and because they applied limited time horizons. So far, research on long-term outcomes of IVF twins and singletons is scarce and inconclusive. The objective of this study is to investigate the short (1-year and long-term (5 and 18-year costs and health outcomes of IVF singleton and twin children and to consider these in estimating the cost-effectiveness of single embryo transfer compared with double embryo transfer, from a societal and a healthcare perspective. Methods/Design A multi-centre cohort study will be performed, in which IVF singletons and IVF twin children born between 2003 and 2005 of whom parents received IVF treatment in one of the five participating Dutch IVF centres, will be compared. Data collection will focus on children at risk of health problems and children in whom health problems actually occurred. First year of life data will be collected in approximately 1,278 children (619 singletons and 659 twin children. Data up to the fifth year of life will be collected in approximately 488 children (200 singletons and 288 twin children. Outcome measures are health status, health-related quality of life and costs. Data will be obtained from hospital information systems, a parent questionnaire and existing registries. Furthermore, a prognostic model will be developed that reflects the short and long-term costs and health outcomes of IVF singleton and twin children. This model will be linked to a Markov model of the short-term cost-effectiveness of single embryo transfer strategies versus double embryo transfer strategies to enable the

Guaranteeing uptime at worl's largest particle physics lab

CERN Multimedia

Brodkin, Jon

2007-01-01

"As the European agency CERN was gearing up to build the world's largest particle accelerator, officials there knew they could not afford to have problems in their technical infrastructure cause any downtime." (1 page)

On the Optimal Policy for the Single-product Inventory Problem with Set-up Cost and a Restricted Production Capacity

NARCIS (Netherlands)

Foreest, N. D. van; Wijngaard, J.

2010-01-01

The single-product, stationary inventory problem with set-up cost is one of the classical problems in stochastic operations research. Theories have been developed to cope with finite production capacity in periodic review systems, and it has been proved that optimal policies for these cases are not

A precise goniometer/tensiometer using a low cost single-board computer

Science.gov (United States)

Favier, Benoit; Chamakos, Nikolaos T.; Papathanasiou, Athanasios G.

2017-12-01

Measuring the surface tension and the Young contact angle of a droplet is extremely important for many industrial applications. Here, considering the booming interest for small and cheap but precise experimental instruments, we have constructed a low-cost contact angle goniometer/tensiometer, based on a single-board computer (Raspberry Pi). The device runs an axisymmetric drop shape analysis (ADSA) algorithm written in Python. The code, here named DropToolKit, was developed in-house. We initially present the mathematical framework of our algorithm and then we validate our software tool against other well-established ADSA packages, including the commercial ramé-hart DROPimage Advanced as well as the DropAnalysis plugin in ImageJ. After successfully testing for various combinations of liquids and solid surfaces, we concluded that our prototype device would be highly beneficial for industrial applications as well as for scientific research in wetting phenomena compared to the commercial solutions.

Underestimating Costs in Public Works Projects

DEFF Research Database (Denmark)

Flyvbjerg, Bent; Holm, Mette K. Skamris; Buhl, Søren L.

2002-01-01

This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth $90 billion (U.S.), it is found with overwhelming statistical significance that the cost...... honest numbers should not trust the cost estimates and cost-benefit analyses produced by project promoters and their analysts. Independent estimates and analyses are needed as are institutional checks and balances to curb deception.......This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth $90 billion (U.S.), it is found with overwhelming statistical significance that the cost...... estimates used to decide whether important infrastructure should be built are highly and systematically misleading. The result is continuous cost escalation of billions of dollars. The sample used in the study is the largest of its kind, allowing for the first time statistically valid conclusions regarding...

Cost Underestimation in Public Works Projects

DEFF Research Database (Denmark)

Flyvbjerg, Bent; Holm, Mette K. Skamris; Buhl, Søren L.

This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth $90 billion (U.S.), it is found with overwhelming statistical significance that the cost...... honest numbers should not trust the cost estimates and cost-benefit analyses produced by project promoters and their analysts. Independent estimates and analyses are needed as are institutional checks and balances to curb deception.......This article presents results from the first statistically significant study of cost escalation in transportation infrastructure projects. Based on a sample of 258 transportation infrastructure projects worth $90 billion (U.S.), it is found with overwhelming statistical significance that the cost...... estimates used to decide whether important infrastructure should be built are highly and systematically misleading. The result is continuous cost escalation of billions of dollars. The sample used in the study is the largest of its kind, allowing for the first time statistically valid conclusions regarding...

The world's largest LNG producer's next market

International Nuclear Information System (INIS)

Fuller, R.; Isworo Suharno; Simandjuntak, W.M.P.

1996-01-01

The development of the domestic gas market in Indonesia, the world's largest liquefied natural gas producing country, is described as part of the overall impact of the country's oil and gas production. The first large scale use of natural gas in Indonesia was established in 1968 when a fertiliser plant using gas as the feedstock was built. Ultimately, through increased yields, this has enabled Indonesia to be self-sufficient in rice and an exporter of fertiliser. Problems which stand in the way of further developments include: capital, though Pertamina and PGN are perceived as attractive for foreign investment; the lack of a regulatory framework for gas; geographical constraints, among them the fact that the gas deposits are remote from the largest population concentrations; lack of infrastructure. There are nevertheless plans for expansion and the provision of an integrated gas pipeline system. Pertamina, which has responsibility for all oil and gas developments, and PGN, whose primary role has been as a manufacturer and distributor of gas, are now working together in the coordination of all gas activities. (10 figures). (UK)

Methanex cuts its methanol costs with Fletcher purchase

International Nuclear Information System (INIS)

Plishner, E.S.

1993-01-01

Methanex (Vancouver, BC) will 'significantly reduce' its unit cost of methanol production with the acquisition of all of Fletcher Challenge's (Auckland, NZ) methanol assets. These include the 800,000-m.t./year Cape Horn plant in Chile, one of the world's largest single train facilities. That plant is 'by far' the lowest-cost supplier of delivered methanol to the U.S., says analyst Sam Kanes of Scotia McLeod (Toronto), with gas costs below $1/1,000 cu.ft. Also included in the deal are two New Zealand plants: Petralgas, with capacity for 520,000 m.t./year, and Synfuel. Synfuel has the capacity to produce the equivalent of 1.8 million m.t./year of chemical-grade methanol, or 70,000 m.t./year of gasoline, or a combination. Currently rated at 450,000 m.t./year of methanol, that could double in 1994 with the addition of distillation capacity. After the transaction, Methanex will have a total of 2.4 million m.t./year of methanol capacity, plus marketing agreements for 1.0 million m.t./year. The company has plans to add 1.2 million m.t. of production (in Trinidad and the U.S.) and 0.6 million m.t. of further marketing arrangements over the next year and a half, bringing the total to over 5.0 million m.t./year. Methanex could have 'about twice as much capacity as the Saudis,' according to one consultant

Low cost solar air heater

International Nuclear Information System (INIS)

Gill, R.S.; Singh, Sukhmeet; Singh, Parm Pal

2012-01-01

Highlights: ► Single glazed low cost solar air heater is more efficient during summer while double glazed is better in winter. ► For the same initial investment, low cost solar air heaters collect more energy than packed bed solar air heater. ► During off season low cost solar air heater can be stored inside as it is light in weight. - Abstract: Two low cost solar air heaters viz. single glazed and double glazed were designed, fabricated and tested. Thermocole, ultraviolet stabilised plastic sheet, etc. were used for fabrication to reduce the fabrication cost. These were tested simultaneously at no load and with load both in summer and winter seasons along with packed bed solar air heater using iron chips for absorption of radiation. The initial costs of single glazed and double glazed are 22.8% and 26.8% of the initial cost of packed bed solar air heater of the same aperture area. It was found that on a given day at no load, the maximum stagnation temperatures of single glazed and double glazed solar air heater were 43.5 °C and 62.5 °C respectively. The efficiencies of single glazed, double glazed and packed bed solar air heaters corresponding to flow rate of 0.02 m 3 /s-m 2 were 30.29%, 45.05% and 71.68% respectively in winter season. The collector efficiency factor, heat removal factor based on air outlet temperature and air inlet temperature for three solar air heaters were also determined.

Worlds Largest Wave Energy Project 2007 in Wales

DEFF Research Database (Denmark)

Christensen, Lars; Friis-Madsen, Erik; Kofoed, Jens Peter

2006-01-01

This paper introduces world largest wave energy project being developed in Wales and based on one of the leading wave energy technologies. The background for the development of wave energy, the total resource ands its distribution around the world is described. In contrast to wind energy turbines...... Dragon has to be scaled in accordance with the wave climate at the deployment site, which makes the Welch demonstrator device the worlds largest WEC so far with a total width of 300 meters. The project budget, the construction methods and the deployment site are also given....... a large number of fundamentally different technologies are utilised to harvest wave energy. The Wave Dragon belongs to the wave overtopping class of converters and the paper describes the fundamentals and the technical solutions used in this wave energy converter. An offshore floating WEC like the Wave...

Some regional costs of a synthetic fuel industry: The case of illinois

Science.gov (United States)

Attanasi, E.D.; Green, E.K.

1981-01-01

The Federal Government's efforts to induce development of a coal-based synthetic fuel industry include direct subsidies, tax concessions, and assurances that it will purchase the industry's output, even if above the market price. In this note it is argued that these subsidies will enable this industry to secure a region's largest and lowest-cost coal deposits and that the costs imposed on other coal users will be substantial. Moreover, because the lowest-cost coal deposits will be committed to synthetic fuels production regardless of the industry's commercial viability, distortions in regional coal markets will develop. If economic efficiency requires that the price of the resource reflect its replacement value, then a State government is justified in imposing a tax on coal destined for subsidized synthetic fuel plants. Amounts of such a tax, based on the higher costs of coal that must be accepted by other users as the result of the subsidized synthetic fuel plants' preempting the largest and lowest-cost deposits, are estimated for the case of Illinois strippable coal. ?? 1981 Annals of Regional Science.

First Experience from the World Largest fully commercial Solar Heating Plant

DEFF Research Database (Denmark)

Heller, Alfred; Furbo, Simon

1997-01-01

The first experience from the largest solar heating plant in the world is given. The plant is situated in Marstal and is has a total area of 8000 square m.......The first experience from the largest solar heating plant in the world is given. The plant is situated in Marstal and is has a total area of 8000 square m....

Understanding the reductions in US corn ethanol production costs: an experience curve approach

NARCIS (Netherlands)

Hettinga, W.; Junginger, H.M.; Dekker, S.C.; Hoogwijk, M.; McAloon, A.; Hicks, K.

2009-01-01

The US is currently the world's largest ethanol producer. An increasing percentage is used as transportation fuel, but debates continue on its costs competitiveness and energy balance. In this study, technological development of ethanol production and resulting cost reductions are investigated by

Optimized Cost per Click in Taobao Display Advertising

OpenAIRE

Zhu, Han; Jin, Junqi; Tan, Chang; Pan, Fei; Zeng, Yifan; Li, Han; Gai, Kun

2017-01-01

Taobao, as the largest online retail platform in the world, provides billions of online display advertising impressions for millions of advertisers every day. For commercial purposes, the advertisers bid for specific spots and target crowds to compete for business traffic. The platform chooses the most suitable ads to display in tens of milliseconds. Common pricing methods include cost per mille (CPM) and cost per click (CPC). Traditional advertising systems target certain traits of users and...

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

International Nuclear Information System (INIS)

Meng, Fang; Koschan, Merry; Melcher, Charles L.; Cohen, Peter

2015-01-01

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 3 Ga 3 Al 2 O 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

Fifteen Years of Operation at NASA's National Transonic Facility with the World's Largest Adjustable Speed Drive

Science.gov (United States)

Sydnor, George H.; Bhatia, Ram; Krattiger, Hansueli; Mylius, Justus; Schafer, D.

2012-01-01

In September 1995, a project was initiated to replace the existing drive line at NASA's most unique transonic wind tunnel, the National Transonic Facility (NTF), with a single 101 MW synchronous motor driven by a Load Commutated Inverter (LCI). This Adjustable Speed Drive (ASD) system also included a custom four-winding transformer, harmonic filter, exciter, switch gear, control system, and feeder cable. The complete system requirements and design details have previously been presented and published [1], as well as the commissioning and acceptance test results [2]. The NTF was returned to service in December 1997 with the new drive system powering the fan. Today, this installation still represents the world s largest horizontal single motor/drive combination. This paper describes some significant events that occurred with the drive system during the first 15 years of service. These noteworthy issues are analyzed and root causes presented. Improvements that have substantially increased the long term viability of the system are given.

Challenges with the largest commercial hydrogen station in the world

Energy Technology Data Exchange (ETDEWEB)

Charbonneau, Thomas; Gauthier, Pierre [Air Liquide Canada (Canada)

2010-07-01

This abstract's objective is to share with the participants the story of the largest hydrogen fueling station made to this date and to kick-start the story, we will cover the challenges; first the technical ones; the operational ones; the distribution ones and; the financial ones. We will then move on to review the logistic (geographic) issues raised by the project and conclude our presentation by sharing the output values of the largest fueling station built so far in the world. (orig.)

Time and travel costs incurred by women attending antenatal tests: A costing study.

Science.gov (United States)

Verhoef, Talitha I; Daley, Rebecca; Vallejo-Torres, Laura; Chitty, Lyn S; Morris, Stephen

2016-09-01

to estimate the costs to women, their friends and family for different antenatal tests in the Down's syndrome (DS) screening pathway. questionnaire-based costing study. eight maternity clinics across the UK. pregnant women (n=574) attending an appointment for DS screening, NIPT or invasive testing between December 2013 and September 2014. using data collected from the questionnaires we calculated the total costs to women by multiplying the time spent at the hospital and travelling to and from it by the opportunity costs of the women and accompanying person and adding travel and childcare costs. Assumptions about the value of opportunity costs were tested in one-way sensitivity analyses. The main outcome measure was the mean cost to the women and friends/family for each test (DS screening, NIPT, and invasive testing). mean costs to women and their family/friend were £33.96 per visit, of which £22.47 were time costs, £9.15 were travel costs and £2.34 were childcare costs. Costs were lowest for NIPT (£22), £32 for DS screening (£44 if combined with NIPT), and highest for invasive testing (£60). Sensitivity analysis revealed that variations around the value of leisure time opportunity costs had the largest influence on the results. there are considerable costs to women, their friends and family when attending different tests in the DS screening pathway. when assessing the cost-effectiveness of changes to this pathway, costs to women should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cost analysis of roll-to-roll fabricated ITO free single and tandem organic solar modules based on data from manufacture

DEFF Research Database (Denmark)

Machui, Florian; Hösel, Markus; Li, Ning

2014-01-01

We present a cost analysis based on state of the art printing and coating processes to fully encapsulated, flexible ITO- and vacuum-free polymer solar cell modules. Manufacturing data for both single junctions and tandem junctions are presented and analyzed. Within this calculation the most...

High cost of nuclear power plants

International Nuclear Information System (INIS)

Bassett, C.

1978-01-01

Retroactive safety standards were found to account for over half the costs of a nuclear power plant and point up the need for an effective cost-benefit analysis of changes made by the Nuclear Regulatory Commission after construction has started. The author compared the Davis-Besse Unit No. 1 construction-cost estimates with the final-cost increases during a rate-case investigation in Ohio. He presents data furnished for ten of the largest construction contracts to illustrate the cost increases involving fixed hardware and intensive labor. The situation was found to repeat with other utilities across the country even though safeguards against irresponsible low bidding were introduced. Low bidding was found to continue, encouraged by the need for retrofitting to meet regulation changes. The average cost per kilowatt of major light-water reactors is shown to have increased from $171 in 1970 to $555 in 1977, while construction duration increased from 43.4 to 95.6 months during the same period

Utilisation patterns and cost of hospital care for people living with HIV in Ireland in 2012: a single-centre study.

Science.gov (United States)

Brennan, Aline; Horgan, Mary; Jackson, Arthur; Browne, John P; Bergin, Colm J

2017-03-01

Data on the pattern and cost of health service use by HIV patients are required for evaluations of the cost-effectiveness of new drugs and technologies as well as being essential for service planning. The aim of this study was to identify the utilisation patterns and cost of hospital care for HIV patients in a single centre in Ireland in 2012. Data on the frequency and non-drug costs of all hospital resources used by HIV patients were extracted from a hospital activity-based costing system. Cost data were analysed using a generalised linear model. A total of 328 patients, 3672 patient months, were included in this study. Patients had a mean of 4.4 scheduled infectious disease outpatient appointments per patient year; 37% of patients also used another outpatient service, 15% in-patient services, 4% day-case service and 18% emergency department services in 2012. Patients with very advanced HIV disease continue to incur a disproportionate amount of the total cost of providing care. This study provides baseline utilisation and cost data for use of both infectious-disease and non-infectious disease hospital services and will be useful for service planning in light of the likely increases in resource demands.

Valuing productivity costs in a changing macroeconomic environment: the estimation of colorectal cancer productivity costs using the friction cost approach.

Science.gov (United States)

Hanly, Paul; Koopmanschap, Marc; Sharp, Linda

2016-06-01

The friction cost approach (FCA) has been proposed as an alternative to the human capital approach for productivity cost valuation. However, FCA estimates are context dependent and influenced by extant macroeconomic conditions. We applied the FCA to estimate colorectal cancer labor productivity costs and assessed the impact of a changing macroeconomic environment on these estimates. Data from colorectal cancer survivors (n = 159) derived from a postal survey undertaken in Ireland March 2010 to January 2011 were combined with national wage data, population-level survival data, and occupation-specific friction periods to calculate temporary and permanent disability, and premature mortality costs using the FCA. The effects of changing labor market conditions between 2006 and 2013 on the friction period were modeled in scenario analyses. Costs were valued in 2008 euros. In the base-case, the total FCA per-person productivity cost for incident colorectal cancer patients of working age at diagnosis was €8543. In scenario 1 (a 2.2 % increase in unemployment), the fall in the friction period caused total productivity costs to decrease by up to 18 % compared to base-case estimates. In scenario 2 (a 9.2 % increase in unemployment), the largest decrease in productivity cost was up to 65 %. Adjusting for the vacancy rate reduced the effect of unemployment on the cost results. The friction period used in calculating labor productivity costs greatly affects the derived estimates; this friction period requires reassessment following changes in labor market conditions. The influence of changes in macroeconomic conditions on FCA-derived cost estimates may be substantial.

Innovative High-Performance Deposition Technology for Low-Cost Manufacturing of OLED Lighting

Energy Technology Data Exchange (ETDEWEB)

Scott, David; Hamer, John

2017-06-30

In this project, OLEDWorks developed and demonstrated the innovative high-performance deposition technology required to deliver dramatic reductions in the cost of manufacturing OLED lighting in production equipment. The current high manufacturing cost of OLED lighting is the most urgent barrier to its market acceptance. The new deposition technology delivers solutions to the two largest parts of the manufacturing cost problem – the expense per area of good product for organic materials and for the capital cost and depreciation of the equipment. Organic materials cost is the largest expense item in the bill of materials and is predicted to remain so through 2020. The high-performance deposition technology developed in this project, also known as the next generation source (NGS), increases material usage efficiency from 25% found in current Gen2 deposition technology to 60%. This improvement alone results in a reduction of approximately $25/m2 of good product in organic materials costs, independent of production volumes. Additionally, this innovative deposition technology reduces the total depreciation cost from the estimated value of approximately $780/m2 of good product for state-of-the-art G2 lines (at capacity, 5-year straight line depreciation) to $170/m2 of good product from the OLEDWorks production line.

Training effectiveness vs. cost effectiveness: The next millennium challenge

International Nuclear Information System (INIS)

Coe, Richard P.

2003-01-01

With the advent of the new millennium and energy deregulation, organizations will be challenged to be cost competitive and profitable. Deregulation in the US energy industry will force utilities and, more specifically, commercial nuclear power production to unprecedented cost control measures. It will also renew the fires of debate about costs vs. safety. With personnel costs being the single largest expenditure for most organizations management will be faced with constant dilemmas of competition for scarce resources. Salaries, benefits and training costs will be under greater scrutiny. Training resources and programs will face increased pressure to be job related, based on conservative requirements and more cost effective than in the past. For nearly two decades the US National Academy for Nuclear Training (NANT) has developed and used industry-wide accreditation and evaluation standards based on the Systematic Approach to Training (SAT). This process assures that existing and emerging technical training is constantly reviewed and evaluated against standardized criteria to assure job relatedness and enhanced job performance. The process also requires management to approve, actively participate in and support the training of NPP personnel. Instructors must be highly skilled and well trained in the SAT process and various instructional strategies. The SAT process is grounded in five interlocking keystone steps; Analysis - Design - Development - Implementation - Evaluation (ADDIE). Evaluation of training is often said to be the most crucial and most difficult step. Here is where an organization determines if the training is effective and meeting the legitimate needs of all of the stakeholders. This QA/QC aspect of training must be an ongoing process involving management, instructors and the students. It is only through the discipline of an SAT based evaluation process that an organization can truly determine if the training is efficient, effective, cost effective and

Toward sustainable harvesting of Africa's largest medicinal plant ...

African Journals Online (AJOL)

Global demand for treating prostate disorders with Prunus africana bark extract has made P. africana Africa's largest medicinal plant export. Unsustainable harvesting practices can lead to local extirpations of this multipurpose tree. Survey research targeting P. africana harvesters in a Tanzania forest reserve revealed that ...

Attitude Determination Method by Fusing Single Antenna GPS and Low Cost MEMS Sensors Using Intelligent Kalman Filter Algorithm

Directory of Open Access Journals (Sweden)

Lei Wang

2017-01-01

Full Text Available For meeting the demands of cost and size for micronavigation system, a combined attitude determination approach with sensor fusion algorithm and intelligent Kalman filter (IKF on low cost Micro-Electro-Mechanical System (MEMS gyroscope, accelerometer, and magnetometer and single antenna Global Positioning System (GPS is proposed. The effective calibration method is performed to compensate the effect of errors in low cost MEMS Inertial Measurement Unit (IMU. The different control strategies fusing the MEMS multisensors are designed. The yaw angle fusing gyroscope, accelerometer, and magnetometer algorithm is estimated accurately under GPS failure and unavailable sideslip situations. For resolving robust control and characters of the uncertain noise statistics influence, the high gain scale of IKF is adjusted by fuzzy controller in the transition process and steady state to achieve faster convergence and accurate estimation. The experiments comparing different MEMS sensors and fusion algorithms are implemented to verify the validity of the proposed approach.

Incidence and costs of achalasia in The Netherlands

NARCIS (Netherlands)

van Hoeij, F. B.; Ponds, F. A.; Smout, A. J.; Bredenoord, A. J.

2018-01-01

Recent reports show increasing incidence of achalasia in some populations. The aim of this study was to estimate incidence, prevalence, and healthcare costs of achalasia in a large cohort in The Netherlands. Data were obtained from the largest Dutch healthcare insurance company (±4.4 million

Incidence and Costs of Clostridium difficile Infections in Canada

Science.gov (United States)

Levy, Adrian R.; Szabo, Shelagh M.; Lozano-Ortega, Greta; Lloyd-Smith, Elisa; Leung, Victor; Lawrence, Robin; Romney, Marc G.

2015-01-01

Background. Limited data are available on direct medical costs and lost productivity due to Clostridium difficile infection (CDI) in Canada. Methods. We developed an economic model to estimate the costs of managing hospitalized and community-dwelling patients with CDI in Canada. The number of episodes was projected based on publicly available national rates of hospital-associated CDI and the estimate that 64% of all CDI is hospital-associated. Clostridium difficile infection recurrences were classified as relapses or reinfections. Resource utilization data came from published literature, clinician interviews, and Canadian CDI surveillance programs, and this included the following: hospital length of stay, contact with healthcare providers, pharmacotherapy, laboratory testing, and in-hospital procedures. Lost productivity was considered for those under 65 years of age, and the economic impact was quantified using publicly available labor statistics. Unit costs were obtained from published sources and presented in 2012 Canadian dollars. Results. There were an estimated 37 900 CDI episodes in Canada in 2012; 7980 (21%) of these were relapses, out of a total of 10 900 (27%) episodes of recurrence. The total cost to society of CDI was estimated at $281 million; 92% ($260 million) was in-hospital costs, 4% ($12 million) was direct medical costs in the community, and 4% ($10 million) was due to lost productivity. Management of CDI relapses alone accounted for $65.1 million (23%). Conclusions. The largest proportion of costs due to CDI in Canada arise from extra days of hospitalization. Interventions reducing the severity of infection and/or relapses leading to rehospitalizations are likely to have the largest absolute effect on direct medical costs. PMID:26191534

Cost estimates for near-term depolyment of advanced traffic management systems. Final report

Energy Technology Data Exchange (ETDEWEB)

Stevens, S.S.; Chin, S.M.

1993-02-15

The objective of this study is to provide cost est engineering, design, installation, operation and maintenance of Advanced Traffic Management Systems (ATMS) in the largest 75 metropolitan areas in the United States. This report gives estimates for deployment costs for ATMS in the next five years, subject to the qualifications and caveats set out in following paragraphs. The report considers infrastructure components required to realize fully a functional ATMS over each of two highway networks (as discussed in the Section describing our general assumptions) under each of the four architectures identified in the MITRE Intelligent Vehicle Highway Systems (IVHS) Architecture studies. The architectures are summarized in this report in Table 2. Estimates are given for eight combinations of highway networks and architectures. We estimate that it will cost between $8.5 Billion (minimal network) and $26 Billion (augmented network) to proceed immediately with deployment of ATMS in the largest 75 metropolitan areas. Costs are given in 1992 dollars, and are not adjusted for future inflation. Our estimates are based partially on completed project costs, which have been adjusted to 1992 dollars. We assume that a particular architecture will be chosen; projected costs are broken by architecture.

Kabob report. Pt. 3. Chevron plant largest in Canada

Energy Technology Data Exchange (ETDEWEB)

1971-01-18

Canada's largest fully integrated primary natural- gas processing and sulfur recovery plant is heading for physical completion by mid-summer of 1971. The Ralph M. Parsons Construction Co. of Canada Ltd., contractor for the S. Kaybob Beaverhill Lake Unit No. 3 gas-processing plant, to be operated by Chevron Standard Ltd., estimates completion by June 30. After that the $80 million complex will have tests and running in time. With any reasonable luck, it should be fully on stream by late summer. Preliminary construction on the 200-acre site started in Jan. 1969 with clearing and contouring of the main plant and sulfur storage sites. Initial rough grading started in the early summer, after spring breakup was over. Delivery of most of the big items was made by rail because the local secondary roads were inadequate for them. Concrete has been a large item. The contractor has its own batch plant on the site for the estimated 28,000 cu yd which will be needed for the whole job. Dominating the construction site from the start has been the high sulfur plant stack, first of the major items to be finished. It will serve to dispose of effluent from the largest sulfur recovery unit in Canada. It is 465 ft high, one of the largest in Alberta, and a significant contribution to pollution control and environmental protection.

Costs of Loyalty Programmes Implementation in Pharmacies

Directory of Open Access Journals (Sweden)

Maria Sierpińska

2010-10-01

Full Text Available Receiving the customer is in todays market realities top marketing companies. The build a sustainable partnership relation between the seller and the buyer is decide on businesses, takings and profit potential. Increasingly, therefore, perpetuates the view that create lasting relationships is an essential factor in improving the effectiveness of marketing activities conducted by modern businesses. The paper presents the implementation costs of loyalty programmes in pharmacies. These costs are presented based on a study of one of the largest pharmacy loyalty programmes in Poland: I care for health.

Costs and potentials of energy conservation in China's coal-fired power industry: A bottom-up approach considering price uncertainties

International Nuclear Information System (INIS)

Chen, Hao; Kang, Jia-Ning; Liao, Hua; Tang, Bao-Jun; Wei, Yi-Ming

2017-01-01

Energy conservation technologies in the coal-fired power sector are important solutions for the environmental pollution and climate change issues. However, a unified framework for estimating their costs and potentials is still needed due to the wide technology choices, especially considering their economic feasibility under fuel and carbon price uncertainties. Therefore, this study has employed a bottom-up approach to analyze the costs and potentials of 32 key technologies’ new promotions during the 13th Five-Year Plan period (2016–2020), which combines the conservation supply curve (CSC) approach and break-even analysis. Findings show that (1) these 32 technologies have a total coal conservation potential of 275.77 Mt with a cost of 238.82 billion yuan, and their break-even coal price is 866 yuan/ton. (2) steam-water circulation system has the largest energy conservation potential in the coal-fired power industry. (3) considering the co-benefits will facilitate these technologies’ promotions, because their break-even coal prices will decrease by 2.35 yuan/ton when the carbon prices increase by 1 yuan/ton. (4) discount rates have the largest impacts on the technologies’ cost-effectiveness, while the future generation level affect their energy conservation potentials most. - Highlights: • The 32 technologies can save 275.77 Mt coal with a cost of 238.82 billion yuan. • The steam-water circulation system has the largest energy conservation potential. • Considering the co-benefits will facilitate the technology promotions • Discount rates have the largest impacts on the technologies’ cost-effectiveness.

Cost trend analysis of initial cancer treatment in Taiwan.

Directory of Open Access Journals (Sweden)

Tsai-Yun Li

Full Text Available BACKGROUND: Despite the high cost of initial cancer care, that is, care in the first year after diagnosis, limited information is available for specific categories of cancer-related costs, especially costs for specific services. This study purposed to identify causes of change in cancer treatment costs over time and to perform trend analyses of the percentage of cancer patients who had received a specific treatment type and the mean cost of care for patients who had received that treatment. METHODOLOGY/PRINCIPAL FINDINGS: The analysis of trends in initial treatment costs focused on cancer-related surgery, chemotherapy, radiation therapy, and treatments other than active treatments. For each cancer-specific trend, slopes were calculated for regression models with 95% confidence intervals. Analyses of patients diagnosed in 2007 showed that the National Health Insurance (NHI system paid, on average, $10,780 for initial care of a gastric cancer patient and $10,681 for initial care of a lung cancer patient, which were inflation-adjusted increases of $6,234 and $5,522, respectively, over the 1996 care costs. During the same interval, the mean NHI payment for initial care for the five specific cancers increased significantly (p<0.05. Hospitalization costs comprised the largest portion of payments for all cancers. During 1996-2007, the use of chemotherapy and radiation therapy significantly increased in all cancer types (p<0.05. In 2007, NHI payments for initial care for these five cancers exceeded $12 billion, and gastric and lung cancers accounted for the largest share. CONCLUSIONS/SIGNIFICANCE: In addition to the growing number of NHI beneficiaries with cancer, treatment costs and the percentage of patients who undergo treatment are growing. Therefore, the NHI must accurately predict the economic burden of new chemotherapy agents and radiation therapies and may need to develop programs for stratifying patients according to their potential benefit

An Introduction to Cost-of-Living Adjustments in Public Retirement Plans: Details Matter

Science.gov (United States)

Jennings, Penelope R.; Jennings, William P.; Phillips, G. Michael

2016-01-01

While financial planning students are expected to be able to understand client retirement plans, subtle differences in cost-of-living adjustments can have major impact on the success of client retirement plans. This teaching note compares the cost-of-living adjustments in the largest government sponsored retirement systems and a hypothetical…

An Improved Particle Swarm Optimization for Selective Single Machine Scheduling with Sequence Dependent Setup Costs and Downstream Demands

Directory of Open Access Journals (Sweden)

Kun Li

2015-01-01

Full Text Available This paper investigates a special single machine scheduling problem derived from practical industries, namely, the selective single machine scheduling with sequence dependent setup costs and downstream demands. Different from traditional single machine scheduling, this problem further takes into account the selection of jobs and the demands of downstream lines. This problem is formulated as a mixed integer linear programming model and an improved particle swarm optimization (PSO is proposed to solve it. To enhance the exploitation ability of the PSO, an adaptive neighborhood search with different search depth is developed based on the decision characteristics of the problem. To improve the search diversity and make the proposed PSO algorithm capable of getting out of local optimum, an elite solution pool is introduced into the PSO. Computational results based on extensive test instances show that the proposed PSO can obtain optimal solutions for small size problems and outperform the CPLEX and some other powerful algorithms for large size problems.

Upgrade and modernization of the six largest HPPs in Macedonia

International Nuclear Information System (INIS)

Hadzievska, M.

2002-01-01

In 1998, Electric Power Company of Macedonia and the International Bank for Development and Reconstruction, started the Power System Improvement Project a part of which is the Project for rehabilitation of the six largest Hydro Power Plants (HPPs) in the Republic of Macedonia. The six largest Hydro Power Plants (HPP Vrutok, HPP Raven, HPP Globocica, HPP Tikves and HPP Spilje and HPP Vrben) represent 91% of the country's hydropower capacity. The rehabilitation program is divided in five parts (contracts) and covers the refurbishment of: turbine runners, turbine and generator bearings, governors, inlet valves; butterfly valves, including accessories and control systems; generators, excitation system and voltage regulation; control system, protection and LV auxiliaries; switch gears and control gears in 220 kV, 110 kV and 35 kV substations. At the moment, only the implementation of switch gears has started, the first phase is already finished, and 50 % of the rehabilitation works for HPP Vrutok, the largest HPP, has been finished. With the realization of this project, greater hydropower production is expected. It also expected that HPPs will become a more vital part of the Macedonian power system

World's third-largest producer of nuclear power. Japan in need of energy

International Nuclear Information System (INIS)

Anon.

2008-01-01

Japan is the third largest oil consumer in the world behind the United States and China, and the second largest net importer of oil. Japan boasts one of the largest economies in the world. The country continues to experience a moderate economic recovery that began in 2003, following a decade of economic stagnation. Japan's real gross domestic product (GDP) grew by 2.5% in 2005 and 2.3% in 2004. The modest upturn over the last few years reflects higher business confidence in Japan, a surge in export demand led by exports to China, and robust consumer spending. Unemployment in Japan fell to 4.4% in 2005, down from an early 2003 peak of 5.5%. Japan has virtually no domestic oil or natural gas reserves, and in 2005 was the second largest net importer of crude oil in the world. Despite the country's dearth of hydrocarbon resources, Japanese companies have actively pursued upstream oil and natural gas projects overseas. Japan remains one of the major exporters of energy-sector capital equipment, and Japanese companies provide engineering, construction, and project management services for energy projects. (orig.)

National impacts of the Weatherization Assistance Program in single-family and small multifamily dwellings

Energy Technology Data Exchange (ETDEWEB)

Brown, M.A.; Berry, L.G.; Balzer, R.A.; Faby, E.

1993-05-01

Since 1976, the US Department of Energy (DOE) has operated one of the largest energy conservation programs in the nation -- the low-income Weatherization Assistance Program. The program strives to increase the energy efficiency of dwellings occupied by low-income persons in order to reduce their energy consumption, lower their fuel bills, increase the comfort of their homes, and safeguard their health. It targets vulnerable groups including the elderly, people with disabilities, and families with children. The most recent national evaluation of the impacts of the Program was completed in 1984 based on energy consumption data for households weatherized in 1981. DOE Program regulations and operations have changed substantially since then: new funding sources, management principles, diagnostic procedures, and weatherization technologies have been incorporated. Many of these new features have been studied in isolation or at a local level; however, no recent evaluation has assessed their combined, nationwide impacts to date or their potential for the future. In 1990, DOE initiated such an evaluation. This evaluation is comprised of three ``impact`` studies (the Single-Family Study, High-Density Multifamily Study, and Fuel-Oil Study) and two ``policy`` studies. Altogether, these five studies will provide a comprehensive national assessment of the Weatherization Assistance Program as it existed in the 1989 Program Year (PY 1989). This report presents the results of the first phase of the Single-Family Study. It evaluates the energy savings and cost effectiveness of the Program as it has been applied to the largest portion of its client base -- low-income households that occupy single-family dwellings, mobile homes, and small (2- to 4-unit) multifamily dwellings. It is based upon a representative national sample that covers the full range of conditions under which the program was implemented in PY 1989.

NAFTA: The World's Largest Trading Zone Turns 20

Science.gov (United States)

Ferrarini, Tawni Hunt; Day, Stephen

2014-01-01

Everyone under the age of 20 who has grown up in North America has lived in the common market created by NAFTA--the North American Free Trade Agreement. In a zone linking the United States, Canada, and Mexico, most goods and investments flow freely across borders to users, consumers, and investors. In 1994, NAFTA created the largest relatively…

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

Science.gov (United States)

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

2012-01-01

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

The Environmental Responsibility of the World’s Largest Banks

Directory of Open Access Journals (Sweden)

Ryszawska Bożena

2018-03-01

Full Text Available Sustainability transition is changing the role and function of banks, specially their products and services also in relation to stakeholders. Banks are one of the main actors supporting the transition to sustainable economy. The purpose of this study is to emphasise the role of world’s largest banks in that process. Banks are slowly responding to the new demand of sustainability and responsibility, and they try to align with it. The paper is based on an overview of the world’s five largest banks that employ corporate social responsibility (CSR reporting standards, together with detailed enumeration of pro-environmental activities included in the reports. The first section of this paper presents the most popular approaches to the problem at hand, as reported in professional literature. Section two presents the characteristics of the CSR actions in banks. The third section discusses the environmental actions of the biggest banks in Global Reporting Initiative (GRI reporting the most popular standard for reporting non-financial information. And the last part of the paper presents the conclusions resulting from the article. The research was conducted using a variety of sources, such as scientific articles, statistical data, CSR reports of the world’s largest banks, as well reporting principles and standard disclosures. The basic method used in the process of writing was a critical analysis of literature and reports concerning the CSR reporting standards, environmental responsibilities of different kinds of entities, as well as own observations based on special reports of banks. In the article, also the analysis of financial market data, induction method and comparison method have been used. The main conclusions of the analysis of the CSR reports disclosed by the world’s largest banks confirm all three of the theses presented in the article. The findings suggest that the banks under study can be regarded as environmentally responsible

Oceans of Opportunity. Harnessing Europe's largest domestic energy resource

International Nuclear Information System (INIS)

Fichaux, N.; Wilkes, J.

2009-09-01

Europe's offshore wind potential is enormous and able to power Europe seven times over. Over 100 GW of offshore wind projects are already in various stages of planning. If realised, these projects would produce 10% of the EU's electricity whilst avoiding 200 million tonnes of CO2 emissions each year. EWEA has a target of 40 GW of offshore wind in the EU by 2020, implying an average annual market growth of 28% over the coming 12 years. The EU market for onshore wind grew by an average 32% per year in the 12-year period from 1992-2004 - what the wind energy industry has achieved on land can be repeated at sea. EWEA's proposed offshore grid builds on the 11 offshore grids currently operating and 21 offshore grids currently being considered by the grid operators in the Baltic and North Seas to give Europe a truly pan-European electricity super highway. Strong political support and action from Europe's policy-makers will allow a new, multi-billion euro industry to be built. This new industry will deliver thousands of green collar jobs and a new renewable energy economy and establish Europe as world leader in offshore wind power technology. A single European electricity market with large amounts of wind power will bring affordable electricity to consumers, reduce import dependence, cut CO2 emissions and allow Europe to access its largest domestic energy source.

Experimental Implementation of a Low-Cost Single Phase Five-Level Inverter for Autonomous PV System Applications Without Batteries

OpenAIRE

Nouaiti, Ayoub; Saad, Abdallah; Mesbahi, Abdelouahed; Khafallah, Mohamed

2018-01-01

This paper presents the design and the implementation of a low-cost single phase five-level inverter for photovoltaic applications. The proposed multilevel inverter is composed of a simple boost converter, a switched-capacitor converter, and an H-bridge converter. An efficient control method which associates a closed-loop regulation method with a simple maximum power point tracking (MPPT) method is applied in order to allow the proposed multilevel inverter to transfer power energy from solar ...

Humans, 'things' and space: costing hospital infection control interventions.

Science.gov (United States)

Page, K; Graves, N; Halton, K; Barnett, A G

2013-07-01

Previous attempts at costing infection control programmes have tended to focus on accounting costs rather than economic costs. For studies using economic costs, estimates tend to be quite crude and probably underestimate the true cost. One of the largest costs of any intervention is staff time, but this cost is difficult to quantify and has been largely ignored in previous attempts. To design and evaluate the costs of hospital-based infection control interventions or programmes. This article also discusses several issues to consider when costing interventions, and suggests strategies for overcoming these issues. Previous literature and techniques in both health economics and psychology are reviewed and synthesized. This article provides a set of generic, transferable costing guidelines. Key principles such as definition of study scope and focus on large costs, as well as pitfalls (e.g. overconfidence and uncertainty), are discussed. These new guidelines can be used by hospital staff and other researchers to cost their infection control programmes and interventions more accurately. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

RIRS versus mPCNL for single renal stone of 2-3 cm: clinical outcome and cost-effective analysis in Chinese medical setting.

Science.gov (United States)

Pan, Jiahua; Chen, Qi; Xue, Wei; Chen, Yonghui; Xia, Lei; Chen, Haige; Huang, Yiran

2013-02-01

The aim of the study was to compare the clinical outcome and the cost-effectiveness between retrograde intra renal surgery (RIRS) and mini-percutaneous nephrolithotripsy (mPCNL) for the management of single renal stone of 2-3 cm in Chinese medical setting. From May 2005 to February 2011, 115 patients with solitary renal calculi were treated either by RIRS or mPCNL. 56 patients were in RIRS group while 59 were in mPCNL group. Patients' demographics between the two groups, in terms of gender, age, BMI, history of ESWL as well as stone side, stone location and stone size were comparable. Peri-operative course, clinical outcome, complication rates and medical cost were compared. The effective quotient (EQ) of two groups was calculated. Data were analyzed using Fisher's exact test, Chi-square test and Student's t test. EQ for RIRS and mPCNL were 0.52 and 0.90. The initial stone-free rate (SFR) of RIRS group and mPCNL group was 71.4 and 96.6 %, respectively (P = 0.000). The mean procedure number was 1.18 in RIRS group and 1.03 in mPCNL group, respectively (P = 0.035). The operative time for RIRS was longer (P = 0.000) while the mean hospital stay was shorter (P = 0.000). There was no statistical difference in peri-operative complications between the groups. The initial hospitalization cost, laboratory and radiology test cost of RIRS group were lower (P = 0.000). However, counting the retreatment cost in the two groups, the total medical expenditure including the overall hospitalization cost, overall laboratory and radiology test cost and post-operative out-patient department (OPD) visit cost was similar between two groups. In conclusion, with similar total medical cost, mPCNL achieved faster stone clearance and lower retreatment rate without major complications, which implied higher cost-effectiveness for the treatment of single renal stone of 2-3 cm in Chinese medical setting. RIRS is also a safe and reliable choice for patients having contraindications or

Cost-effectiveness in the management of Dupuytren's contracture. A Canadian cost-utility analysis of current and future management strategies.

Science.gov (United States)

Baltzer, H; Binhammer, P A

2013-08-01

In Canada, Dupuytren's contracture is managed with partial fasciectomy or percutaneous needle aponeurotomy (PNA). Injectable collagenase will soon be available. The optimal management of Dupuytren's contracture is controversial and trade-offs exist between the different methods. Using a cost-utility analysis approach, our aim was to identify the most cost-effective form of treatment for managing Dupuytren's contracture it and the threshold at which collagenase is cost-effective. We developed an expected-value decision analysis model for Dupuytren's contracture affecting a single finger, comparing the cost-effectiveness of fasciectomy, aponeurotomy and collagenase from a societal perspective. Cost-effectiveness, one-way sensitivity and variability analyses were performed using standard thresholds for cost effective treatment ($50 000 to $100 000/QALY gained). Percutaneous needle aponeurotomy was the preferred strategy for managing contractures affecting a single finger. The cost-effectiveness of primary aponeurotomy improved when repeated to treat recurrence. Fasciectomy was not cost-effective. Collagenase was cost-effective relative to and preferred over aponeurotomy at $875 and $470 per course of treatment, respectively. In summary, our model supports the trend towards non-surgical interventions for managing Dupuytren's contracture affecting a single finger. Injectable collagenase will only be feasible in our publicly funded healthcare system if it costs significantly less than current United States pricing.

Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon.

Science.gov (United States)

Scotland, G S; McLernon, D; Kurinczuk, J J; McNamee, P; Harrild, K; Lyall, H; Rajkhowa, M; Hamilton, M; Bhattacharya, S

2011-08-01

To assess the cumulative costs and consequences of double embryo transfer (DET) or elective single embryo transfer (eSET) in women commencing in vitro fertilisation (IVF) treatment aged 32, 36 and 39 years. Microsimulation model. Three assisted reproduction centres in Scotland. A total of 6153 women undergoing treatment at one of three Scottish IVF clinics, between January 1997 and June 2007. A microsimulation model, populated using data inputs derived from a large clinical data set and published literature, was developed to compare the costs and consequences of using eSET or DET over multiple treatment cycles. Disability-free live births; twin pregnancy rate; women's quality-adjusted life-years (QALYs); health service costs. Not only did DET produce a higher cumulative live birth rate compared with eSET for women of all three ages, but also a higher twin pregnancy rate. Compared with eSET, DET ranged from costing an additional £ 27,356 per extra live birth in women commencing treatment aged 32 years, to costing £ 15,539 per extra live birth in 39-year-old women. DET cost ∼ £ 28,300 and ∼ £ 20,300 per additional QALY in women commencing treatment aged 32 and 39 years, respectively. Considering the high twin pregnancy rate associated with DET, coupled with uncertainty surrounding QALY gains, eSET is likely to be the preferred option for most women aged ≤ 36 years. The cost-effectiveness of DET improves with age, and may be considered cost-effective in some groups of older women. The decision may best be considered on a case-by-case basis for women aged 37-39 years. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

[Costs and benefits of quality management].

Science.gov (United States)

Schroeder-Printzen, I

2014-01-01

The establishment of quality management (QM) has been mandatory for health care providers of the national health insurance since 2004; however, certification is so far only compulsory for rehabilitation clinics. The costs have so far only been quantified in a few medical studies, while they are widely known in business administration with a basic distinction made between planning, steering, auditing, and declaration costs. Another business economics approach differentiates between prevention, appraisal, and non-conformance costs. The benefits of QM relates to customers, employees, external service providers, and health insurance providers. Also important in our consideration of the patient as a customer is that they should not be considered a customer in the usual business sense because the patient is in an emergency situation and can not freely decide. Improvements in treatment quality and in reducing the rate of adverse events make up the largest portion of the benefits of QM. Furthermore, QM can have a positive influence on motivation and employee recruitment. In addition, the cost savings that result despite costs for QM must not be forgotten.

Statistics of the largest sunspot and facular areas per solar cycle

International Nuclear Information System (INIS)

Willis, D.M.; Kabasakal Tulunay, Y.

1979-01-01

The statistics of extreme values is used to investigate the statistical properties of the largest areas sunspots and photospheric faculae per solar cycle. The largest values of the synodic-solar-rotation mean areas of umbrae, whole spots and faculae, which have been recorded for nine solar cycles, are each shown to comply with the general form of the extreme value probability function. Empirical expressions are derived for the three extreme value populations from which the characteristic statistical parameters, namely the mode, median, mean and standard deviation, can be calculated for each population. These three extreme value populations are also used to find the expected ranges of the extreme areas in a group of solar cycles as a function of the number of cycles in the group. The extreme areas of umbrae and whole spots have a dispersion comparable to that found by Siscoe for the extreme values of sunspot number, whereas the extreme areas of faculae have a smaller dispersion which is comparable to that found by Siscoe for the largest geomagnetic storm per solar cycle. The expected range of the largest sunspot area per solar cycle for a group of one hundred cycles appears to be inconsistent with the existence of the prolonged periods of sunspot minima that have been inferred from the historical information on solar variability. This inconsistency supports the contention that there are temporal changes of solar-cycle statistics during protracted periods of sunspot minima (or maxima). Indeed, without such temporal changes, photospheric faculae should have been continually observable throughout the lifetime of the Sun. (orig.)

Impact of coil price knowledge by the operator on the cost of aneurysm coiling. A single center study.

Science.gov (United States)

Finitsis, Stephanos; Fahed, Robert; Gaulin, Ian; Roy, Daniel; Weill, Alain

2017-09-15

Endovascular treatment of aneurysms with coils is among the most frequent treatments in interventional neuroradiology, and represents an important expense. Each manufacturer has created several types of coils, with prices varying among brands and coil types. The objective of this study was to assess the impact of cost awareness of the exact price of each coil by the operating physician on the total cost of aneurysm coiling. This was a comparative study conducted over 1 year in a single tertiary care center. The reference cohort and the experimental cohort consisted of all aneurysm embolization procedures performed during the first 6 months and the last 6 months, respectively. During the second period, physicians were given an information sheet with the prices of all available coils and were requested to look at the sheet during each procedure with the instruction to try to reduce the total cost of the coils used. Expenses related to the coiling procedures during each period were compared. 77 aneurysms (39 ruptured) in the reference cohort and 73 aneurysms (36 ruptured) in the experimental cohort were treated, respectively. There was no statistically significant difference regarding aneurysm location and mean size. The overall cost of the coiling procedures, the mean number of coils used per procedure, and the median cost of each procedure did not differ significantly between the two cohorts. Awareness of the precise price of coils by operators without any additional measure did not have a scientifically proven impact on the cost of aneurysm embolization. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Analysis of the equilibrium trip cost accounting for the fuel cost in a single-lane traffic system without late arrival

Science.gov (United States)

Tang, Tie-Qiao; Wang, Tao; Chen, Liang; Huang, Hai-Jun

2018-01-01

In this paper, we introduce the fuel cost into each commuter's trip cost, define a new trip cost without late arrival and its corresponding equilibrium state, and use a car-following model to explore the impacts of the fuel cost on each commuter's departure time, departure interval, arrival time, arrival interval, traveling time, early arrival time and trip cost at the above equilibrium state. The numerical results show that considering the fuel cost in each commuter's trip cost has positive impacts on his trip cost and fuel cost, and the traffic situation in the system without late arrival, i.e., each commuter should explicitly consider the fuel cost in his trip cost.

Fishing down the largest coral reef fish species.

Science.gov (United States)

Fenner, Douglas

2014-07-15

Studies on remote, uninhabited, near-pristine reefs have revealed surprisingly large populations of large reef fish. Locations such as the northwestern Hawaiian Islands, northern Marianas Islands, Line Islands, U.S. remote Pacific Islands, Cocos-Keeling Atoll and Chagos archipelago have much higher reef fish biomass than islands and reefs near people. Much of the high biomass of most remote reef fish communities lies in the largest species, such as sharks, bumphead parrots, giant trevally, and humphead wrasse. Some, such as sharks and giant trevally, are apex predators, but others such as bumphead parrots and humphead wrasse, are not. At many locations, decreases in large reef fish species have been attributed to fishing. Fishing is well known to remove the largest fish first, and a quantitative measure of vulnerability to fishing indicates that large reef fish species are much more vulnerable to fishing than small fish. The removal of large reef fish by fishing parallels the extinction of terrestrial megafauna by early humans. However large reef fish have great value for various ecological roles and for reef tourism. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cost, energy use and GHG emissions for forest biomass harvesting operations

International Nuclear Information System (INIS)

Zhang, Fengli; Johnson, Dana M.; Wang, Jinjiang; Yu, Chunxia

2016-01-01

For forest-based biomass to become a significant contribution to the United States' energy portfolio, harvesting operations must be physically feasible and economically viable. An assessment of cost, energy and greenhouse gas (GHG) emissions of forest biomass harvesting was conducted. The assessment differentiates harvesting systems by cut-to-length and whole tree; harvest types of 30%, 70%, and 100% cut; and forest types of hardwoods, softwoods, mixed hardwood/softwood, and softwood plantations. Harvesting cost models were developed for economic assessment and life cycle energy and emission assessment was applied to calculate energy and emissions for different harvesting scenarios, considering material and energy inputs (machinery, diesel, etc.) and outputs (GHG emissions) for each harvesting process (felling, forwarding/skidding, etc.). The developed harvesting cost models and the life cycle energy and emission assessment method were applied in Michigan, U.S. using information collected from different sources. A sensitivity analysis was performed for selected input variables for the harvesting operations in order to explore their relative importance. The results indicated that productivity had the largest impact on harvesting cost followed by machinery purchase price, yearly scheduled hours, and expected utilization. Productivity and fuel use, as well as fuel factors, are the most influential environmental impacts of harvesting operations. - Highlights: • Life cycle energy and emissions for forest biomass harvesting operations. • Harvesting cost models were developed for economic assessment. • Productivity had the largest impact on harvesting cost. • Fuel use contributes the most emissions while lubricants contribute the least.

The Multivariate Largest Lyapunov Exponent as an Age-Related Metric of Quiet Standing Balance

Directory of Open Access Journals (Sweden)

Kun Liu

2015-01-01

Full Text Available The largest Lyapunov exponent has been researched as a metric of the balance ability during human quiet standing. However, the sensitivity and accuracy of this measurement method are not good enough for clinical use. The present research proposes a metric of the human body’s standing balance ability based on the multivariate largest Lyapunov exponent which can quantify the human standing balance. The dynamic multivariate time series of ankle, knee, and hip were measured by multiple electrical goniometers. Thirty-six normal people of different ages participated in the test. With acquired data, the multivariate largest Lyapunov exponent was calculated. Finally, the results of the proposed approach were analysed and compared with the traditional method, for which the largest Lyapunov exponent and power spectral density from the centre of pressure were also calculated. The following conclusions can be obtained. The multivariate largest Lyapunov exponent has a higher degree of differentiation in differentiating balance in eyes-closed conditions. The MLLE value reflects the overall coordination between multisegment movements. Individuals of different ages can be distinguished by their MLLE values. The standing stability of human is reduced with the increment of age.

Crash testing the largest experiment on Earth

OpenAIRE

Cauchi, Marija

2015-01-01

Under Europe lies a 27 km tunnel that is both the coldest and hottest place on Earth. The Large Hadron Collider (LHC) has already found out what gives mass to all the matter in the Universe. It is now trying to go even deeper into what makes up everything we see around us. Dr Marija Cauchi writes about her research that helped protect this atom smasher from itself. Photography by Jean Claude Vancell. http://www.um.edu.mt/think/crash-testing-the-largest-experiment-on-earth/

Cost comparisons

CERN Multimedia

CERN Bulletin

2010-01-01

How much does the LHC cost? And how much does this represent in other currencies? Below we present a table showing some comparisons with the cost of other projects. Looking at the figures, you will see that the cost of the LHC can be likened to that of three skyscrapers, or two seasons of Formula 1 racing! One year's budget of a single large F1 team is comparable to the entire materials cost of the ATLAS or CMS experiments.   Please note that all the figures are rounded for ease of reading.    CHF € $   LHC 4.6 billions 3 billions  4 billions   Space Shuttle Endeavour (NASA) 1.9 billion 1.3 billion 1.7 billion   Hubble Space Telescope (cost at launch – NASA/...

Life Cycle Assessment and Costing Methods for Device Procurement: Comparing Reusable and Single-Use Disposable Laryngoscopes.

Science.gov (United States)

Sherman, Jodi D; Raibley, Lewis A; Eckelman, Matthew J

2018-01-09

Traditional medical device procurement criteria include efficacy and safety, ease of use and handling, and procurement costs. However, little information is available about life cycle environmental impacts of the production, use, and disposal of medical devices, or about costs incurred after purchase. Reusable and disposable laryngoscopes are of current interest to anesthesiologists. Facing mounting pressure to quickly meet or exceed conflicting infection prevention guidelines and oversight body recommendations, many institutions may be electively switching to single-use disposable (SUD) rigid laryngoscopes or overcleaning reusables, potentially increasing both costs and waste generation. This study provides quantitative comparisons of environmental impacts and total cost of ownership among laryngoscope options, which can aid procurement decision making to benefit facilities and public health. We describe cradle-to-grave life cycle assessment (LCA) and life cycle costing (LCC) methods and apply these to reusable and SUD metal and plastic laryngoscope handles and tongue blade alternatives at Yale-New Haven Hospital (YNHH). The US Environmental Protection Agency's Tool for the Reduction and Assessment of Chemical and other environmental Impacts (TRACI) life cycle impact assessment method was used to model environmental impacts of greenhouse gases and other pollutant emissions. The SUD plastic handle generates an estimated 16-18 times more life cycle carbon dioxide equivalents (CO2-eq) than traditional low-level disinfection of the reusable steel handle. The SUD plastic tongue blade generates an estimated 5-6 times more CO2-eq than the reusable steel blade treated with high-level disinfection. SUD metal components generated much higher emissions than all alternatives. Both the SUD handle and SUD blade increased life cycle costs compared to the various reusable cleaning scenarios at YNHH. When extrapolated over 1 year (60,000 intubations), estimated costs increased

Development of advanced Czochralski Growth Process to produce low cost 150 KG silicon ingots from a single crucible for technology readiness

Science.gov (United States)

1981-01-01

The goals in this program for advanced czochralski growth process to produce low cost 150 kg silicon ingots from a single crucible for technology readiness are outlined. To provide a modified CG2000 crystal power capable of pulling a minimum of five crystals, each of approximately 30 kg in weight, 150 mm diameter from a single crucible with periodic melt replenishment. Crystals to have: resistivity of 1 to 3 ohm cm, p-type; dislocation density below 1- to the 6th power per cm; orientation (100); after growth yield of greater than 90%. Growth throughput of greater than 2.5 kg per hour of machine operation using a radiation shield. Prototype equipment suitable for use as a production facility. The overall cost goal is $.70 per peak watt by 1986. To accomplish these goals, the modified CG2000 grower and development program includes: (1) increased automation with a microprocessor based control system; (2) sensors development which will increase the capability of the automatic controls system, and provide technology transfer of the developed systems.

Commerical electric power cost studies. Capital cost addendum multi-unit coal and nuclear stations

International Nuclear Information System (INIS)

1977-09-01

This report is the culmination of a study performed to develop designs and associated capital cost estimates for multi-unit nuclear and coal commercial electric power stations, and to determine the distribution of these costs among the individual units. This report addresses six different types of 2400 MWe (nominal) multi-unit stations as follows: Two Unit PWR Station-1139 MWe Each, Two Unit BWR Station-1190 MWe Each, Two Unit High Sulfur Coal-Fired Station-1232 MWe Each, Two Unit Low Sulfur Coal-Fired Station-1243 MWe Each, Three Unit High Sulfur Coal-Fired Station-794 MWe Each, Three Unit Low Sulfur Coal-Fired Station-801 MWe Each. Recent capital cost studies performed for ERDA/NRC of single unit nuclear and coal stations are used as the basis for developing the designs and costs of the multi-unit stations. This report includes the major study groundrules, a summary of single and multi-unit stations total base cost estimates, details of cost estimates at the three digit account level and plot plan drawings for each multi-unit station identified

Cost-estimating relationships for space programs

Science.gov (United States)

Mandell, Humboldt C., Jr.

1992-01-01

Cost-estimating relationships (CERs) are defined and discussed as they relate to the estimation of theoretical costs for space programs. The paper primarily addresses CERs based on analogous relationships between physical and performance parameters to estimate future costs. Analytical estimation principles are reviewed examining the sources of errors in cost models, and the use of CERs is shown to be affected by organizational culture. Two paradigms for cost estimation are set forth: (1) the Rand paradigm for single-culture single-system methods; and (2) the Price paradigms that incorporate a set of cultural variables. For space programs that are potentially subject to even small cultural changes, the Price paradigms are argued to be more effective. The derivation and use of accurate CERs is important for developing effective cost models to analyze the potential of a given space program.

The cost of antibiotic mass drug administration for trachoma control in a remote area of South Sudan.

Science.gov (United States)

Kolaczinski, Jan H; Robinson, Emily; Finn, Timothy P

2011-10-01

Mass drug administration (MDA) of antibiotics is a key component of the so-called "SAFE" strategy for trachoma control, while MDA of anthelminthics provides the cornerstone for control of a number of other neglected tropical diseases (NTDs). Simultaneous delivery of two or more of these drugs, renowned as "integrated NTD control," is being promoted to reduce costs and expand intervention coverage. A cost analysis was conducted alongside an MDA campaign in a remote trachoma endemic area, to inform budgeting for NTD control in South Sudan. A first round of antibiotic MDA was conducted in the highly trachoma endemic county of Mayom, Unity state, from June to August 2010. A core team of seven staff delivered the intervention, including recruitment and training of 44 supervisors and 542 community drug distributors. Using an ingredients approach, financial and economic costs were captured from the provider perspective in a detailed costing database. Overall, 123,760 individuals were treated for trachoma, resulting in an estimated treatment coverage of 94%. The economic cost per person treated was USD 1.53, excluding the cost of the antibiotic azithromycin. Ninety four per cent of the delivery costs were recurrent costs, with personnel and travel/transport costs taking up the largest share. In a remote setting and for the initial round, MDA of antibiotics was considerably more expensive than USD 0.5 per person treated, an estimate frequently quoted to advocate for integrated NTD control. Drug delivery costs in South Sudan are unlikely to decrease substantially during subsequent MDA rounds, as the major cost drivers were recurrent costs. MDA campaigns for delivery of one or more drugs in South Sudan should thus be budgeted at around USD 1.5 per person treated, at least until further costing data for delivery of other NTD drugs, singly or in combination, are available.

The cost of antibiotic mass drug administration for trachoma control in a remote area of South Sudan.

Directory of Open Access Journals (Sweden)

Jan H Kolaczinski

2011-10-01

Full Text Available BACKGROUND: Mass drug administration (MDA of antibiotics is a key component of the so-called "SAFE" strategy for trachoma control, while MDA of anthelminthics provides the cornerstone for control of a number of other neglected tropical diseases (NTDs. Simultaneous delivery of two or more of these drugs, renowned as "integrated NTD control," is being promoted to reduce costs and expand intervention coverage. A cost analysis was conducted alongside an MDA campaign in a remote trachoma endemic area, to inform budgeting for NTD control in South Sudan. METHODS AND FINDINGS: A first round of antibiotic MDA was conducted in the highly trachoma endemic county of Mayom, Unity state, from June to August 2010. A core team of seven staff delivered the intervention, including recruitment and training of 44 supervisors and 542 community drug distributors. Using an ingredients approach, financial and economic costs were captured from the provider perspective in a detailed costing database. Overall, 123,760 individuals were treated for trachoma, resulting in an estimated treatment coverage of 94%. The economic cost per person treated was USD 1.53, excluding the cost of the antibiotic azithromycin. Ninety four per cent of the delivery costs were recurrent costs, with personnel and travel/transport costs taking up the largest share. CONCLUSIONS: In a remote setting and for the initial round, MDA of antibiotics was considerably more expensive than USD 0.5 per person treated, an estimate frequently quoted to advocate for integrated NTD control. Drug delivery costs in South Sudan are unlikely to decrease substantially during subsequent MDA rounds, as the major cost drivers were recurrent costs. MDA campaigns for delivery of one or more drugs in South Sudan should thus be budgeted at around USD 1.5 per person treated, at least until further costing data for delivery of other NTD drugs, singly or in combination, are available.

A comparison of cost-based pricing rules for natural gas distribution utilities

International Nuclear Information System (INIS)

Klein, C.C.

1993-01-01

Partial-equilibrium social welfare deadweight losses under uniform Ramsey pricing, a cost allocation pricing method, and the actual average revenues by customer class for two natural gas distribution utilities are calculated and compared. Marginal cost estimates are derived from a multiple-output translog variable cost function and used, along with three sets of demand elasticities, to generate the Ramsey prices and welfare losses. The actual and cost-allocation prices are taken directly from rate case files. The largest social welfare losses are associated with the cost-allocation rule, as high as 10-25% of revenue, despite suggestions in the literature to the contrary. (Author)

Predicting Traffic Flow in Local Area Networks by the Largest Lyapunov Exponent

Directory of Open Access Journals (Sweden)

Yan Liu

2016-01-01

Full Text Available The dynamics of network traffic are complex and nonlinear, and chaotic behaviors and their prediction, which play an important role in local area networks (LANs, are studied in detail, using the largest Lyapunov exponent. With the introduction of phase space reconstruction based on the time sequence, the high-dimensional traffic is projected onto the low dimension reconstructed phase space, and a reduced dynamic system is obtained from the dynamic system viewpoint. Then, a numerical method for computing the largest Lyapunov exponent of the low-dimensional dynamic system is presented. Further, the longest predictable time, which is related to chaotic behaviors in the system, is studied using the largest Lyapunov exponent, and the Wolf method is used to predict the evolution of the traffic in a local area network by both Dot and Interval predictions, and a reliable result is obtained by the presented method. As the conclusion, the results show that the largest Lyapunov exponent can be used to describe the sensitivity of the trajectory in the reconstructed phase space to the initial values. Moreover, Dot Prediction can effectively predict the flow burst. The numerical simulation also shows that the presented method is feasible and efficient for predicting the complex dynamic behaviors in LAN traffic, especially for congestion and attack in networks, which are the main two complex phenomena behaving as chaos in networks.

Invertebrate population genetics across Earth's largest habitat: The deep-sea floor.

Science.gov (United States)

Taylor, M L; Roterman, C N

2017-10-01

Despite the deep sea being the largest habitat on Earth, there are just 77 population genetic studies of invertebrates (115 species) inhabiting non-chemosynthetic ecosystems on the deep-sea floor (below 200 m depth). We review and synthesize the results of these papers. Studies reveal levels of genetic diversity comparable to shallow-water species. Generally, populations at similar depths were well connected over 100s-1,000s km, but studies that sampled across depth ranges reveal population structure at much smaller scales (100s-1,000s m) consistent with isolation by adaptation across environmental gradients, or the existence of physical barriers to connectivity with depth. Few studies were ocean-wide (under 4%), and 48% were Atlantic-focused. There is strong emphasis on megafauna and commercial species with research into meiofauna, "ecosystem engineers" and other ecologically important species lacking. Only nine papers account for ~50% of the planet's surface (depths below 3,500 m). Just two species were studied below 5,000 m, a quarter of Earth's seafloor. Most studies used single-locus mitochondrial genes revealing a common pattern of non-neutrality, consistent with demographic instability or selective sweeps; similar to deep-sea hydrothermal vent fauna. The absence of a clear difference between vent and non-vent could signify that demographic instability is common in the deep sea, or that selective sweeps render single-locus mitochondrial studies demographically uninformative. The number of population genetics studies to date is miniscule in relation to the size of the deep sea. The paucity of studies constrains meta-analyses where broad inferences about deep-sea ecology could be made. © 2017 The Authors. Molecular Ecology Published by John Wiley & Sons Ltd.

Increase the Performance of Companies in the Energy Sector by Implementing the Activity-Based Costing

OpenAIRE

Letitia-Maria Rof; Sorinel Capusneanu

2015-01-01

This article highlights the increasing performances as result of implementation stages of the ActivityBased Costing in the companies operating in the energy sector in Romania. There are presented some aspects of the usefulness of applying the Activity-Based Costing in the energy sector and the advantages it offers compared to traditional costing. There are also outlined the steps for applying the Activity-Based Costing and its implementation in the largest hydropower producer in Romania. The ...

Estimating outcomes and cost effectiveness using a single-arm clinical trial: ofatumumab for double-refractory chronic lymphocytic leukemia.

Science.gov (United States)

Hatswell, Anthony J; Thompson, Gwilym J; Maroudas, Penny A; Sofrygin, Oleg; Delea, Thomas E

2017-01-01

Ofatumumab (Arzerra ® , Novartis) is a treatment for chronic lymphocytic leukemia refractory to fludarabine and alemtuzumab [double refractory (DR-CLL)]. Ofatumumab was licensed on the basis of an uncontrolled Phase II study, Hx-CD20-406, in which patients receiving ofatumumab survived for a median of 13.9 months. However, the lack of an internal control arm presents an obstacle for the estimation of comparative effectiveness. The objective of the study was to present a method to estimate the cost effectiveness of ofatumumab in the treatment of DR-CLL. As no suitable historical control was available for modelling, the outcomes from non-responders to ofatumumab were used to model the effect of best supportive care (BSC). This was done via a Cox regression to control for differences in baseline characteristics between groups. This analysis was included in a partitioned survival model built in Microsoft ® Excel with utilities and costs taken from published sources, with costs and quality-adjusted life years (QALYs) were discounted at a rate of 3.5% per annum. Using the outcomes seen in non-responders, ofatumumab is expected to add approximately 0.62 life years (1.50 vs. 0.88). Using published utility values this translates to an additional 0.30 QALYs (0.77 vs. 0.47). At the list price, ofatumumab had a cost per QALY of £130,563, and a cost per life year of £63,542. The model was sensitive to changes in assumptions regarding overall survival estimates and utility values. This study demonstrates the potential of using data for non-responders to model outcomes for BSC in cost-effectiveness evaluations based on single-arm trials. Further research is needed on the estimation of comparative effectiveness using uncontrolled clinical studies.

Cost consideration in the clinical guidance documents of physician specialty societies in the United States.

Science.gov (United States)

Schwartz, Jennifer A T; Pearson, Steven D

2013-06-24

Despite increasing concerns regarding the cost of health care, the consideration of costs in the development of clinical guidance documents by physician specialty societies has received little analysis. To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. Qualitative document review. Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations. Methodological statements for clinical guidance documents indicated that 17 of 30 physician societies (57%) explicitly integrated costs, 4 (13%) implicitly considered costs, 3 (10%) intentionally excluded costs, and 6 (20%) made no mention. Of the 17 societies that explicitly integrated costs, 9 (53%) consistently used a formal system in which the strength of recommendation was influenced in part by costs, whereas 8 (47%) were inconsistent in their approach or failed to mention the exact mechanism for considering costs. Among the 138 specific recommendations in these guidance documents that included cost as part of the rationale, the most common form of recommendation (50 [36%]) encouraged the use of a specific medical service because of equal effectiveness and lower cost. Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions.

Economic evaluation of single-tooth replacement: dental implant versus fixed partial denture.

Science.gov (United States)

Kim, Younhee; Park, Joo-Yeon; Park, Sun-Young; Oh, Sung-Hee; Jung, YeaJi; Kim, Ji-Min; Yoo, Soo-Yeon; Kim, Seong-Kyun

2014-01-01

This study assessed the cost-effectiveness from a societal perspective of a dental implant compared with a three-unit tooth-supported fixed partial denture (FPD) for the replacement of a single tooth in 2010. A decision tree was developed to estimate cost-effectiveness over a 10-year period. The survival rates of single-tooth implants and FPDs were extracted from a meta-analysis of single-arm studies. Medical costs included initial treatment costs, maintenance costs, and costs to treat complications. Patient surveys were used to obtain the costs of the initial single-tooth implant or FPD. Maintenance costs and costs to treat complications were based on surveys of seven clinical experts at dental clinics or hospitals. Transportation costs were calculated based on the number of visits for implant or FPD treatment. Patient time costs were estimated using the number of visits and time required, hourly wage, and employment rate. Future costs were discounted by 5% to convert to present values. The results of a 10-year period model showed that a single dental implant cost US $261 (clinic) to $342 (hospital) more than an FPD and had an average survival rate that was 10.4% higher. The incremental cost-effectiveness ratio was $2,514 in a clinic and $3,290 in a hospital for a prosthesis in situ for 10 years. The sensitivity analysis showed that initial treatment costs and survival rate influenced the cost-effectiveness. If the cost of an implant were reduced to 80% of the current cost, the implant would become the dominant intervention. Although the level of evidence for effectiveness is low, and some aspects of single-tooth implants or FPDs, such as satisfaction, were not considered, this study will help patients requiring single-tooth replacement to choose the best treatment option.

School Transportation Costs, Policies and Practices: A Review of Issues in New York and Selected States.

Science.gov (United States)

New York State Education Dept., Albany. Educational Research Services Unit.

To draw comparisons for assessing transportation costs and developing recommendations for legislative action in New York, this study compares school transportation policies and practices that may be related to differences in transportation costs in eight states having the largest public school enrollments for 1980. Data were obtained from existing…

Maintenance cost models in deregulated power systems under opportunity costs

International Nuclear Information System (INIS)

Al-Arfaj, K.; Dahal, K.; Azaiez, M.N.

2007-01-01

In a centralized power system, the operator is responsible for scheduling maintenance. There are different types of maintenance, including corrective maintenance; predictive maintenance; preventive maintenance; and reliability-centred maintenance. The main cause of power failures is poor maintenance. As such, maintenance costs play a significant role in deregulated power systems. They include direct costs associated with material and labor costs as well as indirect costs associated with spare parts inventory, shipment, test equipment, indirect labor, opportunity costs and cost of failure. In maintenance scheduling and planning, the cost function is the only component of the objective function. This paper presented the results of a study in which different components of maintenance costs were modeled. The maintenance models were formulated as an optimization problem with single and multiple objectives and a set of constraints. The maintenance costs models could be used to schedule the maintenance activities of power generators more accurately and to identify the best maintenance strategies over a period of time as they consider failure and opportunity costs in a deregulated environment. 32 refs., 4 tabs., 4 figs

Retrofitted Solar Domestic Hot Water Systems for Swedish Single-Family Houses—Evaluation of a Prototype and Life-Cycle Cost Analysis

Directory of Open Access Journals (Sweden)

Luis Ricardo Bernardo

2016-11-01

Full Text Available According to recent technology road maps, system cost reductions and development of standardised plug-and-function systems are some of the most important goals for solar heating technology development. Retrofitting hot water boilers in single-family houses when installing solar collectors has the potential to significantly reduce both material and installation costs. Previous studies have investigated such retrofitting, using theoretical simulations and laboratory tests, but no actual installations were made and tested in practice. This article describes the installation, measured performance and cost effectiveness of a retrofitting solution that converts existing domestic hot water heaters to a solar domestic hot water system. The measured performance is characterised by the monthly and annual solar fractions. The cost effectiveness is evaluated by a life-cycle cost analysis, comparing the retrofitted system to a conventional solar domestic hot water system and the case without any solar heating system. Measurements showed that approximately 50% of the 5000 kWh/year of domestic hot water consumption was saved by the retrofitted system in south Sweden. Such savings are in agreement with previous estimations and are comparable to the energy savings when using a conventional solar domestic hot water system. The life-cycle cost analysis showed that, according to the assumptions and given climate, the return on investment of the retrofitted system is approximately 17 years, while a conventional system does not reach profitability during its lifetime of 25 years.

In search of low cost titanium: the Fray Farthing Chen (FFC) Cambridge process

CSIR Research Space (South Africa)

Oosthuizen, SJ

2010-10-01

Full Text Available delivering a sponge product, aimed at replacing Kroll sponge alone, does not have potential for large reduction in overall titanium cost. Significant cost savings can only be achieved by also reducing the large number of process steps required to process... the sponge to mill product, including sponge purification, comminution, electrode forming, Vacuum Arc Re-melting, Hot and cold rolling. Presently, economy of scale in the production of titanium dictates that it is most cost effective to cast the largest...

The differential impact of low-carbon technologies on climate change mitigation cost under a range of socioeconomic and climate policy scenarios

International Nuclear Information System (INIS)

Barron, Robert; McJeon, Haewon

2015-01-01

This paper considers the effect of several key parameters of low carbon energy technologies on the cost of abatement. A methodology for determining the minimum level of performance required for a parameter to have a statistically significant impact on CO 2 abatement cost is developed and used to evaluate the impact of eight key parameters of low carbon energy supply technologies on the cost of CO 2 abatement. The capital cost of nuclear technology is found to have the greatest impact of the parameters studied. The cost of biomass and CCS technologies also have impacts, while their efficiencies have little, if any. Sensitivity analysis of the results with respect to population, GDP, and CO 2 emission constraint show that the minimum performance level and impact of nuclear technologies is consistent across the socioeconomic scenarios studied, while the other technology parameters show different performance under higher population, lower GDP scenarios. Solar technology was found to have a small impact, and then only at very low costs. These results indicate that the cost of nuclear is the single most important driver of abatement cost, and that trading efficiency for cost may make biomass and CCS technologies more competitive. - Highlights: • The impact of low carbon energy technology on abatement cost is considered. • Nuclear has the largest impact among technologies considered. • Cost has higher impact than efficiency for biomass technologies. • Biomass technologies generally have larger impacts than carbon capture. • Biomass technologies are more valuable in low GDP, high population scenarios

A prospective study to determine the costs incurred by families of children newly diagnosed with cancer in Ontario.

Science.gov (United States)

Tsimicalis, Argerie; Stevens, Bonnie; Ungar, Wendy J; McKeever, Patricia; Greenberg, Mark; Agha, Mohammad; Guerriere, Denise; Barr, Ronald; Naqvi, Ahmed; Moineddin, Rahim

2012-10-01

A diagnosis of cancer in childhood places a considerable economic burden on families, although costs are not well described. The objectives of this study were to identify and determine independent predictors of the direct and time costs incurred by such families. A prospective, cost-of-illness study was conducted in families of children newly diagnosed with cancer. Parents recorded the resources consumed and costs incurred during 1 week per month for three consecutive months beginning the fourth week following diagnosis and listed any additional costs incurred since then. Descriptive and multiple regression analyses were performed to describe families' costs (expressed in 2007 Canadian dollars) and to determine direct and time cost predictors. In total, 28 fathers and 71 mothers participated. The median total direct and time costs in 3 months were $CAD3503 and $CAD23 130, respectively, per family. The largest component of direct costs was travel and of time costs was time allocated previously for unpaid activities. There were no statistically significant predictors of direct costs. Six per cent of the variance for time costs was explained by language spoken at home. Families of children with cancer are confronted with a wide range of direct and time costs, the largest being travel and time allocated previously for unpaid activities. Copyright © 2011 John Wiley & Sons, Ltd.

Lagisza, world's largest CFB boiler, begins commercial operation

Energy Technology Data Exchange (ETDEWEB)

Nuortimo, K. [Foster Wheeler, Varkaus (Finland)

2010-04-15

Early operating experience with the Lagisza circulating fluidised bed (CFB) boiler in Poland - the world's largest such boiler to date, and also the first one with supercritical steam conditions - has been positive. 3 figs., 4 tabs.

Potentials and costs of carbon dioxide mitigation in the world's buildings

International Nuclear Information System (INIS)

Urge-Vorsatz, Diana; Novikova, Aleksandra

2008-01-01

Buildings are responsible for over a third of global energy-related carbon dioxide (CO 2 ) emissions. A significant share of these emissions can be avoided cost effectively through improved energy efficiency, while providing the same or higher level of energy services. How large is this emission reduction potential globally and how much will it cost for society to unlock it? This paper provides answers to these questions, presenting the results of bottom-up research conducted for the Intergovernmental Panel on Climate Change (IPCC), based on the assessment of 80 country- or regional-level mitigation studies throughout the world. First, the paper analyses the findings of these studies in a common framework. Then, it aggregates their results into a global estimate of CO 2 mitigation potential. The paper concludes that by 2020 it is possible to cut cost effectively approximately 29% of buildings-related global CO 2 emissions, the largest among all sectors reported by the IPCC, representing a 3.2 GtCO 2 eq. reduction. Developing countries house the largest cost-effective potential with up to 52% of building-level emissions, whereas transition economies and industrialised countries have cost-effective potentials of up to 37% and 25%, respectively. Energy-efficient lighting was identified as the most attractive measure worldwide, in terms of both reduction potential and cost effectiveness. If this potential is realised, the building-related CO 2 emissions would stay constant over 2004-2030. These stabilisation levels (if achieved by all other sectors) would cancel about 3 o C temperature increase over the projected period of time

Temporal properties of seismicity and largest earthquakes in SE Carpathians

Directory of Open Access Journals (Sweden)

S. Byrdina

2006-01-01

Full Text Available In order to estimate the hazard rate distribution of the largest seismic events in Vrancea, South-Eastern Carpathians, we study temporal properties of historical and instrumental catalogues of seismicity. First, on the basis of Generalized Extreme Value theory we estimate the average return period of the largest events. Then, following Bak et al. (2002 and Corral (2005a, we study scaling properties of recurrence times between earthquakes in appropriate spatial volumes. We come to the conclusion that the seismicity is temporally clustered, and that the distribution of recurrence times is significantly different from a Poisson process even for times largely exceeding corresponding periods of foreshock and aftershock activity. Modeling the recurrence times by a gamma distributed variable, we finally estimate hazard rates with respect to the time elapsed from the last large earthquake.

Construction Cost Growth for New Department of Energy Nuclear Facilities

Energy Technology Data Exchange (ETDEWEB)

Kubic, Jr., William L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2014-05-25

Cost growth and construction delays are problems that plague many large construction projects including the construction of new Department of Energy (DOE) nuclear facilities. A study was conducted to evaluate cost growth of large DOE construction projects. The purpose of the study was to compile relevant data, consider the possible causes of cost growth, and recommend measures that could be used to avoid extreme cost growth in the future. Both large DOE and non-DOE construction projects were considered in this study. With the exception of Chemical and Metallurgical Research Building Replacement Project (CMRR) and the Mixed Oxide Fuel Fabrication Facility (MFFF), cost growth for DOE Nuclear facilities is comparable to the growth experienced in other mega construction projects. The largest increase in estimated cost was found to occur between early cost estimates and establishing the project baseline during detailed design. Once the project baseline was established, cost growth for DOE nuclear facilities was modest compared to non-DOE mega projects.

US nuclear industry plans squeeze on O and M costs

International Nuclear Information System (INIS)

Anon.

1994-01-01

The United States nuclear industry, still the largest in the world with 107 operating commercial plants, wants to squeeze still more fat out of operation and maintenance costs. Success or failure could decide whether many operating units remain competitive with other forms of baseload electricity generation over the coming decade. (Author)

PNNL supercomputer to become largest computing resource on the Grid

CERN Multimedia

2002-01-01

Hewlett Packard announced that the US DOE Pacific Northwest National Laboratory will connect a 9.3-teraflop HP supercomputer to the DOE Science Grid. This will be the largest supercomputer attached to a computer grid anywhere in the world (1 page).

Worlds largest particle physics laboratory selects Proxim Wireless Mesh

CERN Multimedia

2007-01-01

"Proxim Wireless has announced that the European Organization for Nuclear Research (CERN), the world's largest particle physics laboratory and the birthplace of the World Wide Web, is using it's ORiNOCO AP-4000 mesh access points to extend the range of the laboratory's Wi-Fi network and to provide continuous monitoring of the lab's calorimeters" (1/2 page)

Discovery of the largest orbweaving spider species: the evolution of gigantism in Nephila.

Science.gov (United States)

Kuntner, Matjaz; Coddington, Jonathan A

2009-10-21

More than 41,000 spider species are known with about 400-500 added each year, but for some well-known groups, such as the giant golden orbweavers, Nephila, the last valid described species dates from the 19(th) century. Nephila are renowned for being the largest web-spinning spiders, making the largest orb webs, and are model organisms for the study of extreme sexual size dimorphism (SSD) and sexual biology. Here, we report on the discovery of a new, giant Nephila species from Africa and Madagascar, and review size evolution and SSD in Nephilidae. We formally describe N. komaci sp. nov., the largest web spinning species known, and place the species in phylogenetic context to reconstruct the evolution of mean size (via squared change parsimony). We then test female and male mean size correlation using phylogenetically independent contrasts, and simulate nephilid body size evolution using Monte Carlo statistics. Nephila females increased in size almost monotonically to establish a mostly African clade of true giants. In contrast, Nephila male size is effectively decoupled and hovers around values roughly one fifth of female size. Although N. komaci females are the largest Nephila yet discovered, the males are also large and thus their SSD is not exceptional.

Discovery of the largest orbweaving spider species: the evolution of gigantism in Nephila.

Directory of Open Access Journals (Sweden)

Matjaz Kuntner

2009-10-01

Full Text Available More than 41,000 spider species are known with about 400-500 added each year, but for some well-known groups, such as the giant golden orbweavers, Nephila, the last valid described species dates from the 19(th century. Nephila are renowned for being the largest web-spinning spiders, making the largest orb webs, and are model organisms for the study of extreme sexual size dimorphism (SSD and sexual biology. Here, we report on the discovery of a new, giant Nephila species from Africa and Madagascar, and review size evolution and SSD in Nephilidae.We formally describe N. komaci sp. nov., the largest web spinning species known, and place the species in phylogenetic context to reconstruct the evolution of mean size (via squared change parsimony. We then test female and male mean size correlation using phylogenetically independent contrasts, and simulate nephilid body size evolution using Monte Carlo statistics.Nephila females increased in size almost monotonically to establish a mostly African clade of true giants. In contrast, Nephila male size is effectively decoupled and hovers around values roughly one fifth of female size. Although N. komaci females are the largest Nephila yet discovered, the males are also large and thus their SSD is not exceptional.

On the statistics of the largest geomagnetic storms per solar cycle

International Nuclear Information System (INIS)

Siscoe, G.L.

1976-01-01

The theory of extreme value statistics is applied to the first, second, and third largest geomagnetic storms in nine solar cycles measured by the average half-daily aa indices compiled by Mayaud. Analytic expressions giving the probability of the extremes per solar cycle as a contour function of storm magnitude are obtained by least squares fitting of the observations to the appropriate theoretical extreme value probability functions. The results are used to obtain the statistical characteristics (mode, median, mean, and standard deviation) for the extreme values. The results are applied to find the expected range of extreme values in a set as a function of the number of solar cycles in the set. We find that the expected range of the largest storm is quite narrow and is larger for the second and third largest storms. The observed range of the extreme half-daily aa index for the nine solar cycles is 354--546 γ. In a set of 100 cycles the range is expanded esentially to 311--680γ, an increase of only 39% in the range. The result supports the argument for a change in solar cycle statistics in the latter part of the Seventeenth Century (the Maunder minimum)

Impacts of optimum cost effective energy efficiency standards

International Nuclear Information System (INIS)

Brancic, A.B.; Peters, J.S.; Arch, M.

1991-01-01

Building Codes are increasingly required to be responsive to social and economic policy concerns. In 1990 the State of Connecticut passes An Act Concerning Global Warming, Public Act 90-219, which mandates the revision of the state building code to require that buildings and building elements be designed to provide optimum cost-effective energy efficiency over the useful life of the building. Further, such revision must meet the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Standard 90.1 - 1989. As the largest electric energy supplier in Connecticut, Northeast Utilities (NU) sponsored a pilot study of the cost effectiveness of alternative building code standards for commercial construction. This paper reports on this study which analyzed design and construction means, building elements, incremental construction costs, and energy savings to determine the optimum cost-effective building code standard. Findings are that ASHRAE 90.1 results in 21% energy savings and alternative standards above it result in significant additional savings. Benefit/cost analysis showed that both are cost effective

Revisiting the phylogeny of Ocellularieae, the second largest tribe within Graphidaceae (lichenized Ascomycota: Ostropales)

Science.gov (United States)

Ekaphan Kraichak; Sittiporn Parnmen; Robert Lücking; Eimy Rivas Plata; Andre Aptroot; Marcela E.S. Caceres; Damien Ertz; Armin Mangold; Joel A. Mercado-Diaz; Khwanruan Papong; Dries Van der Broeck; Gothamie Weerakoon; H. Thorsten. Lumbsch; NO-VALUE

2014-01-01

We present an updated 3-locus molecular phylogeny of tribe Ocellularieae, the second largest tribe within subfamily Graphidoideae in the Graphidaceae. Adding 165 newly generated sequences from the mitochondrial small subunit rDNA (mtSSU), the nuclear large subunit rDNA (nuLSU), and the second largest subunit of the DNA-directed RNA polymerase II (RPB2), we currently...

APT cost scaling: Preliminary indications from a Parametric Costing Model (PCM)

International Nuclear Information System (INIS)

Krakowski, R.A.

1995-01-01

A Parametric Costing Model has been created and evaluate as a first step in quantitatively understanding important design options for the Accelerator Production of Tritium (APT) concept. This model couples key economic and technical elements of APT in a two-parameter search of beam energy and beam power that minimizes costs within a range of operating constraints. The costing and engineering depth of the Parametric Costing Model is minimal at the present open-quotes entry levelclose quotes, and is intended only to demonstrate a potential for a more-detailed, cost-based integrating design tool. After describing the present basis of the Parametric Costing Model and giving an example of a single parametric scaling run derived therefrom, the impacts of choices related to resistive versus superconducting accelerator structures and cost of electricity versus plant availability (open-quotes load curveclose quotes) are reported. Areas of further development and application are suggested

Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country.

Science.gov (United States)

Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

2017-04-01

It is believed that laboratory tariffs in Iran don't reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector's tariffs in 2015. This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories.

Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy.

Science.gov (United States)

Narra, Roberta; Maestri, Marcello; Budke, Christine M; Tamarozzi, Francesca; Mariconti, Mara; Nicoletti, Giovanni J; Rinaldi, Francesca; Brunetti, Enrico

2016-08-03

Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the "San Matteo" Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach. © The American Society of Tropical Medicine and Hygiene.

Alliancing process helps BP control Prudhoe Bay costs

International Nuclear Information System (INIS)

Darley, J.R.

1992-01-01

Production and revenues from America's largest oil field are declining. The cost of operating it is rising. If both trends were to continue unchecked, oil production at Prudhoe Bay on Alaska's North Slope could become uneconomic in the next decade. Simply maintaining operating expenditures at current levels - barring a dramatic, lasting increase in oil prices - would postpone the day of reckoning by only a few years. Despite ongoing investments in tempering the decline - gas and water handling expansions, development drilling, enhanced oil recovery, and well maintenance and repair programs - production will continue to decline. That's why it's imperative we reverse the tide of rising costs. This paper reports that to continue to produce oil at Prudhoe well into the 21st century, we must immediately - and continually - cut costs to reflect declining production and revenues

What factors increase the risk of incurring high market impact costs?

NARCIS (Netherlands)

Bikker, Jacob A.; Spierdijk, Laura; van der Sluis, Pieter-Jelle

2010-01-01

This article applies quantile regression to assess the factors that influence the risk of incurring high trading costs. Using data on the equity trades of the world's second largest pension fund in the first quarter of 2002, we show that trade timing, momentum, volatility and the type of broker

Hospital financing: calculating inpatient capital costs in Germany with a comparative view on operating costs and the English costing scheme.

Science.gov (United States)

Vogl, Matthias

2014-04-01

The paper analyzes the German inpatient capital costing scheme by assessing its cost module calculation. The costing scheme represents the first separated national calculation of performance-oriented capital cost lump sums per DRG. The three steps in the costing scheme are reviewed and assessed: (1) accrual of capital costs; (2) cost-center and cost category accounting; (3) data processing for capital cost modules. The assessment of each step is based on its level of transparency and efficiency. A comparative view on operating costing and the English costing scheme is given. Advantages of the scheme are low participation hurdles, low calculation effort for G-DRG calculation participants, highly differentiated cost-center/cost category separation, and advanced patient-based resource allocation. The exclusion of relevant capital costs, nontransparent resource allocation, and unclear capital cost modules, limit the managerial relevance and transparency of the capital costing scheme. The scheme generates the technical premises for a change from dual financing by insurances (operating costs) and state (capital costs) to a single financing source. The new capital costing scheme will intensify the discussion on how to solve the current investment backlog in Germany and can assist regulators in other countries with the introduction of accurate capital costing. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

CERN, World's largest particle physics lab, selects Progress SonicMQ

CERN Document Server

2007-01-01

"Progress Software Corporation (NADAQ: PRGS), a global supplier of application insfrastructure software used to develop, deploy, integrate and manage business applications, today announced that CERN the world's largest physis laboratory and particle accelerator, has chosen Progress® SonicMQ® for mission-critical message delivery." (1 page)

Synchrotron Emission on the Largest Scales: Radio Detection of the ...

Indian Academy of Sciences (India)

Abstract. Shocks and turbulence generated during large-scale structure formation are predicted to produce large-scale, low surface-brightness synchrotron emission. On the largest scales, this emission is globally correlated with the thermal baryon distribution, and constitutes the 'syn- chrotron cosmic-web'. I present the ...

Distribution of the Largest Eigenvalues of the Levi-Smirnov Ensemble

International Nuclear Information System (INIS)

Wieczorek, W.

2004-01-01

We calculate the distribution of the k-th largest eigenvalue in the random matrix Levi - Smirnov Ensemble (LSE), using the spectral dualism between LSE and chiral Gaussian Unitary Ensemble (GUE). Then we reconstruct universal spectral oscillations and we investigate an asymptotic behavior of the spectral distribution. (author)

Design and Construction of an Autonomous Low-Cost Pulse Height Analyzer and a Single Channel Analyzer for Moessbauer Spectroscopy

International Nuclear Information System (INIS)

Velasquez, A.A.; Trujillo, J.M.; Morales, A.L.; Tobon, J.E.; Gancedo, J.R.; Reyes, L.

2005-01-01

A multichannel analyzer (MCA) and a single channel-analyzer (SCA) for Moessbauer spectrometry application have been designed and built. Both systems include low-cost digital and analog components. A microcontroller manages, either in PHA or MCS mode, the data acquisition, data storage and setting of the pulse discriminator limits. The user can monitor the system from an external PC through the serial port with the RS232 communication protocol. A graphic interface made with the LabVIEW software allows the user to adjust digitally the lower and upper limits of the pulse discriminator, and to visualize as well as save the PHA spectra in a file. The system has been tested using a 57Co radioactive source and several iron compounds, yielding satisfactory results. The low cost of its design, construction and maintenance make this equipment an attractive choice when assembling a Moessbauer spectrometer

Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons.

Directory of Open Access Journals (Sweden)

Julia K Ostermann

Full Text Available The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group with the costs for those receiving usual care (control group.Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.Data from 44,550 patients (67.3% females were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14-7,414.29] than in the control group (EUR 5,857.56 [5,650.98-6,064.13]; p<0.0001 with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48-3,809.53] vs. control EUR 3,092.84 [2,981.31-3,204.37] and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90-1,102.59] vs. control EUR 867.87 [853.52-882.21]. Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.

What factors increase the risk of incurring high market impact costs?

NARCIS (Netherlands)

Bikker, Jacob A.; Spierdijk, L.; van der Sluis, Pieter Jelle

2010-01-01

This article applies quantile regression to assess the factors that influence the risk of incurring high trading costs. Using data on the equity trades of the world’s second largest pension fund in the first quarter of 2002, we show that trade timing, momentum, volatility and the type of broker

The largest subsea hot tap (future tap flange) at Angel Field, Australia

Energy Technology Data Exchange (ETDEWEB)

Lad, Deepak; Drysdale, Colin [T.D. Williamson (United States); Naidoo, Sashie [T.D. Williamson (Australia)

2008-07-01

A subsea hot tap was conducted near the gas production platforms in Angel Field, Australia in September 2007 and verified as the largest no. 900 subsea hot tap by Australian authorities. This paper outlines the subsea tapping process, risks and safety issues in deep water environment, including the need to ensure 100% system accuracy and that the machine fluids used to operate the subsea tapping machines were environmentally friendly. The testing phase included land and water testing. In the land tests, issues relating to metal hardness, temperature, pressure and ocean currents that affected machine stability, torque and cutting rate were considered. All preliminary design and testing focused on being able to mount the tapping machine to a pre-existing hot-tap flange and conduct the tapping operation, start to finish, preferably without changing the cutter. The water depth tests took place inside a pressurized, underwater hyperbaric chamber. The equipment repeated the land testing process in conditions duplicating that of the actual project site. Timing was also measured in multiple climatic conditions (except water depth) to obtain an estimation of various scenarios. The field tapping process was conducted without problems in over six hours with a single cutter and without any stalls. (author)

Cost analysis of living donor kidney transplantation in China: a single-center experience.

Science.gov (United States)

Zhao, Wenyu; Zhang, Lei; Han, Shu; Zhu, Youhua; Wang, Liming; Zhou, Meisheng; Zeng, Li

2012-01-01

Kidney transplantation is the most cost-effective option for the treatment of end-stage renal disease, but the financial aspects of kidney transplantation have not yet been fully investigated. The purpose of this study was to determine the hospital cost of living donor kidney transplantation in China and to identify factors associated with the high cost. Demographic and clinical data of 103 consecutive patients who underwent living donor kidney transplantation from January 2007 to January 2011 at our center were reviewed, and detailed hospital cost of initial admission for kidney transplantation was analyzed. A stepwise multiple regression analysis was computed to determine predictors affecting the total hospital cost. The median total hospital cost was US $10,531, of which 69.2% was for medications, 13.2% for surgical procedures, 11.4% for para clinics, 3.7% for accommodations, 0.5% for nursing care, and 2.0% for other miscellaneous medical services. A multivariate stepwise logistic regression model for overall cost of transplantation revealed that the length of hospital stay, induction therapy, steroid-resistant rejection, maintenance therapy, infection status and body weight were independent predictors affecting the total hospitalization cost. Although the cost of living donor kidney transplantation in China is much lower than that in developed countries, it is a heavy burden for both the government and the patients. As medications formed the greater proportion of the total hospitalization cost, efforts to reduce the cost of drugs should be addressed.

Sulphur guidelines cost $50 million

Energy Technology Data Exchange (ETDEWEB)

1974-01-21

Nearly all gas processing plants requiring remedial work on their sulfur recovery facilities have had applications filed for approval of new construction or modifications. Several jobs have been completed, but some of the largest have not received final approvals from the ERCB and the Alberta department of the environment. It is probable that toal capital expenditures for remedial work will be less than the original forecasts when the guide lines were proclaimed 3 yr ago. Several projects have been rolled in with plant expansions and installation of other new facilities. Even if a portion of these costs is attributed specifically to meeting sulfur guide lines, the total industry investment will probably not exceed $50 million. The principal item in this calculation is the $15 million project for Shell Canada Ltd. at its Waterton plant. This involves installation of a SCOT tail gas cleanup unit and related facilities, to be completed early in 1975. Among the operators of the 6 largest gas plants not meeting specifications in the top size category, Shell was the only one which elected not to apply for exemption.

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

Directory of Open Access Journals (Sweden)

Peter J Neumann

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

Cost analysis of the development and implementation of a spatial decision support system for malaria elimination in Solomon Islands.

Science.gov (United States)

Marston, Luke; Kelly, Gerard C; Hale, Erick; Clements, Archie C A; Hodge, Andrew; Jimenez-Soto, Eliana

2014-08-18

The goal of malaria elimination faces numerous challenges. New tools are required to support the scale up of interventions and improve national malaria programme capacity to conduct detailed surveillance. This study investigates the cost factors influencing the development and implementation of a spatial decision support system (SDSS) for malaria elimination in the two elimination provinces of Isabel and Temotu, Solomon Islands. Financial and economic costs to develop and implement a SDSS were estimated using the Solomon Islands programme's financial records. Using an ingredients approach, verified by stakeholders and operational reports, total costs for each province were quantified. A budget impact sensitivity analysis was conducted to investigate the influence of variations in standard budgetary components on the costs and to identify potential cost savings. A total investment of US$ 96,046 (2012 constant dollars) was required to develop and implement the SDSS in two provinces (Temotu Province US$ 49,806 and Isabel Province US$ 46,240). The single largest expense category was for computerized equipment totalling approximately US$ 30,085. Geographical reconnaissance was the most expensive phase of development and implementation, accounting for approximately 62% of total costs. Sensitivity analysis identified different cost factors between the provinces. Reduced equipment costs would deliver a budget saving of approximately 10% in Isabel Province. Combined travel costs represented the greatest influence on the total budget in the more remote Temotu Province. This study provides the first cost analysis of an operational surveillance tool used specifically for malaria elimination in the South-West Pacific. It is demonstrated that the costs of such a decision support system are driven by specialized equipment and travel expenses. Such factors should be closely scrutinized in future programme budgets to ensure maximum efficiencies are gained and available resources

Discovery of the Largest Orbweaving Spider Species: The Evolution of Gigantism in Nephila

OpenAIRE

Kuntner, Matja?; Coddington, Jonathan A.

2009-01-01

Background More than 41,000 spider species are known with about 400?500 added each year, but for some well-known groups, such as the giant golden orbweavers, Nephila, the last valid described species dates from the 19th century. Nephila are renowned for being the largest web-spinning spiders, making the largest orb webs, and are model organisms for the study of extreme sexual size dimorphism (SSD) and sexual biology. Here, we report on the discovery of a new, giant Nephila species from Africa...

Alcohol-related hand injuries: an unnecessary social and economic cost.

OpenAIRE

Marston, R. A.

1992-01-01

Severe hand injuries constitute the largest number of acute referrals to this plastic surgery unit, the admission of these patients often displacing routine admissions due to bed shortages, thus increasing waiting list time. This study showed that a high percentage of these injuries were alcohol-related and were therefore preventable. The economic cost to the unit is discussed.

Single liner shipping service design

DEFF Research Database (Denmark)

Plum, Christian Edinger Munk; Pisinger, David; Salazar-González, Juan-José

2014-01-01

The design of container shipping networks is an important logistics problem, involving assets and operational costs measured in billions of dollars. To guide the optimal deployment of the ships, a single vessel round trip is considered by minimizing operational costs and flowing the best paying...

Selected Tether Applications Cost Model

Science.gov (United States)

Keeley, Michael G.

1988-01-01

Diverse cost-estimating techniques and data combined into single program. Selected Tether Applications Cost Model (STACOM 1.0) is interactive accounting software tool providing means for combining several independent cost-estimating programs into fully-integrated mathematical model capable of assessing costs, analyzing benefits, providing file-handling utilities, and putting out information in text and graphical forms to screen, printer, or plotter. Program based on Lotus 1-2-3, version 2.0. Developed to provide clear, concise traceability and visibility into methodology and rationale for estimating costs and benefits of operations of Space Station tether deployer system.

Energetic costs of performance in trained and untrained Anolis carolinensis lizards.

Science.gov (United States)

Lailvaux, Simon P; Wang, Andrew Z; Husak, Jerry F

2018-03-12

The energetic costs of performance constitute a non-trivial component of animals' daily energetic budgets. However, we currently lack an understanding of how those costs are partitioned among the various stages of performance development, maintenance, and production. We manipulated individual investment in performance by training Anolis carolinensis lizards for endurance or sprinting ability. We then measured energetic expenditure both at rest and immediately following exercise to test whether such training alters the maintenance and production costs of performance. Trained lizards had lower resting metabolic rates than controls, suggestive of a maintenance saving associated with enhanced performance as opposed to a cost. Production costs also differed, with sprint-trained lizards incurring the largest energetic performance cost and experiencing the longest recovery times compared to endurance trained and control animals. Although performance training modifies metabolism, production costs are probably the key drivers of trade-offs between performance and other life-history traits in this species. © 2018. Published by The Company of Biologists Ltd.

Costing the Australian National Hand Hygiene Initiative.

Science.gov (United States)

Page, K; Barnett, A G; Campbell, M; Brain, D; Martin, E; Fulop, N; Graves, N

2014-11-01

The Australian National Hand Hygiene Initiative (NHHI) is a major patient safety programme co-ordinated by Hand Hygiene Australia (HHA) and funded by the Australian Commission for Safety and Quality in Health Care. The annual costs of running this programme need to be understood to know the cost-effectiveness of a decision to sustain it as part of health services. To estimate the annual health services cost of running the NHHI; the set-up costs are excluded. A health services perspective was adopted for the costing and collected data from the 50 largest public hospitals in Australia that implemented the initiative, covering all states and territories. The costs of HHA, the costs to the state-level infection-prevention groups, the costs incurred by each acute hospital, and the costs for additional alcohol-based hand rub are all included. The programme cost AU$5.56 million each year (US$5.76, £3.63 million). Most of the cost is incurred at the hospital level (65%) and arose from the extra time taken for auditing hand hygiene compliance and doing education and training. On average, each infection control practitioner spent 5h per week on the NHHI, and the running cost per annum to their hospital was approximately AU$120,000 in 2012 (US$124,000, £78,000). Good estimates of the total costs of this programme are fundamental to understanding the cost-effectiveness of implementing the NHHI. This paper reports transparent costing methods, and the results include their uncertainty. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

THE CHALLENGE OF THE LARGEST STRUCTURES IN THE UNIVERSE TO COSMOLOGY

International Nuclear Information System (INIS)

Park, Changbom; Choi, Yun-Young; Kim, Sungsoo S.; Kim, Kap-Sung; Kim, Juhan; Gott III, J. Richard

2012-01-01

Large galaxy redshift surveys have long been used to constrain cosmological models and structure formation scenarios. In particular, the largest structures discovered observationally are thought to carry critical information on the amplitude of large-scale density fluctuations or homogeneity of the universe, and have often challenged the standard cosmological framework. The Sloan Great Wall (SGW) recently found in the Sloan Digital Sky Survey (SDSS) region casts doubt on the concordance cosmological model with a cosmological constant (i.e., the flat ΛCDM model). Here we show that the existence of the SGW is perfectly consistent with the ΛCDM model, a result that only our very large cosmological N-body simulation (the Horizon Run 2, HR2) could supply. In addition, we report on the discovery of a void complex in the SDSS much larger than the SGW, and show that such size of the largest void is also predicted in the ΛCDM paradigm. Our results demonstrate that an initially homogeneous isotropic universe with primordial Gaussian random phase density fluctuations growing in accordance with the general relativity can explain the richness and size of the observed large-scale structures in the SDSS. Using the HR2 simulation we predict that a future galaxy redshift survey about four times deeper or with 3 mag fainter limit than the SDSS should reveal a largest structure of bright galaxies about twice as big as the SGW.

Preliminary Multivariable Cost Model for Space Telescopes

Science.gov (United States)

Stahl, H. Philip

2010-01-01

Parametric cost models are routinely used to plan missions, compare concepts and justify technology investments. Previously, the authors published two single variable cost models based on 19 flight missions. The current paper presents the development of a multi-variable space telescopes cost model. The validity of previously published models are tested. Cost estimating relationships which are and are not significant cost drivers are identified. And, interrelationships between variables are explored

Cost Modeling for Space Telescope

Science.gov (United States)

Stahl, H. Philip

2011-01-01

Parametric cost models are an important tool for planning missions, compare concepts and justify technology investments. This paper presents on-going efforts to develop single variable and multi-variable cost models for space telescope optical telescope assembly (OTA). These models are based on data collected from historical space telescope missions. Standard statistical methods are used to derive CERs for OTA cost versus aperture diameter and mass. The results are compared with previously published models.

Is total pancreatectomy as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy? A single center, prospective, observational study.

Science.gov (United States)

Casadei, Riccardo; Ricci, Claudio; Taffurelli, Giovanni; Guariniello, Anna; Di Gioia, Anthony; Di Marco, Mariacristina; Pagano, Nico; Serra, Carla; Calculli, Lucia; Santini, Donatella; Minni, Francesco

2016-09-01

Total pancreatectomy is actually considered a viable option in selected patients even if large comparative studies between partial versus total pancreatectomy are not currently available. Our aim was to evaluate whether total pancreatectomy can be considered as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy. A single center, prospective, observational trial, regarding postoperative outcomes, long-term results, and cost-effectiveness, in a tertiary referral center was conducted, comparing consecutive patients who underwent elective total pancreatectomy and/or pancreaticoduodenectomy. Seventy-three consecutive elective total pancreatectomies and 184 pancreaticoduodenectomies were compared. There were no significant differences regarding postoperative outcomes and overall survival. The quality of life, evaluated in 119 patients according to the EQ-5D-5L questionnaire, showed that there were no significant differences regarding the five items considered. The mean EQ-5D-5L score was similar in the two procedures (total pancreatectomy = 0.872, range 0.345-1.000; pancreaticoduodenectomy = 0.832, range 0.393-1.000; P = 0.320). The impact of diabetes according to the Problem Areas in Diabetes (PAID) questionnaire did not show any significant differences except for question 13 (total pancreatectomy = 0.60; pancreaticoduodenectomy = 0.19; P = 0.022). The cost-effectiveness analysis suggested that the quality-adjusted life year was not significantly different between the two procedures (total pancreatectomy = 0.910, range 0.345-1.000; pancreaticoduodenectomy = 0.910, range -0.393-1.000; P = 0.320). From this study, it seems reasonable to suggest that total pancreatectomy can be considered as safe, feasible, and efficacious as PD and acceptable in terms of cost-effectiveness.

Prospects for the synthesis of large single-crystal diamonds

International Nuclear Information System (INIS)

Khmelnitskiy, R A

2015-01-01

The unique properties of diamond have stimulated the study of and search for its applications in many fields, including optics, optoelectronics, electronics, biology, and electrochemistry. Whereas chemical vapor deposition allows the growth of polycrystalline diamond plates more than 200 mm in diameter, most current diamond application technologies require large-size (25 mm and more) single-crystal diamond substrates or films suitable for the photolithography process. This is quite a challenge, because the largest diamond crystals currently available are 10 mm or less in size. This review examines three promising approaches to fabricating large-size diamond single crystals: growing large-size single crystals, the deposition of heteroepitaxial diamond films on single-crystal substrates, and the preparation of composite diamond substrates. (reviews of topical problems)

The great environmental restoration cost estimating shootout: A blind test of three DOE cost estimating groups

International Nuclear Information System (INIS)

Klemen, Paul

1992-01-01

The cost of the Department of Energy's (DOE) Environmental Restoration (ER) Program has increased steadily over the last three years and, in the process, has drawn increasing scrutiny from Congress, the public, and government agencies such as the Office of Management and Budget and the General Accounting Office. Programmatic costs have been reviewed by many groups from within the DOE as well as from outside agencies. While cost may appear to be a universally applicable barometer of project conditions, it is actually a single dimensional manifestation of a complex set of conditions. As such, variations in cost estimates can be caused by a variety of underlying factors such as changes in scope, schedule, performing organization, economic conditions, or regulatory environment. This paper will examine the subject of cost estimates by evaluating three different cost estimates prepared for a single project including two estimates prepared by project proponents and another estimate prepared by a review team. The paper identifies the reasons for cost growth as measured by the different estimates and evaluates the ability of review estimates to measure the validity of costs. The comparative technique used to test the three cost estimates will identify the reasons for changes in the estimated cost, over time, and evaluate the ability of an independent review to correctly identify the reasons for cost growth and evaluate the reasonableness of the cost proposed by the project proponents. Recommendations are made for improved cost estimates and improved cost estimate reviews. Conclusions are reached regarding the differences in estimate results that can be attributed to differences in estimating techniques, the implications of these differences for decision makers, and circumstances that are unique to environmental cost estimating. (author)

Long-term outcomes after allogeneic hematopoietic stem cell transplantation for metachromatic leukodystrophy: the largest single-institution cohort report

OpenAIRE

Boucher, Alexander A.; Miller, Weston; Shanley, Ryan; Ziegler, Richard; Lund, Troy; Raymond, Gerald; Orchard, Paul J.

2015-01-01

Background Metachromatic Leukodystrophy (MLD) is a rare, fatal demyelinating disorder with limited treatment options. Published outcomes after hematopoietic stem cell transplantation (HSCT) are scant and mixed. We report survival and function following HSCT for a large, single-center MLD cohort. Methods Transplant-related data, survival and serial measures (brain MRI, nerve conduction velocity (NCV), neurologic and neuropsychology evaluations) were reviewed. When possible, parental interviews...

[Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix].

Science.gov (United States)

Martin, J; Neurohr, C; Bauer, M; Weiss, M; Schleppers, A

2008-05-01

The aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. On the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. Data of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS) II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265 EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426 EUR and 1,145 EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). For the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.

Design and Construction of an Autonomous Low-Cost Pulse Height Analyzer and a Single Channel Analyzer for Mössbauer Spectroscopy

Science.gov (United States)

Velásquez, A. A.; Gancedo, J. R.; Trujillo, J. M.; Morales, A. L.; Tobón, J. E.; Reyes, L.

2005-04-01

A multichannel analyzer (MCA) and a single channel-analyzer (SCA) for Mössbauer spectrometry application have been designed and built. Both systems include low-cost digital and analog components. A microcontroller manages, either in PHA or MCS mode, the data acquisition, data storage and setting of the pulse discriminator limits. The user can monitor the system from an external PC through the serial port with the RS232 communication protocol. A graphic interface made with the LabVIEW software allows the user to adjust digitally the lower and upper limits of the pulse discriminator, and to visualize as well as save the PHA spectra in a file. The system has been tested using a 57Co radioactive source and several iron compounds, yielding satisfactory results. The low cost of its design, construction and maintenance make this equipment an attractive choice when assembling a Mössbauer spectrometer.

Mass balance of Greenland's three largest outlet glaciers - 2000–2010

NARCIS (Netherlands)

Howat, I.M.; Ahn, Y.; Joughin, I.; van den Broeke, M.R.; Lenaerts, J.T.M.; Smith, B.

2011-01-01

Acceleration of Greenland's three largest outlet glaciers, Helheim, Kangerdlugssuaq and Jakobshavn Isbræ, accounted for a substantial portion of the ice sheet's mass loss over the past decade. Rapid changes in their discharge, however, make their cumulative mass-change uncertain. We derive monthly

The Single-Phase ProtoDUNE Technical Design Report

Energy Technology Data Exchange (ETDEWEB)

Abi, B. [Univ. of Padova (Italy); et al.

2017-06-21

ProtoDUNE-SP is the single-phase DUNE Far Detector prototype that is under construction and will be operated at the CERN Neutrino Platform (NP) starting in 2018. ProtoDUNE-SP, a crucial part of the DUNE effort towards the construction of the first DUNE 10-kt fiducial mass far detector module (17 kt total LAr mass), is a significant experiment in its own right. With a total liquid argon (LAr) mass of 0.77 kt, it represents the largest monolithic single-phase LArTPC detector to be built to date. It's technical design is given in this report.

goGPS: open source software for enhancing the accuracy of low-cost receivers by single-frequency relative kinematic positioning

International Nuclear Information System (INIS)

Realini, Eugenio; Reguzzoni, Mirko

2013-01-01

goGPS is a free and open source satellite positioning software package aiming to provide a collaborative platform for research and teaching purposes. It was first published in 2009 and since then several related projects are on-going. Its objective is the investigation of strategies for enhancing the accuracy of low-cost single-frequency GPS receivers, mainly by relative positioning with respect to a base station and by a tailored extended Kalman filter working directly on code and phase observations. In this paper, the positioning algorithms implemented in goGPS are presented, emphasizing the modularity of the software design; two specific strategies to support the navigation with low-cost receivers are also proposed and discussed, namely an empirical observation weighting function calibrated on the receiver signal-to-noise ratio and the inclusion of height information from a digital terrain model as an additional observation in the Kalman filter. The former is crucial when working with high-sensitivity receivers, while the latter can significantly improve the positioning in the vertical direction. The overall goGPS positioning accuracy is assessed by comparison with a dual-frequency receiver and with the positioning computed by a standard low-cost receiver. The benefits of the calibrated weighting function and the digital terrain model are investigated by an experiment in a dense urban environment. It comes out that the use of goGPS and low-cost receivers leads to results comparable with those obtained by higher level receivers; goGPS has good performances also in a dense urban environment, where its additional features play an important role. (paper)

New generation of single-chip microcomputers focused on cost performance

Energy Technology Data Exchange (ETDEWEB)

Akao, Y.; Iwashita, H. (Hitachi, Ltd., Tokyo (Japan))

1993-06-01

A single-chip microcomputer which incorporates a CPU (central processing unit), memory, and peripheral functions in one chip has been increasingly applied to various fields as the heart of electronic equipment in terms of its economy, compactness, lightness, and suitability for mass production. In response to a wide variety of needs, a lineup must have substantial breadth with regard to performance, on-chip memory capacity, on-chip peripheral functions, operating voltage, and packaging. In particular, low-voltage high-speed operation, high integration, expanded address space, and improved software productivity, which are required for mobile communication terminals, are the common needs for single-chip microcomputers. In accordance with these needs, Hitachi has been actively developing new products. The present paper introduces Hitachi's lineup of single-chip microcomputers. 10 figs., 1 tab.

Cost Estimating Handbook for Environmental Restoration

International Nuclear Information System (INIS)

1993-01-01

Environmental restoration (ER) projects have presented the DOE and cost estimators with a number of properties that are not comparable to the normal estimating climate within DOE. These properties include: An entirely new set of specialized expressions and terminology. A higher than normal exposure to cost and schedule risk, as compared to most other DOE projects, due to changing regulations, public involvement, resource shortages, and scope of work. A higher than normal percentage of indirect costs to the total estimated cost due primarily to record keeping, special training, liability, and indemnification. More than one estimate for a project, particularly in the assessment phase, in order to provide input into the evaluation of alternatives for the cleanup action. While some aspects of existing guidance for cost estimators will be applicable to environmental restoration projects, some components of the present guidelines will have to be modified to reflect the unique elements of these projects. The purpose of this Handbook is to assist cost estimators in the preparation of environmental restoration estimates for Environmental Restoration and Waste Management (EM) projects undertaken by DOE. The DOE has, in recent years, seen a significant increase in the number, size, and frequency of environmental restoration projects that must be costed by the various DOE offices. The coming years will show the EM program to be the largest non-weapons program undertaken by DOE. These projects create new and unique estimating requirements since historical cost and estimating precedents are meager at best. It is anticipated that this Handbook will enhance the quality of cost data within DOE in several ways by providing: The basis for accurate, consistent, and traceable baselines. Sound methodologies, guidelines, and estimating formats. Sources of cost data/databases and estimating tools and techniques available at DOE cost professionals

Just-in-time preemptive single machine problem with costs of earliness/tardiness, interruption and work-in-process

Directory of Open Access Journals (Sweden)

Mohammad Kazemi

2012-04-01

Full Text Available This paper considers preemption and idle time are allowed in a single machine scheduling problem with just-in-time (JIT approach. It incorporates Earliness/Tardiness (E/T penalties, interruption penalties and holding cost of jobs which are waiting to be processed as work-in-process (WIP. Generally in non-preemptive problems, E/T penalties are a function of the completion time of the jobs. Then, we introduce a non-linear preemptive scheduling model where the earliness penalty depends on the starting time of a job. The model is liberalized by an elaborately–designed procedure to reach the optimum solution. To validate and verify the performance of proposed model, computational results are presented by solving a number of numerical examples.

Single-incision laparoscopic appendectomy using homemade glove port at low cost

Directory of Open Access Journals (Sweden)

Sang Myoung Lee

2016-01-01

Full Text Available Purpose: The aim of this study was to report homemade glove port technique for single-incision laparoscopic appendectomy (SILA. Materials and Methods: Our homemade glove port was composed of a size 6 latex sterile surgical glove, a sterilized plastic bangle, and three pieces of silicon tube (5 cm in length that were used as the suction tube. Clinical data were retrospectively collected from those patients who underwent SILA at Bucheon St. Mary's Hospital, Bucheon, Gyeonggi-do, South Korea between February 2014 and June 2014, including patient demographics, and operative and postoperative outcomes. To compare the outcomes, a retrospective review was performed for those patients who underwent conventional laparoscopic appendectomy (CLA between October 2013 and January 2014. Both SILA and CLA were performed by the same surgical team. Results: The SILA and CLA groups included 37 and 57 patients, respectively. The mean age, weight, body mass index (BMI, operation time, and pathologic diagnosis of gangrenous appendicitis were not significantly different between the two groups. However, the mean hospital stay in the CLA group was significantly (P = 0.018 longer than that in the SILA group (4.2 days vs 3.5 days. There was no conversion to open surgery in both the groups. Of the cases who underwent SILA, 10 (27.0% needed insertion of additional port and drain. There was one (3.2% complication of umbilical surgical site infection. Conclusion: In this study, SILA, with homemade glove port, was technically feasible and safe at low cost.

Development of a Practical Costing Method for Hospitals

OpenAIRE

Cao, Pengyu; Toyabe, Shin-ichi; Akazawa, Kouhei

2006-01-01

To realize an effective cost control, a practical and accurate cost accounting system is indispensable in hospitals. In traditional cost accounting systems, the volume-based costing (VBC) is the most popular cost accounting method. In this method, the indirect costs are allocated to each cost object (services or units of a hospital) using a single indicator named a cost driver (e.g., Labor hours, revenues or the number of patients). However, this method often results in rough and inaccurate r...

Detecting single-electron events in TEM using low-cost electronics and a silicon strip sensor.

Science.gov (United States)

Gontard, Lionel C; Moldovan, Grigore; Carmona-Galán, Ricardo; Lin, Chao; Kirkland, Angus I

2014-04-01

There is great interest in developing novel position-sensitive direct detectors for transmission electron microscopy (TEM) that do not rely in the conversion of electrons into photons. Direct imaging improves contrast and efficiency and allows the operation of the microscope at lower energies and at lower doses without loss in resolution, which is especially important for studying soft materials and biological samples. We investigate the feasibility of employing a silicon strip detector as an imaging detector for TEM. This device, routinely used in high-energy particle physics, can detect small variations in electric current associated with the impact of a single charged particle. The main advantages of using this type of sensor for direct imaging in TEM are its intrinsic radiation hardness and large detection area. Here, we detail design, simulation, fabrication and tests in a TEM of the front-end electronics developed using low-cost discrete components and discuss the limitations and applications of this technology for TEM.

Sensorless control of low-cost single-phase hybrid switched reluctance motor drive

DEFF Research Database (Denmark)

Jakobsen, Uffe; Lu, Kaiyuan; Rasmussen, Peter Omand

2013-01-01

This paper presents a sensorless-controlled, low-cost, low-power, variable-speed drive system suitable for fan and pump applications. The main advantages of this drive system are the low system cost, simple converter structure, and simple but robust sensorless control technique. The drive motor...... is a special Hybrid Switched Reluctance Motor (HSRM). The proposed sensorless control method utilizes beneficially the stator side permanent magnet field and its performance is motor parameter independent. The unique low-cost drive system solution, simple and robust sensorless control features of this drive...

Sensorless Control of Low-cost Single-phase Hybrid Switched Reluctance Motor Drive

DEFF Research Database (Denmark)

Jakobsen, Uffe; Lu, Kaiyuan; Rasmussen, Peter Omand

2015-01-01

This paper presents a sensorless-controlled, low-cost, low-power, and variable-speed drive system suitable for fan and pump applications. The main advantages of this drive system are the low system cost, simple converter structure, and simple but robust sensorless control technique. The drive motor...... is a special hybrid switched reluctance motor. The proposed sensorless control method beneficially utilizes the stator side PM field and its performance is motor parameter independent. The unique low-cost drive system solution, simple and robust sensorless control features of this drive system, is demonstrated...

The "basic" approach: a single-centre experience with a cost-reducing model for paediatric cardiac extracorporeal membrane oxygenation.

Science.gov (United States)

Padalino, Massimo A; Tessari, Chiara; Guariento, Alvise; Frigo, Anna C; Vida, Vladimiro L; Marcolongo, Andrea; Zanella, Fabio; Harvey, Michael J; Thiagarajan, Ravi R; Stellin, Giovanni

2017-04-01

Extracorporeal membrane oxygenation (ECMO) is a lifesaving but expensive therapy in terms of financial, technical and human resources. We report our experience with a 'basic' ECMO support model, consisting of ECMO initiated and managed without the constant presence of a bedside specialist, to assess safety, clinical outcomes and financial impact on our health system. We did a retrospective single-centre study of paediatric cardiac ECMO between January 2001 and March 2014. Outcomes included postimplant complications and survival at weaning and at discharge. We used activity based costing to compare the costs of current basic ECMO with those of a 'full optional' dedicated ECMO team (hypothesis 1); ECMO with a bedside nurse and perfusionist (hypothesis 2), and ECMO with a bedside perfusionist (hypothesis 3). Basic cardiac ECMO was required for 121 patients (median age 75 days, median weight 4.4 kg). A total of 107 patients (88%) had congenital heart disease; 37 had univentricular physiology. The median duration of ECMO was 7 days (interquartile range [IQR], 4-15 days). Overall survival at weaning and at 30 days in the neonatal and paediatric age groups was 58.6% and 30.6%, respectively; these results were not significantly different from Extracorporeal Life Support Organization data. Cost analysis revealed a saving of €30 366, €22 144 and €13 837 for each patient on basic ECMO for hypotheses 1, 2 and 3, respectively. Despite reduced human, technical and economical resources, a basic ECMO model without a bedside specialist was associated with satisfactory survival and lower costs. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Costs of Reducing Greenhouse Gas Emissions: A Case Study of India’s Power Generation Sector

OpenAIRE

Manish Gupta

2006-01-01

If India were to participate in any international effort towards mitigating CO2 emissions, the power sector which is one of the largest emitters of CO2 in the country would be required to play a major role. In this context the study estimates the marginal abatement costs, which correspond to the costs incurred by the power plants to reduce one unit of CO2 from the current level. The study uses an output distance function approach and its duality with the revenue function to derive these costs...

Energy-dense fast food products cost less: an observational study of the energy density and energy cost of Australian fast foods.

Science.gov (United States)

Wellard, Lyndal; Havill, Michelle; Hughes, Clare; Watson, Wendy L; Chapman, Kathy

2015-12-01

To examine the association between energy cost and energy density of fast food products. Twenty Sydney outlets of the five largest fast food chains were surveyed four times. Price and kilojoule data were collected for all limited-time-only menu items (n=54) and a sample of standard items (n=67). Energy cost ($/kilojoule) and energy density (kilojoules/gram) of menu items were calculated. There was a significant inverse relationship between menu item energy density and energy cost (pFast food chains could provide a wider range of affordable, lower-energy foods, use proportional pricing of larger serve sizes, or change defaults in meals to healthier options. More research is required to determine the most effective strategy to reduce the negative impact of fast food on the population's diet. Current pricing in the fast food environment may encourage unhealthier purchases. © 2015 Public Health Association of Australia.

Modeling nexus of urban heat island mitigation strategies with electricity/power usage and consumer costs: a case study for Phoenix, Arizona, USA

Science.gov (United States)

Silva, Humberto; Fillpot, Baron S.

2018-01-01

A reduction in both power and electricity usage was determined using a previously validated zero-dimensional energy balance model that implements mitigation strategies used to reduce the urban heat island (UHI) effect. The established model has been applied to show the change in urban characteristic temperature when executing four common mitigation strategies: increasing the overall (1) emissivity, (2) vegetated area, (3) thermal conductivity, and (4) albedo of the urban environment in a series of increases by 5, 10, 15, and 20% from baseline values. Separately, a correlation analysis was performed involving meteorological data and total daily energy (TDE) consumption where the 24-h average temperature was shown to have the greatest correlation to electricity service data in the Phoenix, Arizona, USA, metropolitan region. A methodology was then developed for using the model to predict TDE consumption reduction and corresponding cost-saving analysis when implementing the four mitigation strategies. The four modeled UHI mitigation strategies, taken in combination, would lead to the largest percent reduction in annual energy usage, where increasing the thermal conductivity is the single most effective mitigation strategy. The single least effective mitigation strategy, increasing the emissivity by 5% from the baseline value, resulted in an average calculated reduction of about 1570 GWh in yearly energy usage with a corresponding 157 million dollar cost savings. When the four parameters were increased in unison by 20% from baseline values, an average calculated reduction of about 2050 GWh in yearly energy usage was predicted with a corresponding 205 million dollar cost savings.

Considering dominance in reduced single-step genomic evaluations.

Science.gov (United States)

Ertl, J; Edel, C; Pimentel, E C G; Emmerling, R; Götz, K-U

2018-06-01

Single-step models including dominance can be an enormous computational task and can even be prohibitive for practical application. In this study, we try to answer the question whether a reduced single-step model is able to estimate breeding values of bulls and breeding values, dominance deviations and total genetic values of cows with acceptable quality. Genetic values and phenotypes were simulated (500 repetitions) for a small Fleckvieh pedigree consisting of 371 bulls (180 thereof genotyped) and 553 cows (40 thereof genotyped). This pedigree was virtually extended for 2,407 non-genotyped daughters. Genetic values were estimated with the single-step model and with different reduced single-step models. Including more relatives of genotyped cows in the reduced single-step model resulted in a better agreement of results with the single-step model. Accuracies of genetic values were largest with single-step and smallest with reduced single-step when only the cows genotyped were modelled. The results indicate that a reduced single-step model is suitable to estimate breeding values of bulls and breeding values, dominance deviations and total genetic values of cows with acceptable quality. © 2018 Blackwell Verlag GmbH.

The largest glitch observed in the Crab pulsar

Science.gov (United States)

Shaw, B.; Lyne, A. G.; Stappers, B. W.; Weltevrede, P.; Bassa, C. G.; Lien, A. Y.; Mickaliger, M. B.; Breton, R. P.; Jordan, C. A.; Keith, M. J.; Krimm, H. A.

2018-05-01

We have observed a large glitch in the Crab pulsar (PSR B0531+21). The glitch occurred around MJD 58064 (2017 November 8) when the pulsar underwent an increase in the rotation rate of Δν = 1.530 × 10-5 Hz, corresponding to a fractional increase of Δν/ν = 0.516 × 10-6 making this event the largest glitch ever observed in this source. Due to our high-cadence and long-dwell time observations of the Crab pulsar we are able to partially resolve a fraction of the total spin-up of the star. This delayed spin-up occurred over a timescale of ˜1.7 days and is similar to the behaviour seen in the 1989 and 1996 large Crab pulsar glitches. The spin-down rate also increased at the glitch epoch by Δ \\dot{ν } / \\dot{ν } = 7 × 10^{-3}. In addition to being the largest such event observed in the Crab, the glitch occurred after the longest period of glitch inactivity since at least 1984 and we discuss a possible relationship between glitch size and waiting time. No changes to the shape of the pulse profile were observed near the glitch epoch at 610 MHz or 1520 MHz, nor did we identify any changes in the X-ray flux from the pulsar. The long-term recovery from the glitch continues to progress as \\dot{ν } slowly rises towards pre-glitch values. In line with other large Crab glitches, we expect there to be a persistent change to \\dot{ν }. We continue to monitor the long-term recovery with frequent, high quality observations.

24 CFR 27.113 - Foreclosure costs.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Foreclosure costs. 27.113 Section 27.113 Housing and Urban Development Office of the Secretary, Department of Housing and Urban... Single Family Mortgages § 27.113 Foreclosure costs. A commission may be allowed to the foreclosure...

CENET: Cost Efficiency in a New Era with new Technology

Energy Technology Data Exchange (ETDEWEB)

Karlsen, Jan E.; Lund, Bjoernar; Bos, Christian F.M.; Stokka, Sigmund

1997-12-31

This report relates to the CENET (Cost Efficiency in a New Era with new Technology) project the oil and gas in Europe. Key objectives of the CENET project are to determine the role of RTD (Research and Technology Development) in European oil and gas industry towards improved value and cost reduction with a particular focus on the means of developing offshore European marginal fields commercially, to identify RTD areas with the largest potential for improved value and cost reduction and technological developments and advances which are likely to increase European competitiveness internationally, and to provide guidance to European governments when deciding RTD priorities. A new era with new technology concerns increased oil and gas potential during the next century, a new era with clean, safe and cost efficient energy production, a new era with a new business structure, and globalization of the industry. 44 tabs., 5 figs., 23 tabs.

A managerial accounting analysis of hospital costs.

Science.gov (United States)

Frank, W G

1976-01-01

Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed.

Longevity in Calumma parsonii, the World's largest chameleon.

Science.gov (United States)

Tessa, Giulia; Glaw, Frank; Andreone, Franco

2017-03-01

Large body size of ectothermic species can be correlated with high life expectancy. We assessed the longevity of the World's largest chameleon, the Parson's chameleon Calumma parsonii from Madagascar by using skeletochronology of phalanges taken from preserved specimens held in European natural history museums. Due to the high bone resorption we can provide only the minimum age of each specimen. The highest minimum age detected was nine years for a male and eight years for a female, confirming that this species is considerably long living among chameleons. Our data also show a strong correlation between snout-vent length and estimated age. Copyright © 2017 Elsevier Inc. All rights reserved.

The cost of care homes for people with dementia in England: a modelling approach.

Science.gov (United States)

Romeo, Renee; Knapp, Martin; Salverda, Suzanne; Orrell, Martin; Fossey, Jane; Ballard, Clive

2017-12-01

To examine the cost of care for people with dementia in institutional care settings, to understand the major cost drivers and to highlight opportunities for service development. Data on 277 residents with dementia in 16 UK residential or nursing homes were collected. We estimated care and support costs and fitted models to the data. Sensitivity analyses were also conducted. Care home residents cost £792 weekly: 95% of the costs accounted for by direct fees. Hospital contacts contributed the largest proportion of the additional costs. Having an established diagnosis of dementia (b = 0.070; p < 0.05) was associated with higher costs. No association was found between cost and needs (b = -0.002; p = 0.818). The absence of an association between cost and needs emphasizes the importance of a more needs-based costing system which could result in clinical and economic advantages. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Experimental Implementation of a Low-Cost Single Phase Five-Level Inverter for Autonomous PV System Applications Without Batteries

Directory of Open Access Journals (Sweden)

A. Nouaiti

2018-02-01

Full Text Available This paper presents the design and the implementation of a low-cost single phase five-level inverter for photovoltaic applications. The proposed multilevel inverter is composed of a simple boost converter, a switched-capacitor converter, and an H-bridge converter. An efficient control method which associates a closed-loop regulation method with a simple maximum power point tracking (MPPT method is applied in order to allow the proposed multilevel inverter to transfer power energy from solar panels to autonomous load with no storage batteries. An experimental prototype of this inverter is fabricated at the laboratory and tested with a digital control system. Obtained results confirm the simplicity and the performance of the proposed photovoltaic system.

Animated-simulation modeling facilitates clinical-process costing.

Science.gov (United States)

Zelman, W N; Glick, N D; Blackmore, C C

2001-09-01

Traditionally, the finance department has assumed responsibility for assessing process costs in healthcare organizations. To enhance process-improvement efforts, however, many healthcare providers need to include clinical staff in process cost analysis. Although clinical staff often use electronic spreadsheets to model the cost of specific processes, PC-based animated-simulation tools offer two major advantages over spreadsheets: they allow clinicians to interact more easily with the costing model so that it more closely represents the process being modeled, and they represent cost output as a cost range rather than as a single cost estimate, thereby providing more useful information for decision making.

Cost-Efficacy Analysis of Out-of-District Special Education Placements: An Evaluative Measure of Behavior Support Intervention in Public Schools.

Science.gov (United States)

Putnam, Robert F.; Luiselli, James K.; Sennett, Kenneth; Malonson, Joanne

2002-01-01

Evaluation of out-of-district special education placement costs in the 15 largest Massachusetts public school districts found the criterion school district (which had developed a system-wide approach to behavioral intervention) had the lowest per capita cost, lowest percentage of total school budget consumed by out-of-district placements, and the…

HTGR Cost Model Users' Manual

International Nuclear Information System (INIS)

Gandrik, A.M.

2012-01-01

The High Temperature Gas-Cooler Reactor (HTGR) Cost Model was developed at the Idaho National Laboratory for the Next Generation Nuclear Plant Project. The HTGR Cost Model calculates an estimate of the capital costs, annual operating and maintenance costs, and decommissioning costs for a high-temperature gas-cooled reactor. The user can generate these costs for multiple reactor outlet temperatures; with and without power cycles, including either a Brayton or Rankine cycle; for the demonstration plant, first of a kind, or nth of a kind project phases; for a single or four-pack configuration; and for a reactor size of 350 or 600 MWt. This users manual contains the mathematical models and operating instructions for the HTGR Cost Model. Instructions, screenshots, and examples are provided to guide the user through the HTGR Cost Model. This model was design for users who are familiar with the HTGR design and Excel. Modification of the HTGR Cost Model should only be performed by users familiar with Excel and Visual Basic.

Wastewater Reuse for Agriculture: Development of a Regional Water Reuse Decision-Support Model (RWRM) for Cost-Effective Irrigation Sources.

Science.gov (United States)

Tran, Quynh K; Schwabe, Kurt A; Jassby, David

2016-09-06

Water scarcity has become a critical problem in many semiarid and arid regions. The single largest water use in such regions is for crop irrigation, which typically relies on groundwater and surface water sources. With increasing stress on these traditional water sources, it is important to consider alternative irrigation sources for areas with limited freshwater resources. One potential irrigation water resource is treated wastewater for agricultural fields located near urban centers. In addition, treated wastewater can contribute an appreciable amount of necessary nutrients for plants. The suitability of reclaimed water for specific applications depends on water quality and usage requirements. The main factors that determine the suitability of recycled water for agricultural irrigation are salinity, heavy metals, and pathogens, which cause adverse effects on human, plants, and soils. In this paper, we develop a regional water reuse decision-support model (RWRM) using the general algebraic modeling system to analyze the cost-effectiveness of alternative treatment trains to generate irrigation water from reclaimed wastewater, with the irrigation water designed to meet crop requirements as well as California's wastewater reuse regulations (Title 22). Using a cost-minimization framework, least-cost solutions consisting of treatment processes and their intensities (blending ratios) are identified to produce alternative irrigation sources for citrus and turfgrass. Our analysis illustrates the benefits of employing an optimization framework and flexible treatment design to identify cost-effective blending opportunities that may produce high-quality irrigation water for a wide range of end uses.

Energy and life-cycle cost analysis of a six-story office building

Science.gov (United States)

Turiel, I.

1981-10-01

An energy analysis computer program, DOE-2, was used to compute annual energy use for a typical office building as originally designed and with several energy conserving design modifications. The largest energy use reductions were obtained with the incorporation of daylighting techniques, the use of double pane windows, night temperature setback, and the reduction of artificial lighting levels. A life-cycle cost model was developed to assess the cost-effectiveness of the design modifications discussed. The model incorporates such features as inclusion of taxes, depreciation, and financing of conservation investments. The energy conserving strategies are ranked according to economic criteria such as net present benefit, discounted payback period, and benefit to cost ratio.

Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia

Science.gov (United States)

Graves, Nicholas; Page, Katie; Martin, Elizabeth; Brain, David; Hall, Lisa; Campbell, Megan; Fulop, Naomi; Jimmeison, Nerina; White, Katherine; Paterson, David; Barnett, Adrian G.

2016-01-01

Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand

Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia.

Directory of Open Access Journals (Sweden)

Nicholas Graves

Full Text Available The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included.The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011-2012.No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits.The Australian National Hand Hygiene Initiative was cost

Single-shell tank interim stabilization risk analysis

International Nuclear Information System (INIS)

Basche, A.D.

1998-01-01

The purpose of the Single-Shell Tank (SST) Interim Stabilization Risk Analysis is to provide a cost and schedule risk analysis of HNF-2358, Rev. 1, Single-Shell Tank Interim Stabilization Project Plan (Project Plan) (Ross et al. 1998). The analysis compares the required cost profile by fiscal year (Section 4.2) and revised schedule completion date (Section 4.5) to the Project Plan. The analysis also evaluates the executability of the Project Plan and recommends a path forward for risk mitigation

A cost-reducing extracorporeal membrane oxygenation (ECMO) program model: a single institution experience.

Science.gov (United States)

Cavarocchi, N C; Wallace, S; Hong, E Y; Tropea, A; Byrne, J; Pitcher, H T; Hirose, H

2015-03-01

The worldwide demand for ECMO support has grown. Its provision remains limited due to several factors (high cost, complicated technology, lack of expertise) that increase healthcare cost. Our goal was to assess if an intensive care unit (ICU)-run ECMO model without continuous bedside perfusionists would decrease costs while maintaining patient safety and outcomes. A new ECMO program was implemented in 2010, consisting of dedicated ICU multidisciplinary providers (ICU-registered nurses, mid-level providers and intensivists). In year one, we introduced an education platform, new technology and dedicated space. In year two, continuous bedside monitoring by perfusionists was removed and new management algorithms designating multidisciplinary providers as first responders were established. The patient safety and cost benefit from the removal of the continuous bedside monitoring of the perfusionists of this new ECMO program was retrospectively reviewed and compared. During the study period, 74 patients (28 patients in year 1 and 46 patients in year 2) were placed on ECMO (mean days: 8 ± 5.7). The total annual hospital expenditure for the ECMO program was significantly reduced in the new model ($234,000 in year 2 vs. $600,264 in year 1), showing a 61% decrease in cost. This cost decrease was attributed to a decreased utilization of perfusion services and the introduction of longer lasting and more efficient ECMO technology. We did not find any significant changes in registered nurse ratios or any differences in outcomes related to ICU safety events. We demonstrated that the ICU-run ECMO model managed to lower hospital cost by reducing the cost of continuous bedside perfusion support without a change in outcomes. © The Author(s) 2014.

Multiple cost criteria for occupational dose reduction

International Nuclear Information System (INIS)

James, J.Z.

1983-01-01

This paper describes a simple, feasible procedure for deciding if a proposed dose reduction measure is justified under ALARA, based on engineering economic principles of project feasibility analysis. Particular attention is given to the fixing of cost criteria: the importance of melding disparate objectives into a single parameter, and the distinction between a cost criterion and a cost consideration. (author)

Behaviors of cost functions in image registration between 201Tl brain tumor single-photon emission computed tomography and magnetic resonance images

International Nuclear Information System (INIS)

Soma, Tsutomu; Takaki, Akihiro; Teraoka, Satomi; Ishikawa, Yasushi; Murase, Kenya; Koizumi, Kiyoshi

2008-01-01

We studied the behaviors of cost functions in the registration of thallium-201 ( 201 Tl) brain tumor single-photon emission computed tomography (SPECT) and magnetic resonance (MR) images, as the similarity index of image positioning. A marker for image registration [technetium-99m ( 99m Tc) point source] was attached at three sites on the heads of 13 patients with brain tumor, from whom 42 sets of 99m Tc- 201 Tl SPECT (the dual-isotope acquisition) and MR images were obtained. The 201 Tl SPECT and MR images were manually registered according to the markers. From the positions where the two images were registered, the position of the 201 Tl SPECT was moved to examine the behaviors of the three cost functions, i.e., ratio image uniformity (RIU), mutual information (MI), and normalized MI (NMI). The cost functions MI and NMI reached the maximum at positions adjacent to those where the SPECT and MR images were manually registered. As for the accuracy of image registration in terms of the cost functions MI and NMI, on average, the images were accurately registered within 3 deg of rotation around the X-, Y-, and Z-axes, and within 1.5 mm (within 2 pixels), 3 mm (within 3 pixels), and 4 mm (within 1 slice) of translation to the X-, Y-, and Z-axes, respectively. In terms of rotation around the Z-axis, the cost function RIU reached the minimum at positions where the manual registration of the two images was substantially inadequate. The MI and NMI were suitable cost functions in the registration of 201 Tl SPECT and MR images. The behavior of the RIU, in contrast, was unstable, being unsuitable as an index of image registration. (author)

Surgical Value of Elective Minimally Invasive Gallbladder Removal: A Cost Analysis of Traditional 4-Port vs Single-Incision and Robotically Assisted Cholecystectomy.

Science.gov (United States)

Newman, Richard M; Umer, Affan; Bozzuto, Bethany J; Dilungo, Jennifer L; Ellner, Scott

2016-03-01

As the cost of health care is subjected to increasingly greater scrutiny, the assessment of new technologies must include the surgical value (SV) of the procedure. Surgical value is defined as outcome divided by cost. The cost and outcome of 50 consecutive traditional (4-port) laparoscopic cholecystectomies (TLC) were compared with 50 consecutive, nontraditional laparoscopic cholecystectomies (NTLC), between October 2012 and February 2014. The NTLC included SILS (n = 11), and robotically assisted single-incision cholecystectomies (ROBOSILS; n = 39). Our primary outcomes included minimally invasive gallbladder removal and same-day discharge. Thirty-day emergency department visits or readmissions were evaluated as a secondary outcome. The direct variable surgeon costs (DVSC) were distilled from our hospital cost accounting system and calculated on a per-case, per item basis. The average DVSC for TLC was $929 and was significantly lower than NTLC at $2,344 (p day discharge. There were no differences observed in secondary outcomes in 30-day emergency department visits (TLC [2%] vs NTLC [6%], p = 0.61) or readmissions (TLC [4%] vs NTLC [2%], p > 0.05), respectively. The relative SV was significantly higher for TLC (1) compared with NTLC (0.34) (p < 0.05), and SILS (0.66) and ROBOSILS (0.36) (p < 0.05). Nontraditional, minimally invasive gallbladder removal (SILS and ROBOSILS) offers significantly less surgical value for elective, outpatient gallbladder removal. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Global CO2 efficiency: Country-wise estimates using a stochastic cost frontier

International Nuclear Information System (INIS)

Herrala, Risto; Goel, Rajeev K.

2012-01-01

This paper examines global carbon dioxide (CO 2 ) efficiency by employing a stochastic cost frontier analysis of about 170 countries in 1997 and 2007. The main contribution lies in providing a new approach to environmental efficiency estimation, in which the efficiency estimates quantify the distance from the policy objective of minimum emissions. We are able to examine a very large pool of nations and provide country-wise efficiency estimates. We estimate three econometric models, corresponding with alternative interpretations of the Cancun vision (Conference of the Parties 2011). The models reveal progress in global environmental efficiency during a preceding decade. The estimates indicate vast differences in efficiency levels, and efficiency changes across countries. The highest efficiency levels are observed in Africa and Europe, while the lowest are clustered around China. The largest efficiency gains were observed in central and eastern Europe. CO 2 efficiency also improved in the US and China, the two largest emitters, but their ranking in terms of CO 2 efficiency deteriorated. Policy implications are discussed. - Highlights: ► We estimate global environmental efficiency in line with the Cancun vision, using a stochastic cost frontier. ► The study covers 170 countries during a 10 year period, ending in 2007. ► The biggest improvements occurred in Europe, and efficiency falls in South America. ► The efficiency ranking of US and China, the largest emitters, deteriorated. ► In 2007, highest efficiency was observed in Africa and Europe, and the lowest around China.

Photovoltaic technology, performance, manufacturing cost and markets

International Nuclear Information System (INIS)

Maycock, P.D.

1999-01-01

A comprehensive discussion of key aspects of photovoltaic energy conversion systems will provide the basis for forecasting PV module shipments from 1999 to 2010. Principal areas covered include: (1) Technology and Performance Status: The module efficiency and performance are described for commercial cell technologies including single crystal silicon, polycrystal silicon, ribbon silicon, film silicon on low cost substrate, amorphous silicon, copper indium diselenide, and cadmium telluride; (2) Manufacturing cost: 1999 costs for PV technologies in production (single crystal silicon, polycrystal silicon, and amorphous silicon) are developed. Manufacturing costs for 10--25 MW plants and 100 MW plants will be estimated; (3) The world PV market is summarized by region, top ten companies, and technology; and (4) Forecast of the World Market (seven market sectors) to 2010 will be presented. Key assumptions, price of modules, incentive programs, price of competing electricity generation will be detailed

Performance of a low cost single beam echosounder : in situ trials in a shallow water coral reef habitat with verification by video

OpenAIRE

Betanzos, A.; Martín, H.A.; Valle, S.; Tizol, R.; Schneider, P.; Hernández, J.L.; Brehmer, Patrice; Linares, E.O.; Guillard, J.; Hermand, J.P.

2015-01-01

In a context of potential overexploitation of fisheries resources in the Sabana-Camagüey Archipelago (Cuba), the Cuban national authorities have expressed the need to collect more in situ information on fish of commercial interest in spawning areas. A newly developed low cost single-beam scientific echosounder has been recently acquired by the Cuban Fisheries Research Centre (CIP). In this work, we provide first results of a comparative analysis carried out in the Sabana-Camagüey ...

Robotic-assisted single-port donor nephrectomy using the da Vinci single-site platform.

Science.gov (United States)

LaMattina, John C; Alvarez-Casas, Josue; Lu, Irene; Powell, Jessica M; Sultan, Samuel; Phelan, Michael W; Barth, Rolf N

2018-02-01

Although single-port donor nephrectomy offers improved cosmetic outcomes, technical challenges have limited its application to selected centers. Our center has performed over 400 single-port donor nephrectomies. The da Vinci single-site robotic platform was utilized in an effort to overcome the steric, visualization, ergonomic, and other technical limitations associated with the single-port approach. Food and Drug Administration device exemption was obtained. Selection criteria for kidney donation included body mass index da Vinci single-site platform. Our experience supported the safety of this approach but found that the technology added cost and complexity without tangible benefit. Development of articulating instruments, energy, and stapling devices will be necessary for increased application of robotic single-site surgery for donor nephrectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Analytic approximation to the largest eigenvalue distribution of a white Wishart matrix

CSIR Research Space (South Africa)

Vlok, JD

2012-08-14

Full Text Available offers largely simplified computation and provides statistics such as the mean value and region of support of the largest eigenvalue distribution. Numeric results from the literature are compared with the approximation and Monte Carlo simulation results...

Navvus FFR to reduce CONTRAst, Cost and radiaTion (CONTRACT); insights from a single-centre clinical and economical evaluation with the RXi Rapid-Exchange FFR device.

Science.gov (United States)

Masdjedi, Kaneshka; Van Mieghem, Nicolas M; Diletti, Roberto; van Geuns, Robert-Jan; de Jaegere, Peter; Regar, Evelyn; Zijlstra, Felix; van Domburg, Ron T; Daemen, Joost

2017-04-15

To assess whether the RXi Navvus system compared to the use of standard Fractional Flow Reserve (FFR) wires reduces total contrast volume, radiation and overall study cost in a real world patient population referred for coronary angiography or percutaneous coronary intervention. FFR is the mainstay of functional hemodynamic assessment of coronary artery lesions. The RXi Navvus system (ACIST Medical Systems, Eden Prairie, MN) is a monorail microcatheter with FFR-measurement capability through optical pressure sensor technology. This is an investigator-initiated, prospective, single-center, observational cohort study. A total of 238 patients were enrolled, 97 patients with Navvus and 141 with conventional pressure-wire based FFR (PW-FFR). Final analyses were performed on the cohort in which only 1 device was used (82 Navvus procedures vs. 136 PW-FFR procedures). No significant differences were found in the total amount of contrast used (150±77 vs 147±79ml; p=0.81), radiation use (6200±4601 vs. 5076±4655 centiG∗cm 2 ; p=0.09) or costs (€1994,- vs. €1930,-; p=0.32) in the Navvus vs. PW-FFR groups respectively. No significant differences were found in the amount of contrast used, total procedural costs or radiation when the Navvus system was used as compared to conventional FFR wires. CONTRACT is an investigator-initiated, prospective, single-center, observational cohort study that evaluated whether the RXi Navvus system compared to the use of standard Fractional Flow Reserve (FFR) wires reduces total contrast volume, radiation and overall study cost in a real world patient population referred for coronary angiography or percutaneous coronary intervention. Use of the RXi Navvus system was associated with comparable procedural costs, amount of radiation and contrast used as compared to PW-FFR systems. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

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

2013-10-01

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

Health-related economic costs of the Three-Mile Island accident.

Science.gov (United States)

Hu, T W; Slaysman, K S

1984-01-01

On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.

A dominant mutation in mediator of paramutation2, one of three second-largest subunits of a plant-specific RNA polymerase, disrupts multiple siRNA silencing processes.

Science.gov (United States)

Sidorenko, Lyudmila; Dorweiler, Jane E; Cigan, A Mark; Arteaga-Vazquez, Mario; Vyas, Meenal; Kermicle, Jerry; Jurcin, Diane; Brzeski, Jan; Cai, Yu; Chandler, Vicki L

2009-11-01

Paramutation involves homologous sequence communication that leads to meiotically heritable transcriptional silencing. We demonstrate that mop2 (mediator of paramutation2), which alters paramutation at multiple loci, encodes a gene similar to Arabidopsis NRPD2/E2, the second-largest subunit of plant-specific RNA polymerases IV and V. In Arabidopsis, Pol-IV and Pol-V play major roles in RNA-mediated silencing and a single second-largest subunit is shared between Pol-IV and Pol-V. Maize encodes three second-largest subunit genes: all three genes potentially encode full length proteins with highly conserved polymerase domains, and each are expressed in multiple overlapping tissues. The isolation of a recessive paramutation mutation in mop2 from a forward genetic screen suggests limited or no functional redundancy of these three genes. Potential alternative Pol-IV/Pol-V-like complexes could provide maize with a greater diversification of RNA-mediated transcriptional silencing machinery relative to Arabidopsis. Mop2-1 disrupts paramutation at multiple loci when heterozygous, whereas previously silenced alleles are only up-regulated when Mop2-1 is homozygous. The dramatic reduction in b1 tandem repeat siRNAs, but no disruption of silencing in Mop2-1 heterozygotes, suggests the major role for tandem repeat siRNAs is not to maintain silencing. Instead, we hypothesize the tandem repeat siRNAs mediate the establishment of the heritable silent state-a process fully disrupted in Mop2-1 heterozygotes. The dominant Mop2-1 mutation, which has a single nucleotide change in a domain highly conserved among all polymerases (E. coli to eukaryotes), disrupts both siRNA biogenesis (Pol-IV-like) and potentially processes downstream (Pol-V-like). These results suggest either the wild-type protein is a subunit in both complexes or the dominant mutant protein disrupts both complexes. Dominant mutations in the same domain in E. coli RNA polymerase suggest a model for Mop2-1 dominance

Semantic-less Breach Detection of Polymorphic Malware in Federated Cloud

OpenAIRE

Yahav Biran; George Collins; Borky John M; Joel Dubow

2017-01-01

Cloud computing is one of the largest emerging utility services that is expected to grow enormously over the next decade. Many organizations are moving into hybrid cloud/hosted computing models. Single cloud service provider introduces cost and environmental challenges. Also, multi-cloud solution implemented by the Cloud tenant is suboptimal as it requires expensive adaptation costs. Cloud Federation is a useful structure for aggregating cloud based services under a single umbrella to share r...

Cost-effectiveness analysis of different embryo transfer strategies in England.

Science.gov (United States)

Dixon, S; Faghih Nasiri, F; Ledger, W L; Lenton, E A; Duenas, A; Sutcliffe, P; Chilcott, J B

2008-05-01

The objective of this study was to assess the cost-effectiveness of different embryo transfer strategies for a single cycle when two embryos are available, and taking the NHS cost perspective. Cost-effectiveness model. Five in vitro fertilisation (IVF) centres in England between 2003/04 and 2004/05. Women with two embryos available for transfer in three age groups (Costs and adverse outcomes are estimated up to 5 years after the birth. Incremental cost per live birth was calculated for different embryo transfer strategies and for three separate age groups: less than 30, 30-35 and 36-39 years. Premature birth, neonatal intensive care unit admissions and days, cerebral palsy and incremental cost-effectiveness ratios. Single fresh embryo transfer (SET) plus frozen single embryo transfer (fzSET) is the more costly in terms of IVF costs, but the lower rates of multiple births mean that in terms of total costs, it is less costly than double embryo transfer (DET). Adverse events increase when moving from SET to SET+fzSET to DET. The probability of SET+fzSET being cost-effective decreases with age. When SET is included in the analysis, SET+fzSET no longer becomes a cost-effective option at any threshold value for all age groups studied. The analyses show that the choice of embryo transfer strategy is a function of four factors: the age of the mother, the relevance of the SET option, the value placed on a live birth and the relative importance placed on adverse outcomes. For each patient group, the choice of strategy is a trade-off between the value placed on a live birth and cost.

Impact of comorbidities on hospitalization costs following hip fracture.

Science.gov (United States)

Nikkel, Lucas E; Fox, Edward J; Black, Kevin P; Davis, Charles; Andersen, Lucille; Hollenbeak, Christopher S

2012-01-04

Hip fractures are common in the elderly, and patients with hip fractures frequently have comorbid illnesses. Little is known about the relationship between comorbid illness and hospital costs or length of stay following the treatment of hip fracture in the United States. We hypothesized that specific individual comorbid illnesses and multiple comorbid illnesses would be directly related to the hospitalization costs and the length of stay for older patients following hip fracture. With use of discharge data from the 2007 Nationwide Inpatient Sample, 32,440 patients who were fifty-five years or older with an isolated, closed hip fracture were identified. Using generalized linear models, we estimated the impact of comorbidities on hospitalization costs and length of stay, controlling for patient, hospital, and procedure characteristics. Hypertension, deficiency anemias, and fluid and electrolyte disorders were the most common comorbidities. The patients had a mean of three comorbidities. Only 4.9% of patients presented without comorbidities. The average estimated cost in our reference patient was $13,805. The comorbidity with the largest increased hospitalization cost was weight loss or malnutrition, followed by pulmonary circulation disorders. Most other comorbidities significantly increased the cost of hospitalization. Compared with internal fixation of the hip fracture, hip arthroplasty increased hospitalization costs significantly. Comorbidities significantly affect the cost of hospitalization and length of stay following hip fracture in older Americans, even while controlling for other variables.

Switzerland's largest wood-pellet factory in Balsthal

International Nuclear Information System (INIS)

Stohler, F.

2004-01-01

This article describes how a small Swiss electricity utility has broken out of its traditional role in power generation and the distribution of electricity and gone into the production of wood pellets. The pellets, which are made from waste wood (sawdust) available from wood processing companies, are produced on a large scale in one of Europe's largest pellets production facilities. The boom in the use of wood pellets for heating purposes is discussed. The article discusses this unusual approach for a Swiss power utility, which also operates a wood-fired power station and is even involved in an incineration plant for household wastes. The markets being aimed for in Switzerland and in Europe are described, including modern low-energy-consumption housing projects. A further project is described that is to use waste wood available from a large wood processing facility planned in the utility's own region

[Direct and indirect costs of fractures due to osteoporosis in Austria].

Science.gov (United States)

Dimai, H-P; Redlich, K; Schneider, H; Siebert, U; Viernstein, H; Mahlich, J

2012-10-01

We examined the financial burden of osteoporosis in Austria. We took both direct and indirect costs into consideration. Direct costs encompass medical costs such as expenses for pharmaceuticals, inpatient and outpatient medical care costs, as well as other medical services (e.g., occupational therapies). Non-medical direct costs include transportation costs and medical devices (e.g., wheel chairs or crutches). Indirect costs refer to costs of productivity losses due to absence of work. Moreover, we included costs for early retirement and opportunity costs of informal care provided by family members. While there exist similar studies for other countries, this is the first comprehensive study for Austria. For our analysis, we combined data of official statistics, expert estimates as well as unique patient surveys that are currently conducted in the course of an international osteoporotic fracture study in Austria. Our estimation of the total annual costs in the year 2008 imposed by osteoporosis in Austria is 707.4 million €. The largest fraction of this amount is incurred by acute hospital treatment. Another significant figure, accounting for 29% of total costs, is the opportunity cost of informal care. The financial burden of osteoporosis in Austria is substantial. Economic evaluations of preventive and therapeutic interventions for the specific context of Austria are needed to inform health policy decision makers. © Georg Thieme Verlag KG Stuttgart · New York.

Life cycle cost of biomass power plant: Monte Carlo simulation of investment

Directory of Open Access Journals (Sweden)

Odavić Petrana

2017-01-01

Full Text Available Assessment of life cycle cost is considered as an important instrument for designing and evaluating success of every project. The aim of this work is to determine the precise impact of the investment costs and future operating and maintenance costs of CHP biomass plant. By using the Monte Carlo simulation are determined variations in the settings and the possible impact on the investment risk. The results show that the investment is justified, thanks to the positive outcome of the net present value (NPV, internal rate of return (IRR and the payback period. The greatest impact on the variability of annual profits have operating costs, which have the highest coefficient of variation of 6.44% and the largest share. Variability of net present value of 4% is acceptable, and the investment is considered as stable.

Combined analyses of costs, market value and eco-costs in circular business models : eco-efficient value creation in remanufacturing

NARCIS (Netherlands)

Vogtländer, J.G.; Scheepens, A.E.; Bocken, N.M.P.; Peck, D.P.

2017-01-01

Eco-efficient Value Creation is a method to analyse innovative product and service design together with circular business strategies. The method is based on combined analyses of the costs, market value (perceived customer value) and eco-costs. This provides a prevention-based single indicator for

Preliminary Cost Model for Space Telescopes

Science.gov (United States)

Stahl, H. Philip; Prince, F. Andrew; Smart, Christian; Stephens, Kyle; Henrichs, Todd

2009-01-01

Parametric cost models are routinely used to plan missions, compare concepts and justify technology investments. However, great care is required. Some space telescope cost models, such as those based only on mass, lack sufficient detail to support such analysis and may lead to inaccurate conclusions. Similarly, using ground based telescope models which include the dome cost will also lead to inaccurate conclusions. This paper reviews current and historical models. Then, based on data from 22 different NASA space telescopes, this paper tests those models and presents preliminary analysis of single and multi-variable space telescope cost models.

Preliminary Multi-Variable Cost Model for Space Telescopes

Science.gov (United States)

Stahl, H. Philip; Hendrichs, Todd

2010-01-01

Parametric cost models are routinely used to plan missions, compare concepts and justify technology investments. This paper reviews the methodology used to develop space telescope cost models; summarizes recently published single variable models; and presents preliminary results for two and three variable cost models. Some of the findings are that increasing mass reduces cost; it costs less per square meter of collecting aperture to build a large telescope than a small telescope; and technology development as a function of time reduces cost at the rate of 50% per 17 years.

Low-Cost Solar Water Heating Research and Development Roadmap

Energy Technology Data Exchange (ETDEWEB)

Hudon, K.; Merrigan, T.; Burch, J.; Maguire, J.

2012-08-01

The market environment for solar water heating technology has changed substantially with the successful introduction of heat pump water heaters (HPWHs). The addition of this energy-efficient technology to the market increases direct competition with solar water heaters (SWHs) for available energy savings. It is therefore essential to understand which segment of the market is best suited for HPWHs and focus the development of innovative, low-cost SWHs in the market segment where the largest opportunities exist. To evaluate cost and performance tradeoffs between high performance hot water heating systems, annual energy simulations were run using the program, TRNSYS, and analysis was performed to compare the energy savings associated with HPWH and SWH technologies to conventional methods of water heating.

The costs of nuclear power

International Nuclear Information System (INIS)

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

1979-01-01

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

The impact of new technology on compact disposal costs

International Nuclear Information System (INIS)

Arrowsmith, H.W.; Zidow, T.M.

1989-01-01

The cost of disposal of low-level waste (LLW) has increased dramatically since the 1960s. In the '60s waste was put into the ground for a fee of less than $1/ft 3 in truck-size quantities. Fees for the same burial services today begin in the $30/ft 3 range and increase rapidly from that level. Although the user fees associated with compacts will clearly exceed $100/ft 3 , improved operating techniques by the generators will reduce the amount of waste produced. Current estimates suggest this reduction will drive the per-cubic-foot cost of disposal over the $200 mark. Technology is the only solution to this predicament. While costs already incurred will contribute to the fixed portion of the base user fees, the means to minimize the variable portion of the fees in now at hand. This variable portion results from on-site processing costs, waste form stability enhancements, and ongoing disposal unit construction. Technology exists to minimize volume through ultra compaction and selective incineration, greatly reducing the ongoing disposal unit construction requirements. Vitrification of incinerator residue provides waste form stability far in excess of that provided by concrete overpacks. As overpacks represent the second largest material cost at an engineered barrier facility, the potential for cost savings is substantial

An Oblivious O(1)-Approximation for Single Source Buy-at-Bulk

KAUST Repository

Goel, Ashish; Post, Ian

2009-01-01

We consider the single-source (or single-sink) buy-at-bulk problem with an unknown concave cost function. We want to route a set of demands along a graph to or from a designated root node, and the cost of routing x units of flow along an edge

The global diversion of pharmaceutical drugs. India: the third largest illicit opium producer?

Science.gov (United States)

Paoli, Letizia; Greenfield, Victoria A; Charles, Molly; Reuter, Peter

2009-03-01

This paper explores India's role in the world illicit opiate market, particularly its role as a producer. India, a major illicit opiate consumer, is also the sole licensed exporter of raw opium: this unique status may be enabling substantial diversion to the illicit market. Participant observation and interviews were carried out at eight different sites. Information was also drawn from all standard secondary sources and the analysis of about 180 drug-related criminal proceedings reviewed by Indian High Courts and the Supreme Court from 1985 to 2001. Diversion from licit opium production takes place on such a large scale that India may be the third largest illicit opium producer after Afghanistan and Burma. With the possible exceptions of 2005 and 2006, 200-300 tons of India's opium may be diverted yearly. After estimating India's opiate consumption on the basis of UN-reported prevalence estimates, we find that diversion from licit production might have satisfied a quarter to more than a third of India's illicit opiate demand to 2004. India is not only among the world's largest consumer of illicit opiates but also one of the largest illicit opium producers. In contrast to all other illicit producers, India owes the latter distinction not to blatantly illicit cultivation but to diversion from licit cultivation. India's experience suggests the difficulty of preventing substantial leakage, even in a relatively well-governed nation.

[Mobile single-pass batch hemodialysis system in intensive care medicine. Reduction of costs and workload in renal replacement therapy].

Science.gov (United States)

Hopf, H-B; Hochscherf, M; Jehmlich, M; Leischik, M; Ritter, J

2007-07-01

This paper describes the introduction of a single-pass batch hemodialysis system for renal replacement therapy in a 14 bed intensive care unit. The goals were to reduce the workload of intensive care unit physicians using an alternative and simpler method compared to continuous veno-venous hemodiafiltration (CVVHDF) and to reduce the costs of hemofiltrate solutions (80,650 EUR per year in our clinic in 2005). We describe and evaluate the process of implementation of the system as well as the achieved and prospective savings. We conclude that a close cooperation of all participants (physicians, nurses, economists, technicians) of a hospital can achieve substantial benefits for patients and employees as well as reduce the economic burden of a hospital.

BALU: Largest autoclave research facility in the world

Directory of Open Access Journals (Sweden)

Hakan Ucan

2016-03-01

Full Text Available Among the large-scale facilities operated at the Center for Lightweight-Production-Technology of the German Aerospace Center in Stade BALU is the world's largest research autoclave. With a loading length of 20m and a loading diameter of 5.8 m the main objective of the facility is the optimization of the curing process operated by components made of carbon fiber on an industrial scale. For this reason, a novel dynamic autoclaving control has been developed that is characterized by peripheral devices to expend the performance of the facility for differential applications, by sensing systems to detect the component state throughout the curing process and by a feedback system, which is capable to intervene into the running autoclave process.

Cost considerations for long-term ecological monitoring

Science.gov (United States)

Caughlan, L.; Oakley, K.L.

2001-01-01

For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program’s focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs, what dollars are spent on, and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program’s longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occurs during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost

The burden of pediatric diarrhea: a cross-sectional study of incurred costs and perceptions of cost among Bolivian families.

Science.gov (United States)

Burke, Rachel M; Rebolledo, Paulina A; Embrey, Sally R; Wagner, Laura Danielle; Cowden, Carter L; Kelly, Fiona M; Smith, Emily R; Iñiguez, Volga; Leon, Juan S

2013-08-02

Worldwide, acute gastroenteritis represents an enormous public health threat to children under five years of age, causing one billion episodes and 1.9 to 3.2 million deaths per year. In Bolivia, which has one of the lower GDPs in South America, an estimated 15% of under-five deaths are caused by diarrhea. Bolivian caregiver expenses related to diarrhea are believed to be minimal, as citizens benefit from universal health insurance for children under five. The goals of this report were to describe total incurred costs and cost burden associated with caregivers seeking treatment for pediatric gastroenteritis, and to quantify relationships among costs, cost burden, treatment setting, and perceptions of costs. From 2007 to 2009, researchers interviewed caregivers (n=1,107) of pediatric patients (costs (e.g. medication, consult fees) and indirect costs (e.g. lost wages). Patient populations were similar across cities in terms of gender, duration of illness, and age, but familial income varied significantly (pcosts to families were significantly higher for inpatients as compared to outpatients of urban (pcosts made up a large proportion of total costs. Forty-five percent of patients' families paid ≥1% of their annual household income for this single diarrheal episode. The perception that cost was affecting family finances was more frequent among those with higher actual cost burden. This study demonstrated that indirect costs due to acute pediatric diarrhea were a large component of total incurred familial costs. Additionally, familial costs associated with a single diarrheal episode affected the actual and perceived financial situation of a large number of caregivers. These data serve as a baseline for societal diarrheal costs before and immediately following the implementation of the rotavirus vaccine and highlight the serious economic importance of a diarrheal episode to Bolivian caregivers.

Impact of pharmacist’s interventions on cost of drug therapy in intensive care unit. Pharmacy

Directory of Open Access Journals (Sweden)

Saokaew S

2009-06-01

antibiotic use accounted for the largest economic impact (1,958.61 USD. Conclusions: Although the statistical was not significant, having a pharmacist participated in ICU patient care team tend to reduced overall drug cost, cost saving, and cost avoidance. The largest cost impact and intervention requirement involved antibiotic use.

The 100-C-7 Remediation Project. An Overview of One of DOE's Largest Remediation Projects - 13260

International Nuclear Information System (INIS)

Post, Thomas C.; Strom, Dean; Beulow, Laura

2013-01-01

The U.S. Department of Energy Richland Operations Office (RL), U.S. Environmental Protection Agency (EPA) and Washington Closure Hanford LLC (WCH) completed remediation of one of the largest waste sites in the U.S. Department of Energy complex. The waste site, 100-C-7, covers approximately 15 football fields and was excavated to a depth of 85 feet (groundwater). The project team removed a total of 2.3 million tons of clean and contaminated soil, concrete debris, and scrap metal. 100-C-7 lies in Hanford's 100 B/C Area, home to historic B and C Reactors. The waste site was excavated in two parts as 100-C-7 and 100-C-7:1. The pair of excavations appear like pit mines. Mining engineers were hired to design their tiered sides, with safety benches every 17 feet and service ramps which allowed equipment access to the bottom of the excavations. The overall cleanup project was conducted over a span of almost 10 years. A variety of site characterization, excavation, load-out and sampling methodologies were employed at various stages of remediation. Alternative technologies were screened and evaluated during the project. A new method for cost effectively treating soils was implemented - resulting in significant cost savings. Additional opportunities for minimizing waste streams and recycling were identified and effectively implemented by the project team. During the final phase of cleanup the project team applied lessons learned throughout the entire project to address the final, remaining source of chromium contamination. The C-7 cleanup now serves as a model for remediating extensive deep zone contamination sites at Hanford. (authors)

DISCOVERY OF THE LARGEST KNOWN LENSED IMAGES FORMED BY A CRITICALLY CONVERGENT LENSING CLUSTER

International Nuclear Information System (INIS)

Zitrin, Adi; Broadhurst, Tom

2009-01-01

We identify the largest known lensed images of a single spiral galaxy, lying close to the center of the distant cluster MACS J1149.5+2223 (z = 0.544). These images cover a total area of ≅150 mbox '' and are magnified ≅200 times. Unusually, there is very little image distortion, implying that the central mass distribution is almost uniform over a wide area (r ≅ 200 kpc) with a surface density equal to the critical density for lensing, corresponding to maximal lens magnification. Many fainter multiply lensed galaxies are also uncovered by our model, outlining a very large tangential critical curve, of radius r ≅ 170 kpc, posing a potential challenge for the standard LCDM cosmology. Because of the uniform central mass distribution, a particularly clean measurement of the mass of the brightest cluster galaxy is possible here, for which we infer stars contribute most of the mass within a limiting radius of ≅30 kpc, with a mass-to-light ratio of M/L B ≅ 4.5(M/L) sun . This cluster with its uniform and central mass distribution acts analogously to a regular magnifying glass, converging light without distorting the images, resulting in the most powerful lens yet discovered for accessing the faint high-z universe.

Hospital costs of ischemic stroke and TIA in the Netherlands.

Science.gov (United States)

Buisman, Leander R; Tan, Siok Swan; Nederkoorn, Paul J; Koudstaal, Peter J; Redekop, William K

2015-06-02

There have been no ischemic stroke costing studies since major improvements were implemented in stroke care. We therefore determined hospital resource use and costs of ischemic stroke and TIA in the Netherlands for 2012. We conducted a retrospective cost analysis using individual patient data from a national diagnosis-related group registry. We analyzed 4 subgroups: inpatient ischemic stroke, inpatient TIA, outpatient ischemic stroke, and outpatient TIA. Costs of carotid endarterectomy and costs of an extra follow-up visit were also estimated. Unit costs were based on reference prices from the Dutch Healthcare Insurance Board and tariffs provided by the Dutch Healthcare Authority. Linear regression analysis was used to examine the association between hospital costs and various patient and hospital characteristics. A total of 35,903 ischemic stroke and 21,653 TIA patients were included. Inpatient costs were €5,328 ($6,845) for ischemic stroke and €2,470 ($3,173) for TIA. Outpatient costs were €495 ($636) for ischemic stroke and €587 ($754) for TIA. Costs of carotid endarterectomy were €6,836 ($8,783). Costs of inpatient days were the largest contributor to hospital costs. Age, hospital type, and region were strongly associated with hospital costs. Hospital costs are higher for inpatients and ischemic strokes compared with outpatients and TIAs, with length of stay (LOS) the most important contributor. LOS and hospital costs have substantially declined over the last 10 years, possibly due to improved hospital stroke care and efficient integrated stroke services. © 2015 American Academy of Neurology.

Cost effectiveness and budget impact of natalizumab in patients with relapsing multiple sclerosis.

Science.gov (United States)

Chiao, Evelyn; Meyer, Kellie

2009-06-01

Disease-modifying therapy (DMT) is the largest single-cost item that contributes to the total per-patient cost of multiple sclerosis (MS), a disabling disorder of the central nervous system. Natalizumab is the most recent DMT to be approved for the treatment of relapsing MS and may be an attractive alternative to interferon beta and glatiramer acetate (GA). To determine from the perspective of a United States payer (1) the incremental cost effectiveness of natalizumab compared with other DMTs and (2) the budgetary impact of utilization of natalizumab for the treatment of relapsing MS. A combined cost effectiveness and budget impact model was developed. Model inputs were drug acquisition costs (wholesale acquisition cost), costs of drug administration and monitoring, costs of treating relapses, anticipated reduction in relapse rates after 2 years of therapy, and estimated market utilization of natalizumab. Outcomes included total 2-year costs of therapy per patient, costs per relapse avoided for each treatment, and overall 2-year costs to the health plan and per member per month (PMPM) costs. Drug acquisition costs are in 2008 US dollars, and all other costs were inflated to 2008 US dollars when necessary. Univariate sensitivity analyses were performed to determine the model inputs with the greatest influence on the cost per relapse avoided for natalizumab. The overall 2-year cost of therapy per patient was $72,120 for natalizumab, $56,790 for intramuscular (IM) interferon beta-1a (IFNbeta-1a), $56,773 for IFNbeta-1b, $57,180 for GA, and $58,538 for subcutaneous (SC) IFNbeta-1a. The cost per relapse avoided was lowest for natalizumab at $56,594, followed by $87,791 for IFNbeta-1b, $93,306 for IM IFNbeta-1a, $96,178 for SC IFNbeta-1a, and $103,665 for GA. The incremental cost-effectiveness ratios of natalizumab relative to IM IFNbeta-1a, IFNbeta-1b, GA, and SC IFNbeta-1a were $23,029, $24,452, $20,671, and $20,403 per additional relapse avoided, respectively. An

Environmental costs of meat production

DEFF Research Database (Denmark)

Nguyen, T Lan T; Hermansen, John Erik; Mogensen, Lisbeth

2012-01-01

This paper aims to address two questions: First, what is the real cost of meat to society if taking into account the environmental costs arising throughout the product life cycle; and second, whether and how the environmental costs related to meat production can be reduced. In addressing the issues...... to be the main contributor to the costs (55%), followed by global warming (21%) and respiratory inorganics (18%). A viable option combining improvement measures in three aspects: feed use, manure management, and manure utilization, reduces the environmental costs by a factor of 1.4. This results in an equal size......, we use pig meat production in the EU as a case study. The environmental costs of meat are displayed first as characterized results at different midpoint categories e.g. global warming, nature occupation, acidification, eutrophication, ecotoxicity, etc., and then aggregated into a single score using...

Regional disparity and cost-effective SO2 pollution control in China: A case study in 5 mega-cities

International Nuclear Information System (INIS)

Kanada, Momoe; Dong, Liang; Fujita, Tsuyoshi; Fujii, Minoru; Inoue, Tsuyoshi; Hirano, Yujiro; Togawa, Takuya; Geng, Yong

2013-01-01

With rapid development, increasing sulfur dioxide (SO 2 ) emission becomes a key environmental issue in China. To respond to this challenge, the Chinese government established a top-down scheme to reduce its SO 2 emissions. However, regional disparity and the associated cost differences brought uncertainties to the policy effectiveness and efficiency. Few studies focus on this field. Therefore, this study tries to fill such a gap by investigating the differences of SO 2 emissions, reduction potential, and cost-effectiveness through use of the GAINS-China model in five mega-cities in China, namely, Beijing, Shanghai, Tianjin, Chongqing, and Hong Kong. A scenario analysis approach is employed, focusing on two technologies named flue gas desulfurization (FGD) and limestone injection (LINJ). Results demonstrated that a large SO 2 reduction potential exists, as well as a great disparity, among the five mega-cities. Chongqing had the largest reduction potential with lowest unit cost, while Beijng and Hong Kong showed the lowest reduction potential with higher unit cost. In Beijing and Shanghai, FGD and LINJ in the power generation sector had the larger reduction potential with the highest cost-effectiveness. However, in Chongqing, the industry sectors also had large reduction potentials. Finally, appropriate SO 2 control strategies and policies are raised by considering the local realities. - Highlights: • The cost-effectiveness of SO 2 control policy was analyzed in five mega-cities in China. • Reduction potential and cost-effectiveness were closely linked to regional disparity. • Beijing and Hong Kong showed lower reduction potential and higher marginal reduction cost. • Chongqing showed the largest reduction potential and the lowest marginal reduction cost

Is Stacking Intervention Components Cost-Effective? An Analysis of the Incredible Years Program

Science.gov (United States)

Foster, E. Michael; Olchowski, Allison E.; Webster-Stratton, Carolyn H.

2007-01-01

The cost-effectiveness of delivering stacked multiple intervention components for children is compared to implementing single intervention by analyzing the Incredible Years Series program. The result suggests multiple intervention components are more cost-effective than single intervention components.

Pragmatic and cost efficient D and D

Energy Technology Data Exchange (ETDEWEB)

Morris, M. [Nuclear Fuel Services, Erwin, TN (United States)

1998-03-01

A great deal of effort is expended by remediation professionals in the pursuit of new technologies to assist them in performing their tasks more efficiently. These individuals understand the cost savings associated with volume reduction and waste minimization and routinely incorporate these practices into their planning. However, the largest cost component on many D and D projects is labor. Increasing the efficiency of work force utilization is frequently the most overlooked technique that can be instituted and which can easily offer major cost savings. Granted, some D and D jobs require highly specialized tools and equipment which are quite expensive. Decreasing these costs is often not an option or will yield minimal results. Conversely, the increase in worker efficiency can usually decrease costs dramatically. During the performance of the Safe Shutdown Project at the Fernald Environmental Management Project (the Fernald site), a process improvement initiative was instituted in support of the development of the Ten Year Plan. Costs associated with the removal of hundreds of thousands of pounds of nuclear material from formerly utilized equipment piping, and ductwork in nuclear facilities at the Fernald site were analyzed. This analysis indicated that the labor component was large enough to merit further inspection. A new approach to the activities was instituted and the results were significant. A macroscopic overview of all work activities utilized work evolution control (sequencing), building segmentation, and efficient use of engineering controls to streamline the D and D process. Overall costs on the first facility were reduced by over 20%. The increased labor efficiency resulted in decreased Personal Protective Equipment costs for field personnel. This approach will be discussed in detail.

Pragmatic and cost efficient D and D

International Nuclear Information System (INIS)

Morris, M.

1998-03-01

A great deal of effort is expended by remediation professionals in the pursuit of new technologies to assist them in performing their tasks more efficiently. These individuals understand the cost savings associated with volume reduction and waste minimization and routinely incorporate these practices into their planning. However, the largest cost component on many D and D projects is labor. Increasing the efficiency of work force utilization is frequently the most overlooked technique that can be instituted and which can easily offer major cost savings. Granted, some D and D jobs require highly specialized tools and equipment which are quite expensive. Decreasing these costs is often not an option or will yield minimal results. Conversely, the increase in worker efficiency can usually decrease costs dramatically. During the performance of the Safe Shutdown Project at the Fernald Environmental Management Project (the Fernald site), a process improvement initiative was instituted in support of the development of the Ten Year Plan. Costs associated with the removal of hundreds of thousands of pounds of nuclear material from formerly utilized equipment piping, and ductwork in nuclear facilities at the Fernald site were analyzed. This analysis indicated that the labor component was large enough to merit further inspection. A new approach to the activities was instituted and the results were significant. A macroscopic overview of all work activities utilized work evolution control (sequencing), building segmentation, and efficient use of engineering controls to streamline the D and D process. Overall costs on the first facility were reduced by over 20%. The increased labor efficiency resulted in decreased Personal Protective Equipment costs for field personnel. This approach will be discussed in detail

Dragon bridge - the world largest dragon-shaped (ARCH steel bridge as element of smart city

Directory of Open Access Journals (Sweden)

Chinh Luong Minh

2016-01-01

Full Text Available Dragon Bridge - The world’s largest dragon-shaped steel bridge, with an installation cost of $85 million USD, features 6 lanes for two separate directions, 666 meters of undulating steel in the shape of a dragon in the Ly Dynasty, the symbol of prosperity in Vietnamese culture. This unique and beautifully lit bridge, which also breathes fire and sprays water. It’s the purposeful integration of the lighting hardware articulates the dragon’s form, and the fire-breathing dragon head. This project transcends the notion of monumental bridge with dynamic colour-changing lighting, creating an iconic sculpture in the skyline that is both reverent and whimsical. The signature feature of the bridge was the massive undulating support structure resembling a dragon flying over the river. The dragon is prominent in Vietnamese culture as a symbol of power and nobility. Dragon Bridge stands out as a model of innovation. It has received worldwide attention in the design community and from the global media for its unique arch support system. Dragon Bridge serves as an example of how aesthetic quality of a design can serve cultural, economic and functional purposes. The article presents design solutions of the object and the evaluation of the technical condition before putting the facility into service.

Parametric cost models for space telescopes

Science.gov (United States)

Stahl, H. Philip; Henrichs, Todd; Dollinger, Courtnay

2017-11-01

Multivariable parametric cost models for space telescopes provide several benefits to designers and space system project managers. They identify major architectural cost drivers and allow high-level design trades. They enable cost-benefit analysis for technology development investment. And, they provide a basis for estimating total project cost. A survey of historical models found that there is no definitive space telescope cost model. In fact, published models vary greatly [1]. Thus, there is a need for parametric space telescopes cost models. An effort is underway to develop single variable [2] and multi-variable [3] parametric space telescope cost models based on the latest available data and applying rigorous analytical techniques. Specific cost estimating relationships (CERs) have been developed which show that aperture diameter is the primary cost driver for large space telescopes; technology development as a function of time reduces cost at the rate of 50% per 17 years; it costs less per square meter of collecting aperture to build a large telescope than a small telescope; and increasing mass reduces cost.

Parametric Cost Models for Space Telescopes

Science.gov (United States)

Stahl, H. Philip; Henrichs, Todd; Dollinger, Courtney

2010-01-01

Multivariable parametric cost models for space telescopes provide several benefits to designers and space system project managers. They identify major architectural cost drivers and allow high-level design trades. They enable cost-benefit analysis for technology development investment. And, they provide a basis for estimating total project cost. A survey of historical models found that there is no definitive space telescope cost model. In fact, published models vary greatly [1]. Thus, there is a need for parametric space telescopes cost models. An effort is underway to develop single variable [2] and multi-variable [3] parametric space telescope cost models based on the latest available data and applying rigorous analytical techniques. Specific cost estimating relationships (CERs) have been developed which show that aperture diameter is the primary cost driver for large space telescopes; technology development as a function of time reduces cost at the rate of 50% per 17 years; it costs less per square meter of collecting aperture to build a large telescope than a small telescope; and increasing mass reduces cost.

Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

Directory of Open Access Journals (Sweden)

Kathryn Schnippel

Full Text Available Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model.The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs, breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD.Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts; the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost.Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to

Cost analysis of procedures related to the management of renal artery stenosis from various perspectives

International Nuclear Information System (INIS)

Helvoort-Postulart, Debby van; Dirksen, Carmen D.; Kessels, Alfons G.H.; Kroon, Abraham A.; Leeuw, Peter W. de; Nelemans, Patricia J.; Engelshoven, Jos M.A. van; Myriam Hunink, M.G.

2006-01-01

To determine the costs associated with the diagnostic work-up and percutaneous revascularization of renal artery stenosis from various perspectives. A prospective multicenter comparative study was conducted between 1998 and 2001. A total of 402 hypertensive patients with suspected renal artery stenosis were included. Costs were assessed of computed tomography angiography (CTA), magnetic resonance angiography (MRA), digital subtraction angiography (DSA), and percutaneous revascularization. From the societal perspective, DSA was the most costly (EUR 1,721) and CTA the least costly diagnostic technique (EUR 424). CTA was the least costly imaging procedure irrespective of the perspective used. The societal costs associated with percutaneous renal artery revascularization ranged from EUR 2,680 to EUR 6,172. Overall the radiology department incurred the largest proportion of the total societal costs. For the management of renal artery stenosis, performing the analysis from different perspectives leads to the same conclusion concerning the least costly diagnostic imaging and revascularization procedure. (orig.)

PET-CT in oncological patients: analysis of informal care costs in cost-benefit assessment.

Science.gov (United States)

Orlacchio, Antonio; Ciarrapico, Anna Micaela; Schillaci, Orazio; Chegai, Fabrizio; Tosti, Daniela; D'Alba, Fabrizio; Guazzaroni, Manlio; Simonetti, Giovanni

2014-04-01

The authors analysed the impact of nonmedical costs (travel, loss of productivity) in an economic analysis of PET-CT (positron-emission tomography-computed tomography) performed with standard contrast-enhanced CT protocols (CECT). From October to November 2009, a total of 100 patients referred to our institute were administered a questionnaire to evaluate the nonmedical costs of PET-CT. In addition, the medical costs (equipment maintenance and depreciation, consumables and staff) related to PET-CT performed with CECT and PET-CT with low-dose nonenhanced CT and separate CECT were also estimated. The medical costs were 919.3 euro for PET-CT with separate CECT, and 801.3 euro for PET-CT with CECT. Therefore, savings of approximately 13% are possible. Moreover, savings in nonmedical costs can be achieved by reducing the number of hospital visits required by patients undergoing diagnostic imaging. Nonmedical costs heavily affect patients' finances as well as having an indirect impact on national health expenditure. Our results show that PET-CT performed with standard dose CECT in a single session provides benefits in terms of both medical and nonmedical costs.

Single Top quark production cross section using ATLAS detector at the LHC

CERN Document Server

Estrada Pastor, Oscar; The ATLAS collaboration

2018-01-01

Measurements of single top-quark production in proton-proton collisions are presented based on the 8 TeV and 13 TeV ATLAS datasets. In the leading order process, a W boson is exchanged in the t-channel. The cross-section for the production of single top-quarks and single anti-top-quarks, their ratio, as well as differential cross-section measurements are also reported. These analyses include limits on anomalous contributions to the Wtb vertex and measurement of the top quark polarization. Measurements of the inclusive and differential cross-sections for the production of a single top quark in association with a W boson, the second largest single-top production mode, are also presented. Finally, evidence for s-channel single-top production in the 8 TeV ATLAS dataset is presented. All measurements are compared to state-of-the-art theoretical calculations.

Financial cost of the admissions for simultaneous pancreas-kidney transplant in a Brazilian hospital.

Science.gov (United States)

Salzedas-Netto, Alcides Augusto; Gonzalez, Adriano Miziara; Fagundes, Ulysses; Linhares, Marcelo Moura; Vicentine, Fernando Pompeu Piza; Romero, Luis Ramiro Núñez; Martins, José Luis; Pestana, José Osmar Medina; Oliva, Carlos Alberto Garcia

2014-11-01

To perform a cost analysis of simultaneous pancreas-kidney transplantation (SPKT) in a Brazilian hospital. Between January 2008 and December 2011, 105 consecutive SPKTs at the Hospital of Kidney and Hypertension in Sao Paulo were evaluated. We evaluated the patient demographics, payment source (public health system or supplementary system), and the impact of each hospital cost component. The evaluated costs were corrected to December 2011 values and converted to US dollars. Of the 105 SPKT patients, 61.9% were men, and 38.1% were women. Eight patients died, and 97 were discharged (92.4%). Eighty-nine procedures were funded by the public health system. The cost for the patients who were discharged was $18.352.27; the cost for the deceased patients was $18.449.96 (p = 0.79). The FOR for SPKT during this period was positive at $5,620.65. The costs were distributed as follows: supplies, 36%; administrative costs, 20%; physician fees, 15%; intensive care unit, 10%; surgical center, 10%; ward, 9%. Mortality did not affect costs, and supplies were the largest cost component.

African Health Sciences - Equinet.pmd

African Journals Online (AJOL)

Brian

Escalating health care costs, inadequate tax revenues and the unsustainable ... than conventional financing sources. Regrettably, the single largest source of financing for health services .... NHI is implemented argued that it would be a double.

Cost-effective master cell bank validation of multiple clinical-grade human pluripotent stem cell lines from a single donor.

Science.gov (United States)

Devito, Liani; Petrova, Anastasia; Miere, Cristian; Codognotto, Stefano; Blakely, Nicola; Lovatt, Archie; Ogilvie, Caroline; Khalaf, Yacoub; Ilic, Dusko

2014-10-01

Standardization guidelines for human pluripotent stem cells are still very broadly defined, despite ongoing clinical trials in the U.S., U.K., and Japan. The requirements for validation of human embryonic (hESCs) and induced pluripotent stem cells (iPSCs) in general follow the regulations for other clinically compliant biologics already in place but without addressing key differences between cell types or final products. In order to realize the full potential of stem cell therapy, validation criteria, methodology, and, most importantly, strategy, should address the shortfalls and efficiency of current approaches; without this, hESC- and, especially, iPSC-based therapy will not be able to compete with other technologies in a cost-efficient way. We addressed the protocols for testing cell lines for human viral pathogens and propose a novel strategy that would significantly reduce costs. It is highly unlikely that the multiple cell lines derived in parallel from a tissue sample taken from one donor would have different profiles of endogenous viral pathogens; we therefore argue that samples from the Master Cell Banks of sibling lines could be safely pooled for validation. We illustrate this approach with tiered validation of two sibling clinical-grade hESC lines, KCL033 and KCL034 (stage 1, sterility; stage 2, specific human pathogens; and stage 3, nonspecific human pathogens). The results of all tests were negative. This cost-effective strategy could also be applied for validation of Master Cell Banks of multiple clinical-grade iPSC lines derived from a single donor. ©AlphaMed Press.

Africa's largest long-lasting insecticide-treated net producer: lessons from A to Z Textiles.

Science.gov (United States)

Masum, Hassan; Shah, Ronak; Schroeder, Karl; Daar, Abdallah S; Singer, Peter A

2010-12-13

Field trials have demonstrated the efficacy of insecticide-treated nets, and the WHO has recently endorsed a shift toward Long-Lasting Insecticide Treated nets (LLINs) due to factors such as reduced distribution costs. However, the need for LLINs poses several challenges. Is it possible to manufacture LLINs in large quantities in the African continent, where malaria is most endemic? When production is located in low-income countries, what role is played by local funding and employment, scaling up manufacturing, and partnerships? What factors influence availability and pricing? A case study of A to Z Textiles was undertaken to answer the question of how large-scale production of LLINs can occur in a low income setting. One of the largest sources of bed nets for Africa, A to Z Textiles is Africa-based, and its Tanzanian operations have a production capacity of 30 million LLINs per year, along with full WHO recommendation for its nets. Our analysis is based on semi-structured interviews with key informants familiar with A to Z, site visits in Tanzania, and literature reviews.This paper discusses the history and current status of A to Z Textiles, identifies the factors that led to its success, and suggests policy considerations that could support similar initiatives in the future. Local funding, scaling up manufacturing, technology transfer, and partnerships all played important roles in A to Z's ascent, as did perceived benefits of local employment and capacity-building. Regulatory issues and procurement rules acted as barriers. A to Z cost-effectively manufactures high-quality LLINs where malaria is most endemic. With a production capacity of 30 million LLINs per year, and full WHOPES (WHO Pesticide Evaluation Scheme) certification, A to Z Textiles demonstrates how key health goods can be successfully produced in the low-income countries that use them. Its example may be instructive and of high interest to readers in the malaria community, especially in developing

Is scratch-cooking a cost-effective way to prepare healthy school meals with US Department of Agriculture foods?

Science.gov (United States)

Woodward-Lopez, Gail; Kao, Janice; Kiesel, Kristin; Lewis Miller, Markell; Boyle, Maria; Drago-Ferguson, Soledad; Braff-Guajardo, Ellen; Crawford, Patricia

2014-09-01

Despite the resurgence of interest in scratch-cooking as a way to increase the quality and appeal of school meals, many school districts are concerned about the cost implications of switching to scratch-cooking. US Department of Agriculture (USDA) Foods are the single largest source of ingredients for school meals, and about half of USDA Foods are diverted for processing before being sent to the school district. We aimed to determine whether school lunch entrées made in a district from basic or raw USDA Foods ingredients can be healthier and less expensive to prepare than those sent to external processors. This cross-sectional study examined the relationship between the extent of scratch-cooking and the nutritional content and cost to prepare entrées. Information was gathered by interview with school foodservice personnel and from school foodservice records from a convenience sample of 10 school districts in California that employed varying degrees of scratch-cooking and is diverse in terms of geographic location and the sociodemographics of the student body. The sample included all elementary school lunch entrées that contain USDA Foods offered during October 2010 for a total sample of 146 entrées. Ordinary least squares regressions were used to test for statistically significant differences in cost and nutrient content of entrées according to the level of scratch-cooking. There was no significant relationship between total costs and level of scratch-cooking. Entrées with the highest scratch-cooking scores had significantly lower food costs, higher labor costs, and not significantly different total costs compared with entrées with no scratch-cooking. Nutrient content was not consistently associated with scratch-cooking, but scratch-cooked entrées did include a larger variety of non-fast-food-type entrées. The findings suggest that scratch-cooking can be a cost-effective way to expand the variety of healthy school lunches prepared with USDA Foods

The cost determinants of routine infant immunization services: a meta-regression analysis of six country studies.

Science.gov (United States)

Menzies, Nicolas A; Suharlim, Christian; Geng, Fangli; Ward, Zachary J; Brenzel, Logan; Resch, Stephen C

2017-10-06

Evidence on immunization costs is a critical input for cost-effectiveness analysis and budgeting, and can describe variation in site-level efficiency. The Expanded Program on Immunization Costing and Financing (EPIC) Project represents the largest investigation of immunization delivery costs, collecting empirical data on routine infant immunization in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. We developed a pooled dataset from individual EPIC country studies (316 sites). We regressed log total costs against explanatory variables describing service volume, quality, access, other site characteristics, and income level. We used Bayesian hierarchical regression models to combine data from different countries and account for the multi-stage sample design. We calculated output elasticity as the percentage increase in outputs (service volume) for a 1% increase in inputs (total costs), averaged across the sample in each country, and reported first differences to describe the impact of other predictors. We estimated average and total cost curves for each country as a function of service volume. Across countries, average costs per dose ranged from $2.75 to $13.63. Average costs per child receiving diphtheria, tetanus, and pertussis ranged from $27 to $139. Within countries costs per dose varied widely-on average, sites in the highest quintile were 440% more expensive than those in the lowest quintile. In each country, higher service volume was strongly associated with lower average costs. A doubling of service volume was associated with a 19% (95% interval, 4.0-32) reduction in costs per dose delivered, (range 13% to 32% across countries), and the largest 20% of sites in each country realized costs per dose that were on average 61% lower than those for the smallest 20% of sites, controlling for other factors. Other factors associated with higher costs included hospital status, provision of outreach services, share of effort to management, level of staff training

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova

Science.gov (United States)

2014-01-01

Background Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Methods Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Results Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. Conclusions The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova.

Science.gov (United States)

Kempers, Jari; Ketting, Evert; Lesco, Galina

2014-07-21

Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH

Foreign exchange risk management : how are the largest non-financial companies in Norway managing their foreign exchange rate exposure?

OpenAIRE

Eriksen, Krister; Wedøe, Ola

2010-01-01

The purpose of this thesis is to investigate how the largest non-financial companies in Norway manage their foreign exchange rate exposure. This is investigated through the use of a survey distributed to a sample the largest non-financial firms in Norway. According to our results, the largest non-financial companies in Norway have a predefined strategy for managing foreign exchange risk, which is defined by the board of directors or by the management in the organisation. The companies’ mai...

New Chicago-Indiana computer network will handle dataflow from world's largest scientific experiment

CERN Multimedia

2006-01-01

"Massive quantities of data will soon begin flowing from the largest scientific instrument ever built into an international netword of computer centers, including one operated jointly by the University of Chicago and Indiana University." (1,5 page)

2016 Alabama PV soft cost and workforce development

Energy Technology Data Exchange (ETDEWEB)

Fox, E. [Savannah River Site (SRS), Aiken, SC (United States); Edwards, T. [Savannah River Site (SRS), Aiken, SC (United States)

2016-12-01

The Southeastern US has the largest potential for growth in the solar industry. However, currently they languish behind the rest of the US. There are several bright spots including the large number of utility scale installations in North Carolina and the recent successes in South Carolina under Act 236. In order to better understand the impacts of state legislation on the growth of the solar industry in the SE US, the Savannah River National Laboratory has undertaken a study to look at the growth in each state in order to develop recommendations to help reduce the cost of solar and to spur the industry. This is the second report in the series. The first focused on developing cost metrics for South Carolina under Act 236. This report focuses on Alabama, the 49th ranked state for solar business, which has very similar population and median income to South Carolina. For this survey, the ten known in-state installers were contacted. Responses were received from seven, representing 70% of the installers, a majority of which provide both residential and commercial installations. Interestingly, none of the respondents serve the utility scale sector. Overall, costs for Alabama are on track with the rest of the country with a reported average cost of $3.29/W-DC for residential systems and $2.44/W-DC for commercial systems. 60% of this cost is attributed to hardware only. Of the remaining costs, installation contributed to the largest percentage of soft costs followed by overhead, marketing and sales, and permitting, respectively. This also closely mirrors results seen in South Carolina. Job growth in the industry is expected to proceed well. An expected 34-42 additional full time equivalent jobs were expected to be added in Alabama within the six month window following the survey period. During the three years following the survey, this number was expected to double with 89-97 additional jobs being added to the market. In both cases, a vast majority of these jobs were for

Malaria community health workers in Myanmar: a cost analysis.

Science.gov (United States)

Kyaw, Shwe Sin; Drake, Tom; Thi, Aung; Kyaw, Myat Phone; Hlaing, Thaung; Smithuis, Frank M; White, Lisa J; Lubell, Yoel

2016-01-25

Myanmar has the highest malaria incidence and attributed mortality in South East Asia with limited healthcare infrastructure to manage this burden. Establishing malaria Community Health Worker (CHW) programmes is one possible strategy to improve access to malaria diagnosis and treatment, particularly in remote areas. Despite considerable donor support for implementing CHW programmes in Myanmar, the cost implications are not well understood. An ingredients based micro-costing approach was used to develop a model of the annual implementation cost of malaria CHWs in Myanmar. A cost model was constructed based on activity centres comprising of training, patient malaria services, monitoring and supervision, programme management, overheads and incentives. The model takes a provider perspective. Financial data on CHWs programmes were obtained from the 2013 financial reports of the Three Millennium Development Goal fund implementing partners that have been working on malaria control and elimination in Myanmar. Sensitivity and scenario analyses were undertaken to outline parameter uncertainty and explore changes to programme cost for key assumptions. The range of total annual costs for the support of one CHW was US$ 966-2486. The largest driver of CHW cost was monitoring and supervision (31-60% of annual CHW cost). Other important determinants of cost included programme management (15-28% of annual CHW cost) and patient services (6-12% of annual CHW cost). Within patient services, malaria rapid diagnostic tests are the major contributor to cost (64% of patient service costs). The annual cost of a malaria CHW in Myanmar varies considerably depending on the context and the design of the programme, in particular remoteness and the approach to monitoring and evaluation. The estimates provide information to policy makers and CHW programme planners in Myanmar as well as supporting economic evaluations of their cost-effectiveness.

A Single-use Strategy to Enable Manufacturing of Affordable Biologics

Directory of Open Access Journals (Sweden)

Renaud Jacquemart

2016-01-01

Full Text Available The current processing paradigm of large manufacturing facilities dedicated to single product production is no longer an effective approach for best manufacturing practices. Increasing competition for new indications and the launch of biosimilars for the monoclonal antibody market have put pressure on manufacturers to produce at lower cost. Single-use technologies and continuous upstream processes have proven to be cost-efficient options to increase biomass production but as of today the adoption has been only minimal for the purification operations, partly due to concerns related to cost and scale-up. This review summarizes how a single-use holistic process and facility strategy can overcome scale limitations and enable cost-efficient manufacturing to support the growing demand for affordable biologics. Technologies enabling high productivity, right-sized, small footprint, continuous, and automated upstream and downstream operations are evaluated in order to propose a concept for the flexible facility of the future.

Musculoskeletal disorder costs and medical claim filing in the US retail trade sector.

Science.gov (United States)

Bhattacharya, Anasua; Leigh, J Paul

2011-01-01

The average costs of Musculoskeletal Disorder (MSD) and odds ratios for filing medical claims related to MSD were examined. The medical claims were identified by ICD 9 codes for four US Census regions within retail trade. Large private firms' medical claims data from Thomson Reuters Inc. MarketScan databases for the years 2003 through 2006 were used. Average costs were highest for claims related to lumbar region (ICD 9 Code: 724.02) and number of claims were largest for low back syndrome (ICD 9 Code: 724.2). Whereas the odds of filing an MSD claim did not vary greatly over time, average costs declined over time. The odds of filing claims rose with age and were higher for females and southerners than men and non-southerners. Total estimated national medical costs for MSDs within retail trade were $389 million (2007 USD).

Ground-Based Telescope Parametric Cost Model

Science.gov (United States)

Stahl, H. Philip; Rowell, Ginger Holmes

2004-01-01

A parametric cost model for ground-based telescopes is developed using multi-variable statistical analysis, The model includes both engineering and performance parameters. While diameter continues to be the dominant cost driver, other significant factors include primary mirror radius of curvature and diffraction limited wavelength. The model includes an explicit factor for primary mirror segmentation and/or duplication (i.e.. multi-telescope phased-array systems). Additionally, single variable models based on aperture diameter are derived. This analysis indicates that recent mirror technology advances have indeed reduced the historical telescope cost curve.

Mixed signals emerging on full cost accounting

International Nuclear Information System (INIS)

Rutherford, D.

1993-01-01

In Ontario, various nongovernmental and governmental agencies have put forward mixed views on the use of full cost accounting (FCA) for electric utilities (Ontario Hydro, in particular). Full cost accounting is defined as a process by which social and environmental impacts of projects and technologies can be quantified and assessed for their comparative consequences on the local community and society at large. A November 1992 statement from the Ontario Ministry of Environment and Energy has said that all social and environmental costs, impacts, risks, and benefits should be considered in planning. A report of the energy task force of the Ontario Round Table on Environment and Economy (ORTEE) included a strong endorsement of FCA. A task force with the mandate to help Ontario Hydro develop a sustainable energy policy includes a group which will examine FCA and how to implement it. Critics of Ontario Hydro note that the utility's recent announcement of offering substantial discounts to some of its largest industrial customers goes directly against FCA. In addition, Hydro's continued reliance on an avoided cost model (without consideration of social and environmental impacts of power generation) makes it difficult for the utility to think beyond traditional approaches. In contrast, British Columbia is announcing a Social Costing policy to evaluate power projects according to their environmental as well as financial impact. Under the right conditions, adopting FCA can offer distinct trade advantages to Ontario. Under international trade agreements that pay heed to environmental costs, jurisdictions which have high environmental standards stand to gain

Evaluation of Costs in Asparagus Production in Relation to Different Technological Processes in Conditions of Slovak Republic

Directory of Open Access Journals (Sweden)

Patrik Burg

2014-01-01

Full Text Available This study deals with analysis structure of cost on the production of asparagus in relation to three different technological processes in conditions of Slovak Republic. Obtained results can be used as a template to prepare budgets and make production decisions to estimate potential returns and to analyze investment and financial analysis decisions in the asparagus cultivation. Production practices used in the budget are based on typical practices for asparagus in this country. From the analysis of the cost structure of assessed variants different technological procedures follows that the largest share of the costs fall to purchased material and labor.

Opportunities for biodiversity gains under the world’s largest reforestation programme

OpenAIRE

Hua, Fangyuan; Wang, Xiaoyang; Zheng, Xinlei; Fisher, Brendan; Wang, Lin; Zhu, Jianguo; Tang, Ya; Yu, Douglas W.; Wilcove, David S.

2016-01-01

Reforestation is a critical means of addressing the environmental and social problems of deforestation. China’s Grain-for-Green Program (GFGP) is the world’s largest reforestation scheme. Here we provide the first nationwide assessment of the tree composition of GFGP forests and the first combined ecological and economic study aimed at understanding GFGP’s biodiversity implications. Across China, GFGP forests are overwhelmingly monocultures or compositionally simple mixed forests. Focusing on...

Dual-Recycling Channel Decision in a Closed-Loop Supply Chain with Cost Disruptions

Directory of Open Access Journals (Sweden)

Yanting Huang

2017-11-01

Full Text Available This paper investigates cost disruptions of new and remanufactured products in a closed-loop supply chain where a manufacturer and a third-party collector recycle used products through online-recycling and offline-recycling channels, respectively. We use a Stackelberg game to acquire the equilibrium decisions of dual-recycling and single-recycling channels and analyze how cost disruptions affect the manufacturer’ production and collection strategies. We show that, cost disruption of new products produces a positive impact whilst the remanufacturing cost disruption has a negative impact on collection quantity of used products and negative cost disruptions of both new and remanufactured products could be profitable to the manufacturer. As for the manufacturer’s channel choice, the dual-recycling channel dominates single-recycling channels when new product cost faces positive disruption, because the manufacturer acts as both a buyer and a competitor to the collector and can determine an appropriate acquisition price and transfer price to coordinate the online-offline recycling channel. While if cost disruption of new products is negative, the manufacturer prefers the dual-recycling channel instead of single-recycling channels only if the remanufacturing cost faces large size of negative disruption.

NASA Software Cost Estimation Model: An Analogy Based Estimation Model

Science.gov (United States)

Hihn, Jairus; Juster, Leora; Menzies, Tim; Mathew, George; Johnson, James

2015-01-01

The cost estimation of software development activities is increasingly critical for large scale integrated projects such as those at DOD and NASA especially as the software systems become larger and more complex. As an example MSL (Mars Scientific Laboratory) developed at the Jet Propulsion Laboratory launched with over 2 million lines of code making it the largest robotic spacecraft ever flown (Based on the size of the software). Software development activities are also notorious for their cost growth, with NASA flight software averaging over 50% cost growth. All across the agency, estimators and analysts are increasingly being tasked to develop reliable cost estimates in support of program planning and execution. While there has been extensive work on improving parametric methods there is very little focus on the use of models based on analogy and clustering algorithms. In this paper we summarize our findings on effort/cost model estimation and model development based on ten years of software effort estimation research using data mining and machine learning methods to develop estimation models based on analogy and clustering. The NASA Software Cost Model performance is evaluated by comparing it to COCOMO II, linear regression, and K-­ nearest neighbor prediction model performance on the same data set.

Sequential Construction of Costly Networks

Energy Technology Data Exchange (ETDEWEB)

Gutfraind, Alexander [Los Alamos National Laboratory

2011-01-01

Natural disasters or attacks often disrupt infrastructure networks requiring a costly recovery. This motivates an optimization problem where the objecitve is to construct the nodes of a graph G(V;E), and the cost of each node is dependent on the number of its neighbors previously constructed, or more generally, any properties of the previously-completed subgraph. In this optimization problem the objective is to find a permutation of the nodes which results in the least construction cost. We prove that in the case where the cost of nodes is a convex function in the number of neighbors, the optimal construction sequence is to start at a single node and move outwards. We also introduce algorithms and heuristics for solving various instances of the problem. Those methods can be applied to help reduce the cost of recovering from disasters as well as to plan the deployment of new network infrastructure.

Cost-effectiveness of treatment strategies for BRAF-mutated metastatic melanoma.

Directory of Open Access Journals (Sweden)

Patti Curl

Full Text Available Genetically-targeted therapies are both promising and costly advances in the field of oncology. Several treatments for metastatic melanoma with a mutation in the BRAF gene have been approved. They extend life but are more expensive than the previous standard of care (dacarbazine. Vemurafenib, the first drug in this class, costs $13,000 per month ($207,000 for a patient with median survival. Patients failing vemurafenib are often given ipilimumab, an immunomodulator, at $150,000 per course. Assessment of cost-effectiveness is a valuable tool to help navigate the transition toward targeted cancer therapy.We performed a cost-utility analysis to compare three strategies for patients with BRAF+ metastatic melanoma using a deterministic expected-value decision tree model to calculate the present value of lifetime costs and quality-adjusted life years (QALYs for each strategy. We performed sensitivity analyses on all variables.In the base case, the incremental cost-effectiveness ratio (ICER for vemurafenib compared with dacarbazine was $353,993 per QALY gained (0.42 QALYs added, $156,831 added. The ICER for vemurafenib followed by ipilimumab compared with vemurafenib alone was $158,139. In sensitivity analysis, treatment cost had the largest influence on results: the ICER for vemurafenib versus dacarbazine dropped to $100,000 per QALY gained with a treatment cost of $3600 per month.The cost per QALY gained for treatment of BRAF+ metastatic melanoma with vemurafenib alone or in combination exceeds widely-cited thresholds for cost-effectiveness. These strategies may become cost-effective with lower drug prices or confirmation of a durable response without continued treatment.

Robotic single-access splenectomy using the Da Vinci Single-Site® platform: a case report.

Science.gov (United States)

Corcione, Francesco; Bracale, Umberto; Pirozzi, Felice; Cuccurullo, Diego; Angelini, Pier Luigi

2014-03-01

Single-access laparoscopic splenectomy can offer patients some advantages. It has many difficulties, such as instrument clashing, lack of triangulation, odd angles and lack of space. The Da Vinci Single-Site® robotic surgery platform could decrease these difficulties. We present a case of single-access robotic splenectomy using this device. A 37 year-old female with idiopathic thrombocytopenic purpura was operated on with a single-site approach, using the Da Vinci Single-Site robotic surgery device. The procedure was successfully completed in 140 min. No intraoperative and postoperative complications occurred. The patient was discharged from hospital on day 3. Single-access robotic splenectomy seems to be feasible and safe using the new robotic single-access platform, which seems to overcome certain limits of previous robotic or conventional single-access laparoscopy. We think that additional studies should also be performed to explore the real cost-effectiveness of the platform. Copyright © 2013 John Wiley & Sons, Ltd.

Cost-Effective Brillouin Optical Time-Domain Analysis Sensor Using a Single Optical Source and Passive Optical Filtering

Directory of Open Access Journals (Sweden)

H. Iribas

2016-01-01

Full Text Available We present a simplified configuration for distributed Brillouin optical time-domain analysis sensors that aims to reduce the cost of the sensor by reducing the number of components required for the generation of the two optical waves involved in the sensing process. The technique is based on obtaining the pump and probe waves by passive optical filtering of the spectral components generated in a single optical source that is driven by a pulsed RF signal. The optical source is a compact laser with integrated electroabsorption modulator and the optical filters are based on fiber Bragg gratings. Proof-of-concept experiments demonstrate 1 m spatial resolution over a 20 km sensing fiber with a 0.9 MHz precision in the measurement of the Brillouin frequency shift, a performance similar to that of much more complex setups. Furthermore, we discuss the factors limiting the sensor performance, which are basically related to residual spectral components in the filtering process.

A New Proposed Cost Model for List Accessing Problem using Buffering

OpenAIRE

Mohanty, Rakesh; Bhoi, Seetaya; Tripathy, Sasmita

2011-01-01

There are many existing well known cost models for the list accessing problem. The standard cost model developed by Sleator and Tarjan is most widely used. In this paper, we have made a comprehensive study of the existing cost models and proposed a new cost model for the list accessing problem. In our proposed cost model, for calculating the processing cost of request sequence using a singly linked list, we consider the access cost, matching cost and replacement cost. The cost of processing a...

Tunneling spin injection into single layer graphene.

Science.gov (United States)

Han, Wei; Pi, K; McCreary, K M; Li, Yan; Wong, Jared J I; Swartz, A G; Kawakami, R K

2010-10-15

We achieve tunneling spin injection from Co into single layer graphene (SLG) using TiO₂ seeded MgO barriers. A nonlocal magnetoresistance (ΔR(NL)) of 130  Ω is observed at room temperature, which is the largest value observed in any material. Investigating ΔR(NL) vs SLG conductivity from the transparent to the tunneling contact regimes demonstrates the contrasting behaviors predicted by the drift-diffusion theory of spin transport. Furthermore, tunnel barriers reduce the contact-induced spin relaxation and are therefore important for future investigations of spin relaxation in graphene.

Ownership, financing, and management strategies of the ten largest for-profit nursing home chains in the United States.

Science.gov (United States)

Harrington, Charlene; Hauser, Clarilee; Olney, Brian; Rosenau, Pauline Vaillancourt

2011-01-01

This study examined the ownership, financing, and management strategies of the 10 largest for-profit nursing home chains in the United States, including the four largest chains purchased by private equity corporations. Descriptive data were collected from Internet searches, company reports, and other sources for the decade 1998-2008. Since 1998, the largest chains have made many changes in their ownership and structure, and some have converted from publicly traded companies to private ownership. This study shows the increasing complexity of corporate nursing home ownership and the lack of public information about ownership and financial status. The chains have used strategies to maximize shareholder and investor value that include increasing Medicare revenues, occupancy rates, and company diversification, establishing multiple layers of corporate ownership, developing real estate investment trusts, and creating limited liability companies. These strategies enhance shareholder and investor profits, reduce corporate taxes, and reduce liability risk. There is a need for greater transparency in ownership and financial reporting and for more government oversight of the largest for-profit chains, including those owned by private equity companies.

Cost Analysis of an Intervention to Prevent Methicillin-Resistant Staphylococcus Aureus (MRSA Transmission.

Directory of Open Access Journals (Sweden)

Michal Chowers

Full Text Available Our objective was to assess the cost implications of a vertical MRSA prevention program that led to a reduction in MRSA bacteremia.We performed a matched historical cohort study and cost analysis in a single hospital in Israel for the years 2005-2011. The cost of MRSA bacteremia was calculated as total hospital cost for patients admitted with bacteremia and for patients with hospital-acquired bacteremia, the difference in cost compared to matched controls. The cost of prevention was calculated as the sum of the cost of microbiology tests, single-use equipment used for patients in isolation, and infection control personnel.An average of 20,000 patients were screened yearly. The cost of prevention was $208,100 per year, with the major contributor being laboratory cost. We calculated that our intervention averted 34 cases of bacteremia yearly: 17 presenting on admission and 17 acquired in the hospital. The average cost of a case admitted with bacteremia was $14,500, and the net cost attributable to nosocomial bacteremia was $9,400. Antibiotics contributed only 0.4% of the total disease management cost. When the annual cost of averted cases of bacteremia and that of prevention were compared, the intervention resulted in annual cost savings of $199,600.A vertical MRSA prevention program targeted at high-risk patients, which was highly effective in preventing bacteremia, is cost saving. These results suggest that allocating resources to targeted prevention efforts might be beneficial even in a single institution in a high incidence country.

Cost Analysis of an Intervention to Prevent Methicillin-Resistant Staphylococcus Aureus (MRSA) Transmission.

Science.gov (United States)

Chowers, Michal; Carmeli, Yehuda; Shitrit, Pnina; Elhayany, Asher; Geffen, Keren

2015-01-01

Our objective was to assess the cost implications of a vertical MRSA prevention program that led to a reduction in MRSA bacteremia. We performed a matched historical cohort study and cost analysis in a single hospital in Israel for the years 2005-2011. The cost of MRSA bacteremia was calculated as total hospital cost for patients admitted with bacteremia and for patients with hospital-acquired bacteremia, the difference in cost compared to matched controls. The cost of prevention was calculated as the sum of the cost of microbiology tests, single-use equipment used for patients in isolation, and infection control personnel. An average of 20,000 patients were screened yearly. The cost of prevention was $208,100 per year, with the major contributor being laboratory cost. We calculated that our intervention averted 34 cases of bacteremia yearly: 17 presenting on admission and 17 acquired in the hospital. The average cost of a case admitted with bacteremia was $14,500, and the net cost attributable to nosocomial bacteremia was $9,400. Antibiotics contributed only 0.4% of the total disease management cost. When the annual cost of averted cases of bacteremia and that of prevention were compared, the intervention resulted in annual cost savings of $199,600. A vertical MRSA prevention program targeted at high-risk patients, which was highly effective in preventing bacteremia, is cost saving. These results suggest that allocating resources to targeted prevention efforts might be beneficial even in a single institution in a high incidence country.

A note on Fenchel cuts for the single-node flow problem

DEFF Research Database (Denmark)

Klose, Andreas

The single-node flow problem, which is also known as the single-sink fixed-charge transportation problem, consists in finding a minimum cost flow from a number of nodes to a single sink. The flow cost comprise an amount proportional to the quantity shipped as well as a fixed charge. In this note......, some structural properties of Fenchel cutting planes for this problem are described. Such cuts might then be applied for solving, e.g., fixed-charge transportation problems and more general fixed-charge network flow problems....

Cost of illness of atrial fibrillation: a nationwide study of societal impact.

Science.gov (United States)

Johnsen, Søren Paaske; Dalby, Lene Worsaae; Täckström, Tomas; Olsen, Jens; Fraschke, Anina

2017-11-10

The prevalence of atrial fibrillation is increasing rapidly; however, to date, population-based data are lacking on the attributable cost of illness of atrial fibrillation from a societal perspective, including both direct and indirect costs. The study was an incidence-based cost-of-illness study based on national registries covering the entire population of Denmark. We identified all patients with a first-time hospital diagnosis of atrial fibrillation between 2001 and 2012. For every atrial fibrillation patient, we identified three age- and sex-matched controls from the general population. Both the total and the attributable costs of atrial fibrillation were estimated based on individual level information on hospital care (in- and out-patient contacts), primary sector care, use of prescription drugs and productivity loss. Average 3-year societal costs per patient attributable to atrial fibrillation were estimated to be €20,403-26,544 during the study period. The costs were highest during the first year after diagnosis of atrial fibrillation. Admission costs constituted the largest cost component, whereas primary sector costs and medicine costs only constituted minor components. The attributable costs were more than two-fold higher among patients experiencing a stroke. The total 3-year cost attributable to atrial fibrillation in Denmark was estimated to be €219-295 million. The societal costs attributable to atrial fibrillation are significant. Reducing the need for hospitalizations, in particular from stroke, is a key factor in controlling the costs.

Advanced Prop-fan Engine Technology (APET) single- and counter-rotation gearbox/pitch change mechanism

Science.gov (United States)

Reynolds, C. N.

1985-01-01

The preliminary design of advanced technology (1992) turboprop engines for single-rotation prop-fans and conceptual designs of pitch change mechanisms for single- and counter-rotation prop-fan application are discussed. The single-rotation gearbox is a split path, in-line configuration. The counter-rotation gearbox is an in-line, differential planetary design. The pitch change mechanisms for both the single- and counter-rotation arrangements are rotary/hydraulic. The advanced technology single-rotation gearbox yields a 2.4 percent improvement in aircraft fuel burn and a one percent improvement in operating cost relative to a current technology gearbox. The 1992 counter-rotation gearbox is 15 percent lighter, 15 percent more reliable, 5 percent lower in cost, and 45 percent lower in maintenance cost than the 1992 single-rotation gearbox. The pitch controls are modular, accessible, and external.

SSC RIAR is the largest centre of research reactors

International Nuclear Information System (INIS)

Kalygin, V.V.

1997-01-01

The State Scientific Centre (SSC) ''Research Institute of Atomic Reactors'' (RIAR) is situated 100 km to the south-east from Moscow, in Dimitrovgrad, the Volga Region of the Russian Federation. SSC RIAR is the largest centre of research reactors in Russia. At present there are 5 types of reactor facilities in operation, including two NPP. One of the main tasks the Centre is the investigations on safety increase for power reactors. Broad international connections are available at the Institute. On the basis of the SSC RIAR during 3 years work has been done on the development of the branch training centre (TC) for the training of operation personnel of research and pilot reactors in Russia. (author). 3 tabs

SSC RIAR is the largest centre of research reactors

Energy Technology Data Exchange (ETDEWEB)

Kalygin, V V [State Scientific Centre, Research Inst. of Atomic Reactors (Russian Federation)

1997-10-01

The State Scientific Centre (SSC) ``Research Institute of Atomic Reactors`` (RIAR) is situated 100 km to the south-east from Moscow, in Dimitrovgrad, the Volga Region of the Russian Federation. SSC RIAR is the largest centre of research reactors in Russia. At present there are 5 types of reactor facilities in operation, including two NPP. One of the main tasks the Centre is the investigations on safety increase for power reactors. Broad international connections are available at the Institute. On the basis of the SSC RIAR during 3 years work has been done on the development of the branch training centre (TC) for the training of operation personnel of research and pilot reactors in Russia. (author). 3 tabs.

Flipping the Calculus Classroom: A Cost-Effective Approach

Science.gov (United States)

Young, Andrea

2015-01-01

This article discusses a cost-effective approach to flipping the calculus classroom. In particular, the emphasis is on low-cost choices, both monetarily and with regards to faculty time, that make the daunting task of flipping a course manageable for a single instructor. Student feedback and overall impressions are also presented.

Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

Directory of Open Access Journals (Sweden)

Glenn A. Melnick PhD

2016-06-01

Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

The single-sink fixed-charge transportation problem: Applications and solution methods

DEFF Research Database (Denmark)

Goertz, Simon; Klose, Andreas

2007-01-01

The single-sink fixed-charge transportation problem (SSFCTP) consists in finding a minimum cost flow from a number of supplier nodes to a single demand node. Shipping costs comprise costs proportional to the amount shipped as well as a fixed-charge. Although the SSFCTP is an important special case...... of the well-known fixed-charge transportation problem, just a few methods for solving this problem have been proposed in the literature. After summarising some applications of this problem arising in manufacturing and transportation, we give an overview on approximation algorithms and worst-case results...

Examining the production costs of antiretroviral drugs.

Science.gov (United States)

Pinheiro, Eloan; Vasan, Ashwin; Kim, Jim Yong; Lee, Evan; Guimier, Jean Marc; Perriens, Joseph

2006-08-22

To present direct manufacturing costs and price calculations of individual antiretroviral drugs, enabling those responsible for their procurement to have a better understanding of the cost structure of their production, and to indicate the prices at which these antiretroviral drugs could be offered in developing country markets. Direct manufacturing costs and factory prices for selected first and second-line antiretroviral drugs were calculated based on cost structure data from a state-owned company in Brazil. Prices for the active pharmaceutical ingredients (API) were taken from a recent survey by the World Health Organization (WHO). The calculated prices for antiretroviral drugs are compared with quoted prices offered by privately-owned, for-profit manufacturers. The API represents the largest component of direct manufacturing costs (55-99%), while other inputs, such as salaries, equipment costs, and scale of production, have a minimal impact. The calculated prices for most of the antiretroviral drugs studied fall within the lower quartile of the range of quoted prices in developing country markets. The exceptions are those drugs, primarily for second-line therapy, for which the API is either under patent, in short supply, or in limited use in developing countries (e.g. abacavir, lopinavir/ritonavir, nelfinavir, saquinavir). The availability of data on the cost of antiretroviral drug production and calculation of factory prices under a sustainable business model provide benchmarks that bulk purchasers of antiretroviral drugs could use to negotiate lower prices. While truly significant price decreases for antiretroviral drugs will depend largely on the future evolution of API prices, the present study demonstrates that for several antiretroviral drugs price reduction is currently possible. Whether or not these reductions materialize will depend on the magnitude of indirect cost and profit added by each supplier over the direct production costs. The ability to

A Single-use Strategy to Enable Manufacturing of Affordable Biologics

OpenAIRE

Jacquemart, Renaud; Vandersluis, Melissa; Zhao, Mochao; Sukhija, Karan; Sidhu, Navneet; Stout, Jim

2016-01-01

The current processing paradigm of large manufacturing facilities dedicated to single product production is no longer an effective approach for best manufacturing practices. Increasing competition for new indications and the launch of biosimilars for the monoclonal antibody market have put pressure on manufacturers to produce at lower cost. Single-use technologies and continuous upstream processes have proven to be cost-efficient options to increase biomass production but as of today the adop...

Massively Parallel Single-Molecule Manipulation Using Centrifugal Force

Science.gov (United States)

Wong, Wesley; Halvorsen, Ken

2011-03-01

Precise manipulation of single molecules has led to remarkable insights in physics, chemistry, biology, and medicine. However, two issues that have impeded the widespread adoption of these techniques are equipment cost and the laborious nature of making measurements one molecule at a time. To meet these challenges, we have developed an approach that enables massively parallel single- molecule force measurements using centrifugal force. This approach is realized in the centrifuge force microscope, an instrument in which objects in an orbiting sample are subjected to a calibration-free, macroscopically uniform force- field while their micro-to-nanoscopic motions are observed. We demonstrate high- throughput single-molecule force spectroscopy with this technique by performing thousands of rupture experiments in parallel, characterizing force-dependent unbinding kinetics of an antibody-antigen pair in minutes rather than days. Currently, we are taking steps to integrate high-resolution detection, fluorescence, temperature control and a greater dynamic range in force. With significant benefits in efficiency, cost, simplicity, and versatility, single-molecule centrifugation has the potential to expand single-molecule experimentation to a wider range of researchers and experimental systems.

A marine heatwave drives massive losses from the world’s largest seagrass carbon stocks

KAUST Repository

Arias-Ortiz, Ariane; Serrano, Oscar; Masqué , Pere; Lavery, P. S.; Mueller, U.; Kendrick, G. A.; Rozaimi, M.; Esteban, A.; Fourqurean, J. W.; Marbà , N.; Mateo, M. A.; Murray, K.; Rule, M. J.; Duarte, Carlos M.

2018-01-01

Seagrass ecosystems contain globally significant organic carbon (C) stocks. However, climate change and increasing frequency of extreme events threaten their preservation. Shark Bay, Western Australia, has the largest C stock reported for a seagrass

Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

Science.gov (United States)

Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

2017-09-19

Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

Medical Expenditure for Chronic Diseases in Mexico: The Case of Selected Diagnoses Treated by the Largest Care Providers.

Science.gov (United States)

Figueroa-Lara, Alejandro; Gonzalez-Block, Miguel Angel; Alarcon-Irigoyen, Jose

2016-01-01

Chronic diseases (CD) are a public health emergency in Mexico. Despite concern regarding the financial burden of CDs in the country, economic studies have focused only on diabetes, hypertension, and cancer. Furthermore, these estimated financial burdens were based on hypothetical epidemiology models or ideal healthcare scenarios. The present study estimates the annual expenditure per patient and the financial burden for the nine most prevalent CDs, excluding cancer, for each of the two largest public health providers in the country: the Ministry of Health (MoH) and the Mexican Institute of Social Security (IMSS). Using the Mexican National Health and Nutrition Survey 2012 (ENSANUT) as the main source of data, health services consumption related to CDs was obtained from patient reports. Unit costs for each provided health service (e.g. consultation, drugs, hospitalization) were obtained from official reports. Prevalence data was obtained from the published literature. Annual expenditure due to health services consumption was calculated by multiplying the quantity of services consumed by the unit cost of each health service. The most expensive CD in both health institutions was chronic kidney disease (CKD), with an annual unit cost for MoH per patient of US$ 8,966 while for IMSS the expenditure was US$ 9,091. Four CDs (CKD, arterial hypertension, type 2 diabetes, and chronic ischemic heart disease) accounted for 88% of the total CDs financial burden (US$ 1.42 billion) in MoH and 85% (US$ 3.96 billion) in IMSS. The financial burden of the nine CDs analyzed represents 8% and 25% of the total annual MoH and IMSS health expenditure, respectively. The financial burden from the nine most prevalent CDs, excluding cancer, is already high in Mexico. This finding by itself argues for the need to improve health promotion and disease detection, diagnosis, and treatment to ensure CD primary and secondary prevention. If the status quo remains, the financial burden could be higher.

Medical Expenditure for Chronic Diseases in Mexico: The Case of Selected Diagnoses Treated by the Largest Care Providers

Science.gov (United States)

Figueroa-Lara, Alejandro; Gonzalez-Block, Miguel Angel; Alarcon-Irigoyen, Jose

2016-01-01

Background Chronic diseases (CD) are a public health emergency in Mexico. Despite concern regarding the financial burden of CDs in the country, economic studies have focused only on diabetes, hypertension, and cancer. Furthermore, these estimated financial burdens were based on hypothetical epidemiology models or ideal healthcare scenarios. The present study estimates the annual expenditure per patient and the financial burden for the nine most prevalent CDs, excluding cancer, for each of the two largest public health providers in the country: the Ministry of Health (MoH) and the Mexican Institute of Social Security (IMSS). Methods Using the Mexican National Health and Nutrition Survey 2012 (ENSANUT) as the main source of data, health services consumption related to CDs was obtained from patient reports. Unit costs for each provided health service (e.g. consultation, drugs, hospitalization) were obtained from official reports. Prevalence data was obtained from the published literature. Annual expenditure due to health services consumption was calculated by multiplying the quantity of services consumed by the unit cost of each health service. Results The most expensive CD in both health institutions was chronic kidney disease (CKD), with an annual unit cost for MoH per patient of US$ 8,966 while for IMSS the expenditure was US$ 9,091. Four CDs (CKD, arterial hypertension, type 2 diabetes, and chronic ischemic heart disease) accounted for 88% of the total CDs financial burden (US$ 1.42 billion) in MoH and 85% (US$ 3.96 billion) in IMSS. The financial burden of the nine CDs analyzed represents 8% and 25% of the total annual MoH and IMSS health expenditure, respectively. Conclusions/Significance The financial burden from the nine most prevalent CDs, excluding cancer, is already high in Mexico. This finding by itself argues for the need to improve health promotion and disease detection, diagnosis, and treatment to ensure CD primary and secondary prevention. If the

Medical Expenditure for Chronic Diseases in Mexico: The Case of Selected Diagnoses Treated by the Largest Care Providers.

Directory of Open Access Journals (Sweden)

Alejandro Figueroa-Lara

Full Text Available Chronic diseases (CD are a public health emergency in Mexico. Despite concern regarding the financial burden of CDs in the country, economic studies have focused only on diabetes, hypertension, and cancer. Furthermore, these estimated financial burdens were based on hypothetical epidemiology models or ideal healthcare scenarios. The present study estimates the annual expenditure per patient and the financial burden for the nine most prevalent CDs, excluding cancer, for each of the two largest public health providers in the country: the Ministry of Health (MoH and the Mexican Institute of Social Security (IMSS.Using the Mexican National Health and Nutrition Survey 2012 (ENSANUT as the main source of data, health services consumption related to CDs was obtained from patient reports. Unit costs for each provided health service (e.g. consultation, drugs, hospitalization were obtained from official reports. Prevalence data was obtained from the published literature. Annual expenditure due to health services consumption was calculated by multiplying the quantity of services consumed by the unit cost of each health service.The most expensive CD in both health institutions was chronic kidney disease (CKD, with an annual unit cost for MoH per patient of US$ 8,966 while for IMSS the expenditure was US$ 9,091. Four CDs (CKD, arterial hypertension, type 2 diabetes, and chronic ischemic heart disease accounted for 88% of the total CDs financial burden (US$ 1.42 billion in MoH and 85% (US$ 3.96 billion in IMSS. The financial burden of the nine CDs analyzed represents 8% and 25% of the total annual MoH and IMSS health expenditure, respectively.The financial burden from the nine most prevalent CDs, excluding cancer, is already high in Mexico. This finding by itself argues for the need to improve health promotion and disease detection, diagnosis, and treatment to ensure CD primary and secondary prevention. If the status quo remains, the financial burden could be

The largest Silurian vertebrate and its palaeoecological implications

Science.gov (United States)

Choo, Brian; Zhu, Min; Zhao, Wenjin; Jia, Liaotao; Zhu, You'an

2014-01-01

An apparent absence of Silurian fishes more than half-a-metre in length has been viewed as evidence that gnathostomes were restricted in size and diversity prior to the Devonian. Here we describe the largest pre-Devonian vertebrate (Megamastax amblyodus gen. et sp. nov.), a predatory marine osteichthyan from the Silurian Kuanti Formation (late Ludlow, ~423 million years ago) of Yunnan, China, with an estimated length of about 1 meter. The unusual dentition of the new form suggests a durophagous diet which, combined with its large size, indicates a considerable degree of trophic specialisation among early osteichthyans. The lack of large Silurian vertebrates has recently been used as constraint in palaeoatmospheric modelling, with purported lower oxygen levels imposing a physiological size limit. Regardless of the exact causal relationship between oxygen availability and evolutionary success, this finding refutes the assumption that pre-Emsian vertebrates were restricted to small body sizes. PMID:24921626

Transumbilical laparoendoscopic single-site donor nephrectomy: Without the use of a single port access device

Directory of Open Access Journals (Sweden)

Deepak Dubey

2011-01-01

Conclusions : Transumbilical LESS-DN can be cost-effectively performed using conventional laparoscopy instruments and without the need for a single port access device. Warm ischemia times with this technique are comparable with that during conventional multiport laparoscopic donor nephrectomy.

THE MASS OF (4) VESTA DERIVED FROM ITS LARGEST GRAVITATIONAL EFFECTS

International Nuclear Information System (INIS)

Kuzmanoski, Mike; Novakovic, Bojan; Apostolovska, Gordana

2010-01-01

In this paper, we present a recalculated value of the mass of (4) Vesta, derived from its largest gravitational perturbations on selected asteroids during their mutual close encounters. This was done by using a new method for mass determination, which is based on the linking of pre-encounter observations to the orbit determined from post-encounter ones. The estimated weighted mean of the mass of (4) Vesta is (1.300 ± 0.001) x 10 -10 M sun .

CONCEPT-5 user's manual. [Power plant costs

Energy Technology Data Exchange (ETDEWEB)

Hudson, C.R. II

1979-01-01

The CONCEPT computer code package was developed to provide conceptual capital cost estimates for nuclear-fueled and fossil-fired power plants. Cost estimates can be made as a function of plant type, size, location, and date of initial operation. The output includes a detailed breakdown of the estimate into direct and indirect costs similar to the accounting system described in document NUS--531. Cost models are currently provided in CONCEPT 5 for single- and multiunit pressurized-water reactors, boiling-water reactors, and cost-fired plants with and without flue gas desulfurization equipment.

Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

Directory of Open Access Journals (Sweden)

Pattaraporn Khongboon

2018-01-01

Full Text Available Background. Rural-urban inequality in long-term care (LTC services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

Key U.S.-built part fails during testing for world's largest particle collider

CERN Multimedia

2007-01-01

"Scientists are scrambling to redesign a key U.S.-built part that broke "with a loud bang and a cloud of dust" during a high-pressure test for the world's largest particle physics collider that is supposed to start up in November, officials sais Tuesday." (1,5 page)

Analysis of the production and transaction costs of forest carbon offset projects in the USA.

Science.gov (United States)

Galik, Christopher S; Cooley, David M; Baker, Justin S

2012-12-15

Forest carbon offset project implementation costs, comprised of both production and transaction costs, could present an important barrier to private landowner participation in carbon offset markets. These costs likewise represent a largely undocumented component of forest carbon offset potential. Using a custom spreadsheet model and accounting tool, this study examines the implementation costs of different forest offset project types operating in different forest types under different accounting and sampling methodologies. Sensitivity results are summarized concisely through response surface regression analysis to illustrate the relative effect of project-specific variables on total implementation costs. Results suggest that transaction costs may represent a relatively small percentage of total project implementation costs - generally less than 25% of the total. Results also show that carbon accounting methods, specifically the method used to establish project baseline, may be among the most important factors in driving implementation costs on a per-ton-of-carbon-sequestered basis, dramatically increasing variability in both transaction and production costs. This suggests that accounting could be a large driver in the financial viability of forest offset projects, with transaction costs likely being of largest concern to those projects at the margin. Copyright © 2012 Elsevier Ltd. All rights reserved.

The economic costs of alcohol consumption in Thailand, 2006.

Science.gov (United States)

Thavorncharoensap, Montarat; Teerawattananon, Yot; Yothasamut, Jomkwan; Lertpitakpong, Chanida; Thitiboonsuwan, Khannika; Neramitpitagkul, Prapag; Chaikledkaew, Usa

2010-06-09

There is evidence that the adverse consequences of alcohol impose a substantial economic burden on societies worldwide. Given the lack of generalizability of study results across different settings, many attempts have been made to estimate the economic costs of alcohol for various settings; however, these have mostly been confined to industrialized countries. To our knowledge, there are a very limited number of well-designed studies which estimate the economic costs of alcohol consumption in developing countries, including Thailand. Therefore, this study aims to estimate these economic costs, in Thailand, 2006. This is a prevalence-based, cost-of-illness study. The estimated costs in this study included both direct and indirect costs. Direct costs included health care costs, costs of law enforcement, and costs of property damage due to road-traffic accidents. Indirect costs included costs of productivity loss due to premature mortality, and costs of reduced productivity due to absenteeism and presenteeism (reduced on-the-job productivity). The total economic cost of alcohol consumption in Thailand in 2006 was estimated at 156,105.4 million baht (9,627 million US$ PPP) or about 1.99% of the total Gross Domestic Product (GDP). Indirect costs outweigh direct costs, representing 96% of the total cost. The largest cost attributable to alcohol consumption is that of productivity loss due to premature mortality (104,128 million baht/6,422 million US$ PPP), followed by cost of productivity loss due to reduced productivity (45,464.6 million baht/2,804 million US$ PPP), health care cost (5,491.2 million baht/339 million US$ PPP), cost of property damage as a result of road traffic accidents (779.4 million baht/48 million US$ PPP), and cost of law enforcement (242.4 million baht/15 million US$ PPP), respectively. The results from the sensitivity analysis revealed that the cost ranges from 115,160.4 million baht to 214,053.0 million baht (7,102.1 - 13,201 million US$ PPP

Single Top quark production cross-section measurements using the ATLAS detector at the LHC

CERN Document Server

Jimenez Pena, Javier; The ATLAS collaboration

2018-01-01

Measurements of single top-quark production in proton-proton collisions are presented based on the 13 TeV and 8 TeV ATLAS datasets. In the leading order process, a W-boson is exchanged in the t-channel. The cross-section for the production of single top-quarks and single antitop-quarks, their ratio, as well as differential cross-section measurements are also reported. Measurements of the inclusive and differential cross-sections for the production of a single top quark in association with a W-boson, the second largest single top production mode are also presented. Evidence for the s-channel single top-quark production in the 8 TeV dataset is presented. Finally, the first measurement of the tZq electroweak production is presented. All measurements are compared to state-of-the art theoretical calculations. (On behalf of the ATLAS collaboration)

Is computer aided detection (CAD) cost effective in screening mammography? A model based on the CADET II study

Science.gov (United States)

2011-01-01

Background Single reading with computer aided detection (CAD) is an alternative to double reading for detecting cancer in screening mammograms. The aim of this study is to investigate whether the use of a single reader with CAD is more cost-effective than double reading. Methods Based on data from the CADET II study, the cost-effectiveness of single reading with CAD versus double reading was measured in terms of cost per cancer detected. Cost (Pound (£), year 2007/08) of single reading with CAD versus double reading was estimated assuming a health and social service perspective and a 7 year time horizon. As the equipment cost varies according to the unit size a separate analysis was conducted for high, average and low volume screening units. One-way sensitivity analyses were performed by varying the reading time, equipment and assessment cost, recall rate and reader qualification. Results CAD is cost increasing for all sizes of screening unit. The introduction of CAD is cost-increasing compared to double reading because the cost of CAD equipment, staff training and the higher assessment cost associated with CAD are greater than the saving in reading costs. The introduction of single reading with CAD, in place of double reading, would produce an additional cost of £227 and £253 per 1,000 women screened in high and average volume units respectively. In low volume screening units, the high cost of purchasing the equipment will results in an additional cost of £590 per 1,000 women screened. One-way sensitivity analysis showed that the factors having the greatest effect on the cost-effectiveness of CAD with single reading compared with double reading were the reading time and the reader's professional qualification (radiologist versus advanced practitioner). Conclusions Without improvements in CAD effectiveness (e.g. a decrease in the recall rate) CAD is unlikely to be a cost effective alternative to double reading for mammography screening in UK. This study

A systematic review of the cost and cost effectiveness of treatment for multidrug-resistant tuberculosis.

Science.gov (United States)

Fitzpatrick, Christopher; Floyd, Katherine

2012-01-01

chosen (the extent to which hospitalization or ambulatory care were relied upon) and (ii) the second-line drugs included in the treatment regimen. When extrapolated to other settings, the best estimate of the cost of treatment varied from US3401 to US195 078, depending on the region and model of care. The cost per DALY averted was lower than GDP per capita in all 14 WHO sub-regions considered, with better cost effectiveness for outpatient versus inpatient models of care. Treatment for MDR-TB can be cost effective in low- and middle-income countries. Evidence about the relative cost effectiveness of outpatient versus inpatient models of care is limited and more data are needed from Africa and Asia--especially India and China, which have the largest number of cases. Unless there is strong evidence that hospitalization is necessary to achieve high rates of adherence to treatment, patients with MDR-TB should be treated using mainly ambulatory care.

Efficacy and cost-effectiveness of an experimental short-term inpatient Dialectical Behavior Therapy (DBT) program: Study protocol for a randomized controlled trial

NARCIS (Netherlands)

L.M.C. van den Bosch (Louise M.); R. Sinnaeve (Roland); L. van Hakkaart-van Roijen (Leona); E.F. van Furth (Eric)

2014-01-01

markdownabstract__Abstract__ Background: Borderline Personality Disorder (BPD) is a serious psychiatric condition associated with substantial mortality, burden and public health costs. DBT is the treatment model with the largest number of published research articles showing effectiveness.

Cost-effectiveness analysis of optimal strategy for tumor treatment

International Nuclear Information System (INIS)

Pang, Liuyong; Zhao, Zhong; Song, Xinyu

2016-01-01

We propose and analyze an antitumor model with combined immunotherapy and chemotherapy. Firstly, we explore the treatment effects of single immunotherapy and single chemotherapy, respectively. Results indicate that neither immunotherapy nor chemotherapy alone are adequate to cure a tumor. Hence, we apply optimal theory to investigate how the combination of immunotherapy and chemotherapy should be implemented, for a certain time period, in order to reduce the number of tumor cells, while minimizing the implementation cost of the treatment strategy. Secondly, we establish the existence of the optimality system and use Pontryagin’s Maximum Principle to characterize the optimal levels of the two treatment measures. Furthermore, we calculate the incremental cost-effectiveness ratios to analyze the cost-effectiveness of all possible combinations of the two treatment measures. Finally, numerical results show that the combination of immunotherapy and chemotherapy is the most cost-effective strategy for tumor treatment, and able to eliminate the entire tumor with size 4.470 × 10"8 in a year.

Low-cost solar collectors using thin-film plastics absorbers and glazings

Energy Technology Data Exchange (ETDEWEB)

Wilhelm, W.G.

1980-01-01

The design, fabrication, performance, cost, and marketing of flat plate solar collectors using plastic absorbers and glazings are described. Manufacturing cost breakdowns are given for single-glazed and double-glazed collectors. (WHK)

Optimal dual-fuel propulsion for minimum inert weight or minimum fuel cost

Science.gov (United States)

Martin, J. A.

1973-01-01

An analytical investigation of single-stage vehicles with multiple propulsion phases has been conducted with the phasing optimized to minimize a general cost function. Some results are presented for linearized sizing relationships which indicate that single-stage-to-orbit, dual-fuel rocket vehicles can have lower inert weight than similar single-fuel rocket vehicles and that the advantage of dual-fuel vehicles can be increased if a dual-fuel engine is developed. The results also indicate that the optimum split can vary considerably with the choice of cost function to be minimized.

Cost and radiation exposure optimization of demineralizer operation

International Nuclear Information System (INIS)

Bernal, F.E.; Burn, R.R.; Cook, G.M.; Simonetti, L.; Simpson, P.A.

1985-01-01

A pool water demineralizer is utilized at a research reactor to minimize impurities that become radioactive; to minimize impurities that react chemically with reactor components; to maintain optical clarity of the pool water; and to minimize aluminum fuel cladding corrosion by maintaining a slightly acidic pH. Balanced against these advantages are the dollar costs of equipment, resins, recharging chemicals, and maintenance; the man-rem costs of radiation exposure during maintenance, demineralizer recharges, and resin replacement; and hazardous chemical exposure. At the Ford Nuclear Reactor (FNR), maintenance of the demineralizer system is the second largest source of radiation exposure to operators. Theoretical and practical aspects of demineralizer operation are discussed. The most obvious way to reduce radiation exposure due to demineralizer system operation is to perform recharges after the reactor has been shut down for the maximum possible time. Setting a higher depletion limit and operating with the optimum system lineup reduce the frequency between recharges, saving both exposure and cost. Recharge frequency and resin lifetime seem to be relatively independent of the quality of the chemicals used and the personnel performing recharges, provided consistent procedures are followed

Constraining the magnitude of the largest event in a foreshock-main shock-aftershock sequence

Science.gov (United States)

Shcherbakov, Robert; Zhuang, Jiancang; Ogata, Yosihiko

2018-01-01

Extreme value statistics and Bayesian methods are used to constrain the magnitudes of the largest expected earthquakes in a sequence governed by the parametric time-dependent occurrence rate and frequency-magnitude statistics. The Bayesian predictive distribution for the magnitude of the largest event in a sequence is derived. Two types of sequences are considered, that is, the classical aftershock sequences generated by large main shocks and the aftershocks generated by large foreshocks preceding a main shock. For the former sequences, the early aftershocks during a training time interval are used to constrain the magnitude of the future extreme event during the forecasting time interval. For the latter sequences, the earthquakes preceding the main shock are used to constrain the magnitudes of the subsequent extreme events including the main shock. The analysis is applied retrospectively to past prominent earthquake sequences.

The Dependence of the Cost of Capital on Degree of Diversification

Directory of Open Access Journals (Sweden)

Zoran Popovic

2018-03-01

Full Text Available The subject of this paper are theoretical and methodological aspects of determining the cost of capital on the example of two companies from the Energoprojekt system. The goal is to point out the most significant problems of determining the cost of capital in general, as well as to identify the most significant determinants of those costs. In addition, the paper has a goal to point out to the degree of impact of diversification of those two companies on the cost of their capital. Using the CAPM, the total cost of capital is calculated for Energoprojekt Holding and Energoprojekt Industrija. In accordance with that, the following hypotheses are formulated: (H0 The value of the beta coefficient of both enterprises is equal to zero, (H1 Volatility of the yield of shares of both companies is higher than the entire market, (H2 The total cost of the Holding's capital is lower than the total cost of the capital of Industrija and (H3 The largest component of the equity cost in both companies is the country risk premium. The first, second and third research hypotheses are confirmed in the paper, while the null hypothesis is rejected. The total cost of capital for Holding is equal to 14,80% and the total cost of capital for Industrija is 17,10%. The main component of the cost of equity is the risk premium of investing in Serbia, which is exceptionally high and is equal to 6,40%.

The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia.

Science.gov (United States)

Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D; Garcia, Patricia J; Bronzan, Rachel; Gill, Michelle M; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W; Newman, Lori

2015-06-01

Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Although this analysis found screening using RPR to be relatively cheap, most (>70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. Copyright © 2015 International Federation of Gynecology and Obstetrics. All rights reserved.

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

Science.gov (United States)

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

2008-09-01

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

Evolution of the Largest Mammalian Genome.

Science.gov (United States)

Evans, Ben J; Upham, Nathan S; Golding, Goeffrey B; Ojeda, Ricardo A; Ojeda, Agustina A

2017-06-01

The genome of the red vizcacha rat (Rodentia, Octodontidae, Tympanoctomys barrerae) is the largest of all mammals, and about double the size of their close relative, the mountain vizcacha rat Octomys mimax, even though the lineages that gave rise to these species diverged from each other only about 5 Ma. The mechanism for this rapid genome expansion is controversial, and hypothesized to be a consequence of whole genome duplication or accumulation of repetitive elements. To test these alternative but nonexclusive hypotheses, we gathered and evaluated evidence from whole transcriptome and whole genome sequences of T. barrerae and O. mimax. We recovered support for genome expansion due to accumulation of a diverse assemblage of repetitive elements, which represent about one half and one fifth of the genomes of T. barrerae and O. mimax, respectively, but we found no strong signal of whole genome duplication. In both species, repetitive sequences were rare in transcribed regions as compared with the rest of the genome, and mostly had no close match to annotated repetitive sequences from other rodents. These findings raise new questions about the genomic dynamics of these repetitive elements, their connection to widespread chromosomal fissions that occurred in the T. barrerae ancestor, and their fitness effects-including during the evolution of hypersaline dietary tolerance in T. barrerae. ©The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Cost Accounting as a Tool for Increasing Cost Transparency in Selective Hepatic Transarterial Chemoembolization.

Science.gov (United States)

Ahmed, Osman; Patel, Mikin; Ward, Thomas; Sze, Daniel Y; Telischak, Kristen; Kothary, Nishita; Hofmann, Lawrence V

2015-12-01

To increase cost transparency and uncover potential areas for savings in patients receiving selective transarterial chemoembolization at a tertiary care academic center. The hospital cost accounting system charge master sheet for direct and total costs associated with selective transarterial chemoembolization in fiscal years 2013 and 2014 was queried for each of the four highest volume interventional radiologists at a single institution. There were 517 cases (range, 83-150 per physician) performed; direct costs incurred relating to care before, during, and after the procedure with respect to labor, supply, and equipment fees were calculated. A median of 48 activity codes were charged per selective transarterial chemoembolization from five cost centers, represented by the angiography suite, units for care before and after the procedure, pharmacy, and observation floors. The average direct cost of selective transarterial chemoembolization did not significantly differ among operators at $9,126.94, $8,768.77, $9,027.33, and $8,909.75 (P = .31). Intraprocedural costs accounted for 82.8% of total direct costs and provided the greatest degree in cost variability ($7,268.47-$7,691.27). The differences in intraprocedural expense among providers were not statistically significant (P = .09), even when separated into more specific procedure-related labor and supply costs. Cost accounting systems could effectively be interrogated as a method for calculating direct costs associated with selective transarterial chemoembolization. The greatest source of expenditure and variability in cost among providers was shown to be intraprocedural labor and supplies, although the effect did not appear to be operator dependent. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid

Directory of Open Access Journals (Sweden)

Francisco J. Estades-Rubio

2017-03-01

Full Text Available Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA in a single injection with standard preparations of hyaluronic acid (HA in five injections in osteoarthritis (OA of the knee. Fifty-four patients with knee osteoarthritis (Kellgren–Lawrence Grade II and III and the Western Ontario and McMaster Universities Arthritis Index (WOMAC pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane® and Group II with HA (Go-ON®. Patient’s evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.

Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid.

Science.gov (United States)

Estades-Rubio, Francisco J; Reyes-Martín, Alvaro; Morales-Marcos, Victor; García-Piriz, Mercedes; García-Vera, Juan J; Perán, Macarena; Marchal, Juan A; Montañez-Heredia, Elvira

2017-03-17

Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren-Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane ® ) and Group II with HA (Go-ON ® ). Patient's evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.

Single-port laparoscopic myomectomy using a new single-port transumbilical morcellation system: initial clinical study.

Science.gov (United States)

Kim, Yong-Wook; Park, Byung-Joon; Ro, Duck-Yeong; Kim, Tae-Eung

2010-01-01

To evaluate the feasibility of single-port laparoscopic myomectomy with transumbilical morcellation and suturing. Continuing prospective study (Canadian Task Force classification II-3). University hospital. Fifteen patients who underwent single-port laparoscopic myomectomy between September 2008 and October 2009 to remove single or multiple uterine myomas, at least 1 in each patient measuring greater than 4 cm in diameter. All single-port laparoscopic myomectomy procedures were performed by a single surgeon (Dr. Y.W. Kim). Myomas were extracted transumbilically by cutting the myomas into smaller pieces with a knife or a conventional electromechanical morcellator. After making a single 1.5- to 2.0-cm umbilical incision, the single-port system, created with a wound retractor and a surgical glove, was inserted. All operations were performed using conventional rigid straight laparoscopic instruments. Laparoscopic suturing was performed in intramural myomas and some subserosal myomas. Patient mean (SD; range) age was 38.3 (5.6; 29-49) years. The number of myomas per patient was 1.6 (1.4; 1-6). The diameter of the largest myomas was 6.1 (1.5; 4.2-9.6) cm. In 4 patients, only a knife was required for transumbilical extraction of myomas, and in 11 patients, transumbilical morcellation with an electromechanical morcellator with or without a knife was used. Transumbilical drainage tubes were inserted into the pelvic cavity in 11 of 15 patients. Operative time was 96.7 (33.8; 35-150) minutes. The decrease in postoperative hemoglobin concentration was 1.8 (1.2; 0.4-3.6) g/dL. During the operations, no patients required blood transfusion. No patients developed postoperative fever. Neither bowel injury nor urinary tract injury occurred in any patient. The postoperative hospital stay was 3.1 (0.8; 2-4) days. Single-port transumbilical morcellation using a conventional electromechanical morcellator with or without a knife is feasible. Single-port laparoscopic myomectomy is an

Africa's largest long-lasting insecticide-treated net producer: lessons from A to Z Textiles

Directory of Open Access Journals (Sweden)

Daar Abdallah S

2010-12-01

Full Text Available Abstract Background Field trials have demonstrated the efficacy of insecticide-treated nets, and the WHO has recently endorsed a shift toward Long-Lasting Insecticide Treated nets (LLINs due to factors such as reduced distribution costs. However, the need for LLINs poses several challenges. Is it possible to manufacture LLINs in large quantities in the African continent, where malaria is most endemic? When production is located in low-income countries, what role is played by local funding and employment, scaling up manufacturing, and partnerships? What factors influence availability and pricing? Discussion A case study of A to Z Textiles was undertaken to answer the question of how large-scale production of LLINs can occur in a low income setting. One of the largest sources of bed nets for Africa, A to Z Textiles is Africa-based, and its Tanzanian operations have a production capacity of 30 million LLINs per year, along with full WHO recommendation for its nets. Our analysis is based on semi-structured interviews with key informants familiar with A to Z, site visits in Tanzania, and literature reviews. This paper discusses the history and current status of A to Z Textiles, identifies the factors that led to its success, and suggests policy considerations that could support similar initiatives in the future. Local funding, scaling up manufacturing, technology transfer, and partnerships all played important roles in A to Z’s ascent, as did perceived benefits of local employment and capacity-building. Regulatory issues and procurement rules acted as barriers. A to Z cost-effectively manufactures high-quality LLINs where malaria is most endemic. Summary With a production capacity of 30 million LLINs per year, and full WHOPES (WHO Pesticide Evaluation Scheme certification, A to Z Textiles demonstrates how key health goods can be successfully produced in the low-income countries that use them. Its example may be instructive and of high interest to

Uncertainty in air quality observations using low-cost sensors

Science.gov (United States)

Castell, Nuria; Dauge, Franck R.; Dongol, Rozina; Vogt, Matthias; Schneider, Philipp

2016-04-01

Air pollution poses a threat to human health, and the WHO has classified air pollution as the world's largest single environmental health risk. In Europe, the majority of the population lives in areas where air quality levels frequently exceed WHO's ambient air quality guidelines. The emergence of low-cost, user-friendly and very compact air pollution platforms allowing observations at high spatial resolution in near real-time, provides us with new opportunities to simultaneously enhance existing monitoring systems as well as enable citizens to engage in more active environmental monitoring (citizen science). However the data sets generated by low-cost sensors show often questionable data quality. For many sensors, neither their error characteristics nor how their measurement capability holds up over time or through a range of environmental conditions, have been evaluated. We have conducted an exhaustive evaluation of the commercial low-cost platform AQMesh (measuring NO, NO2, CO, O3, PM10 and PM2.5) in laboratory and in real-world conditions in the city of Oslo (Norway). Co-locations in field of 24 platforms were conducted over a 6 month period (April to September 2015) allowing to characterize the temporal variability in the performance. Additionally, the field performance included the characterization on different monitoring urban monitoring sites characteristic of both traffic and background conditions. All the evaluations have been conducted against CEN reference method analyzers maintained according to the Norwegian National Reference Laboratory quality system. The results show clearly that a good performance in laboratory does not imply similar performance in real-world outdoor conditions. Moreover, laboratory calibration is not suitable for subsequent measurements in urban environments. In order to reduce the errors, sensors require on-site field calibration. Even after such field calibration, the platforms show a significant variability in the performance

The social cost of drugs in France in 2010.

Science.gov (United States)

Kopp, Pierre; Ogrodnik, Marysia

2017-09-01

The social cost of drugs is the monetary cost of both the consequences of their trade and their consumption. In this paper, drugs considered are tobacco and alcohol, which are legal, plus those that are illegal. The social cost is the sum of the external cost: value of loss in quality of life, value of years of life lost and value of loss in productivity, plus public expenditure. Public expenditure consists of public spending on medical care, prevention, and law enforcement, minus savings from unpaid pensions and taxes levied on tobacco and alcohol. The parameters for the calculations have used the recommendations of a French governmental working group (2013) Quinet, L'évaluation socioéconomique des investissements publics [Internet], Centre d'Analyse Stratégique, 2013, http://www.strategie.gouv.fr/sites/strategie.gouv.fr/files/archives/CGSP_Evaluation_socioeconomique_17092013.pdf , and the health data were derived from the scientific literature. The social costs are €122 billion for tobacco, €118 billion for alcohol, and €8.7 billion for illegal drugs. The largest fraction of the costs (53, 56, and 31 %, respectively) derives from the number of deaths, 79,000 for tobacco, 49,000 for alcohol, and 1600 for illegal drugs, given the high cost of a year of life lost (€115,000). The external cost corresponds to 86, 97, and 68 % of the social cost, respectively, for tobacco, alcohol, and illegal drugs. The annual drug-related net expenditure represents €13.9, €3.0, and €2.3 billion, respectively, for tobacco, alcohol, and illegal drugs. The tax revenues on tobacco and alcohol, €10.4 and €3.2 billion, represent less than half of the corresponding healthcare costs, which are €25.9 and €7.7 billion.

Largest US oil and gas fields, August 1993

Energy Technology Data Exchange (ETDEWEB)

1993-08-06

The Largest US Oil and Gas Fields is a technical report and part of an Energy Information Administration (EIA) series presenting distributions of US crude oil and natural gas resources, developed using field-level data collected by EIA`s annual survey of oil and gas proved reserves. The series` objective is to provide useful information beyond that routinely presented in the EIA annual report on crude oil and natural gas reserves. These special reports also will provide oil and gas resource analysts with a fuller understanding of the nature of US crude oil and natural gas occurrence, both at the macro level and with respect to the specific subjects addressed. The series` approach is to integrate EIA`s crude oil and natural gas survey data with related data obtained from other authoritative sources, and then to present illustrations and analyses of interest to a broad spectrum of energy information users ranging from the general public to oil and gas industry personnel.

Largest US oil and gas fields, August 1993

International Nuclear Information System (INIS)

1993-01-01

The Largest US Oil and Gas Fields is a technical report and part of an Energy Information Administration (EIA) series presenting distributions of US crude oil and natural gas resources, developed using field-level data collected by EIA's annual survey of oil and gas proved reserves. The series' objective is to provide useful information beyond that routinely presented in the EIA annual report on crude oil and natural gas reserves. These special reports also will provide oil and gas resource analysts with a fuller understanding of the nature of US crude oil and natural gas occurrence, both at the macro level and with respect to the specific subjects addressed. The series' approach is to integrate EIA's crude oil and natural gas survey data with related data obtained from other authoritative sources, and then to present illustrations and analyses of interest to a broad spectrum of energy information users ranging from the general public to oil and gas industry personnel

The 100-C-7 Remediation Project. An Overview of One of DOE's Largest Remediation Projects - 13260

Energy Technology Data Exchange (ETDEWEB)

Post, Thomas C. [U.S. Department of Energy Richland Operations Office, Richland, WA 99352 (United States); Strom, Dean [Washington Closure Hanford LLC, 2620 Fermi Avenue, Richland, WA 99354 (United States); Beulow, Laura [U.S. Environmental Protection Agency, 309 Bradley Boulevard, Suite 115, Richland, WA 99352 (United States)

2013-07-01

The U.S. Department of Energy Richland Operations Office (RL), U.S. Environmental Protection Agency (EPA) and Washington Closure Hanford LLC (WCH) completed remediation of one of the largest waste sites in the U.S. Department of Energy complex. The waste site, 100-C-7, covers approximately 15 football fields and was excavated to a depth of 85 feet (groundwater). The project team removed a total of 2.3 million tons of clean and contaminated soil, concrete debris, and scrap metal. 100-C-7 lies in Hanford's 100 B/C Area, home to historic B and C Reactors. The waste site was excavated in two parts as 100-C-7 and 100-C-7:1. The pair of excavations appear like pit mines. Mining engineers were hired to design their tiered sides, with safety benches every 17 feet and service ramps which allowed equipment access to the bottom of the excavations. The overall cleanup project was conducted over a span of almost 10 years. A variety of site characterization, excavation, load-out and sampling methodologies were employed at various stages of remediation. Alternative technologies were screened and evaluated during the project. A new method for cost effectively treating soils was implemented - resulting in significant cost savings. Additional opportunities for minimizing waste streams and recycling were identified and effectively implemented by the project team. During the final phase of cleanup the project team applied lessons learned throughout the entire project to address the final, remaining source of chromium contamination. The C-7 cleanup now serves as a model for remediating extensive deep zone contamination sites at Hanford. (authors)

Single Cell Assay for Analyzing Single Cell Exosome and Endocrine Secretion and Cancer Markers

Science.gov (United States)

Chiu, Yu-Jui

To understand the inhomogeneity of cells in biological systems, there is a growing demand for the capability to characterize the properties of individual single cells. Since single cell studies require continuous monitoring of the cell behaviors instead of a snapshot test at a single time point, an effective single-cell assay that can support time lapsed studies in a high throughput manner is desired. Most currently available single-cell technologies cannot provide proper environments to sustain cell growth and cannot provide, for appropriate cell types, proliferation of single cells and convenient, non-invasive tests of single cell behaviors from molecular markers. In this dissertation, I present a highly versatile single-cell assay that can accommodate different cellular types, enable easy and efficient single cell loading and culturing, and be suitable for the study of effects of in-vitro environmental factors in combination with drug screening. The salient features of the assay are the non-invasive collection and surveying of single cell secretions at different time points and massively parallel translocation of single cells by user defined criteria, producing very high compatibility to the downstream process such as single cell qPCR and sequencing. Above all, the acquired information is quantitative -- for example, one of the studies is measured by the number of exosomes each single cell secretes for a given time period. Therefore, our single-cell assay provides a convenient, low-cost, and enabling tool for quantitative, time lapsed studies of single cell properties.

The Practice of Cost Estimation for Decommissioning of Nuclear Facilities

International Nuclear Information System (INIS)

Davidova, Ivana; Desecures, Sylvain; Lexow, Thomas; Buonarroti, Stefano; Marini, Giuseppe; Pescatore, Claudio; Rehak, Ivan; Weber, Inge; ); Daniska, Vladimir; Linan, Jorge Borque; Caroll, Simon; Hedberg, Bjoern; De La Gardie, Fredrik; Haenggi, Hannes; Laguardia, Thomas S.; Ridpath, Andy

2015-01-01

Decommissioning of both commercial and R and D nuclear facilities is expected to increase significantly in the coming years, and the largest of such industrial decommissioning projects could command considerable budgets. Several approaches are currently being used for decommissioning cost estimations, with an international culture developing in the field. The present cost estimation practice guide was prepared in order to offer international actors specific guidance in preparing quality cost and schedule estimates to support detailed budgeting for the preparation of decommissioning plans, for the securing of funds and for decommissioning implementation. This guide is based on current practices and standards in a number of NEA member countries and aims to help consolidate the practice and process of decommissioning cost estimation so as to make it more widely understood. It offers a useful reference for the practitioner and for training programmes. The remainder of report is divided into the following chapters: - Chapter 2 covers the purpose and nature of decommissioning cost estimates, approaches to cost estimation and the major elements of a cost estimate. - Chapter 3 examines the development of the integrated schedule of the activity-dependent work scope and the determination of the project critical path. - Chapter 4 describes the attributes of a quality assurance programme applicable to cost estimation and the use and cautions of benchmarking the estimate from other estimates or actual costs. - Chapter 5 describes the pyramidal structure of the report, and the scope and content that should be included in the cost study report to ensure consistency and transparency in the estimate underpinnings. - Chapter 6 provides some observations, conclusions and recommendations on the use of this guide

How the largest electric and gas utility companies administer public relations

Energy Technology Data Exchange (ETDEWEB)

Bogart, J.D.

1979-04-12

This article describes the findings of a survey conducted by the author in the second half of 1978 to determine the sizes of the public relations staffs of the nation's largest operating electric and gas utilities, their budgets, organizational differences, and specific functions. Common public relations issues and major public relations problems of the utilities are identified, as well as recent trends or changes in budgeting and organization. Some functional variations of public relations departments among utility companies were detected and described.

Environmental isotope signatures of the largest freshwater lake in Kerala

International Nuclear Information System (INIS)

Unnikrishnan Warrier, C.

2007-01-01

Sasthamkotta lake, the largest freshwater lake in Kerala, serves as a source for drinking water for more than half a million people. Environmental 137 Cs analysis done on undisturbed sediment core samples reveals that the recent rate of sedimentation is not uniform in the lake. The useful life of lake is estimated as about 800 years. The δD and δ 18 O values of the lake waters indicate that the lake is well mixed with a slight variation horizontally. The stable isotope studies on well waters from the catchment indicate hydraulic communication with the lake and lake groundwater system is flow-through type. Analytical model also supports this view. (author)

The costs and cost-effectiveness of a school-based comprehensive intervention study on childhood obesity in China.

Directory of Open Access Journals (Sweden)

Liping Meng

Full Text Available The dramatic rise of overweight and obesity among Chinese children has greatly affected the social economic development. However, no information on the cost-effectiveness of interventions in China is available. The objective of this study is to evaluate the cost and the cost-effectiveness of a comprehensive intervention program for childhood obesity. We hypothesized the integrated intervention which combined nutrition education and physical activity (PA is more cost-effective than the same intensity of single intervention.And Findings: A multi-center randomized controlled trial conducted in six large cities during 2009-2010. A total of 8301 primary school students were categorized into five groups and followed one academic year. Nutrition intervention, PA intervention and their shared common control group were located in Beijing. The combined intervention and its' control group were located in other 5 cities. In nutrition education group, 'nutrition and health classes' were given 6 times for the students, 2 times for the parents and 4 times for the teachers and health workers. "Happy 10" was carried out twice per day in PA group. The comprehensive intervention was a combination of nutrition and PA interventions. BMI and BAZ increment was 0.65 kg/m(2 (SE 0.09 and 0.01 (SE 0.11 in the combined intervention, respectively, significantly lower than that in its' control group (0.82 ± 0.09 for BMI, 0.10 ± 0.11 for BAZ. No significant difference were found neither in BMI nor in BAZ change between the PA intervention and its' control, which is the same case in the nutrition intervention. The single intervention has a relative lower intervention costs compared with the combined intervention. Labor costs in Guangzhou, Shanghai and Jinan was higher compared to other cities. The cost-effectiveness ratio was $120.3 for BMI and $249.3 for BAZ in combined intervention, respectively.The school-based integrated obesity intervention program was cost

Total generating costs: coal and nuclear plants

International Nuclear Information System (INIS)

1979-02-01

The study was confined to single and multi-unit coal- and nuclear-fueled electric-generating stations. The stations are composed of 1200-MWe PWRs; 1200-MWe BWRs; 800-and 1200-MWe High-Sulfur Coal units, and 800- and 1200-MWe Low-Sulfur Coal units. The total generating cost estimates were developed for commercial operation dates of 1985 and 1990; for 5 and 8% escalation rates, for 10 and 12% discount rates; and, for capacity factors of 50, 60, 70, and 80%. The report describes the methodology for obtaining annualized capital costs, levelized coal and nuclear fuel costs, levelized operation and maintenance costs, and the resulting total generating costs for each type of station. The costs are applicable to a hypothetical Middletwon site in the Northeastern United States. Plant descriptions with general design parameters are included. The report also reprints for convenience, summaries of capital cost by account type developed in the previous commercial electric-power cost studies. Appropriate references are given for additional detailed information. Sufficient detail is given to allow the reader to develop total generating costs for other cases or conditions

Optimisation of single-pipe heating systems with heating cost distribution and supporting room air processes in industrial housing construction in the new Laender. Pt. 2. Heating cost distribution and energy diagnosis; Optimierung von Einrohrheizungsanlagen mit Heizkostenverteilung sowie flankierenden Raumluftprozessen im industriellen Wohnungsbau der NBL. T. 2. Heizkostenverteilung und Energiediagnose

Energy Technology Data Exchange (ETDEWEB)

Bach, H; Bauer, M; Eisenmann, G; Haupt, C; Tritschler, M

1996-12-01

The second part of the present research report focusses on energy diagnosis and heating cost distribution in single-pipe heating systems. It describes energy diagnosis with regard to its aims and methods. The subject of heating cost distribution is addressed with a statistical evaluation of the field studies carried out in the course of the research project. The use of heating cost distributors is examined by simulation calculations and assessed on this basis. (HW) [Deutsch] Die Themenschwerpunkte des 2. Teils des Forschungsberichtes sind die Energiediagnose und die Heizkostenverteilung in Einrohranlagen. Bezueglich der Energiediagnose werden Ziel und Methoden beschrieben. Zur Thematik Heizkostenverteilung werden die durchgefuehrten Feldversuche statistisch ausgewertet. Der Einsatz der Heizkostenverteilsysteme wird durch Simulationsrechnungen untersucht und beurteilt. (HW)

Nuclear plant life cycle costs

International Nuclear Information System (INIS)

Durante, R.W.

1994-01-01

Life cycle costs of nuclear power plants in the United States are discussed. The author argues that these costs have been mishandled or neglected. Decommissioning costs have escalated, e.g. from $328 per unit in 1991 to $370 in 1993 for the Sacramento Municipal Utility District, though they still only amount to less than 0.1 cent per kWh. Waste management has been complicated in the U.S. by the decision to abandon civilian reprocessing; by the year 2000, roughly 30 U.S. nuclear power units will have filled their storage pools; dry storage has been delayed, and will be an expense not originally envisaged. Some examples of costs of major component replacement are provided. No single component has caused as much operational disruption and financial penalties as the steam generator. Operation and maintenance costs have increased steadily, and now amount to more than 70% of production costs. A strategic plan by the Nuclear Power Oversight Committee (of U.S. utilities) will ensure that the ability to correctly operate and maintain a nuclear power plant is built into the original design. 6 figs

CERN: Digital image analysis in the world's largest research center for particle physics

CERN Multimedia

2005-01-01

Those interested in researching into the smallest building blocks that matter is made up of need the largest instruments. CERN, near Geneva, Switzerland is where the most powerful circular accelerator in the world is being built: the Large Hadron Collider (LHC) for proton collisions. It has a circumference of 26.7 km (4 pages)

Industrial cost effective n-pasha solar cells with >20% efficiency

Energy Technology Data Exchange (ETDEWEB)

Romijn, I.G.; Van Aken, B.; Anker, J.; Barton, P.; Gutjahr, A.; Komatsu, Y.; Koppes, M.; Kossen, E.J.; Lamers, M.; Saynova, D.S.; Tool, C.J.J.; Zhang, Y. [ECN Solar Energy, P.O. Box 1, NL-1755 ZG Petten (Netherlands); Venema, P.R.; Vlooswijk, A.H.G. [Tempress Systems BV, Radeweg 31, 8171 MD Vaassen (Netherlands); Schmitt, C.; Kuehnlein, H.; Bay, N. [RENA GmbH, Hans-Bunte-Strasse 19, D-79108, Freiburg im Breisgau (Germany); Koenig, M.; Stassen, A.F. [Heraeus Precious Metals GmbH and Co. KG, Heraeusstrasse 12-14, D-63450, Hanau (Germany)

2013-10-15

The n-Pasha cell is a bifacial solar cell concept with average efficiencies between 19.8% and 20% and is optimized to enable high efficiencies with narrow distribution on wafers from the complete n-type ingots (2 to 10 {omega}-cm). This reduces the yield losses from a wafer point of view, which is important since the wafer costs make up the largest part ({approx}40%) of the total module costs for n-Pasha modules. The module fabrication itself adds up to {approx}35% of the module costs/Wp costs, which leaves {approx}25% of the costs/Wp for the cell production. We found that the costs/Wp for the 20% n-Pasha cell and module process are very similar to those of a 19% p-type cell, assuming similar wafer and module manufacturing costs. In the paper the successful implementation of a reduction of >60% in BBr{sub 3} consumption, and a reduction of >50% in Ag consumption are described, while keeping the n-Pasha cell efficiency at the same level. According to our calculations, the achieved reduction of the Ag and BBr{sub 3} consumption will lower the costs/Wp for n-Pasha modules below that of p-type. The majority of the efficiency losses in the n-Pasha cell are due to recombination in the diffused layers and below the contact regions. By tuning both the emitter and BSF profile, an efficiency gain of 0.4% absolute has been obtained. Based on the simulations and experimental results, the path towards further optimization and efficiencies approaching 21% is shown.

Single top quark production cross section using the ATLAS detector at the LHC

CERN Document Server

Cioara, Irina Antonela; The ATLAS collaboration

2017-01-01

Measurements of single top-quark production in proton-proton collisions are presented based on the 8 TeV and 13 TeV ATLAS datasets. In the leading order process, a W boson is exchanged in the t-channel. The cross-section for the production of single top-quarks and single anti-top-quarks total production cross sections, their ratio, as well as a measurement of the inclusive production cross section is presented. At 8 TeV, differential cross-section measurements of the t-channel process are also reported, these analyses include limits on anomalous contributions to the Wtb vertex and measurement of the top quark polarization. A measurement of the production cross section of a single top quark in association with a W boson, the second largest single-top production mode, is also presented. Finally, evidence for s-channel single-top production in the 8 TeV ATLAS dataset is presented. All measurements are compared to state-of-the-art theoretical calculations.

The Affordability of MyPlate: An Analysis of SNAP Benefits and the Actual Cost of Eating According to the Dietary Guidelines.

Science.gov (United States)

Mulik, Kranti; Haynes-Maslow, Lindsey

2017-09-01

To estimate the funds required to support a MyPlate diet and to estimate the additional costs needed for Supplemental Nutrition Assistance Program recipients to adhere to the MyPlate diet. Using the US Department of Agriculture's (USDA's) MyPlate dietary guidelines that specify recommendations for individuals based on age and gender and retail price data from the USDA, the cost of following USDA's MyPlate guidelines for consuming 3 meals daily was estimated for the following individuals: children, adolescents, female adults, male adults, female seniors, male seniors, and a 4-person family. Cost of consuming a MyPlate diet, including canned, frozen, and fresh produce as part of the diet. Descriptive analysis of the cost of consuming a MyPlate diet. Consuming a MyPlate diet consisting of only fresh fruits and vegetables is the most expensive diet. The monthly additional costs on an individual basis is the largest for boys aged 12-17 years ($75/mo) because they have the largest quantity of food consumed compared with all other gender and age groups. The monthly cost for a family of 4 ranged from $1,109 to $1,249/mo. The monetary amount of Supplemental Nutrition Assistance Program benefits may be insufficient to support a healthy diet recommended by federal nutrition guidelines. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Peran Maskapai Penerbangan Berbiaya Murah/Low Cost Carrier (LCC) di Bandara Adisutjipto-Yogyakarta untuk Mendukung Peningkatan Jumlah Wisatawan Domestik

OpenAIRE

Yuke Sri Rizki

2013-01-01

Indonesia has many and varied tourism destinations. Tourism sector is one of the five sectors which has the largest foreign exchange. One of transportation mode supporting the growth of tourism is air transportation mode. One service provided by air transportation is the low cost airlines or the Low Cost Carrier (LCC). The aim of this study is to determine the role of LCC in Adisutjipto Airport Yogyakarta in increasing number of domestic tourist. This study using descriptive analysis and qual...

On the relation between cost and service models for general inventory systems

NARCIS (Netherlands)

Houtum, van G.J.J.A.N.; Zijm, W.H.M.

2000-01-01

In this paper, we present a systematic overview of possible relations between cost and service models for fairly general single- and multi-stage inventory systems. In particular, we relate various types of penalty costs in pure cost models to equivalent types of service measures in service models.

Collaborative spectrum sensing based on the ratio between largest eigenvalue and Geometric mean of eigenvalues

KAUST Repository

Shakir, Muhammad

2011-12-01

In this paper, we introduce a new detector referred to as Geometric mean detector (GEMD) which is based on the ratio of the largest eigenvalue to the Geometric mean of the eigenvalues for collaborative spectrum sensing. The decision threshold has been derived by employing Gaussian approximation approach. In this approach, the two random variables, i.e. The largest eigenvalue and the Geometric mean of the eigenvalues are considered as independent Gaussian random variables such that their cumulative distribution functions (CDFs) are approximated by a univariate Gaussian distribution function for any number of cooperating secondary users and received samples. The approximation approach is based on the calculation of exact analytical moments of the largest eigenvalue and the Geometric mean of the eigenvalues of the received covariance matrix. The decision threshold has been calculated by exploiting the CDF of the ratio of two Gaussian distributed random variables. In this context, we exchange the analytical moments of the two random variables with the moments of the Gaussian distribution function. The performance of the detector is compared with the performance of the energy detector and eigenvalue ratio detector. Analytical and simulation results show that our newly proposed detector yields considerable performance advantage in realistic spectrum sensing scenarios. Moreover, our results based on proposed approximation approach are in perfect agreement with the empirical results. © 2011 IEEE.

Cost effective multi-storey passive residential houses. Costs, technology, solutions, experiences of users; Kostenguenstige mehrgeschossige Passivwohnhaeuser. Kosten, Technik, Loesungen, Nutzererfahrungen

Energy Technology Data Exchange (ETDEWEB)

Schoeberl, Helmut

2013-08-01

Energy-efficient buildings in the range of single-family houses are no longer a rarity. The passive house technology and the costs are the significant barriers in the field of multi-storey housings. For the first time, the author of the book under consideration summarizes the planning tools, building envelope, building services, construction costs and the introduction of users by means of several passive house projects. The demands, components and challenges of the passive house are presented. Even experienced planners and decision-makers with get many detailed solutions and an accurate arrangement of additional costs.

The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis.

Science.gov (United States)

Mills, Edward J; Kanters, Steve; Hagopian, Amy; Bansback, Nick; Nachega, Jean; Alberton, Mark; Au-Yeung, Christopher G; Mtambo, Andy; Bourgeault, Ivy L; Luboga, Samuel; Hogg, Robert S; Ford, Nathan

2011-11-23

To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. Human capital cost analysis using publicly accessible data. Sub-Saharan African countries. Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries. The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors. In the nine source countries the estimated government subsidised cost of a doctor's education ranged from $21,000 (£13,000; €15,000) in Uganda to $58,700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m). Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their

Preliminary Multi-Variable Parametric Cost Model for Space Telescopes

Science.gov (United States)

Stahl, H. Philip; Hendrichs, Todd

2010-01-01

This slide presentation reviews creating a preliminary multi-variable cost model for the contract costs of making a space telescope. There is discussion of the methodology for collecting the data, definition of the statistical analysis methodology, single variable model results, testing of historical models and an introduction of the multi variable models.

Estimating the cost of blood: past, present, and future directions.

Science.gov (United States)

Shander, Aryeh; Hofmann, Axel; Gombotz, Hans; Theusinger, Oliver M; Spahn, Donat R

2007-06-01

Understanding the costs associated with blood products requires sophisticated knowledge about transfusion medicine and is attracting the attention of clinical and administrative healthcare sectors worldwide. To improve outcomes, blood usage must be optimized and expenditures controlled so that resources may be channeled toward other diagnostic, therapeutic, and technological initiatives. Estimating blood costs, however, is a complex undertaking, surpassing simple supply versus demand economics. Shrinking donor availability and application of a precautionary principle to minimize transfusion risks are factors that continue to drive the cost of blood products upward. Recognizing that historical accounting attempts to determine blood costs have varied in scope, perspective, and methodology, new approaches have been initiated to identify all potential cost elements related to blood and blood product administration. Activities are also under way to tie these elements together in a comprehensive and practical model that will be applicable to all single-donor blood products without regard to practice type (e.g., academic, private, multi- or single-center clinic). These initiatives, their rationale, importance, and future directions are described.

Continuous Czochralski growth: Silicon sheet growth development of the large area silicon sheet task of the Low Cost Silicon Solar Array project

Science.gov (United States)

1978-01-01

The primary objective of this contract is to develop equipment and methods for the economic production of single crystal ingot material by the continuous Czochralski (CZ) process. Continuous CZ is defined for the purpose of this work as the growth of at least 100 kilograms of ingot from only one melt container. During the reporting period (October, 1977 - September, 1978), a modified grower was made fully functional and several recharge runs were performed. The largest run lasted 44 hours and over 42 kg of ingot was produced. Little, if any, degradation in efficiency was observed as a result of pulling multiple crystals from one crucible. Solar efficiencies observed were between 9.3 and 10.4% AMO (13.0 and 14.6% AMI) compared to 10.5% (14.7% AMI) for optimum CZ material control samples. Using the SAMICS/IPEG format, economic analysis of continuous CZ suggests that 1986 DoE cost goals can only be met by the growth of large diameter, large mass crystals.

A single molecule DNA flow stretching microscope for undergraduates

NARCIS (Netherlands)

Williams, Kelly; Grafe, Brendan; Burke, Kathryn M.; Tanner, Nathan; van Oijen, Antoine M.; Loparo, Joseph; Price, Allen C.

2011-01-01

The design of a simple, safe, and inexpensive single molecule flow stretching instrument is presented. The instrument uses a low cost upright microscope coupled to a webcam for imaging single DNA molecules that are tethered in an easy to construct microfluidic flow cell. The system requires no

Low cost anaerobic system for Indonesia: single baffled septic tank.

Science.gov (United States)

Wibisono, G; Mathew, K; Ho, Goen

2003-01-01

The insertion of a single baffle into a laboratory septic tank to mix incoming feed with sludge has been shown to improve anaerobic degradation of the feed. This is particularly true of soluble organic matter such as glucose. Oil or cellulose fed separately does not undergo degradation. It is expected however that a balanced feed such as sewage will be better degraded.

Recruitment strategy cost and impact on minority accrual to a breast cancer prevention trial.

Science.gov (United States)

Dew, Alexander; Khan, Seema; Babinski, Christie; Michel, Nancy; Heffernan, Marie; Stephan, Stefanie; Jordan, Neil; Jovanovic, Borko; Carney, Paula; Bergan, Raymond

2013-04-01

Recruitment of minorities to cancer prevention trials is difficult and costly. Early-phase cancer prevention trials have fewer resources to promote recruitment. Identifying cost-effective strategies that can replace or supplement traditional recruitment methods and improve minority accrual to small, early-phase cancer prevention trials are of critical importance. To compare the costs of accrual strategies used in a small breast cancer prevention trial and assess their impact on recruitment and minority accrual. A total of 1196 potential subjects with a known recruitment source contacted study coordinators about the SOY study, a breast cancer prevention trial. Recruitment strategies for this study included recruitment from within the Northwestern University network (internal strategy), advertisements placed on public transportation (Chicago Transit Authority (CTA)), health-related events, media (print/radio/television), and direct mail. Total recruitment strategy cost included the cost of study personnel and material costs calculated from itemized receipts. Incremental cost-effectiveness ratios (ICERs) were calculated to compare the relative cost-effectiveness of each recruitment strategy. If a strategy was more costly and less effective than its comparator, then that strategy was considered dominated. Scenarios that were not dominated were compared. The primary effectiveness measure was the number of consents. Separate ICERs were calculated using the number of minority consents as the effectiveness measure. The total cost of SOY study recruitment was US$164,585, which included the cost of materials (US$26,133) and personnel (US$138,452). The internal referral strategy was the largest source of trial contacts (748/1196; 63%), consents (107/150; 71%), and minority consents (17/34; 50%) and was the most expensive strategy (US$139,033). CTA ads generated the second largest number of trial contacts (326/1196; 27%), the most minority contacts (184/321; 57%), and 16

Energy scavenging based on a single-crystal PMN-PT nanobelt

Science.gov (United States)

Wu, Fan; Cai, Wei; Yeh, Yao-Wen; Xu, Shiyou; Yao, Nan

2016-03-01

Self-powered nanodevices scavenging mechanical energy require piezoelectric nanostructures with high piezoelectric coefficients. Here we report the fabrication of a single-crystal (1 - x)Pb(Mg1/3Nb2/3)O3 - xPbTiO3 (PMN-PT) nanobelt with a superior piezoelectric constant (d33 = ~550 pm/V), which is approximately ~150%, 430%, and 2100% of the largest reported values for previous PMN-PT, PZT and ZnO nanostructures, respectively. The high d33 of the single-crystalline PMN-PT nanobelt results from the precise orientation control during its fabrication. As a demonstration of its application in energy scavenging, a piezoelectric nanogenerator (PNG) is built on the single PMN-PT nanobelt, generating a maximum output voltage of ~1.2 V. This value is ~4 times higher than that of a single-CdTe PNG, ~13 times higher than that of a single-ZnSnO3 PNG, and ~26 times higher than that of a single-ZnO PNG. The profoundly increased output voltage of a lateral PNG built on a single PMN-PT nanobelt demonstrates the potential application of PMN-PT nanostructures in energy harvesting, thus enriching the material choices for PNGs.

Cost-of-illness analysis of type 2 diabetes mellitus in Iran.

Directory of Open Access Journals (Sweden)

Mehdi Javanbakht

Full Text Available Diabetes is a worldwide high prevalence chronic progressive disease that poses a significant challenge to healthcare systems. The aim of this study is to provide a detailed economic burden of diagnosed type 2 diabetes mellitus (T2DM and its complications in Iran in 2009 year.This is a prevalence-based cost-of-illness study focusing on quantifying direct health care costs by bottom-up approach. Data on inpatient hospital services, outpatient clinic visits, physician services, drugs, laboratory test, education and non-medical cost were collected from two national registries. The human capital approach was used to calculate indirect costs separately in male and female and also among different age groups.The total national cost of diagnosed T2DM in 2009 is estimated at 3.78 billion USA dollars (USD including 2.04±0.28 billion direct (medical and non-medical costs and indirect costs of 1.73 million. Average direct and indirect cost per capita was 842.6±102 and 864.8 USD respectively. Complications (48.9% and drugs (23.8% were main components of direct cost. The largest components of medical expenditures attributed to diabetes's complications are cardiovascular disease (42.3% of total Complications cost, nephropathy (23% and ophthalmic complications (14%. Indirect costs include temporarily disability (335.7 million, permanent disability (452.4 million and reduced productivity due to premature mortality (950.3 million.T2DM is a costly disease in the Iran healthcare system and consume more than 8.69% of total health expenditure. In addition to these quantified costs, T2DM imposes high intangible costs on society in terms of reduced quality of life. Identification of effective new strategies for the control of diabetes and its complications is a public health priority.

Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

Science.gov (United States)

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 2010–2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

Mutation dynamics and fitness effects followed in single cells.

Science.gov (United States)

Robert, Lydia; Ollion, Jean; Robert, Jerome; Song, Xiaohu; Matic, Ivan; Elez, Marina

2018-03-16

Mutations have been investigated for more than a century but remain difficult to observe directly in single cells, which limits the characterization of their dynamics and fitness effects. By combining microfluidics, time-lapse imaging, and a fluorescent tag of the mismatch repair system in Escherichia coli , we visualized the emergence of mutations in single cells, revealing Poissonian dynamics. Concomitantly, we tracked the growth and life span of single cells, accumulating ~20,000 mutations genome-wide over hundreds of generations. This analysis revealed that 1% of mutations were lethal; nonlethal mutations displayed a heavy-tailed distribution of fitness effects and were dominated by quasi-neutral mutations with an average cost of 0.3%. Our approach has enabled the investigation of single-cell individuality in mutation rate, mutation fitness costs, and mutation interactions. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

The Copenhagen Accord: abatement costs and carbon prices resulting from the submissions

International Nuclear Information System (INIS)

Elzen, Michel G.J. den; Hof, Andries F.; Mendoza Beltran, Angelica; Grassi, Giacomo; Roelfsema, Mark; Ruijven, Bas van; Vliet, Jasper van; Vuuren, Detlef P. van

2011-01-01

As part of the Copenhagen Accord, individual countries have submitted greenhouse gas reduction proposals for the year 2020. This paper analyses the implications for emission reductions, the carbon price, and abatement costs of these submissions. The submissions of the Annex I (industrialised) countries are estimated to lead to a total reduction target of 12-18% below 1990 levels. The submissions of the seven major emerging economies are estimated to lead to an 11-14% reduction below baseline emissions, depending on international (financial) support. Global abatement costs in 2020 are estimated at about USD 60-100 billion, assuming that at least two-thirds of Annex I emission reduction targets need to be achieved domestically. The largest share of these costs are incurred by Annex I countries, although the costs as share of GDP are similar for Annex I as a group and the seven emerging economies as a group, even when assuming substantial international transfers from Annex I countries to the emerging economies to finance their abatement costs. If the restriction of achieving two-thirds of the emission reduction target domestically is abandoned, it would more than double the international carbon price and at the same time reduce global abatement costs by almost 25%.

Single Shell Tank (SST) Program Plan

International Nuclear Information System (INIS)

HAASS, C.C.

2000-01-01

This document provides an initial program plan for retrieval of the single-shell tank waste. Requirements, technical approach, schedule, organization, management, and cost and funding are discussed. The program plan will be refined and updated in fiscal year 2000

Single Shell Tank (SST) Program Plan

Energy Technology Data Exchange (ETDEWEB)

HAASS, C.C.

2000-03-21

This document provides an initial program plan for retrieval of the single-shell tank waste. Requirements, technical approach, schedule, organization, management, and cost and funding are discussed. The program plan will be refined and updated in fiscal year 2000.

Health insurance coverage and its impact on medical cost: observations from the floating population in China.

Directory of Open Access Journals (Sweden)

Yinjun Zhao

Full Text Available China has the world's largest floating (migrant population, which has characteristics largely different from the rest of the population. Our goal is to study health insurance coverage and its impact on medical cost for this population.A telephone survey was conducted in 2012. 644 subjects were surveyed. Univariate and multivariate analysis were conducted on insurance coverage and medical cost.82.2% of the surveyed subjects were covered by basic insurance at hometowns with hukou or at residences. Subjects' characteristics including age, education, occupation, and presence of chronic diseases were associated with insurance coverage. After controlling for confounders, insurance coverage was not significantly associated with gross or out-of-pocket medical cost.For the floating population, health insurance coverage needs to be improved. Policy interventions are needed so that health insurance can have a more effective protective effect on cost.

Microstructural evolution of reduced-activation martensitic steel under single and sequential ion irradiations

Energy Technology Data Exchange (ETDEWEB)

Luo, Fengfeng [Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, Hubei Nuclear Solid Physics Key Laboratory and School of Physics and Technology, Wuhan University, Wuhan 430072 (China); Guo, Liping, E-mail: guolp@whu.edu.cn [Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, Hubei Nuclear Solid Physics Key Laboratory and School of Physics and Technology, Wuhan University, Wuhan 430072 (China); Jin, Shuoxue; Li, Tiecheng; Zheng, Zhongcheng [Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, Hubei Nuclear Solid Physics Key Laboratory and School of Physics and Technology, Wuhan University, Wuhan 430072 (China); Yang, Feng; Xiong, Xuesong; Suo, Jinping [State Key Laboratory of Mould Technology, Institute of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074 (China)

2013-07-15

Microstructural evolution of super-clean reduced-activation martensitic steels irradiated with single-beam (Fe{sup +}) and sequential-beam (Fe{sup +} plus He{sup +}) at 350 °C and 550 °C was studied. Sequential-beam irradiation induced smaller size and larger number density of precipitates compared to single-beam irradiation at 350 °C. The largest size of cavities was observed after sequential-beam irradiation at 550 °C. The segregation of Cr and W and depletion of Fe in carbides were observed, and the maximum depletion of Fe and enrichment of Cr occurred under irradiation at 350 °C.

Cost Analysis In A Multi-Mission Operations Environment

Science.gov (United States)

Newhouse, M.; Felton, L.; Bornas, N.; Botts, D.; Roth, K.; Ijames, G.; Montgomery, P.

2014-01-01

Spacecraft control centers have evolved from dedicated, single-mission or single missiontype support to multi-mission, service-oriented support for operating a variety of mission types. At the same time, available money for projects is shrinking and competition for new missions is increasing. These factors drive the need for an accurate and flexible model to support estimating service costs for new or extended missions; the cost model in turn drives the need for an accurate and efficient approach to service cost analysis. The National Aeronautics and Space Administration (NASA) Huntsville Operations Support Center (HOSC) at Marshall Space Flight Center (MSFC) provides operations services to a variety of customers around the world. HOSC customers range from launch vehicle test flights; to International Space Station (ISS) payloads; to small, short duration missions; and has included long duration flagship missions. The HOSC recently completed a detailed analysis of service costs as part of the development of a complete service cost model. The cost analysis process required the team to address a number of issues. One of the primary issues involves the difficulty of reverse engineering individual mission costs in a highly efficient multimission environment, along with a related issue of the value of detailed metrics or data to the cost model versus the cost of obtaining accurate data. Another concern is the difficulty of balancing costs between missions of different types and size and extrapolating costs to different mission types. The cost analysis also had to address issues relating to providing shared, cloud-like services in a government environment, and then assigning an uncertainty or risk factor to cost estimates that are based on current technology, but will be executed using future technology. Finally the cost analysis needed to consider how to validate the resulting cost models taking into account the non-homogeneous nature of the available cost data and the