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Sample records for rapidly decreasing costs

  1. Decreasing Serial Cost Sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter

    The increasing serial cost sharing rule of Moulin and Shenker [Econometrica 60 (1992) 1009] and the decreasing serial rule of de Frutos [Journal of Economic Theory 79 (1998) 245] have attracted attention due to their intuitive appeal and striking incentive properties. An axiomatic characterization...

  2. Decreasing serial cost sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter Raahave

    2009-01-01

    The increasing serial cost sharing rule of Moulin and Shenker (Econometrica 60:1009-1037, 1992) and the decreasing serial rule of de Frutos (J Econ Theory 79:245-275, 1998) are known by their intuitive appeal and striking incentive properties. An axiomatic characterization of the increasing serial...

  3. The decreasing cost of telemedicine and telehealth.

    Science.gov (United States)

    Doolittle, Gary C; Spaulding, Ashley O'Neal; Williams, Arthur R

    2011-11-01

    The teleoncology practice based at the University of Kansas Medical Center (KUMC) in Kansas City, Kansas, is one of the longest running practices of its kind worldwide. The practice began in 1995 and connected an oncologist at KUMC with a rural medical center in Hays, Kansas. Fifteen years later, the practice continues to thrive at Hays Medical Center and has also expanded to include two additional sites within the state-the Northeast Kansas Center for Health and Wellness in Horton and Goodland Regional Medical Center in Goodland-that offer regularly scheduled teleoncology clinics. While the KUMC practice has witnessed an expansion in service sites throughout its history, the practice has seen a significant decrease in the costs associated with providing such services since its inception. The cost decrease can, in part, be attributed to an increase in the number of teleoncology visits conducted through the practice since it began. In Fiscal Year 1995 (FY 1995), 103 teleoncology visits resulted in a cost per visit of $812. Five years later, the FY 2000 $410 per visit cost for 121 visits was almost half the cost identified in the initial cost analysis. The FY 2003 cost per visit for 219 visits saw another decrease to $401, and the most recent FY 2005 cost analysis yielded another decrease to $251 per visit for 235 visits. The data reported below are likely to be the best now available to track time trends in the cost of providing telemedicine or telehealth consultations. The Conclusion and Policy Recommendations at the end of this article will focus on both the cost-time profile and some other challenges and lessons learned.

  4. Intravenous theophylline rapidly decreases post-lumbar puncture headaches.

    Science.gov (United States)

    Ergün, Ufuk; Ünal-Artık, H Aybüke; İnan, Leven E; Yoldaş, Tahir

    2016-09-01

    When managing therapy for the post-lumbar puncture headaches (PLPHs), an efficacious, fast-acting, practical and safe method is preferred. Invasive methods have known complications and oral medications might be problematic when nausea and vomiting occurs with severe headaches. The aim of this study was to highlight the brief initial time for a remarkable decrease of PLPH pain levels after the administration of IV theophylline infusion. We observed that IV theophylline infusion has a rapid and marked effect on decreasing pain in PLPHs. At 30 min of theophylline infusion, mean VAS levels were decreased by 47.1 % and at 60 min of infusion, the decrease of pain was 61.9 %. We conclude that IV theophylline infusion is a rapidly effective, noninvasive, practical and low-cost way to treat PLPHs. To the best of our knowledge, this is the first study to highlight both the efficacy and the speed of the effect of pain relief in PLPHs.

  5. The stand-alone test and decreasing serial cost sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Thorlund-Petersen, Lars

    2000-01-01

    The rule of decreasing serial cost sharing defined in de Frutos [1] over the class of concave cost functions may violate the important stand-alone test. Sufficient conditions for the test to be satisfied are given, in terms of individual rationality as well as coalitional stability. These conditi......The rule of decreasing serial cost sharing defined in de Frutos [1] over the class of concave cost functions may violate the important stand-alone test. Sufficient conditions for the test to be satisfied are given, in terms of individual rationality as well as coalitional stability....... These conditions restrict the shape of the cost function and the distribution of demands...

  6. Rapid, cost-effective liquid chromatograghic method for the ...

    African Journals Online (AJOL)

    GRACE

    2006-07-03

    Jul 3, 2006 ... 1Department of Medicinal Chemistry and Quality Control, National Institute for Pharmaceutical Research and Development, Abuja,. Nigeria. ... A rapid and cost effective method for the analysis of metronidazole in biological samples was ... effective HPLC method of assaying metronidazole both in.

  7. Sudden collapse of vacuoles in Saintpaulia sp. palisade cells induced by a rapid temperature decrease.

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    Kadohama, Noriaki; Goh, Tatsuaki; Ohnishi, Miwa; Fukaki, Hidehiro; Mimura, Tetsuro; Suzuki, Yoshihiro

    2013-01-01

    It is well known that saintpaulia leaf is damaged by the rapid temperature decrease when cold water is irrigated onto the leaf surface. We investigated this temperature sensitivity and the mechanisms of leaf damage in saintpaulia (Saintpaulia sp. cv. 'Iceberg') and other Gesneriaceae plants. Saintpaulia leaves were damaged and discolored when subjected to a rapid decrease in temperature, but not when the temperature was decreased gradually. Sensitivity to rapid temperature decrease increased within 10 to 20 min during pre-incubation at higher temperature. Injury was restricted to the palisade mesophyll cells, where there was an obvious change in the color of the chloroplasts. During a rapid temperature decrease, chlorophyll fluorescence monitored by a pulse amplitude modulated fluorometer diminished and did not recover even after rewarming to the initial temperature. Isolated chloroplasts were not directly affected by the rapid temperature decrease. Intracellular pH was monitored with a pH-dependent fluorescent dye. In palisade mesophyll cells damaged by rapid temperature decrease, the cytosolic pH decreased and the vacuolar membrane collapsed soon after a temperature decrease. In isolated chloroplasts, chlorophyll fluorescence declined when the pH of the medium was lowered. These results suggest that a rapid temperature decrease directly or indirectly affects the vacuolar membrane, resulting in a pH change in the cytosol that subsequently affects the chloroplasts in palisade mesophyll cells. We further confirmed that the same physiological damage occurs in other Gesneriaceae plants. These results strongly suggested that the vacuoles of palisade mesophyll cells collapsed during the initial phase of leaf injury.

  8. Sudden collapse of vacuoles in Saintpaulia sp. palisade cells induced by a rapid temperature decrease.

    Directory of Open Access Journals (Sweden)

    Noriaki Kadohama

    Full Text Available It is well known that saintpaulia leaf is damaged by the rapid temperature decrease when cold water is irrigated onto the leaf surface. We investigated this temperature sensitivity and the mechanisms of leaf damage in saintpaulia (Saintpaulia sp. cv. 'Iceberg' and other Gesneriaceae plants. Saintpaulia leaves were damaged and discolored when subjected to a rapid decrease in temperature, but not when the temperature was decreased gradually. Sensitivity to rapid temperature decrease increased within 10 to 20 min during pre-incubation at higher temperature. Injury was restricted to the palisade mesophyll cells, where there was an obvious change in the color of the chloroplasts. During a rapid temperature decrease, chlorophyll fluorescence monitored by a pulse amplitude modulated fluorometer diminished and did not recover even after rewarming to the initial temperature. Isolated chloroplasts were not directly affected by the rapid temperature decrease. Intracellular pH was monitored with a pH-dependent fluorescent dye. In palisade mesophyll cells damaged by rapid temperature decrease, the cytosolic pH decreased and the vacuolar membrane collapsed soon after a temperature decrease. In isolated chloroplasts, chlorophyll fluorescence declined when the pH of the medium was lowered. These results suggest that a rapid temperature decrease directly or indirectly affects the vacuolar membrane, resulting in a pH change in the cytosol that subsequently affects the chloroplasts in palisade mesophyll cells. We further confirmed that the same physiological damage occurs in other Gesneriaceae plants. These results strongly suggested that the vacuoles of palisade mesophyll cells collapsed during the initial phase of leaf injury.

  9. Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs.

    Science.gov (United States)

    Iannettoni, Mark D; Lynch, William R; Parekh, Kalpaj R; McLaughlin, Kelley A

    2011-04-01

    The majority of costs associated with esophagectomy are related to the initial 3 days of hospital stay requiring intensive care unit stays, ventilator support, and intraoperative time. Additional costs arise from hospital-based services. The major cost increases are related to complications associated with the procedure. We attempted to define these costs and identify expense management by streamlining care through strict adherence to patient care maps, operative standardization, and rapid discharge planning to reduce variability. Utilizing methods of Kaizen philosophy we evaluated all processes related to the entire experience of esophageal resection. This process has taken over 5 years to achieve, with quality and cost being tracked over this time period. Cost analysis included expenses related to intensive care unit, anesthesia, disposables, and hospital services. Quality improvement measures were related to intraoperative complications, in-hospital complications, and postoperative outcomes. The Institutional Review Board approved the use of anonymous data from standard clinical practice because no additional treatment was planned (observational study). Utilizing a continuous process improvement methodology, a 43% reduction in cost per case has been achieved with a significant increase in contribution margin for esophagectomy. The length of stay has been reduced from 14 days to 5. With intraoperative and postoperative standardization the leak rate has dropped from 12% to less than 3% to no leaks in our current Kaizen modification of care in our last 64 patients. Utilizing lean manufacturing techniques and continuous process evaluation we have attempted to eliminate variability, standardized the phases of care resulting in improved outcomes, decreased length of stay, and improved contribution margins. These Kaizen improvements require continuous interventions, strict adherence to care maps, and input from all levels for quality improvements. Copyright © 2011 The

  10. Rapid Cost Assessment of Space Mission Concepts Through Application of Complexity-Based Cost Indices

    Science.gov (United States)

    Peterson, Craig E.; Cutts, James; Balint, Tibor; Hall, James B.

    2008-01-01

    This slide presentation reviews the development of a rapid cost assessment models for evaluation of exploration missions through the application of complexity based cost indices. In Fall of 2004, NASA began developing 13 documents, known as "strategic roadmaps," intended to outline a strategy for space exploration over the next 30 years. The Third Strategic Roadmap, The Strategic Roadmap for Solar System Exploration, focused on strategy for robotic exploration of the Solar System. Development of the Strategic Roadmap for Solar System Exploration led to the investigation of a large variety of missions. However, the necessity of planning around scientific inquiry and budgetary constraints made it necessary for the roadmap development team to evaluate potential missions not only for scientific return but also cost. Performing detailed cost studies for each of the large number of missions was impractical given the time constraints involved and lack of detailed mission studies; so a method of rapid cost assessment was developed by us to allow preliminary analysis. It has been noted that there is a strong correlation between complexity and cost and schedule of planetary missions. While these correlations were made after missions had been built and flown (successfully or otherwise), it seemed likely that a similar approach could provide at least some relative cost ranking. Cost estimation relationships (CERs) have been developed based on subsystem design choices. These CERs required more detailed information than available, forcing the team to adopt a more high level approach. Costing by analogy has been developed for small satellites, however, planetary exploration missions provide such varying spacecraft requirements that there is a lack of adequately comparable missions that can be used for analogy.

  11. The impact of unit cost reductions on gross profit: Increasing or decreasing returns?

    Directory of Open Access Journals (Sweden)

    Ely Dahan

    2011-09-01

    Full Text Available We suggest that marketers actively participate in reducing unit costs during new product development, consistent with the theme of integrated marketing and manufacturing. Most marketing managers misjudge the impact on gross profit of reducing variable unit manufacturing costs, mistakenly believing that such cost reductions yield decreasing or linear returns while they actually generate increasing returns.

  12. The Hepatitis C Genotype 1 Paradox: Cost per Treatment Is Increasing, but Cost per Cure Is Decreasing

    Directory of Open Access Journals (Sweden)

    Stephen D Shafran

    2015-01-01

    Full Text Available Significant attention has been focused on the perceived increase in the cost of antiviral treatment for hepatitis C genotype 1 infection since the approval of the first direct-acting antiviral agents in 2011. Using Canadian list prices, the present analysis points out a paradox: while the cost per antiviral regimen is increasing, the cost per cure is decreasing, especially with interferon-free therapy. In a publicly funded health care system, the lowest cost per cure is a more valuable measure of value for public money than the cost per regimen.

  13. Early initiation of postpartum contraception: does it decrease rapid repeat pregnancy in adolescents?

    Science.gov (United States)

    Damle, Lauren F; Gohari, Amir C; McEvoy, Anna K; Desale, Sameer Y; Gomez-Lobo, Veronica

    2015-02-01

    Rapid repeat adolescent pregnancy is a significant public health concern. An effective and practical means of decreasing unintended second adolescent pregnancies needs to be identified. The objective of this study is to determine if early initiation of contraception, and in particular long acting reversible contraception (LARC), decreases rapid repeat pregnancy among first time adolescent mothers. Retrospective cohort study. Urban teaching hospital. 340 first-time adolescent mothers age ≤ 19. None, study was retrospective. Repeat pregnancy within 2 years. 340 first time adolescent mothers with a documented follow-up time of 2 years had a repeat pregnancy rate of 35%. Average time from delivery to repeat pregnancy was 9.9 ± 6.4 months. Logistic regression analysis comparing adolescents with and without repeat pregnancy revealed that leaving the hospital postpartum without initiating any contraception was associated with significant increase risk of repeat pregnancy (OR = 2.447, 95% CI 1.326-4.515). Follow-up within 8 weeks postpartum was associated with lower chance of repeat pregnancy (OR = 0.322, 95% CI 0.172-0.603). Initiation of a LARC method (either an intrauterine device or etonogestrel subdermal implant) by 8 weeks postpartum was also associated with decreased chance of rapid repeat pregnancy (OR = 0.118, 95% CI 0.035-0.397). Adolescent mothers who initiate a LARC method within 8 weeks of delivery are less likely to have a repeat pregnancy within 2 years than those who choose other methods or no method. First time adolescent mothers should be counseled about this advantage of using LARC. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. Rapidly falling costs of battery packs for electric vehicles

    Science.gov (United States)

    Nykvist, Björn; Nilsson, Måns

    2015-04-01

    To properly evaluate the prospects for commercially competitive battery electric vehicles (BEV) one must have accurate information on current and predicted cost of battery packs. The literature reveals that costs are coming down, but with large uncertainties on past, current and future costs of the dominating Li-ion technology. This paper presents an original systematic review, analysing over 80 different estimates reported 2007-2014 to systematically trace the costs of Li-ion battery packs for BEV manufacturers. We show that industry-wide cost estimates declined by approximately 14% annually between 2007 and 2014, from above US$1,000 per kWh to around US$410 per kWh, and that the cost of battery packs used by market-leading BEV manufacturers are even lower, at US$300 per kWh, and has declined by 8% annually. Learning rate, the cost reduction following a cumulative doubling of production, is found to be between 6 and 9%, in line with earlier studies on vehicle battery technology. We reveal that the costs of Li-ion battery packs continue to decline and that the costs among market leaders are much lower than previously reported. This has significant implications for the assumptions used when modelling future energy and transport systems and permits an optimistic outlook for BEVs contributing to low-carbon transport.

  15. Operational response to malaria epidemics: are rapid diagnostic tests cost-effective?

    Science.gov (United States)

    Rolland, Estelle; Checchi, Francesco; Pinoges, Loretxu; Balkan, Suna; Guthmann, Jean-Paul; Guerin, Philippe J

    2006-04-01

    To compare the cost-effectiveness of malaria treatment based on presumptive diagnosis with that of malaria treatment based on rapid diagnostic tests (RDTs). We calculated direct costs (based on experience from Ethiopia and southern Sudan) and effectiveness (in terms of reduced over-treatment) of a free, decentralised treatment programme using artesunate plus amodiaquine (AS + AQ) or artemether-lumefantrine (ART-LUM) in a Plasmodium falciparum epidemic. Our main cost-effectiveness measure was the incremental cost per false positive treatment averted by RDTs. As malaria prevalence increases, the difference in cost between presumptive and RDT-based treatment rises. The threshold prevalence above which the RDT-based strategy becomes more expensive is 21% in the AS + AQ scenario and 55% in the ART-LUM scenario, but these thresholds increase to 58 and 70%, respectively, if the financing body tolerates an incremental cost of 1 euro per false positive averted. However, even at a high (90%) prevalence of malaria consistent with an epidemic peak, an RDT-based strategy would only cost moderately more than the presumptive strategy: +29.9% in the AS + AQ scenario and +19.4% in the ART-LUM scenario. The treatment comparison is insensitive to the age and pregnancy distribution of febrile cases, but is strongly affected by variation in non-biomedical costs. If their unit price were halved, RDTs would be more cost-effective at a malaria prevalence up to 45% in case of AS + AQ treatment and at a prevalence up to 68% in case of ART-LUM treatment. In most epidemic prevalence scenarios, RDTs would considerably reduce over-treatment for only a moderate increase in costs over presumptive diagnosis. A substantial decrease in RDT unit price would greatly increase their cost-effectiveness, and should thus be advocated. A tolerated incremental cost of 1 euro is probably justified given overall public health and financial benefits. The RDTs should be considered for malaria epidemics if

  16. Rapid Decrease in Populations of Wild Ring-Tailed Lemurs (Lemur catta) in Madagascar.

    Science.gov (United States)

    LaFleur, Marni; Clarke, Tara A; Reuter, Kim; Schaeffer, Toby

    2016-01-01

    Lemurs are the most threatened group of mammals on earth. Lemur catta (ring-tailed lemur) represents one of the most iconic lemur species and faces numerous anthropogenic threats in the wild. In this study, we present population estimates from 32 sites across the range of L. catta, collected from primary and secondary data sources, to assess the number of ring-tailed lemurs left in the wild. We estimate that there are approximately 2,220 individual L. catta remaining in the 32 sites considered. We note local extinctions of populations of L. catta in at least 12 of the 32 sites examined, and that significantly more extinctions occurred in areas without some form of protection. This decrease in extant populations could represent a decrease of more than 95% of all ring-tailed lemurs in Madagascar since the year 2000. While these results should be considered preliminary, we stress the rapid decline of the species and note that habitat loss, bushmeat hunting and the illegal pet trade are driving populations to local extinction. Based on the data presented here, urgent and immediate funding and conservation action are crucial to ensure the viability of the remaining wild populations of ring-tailed lemurs. © 2017 S. Karger AG, Basel.

  17. Phencyclidine rapidly decreases neuronal mRNA of brain-derived neurotrophic factor.

    Science.gov (United States)

    Katanuma, Yusuke; Numakawa, Tadahiro; Adachi, Naoki; Yamamoto, Noriko; Ooshima, Yoshiko; Odaka, Haruki; Inoue, Takafumi; Kunugi, Hiroshi

    2014-06-01

    Downregulation of brain-derived neurotrophic factor (BDNF), a member of neurotrophin family, has been implicated in psychiatric diseases including schizophrenia. However, detailed mechanisms of its reduction in patients with schizophrenia remain unclear. Here, using cultured cortical neurons, we monitored BDNF mRNA levels following acute application of phencyclidine [PCP; an N-methyl-d-aspartate (NMDA) receptor blocker], which is known to produce schizophrenia-like symptoms. We found that PCP rapidly caused a reduction in total amount of BDNF transcripts without effect on cell viability, while mRNA levels of nerve growth factor was intact. Actinomycin-D (ActD), an RNA synthesis inhibitor, decreased total BDNF mRNA levels similar to PCP, and coapplication of ActD with PCP did not show further reduction in BDNF mRNA compared with solo application of each drug. Among BDNF exons I, IV, and VI, the exon IV, which is positively regulated by neuronal activity, was highly sensitive to PCP. Furthermore, PCP inactivated cAMP response element-binding protein (CREB; a regulator of transcriptional activity of exon IV). The inactivation of CREB was also achieved by an inhibitor for Ca(2+) /calmodulin kinase II (CaMKII), although coapplication with PCP induced no further inhibition on the CREB activity. It is possible that PCP decreases BDNF transcription via blocking the NMDA receptor/CaMKII/CREB signaling. Copyright © 2014 Wiley Periodicals, Inc.

  18. Cost and Impact on Patient Length of Stay of Rapid Molecular Testing for Clostridium difficile.

    Science.gov (United States)

    Sewell, Bernadette; Rees, Eugene; Thomas, Ian; Ch'ng, Chin Lye; Isaac, Mike; Berry, Nidhika

    2014-12-01

    A study was performed to assess the cost of a rapid molecular assay (PCR) for diagnosis of Clostridium difficile infection (CDI) and the impact of its routine use on patient length of stay (LOS) in comparison with cell culture cytotoxin neutralization assay (CCNA). From March 2011 to September 2011, Xpert(®) C. difficile (Cepheid, Sunnyvale, CA, USA) PCR was used on patients with suspicion of CDI in two acute care hospitals in Abertawe Bro Morgannwg University Health Board, Swansea, Wales, UK. Test results were used for patient management. LOS and time to reportable result were compared for negative and positive prospective patients tested by PCR and historic control patients tested by CCNA during March 2010 to September 2010. Tests were priced using micro-costing and a cost comparison analysis was undertaken. In total, 506 patients were included. Time to reportable result for PCR samples was 1.53 h compared to 46.54 h for CCNA negatives and 22.45 h for CCNA positives. Patients tested by CCNA stayed 4.88 days longer in hospital compared to PCR patients if they tested positive and 7.03 days if tests were negative. The mean reduction in LOS observed in our study has the potential to generate cost savings of up to £2,292.62 for every patient with suspected CDI, if samples were to be tested routinely with PCR instead of CCNA. A rapid molecular test for C. difficile in an acute hospital setting produced quick results that led to a decrease in LOS compared to historic CCNA control patients. This could result in considerable savings through reduced excess inpatient days.

  19. Physician Assistants Improve Efficiency and Decrease Costs in Outpatient Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Resnick, Cory M; Daniels, Kimberly M; Flath-Sporn, Susan J; Doyle, Michael; Heald, Ronald; Padwa, Bonnie L

    2016-11-01

    To determine the effects on time, cost, and complication rates of integrating physician assistants (PAs) into the procedural components of an outpatient oral and maxillofacial surgery practice. This is a prospective cohort study of patients from the Department of Plastic and Oral Surgery at Boston Children's Hospital who underwent removal of 4 impacted third molars with intravenous sedation in our outpatient facility. Patients were separated into the "no PA group" and PA group. Process maps were created to capture all activities from room preparation to patient discharge, and all activities were timed for each case. A time-driven activity-based costing method was used to calculate the average times and costs from the provider's perspective for each group. Complication rates were calculated during the periods for both groups. Descriptive statistics were calculated, and significance was set at P oral and maxillofacial surgeon was directly involved in the procedure decreased by an average of 19.2 minutes after the introduction of PAs (P complications were found. The addition of PAs into the procedural components of an outpatient oral and maxillofacial surgery practice resulted in decreased costs whereas complication rates remained constant. The increased availability of the oral and maxillofacial surgeon after the incorporation of PAs allows for more patients to be seen during a clinic session, which has the potential to further increase efficiency and revenue. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Systematic Review of the Cost and Cost-Effectiveness of Rapid Endovascular Therapy for Acute Ischemic Stroke.

    Science.gov (United States)

    Sevick, Laura K; Ghali, Sarah; Hill, Michael D; Danthurebandara, Vishva; Lorenzetti, Diane L; Noseworthy, Tom; Spackman, Eldon; Clement, Fiona

    2017-09-01

    Rapid endovascular therapy (EVT) is an emerging treatment option for acute ischemic stroke. Several economic evaluations have been published examining the cost-effectiveness of EVT, and many international bodies are currently making adoption decisions. The objective of this study was to establish the cost-effectiveness of EVT for ischemic stroke patients and to synthesize all the publicly available economic literature. A systematic review of the published literature was conducted to identify economic evaluations and cost analyses of EVT for acute ischemic stroke patients. Systematic review best practices were followed, and study quality was assessed. Four-hundred sixty-three articles were identified from electronic databases. After deduplication, abstract review, and full-text review, 17 studies were included. Seven of the studies were cost analyses, and 10 were cost-effectiveness studies. Generally, the cost analyses reported on the cost of the approach/procedure or the hospitalization costs associated with EVT. All of the cost-effectiveness studies reported a cost per quality-adjusted life year as the primary outcomes. Studies varied in regards to the costs considered, the perspective adopted, and the time horizon used. All the studies reported a cost per quality-adjusted life year of cost and cost-effectiveness of EVT. The cost analyses suggested that although EVT was associated with higher costs, it also resulted in improved patient outcomes. From the cost-effectiveness studies, EVT seems to be good value for money when a threshold of $50 000 per quality-adjusted life year gained is adopted. © 2017 American Heart Association, Inc.

  1. Does a palliative care consult decrease the cost of caring for hospitalized patients with dementia?

    Science.gov (United States)

    Araw, Marissa; Kozikowski, Andrzej; Sison, Cristina; Mir, Tanveer; Saad, Maha; Corrado, Lauren; Pekmezaris, Renee; Wolf-Klein, Gisele

    2015-12-01

    Advanced dementia (AD) is a terminal disease. Palliative care is increasingly becoming of critical importance for patients afflicted with AD. The primary objective of this study was to compare pharmacy cost before and after a palliative care consultation (PCC) in patients with end-stage dementia. A secondary objective was to investigate the cost of particular types of medication before and after a PCC. This was a retrospective study of 60 hospitalized patients with end-stage dementia at a large academic tertiary care hospital from January 1, 2010 to October 1, 2011, in order to investigate pharmacy costs before and after a PCC. In addition to demographics, we carried out a comparison of the average daily pharmacy cost and comparison of the proportion of subjects taking each medication type (cardiac, analgesics, antibiotics, antipsychotics and antiemetics) before and after a PCC. There was a significant decrease in overall average daily pharmacy cost from before to after a PCC ($31.16 ± 24.71 vs. $20.83 ± 19.56; p dementia patients. Our study corroborates the benefits of palliative care team intervention in managing elderly hospitalized dementia patients.

  2. An Extreme Mountain Ultra-Marathon Decreases the Cost of Uphill Walking and Running.

    Science.gov (United States)

    Vernillo, Gianluca; Savoldelli, Aldo; Skafidas, Spyros; Zignoli, Andrea; La Torre, Antonio; Pellegrini, Barbara; Giardini, Guido; Trabucchi, Pietro; Millet, Grégoire P; Schena, Federico

    2016-01-01

    Purpose: To examine the effects of the world's most challenging mountain ultramarathon (MUM, 330 km, cumulative elevation gain of +24,000 m) on the energy cost and kinematics of different uphill gaits. Methods: Before (PRE) and immediately after (POST) the competition, 19 male athletes performed three submaximal 5-min treadmill exercise trials in a randomized order: walking at 5 km·h(-1), +20%; running at 6 km·h(-1), +15%; and running at 8 km·h(-1), +10%. During the three trials, energy cost was assessed using an indirect calorimetry system and spatiotemporal gait parameters were acquired with a floor-level high-density photoelectric cells system. Results: The average time of the study participants to complete the MUM was 129 h 43 min 48 s (range: 107 h 29 min 24 s to 144 h 21 min 0 s). Energy costs in walking (-11.5 ± 5.5%, P running condition decreased between PRE and POST, with a reduction both in the heart rate (-11.3, -10.0, and -9.3%, respectively) and oxygen uptake only for the walking condition (-6.5%). No consistent and significant changes in the kinematics variables were detected (P-values from 0.10 to 0.96). Conclusion: Though fatigued after completing the MUM, the subjects were still able to maintain their uphill locomotion patterns noted at PRE. The decrease (improvement) in the energy costs was likely due to the prolonged and repetitive walking/running, reflecting a generic improvement in the mechanical efficiency of locomotion after ~130 h of uphill locomotion rather than constraints imposed by the activity on the musculoskeletal structure and function.

  3. An extreme mountain ultra-marathon decreases the cost of uphill walking and running

    Directory of Open Access Journals (Sweden)

    Gianluca Vernillo

    2016-11-01

    Full Text Available Purpose: To examine the effects of the world’s most challenging mountain ultramarathon (MUM, 330 km, cumulative elevation gain of +24000 m on the energy cost and kinematics of different uphill gaits. Methods: Before (PRE and immediately after (POST the competition, 19 male athletes performed three submaximal 5-min treadmill exercise trials in a randomized order: walking at 5 km·h-1, +20%; running at 6 km·h-1, +15%; and running at 8 km·h-1, +10%. During the three trials, energy cost was assessed using an indirect calorimetry system and spatiotemporal gait parameters were acquired with a floor-level high-density photoelectric cells system. Results: The average time of the study participants to complete the MUM was 129 h 43 min 48 s (range: 107 h 29 min 24 s to 144 h 21 min 0 s. Energy costs in walking (-11.5 ± 5.5%, P < 0.001, as well as in the first (-7.2 ± 3.1%, P = 0.01 and second (-7.0 ± 3.9%, P = 0.02 running condition decreased between PRE and POST, with a reduction both in the heart rate (-11.3%, -10.0%, and -9.3%, respectively and oxygen uptake only for the walking condition (-6.5%. No consistent and significant changes in the kinematics variables were detected (P values from 0.10 to 0.96. Conclusion: Though fatigued after completing the MUM, the subjects were still able to maintain their uphill locomotion patterns noted at PRE. The decrease (improvement in the energy costs was likely due to the prolonged and repetitive walking/running, reflecting a generic improvement in the mechanical efficiency of locomotion after ~130 h of uphill locomotion rather than constraints imposed by the activity on the musculoskeletal structure and function.

  4. A low cost rapid prototype platform for a three phase PFC rectifier application

    DEFF Research Database (Denmark)

    Haase, Frerk; Kouchaki, Alireza; Nymand, Morten

    2015-01-01

    In this paper the design and development of a low cost rapid prototype platform for a Three Phase PFC rectifier application is presented. The active rectifier consists of a SiC-MOSFET based PWM converter and a low cost rapid prototype platform for simulating and implementing the digital control...... is then performed using automatic code generation for embedded targets, which provided a close link between simulation and implementation of the PFC controller. The paper shows how this rapid prototype platform developed and how it was used for the design and implementation of the controller for a high efficient Si...

  5. Low-Cost Inkjet Printing Technology for the Rapid Prototyping of Transducers

    Science.gov (United States)

    Andò, Bruno; Baglio, Salvatore; Bulsara, Adi R.; Emery, Teresa; Marletta, Vincenzo; Pistorio, Antonio

    2017-01-01

    Recently, there has been an upsurge in efforts dedicated to developing low-cost flexible electronics by exploiting innovative materials and direct printing technologies. This interest is motivated by the need for low-cost mass-production, shapeable, and disposable devices, and the rapid prototyping of electronics and sensors. This review, following a short overview of main printing processes, reports examples of the development of flexible transducers through low-cost inkjet printing technology. PMID:28368318

  6. Operational response to malaria epidemics: are rapid diagnostic tests cost-effective?

    OpenAIRE

    Rolland, E; Checchi, F; Pinoges, L.; Balkan, S; Guthmann, J P; Guerin, P. J.

    2006-01-01

    OBJECTIVE: To compare the cost-effectiveness of malaria treatment based on presumptive diagnosis with that of malaria treatment based on rapid diagnostic tests (RDTs). METHODS: We calculated direct costs (based on experience from Ethiopia and southern Sudan) and effectiveness (in terms of reduced over-treatment) of a free, decentralised treatment programme using artesunate plus amodiaquine (AS + AQ) or artemether-lumefantrine (ART-LUM) in a Plasmodium falciparum epidemic. Our main cost-effect...

  7. Low-Cost Inkjet Printing Technology for the Rapid Prototyping of Transducers.

    Science.gov (United States)

    Andò, Bruno; Baglio, Salvatore; Bulsara, Adi R; Emery, Teresa; Marletta, Vincenzo; Pistorio, Antonio

    2017-04-01

    Recently, there has been an upsurge in efforts dedicated to developing low-cost flexible electronics by exploiting innovative materials and direct printing technologies. This interest is motivated by the need for low-cost mass-production, shapeable, and disposable devices, and the rapid prototyping of electronics and sensors. This review, following a short overview of main printing processes, reports examples of the development of flexible transducers through low-cost inkjet printing technology.

  8. Generic Drugs - Decreasing Costs and Room for Increased Number of Kidney Transplantations.

    Science.gov (United States)

    Spasovski, Goce

    2015-01-01

    Kidney transplantation is the best treatment option in comparison to dialysis, although patients are obliged to receive life-long medical treatment with immunosuppressive drugs (ISDs) for prevention of the graft rejection. Such immunosuppressive treatment may be costly and associated with multiple adverse effects. Since costs are viewed as one of the major constraints for the increasing number of transplantation, the use of generic ISDs may decrease the overall cost of transplantation and raise the possibility for its further development. An ideal ISD should have the security margin between toxic and therapeutic dose, and prevent development of acute or chronic rejection of the transplanted kidney. This is particularly important for drugs with a "narrow therapeutical index" (NTI), where small differences in dose or concentration lead to dose and concentration-dependent, serious therapeutic failures and/or adverse drug reactions. The NTI generic drug is approved if within 90%-112% of the area under the curve of the original product the pharmacokinetics fulfills the strict criteria of pharmaceutical equivalence and bioequivalence. Every generic has to be proven to be bioequivalent to the innovator product, and not to other generic products because of the possible generic "drift". Thus, the generic ISDs may be economically attractive, but theoretically, they may pose a risk to transplant patients. Such risks may be reduced if a long-term clinical studies showing cost-effectiveness of generic ISDs in de novo and prevalent transplant patients for every new generic ISD are performed. In conclusion, the increased number of solid organ transplantation goes in line with the increased health care expenditure for ISDs. The generic immunosuppressants could be a possible solution if safely substituted for innovator products or other generic drug of choice. The substantial cost reduction needs to be redirected into organ donation initiatives so that more patients can benefit

  9. Last Mile Asset Monitoring; Low Cost Rapid Deployment Asset Monitoring

    Science.gov (United States)

    Zumr, Zdenek

    Installation and utilization of residential distribution transformers has not changed substantially over a long period of time. Utilities typically size their transformers based on a formula that takes into account broadly what types and how many dwellings will be connected. Most new residential dwellings feature 200 Amp service per household with an anticipated energy demand of under 20,000 kWh per year. Average electrical energy consumption varies from state to state but averages to 11,280 kWh per year. Energy demand is expected to fall into a typical residential load curve that shows increased demand early in the morning, then decreasing during the day and another peak early to late evening. Distribution transformers are sized at the limit of the combined evening peak with the assumption that the transformer has enough thermal mass to absorb short overloads that may occur when concurrent loading situations among multiple dwellings arise. The assumption that concurrent loading is of short duration and the transformer can cool off during the night time has been validated over the years and has become standard practice. This has worked well when dwelling loads follow an averaging scheme and low level of coincidence. With the arrival of electric vehicles (EV's) this assumption has to be reevaluated. The acquisition of an electric vehicle in a household can drive up energy demand by over 4000 kWh per year. Potentially problematic is the increased capacity of battery packs and the resulting proliferation of Level 2 chargers. The additional load of a single Level 2 charger concurring with the combined evening peak load will push even conservatively sized distribution transformers over their nameplate rating for a substantial amount of time. Additionally, unlike common household appliances of similar power requirements such as ovens or water heaters, a Level 2 battery charger will run at peak power consumption for several hours, and the current drawn by the EVs has very

  10. Personalized medicine for prevention: can risk stratified screening decrease colorectal cancer mortality at an acceptable cost?

    Science.gov (United States)

    Subramanian, Sujha; Bobashev, Georgiy; Morris, Robert J; Hoover, Sonja

    2017-04-01

    Tailored health care interventions are expected to transform clinical practice. The objective of this study was to develop an innovative model to assess the effectiveness, cost, and harms of risk stratified colorectal cancer screening. We updated a previously validated microsimulation model consisting of three interlinked components: risk assessment, natural history, and screening/treatment modules. We used data from representative national surveys and the literature to create a synthetic population that mimics the family history and genetic profile of the US population. We applied risk stratification based on published risk assessment tools to triage individuals into five risk categories: high, increased, medium, decreased, and low. On average, the incremental cost of risk stratified screening for colorectal cancer compared to the current approach at 60% and 80% compliance rates is $18,342 and $23,961 per life year gained. The harms in terms of false positives and perforations are consistently lower for personalized scenarios across all compliance rates. False positives are reduced by more than 47.0% and perforations by at least 9.9%. There is considerable uncertainty in the life years gained, but the reduction in harms remains stable under all scenarios. A key finding is that risk stratified screening can reduce harms at all levels of compliance. Therefore, selection of screening scenarios should include comprehensive comparisons of mortality, harms from screening, and cost. This study provides guidance for evaluating risk stratified cancer screening and further research is required to identify optimal implementation approaches in the real-world setting.

  11. Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost.

    Science.gov (United States)

    McCray, Sally; Maunder, Kirsty; Krikowa, Renee; MacKenzie-Shalders, Kristen

    2018-02-01

    65% vs 85%; P=0.011, respectively). Total mean plate waste decreased from 29% (traditional foodservice model) to 12% (room service) (Pservice across all Press Ganey meal scores: 68th to 86th percentile overall; 64th to 95th percentile for "quality of food"; and 60th to 99th percentile for "flavor of food." Evaluated during comparable times of the year, patient meal costs decreased by 15% with room service. A patient-centered foodservice model, such as room service, can improve patient nutritional intake and enhance patient satisfaction in a budget constrained health care environment. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  12. Decreasing pressure ulcer risk during hospital procedures: a rapid process improvement workshop.

    Science.gov (United States)

    Haugen, Vicki; Pechacek, Judy; Maher, Travis; Wilde, Joy; Kula, Larry; Powell, Julie

    2011-01-01

    A 300-bed acute care community hospital used a 2-day "Rapid Process Improvement Workshop" to identify factors contributing to facility-acquired pressure ulcers (PU). The Rapid Process Improvement Workshop included key stakeholders from all procedural areas providing inpatient services and used standard components of rapid process improvement: data analysis, process flow charting, factor identification, and action plan development.On day 1, the discovery process revealed increased PU risk related to prolonged immobility when transporting patients for procedures, during imaging studies, and during the perioperative period. On day 2, action plans were developed that included communication of PU risk or presence of an ulcer,measures to shorten procedure times when clinically appropriate, implementation of prevention techniques during procedures, and recommendations for mattress upgrades. In addition, educational programs about PU prevention were developed, schedules for presentations were established, and an online power point presentation was completed and placed in a learning management system module. Finally, our nursing department amended a hospital wide handoff communication tool to include skin status and PU risk level. This tool is used in all patient handoff situations, including nonnursing departments such as radiology. Patients deemed at risk for ulcers were provided "Braden Risk" armbands to enhance interdepartmental awareness.

  13. Implementation of Rapid Prototyping Tools for Power Loss and Cost Minimization of DC-DC Converters

    Directory of Open Access Journals (Sweden)

    Amruta V. Kulkarni

    2016-07-01

    Full Text Available In this paper, power loss and cost models of power electronic converters based on converter ratings and datasheet information are presented. These models aid in creating rapid prototypes which facilitate the component selection process. Through rapid prototyping, users can estimate power loss and cost which are essential in design decisions. The proposed approach treats main power electronic components of a converter as building blocks that can be arranged to obtain multiple topologies to facilitate rapid prototyping. In order to get system-level power loss and cost models, two processes are implemented. The first process automatically provides minimum power loss or cost estimates and identifies components for specific applications and ratings; the second process estimates power losses and costs of each component of interest as well as the whole system. Two examples are used to illustrate the proposed approaches—boost and buck converters in continuous conduction mode. Achieved cost and loss estimates are over 93% accurate when compared to measured losses and real cost data. This research presents derivations of the proposed models, experimental validation of the models and demonstration of a user friendly interface that integrates all the models. Tools presented in this paper are expected to be very useful for practicing engineers, designers, and researchers, and are flexible and adaptable with changing or new technologies and varying component prices.

  14. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

    Directory of Open Access Journals (Sweden)

    Bruce R Schackman

    2007-05-01

    Full Text Available New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti.A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care, rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care, and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000.In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource

  15. Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

    Science.gov (United States)

    Schackman, Bruce R; Neukermans, Christopher P; Fontain, Sandy N Nerette; Nolte, Claudine; Joseph, Patrice; Pape, Jean W; Fitzgerald, Daniel W

    2007-05-01

    New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti. A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care), rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care), and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs) of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000. In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource-poor countries

  16. Rapid, low-cost prototyping of centrifugal microfluidic devices for effective implementation of various microfluidic components

    Directory of Open Access Journals (Sweden)

    Smith, Suzanne

    2015-05-01

    Full Text Available A centrifugal microfluidic platform to develop various microfluidic operations – the first of its kind in South Africa – is presented. Rapid and low-cost prototyping of centrifugal microfluidic disc devices, as well as a set-up to test the devices using centrifugal forces, is described. Preliminary results show that various microfluidic operations such as fluidic valving, transportation, and microfluidic droplet generation can be achieved. This work provides a complete centrifugal microfluidic platform and the building blocks on which to develop a variety of microfluidic applications and potential products rapidly and at a low cost.

  17. Atkins diet program rapidly decreases atherogenic index of plasma in trained adapted overweight men.

    Science.gov (United States)

    Caminhotto, Rennan de Oliveira; Fonseca, Felipe Lucas Tavares da; Castro, Natalie Carolina de; Arantes, João Pedro; Sertié, Rogério Antonio Laurato

    2015-12-01

    The Atkins diet program is a great example of the application of low carbohydrate diets for obesity, with the intention of weight loss and improvement in cardiovascular risk (CV risk). A good CV risk predictor is the atherogenic index of plasma (AIP) calculated as log (TG/HDL [mmol]), which is strongly affected by serum triglycerides, which in turn is associated with the carbohydrate intake. This study determined the effect of the initial phase of Atkins diet program, consisting in 20 g/day of carbohydrate intake with positive urinary ketones measure, in AIP of 12 adult overweight trained adapted men. The AIP was calculated before and after intervention. After 14 days, BMI and triglycerides decreased significantly, while HDL-C increased. No alterations were described in LDL plasmatic concentration. Prior to the diet, 58.3% of subjects presented high CV risk and after 14 days of the diet program only 33.3% of subjects were classified as high CV risk, while more than 66% were low CV risk. The intervention was effective in 11 of 12 participants. However, in one person the dietary intervention increased AIP index. The initial phase of Atkins diet program could significantly decrease the AIP in 11 of 12 adult overweight trained adapted men. Dietary individual responses need to be more studied.

  18. Liver Stiffness Decreases Rapidly in Response to Successful Hepatitis C Treatment and Then Plateaus.

    Directory of Open Access Journals (Sweden)

    Sweta Chekuri

    Full Text Available To investigate the impact of a sustained virological response (SVR to hepatitis C virus (HCV treatment on liver stiffness (LS.LS, measured by transient elastography (FibroScan, demographic and laboratory data of patients treated with interferon (IFN-containing or IFN-free regimens who had an SVR24 (undetectable HCV viral load 24 weeks after the end of treatment were analyzed using two-tailed paired t-tests, Mann-Whitney Wilcoxon Signed-rank tests and linear regression. Two time intervals were investigated: pre-treatment to SVR24 and SVR24 to the end of follow-up. LS scores ≥ 12.5 kPa indicated LS-defined cirrhosis. A p-value below 0.05 was considered statistically significant.The median age of the patients (n = 100 was 60 years [IQR (interquartile range 54-64; 72% were male; 60% were Caucasian; and 42% had cirrhosis pre-treatment according to the FibroScan measurement. The median LS score dropped from 10.40 kPa (IQR: 7.25-18.60 pre-treatment to 7.60 kPa (IQR: 5.60-12.38 at SVR24, p <0.01. Among the 42 patients with LS-defined cirrhosis pre-treatment, 25 (60% of patients still had LS scores ≥ 12.5 kPa at SVR24, indicating the persistence of cirrhosis. The median change in LS was similar in patients receiving IFN-containing and IFN-free regimens: -1.95 kPa (IQR: -5.75 --0.38 versus -2.40 kPa (IQR: -7.70 --0.23, p = 0.74. Among 56 patients with a post-SVR24 LS measurement, the LS score changed by an additional -0.90 kPa (IQR: -2.98-0.5 during a median follow-up time of 1.17 (IQR: 0.88-1.63 years, which was not a statistically significant decrease (p = 0.99.LS decreased from pre-treatment to SVR24, but did not decrease significantly during additional follow-up. Earlier treatment may be needed to reduce the burden of liver disease.

  19. Cost-effectiveness of rapid susceptibility testing against second-line drugs for tuberculosis

    NARCIS (Netherlands)

    Dowdy, D. W.; van't Hoog, A.; Shah, M.; Cobelens, F.

    2014-01-01

    Drug susceptibility testing (DST) against second-line tuberculosis drugs (SLDs) is essential for improving outcomes among multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) cases. To evaluate the potential cost-effectiveness of rapid DST for SLDs. We constructed a

  20. Low-Cost Rapid Prototyping of Whole-Glass Microfluidic Devices

    Science.gov (United States)

    Yuen, Po Ki; Goral, Vasiliy N.

    2012-01-01

    A low-cost, straightforward, rapid prototyping of whole-glass microfluidic devices is presented using glass-etching cream that can be easily purchased in local stores. A self-adhered vinyl stencil cut out by a desktop digital craft cutter was used as an etching mask for patterning microstructures in glass using the glass-etching cream. A specific…

  1. Decreased cost and improved feeding tolerance in VLBW infants fed an exclusive human milk diet.

    Science.gov (United States)

    Assad, M; Elliott, M J; Abraham, J H

    2016-03-01

    Human milk is the best form of nutrition for preterm infants and has been associated with a lower incidence of necrotizing enterocolitis (NEC). Infants that develop NEC have a higher incidence of feeding intolerance and longer hospitalizations. The combination of a donor milk bank and donor milk-derived fortifier has changed feeding practices in neonatal intensive care units (NICU). The purpose of this study is to assess the benefits and cost of an exclusive human milk (EHM) diet in very low birth weight (VLBW) infants in a community level III NICU. This is a retrospective study including preterm infants ⩽28 weeks and/or VLBW (⩽1500 g) who were enrolled from March 2009 until March 2014. Infants were grouped as follows: group H (entirely human milk based, born March 2012 to 2014), group B (bovine-based fortifier and maternal milk, born March 2009 to 2012), group M (mixed combination of maternal milk, bovine-based fortifier and formula, born March 2009 to 2012) and group F (formula fed infants, born March 2009 to 2012). Baseline characteristics among the four groups were similar. The study included 293 infants between gestational ages 23 to 34 weeks and birth weights between 490 and 1700 g. Feeding intolerance occurred less often (P<0.0001), number of days to full feeds was lower (P<0.001), incidence of NEC was lower (P<0.011), and total hospitalization costs were lower by up to $106,968 per infant (P<0.004) in those fed an EHM diet compared with the other groups. Average weight gain per day was similar among the four groups (18.5 to 20.6 g per day). Implementing an EHM diet in our VLBW infants has led to a significant decrease in the incidence of NEC. Other benefits of this diet include: decreased feeding intolerance, shorter time to full feeds, shorter length of stay, and lower hospital and physician charges for extremely premature and VLBW infants.

  2. Design and use of performance measures to decrease low-value services and achieve cost-conscious care

    NARCIS (Netherlands)

    Baker, D.W.; Qaseem, A.; Reynolds, P.P.; Gardner, L.A.; Schneider, E.C.

    2013-01-01

    Improving quality of care while decreasing the cost of health care isa national priority. The American College of Physicians recently launched its High-Value Care Initiative to help physicians and patients understand the benefits, harms, and costs of interventions and to determine whether services

  3. Low Cost Rapid Response Spacecraft, (LCRRS): A Research Project in Low Cost Spacecraft Design and Fabrication in a Rapid Prototyping Environment

    Science.gov (United States)

    Spremo, Stevan; Bregman, Jesse; Dallara, Christopher D.; Ghassemieh, Shakib M.; Hanratty, James; Jackson, Evan; Kitts, Christopher; Klupar, Pete; Lindsay, Michael; Ignacio, Mas; hide

    2009-01-01

    The Low Cost Rapid Response Spacecraft (LCRRS) is an ongoing research development project at NASA Ames Research Center (ARC), Moffett Field, California. The prototype spacecraft, called Cost Optimized Test for Spacecraft Avionics and Technologies (COTSAT) is the first of what could potentially be a series of rapidly produced low-cost satellites. COTSAT has a target launch date of March 2009 on a SpaceX Falcon 9 launch vehicle. The LCRRS research system design incorporates use of COTS (Commercial Off The Shelf), MOTS (Modified Off The Shelf), and GOTS (Government Off The Shelf) hardware for a remote sensing satellite. The design concept was baselined to support a 0.5 meter Ritchey-Chretien telescope payload. This telescope and camera system is expected to achieve 1.5 meter/pixel resolution. The COTSAT team is investigating the possibility of building a fully functional spacecraft for $500,000 parts and $2,000,000 labor. Cost is dramatically reduced by using a sealed container, housing the bus and payload subsystems. Some electrical and RF designs were improved/upgraded from GeneSat-1 heritage systems. The project began in January 2007 and has yielded two functional test platforms. It is expected that a flight-qualified unit will be finished in December 2008. Flight quality controls are in place on the parts and materials used in this development with the aim of using them to finish a proto-flight satellite. For LEO missions the team is targeting a mission class requiring a minimum of six months lifetime or more. The system architecture incorporates several design features required by high reliability missions. This allows for a true skunk works environment to rapidly progress toward a flight design. Engineering and fabrication is primarily done in-house at NASA Ames with flight certifications on materials. The team currently employs seven Full Time Equivalent employees. The success of COTSATs small team in this effort can be attributed to highly cross trained

  4. Decrease in Urinary Incontinence Management Costs in Women Enrolled in a Clinical Trial of Weight Loss to Treat Urinary Incontinence

    Science.gov (United States)

    Subak, Leslee L.; Pinto, Angela Marinilli; Wing, Rena R.; Nakagawa, Sanae; Kusek, John W.; Herman, William H.; Kuppermann, Miriam

    2012-01-01

    Objective To estimate the effect of a decrease in urinary incontinence frequency on urinary incontinence management costs among women enrolled in a clinical trial of a weight loss intervention and to identify factors that predict change in cost. Methods This is a secondary cohort analysis of 338 obese and overweight women with ≥ 10 weekly episodes of urinary incontinence enrolled in an 18-month randomized clinical trial of a weight loss intervention compared to a structured education program to treat urinary incontinence. Quantities of resources used for incontinence management, including pads, additional laundry, and dry cleaning were reported by participants. Direct costs for urinary incontinence management (“cost”) were calculated by multiplying resources used by national resource costs (in 2006 U.S. dollars). Randomized groups were combined to examine the effects of change in incontinence frequency on cost. Possible predictors of change in cost were examined using generalized estimating equations controlling for factors associated with change in cost in univariable analyses. Results Mean (±SD) age was 53±10 years and baseline weight was 97+17 kg. Mean weekly urinary incontinence frequency was 24+18 at baseline and decreased by 37% at 6 months and 60% at 18 months follow-up (both Pincontinence frequency. Mean cost decreased by 54% at 6 months and 81% at 18 months (both Pincontinence episodes per week and 21% for each 5 kg of weight lost (Pincontinence, incontinence management cost decreased by 81% at 18 months ($327 per woman per year) and was strongly and independently associated with decreasing incontinence frequency. PMID:22825085

  5. Bucking logs to cable yarder capacity can decrease yarding costs and minimize wood wastage

    Science.gov (United States)

    Chris B. LeDoux

    1986-01-01

    Data from select time and motions studies and a forest model plot, used in a simulation model, show that logging managers planning felling, bucking, and limbing for a cable yarding operation must consider the effect of alternate bucking rules on wood wastage, yarding production rates and cost, the number of choker to fly and total logging costs. Results emphasize then...

  6. Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs

    NARCIS (Netherlands)

    Neelemaat, Floor; Bosmans, Judith E; Thijs, Abel; Seidell, Jaap C; van Bokhorst-de van der Schueren, Marian A E

    2012-01-01

    BACKGROUND & AIMS: Older people are vulnerable to malnutrition which leads to increased health care costs. The aim of this study was to evaluate the cost-effectiveness of nutritional supplementation from a societal perspective. DESIGN: This randomized controlled trial included hospital admitted

  7. Castable Bulk Metallic Glass Strain Wave Gears: Towards Decreasing the Cost of High-Performance Robotics.

    Science.gov (United States)

    Hofmann, Douglas C; Polit-Casillas, Raul; Roberts, Scott N; Borgonia, John-Paul; Dillon, Robert P; Hilgemann, Evan; Kolodziejska, Joanna; Montemayor, Lauren; Suh, Jong-Ook; Hoff, Andrew; Carpenter, Kalind; Parness, Aaron; Johnson, William L; Kennett, Andrew; Wilcox, Brian

    2016-11-24

    The use of bulk metallic glasses (BMGs) as the flexspline in strain wave gears (SWGs), also known as harmonic drives, is presented. SWGs are unique, ultra-precision gearboxes that function through the elastic flexing of a thin-walled cup, called a flexspline. The current research demonstrates that BMGs can be cast at extremely low cost relative to machining and can be implemented into SWGs as an alternative to steel. This approach may significantly reduce the cost of SWGs, enabling lower-cost robotics. The attractive properties of BMGs, such as hardness, elastic limit and yield strength, may also be suitable for extreme environment applications in spacecraft.

  8. Rapid Cost Assessment of Space Mission Concepts through Application of Complexity Indices

    Science.gov (United States)

    Peterson, Craig; Cutts, James; Balint, Tibor; Hall, James B.

    2008-01-01

    In 2005, the Solar System Exploration Strategic Roadmap Conmrittee (chartered by NASA to develop the roadmap for Solar System Exploration Missions for the coming decades) found itself posed with the difficult problem of sorting through several mission concepts and determining their relative costs. While detailed mission studies are the normal approach to costing, neither the budget nor schedule allotted to the conmrittee could support such studies. Members of the Jet Propulsion Laboratory (JPL) supporting the conmrittee were given the challenge of developing a semi-quantitative approach that could provide the relative costs of these missions, without requiring an in depth study of the missions. In response to this challenge, a rapid cost assessment methodology based on a set of mission cost/complexity indexes was developed. This methodology also underwent two separate validations, one comparing its results when applied to historical missions, and another comparing its estimates against those of veteran space mission managers. Remarkably good agreement was achieved, suggesting that this approach provides an effective early indication of space mission costs.

  9. Implementation of a shared-savings program for surgical supplies decreases inventory cost.

    Science.gov (United States)

    Eiferman, Daniel; Bhakta, Ankur; Khan, Safdar

    2015-10-01

    Management of operating room inventory has substantial cost-saving opportunities if surgeons agree to standardize supplies used to perform procedures; however, there is no incentive for surgeons to participate in these decisions, because the cost-savings are realized only by the hospital, not the practitioner. In an attempt to engage surgeons with the management of the operating room supply chain, a shared-savings programs was instituted that returned 50% of money saved to the surgery divisions. Opportunities for savings in the use of biologic mesh, cranial plating systems, and neurostimulators was identified. Each item was assigned a physician champion responsible for ensuring that there was clinical equipoise between the products being used. Any cost-savings realized during the fiscal year were shared 50-50 between the hospital and the surgery divisions. The total cost-savings was $893,865 with $446,932 being shared across 15 surgery divisions. Standardization of cranial plating systems ($374,805) generated the greatest amounts of savings followed by neurostimulators ($278,404) and biologic mesh ($240,655). Aligning hospital and surgeon incentives led to dramatic cost-savings and standardization of the operative inventory used. Quality of care is not compromised by this approach, and no conflicts of interest are created. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Organizational Perspectives on Rapid Response Team Structure, Function, and Cost: A Qualitative Study.

    Science.gov (United States)

    Smith, Patricia L; McSweeney, Jean

    Understanding how an organization determines structure and function of a rapid response team (RRT), as well as cost evaluation and implications, can provide foundational knowledge to guide decisions about RRTs. The objectives were to (1) identify influencing factors in organizational development of RRT structure and function and (2) describe evaluation of RRT costs. Using a qualitative, ethnographic design, nurse executives and experts in 15 moderate-size hospitals were interviewed to explore their decision-making processes in determining RRT structure and function. Face-to-face interviews were audio recorded and transcribed verbatim and verified for accurateness. Using content analysis and constant comparison, interview data were analyzed. Demographic data were analyzed using descriptive statistics. The sample included 27 participants from 15 hospitals in 5 south-central states. They described a variety of RRT responders and functions, with the majority of hospitals having a critical care charge nurse attending all RRT calls for assistance. Others described a designated RRT nurse with primary RRT duties as responder to all RRT calls. Themes of RRT development from the data included influencers, decision processes, and thoughts about cost. It is important to understand how hospitals determine optimal structure and function to enhance support of quality nursing care. Determining the impact of an RRT on costs and benefits is vital in balancing patient safety and limited resources. Future research should focus on clarifying differences between team structure and function in outcomes as well as the most effective means to estimate costs and benefits.

  11. The cost of implementing a nationwide program to decrease the epilepsy treatment gap in a high gap country

    Directory of Open Access Journals (Sweden)

    Gretchen L. Birbeck

    2012-10-01

    Full Text Available Healthcare systems in many low income countries have evolved to provide services for acute, infections and are poorly structured for the provision of chronic, non-communicable diseases which are increasingly common. Epilepsy is a common chronic neurologic condition and antiepileptic drugs are affordable, but the epilepsy treatment gap remains >90% in most African countries. The World Health Organization has recently released evidence-based guidelines for epilepsy care provision at the primary care level. Based upon these guidelines, we estimated all direct costs associated with epilepsy care provision as well as the cost of healthcare worker training and social marketing. We developed a model for epilepsy care delivery primarily by primary healthcare workers. We then used a variety of sources to develop cost estimates for the actual implementation and maintenance of this program being as comprehensive as possible to include all costs incurred within the health sector. Key sensitivity analyses were completed to better understand how changes in costs for individual aspects of care impact the overall cost of care delivery. Even after including the costs of healthcare worker retraining, social marketing and capital expenditures, epilepsy care can be provided at less than $25.00 per person with epilepsy per year. This is substantially less than for drugs alone for other common chronic conditions. Implementation of epilepsy care guidelines for patients receiving care at the primary care level is a cost effective approach to decreasing the epilepsy treatment gap in high gap, low income countries.

  12. Voluntary hyperventilation before a rapid-sequence induction of anesthesia does not decrease postintubation PaCO2.

    Science.gov (United States)

    Choinière, A; Girard, F; Boudreault, D; Ruel, M; Girard, D C

    2001-11-01

    To prevent hypercapnia, voluntary hyperventilation is recommended for patients with increased intracranial pressure before the induction of general anesthesia. We sought to determine whether this maneuver results in a lower PaCO2 than breathing 3 min of oxygen 100% by face mask (preoxygenation) after intubation. Thirty patients requiring general anesthesia were randomly assigned to breathe either 3 min of oxygen 100% by face mask (Group P) or 1 min of oxygen 100% followed by 2 min of voluntary hyperventilation with oxygen 100% (Group H). All patients received a standard rapid-sequence induction of anesthesia followed by a 90-s period of apnea. Patients were then tracheally intubated and mechanically ventilated. Five arterial blood gas samples were taken: with room air, after preoxygenation or hyperventilation, after 60 and 90 s of apnea, and after tracheal intubation. Voluntary hyperventilation decreased PaCO2 before rapid-sequence induction (hyperventilation, 30.0 +/- 3.5 mm Hg versus preoxygenation, 37.9 +/- 5.2 mm Hg; P hyperventilation, 36.1 +/- 3.3 mm Hg versus preoxygenation, 35.6 +/- 3.4 mm Hg; P = 0.673), and no benefit was found after intubation (hyperventilation, 40.5 +/- 3.9 mm Hg versus preoxygenation, 41.4 +/- 2.7 mm Hg; P = 0.603). We conclude that voluntary hyperventilation before rapid-sequence induction does not provide protection against potential hypercapnia during intubation. Voluntary hyperventilation before anesthesia induction is recommended for patients with increased intracranial pressure to prevent hypercapnia. This randomized, prospective study demonstrated that this maneuver does not result in a lower postintubation PaCO2 than standard preoxygenation.

  13. Productivity costs decrease after endoscopic sinus surgery for refractory chronic rhinosinusitis.

    Science.gov (United States)

    Rudmik, Luke; Smith, Timothy L; Mace, Jess C; Schlosser, Rodney J; Hwang, Peter H; Soler, Zachary M

    2016-03-01

    The primary objective of this pilot study was to define the change in productivity costs following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Secondary objectives were to identify CRS-related characteristics that may influence the degree of productivity improvement after ESS. Prospective, multi-institutional, observational cohort study. The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time were quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US Census and the 2013 US Department of Labor statistics. Twenty-seven patients with refractory CRS who underwent ESS were followed for a mean of 15 months (range, 8-25 months). Following ESS, there were improvements in annual absenteeism (22 days reduced to 3 days), annual presenteeism (41 days reduced to 19 days), and annual household days lost (12 days reduced to 6 days). Overall, the preoperative productivity costs were reduced after ESS ($9,190 vs. $3,373, respectively; P costs associated with receiving ESS for refractory CRS. Future studies with larger sample sizes will need to validate the results from this pilot study. 2c Laryngoscope, 126:570-574, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Adoption of Angiomax at Christus Santa Rosa Medical Center decreases costs and increases satisfaction.

    Science.gov (United States)

    Starin, Elvira

    2005-01-01

    Angiomax allows for easier post-percutaneous coronary intervention care and enhanced throughput and has become the gold standard of care in our institution. This article describes how Angiomax was brought into our hospital; the rationale and science to support its use; and the resulting patient and staff satisfaction, improved throughput, and cost savings.

  15. DECREASING THE COST OF WIND TURBINE WITH VERTICALLY INSTALLED ROTOR WHEEL

    Directory of Open Access Journals (Sweden)

    Anisimov V.K.

    2008-08-01

    Full Text Available The cost dependence of the most expensive parts of the vertical rotor windmill and their sizes (height and diameter was studied. The formulae were obtained allowing determining the optimum value of such dependence for different modifications of a windmill: with or without wind concentrator.

  16. Orlistat for the treatment of obesity: rapid review and cost-effectiveness model.

    Science.gov (United States)

    Foxcroft, D R; Milne, R

    2000-10-01

    The aim of this study is to clarify the potential benefits, disbenefits and costs of Orlistat for the treatment of obesity. The method was a search for relevant systematic reviews and randomized controlled trials, in Medline, Pre-Medline, Embase and the Cochrane Library, using Orlistat and its synonyms. Identified trials were appraised using a standard appraisal checklist and trial data were extracted for use in cost-effectiveness modelling. Three large multicentre, randomized placebo controlled trials were included in the rapid review. On average, Orlistat results in obese people losing an additional 3-4% of their initial body weight over diet alone during a 2 year period. There was no strong evidence that this short-term weight loss would have a longer-term impact on morbidity and mortality. The cost utility of Orlistat treatment was estimated at around 46,000 Pounds per Quality Adjusted Life Year gained (extreme values sensitivity analysis 14,000 Pounds to 132,000 Pounds). This rapid review raises some important questions about the potential value of Orlistat in the treatment of obesity. Further research is needed, not only to clarify the longer-term impact of Orlistat treatment, but also to uncover the longer-term impact on mortality and morbidity from short-term weight loss.

  17. Rapid prototyping prosthetic hand acting by a low-cost shape-memory-alloy actuator.

    Science.gov (United States)

    Soriano-Heras, Enrique; Blaya-Haro, Fernando; Molino, Carlos; de Agustín Del Burgo, José María

    2018-01-08

    The purpose of this article is to develop a new concept of modular and operative prosthetic hand based on rapid prototyping and a novel shape-memory-alloy (SMA) actuator, thus minimizing the manufacturing costs. An underactuated mechanism was needed for the design of the prosthesis to use only one input source. Taking into account the state of the art, an underactuated mechanism prosthetic hand was chosen so as to implement the modifications required for including the external SMA actuator. A modular design of a new prosthesis was developed which incorporated a novel SMA actuator for the index finger movement. The primary objective of the prosthesis is achieved, obtaining a modular and functional low-cost prosthesis based on additive manufacturing executed by a novel SMA actuator. The external SMA actuator provides a modular system which allows implementing it in different systems. This paper combines rapid prototyping and a novel SMA actuator to develop a new concept of modular and operative low-cost prosthetic hand.

  18. Response of canopy nitrogen uptake to a rapid decrease in bulk nitrate deposition in two eastern Canadian boreal forests.

    Science.gov (United States)

    Houle, D; Marty, C; Duchesne, L

    2015-01-01

    A few studies have reported a recent and rapid decline in NO3(-) deposition in eastern North America. Whether this trend can be observed at remote boreal sites with low rates of N deposition and how it could impact canopy uptake (CU) of N remain unknown. Here we report trends between 1997/1999 and 2012 for precipitation, throughfall N deposition as well as inorganic N CU for two boreal forest sites of Quebec, Canada, with contrasted N deposition rates and tree species composition. NO3(-) bulk deposition declined by approximately 50% at both sites over the studied period while no change was observed for NH4(+). As a result, the contribution of NH4(+) to inorganic N deposition changed from ~33% to more than 50% during the study period. On average, 52-59% of N deposition was intercepted by the canopy, the retention being higher for NH4(+) (60-67%) than for NO3(-) (45-54%). The decrease in NO3(-) bulk deposition and the increase in the NH4(+):NO3(-) ratio had important impacts on N-canopy interactions. The contribution of NH4(+) CU to that of total inorganic N CU increased at both sites but the trend was significant only at Tirasse (lowest N deposition). At this site, absolute NO3(-) CU significantly decreased (as did total N CU) during the study period, a consequence of the strong relationship (r(2) = 0.88) between NO3(-) bulk deposition and NO3(-) CU. Our data suggest that N interactions with forest canopies may change rapidly with changes in N deposition as well as with tree species composition.

  19. How Performance-Contingent Reward Prospect Modulates Cognitive Control: Increased Cue Maintenance at the Cost of Decreased Flexibility

    Science.gov (United States)

    Hefer, Carmen; Dreisbach, Gesine

    2017-01-01

    Growing evidence suggests that reward prospect promotes cognitive stability in terms of increased context or cue maintenance. In 3 Experiments, using different versions of the AX-continuous performance task, we investigated whether this reward effect comes at the cost of decreased cognitive flexibility. Experiment 1 shows that the reward induced…

  20. Can We Increase the Value and Decrease the Cost of Clinical Skills Assessment?

    Science.gov (United States)

    Burdick, William P; Boulet, John R; LeBlanc, Kim Edward

    2017-08-22

    Although the authors do not agree with medical students' bid to end the United States Medical Licensing Examination Step 2 Clinical Skills or Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation tests, they concur with Ecker and colleagues that conducting further research to support the validity argument, providing greater feedback on performance, and exploring options to reduce costs are important for addressing students' concerns. Evidence to support the validity of clinical skills exam scores and associated inferences already exists. What is lacking, and would help further justify the use of these examinations, is more evidence to support the "extrapolation" argument-that is, is performance on these examinations related to actual patient care? Enhanced feedback on exam performance should also be considered. While performance data from licensing examinations should be used judiciously given the primary purpose of these tests, additional data would be helpful to learners and their institutions. Centralized testing remains the least costly design, but efficiencies of standardized patient training, case development, and scoring can be reviewed. Scoring modifications made in the past several years at substantial cost should be evaluated to determine whether they have achieved desired goals. Testing organizations can and should embrace these essential elements of transparency and accountability to address concerns about the value of clinical skills examinations.

  1. A RAPID ASSESSMENT MODEL FOR UNDERSTANDING THE SOCIAL COST OF CARBON

    OpenAIRE

    STEPHEN C. NEWBOLD; CHARLES GRIFFITHS; CHRIS MOORE; ANN WOLVERTON; ELIZABETH KOPITS

    2013-01-01

    The "social cost of carbon" (SCC) is the present value of the stream of future damages from one additional unit of carbon emissions in a particular year. This paper develops a rapid assessment model for the SCC. The model includes the essential ingredients for calculating the SCC at the global scale and is designed to be transparent and easy to use and modify. Our goal is to provide a tool to help analysts and decision-makers quickly explore the implications of various modeling assumptions fo...

  2. The Rapid Transit System That Achieves Higher Performance with Lower Life-Cycle Costs

    Science.gov (United States)

    Sone, Satoru; Takagi, Ryo

    In the age of traction system made of inverter and ac traction motors, distributed traction system with pure electric brake of regenerative mode has been recognised very advantageous. This paper proposes a new system as the lowest life-cycle cost system for high performance rapid transit, a new architecture and optimum parameters of power feeding system, and a new running method of trains. In Japan, these components of this proposal, i.e. pure electric brake and various countermeasures of reducing loss of regeneration have been already popular but not as yet the new running method for better utilisation of the equipment and for lower life-cycle cost. One example of what are proposed in this paper will be made as Tsukuba Express, which is under construction as the most modern commuter railway in Greater Tokyo area.

  3. High-throughput rapid-prototyping of low-cost paper-based microfluidics.

    Science.gov (United States)

    Ghaderinezhad, Fariba; Amin, Reza; Temirel, Mikail; Yenilmez, Bekir; Wentworth, Adam; Tasoglu, Savas

    2017-06-15

    Paper-based micro analytical devices offer significant advantages compared to the conventional microfluidic chips including cost-effectiveness, ease of fabrication, and ease of use while preserving critical features including strong capillary action and biological compatibility. In this work, we demonstrate an inexpensive, rapid method for high-throughput fabrication of paper-based microfluidics by patterning hydrophobic barriers using a desktop pen plotter integrated with a custom-made, low-cost paper feeder. We tested various types of commercial permanent markers and compared their water-resistant capabilities for creating hydrophobic barriers. Additionally, we studied the performance of markers with different types of paper, plotting speeds, and pattern dimensions. To verify the effectiveness of the presented fabrication method, colorimetric analysis was performed on the results of a glucose assay.

  4. Adapting and Evaluating a Rapid, Low-Cost Method to Enumerate Flies in the Household Setting.

    Science.gov (United States)

    Wolfe, Marlene K; Dentz, Holly N; Achando, Beryl; Mureithi, MaryAnne; Wolfe, Tim; Null, Clair; Pickering, Amy J

    2017-02-08

    Diarrhea is a leading cause of death among children under 5 years of age worldwide. Flies are important vectors of diarrheal pathogens in settings lacking networked sanitation services. There is no standardized method for measuring fly density in households; many methods are cumbersome and unvalidated. We adapted a rapid, low-cost fly enumeration technique previously developed for industrial settings, the Scudder fly grill, for field use in household settings. We evaluated its performance in comparison to a sticky tape fly trapping method at latrine and food preparation areas among households in rural Kenya. The grill method was more sensitive; it detected the presence of any flies at 80% (433/543) of sampling locations versus 64% (348/543) of locations by the sticky tape. We found poor concordance between the two methods, suggesting that standardizing protocols is important for comparison of fly densities between studies. Fly species identification was feasible with both methods; however, the sticky tape trap allowed for more nuanced identification. Both methods detected a greater presence of bottle flies near latrines compared with food preparation areas (P < 0.01). The grill method detected more flies at the food preparation area compared with near the latrine (P = 0.014) while the sticky tape method detected no difference. We recommend the Scudder grill as a sensitive fly enumeration tool that is rapid and low cost to implement. © The American Society of Tropical Medicine and Hygiene.

  5. Rapid Bioassessment and In Situ Bioassay: Cost Effective Tools for Environmental Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Wike, L.D.

    2002-08-23

    Environmental impact can be difficult to assess, especially at the ecosystem level. Any impact assessment methodology that can give cost effective and timely results is highly desirable. Rapid bioassessment (RBA) is cost effective and produces timely results. Several types of RBA have been used at the Savannah River Site (SRS) to assess stream conditions, including the Index of Biotic Integrity (IBI) based on fish community characteristics, and various techniques using aquatic macroinvertebrate species diversity and abundance. In an attempt to broaden the applicability of the RBA concept, we have also begun to develop RBA techniques for seep-fed wetlands and terrestrial habitats. These techniques will focus on vertebrate and macroinvertebrate assemblages for seep-fed wetlands and arthropod assemblages for terrestrial habitats. In situ bioassay is another technique that could be used for rapid and economical assessment of the effects of anthropogenic disturbance. We propose the development of two methods of in situ bioassay that can address bioavailability of constituents of concern. The use of caged bioassay organisms can be applied to terrestrial systems such as capped or existing waste sites using the common house cricket. Another proposed bioassay could use a resident species, such as the imported red fire ant, which is found in disturbed habitats and open areas such as waste sites. Combining in situ techniques with RBA methodologies has the potential to provide a comprehensive assessment of chemical and physical impacts to a wide range of ecosystem types.

  6. VAPI: low-cost, rapid automated visual inspection system for Petri plate analysis

    Science.gov (United States)

    Chatburn, L. T.; Kirkup, B. C.; Polz, M. F.

    2007-09-01

    Most culture-based microbiology tasks utilize a petri plate during processing, but rarely do the scientists capture the full information available from the plate. In particular, visual analysis of plates is an under-developed rich source of data that can be rapid and non-invasive. However, collecting this data has been limited by the difficulties of standardizing and quantifying human observations, by the limits of a scientists' fatigue, and by the cost of automating the process. The availability of specialized counting equipment and intelligent camera systems has not changed this - they are prohibitively expensive for many laboratories, only process a limited number of plate types, are often destructive to the sample, and have limited accuracy. This paper describes an automated visual inspection solution, VAPI, that employs inexpensive consumer computing hardware and digital cameras along with custom cross-platform open-source software written in C++, combining Trolltech's Qt GUI toolkit with Intel's OpenCV computer vision library. The system is more accurate than common commercial systems costing many times as much, while being flexible in use and offering comparable responsiveness. VAPI not only counts colonies but also sorts and enumerates colonies by morphology, tracks colony growth by time series analysis, and provides other analytical resources. Output to XML files or directly to a database provides data that can be easily maintained and manipulated by the end user, offering ready access for system enhancement, interaction with other software systems, and rapid development of advanced analysis applications.

  7. Ion Torren Semiconductor Sequencing Allows Rapid, Low Cost Sequencing of the Human Exome ( 7th Annual SFAF Meeting, 2012)

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, David [EdgeBio

    2012-06-01

    David Jenkins on "Ion Torrent semiconductor sequencing allows rapid, low-cost sequencing of the human exome" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

  8. A Rapid and Low-Cost PCR Thermal Cycler for Low Resource Settings.

    Directory of Open Access Journals (Sweden)

    Grace Wong

    Full Text Available Many modern molecular diagnostic assays targeting nucleic acids are typically confined to developed countries or to the national reference laboratories of developing-world countries. The ability to make technologies for the rapid diagnosis of infectious diseases broadly available in a portable, low-cost format would mark a revolutionary step forward in global health. Many molecular assays are also developed based on polymerase chain reactions (PCR, which require thermal cyclers that are relatively heavy (>20 pounds and need continuous electrical power. The temperature ramping speed of most economical thermal cyclers are relatively slow (2 to 3 °C/s so a polymerase chain reaction can take 1 to 2 hours. Most of all, these thermal cyclers are still too expensive ($2k to $4k for low-resource setting uses.In this article, we demonstrate the development of a low-cost and rapid water bath based thermal cycler that does not require active temperature control or continuous power supply during PCR. This unit costs $130 to build using commercial off-the-shelf items. The use of two or three vacuum-insulated stainless-steel Thermos food jars containing heated water (for denaturation and annealing/extension steps and a layer of oil on top of the water allow for significantly stabilized temperatures for PCR to take place. Using an Arduino-based microcontroller, we automate the "archaic" method of hand-transferring PCR tubes between water baths.We demonstrate that this innovative unit can deliver high speed PCR (17 s per PCR cycle with the potential to go beyond the 1,522 bp long amplicons tested in this study and can amplify from templates down to at least 20 copies per reaction. The unit also accepts regular PCR tubes and glass capillary tubes. The PCR efficiency of our thermal cycler is not different from other commercial thermal cyclers. When combined with a rapid nucleic acid detection approach, the thermos thermal cycler (TTC can enable on-site molecular

  9. A Rapid and Low-Cost PCR Thermal Cycler for Infectious Disease Diagnostics.

    Science.gov (United States)

    Chan, Kamfai; Wong, Pui-Yan; Yu, Peter; Hardick, Justin; Wong, Kah-Yat; Wilson, Scott A; Wu, Tiffany; Hui, Zoe; Gaydos, Charlotte; Wong, Season S

    2016-01-01

    The ability to make rapid diagnosis of infectious diseases broadly available in a portable, low-cost format would mark a great step forward in global health. Many molecular diagnostic assays are developed based on using thermal cyclers to carry out polymerase chain reaction (PCR) and reverse-transcription PCR for DNA and RNA amplification and detection, respectively. Unfortunately, most commercial thermal cyclers are expensive and need continuous electrical power supply, so they are not suitable for uses in low-resource settings. We have previously reported a low-cost and simple approach to amplify DNA using vacuum insulated stainless steel thermoses food cans, which we have named it thermos thermal cycler or TTC. Here, we describe the use of an improved set up to enable the detection of viral RNA targets by reverse-transcription PCR (RT-PCR), thus expanding the TTC's ability to identify highly infectious, RNA virus-based diseases in low resource settings. The TTC was successful in demonstrating high-speed and sensitive detection of DNA or RNA targets of sexually transmitted diseases, HIV/AIDS, Ebola hemorrhagic fever, and dengue fever. Our innovative TTC costs less than $200 to build and has a capacity of at least eight tubes. In terms of speed, the TTC's performance exceeded that of commercial thermal cyclers tested. When coupled with low-cost endpoint detection technologies such as nucleic acid lateral-flow assay or a cell-phone-based fluorescence detector, the TTC will increase the availability of on-site molecular diagnostics in low-resource settings.

  10. A Rapid and Low-Cost PCR Thermal Cycler for Infectious Disease Diagnostics.

    Directory of Open Access Journals (Sweden)

    Kamfai Chan

    Full Text Available The ability to make rapid diagnosis of infectious diseases broadly available in a portable, low-cost format would mark a great step forward in global health. Many molecular diagnostic assays are developed based on using thermal cyclers to carry out polymerase chain reaction (PCR and reverse-transcription PCR for DNA and RNA amplification and detection, respectively. Unfortunately, most commercial thermal cyclers are expensive and need continuous electrical power supply, so they are not suitable for uses in low-resource settings. We have previously reported a low-cost and simple approach to amplify DNA using vacuum insulated stainless steel thermoses food cans, which we have named it thermos thermal cycler or TTC. Here, we describe the use of an improved set up to enable the detection of viral RNA targets by reverse-transcription PCR (RT-PCR, thus expanding the TTC's ability to identify highly infectious, RNA virus-based diseases in low resource settings. The TTC was successful in demonstrating high-speed and sensitive detection of DNA or RNA targets of sexually transmitted diseases, HIV/AIDS, Ebola hemorrhagic fever, and dengue fever. Our innovative TTC costs less than $200 to build and has a capacity of at least eight tubes. In terms of speed, the TTC's performance exceeded that of commercial thermal cyclers tested. When coupled with low-cost endpoint detection technologies such as nucleic acid lateral-flow assay or a cell-phone-based fluorescence detector, the TTC will increase the availability of on-site molecular diagnostics in low-resource settings.

  11. Rapid experimental evolution of pesticide resistance in C. elegans entails no costs and affects the mating system.

    Directory of Open Access Journals (Sweden)

    Patricia C Lopes

    Full Text Available Pesticide resistance is a major concern in natural populations and a model trait to study adaptation. Despite the importance of this trait, the dynamics of its evolution and of its ecological consequences remain largely unstudied. To fill this gap, we performed experimental evolution with replicated populations of Caenorhabditis elegans exposed to the pesticide Levamisole during 20 generations. Exposure to Levamisole resulted in decreased survival, fecundity and male frequency, which declined from 30% to zero. This was not due to differential susceptibility of males. Rather, the drug affected mobility, resulting in fewer encounters, probably leading to reduced outcrossing rates. Adaptation, i.e., increased survival and fecundity, occurred within 10 and 20 generations, respectively. Male frequency also increased by generation 20. Adaptation costs were undetected in the ancestral environment and in presence of Ivermectin, another widely-used pesticide with an opposite physiological effect. Our results demonstrate that pesticide resistance can evolve at an extremely rapid pace. Furthermore, we unravel the effects of behaviour on life-history traits and test the environmental dependence of adaptation costs. This study establishes experimental evolution as a powerful tool to tackle pesticide resistance, and paves the way to further investigations manipulating environmental and/or genetic factors underlying adaptation to pesticides.

  12. Cost-effective and rapid blood analysis on a cell-phone.

    Science.gov (United States)

    Zhu, Hongying; Sencan, Ikbal; Wong, Justin; Dimitrov, Stoyan; Tseng, Derek; Nagashima, Keita; Ozcan, Aydogan

    2013-04-07

    We demonstrate a compact and cost-effective imaging cytometry platform installed on a cell-phone for the measurement of the density of red and white blood cells as well as hemoglobin concentration in human blood samples. Fluorescent and bright-field images of blood samples are captured using separate optical attachments to the cell-phone and are rapidly processed through a custom-developed smart application running on the phone for counting of blood cells and determining hemoglobin density. We evaluated the performance of this cell-phone based blood analysis platform using anonymous human blood samples and achieved comparable results to a standard bench-top hematology analyser. Test results can either be stored on the cell-phone memory or be transmitted to a central server, providing remote diagnosis opportunities even in field settings.

  13. Calotropis procera seedlings could be used as a rapid cost effective bioindicator for measuring aluminum environmental pollution

    Science.gov (United States)

    Mosa, Kareem A.; El-Keblawy, Ali; Najar, Atyat

    2017-04-01

    Calotropis procera seedlings could be used as a rapid cost effective bioindicator for measuring aluminum environmental pollution Kareem A. Mosa, Ali El-Keblawy, Atyat Najar Department of Applied Biology, College of Sciences, University of Sharjah, UAE Rapid industrialization and urbanization processes has led to the incorporation of different heavy metals in natural resources like soil, water and air thus affecting their quality. Aluminum (Al) is a dominant heavy metal pollutant that causes serious toxic effects to living systems including plants. Therefore, it is critical to regularly monitor the changes in Al levels in natural resources. Living organisms could be used as bioindicators for monitoring and measuring the levels of heavy metals in environmental samples. The aim of this study was to develop a cost effective bioindicator for monitoring aluminum (Al) and assess the damage caused by Al bioaccumulation using the root system of Calotropis Procera seedlings. A hydroponic system was developed for growing C. Procera in four different concentrations of Al (20, 40, 60 and 80 ppm). Root length and shoot fresh and dry weights were assessed after 5, 10, 15 and 20 days of Al treatment. The results showed remarkable sensitivity of C. Procera seedlings for the different concentrations of Al. There was gradual but significant decrease in C. Procera root length with the increase in the Al concentrations. X-ray fluorescence microscopy (XRF) analysis indicated a significant increase in Al concentration in C. Procera roots with the increase of both Al concentration in the hydroponic solution and the growing period. Moreover, electrical conductivity analysis showed that Al induced damage to C. Procera root plasma membrane as indicated by the increase in electrolyte leakages. Randomly amplified polymorphic DNA (RAPD) PCR analysis confirmed the genotoxin effect of Al which induced C. Procera genomic DNA modification. Altogether, the result demonstrated that C. Procera could

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

    Science.gov (United States)

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

    2018-01-08

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

  15. A Rapid and Low-Cost Nonlithographic Method to Fabricate Biomedical Microdevices for Blood Flow Analysis

    Directory of Open Access Journals (Sweden)

    Elmano Pinto

    2014-12-01

    Full Text Available Microfluidic devices are electrical/mechanical systems that offer the ability to work with minimal sample volumes, short reactions times, and have the possibility to perform massive parallel operations. An important application of microfluidics is blood rheology in microdevices, which has played a key role in recent developments of lab-on-chip devices for blood sampling and analysis. The most popular and traditional method to fabricate these types of devices is the polydimethylsiloxane (PDMS soft lithography technique, which requires molds, usually produced by photolithography. Although the research results are extremely encouraging, the high costs and time involved in the production of molds by photolithography is currently slowing down the development cycle of these types of devices. Here we present a simple, rapid, and low-cost nonlithographic technique to create microfluidic systems for biomedical applications. The results demonstrate the ability of the proposed method to perform cell free layer (CFL measurements and the formation of microbubbles in continuous blood flow.

  16. Low-Cost Rotating Experimentation in Compressor Aerodynamics Using Rapid Prototyping

    Directory of Open Access Journals (Sweden)

    Mathias Michaud

    2016-01-01

    Full Text Available With the rapid evolution of additive manufacturing, 3D printed parts are no longer limited to display purposes but can also be used in structural applications. The objective of this paper is to show that 3D prototyping can be used to produce low-cost rotating turbomachinery rigs capable of carrying out detailed flow measurements that can be used, among other things, for computational fluid dynamics (CFD code validation. A fully instrumented polymer two-stage axial-mixed flow compressor test rig was designed and fabricated with stereolithography (SLA technology by a team of undergraduate students as part of a senior-year design course. Experiments were subsequently performed on this rig to obtain both the overall pressure rise characteristics of the compressor and the stagnation pressure distributions downstream of the blade rows for comparison with CFD simulations. In doing so, this work provides a first-of-a-kind assessment of the use of polymer additive technology for low-cost rotating turbomachinery experimentation with detailed measurements.

  17. Design and use of performance measures to decrease low-value services and achieve cost-conscious care.

    Science.gov (United States)

    Baker, David W; Qaseem, Amir; Reynolds, P Preston; Gardner, Lea Anne; Schneider, Eric C

    2013-01-01

    Improving quality of care while decreasing the cost of health care isa national priority. The American College of Physicians recently launched its High-Value Care Initiative to help physicians and patients understand the benefits, harms, and costs of interventions and to determine whether services provide good value. Public and private payers continue to measure underuse of high-value services(for example, preventive services, medications for chronic disease),but they are now widely using performance measures to assess use of low-value interventions (such as imaging for patients with uncomplicated low back pain) and using the results for public reporting and pay-for-performance. This paper gives an overview of performance measures that target low-value services to help physicians understand the strengths and limitations of these measures,provides specific examples of measures that assess use of low-value services, and discusses how these measures can be used in clinical practice and policy.

  18. The cost-effectiveness of rapid HIV testing in substance abuse treatment: results of a randomized trial.

    Science.gov (United States)

    Schackman, Bruce R; Metsch, Lisa R; Colfax, Grant N; Leff, Jared A; Wong, Angela; Scott, Callie A; Feaster, Daniel J; Gooden, Lauren; Matheson, Tim; Haynes, Louise F; Paltiel, A David; Walensky, Rochelle P

    2013-02-01

    The President's National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk-reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost-Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. Rapid, simple, and cost-effective treatments to achieve long-term hydrophilic PDMS surfaces

    Science.gov (United States)

    Hemmilä, Samu; Cauich-Rodríguez, Juan V.; Kreutzer, Joose; Kallio, Pasi

    2012-10-01

    This paper describes rapid, simple, and cost-effective treatments for producing biocompatible and long-term hydrophilic polydimethylsiloxane (PDMS) surfaces identified in an experimental study investigating 39 treatments in all. The wetting of the surfaces was monitored during six months. Changes in surface morphology and chemical composition were also analyzed. Some of the treatments are presented here for the first time, while for earlier presented treatments the selection of investigated parameters was wider and the observation period for the surface wetting longer. The PDMS surfaces were modified by surface activation, physisorption, and synthesis of both “grafting to” and “grafting from” polymer brushes. In surface activation, the PDMS sample was exposed to oxygen plasma, with several combinations of exposure time and RF power. In the physisorption and synthesis of polymer brushes, three commercially available and biocompatible chemicals were used: 2-hydroxyethyl methacrylate (HEMA), polyethylene glycol (PEG), and polyvinylpyrrolidone (PVP). Thirty-three of the 39 treatments rendered the PDMS hydrophilic, and in 12 cases the hydrophilicity lasted at least six months. Seven of these long-term hydrophilic coatings supported a contact angle of 30° or less. Three of the long-lasting hydrophilic coatings required only minutes to prepare.

  20. Improved rapid magnitude estimation for a community-based, low-cost MEMS accelerometer network

    Science.gov (United States)

    Chung, Angela I.; Cochran, Elizabeth S.; Kaiser, Anna E.; Christensen, Carl M.; Yildirim, Battalgazi; Lawrence, Jesse F.

    2015-01-01

    Immediately following the Mw 7.2 Darfield, New Zealand, earthquake, over 180 Quake‐Catcher Network (QCN) low‐cost micro‐electro‐mechanical systems accelerometers were deployed in the Canterbury region. Using data recorded by this dense network from 2010 to 2013, we significantly improved the QCN rapid magnitude estimation relationship. The previous scaling relationship (Lawrence et al., 2014) did not accurately estimate the magnitudes of nearby (estimates earthquake magnitudes within 1 magnitude unit of the GNS Science GeoNet earthquake catalog magnitudes for 99% of the events tested, within 0.5 magnitude units for 90% of the events, and within 0.25 magnitude units for 57% of the events. These magnitudes are reliably estimated within 3 s of the initial trigger recorded on at least seven stations. In this report, we present the methods used to calculate a new scaling relationship and demonstrate the accuracy of the revised magnitude estimates using a program that is able to retrospectively estimate event magnitudes using archived data.

  1. Growth-promoting technologies decrease the carbon footprint, ammonia emissions, and costs of California beef production systems.

    Science.gov (United States)

    Stackhouse, K R; Rotz, C A; Oltjen, J W; Mitloehner, F M

    2012-12-01

    Increased animal performance is suggested as one of the most effective mitigation strategies to decrease greenhouse gas (GHG) and ammonia (NH(3)) emissions from livestock production per unit of product produced. Little information exists, however, on the effects of increased animal productivity on the net decrease in emission from beef production systems. A partial life cycle assessment (LCA) was conducted using the Integrated Farm System Model (IFSM) to estimate GHG and NH(3) emissions from representative beef production systems in California that use various management technologies to enhance animal performance. The IFSM is a farm process model that simulates crop growth, feed production, animal performance, and manure production and handling through time to predict the performance, economics, and environmental impacts of production systems. The simulated beef production systems compared were 1) Angus-natural, with no use of growth-enhancing technologies, 2) Angus-implant, with ionophore and growth-promoting implant (e.g., estrogen/trenbolone acetate-based) application, 3) Angus-ß2-adrenergic agonists (BAA; e.g., zilpaterol), with ionophore, growth-promoting implant, and BAA application, 4) Holstein-implant, with growth implant and ionophore application, and 5) Holstein-BAA, with ionophore, growth implant, and BAA use. During the feedlot phase, use of BAA decreased NH(3) emission by 4 to 9 g/kg HCW, resulting in a 7% decrease in NH(3) loss from the full production system. Combined use of ionophore, growth implant, and BAA treatments decreased NH(3) emission from the full production system by 14 g/kg HCW, or 13%. The C footprint of beef was decreased by 2.2 kg carbon dioxide equivalent (CO(2)e)/kg HCW using all the growth-promoting technologies, and the Holstein beef footprint was decreased by 0.5 kg CO(2)e/kg HCW using BAA. Over the full production systems, these decreases were relatively small at 9% and 5% for Angus and Holstein beef, respectively. The growth

  2. The cost effectiveness of rapid-acting insulin aspart compared with human insulin in type 2 diabetes patients: an analysis from the Japanese third-party payer perspective.

    Science.gov (United States)

    Pollock, R F; Valentine, W J; Pilgaard, T; Nishimura, H

    2011-01-01

    . 4.684 years) and an increase of 0.023 quality-adjusted life-years (QALYs) (3.800 vs. 3.776 QALYs) when compared with regular human insulin. Insulin aspart also incurred lower costs (JPY 481,586 vs. 594,717, difference -113,131) which resulted from the decreased incidence of cardiovascular events with insulin aspart (0.013 events per patient year vs. 0.030 on regular human insulin). Breakdown of costs indicated that pharmacy costs were higher with insulin aspart (JPY 346,608 vs. 278,468), but these costs were more than offset by the reduced costs associated with cardiovascular complications and hypoglycaemia over 5 years of treatment (JPY 134,978 vs. 316,249). Sensitivity analysis showed that insulin aspart was still cost-effective in the case where only 18% of the within-trial cardiovascular and mortality benefit over regular human insulin was captured in the model (assuming a willingness-to-pay threshold of JPY 5,000,000). The NICE study cohort was relatively small (n = 325), meaning that caution should be exercised when calculating and interpreting the incremental cost-effectiveness ratio. Also, despite the differences in cardiovascular risk profile between the Japanese and UK populations, UKPDS-derived risk equations were used to project MI outcomes and PCI and CABG procedures and UKPDS HRQoL scores were applied to all health states. While these risk formulas and HRQoL utilities may not be directly applicable to the Japanese population, no equivalent Japanese-specific data are currently available. In a Japanese type 2 diabetes population, prescribing rapid-acting insulin aspart significantly reduced cardiovascular complications over 5- and 10-year time horizons, resulting in increased quality of life and decreased costs when compared with human insulin.

  3. Elevated guideway cost-ride quality studies for group rapid transit systems

    Science.gov (United States)

    1977-10-01

    A methodology is developed for relating cost to ride quality in elevated guideway : system design, based upon directly relating guideway structural properties and : construction tolerances to both cost and ride quality. It is illustrated in detail : ...

  4. Association of apneic oxygenation with decreased desaturation rates during rapid sequence intubation by a Chinese emergency medicine service

    Science.gov (United States)

    Mao, Yong; Qin, Zong-He

    2015-01-01

    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The achievement rate of emergency medicine inhabitants in airway management improved enhanced essentially subsequent to finishing anaesthesiology turn. There was a slightly higher rate of quick sequence intubation in the postapneic oxygenation groups (preapneic oxygenation 6.4%; postapneic oxygenation 9.1%). The majority of patients intubated in both groups were men (preapneic oxygenation 72.3%; postapneic oxygenation 63.5%). A higher percentage of patients in the preapneic oxygenation group had a Cormack-Lehane grade III or worse view (23.2% versus 11.8%). Anaesthesiology turns should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management. PMID:26379959

  5. Rapid and low-cost prototyping of medical devices using 3D printed molds for liquid injection molding.

    Science.gov (United States)

    Chung, Philip; Heller, J Alex; Etemadi, Mozziyar; Ottoson, Paige E; Liu, Jonathan A; Rand, Larry; Roy, Shuvo

    2014-06-27

    Biologically inert elastomers such as silicone are favorable materials for medical device fabrication, but forming and curing these elastomers using traditional liquid injection molding processes can be an expensive process due to tooling and equipment costs. As a result, it has traditionally been impractical to use liquid injection molding for low-cost, rapid prototyping applications. We have devised a method for rapid and low-cost production of liquid elastomer injection molded devices that utilizes fused deposition modeling 3D printers for mold design and a modified desiccator as an injection system. Low costs and rapid turnaround time in this technique lower the barrier to iteratively designing and prototyping complex elastomer devices. Furthermore, CAD models developed in this process can be later adapted for metal mold tooling design, enabling an easy transition to a traditional injection molding process. We have used this technique to manufacture intravaginal probes involving complex geometries, as well as overmolding over metal parts, using tools commonly available within an academic research laboratory. However, this technique can be easily adapted to create liquid injection molded devices for many other applications.

  6. Low-cost Method for Obtaining Medical Rapid Prototyping Using Desktop 3D printing: A Novel Technique for Mandibular Reconstruction Planning.

    Science.gov (United States)

    Velasco, Ignacio; Vahdani, Soheil; Ramos, Hector

    2017-09-01

    Three-dimensional (3D) printing is relatively a new technology with clinical applications, which enable us to create rapid accurate prototype of the selected anatomic region, making it possible to plan complex surgery and pre-bend hardware for individual surgical cases. This study aimed to express our experience with the use of medical rapid prototype (MRP) of the maxillofacial region created by desktop 3D printer and its application in maxillofacial reconstructive surgeries. Three patients with benign mandible tumors were included in this study after obtaining informed consent. All patient's maxillofacial CT scan data was processed by segmentation and isolation software and mandible MRP was printed using our desktop 3D printer. These models were used for preoperative surgical planning and prebending of the reconstruction plate. MRP created by desktop 3D printer is a cost-efficient, quick and easily produced appliance for the planning of reconstructive surgery. It can contribute in patient orientation and helping them in a better understanding of their condition and proposed surgical treatment. It helps surgeons for pre-operative planning in the resection or reconstruction cases and represent an excellent tool in academic setting for residents training. The pre-bended reconstruction plate based on MRP, resulted in decreased surgery time, cost and anesthesia risks on the patients. Key words: 3D printing, medical modeling, rapid prototype, mandibular reconstruction, ameloblastoma.

  7. Women Saw Large Decrease In Out-Of-Pocket Spending For Contraceptives After ACA Mandate Removed Cost Sharing.

    Science.gov (United States)

    Becker, Nora V; Polsky, Daniel

    2015-07-01

    The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance. Project HOPE—The People-to-People Health Foundation, Inc.

  8. A Marginal Cost Based "Social Cost of Carbon" Provides Inappropriate Guidance in a World That Needs Rapid and Deep Decarbonization

    Science.gov (United States)

    Morgan, M. G.; Vaishnav, P.; Azevedo, I. L.; Dowlatabadi, H.

    2016-12-01

    An interagency working group in the U.S. government has used three integrated assessment models of climate change to estimate "the social cost of carbon" and U.S. Federal Agencies and many others are using these figures as the benchmark for sound public policy. We argue that assessing the cost of emissions of CO2 on the margin is inappropriate for at least four reasons: 1) Greenhouse gas concentrations are cumulative and their radiative forcing is a non-linear function of the atmospheric concentration of many radiatively active gases. A marginal approach ignores these interactions and dependence of net forcing on concentrations of other greenhouse gases in the atmosphere. 2) Geologic evidence points to three quasi-equilibrium climate states. We know that the response of the climate system to changes in radiative forcing is non-linear. We also know that the feedbacks that have blessed us with a stable "climate optimum" for the past 10,000 years are uncertain in magnitude and operate over limited perturbations. Beyond that perturbation, it is likely that climate system dynamics will tip to a very different climate state. The probability and consequences of such climate transitions cannot be treated using a marginal approach. 3) Climate change and its impacts will vary by location, ecosystem and socio-economic context. The responses of social, economic and ecological systems are also likely to be non-linear, display hysteresis, and "tipping" or bifurcation. 4) We neither know how to characterize such impacts nor how they will be valued across different cultures and societies. Indeed, monetizing and discounting these heterogeneous and contextual impacts as a single global metric displays a hubris that has been roundly condemned by ethicists and decision-analysts. After outlining these limitations, we describe several strategies that could be used to inform climate policy to achieving deep decarbonization.

  9. Rapid and low-cost fabrication of polystyrene-based molds for PDMS microfluidic devices using a CO2 laser

    KAUST Repository

    Li, Huawei

    2011-11-01

    In this article, we described a rapid and low-cost method to fabricate polystyrene molds for PDMS microfluidic devices using a CO2 laser system. It takes only several minutes to fabricate the polystyrene mold with bump pattern on top of it using a CO2 laser system. The bump pattern can be easily transferred to PDMS and fabricate microchannles as deep as 3μm on PDMS. © (2012) Trans Tech Publications, Switzerland.

  10. Cost awareness decreases total percutaneous coronary intervention procedural cost: The SHOPPING (Show How Options in Price for Procedures Can Be Influenced Greatly) trial.

    Science.gov (United States)

    Asher, Elad; Mansour, John; Wheeler, Adam; Kendrick, Daniel; Cunningham, Michael; Parikh, Sahil; Zidar, David; Harford, Todd; Simon, Daniel I; Kashyap, Vikram S

    2017-06-01

    We initiated the SHOPPING Trial (Show How Options in Price for Procedures can be InflueNced Greatly) to see if percutaneous coronary intervention (PCI) procedures can be performed at a lower cost in a single institution. Procedural practice variability is associated with inefficiency and increased cost. We hypothesized that announcing costs for all supplies during a catheterization procedure and reporting individual operator cost relative to peers would spur cost reduction without affecting clinical outcomes. Baseline costs of 10 consecutive PCI procedures performed by 9 interventional cardiologists were documented during a 90-day interval. Costs were reassessed after instituting cost announcing and peer reporting the next quarter. The intervention involved labeling of all endovascular supplies, equipment, devices, and disposables in the catheterization laboratory and announcement of the unit price for each piece when requested. For each interventionalist, procedure time and costs were measured and analyzed prior to and after the intervention. We found that total PCI procedural cost was significantly reduced by an average of $234.77 (P = 0.01), equating to a total savings of $21,129.30 over the course of 90 PCI procedures. Major Adverse Cardiac and Cerebrovascular Event (MACCE) rates were similar during both periods (2.3% vs. 3.5%, P = NS). Announcing costs in the catheterization laboratory during single vessel PCI and peer reporting leads to cost reduction without affecting clinical outcomes. This intervention may have a role in more complex coronary and peripheral interventional procedures, and in other procedural areas where multiple equipment and device alternatives with variable costs are available. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Decreased health care utilization and health care costs in the inpatient and emergency department setting following initiation of ketogenic diet in pediatric patients: The experience in Ontario, Canada.

    Science.gov (United States)

    Whiting, Sharon; Donner, Elizabeth; RamachandranNair, Rajesh; Grabowski, Jennifer; Jetté, Nathalie; Duque, Daniel Rodriguez

    2017-03-01

    To assess the change in inpatient and emergency department utilization and health care costs in children on the ketogenic diet for treatment of epilepsy. Data on children with epilepsy initiated on the ketogenic diet (KD) Jan 1, 2000 and Dec 31, 2010 at Ontario pediatric hospitals were linked to province wide inpatient, emergency department (ED) data at the Institute for Clinical Evaluative Sciences. ED and inpatient visits and costs for this cohort were compared for a maximum of 2 years (730days) prior to diet initiation and for a maximum of 2 years (730days) following diet initiation. KD patient were compared to matched group of children with epilepsy who did not receive the ketogenic diet (no KD). Children on the KD experienced a mean decrease in ED visits of 2.5 visits per person per year [95% CI (1.5-3.4)], and a mean decrease of 0.8 inpatient visits per person per year [95% CI (0.3-1.3)], following diet initiation. They had a mean decrease in ED costs of $630 [95% CI (249-1012)] per person per year and a median decrease in inpatient costs of $1059 [IQR: 7890; pdiet experienced a mean reduction of 2.1 ED visits per child per year [95% CI (1.0-3.2)] and a mean decrease of 0.6 [95% CI (0.1-1.1)] inpatient visits per child per year. Patients on the KD experienced a reduction of $442 [95% CI (34.4-850)] per child per year more in ED costs than the matched group. The ketogenic diet group had greater median decrease in inpatient costs per child per year than the matched group [pketogenic diet, experienced decreased ED and inpatient visits as well as costs following diet initiation in Ontario, Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Bubble nasal CPAP, early surfactant treatment, and rapid extubation are associated with decreased incidence of bronchopulmonary dysplasia in very-low-birth-weight newborns: efficacy and safety considerations.

    Science.gov (United States)

    Friedman, Charles A; Menchaca, Robert C; Baker, Mary C; Rivas, Clarissa K; Laberge, Raymond N; Rios, Enrique H; Haider, Syed H; Romero, Edgar J; Eason, Elizabeth B; Fraley, J Kennard; Woldesenbet, Mesfin

    2013-07-01

    Current literature has been inconsistent in demonstrating that minimizing the duration of mechanical ventilation in very-low-birth-weight (VLBW) newborns reduces lung damage. To determine if introduction of bubble nasal CPAP (bnCPAP), early surfactant treatment, and rapid extubation (combined bnCPAP strategy) in our community-based neonatal ICU reduced bronchopulmonary dysplasia (BPD). This was a 7-year retrospective,single-institution review of respiratory outcomes in 633 VLBW babies before and after introduction of the combined bnCPAP strategy. Coincident changes in newborn care were taken into account with a logistic regression model. The average percentage of VLBW newborns with BPD decreased to 25.8% from 35.4% (P = .02), reaching a minimum in the last post-bnCPAP year of22.1% (P = .02). When other coincident changes in newborn care during the study years were taken into account, VLBW babies in the post-bnCPAP years had a 43% lower chance of developing BPD(P = .003, odds ratio 0.43, 95% CI 0.25– 0.75). Decreases occurred in mechanical ventilation and the percentage of infants discharged on diuretics and on supplemental oxygen. Among the subset of extremely-low-birth-weight newborns, improved respiratory outcomes in the post-bnCPAP years,as compared to outcomes in the pre-bnCPAP years, included an increase in the percentage alive and off mechanical ventilation at 1 week postnatal age (P < .001), a more rapid extubation rate(P < .03), a decrease in the median days on mechanical ventilation (P = .002), and a decrease in the percentage with BPD plus died (P = .01). Post-bnCPAP extremely-low-birth-weight babies had a statistically significant decrease in retinopathy of prematurity, an increase in low-grade intraventricular hemorrhage, and a decrease in ductal ligations. A combined BnCPAP strategy may contribute to a reduction of BPD, after adjusting for concurrent treatments.

  13. Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations.

    Science.gov (United States)

    Webb, Michael; Fahimi, Saman; Singh, Gitanjali M; Khatibzadeh, Shahab; Micha, Renata; Powles, John; Mozaffarian, Dariush

    2017-01-10

     To quantify the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide.  Global modeling study.  183 countries.  Full adult population in each country.  A "soft regulation" national policy that combines targeted industry agreements, government monitoring, and public education to reduce population sodium intake, modeled on the recent successful UK program. To account for heterogeneity in efficacy across countries, a range of scenarios were evaluated, including 10%, 30%, 0.5 g/day, and 1.5 g/day sodium reductions achieved over 10 years. We characterized global sodium intakes, blood pressure levels, effects of sodium on blood pressure and of blood pressure on cardiovascular disease, and cardiovascular disease rates in 2010, each by age and sex, in 183 countries. Country specific costs of a sodium reduction policy were estimated using the World Health Organization Noncommunicable Disease Costing Tool. Country specific impacts on mortality and disability adjusted life years (DALYs) were modeled using comparative risk assessment. We only evaluated program costs, without incorporating potential healthcare savings from prevented events, to provide conservative estimates of cost effectiveness MAIN OUTCOME MEASURE:  Cost effectiveness ratio, evaluated as purchasing power parity adjusted international dollars (equivalent to the country specific purchasing power of US$) per DALY saved over 10 years.  Worldwide, a 10% reduction in sodium consumption over 10 years within each country was projected to avert approximately 5.8 million DALYs/year related to cardiovascular diseases, at a population weighted mean cost of I$1.13 per capita over the 10 year intervention. The population weighted mean cost effectiveness ratio was approximately I$204/DALY. Across nine world regions, estimated cost effectiveness of sodium reduction was best in South Asia (I$116/DALY); across the world

  14. Analysis of Base Services Structure and Development of Cost-Saving Strategies to Counterattack Decreasing Funding Levels

    Science.gov (United States)

    2005-12-01

    social , ethnic , religious, age, etc.), and the individual mix of interests and economic objectives can never be exactly the same between two...41 1. Cost Benefit Analysis .........................................................................41 2. Social Cost Benefit...us salivating for more. This quality cuisine was second only to Kathy’s always phenomenal culinary masterpieces. Thank you, cutie! xviii

  15. Cost effectiveness of single-dose nevirapine regimen for mothers and babies to decrease vertical HIV-1 transmission in sub-Saharan Africa.

    Science.gov (United States)

    Marseille, E; Kahn, J G; Mmiro, F; Guay, L; Musoke, P; Fowler, M G; Jackson, J B

    1999-09-04

    Identification of economical interventions to decrease HIV-1 transmission to children is an urgent public-health priority in sub-Saharan Africa. We assessed the cost effectiveness of the HIVNET 012 nevirapine regimen. We assessed cost effectiveness in a hypothetical cohort of 20,000 pregnant women in sub-Saharan Africa. Our main outcome measures were programme cost, paediatric HIV-1 cases averted, cost per case averted, and cost per disability-adjusted life-year (DALY). We compared HIVNET 012 with other short-course antiretroviral regimens. We also compared two implementation strategies: counselling and HIV-1 testing before treatment (targeted treatment), or nevirapine for all pregnant women (universal treatment, no counselling and testing). We did univariate and multivariate sensitivity analyses. For universal treatment with 30% HIV-1 seroprevalence, the HIVNET 012 regimen would avert 603 cases of HIV-1 in babies, cost US$83,333, and generate 15,862 DALYs. The associated cost-effectiveness ratios were $138 per case averted or $5.25 per DALY. At 15% seroprevalence, the universal treatment option would cost $83,333 and avert 302 cases at $276 per case averted or $10.51 per DALY. For targeted treatment at 30% seroprevalence, HIVNET 012 would cost $141,922 and avert 476 cases at $298 per case averted or $11.29 per DALY. With seroprevalence higher than 3.0% for universal and 4.5% for targeted treatment, the HIVNET 012 regimen was likely to be as cost effective as other public-health interventions. The cost effectiveness of HIVNET 012 was robust under a wide range of parameters in the sensitivity analysis. The HIVNET 012 regimen can be highly cost-effective in high seroprevalence settings. In lower seroprevalence areas, when multidose regimens are not cost effective, nevirapine therapy could have a major public-health impact at a reasonable cost.

  16. Manufacturing of Low Cost, Durable Membrane Electrode Assemblies Engineered for Rapid Conditioning

    Energy Technology Data Exchange (ETDEWEB)

    Busby, Colin [W. L. Gore & Associates Inc., Newark, DE (United States)

    2017-05-23

    Over the past 20 years significant progress in membrane-electrode assembly (MEA) technology development for polymer electrolyte fuel cells (PEMFCs) has resulted in the PEMFC technology approaching a commercial reality for transportation applications. However, there remain two primary technical challenges to be addressed in the MEA. First and foremost is meeting the automotive cost targets: Producing a fuel cell stack cost competitive with today’s internal combustion engine. In addition to the material cost, MEA (and other components) and stack assembly production methods must be amenable for use in low cost, high speed, automotive assembly line. One impediment to this latter goal is that stack components must currently go through a long and tedious conditioning procedure before they produce optimal power. This so-called “break-in” can take many hours, and can involve quite complex voltage, temperature and/or pressure steps. These break-in procedures must be simplified and the time required reduced if fuel cells are to become a viable automotive engine. The second challenge is to achieve the durability targets in real-world automotive duty cycle operations. Significant improvements in cost, break-in time, and durability for the key component of fuel cell stacks, MEAs were achieved in this project. Advanced modeling was used to guide design of the new MEA to maximize performance and durability. A new, innovative process and manufacturing approach utilizing direct in-line coating using scalable, cost-competitive, continuous high volume 3-layer rolled-good manufacturing processes was developed and validated by single cell and short stack testing. In addition, the direct coating methods employed were shown to reduce the cost for sacrificial films. Furthermore, Gore has demonstrated a 10 µm reinforced membrane that is used in the new low-cost process and can meet automotive power density and durability targets. Across a wide range of operating conditions, the

  17. Cost-effectiveness of malaria microscopy and rapid diagnostic tests versus presumptive diagnosis

    DEFF Research Database (Denmark)

    Batwala, Vincent; Magnussen, Pascal; Hansen, Kristian Schultz

    2011-01-01

    at rural operational primary care centres. METHODS: Three health centres (HCs) were randomized to three diagnostic arms (microscopy, RDT and presumptive diagnosis) in a district of low and another of high malaria transmission intensities in Uganda. Some 22,052 patients presenting with fever at outpatients...... departments were enrolled from March 2010 to February 2011. Of these, a random sample of 1,627 was selected to measure additional socio-economic characteristics. Costing was performed following the standard step-down cost allocation and the ingredients approach. Effectiveness was measured as the number...

  18. Costs of Rapid HIV Screening in an Urban Emergency Department and a Nearby County Jail in the Southeastern United States.

    Directory of Open Access Journals (Sweden)

    Anne C Spaulding

    Full Text Available Emergency departments and jails provide medical services to persons at risk for HIV infection and are recommended venues for HIV screening. Our main objective in this study was to analyze the cost per new HIV diagnosis associated with the HIV screening program in these two venues. The emergency department's parallel testing program was conducted at Grady Memorial Hospital in Atlanta, Georgia starting in 2008; the jail's integrated testing program began at the Fulton County (GA Jail in 2011. The two sites, four miles apart from one another, employed the same rapid HIV test. Ascertainment that cases were new differed by site; only the jail systematically checked identities against health department HIV registries. The program in the emergency department used dedicated HIV test counselors and made 242 diagnoses over a 40-month period at a cost of $2,981 per diagnosis. The jail program used staff nurses, and found 41 new HIV cases over 10.5 months at a cost of $6,688 per new diagnosis. Differences in methods for ascertainment of new diagnoses, previously undiagnosed HIV sero-positivity, and methodologies used for assessing program costs prevent concluding that one program was more economical than the other. Nonetheless, our findings show that testing in both venues yielded many new diagnoses, with the costs within the range reported in the literature.

  19. A rapid and low-cost DNA extraction method for isolating ...

    African Journals Online (AJOL)

    The price of commercial DNA extraction methods makes the routine use of polymerase chain reaction amplification (PCR) based methods rather costly for scientists in developing countries. A guanidium thiocayante-based DNA extraction method was investigated in this study for the isolation of Escherichia coli (E. coli) DNA ...

  20. Preliminary feasibility studies in times of rapid cost escalation. [Oil shale and tar sand industries

    Energy Technology Data Exchange (ETDEWEB)

    Oliver, E.D.; Moll, A.J.

    1976-01-01

    Not the least of the problems delaying the development and commercialization of synthetic fuel processes has been the extraordinary escalation of cost estimates by factors of up to ten in the past eight years. This study identifies and analyzes some of the most important contributing factors that have converged in the last few years. These factors include overoptimism and ill-defined project scope in the early stages, tightening environmental controls, difficulties in obtaining raw materials and fuels, general inflationary trends, ''hyperinflation'' of the costs of critical equipment, local labor shortages, and increased times required for procurement and construction. Cost increases have been particularly dramatic for ''offsites,'' liberally defined as nonprocess related parts of projects. Case histories of oil shale and tar sand developments are analyzed. Learning curves of costs during development and commercial use are studied. The analysis suggests that the worst of the extraordinary increases (above general inflationary trends) are probably over. Criteria to judge the state of development of processes are given, and some procedures to avoid future pitfalls are suggested.

  1. Dimensional Error in Rapid Prototyping with Open Source Software and Low-cost 3D-printer.

    Science.gov (United States)

    Rendón-Medina, Marco A; Andrade-Delgado, Laura; Telich-Tarriba, Jose E; Fuente-Del-Campo, Antonio; Altamirano-Arcos, Carlos A

    2018-01-01

    Rapid prototyping models (RPMs) had been extensively used in craniofacial and maxillofacial surgery, especially in areas such as orthognathic surgery, posttraumatic or oncological reconstructions, and implantology. Economic limitations are higher in developing countries such as Mexico, where resources dedicated to health care are limited, therefore limiting the use of RPM to few selected centers. This article aims to determine the dimensional error of a low-cost fused deposition modeling 3D printer (Tronxy P802MA, Shenzhen, Tronxy Technology Co), with Open source software. An ordinary dry human mandible was scanned with a computed tomography device. The data were processed with open software to build a rapid prototype with a fused deposition machine. Linear measurements were performed to find the mean absolute and relative difference. The mean absolute and relative difference was 0.65 mm and 1.96%, respectively ( P = 0.96). Low-cost FDM machines and Open Source Software are excellent options to manufacture RPM, with the benefit of low cost and a similar relative error than other more expensive technologies.

  2. A novel low-cost mobile robot for rapid prototyping of precision farming applications

    DEFF Research Database (Denmark)

    Jensen, Kjeld; Neerup, Mathias Mikkel; Larsen, Leon Bonde

    field experiments using field robots which is typically a demanding task in terms of time consumption and logistics. Small indoor robots are sometimes used to emulate the larger field robots which allows for rapid prototyping and intermediate testing in the laboratory before moving to the field...... experiments. In this work we present a novel FrobitPro robot platform designed for rapid prototyping of FroboMind field robot applications. FrobitPro has a fundamental design similar to many current wheeled and tracked robots such as the Kongskilde Robotti, and the workflow of migrating from simulation...... to FrobitPro to field robot is therefore merely a matter of using different low level interface components. The FrobitPro robot is capable of carrying larger sensors such as RTK- GNSS, LIDAR and 3d stereo vision cameras. The platform supports interchangeable wheels for accurate indoor driving as well...

  3. Low-cost rapid prototyping of flexible plastic paper based microfluidic devices

    KAUST Repository

    Fan, Yiqiang

    2013-04-01

    This research presents a novel rapid prototyping method for paper-based flexible microfluidic devices. The microchannels were fabricated using laser ablation on a piece of plastic paper (permanent paper), the dimensions of the microchannels was carefully studied for various laser powers and scanning speeds. After laser ablation of the microchannels on the plastic paper, a transparent poly (methyl methacrylate)(PMMA) film was thermally bonded to the plastic paper to enclose the channels. After connection of tubing, the device was ready to use. An example microfluidic device (droplet generator) was also fabricated using this technique. Due to the flexibility of the fabricated device, this technique can be used to fabricate 3D microfluidic devices. The fabrication process was simple and rapid without any requirement of cleanroom facilities. © 2013 IEEE.

  4. Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda.

    Science.gov (United States)

    Hansen, Kristian S; Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham; Clarke, Siân E

    2017-06-01

    In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality among children under 5, due to lack of access to prompt and appropriate diagnosis and treatment. Many countries have scaled-up community health workers (CHWs) as a strategy towards improving access. The present study was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever 'appropriately treated for malaria with ACT' were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision, allowances for CHWs and provision of mRDTs and ACTs. The opportunity costs of time utilised by CHWs were estimated based on self-reporting. Household costs of subsequent treatment-seeking at public health centres and private health providers were captured in a sample of households. mRDTs performed by CHWs was associated with large improvements in appropriate treatment of malaria in both transmission settings. This resulted in low incremental costs for the health sector at US$3.0 per appropriately treated child in the moderate-to-high transmission area. Higher incremental costs at US$13.3 were found in the low transmission area due to lower utilisation of CHW services and higher programme costs. Incremental costs from a societal perspective were marginally higher. The use of mRDTs by CHWs improved the targeting of ACTs to children with malaria and was likely to be considered a cost-effective intervention compared to a presumptive diagnosis in the moderate-to-high transmission area. In contrast to this, in the low transmission area with low attendance, RDT use by CHWs was

  5. Integrating Low-Cost Rapid Usability Testing into Agile System Development of Healthcare IT: A Methodological Perspective.

    Science.gov (United States)

    Kushniruk, Andre W; Borycki, Elizabeth M

    2015-01-01

    The development of more usable and effective healthcare information systems has become a critical issue. In the software industry methodologies such as agile and iterative development processes have emerged to lead to more effective and usable systems. These approaches highlight focusing on user needs and promoting iterative and flexible development practices. Evaluation and testing of iterative agile development cycles is considered an important part of the agile methodology and iterative processes for system design and re-design. However, the issue of how to effectively integrate usability testing methods into rapid and flexible agile design cycles has remained to be fully explored. In this paper we describe our application of an approach known as low-cost rapid usability testing as it has been applied within agile system development in healthcare. The advantages of the integrative approach are described, along with current methodological considerations.

  6. FURTHER COMMENT ON "A RAPID ASSESSMENT MODEL FOR UNDERSTANDING THE SOCIAL COST OF CARBON"

    OpenAIRE

    STEPHEN C. NEWBOLD; CHARLES GRIFFITHS; CHRIS MOORE; ANN WOLVERTON; ELIZABETH KOPITS

    2014-01-01

    In this reply to the comment by Gerlagh, we confirm an error in our estimate of the certainty-equivalent social cost of carbon (SCC) reported in Newbold et al. (2013), and we discuss the underlying conceptual difficulties that arise in conducting a social welfare analysis when preferences are heterogeneous or uncertain. The certainty-equivalent SCC depends crucially on the reference level of per capita consumption used to normalize marginal utility across possible preference parameters, and o...

  7. Screening and Rapid Molecular Diagnosis of Tuberculosis in Prisons in Russia and Eastern Europe: A Cost-Effectiveness Analysis

    Science.gov (United States)

    Winetsky, Daniel E.; Negoescu, Diana M.; DeMarchis, Emilia H.; Almukhamedova, Olga; Dooronbekova, Aizhan; Pulatov, Dilshod; Vezhnina, Natalia; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.

    2012-01-01

    Background Prisons of the former Soviet Union (FSU) have high rates of multidrug-resistant tuberculosis (MDR-TB) and are thought to drive general population tuberculosis (TB) epidemics. Effective prison case detection, though employing more expensive technologies, may reduce long-term treatment costs and slow MDR-TB transmission. Methods and Findings We developed a dynamic transmission model of TB and drug resistance matched to the epidemiology and costs in FSU prisons. We evaluated eight strategies for TB screening and diagnosis involving, alone or in combination, self-referral, symptom screening, mass miniature radiography (MMR), and sputum PCR with probes for rifampin resistance (Xpert MTB/RIF). Over a 10-y horizon, we projected costs, quality-adjusted life years (QALYs), and TB and MDR-TB prevalence. Using sputum PCR as an annual primary screening tool among the general prison population most effectively reduced overall TB prevalence (from 2.78% to 2.31%) and MDR-TB prevalence (from 0.74% to 0.63%), and cost US$543/QALY for additional QALYs gained compared to MMR screening with sputum PCR reserved for rapid detection of MDR-TB. Adding sputum PCR to the currently used strategy of annual MMR screening was cost-saving over 10 y compared to MMR screening alone, but produced only a modest reduction in MDR-TB prevalence (from 0.74% to 0.69%) and had minimal effect on overall TB prevalence (from 2.78% to 2.74%). Strategies based on symptom screening alone were less effective and more expensive than MMR-based strategies. Study limitations included scarce primary TB time-series data in FSU prisons and uncertainties regarding screening test characteristics. Conclusions In prisons of the FSU, annual screening of the general inmate population with sputum PCR most effectively reduces TB and MDR-TB prevalence, doing so cost-effectively. If this approach is not feasible, the current strategy of annual MMR is both more effective and less expensive than strategies using self

  8. Screening and rapid molecular diagnosis of tuberculosis in prisons in Russia and Eastern Europe: a cost-effectiveness analysis.

    Directory of Open Access Journals (Sweden)

    Daniel E Winetsky

    Full Text Available Prisons of the former Soviet Union (FSU have high rates of multidrug-resistant tuberculosis (MDR-TB and are thought to drive general population tuberculosis (TB epidemics. Effective prison case detection, though employing more expensive technologies, may reduce long-term treatment costs and slow MDR-TB transmission.We developed a dynamic transmission model of TB and drug resistance matched to the epidemiology and costs in FSU prisons. We evaluated eight strategies for TB screening and diagnosis involving, alone or in combination, self-referral, symptom screening, mass miniature radiography (MMR, and sputum PCR with probes for rifampin resistance (Xpert MTB/RIF. Over a 10-y horizon, we projected costs, quality-adjusted life years (QALYs, and TB and MDR-TB prevalence. Using sputum PCR as an annual primary screening tool among the general prison population most effectively reduced overall TB prevalence (from 2.78% to 2.31% and MDR-TB prevalence (from 0.74% to 0.63%, and cost US$543/QALY for additional QALYs gained compared to MMR screening with sputum PCR reserved for rapid detection of MDR-TB. Adding sputum PCR to the currently used strategy of annual MMR screening was cost-saving over 10 y compared to MMR screening alone, but produced only a modest reduction in MDR-TB prevalence (from 0.74% to 0.69% and had minimal effect on overall TB prevalence (from 2.78% to 2.74%. Strategies based on symptom screening alone were less effective and more expensive than MMR-based strategies. Study limitations included scarce primary TB time-series data in FSU prisons and uncertainties regarding screening test characteristics.In prisons of the FSU, annual screening of the general inmate population with sputum PCR most effectively reduces TB and MDR-TB prevalence, doing so cost-effectively. If this approach is not feasible, the current strategy of annual MMR is both more effective and less expensive than strategies using self-referral or symptom screening alone

  9. Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda

    DEFF Research Database (Denmark)

    Hansen, Kristian S; Ndyomugyenyi, Richard; Magnussen, Pascal

    2017-01-01

    In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality among children under 5, due to lack of access to prompt and appropriate diagnosis and treatment. Many countries have scaled-up community health workers (CHWs) as a strategy towards improving access. The present study...... was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT......) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever 'appropriately treated for malaria with ACT' were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision...

  10. Involvement of Ca2+ in Vacuole Degradation Caused by a Rapid Temperature Decrease in Saintpaulia Palisade Cells: A Case of Gene Expression Analysis in a Specialized Small Tissue.

    Science.gov (United States)

    Ohnishi, Miwa; Kadohama, Noriaki; Suzuki, Yoshihiro; Kajiyama, Tomoharu; Shichijo, Chizuko; Ishizaki, Kimitsune; Fukaki, Hidehiro; Iida, Hidetoshi; Kambara, Hideki; Mimura, Tetsuro

    2015-07-01

    Saintpaulia (African violet) leaves are known to be damaged by a rapid temperature decrease when cold water is applied to the leaf surface; the injury is ascribed to the chloroplast damage caused by the cytosolic pH decrease following the degradation of the vacuolar membrane in the palisade cells. In this report, we present evidence for the involvement of Ca(2+) in facilitating the collapse of the vacuolar membrane and in turn in the temperature sensitivity of Saintpaulia leaves. In the presence of a Ca(2+) chelator (EGTA) or certain Ca(2+) channel inhibitors (Gd(3+) or La(3+)) but not others (verapamil or nifedipine), the pH of the vacuole, monitored through BCECF (2',7'-bis(carboxyethyl)-4 or 5-carboxyfluorescein) fluorescence, did not increase in response to a rapid temperature drop. These pharmacological observations are consistent with the involvement of mechanosensitive Ca(2+) channels in the collapse of the vacuolar membrane. The high level of expression of an MCA- (Arabidopsis mechanosensitive Ca(2+) channel) like gene, a likely candidate for a mechanosensitive Ca(2+) channel(s) in plant cells, was confirmed in the palisade tissue in Saintpaulia leaves by using a newly developed method of gene expression analysis for the specialized small tissues. © The Author 2015. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  11. Rapid cross platform healthcare gaming design and implementation: The cost effective methodology.

    Science.gov (United States)

    Zhang, Melvyn W B; Ho, Roger C M

    2016-11-14

    There have been massive advances in E-Health and M-Health technology, with recent interest in the utility of games for healthcare and the promotion of well-being and recovery as well as patient empowerment. There has been various review demonstrating the clinical effectiveness and efficacy of games for healthcare. It is the aim of this technical note to illustrate how appropriate gaming engines could be used by non-expert clinicians to program games that could run across various platforms, as well as games that could integrate well with existing mechanical sensors. This would address the limitations with regards to the evidence base of games, as well as the limitations in the deployment of games to various participants. More importantly, games designed are also more likely to be cost-effective and lower in cost. The ability of integration with existing mechanical sensors would value-add existing games and enable recovery and remediation in various domains of health. This would further expand the potential of games as an adjunctive treatment for patients, or at least, to maintain the gains that they have made in their recovery process.

  12. Rapid, low cost prototyping of transdermal devices for personal healthcare monitoring.

    Science.gov (United States)

    Sharma, Sanjiv; Saeed, Anwer; Johnson, Christopher; Gadegaard, Nikolaj; Cass, Anthony Eg

    2017-04-01

    The next generation of devices for personal healthcare monitoring will comprise molecular sensors to monitor analytes of interest in the skin compartment. Transdermal devices based on microneedles offer an excellent opportunity to explore the dynamics of molecular markers in the interstitial fluid, however good acceptability of these next generation devices will require several technical problems associated with current commercially available wearable sensors to be overcome. These particularly include reliability, comfort and cost. An essential pre-requisite for transdermal molecular sensing devices is that they can be fabricated using scalable technologies which are cost effective. We present here a minimally invasive microneedle array as a continuous monitoring platform technology. Method for scalable fabrication of these structures is presented. The microneedle arrays were characterised mechanically and were shown to penetrate human skin under moderate thumb pressure. They were then functionalised and evaluated as glucose, lactate and theophylline biosensors. The results suggest that this technology can be employed in the measurement of metabolites, therapeutic drugs and biomarkers and could have an important role to play in the management of chronic diseases.

  13. Cell-on-hydrogel platform made of agar and alginate for rapid, low-cost, multidimensional test of antimicrobial susceptibility.

    Science.gov (United States)

    Sun, Han; Liu, Zhengzhi; Hu, Chong; Ren, Kangning

    2016-08-02

    Antimicrobial resistance (AMR) is a rapidly increasing threat to the effective treatment of infectious diseases worldwide. The two major remedies include: (1) using narrow-spectrum antibiotics based on rapid diagnosis; and (2) developing new antibiotics. A key part of both remedies is the antimicrobial susceptibility test (AST). However, the current standard ASTs that monitor colony formation are costly and time-consuming and the new strategies proposed are not yet practical to be implemented. Herein, we report a strategy to fabricate whole-hydrogel microfluidic chips using alginate-doped agar. This agar-based microfabrication makes it possible to prepare inexpensive hydrogel devices, and allows a seamless link between microfluidics and conventional agar-based cell culture. Different from common microfluidic systems, in our system the cells are cultured on top of the device, similar to normal agar plate culture; on the other hand, the microfluidic channels inside the hydrogel allow precise generation of linear gradient of drugs, thus giving a better performance than the conventional disk diffusion method. Cells in this system are not exposed to any shear flow, which allows the reliable tracking of individual cells and AST results to be obtained within 2-3 hours. Furthermore, our system could test the synergistic effect of drugs through two-dimensional gradient generation. Finally, the platform could be directly implemented to new drug discovery and other applications wherein a fast, cost-efficient method for studying the response of microorganisms upon drug administration is desirable.

  14. Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs.

    Science.gov (United States)

    Bond, William F; Kim, Minchul; Franciskovich, Chris M; Weinberg, Jason E; Svendsen, Jessica D; Fehr, Linda S; Funk, Amy; Sawicki, Robert; Asche, Carl V

    2017-12-05

    Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs. Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases. The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed to Medicare. We matched 325 cases and 325 controls (51.1% female and 48.9% male, mean age 81). 320/325 (98.5%) ACP versus 243/325 (74.8%) of controls had a Healthcare Power of Attorney (odds ratio [OR] 21.6, 95% CI 8.6-54.1) and 172/325(52.9%) ACP versus 145/325 (44.6%) controls had Practitioner Orders for Life Sustaining Treatment (OR 1.40, 95% CI 1.02-1.90) post-ACP/postmatch. Adjusted results showed ACP cases had fewer inpatient admissions (-0.37 admissions, 95% CI -0.66 to -0.08), and inpatient days (-3.66 days, 95% CI -6.23 to -1.09), with no differences in hospice, hospice days, skilled nursing facility use, home health use, 30-day readmissions, or emergency department visits. Adjusted costs were $9,500 lower in the ACP group (95% CI -$16,207 to -$2,793). ACP increases documentation and was associated with a reduction in overall costs driven primarily by a reduction in inpatient utilization. Our data set was limited by small numbers of minorities and cancer patients.

  15. Rapid, sensitive and cost effective method for isolation of viral DNA from feacal samples of dogs

    Directory of Open Access Journals (Sweden)

    Savi.

    2010-06-01

    Full Text Available A simple method for viral DNA extraction using chelex resin was developed. The method used was eco-friendly and cost effective compared to other methods such as phenol chloroform method which use health hazardous organic reagents. Further, a polymerase chain reaction (PCR based detection of canine parvovirus (CPV using primers from conserved region of VP2 gene was developed. To increase the sensitivity and specificity of reaction, nested PCR was designed. PCR reaction was optimized to amplify 747bp product of VP2 gene. The assay can be completed in few hours and doesn’t need hazardous chemicals. Thus, the sample preparation using chelating resin along with nested PCR seems to be a sensitive, specific and practical method for the detection of CPV in diarrhoeal feacal samples. [Vet. World 2010; 3(3.000: 105-106

  16. Rapid, Low-Cost, and Ecofriendly Approach for Iron Nanoparticle Synthesis Using Aspergillus oryzae TFR9

    Directory of Open Access Journals (Sweden)

    Jagadish Chandra Tarafdar

    2013-01-01

    Full Text Available Development of reliable and ecofriendly green approach for synthesis of metallic nanoparticles biologically is an important step in the field of application of nanoscience and nanotechnology. The present paper reports the green approach for iron nanoparticle synthesis using Aspergillus oryzae TFR9 using FeCl3 as a precursor metal salt. Valid characterization techniques employed for biosynthesized iron nanoparticles including dynamic light scattering (DLS, transmission electron microscopy (TEM, and high resolution-transmission electron microscopy (HR-TEM for morphological study. X-ray energy dispersive spectroscopy (EDS spectrum confirmed the presence of elemental iron signal in high percentage. Apart from ecofriendliness and easy availability, low-cost biomass production will be more advantageous when compared to other chemical methods. Biosynthesis of iron nanoparticles using fungus has greater commercial viability that it may be used in agriculture, biomedicals and engineering sector.

  17. Improving quality and decreasing cost in gynecologic oncology care. Society of gynecologic oncology recommendations for clinical practice.

    Science.gov (United States)

    Rimel, B J; Burke, William M; Higgins, Robert V; Lee, Paula S; Lutman, Christopher V; Parker, Lynn

    2015-05-01

    To identify potential cost savings in gynecologic oncology care without sacrificing quality. Members of the Clinical Practice Committee of the Society of Gynecologic Oncology were asked to review current practice patterns in gynecologic oncology and assess the potential for cost savings founded on evidence-based medicine and current guidelines. Five clinical practices were identified including the following: vaginal cytology for endometrial cancer survivors; colposcopy for low grade cytologic abnormalities for cervical cancer survivors; routine imaging studies for gynecologic cancer survivors; screening for ovarian cancer with serum biomarkers and ultrasound; and improving palliative care for gynecologic cancer patients. Review of the published literature and guidelines were performed to make evidence-based recommendations for cost effective quality gynecologic oncology care. • Do not perform Pap tests of the vaginal cuff in patients with a history of endometrial cancer. • Do not perform colposcopy for low grade Pap tests in women with a history of cervical cancer. • Avoid routine imaging for cancer surveillance in asymptomatic women with gynecologic cancer, specifically ovarian, endometrial, cervical, vulvar and vaginal cancer. • Do not screen women at low risk for ovarian cancer with ultrasound or CA-125 or other biomarkers. • Do not delay basic level palliative care for women with advanced or relapsed gynecologic cancer, do refer to a palliative care specialist when needed, and avoid unnecessary treatments at life's end. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. A low-cost microfluidic chip for rapid genotyping of malaria-transmitting mosquitoes.

    Science.gov (United States)

    Liu, Changchun; Mauk, Michael G; Hart, Robert; Bonizzoni, Mariangela; Yan, Guiyun; Bau, Haim H

    2012-01-01

    Vector control is one of the most effective measures to prevent the transmission of malaria, a disease that causes over 600,000 deaths annually. Around 30-40 Anopheles mosquito species are natural vectors of malaria parasites. Some of these species cannot be morphologically distinguished, but have behavioral and ecological differences. Emblematic of this is the Anopheles gambiae species complex. The correct identification of vector species is fundamental to the development of control strategies and epidemiological studies of disease transmission. An inexpensive, disposable, field-deployable, sample-to-answer, microfluidic chip was designed, constructed, and tested for rapid molecular identification of Anopheles gambiae and Anopheles arabiensis. The chip contains three isothermal amplification reactors. One test reactor operates with specific primers to amplify Anopheles gambiae DNA, another with specific primers for Anopheles arabiensis DNA, and the third serves as a negative control. A mosquito leg was crushed on an isolation membrane. Two discs, laden with mosquito tissue, were punched out of the membrane and inserted into the two test chambers. The isolated, disc-bound DNA served as a template in the amplification processes. The amplification products were detected with intercalating fluorescent dye that was excited with a blue light-emitting diode. The emitted light was observed by eye and recorded with a cell-phone camera. When the target consisted of Anopheles gambiae, the reactor containing primers specific to An. gambiae lit up while the other two reactors remained dark. When the target consisted of Anopheles arabiensis, the reactor containing primers specific to An. arabiensis lit up while the other two reactors remained dark. The microfluidic chip provides a means to identify mosquito type through molecular analysis. It is suitable for field work, allowing one to track the geographical distribution of mosquito populations and community structure

  19. The direct cost of traumatic secretion transfer in hermaphroditic land snails: individuals stabbed with a love dart decrease lifetime fecundity.

    Science.gov (United States)

    Kimura, Kazuki; Chiba, Satoshi

    2015-04-07

    Several taxa of simultaneously hermaphroditic land snails exhibit a conspicuous mating behaviour, the so-called shooting of love darts. During mating, such land snail species transfer a specific secretion by stabbing a mating partner's body with the love dart. It has been shown that sperm donors benefit from this traumatic secretion transfer, because the secretions manipulate the physiology of a sperm recipient and increase the donors' fertilization success. However, it is unclear whether reception of dart shooting is costly to the recipients. Therefore, the effect of sexual conflict and antagonistic arms races on the evolution of traumatic secretion transfer in land snails is still controversial. To examine this effect, we compared lifetime fecundity and longevity between the individuals that received and did not receive dart shooting from mating partners in Bradybaena pellucida. Our experiments showed that the dart-receiving snails suffered reduction in lifetime fecundity and longevity. These results suggest that the costly mating behaviour, dart shooting, generates conflict between sperm donors and recipients and that sexually antagonistic arms races have contributed to the diversification of the morphological and behavioural traits relevant to dart shooting. Our findings also support theories suggesting a violent escalation of sexual conflict in hermaphroditic animals. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  20. Feed-in tariffs versus quotas: how to promote renewable s and stimulate technical progress for cost decrease?

    Energy Technology Data Exchange (ETDEWEB)

    Menanteau, Ph.; Finon, D.; Lamy, M.L

    2002-07-01

    Incentive schemes for the development of renewable energy sources may focus on quantities (defining national targets and setting up bidding systems, or quota systems providing for green certificate trading), or they may focus on prices (feed-in tariffs). Whatever the system chosen, the role of the public authorities is quite specific: to stimulate technical progress and speed up the technological learning processes so that ultimately renewable energy technologies will be able to compete with conventional technologies, once the environmental costs have been internalized. A comparison of instruments must thus take into account the characteristics of the innovation process and adoption conditions (uncertainties regarding cost curves, learning effects) which means also looking at dynamic efficiency criteria. The paper concludes that a system of feed-in tariffs is more efficient than a bidding system, but highlights the theoretical interest of green certificate trading which must be confirmed through practice, given the influence of market structures and rules on the performance of this type of approach. (author)

  1. Assessing the Potential of Low-Cost 3D Cameras for the Rapid Measurement of Plant Woody Structure

    Directory of Open Access Journals (Sweden)

    Charles Nock

    2013-11-01

    Full Text Available Detailed 3D plant architectural data have numerous applications in plant science, but many existing approaches for 3D data collection are time-consuming and/or require costly equipment. Recently, there has been rapid growth in the availability of low-cost, 3D cameras and related open source software applications. 3D cameras may provide measurements of key components of plant architecture such as stem diameters and lengths, however, few tests of 3D cameras for the measurement of plant architecture have been conducted. Here, we measured Salix branch segments ranging from 2–13 mm in diameter with an Asus Xtion camera to quantify the limits and accuracy of branch diameter measurement with a 3D camera. By scanning at a variety of distances we also quantified the effect of scanning distance. In addition, we also test the sensitivity of the program KinFu for continuous 3D object scanning and modeling as well as other similar software to accurately record stem diameters and capture plant form (<3 m in height. Given its ability to accurately capture the diameter of branches >6 mm, Asus Xtion may provide a novel method for the collection of 3D data on the branching architecture of woody plants. Improvements in camera measurement accuracy and available software are likely to further improve the utility of 3D cameras for plant sciences in the future.

  2. FREQ-Seq: a rapid, cost-effective, sequencing-based method to determine allele frequencies directly from mixed populations.

    Directory of Open Access Journals (Sweden)

    Lon M Chubiz

    Full Text Available Understanding evolutionary dynamics within microbial populations requires the ability to accurately follow allele frequencies through time. Here we present a rapid, cost-effective method (FREQ-Seq that leverages Illumina next-generation sequencing for localized, quantitative allele frequency detection. Analogous to RNA-Seq, FREQ-Seq relies upon counts from the >10(5 reads generated per locus per time-point to determine allele frequencies. Loci of interest are directly amplified from a mixed population via two rounds of PCR using inexpensive, user-designed oligonucleotides and a bar-coded bridging primer system that can be regenerated in-house. The resulting bar-coded PCR products contain the adapters needed for Illumina sequencing, eliminating further library preparation. We demonstrate the utility of FREQ-Seq by determining the order and dynamics of beneficial alleles that arose as a microbial population, founded with an engineered strain of Methylobacterium, evolved to grow on methanol. Quantifying allele frequencies with minimal bias down to 1% abundance allowed effective analysis of SNPs, small in-dels and insertions of transposable elements. Our data reveal large-scale clonal interference during the early stages of adaptation and illustrate the utility of FREQ-Seq as a cost-effective tool for tracking allele frequencies in populations.

  3. A low cost and palm-size analyzer for rapid and sensitive protein detection by AC electrokinetics capacitive sensing.

    Science.gov (United States)

    Liu, Xiaozhu; Cheng, Cheng; Wu, Jayne; Eda, Shigetoshi; Guo, Yongcai

    2017-04-15

    Specific detection of protein biomarkers has a wide range of applications in areas such as medical science, diagnostics, and pharmacology. Quantitative detection of protein biomarkers in biological media, such as serum, is critically important in detecting disease or physiological malfunction, or tracking disease progression. Among various detection methods, electrical detection is particularly well suited for point-of-care (POC) specific protein detection, being of low cost, light weight and small form factor. A portable system for sensitive and quantitative detection of protein biomarkers will be highly valuable in controlling and preventing diseases outbreaks. Recently, an alternating current electrokinetic (ACEK) capacitive sensing method has been reported to demonstrate very promising performance on rapid and sensitive detection of specific protein from serum. In this work, a low cost and portable analyzer with good accuracy is developed to use with ACEK capacitive sensing to produce a true POC technology. The development of a board-level capacitance readout system is presented, as well as the adaption of the protocol for use with ACEK capacitive sensing. Results showed that the developed system could achieve a limit of detection of 10ng/mL, comparable to a sophisticated benchtop instrument. With its small size and light-weight similar to a smart phone, the developed system is ready to be applicable to POC diagnostics. Further, the readout system can be readily expanded for multichannel monitoring and telecommunication capabilities. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Rapid and Low-Cost CRP Measurement by Integrating a Paper-Based Microfluidic Immunoassay with Smartphone (CRP-Chip).

    Science.gov (United States)

    Dong, Meili; Wu, Jiandong; Ma, Zimin; Peretz-Soroka, Hagit; Zhang, Michael; Komenda, Paul; Tangri, Navdeep; Liu, Yong; Rigatto, Claudio; Lin, Francis

    2017-03-26

    Traditional diagnostic tests for chronic diseases are expensive and require a specialized laboratory, therefore limiting their use for point-of-care (PoC) testing. To address this gap, we developed a method for rapid and low-cost C-reactive protein (CRP) detection from blood by integrating a paper-based microfluidic immunoassay with a smartphone (CRP-Chip). We chose CRP for this initial development because it is a strong biomarker of prognosis in chronic heart and kidney disease. The microfluidic immunoassay is realized by lateral flow and gold nanoparticle-based colorimetric detection of the target protein. The test image signal is acquired and analyzed using a commercial smartphone with an attached microlens and a 3D-printed chip-phone interface. The CRP-Chip was validated for detecting CRP in blood samples from chronic kidney disease patients and healthy subjects. The linear detection range of the CRP-Chip is up to 2 μg/mL and the detection limit is 54 ng/mL. The CRP-Chip test result yields high reproducibility and is consistent with the standard ELISA kit. A single CRP-Chip can perform the test in triplicate on a single chip within 15 min for less than 50 US cents of material cost. This CRP-Chip with attractive features of low-cost, fast test speed, and integrated easy operation with smartphones has the potential to enable future clinical PoC chronic disease diagnosis and risk stratification by parallel measurements of a panel of protein biomarkers.

  5. Tennis in hot and cool conditions decreases the rapid muscle torque production capacity of the knee extensors but not of the plantar flexors.

    Science.gov (United States)

    Girard, Olivier; Racinais, Sébastien; Périard, Julien D

    2014-04-01

    To assess the time course of changes in rapid muscle force/torque production capacity and neuromuscular activity of lower limb muscles in response to prolonged (∼2 h) match-play tennis under heat stress. The rates of torque development (RTD) and electromyographic activity (EMG; ie, root mean square) rise were recorded from 0 to 30, -50, -100 and -200 ms during brief (3-5 s) explosive maximal isometric voluntary contractions (MVC) of the knee extensors (KE) and plantar flexors (PF), along with the peak RTD within the entirety of the torque-time curve. These values were recorded in 12 male tennis players before (prematch) and after (postmatch, 24 and 48 h) match-play in HOT (∼37°C) and COOL (∼22°C) conditions. The postmatch core temperature was greater in the HOT (∼39.4°C) vs COOL (∼38.7°C) condition (ptorque. Furthermore, the rate of KE EMG activity rise remained unchanged. Conversely, the PF contractile RTD and rate of EMG activity rise were unaffected by the exercise or environmental conditions. In the KE, a reduction in maximal torque production capacity following prolonged match-play tennis appears to account for the decrease in the rate of torque development, independent of environmental conditions, while remaining unchanged in the PF.

  6. Application Anti Microbial Activity Test and Direct Inoculation of Urinary Specimen Test to Increase the Quality of Results and Decrease the Production Cost in Clinical Microbiology Laboratory, Sanglah General Hospital Hospital, Bali-Indonesia

    Directory of Open Access Journals (Sweden)

    Nyoman Sri-Budayanti

    2012-05-01

    Full Text Available Objective: Urinary tract infection (UTI is the most common bacterial infection in general practice and in hospitals. Fast and accurate urine culture and sensitivity test are needed for adequate therapy. Anti Microbial Activity test (AMA test that is used to detect the presence of antibiotics in urine specimens is not commonly used in clinical microbiology laboratories. Some laboratories are still using indirect inoculation technique using enriched media before inoculating onto the agar media. The aim of this research is to compare results of urinary examination of direct inoculation technique with AMA test with indirect inoculation technique without AMA test.Methods: A number of 210 urine specimens were collected in Clinical Microbiology Laboratory at Sanglah General Hospital within a time period between 16 June until 16 July 2009.Results: Antibiotics were detected in 40% of the urinary specimens; whereas 48.1% showed no evidence of UTI, that is negative AMA test and sterile urinary culture or colony growth < 105 CFU/ml. Only 11.9% of the specimens indicates urinary tract infections. The examination can be completed within 2-3 days which is shorter than indirect inoculation test which require 5-7 days. Direct inoculation technique can reduce the cost of production three-fold the costs require for an indirect inoculation test.Conclusions: Application of AMA test and direct inoculation technique can give results more rapidly, reliable and useful for clinicians. This also decrease the laboratory’s cost of production.

  7. Is liver transplantation using organs donated after cardiac death cost-effective or does it decrease waitlist death by increasing recipient death?

    Science.gov (United States)

    Dageforde, Leigh Anne; Feurer, Irene D; Pinson, C Wright; Moore, Derek E

    2013-03-01

    The aim of this study was to evaluate the cost-effectiveness in liver transplantation (LT) of utilizing organs donated after cardiac death (DCD) compared with organs donated after brain death (DBD). A Markov-based decision analytic model was created to compare two LT waitlist strategies distinguished by organ type: (i) DBD organs only, and (ii) DBD and DCD organs. The model simulated outcomes for patients over 10 years with annual cycles through one of four health states: survival; ischaemic cholangiopathy; retransplantation, and death. Baseline values and ranges were determined from an extensive literature review. Sensitivity analyses tested model strength and parameter variability. Overall survival is decreased, and biliary complications and retransplantation are increased in recipients of DCD livers. Recipients of DBD livers gained 5.6 quality-adjusted life years (QALYs) at a cost of US$69 000/QALY, whereas recipients on the DBD + DCD LT waitlist gained 6.0 QALYs at a cost of US$61 000/QALY. The DBD + DCD organ strategy was superior to the DBD organ-only strategy. The extension of life and quality of life provided by DCD LT to patients on the waiting list who might otherwise not receive a liver transplant makes the continued use of DCD livers cost-effective. © 2012 International Hepato-Pancreato-Biliary Association.

  8. Rapid, scalable, and low-cost purification of recombinant adeno-associated virus produced by baculovirus expression vector system

    Directory of Open Access Journals (Sweden)

    Pierre-Olivier Buclez

    2016-01-01

    Full Text Available Recombinant adeno-associated viruses (rAAV are largely used for gene transfer in research, preclinical developments, and clinical trials. Their broad in vivo biodistribution and long-term efficacy in postmitotic tissues make them good candidates for numerous gene transfer applications. Upstream processes able to produce large amounts of rAAV were developed, particularly those using baculovirus expression vector system. In parallel, downstream processes present a large panel of purification methods, often including multiple and time consuming steps. Here, we show that simple tangential flow filtration, coupled with an optimized iodixanol-based isopycnic density gradient, is sufficient to purify several liters of crude lysate produced by baculovirus expression vector system in only one working day, leading to high titers and good purity of rAAV products. Moreover, we show that the viral vectors retain their in vitro and in vivo functionalities. Our results demonstrate that simple, rapid, and relatively low-cost methods can easily be implemented for obtaining a high-quality grade of gene therapy products based on rAAV technology.

  9. Rapid detection of Clostridium difficile via magnetic bead aggregation in cost-effective polyester microdevices with cell phone image analysis.

    Science.gov (United States)

    DuVall, Jacquelyn A; Cabaniss, Scott T; Angotti, Morgan L; Moore, John H; Abhyankar, Mayuresh; Shukla, Nishant; Mills, Daniel L; Kessel, Bryan G; Garner, Gavin T; Swami, Nathan S; Landers, James P

    2016-10-07

    Pathogen detection has traditionally been accomplished by utilizing methods such as cell culture, immunoassays, and nucleic acid amplification tests; however, these methods are not easily implemented in resource-limited settings because special equipment for detection and thermal cycling is often required. In this study, we present a magnetic bead aggregation assay coupled to an inexpensive microfluidic fabrication technique that allows for cell phone detection and analysis of a notable pathogen in less than one hour. Detection is achieved through the use of a custom-built system that allows for fluid flow control via centrifugal force, as well as manipulation of magnetic beads with an adjustable rotating magnetic field. Cell phone image capture and analysis is housed in a 3D-printed case with LED backlighting and a lid-mounted Android phone. A custom-written application (app.) is employed to interrogate images for the extent of aggregation present following loop-mediated isothermal amplification (LAMP) coupled to product-inhibited bead aggregation (PiBA) for detection of target sequences. Clostridium difficile is a pathogen of increasing interest due to its causative role in intestinal infections following antibiotic treatment, and was therefore chosen as the pathogen of interest in the present study to demonstrate the rapid, cost-effective, and sequence-specific detection capabilities of the microfluidic platform described herein.

  10. Establishing a safe, rapid, convenient and low-cost antiviral assay of interferon bioactivity based on recombinant VSV expressing GFP.

    Science.gov (United States)

    Chen, Weiye; Wen, Zhiyuan; Zhang, Jialin; Li, Cuicui; Huang, Kehe; Bu, Zhigao

    2017-08-20

    The methods of the quantitative assay of the antiviral activity of interferons (IFNs) (type I, II or III) are very important during carrying out of the research of them, since they were found. Here a recombinant vesicular stomatitis virus expressing green fluorescent protein (GFP) (VSV/GFP) and MDBK cells were used to develop an antiviral assay (AVA) for IFNs. This method was carried out on a 96-well cell culture plate, and the half reduction of virus replication was quantified by assaying GFP. To quantify GFP, cell lysis buffer was directly added to the wells infected with VSV/GFP to lyse cells, the VSV/GFP was then inactivated, and relative fluorescence unit (RFU) of GFP was measured and used to calculate the antiviral activity. This method needed only one step instead of three steps in the staining method with naphthol blue black, medium with phenol red can be used, and it had good reproducibility. The GFP-containing samples could be stored at 4°C in a wet box for at least 1 week without affecting the assay results. In addition, the results obtained with this method were similar to those obtained with the staining method. In conclusion, a safe, rapid, convenient and low-cost AVA of IFN based on recombinant VSV/GFP was established. Copyright © 2017. Published by Elsevier B.V.

  11. Rapid, low-cost photogrammetry to monitor volcanic eruptions: an example from Mount St. Helens, Washington, USA

    Science.gov (United States)

    Diefenbach, Angela K.; Crider, Juliet G.; Schilling, Steve P.; Dzurisin, Daniel

    2012-01-01

    We describe a low-cost application of digital photogrammetry using commercially available photogrammetric software and oblique photographs taken with an off-the-shelf digital camera to create sequential digital elevation models (DEMs) of a lava dome that grew during the 2004–2008 eruption of Mount St. Helens (MSH) volcano. Renewed activity at MSH provided an opportunity to devise and test this method, because it could be validated against other observations of this well-monitored volcano. The datasets consist of oblique aerial photographs (snapshots) taken from a helicopter using a digital single-lens reflex camera. Twelve sets of overlapping digital images of the dome taken during 2004–2007 were used to produce DEMs and to calculate lava dome volumes and extrusion rates. Analyses of the digital images were carried out using photogrammetric software to produce three-dimensional coordinates of points identified in multiple photos. The evolving morphology of the dome was modeled by comparing successive DEMs. Results were validated by comparison to volume measurements derived from traditional vertical photogrammetric surveys by the US Geological Survey Cascades Volcano Observatory. Our technique was significantly less expensive and required less time than traditional vertical photogrammetric techniques; yet, it consistently yielded volume estimates within 5% of the traditional method. This technique provides an inexpensive, rapid assessment tool for tracking lava dome growth or other topographic changes at restless volcanoes.

  12. Low-cost, rapidly-developed, 3D printed in vitro corpus callosum model for mucopolysaccharidosis type I.

    Science.gov (United States)

    Tabet, Anthony; Gardner, Matthew; Swanson, Sebastian; Crump, Sydney; McMeekin, Austin; Gong, Diana; Tabet, Rebecca; Hacker, Benjamin; Nestrasil, Igor

    2016-01-01

    The rising prevalence of high throughput screening and the general inability of (1) two dimensional (2D) cell culture and (2) in vitro release studies to predict in vivo neurobiological and pharmacokinetic responses in humans has led to greater interest in more realistic three dimensional (3D) benchtop platforms. Advantages of 3D human cell culture over its 2D analogue, or even animal models, include taking the effects of microgeometry and long-range topological features into consideration. In the era of personalized medicine, it has become increasingly valuable to screen candidate molecules and synergistic therapeutics at a patient-specific level, in particular for diseases that manifest in highly variable ways. The lack of established standards and the relatively arbitrary choice of probing conditions has limited in vitro drug release to a largely qualitative assessment as opposed to a predictive, quantitative measure of pharmacokinetics and pharmacodynamics in tissue. Here we report the methods used in the rapid, low-cost development of a 3D model of a mucopolysaccharidosis type I patient's corpus callosum, which may be used for cell culture and drug release. The CAD model is developed from in vivo brain MRI tracing of the corpus callosum using open-source software, printed with poly (lactic-acid) on a Makerbot Replicator 5X, UV-sterilized, and coated with poly (lysine) for cellular adhesion. Adaptations of material and 3D printer for expanded applications are also discussed.

  13. A sodium-activated potassium channel supports high-frequency firing and reduces energetic costs during rapid modulations of action potential amplitude.

    Science.gov (United States)

    Markham, Michael R; Kaczmarek, Leonard K; Zakon, Harold H

    2013-04-01

    We investigated the ionic mechanisms that allow dynamic regulation of action potential (AP) amplitude as a means of regulating energetic costs of AP signaling. Weakly electric fish generate an electric organ discharge (EOD) by summing the APs of their electric organ cells (electrocytes). Some electric fish increase AP amplitude during active periods or social interactions and decrease AP amplitude when inactive, regulated by melanocortin peptide hormones. This modulates signal amplitude and conserves energy. The gymnotiform Eigenmannia virescens generates EODs at frequencies that can exceed 500 Hz, which is energetically challenging. We examined how E. virescens meets that challenge. E. virescens electrocytes exhibit a voltage-gated Na(+) current (I(Na)) with extremely rapid recovery from inactivation (τ(recov) = 0.3 ms) allowing complete recovery of Na(+) current between APs even in fish with the highest EOD frequencies. Electrocytes also possess an inwardly rectifying K(+) current and a Na(+)-activated K(+) current (I(KNa)), the latter not yet identified in any gymnotiform species. In vitro application of melanocortins increases electrocyte AP amplitude and the magnitudes of all three currents, but increased I(KNa) is a function of enhanced Na(+) influx. Numerical simulations suggest that changing I(Na) magnitude produces corresponding changes in AP amplitude and that K(Na) channels increase AP energy efficiency (10-30% less Na(+) influx/AP) over model cells with only voltage-gated K(+) channels. These findings suggest the possibility that E. virescens reduces the energetic demands of high-frequency APs through rapidly recovering Na(+) channels and the novel use of KNa channels to maximize AP amplitude at a given Na(+) conductance.

  14. Nicotine increases impulsivity and decreases willingness to exert cognitive effort despite improving attention in "slacker" rats: insights into cholinergic regulation of cost/benefit decision making.

    Science.gov (United States)

    Hosking, Jay G; Lam, Fred C W; Winstanley, Catharine A

    2014-01-01

    Successful decision making in our daily lives requires weighing an option's costs against its associated benefits. The neuromodulator acetylcholine underlies both the etiology and treatment of a number of illnesses in which decision making is perturbed, including Alzheimer's disease, attention-deficit/hyperactivity disorder, and schizophrenia. Nicotine acts on the cholinergic system and has been touted as a cognitive enhancer by both smokers and some researchers for its attention-boosting effects; however, it is unclear whether treatments that have a beneficial effect on attention would also have a beneficial effect on decision making. Here we utilize the rodent Cognitive Effort Task (rCET), wherein animals can choose to allocate greater visuospatial attention for a greater reward, to examine cholinergic contributions to both attentional performance and choice based on attentional demand. Following the establishment of baseline behavior, four drug challenges were administered: nicotine, mecamylamine, scopolamine, and oxotremorine (saline plus three doses for each). As per previous rCET studies, animals were divided by their baseline preferences, with "worker" rats choosing high-effort/high-reward options more than their "slacker" counterparts. Nicotine caused slackers to choose even fewer high-effort trials than at baseline, but had no effect on workers' choice. Despite slackers' decreased willingness to expend effort, nicotine improved their attentional performance on the task. Nicotine also increased measures of motor impulsivity in all animals. In contrast, scopolamine decreased animals' choice of high-effort trials, especially for workers, while oxotremorine decreased motor impulsivity for all animals. In sum, the cholinergic system appears to contribute to decision making, and in part these contributions can be understood as a function of individual differences. While nicotine has been considered as a cognitive enhancer, these data suggest that its modest

  15. Nicotine Increases Impulsivity and Decreases Willingness to Exert Cognitive Effort despite Improving Attention in “Slacker” Rats: Insights into Cholinergic Regulation of Cost/Benefit Decision Making

    Science.gov (United States)

    Hosking, Jay G.; Lam, Fred C. W.; Winstanley, Catharine A.

    2014-01-01

    Successful decision making in our daily lives requires weighing an option’s costs against its associated benefits. The neuromodulator acetylcholine underlies both the etiology and treatment of a number of illnesses in which decision making is perturbed, including Alzheimer’s disease, attention-deficit/hyperactivity disorder, and schizophrenia. Nicotine acts on the cholinergic system and has been touted as a cognitive enhancer by both smokers and some researchers for its attention-boosting effects; however, it is unclear whether treatments that have a beneficial effect on attention would also have a beneficial effect on decision making. Here we utilize the rodent Cognitive Effort Task (rCET), wherein animals can choose to allocate greater visuospatial attention for a greater reward, to examine cholinergic contributions to both attentional performance and choice based on attentional demand. Following the establishment of baseline behavior, four drug challenges were administered: nicotine, mecamylamine, scopolamine, and oxotremorine (saline plus three doses for each). As per previous rCET studies, animals were divided by their baseline preferences, with “worker” rats choosing high-effort/high-reward options more than their “slacker” counterparts. Nicotine caused slackers to choose even fewer high-effort trials than at baseline, but had no effect on workers’ choice. Despite slackers’ decreased willingness to expend effort, nicotine improved their attentional performance on the task. Nicotine also increased measures of motor impulsivity in all animals. In contrast, scopolamine decreased animals’ choice of high-effort trials, especially for workers, while oxotremorine decreased motor impulsivity for all animals. In sum, the cholinergic system appears to contribute to decision making, and in part these contributions can be understood as a function of individual differences. While nicotine has been considered as a cognitive enhancer, these data suggest

  16. Nicotine increases impulsivity and decreases willingness to exert cognitive effort despite improving attention in "slacker" rats: insights into cholinergic regulation of cost/benefit decision making.

    Directory of Open Access Journals (Sweden)

    Jay G Hosking

    Full Text Available Successful decision making in our daily lives requires weighing an option's costs against its associated benefits. The neuromodulator acetylcholine underlies both the etiology and treatment of a number of illnesses in which decision making is perturbed, including Alzheimer's disease, attention-deficit/hyperactivity disorder, and schizophrenia. Nicotine acts on the cholinergic system and has been touted as a cognitive enhancer by both smokers and some researchers for its attention-boosting effects; however, it is unclear whether treatments that have a beneficial effect on attention would also have a beneficial effect on decision making. Here we utilize the rodent Cognitive Effort Task (rCET, wherein animals can choose to allocate greater visuospatial attention for a greater reward, to examine cholinergic contributions to both attentional performance and choice based on attentional demand. Following the establishment of baseline behavior, four drug challenges were administered: nicotine, mecamylamine, scopolamine, and oxotremorine (saline plus three doses for each. As per previous rCET studies, animals were divided by their baseline preferences, with "worker" rats choosing high-effort/high-reward options more than their "slacker" counterparts. Nicotine caused slackers to choose even fewer high-effort trials than at baseline, but had no effect on workers' choice. Despite slackers' decreased willingness to expend effort, nicotine improved their attentional performance on the task. Nicotine also increased measures of motor impulsivity in all animals. In contrast, scopolamine decreased animals' choice of high-effort trials, especially for workers, while oxotremorine decreased motor impulsivity for all animals. In sum, the cholinergic system appears to contribute to decision making, and in part these contributions can be understood as a function of individual differences. While nicotine has been considered as a cognitive enhancer, these data suggest

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

    Science.gov (United States)

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

    2010-09-01

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

  18. A strategy to decide whether to move the last case of the day in an operating room to another empty operating room to decrease overtime labor costs.

    Science.gov (United States)

    Dexter, F

    2000-10-01

    We examined how to program an operating room (OR) information system to assist the OR manager in deciding whether to move the last case of the day in one OR to another OR that is empty to decrease overtime labor costs. We first developed a statistical strategy to predict whether moving the case would decrease overtime labor costs for first shift nurses and anesthesia providers. The strategy was based on using historical case duration data stored in a surgical services information system. Second, we estimated the incremental overtime labor costs achieved if our strategy was used for moving cases versus movement of cases by an OR manager who knew in advance exactly how long each case would last. We found that if our strategy was used to decide whether to move cases, then depending on parameter values, only 2.0 to 4.3 more min of overtime would be required per case than if the OR manager had perfect retrospective knowledge of case durations. The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved. The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays, can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved.

  19. A comparative analysis of costs of single and dual rapid HIV and syphilis diagnostics: results from a randomised controlled trial in Colombia.

    Science.gov (United States)

    Obure, Carol Dayo; Gaitan-Duarte, Hernando; Losada Saenz, Ricardo; Gonzalez, Lina; Angel-Muller, Edith; Laverty, Maura; Perez, Freddy

    2017-11-01

    HIV and congenital syphilis are major public health burdens contributing to substantial perinatal morbidity and mortality globally. Although studies have reported on the costs and cost-effectiveness of rapid diagnostic tests (RDTs) for syphilis screening within antenatal care in a number of resource-constrained settings, empirical evidence on country-specific cost and estimates of single RDTs compared with dual RDTs for HIV and syphilis are limited. A cluster randomised controlled study design was used to compare the incremental costs of two testing algorithms: (1) single RDTs for HIV and syphilis and (2) dual RDTs for HIV and syphilis, in 12 health facilities in Bogota and Cali, Colombia. The costs of single HIV and syphilis RDTs and dual HIV and syphilis RDTs were collected from each of the health facilities. The economic costs per woman tested for HIV and syphilis and costs per woman treated for syphilis defined as the total costs required to test and treat one woman for syphilis were estimated. A total of 2214 women were tested in the study facilities. Cost per pregnant woman tested and cost per woman treated for syphilis were US$10.26 and US$607.99, respectively in the single RDT arm. For the dual RDTs, the cost per pregnant woman tested for HIV and syphilis and cost per woman treated for syphilis were US$15.89 and US$1859.26, respectively. Overall costs per woman tested for HIV and syphilis and cost per woman treated for syphilis were lower in Cali compared with Bogota across both intervention arms. Staff costs accounted for the largest proportion of costs while treatment costs comprised <1% of the preventive programme. Findings show lower average costs for single RDTs compared with dual RDTs with costs sensitive to personnel costs and the scale of output at the health facilities. NCT02454816; results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Moving toward rapid and low-cost point-of-care molecular diagnostics with a repurposed 3D printer and RPA.

    Science.gov (United States)

    Chan, Kamfai; Wong, Pui-Yan; Parikh, Chaitanya; Wong, Season

    2018-01-12

    Traditionally, the majority of nucleic acid amplification-based molecular diagnostic tests are done in centralized settings. In recent years, point-of-care tests have been developed for use in low-resource settings away from central laboratories. While most experts agree that point-of-care molecular tests are greatly needed, their availability as cost-effective and easy-to-operate tests remains an unmet goal. In this article, we discuss our efforts to develop a recombinase polymerase amplification reaction-based test that will meet these criteria. First, we describe our efforts in repurposing a low-cost 3D printer as a platform that can carry out medium-throughput, rapid, and high-performing nucleic acid extraction. Next, we address how these purified templates can be rapidly amplified and analyzed using the 3D printer's heated bed or the deconstructed, low-cost thermal cycler we have developed. In both approaches, real-time isothermal amplification and detection of template DNA or RNA can be accomplished using a low-cost portable detector or smartphone camera. Last, we demonstrate the capability of our technologies using foodborne pathogens and the Zika virus. Our low-cost approach does not employ complicated and high-cost components, making it suitable for resource-limited settings. When integrated and commercialized, it will offer simple sample-to-answer molecular diagnostics. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. Application of thermohydraulic dispatcher in low temperature district heating systems for decreasing heat carrier transportation energy cost and increasing reliability of heat supply

    Science.gov (United States)

    Yavorovsky, Y. V.; Romanov, D. O.; Sennikov, V. V.; Sultanguzin, I. A.; Malenkov, A. S.; Zhigulina, E. V.; Lulaev, A. V.

    2017-11-01

    Low pressure district heating systems have low breakdown rate and allow decreasing heat carrier transportation energy cost by means of avoiding throttling of available water head. One of the basic elements of such systems is thermohydraulic dispatcher (THD) which separates primary circuit and secondary circuit (or circuits) that allows avoiding mutual hydraulic influence of circuits on each other and reducing water heads of network pumps. Analysis of perspective ways of using thermohydraulic dispatcher (THD) in low temperature district heating systems is made in this paper. Principal scheme and mathematical model of low pressure and temperature district heating system based on CHP generation with THD are considered. The main advantages of such systems are pointed out.

  2. Low-Cost and Rapid Fabrication of Metallic Nanostructures for Sensitive Biosensors Using Hot-Embossing and Dielectric-Heating Nanoimprint Methods

    Directory of Open Access Journals (Sweden)

    Kuang-Li Lee

    2017-07-01

    Full Text Available We propose two approaches—hot-embossing and dielectric-heating nanoimprinting methods—for low-cost and rapid fabrication of periodic nanostructures. Each nanofabrication process for the imprinted plastic nanostructures is completed within several seconds without the use of release agents and epoxy. Low-cost, large-area, and highly sensitive aluminum nanostructures on A4 size plastic films are fabricated by evaporating aluminum film on hot-embossing nanostructures. The narrowest bandwidth of the Fano resonance is only 2.7 nm in the visible light region. The periodic aluminum nanostructure achieves a figure of merit of 150, and an intensity sensitivity of 29,345%/RIU (refractive index unit. The rapid fabrication is also achieved by using radio-frequency (RF sensitive plastic films and a commercial RF welding machine. The dielectric-heating, using RF power, takes advantage of the rapid heating/cooling process and lower electric power consumption. The fabricated capped aluminum nanoslit array has a 5 nm Fano linewidth and 490.46 nm/RIU wavelength sensitivity. The biosensing capabilities of the metallic nanostructures are further verified by measuring antigen–antibody interactions using bovine serum albumin (BSA and anti-BSA. These rapid and high-throughput fabrication methods can benefit low-cost, highly sensitive biosensors and other sensing applications.

  3. Standardizing documentation and the clinical approach to apnea of prematurity reduces length of stay, improves staff satisfaction, and decreases hospital cost.

    Science.gov (United States)

    Butler, T Jeffrey; Firestone, Kimberly S; Grow, Jennifer L; Kantak, Anand D

    2014-06-01

    Apnea of prematurity, a common disorder, can severely compromise an infant's condition unless correctly diagnosed and treated. Infants with a history of apnea of prematurity can be discharged home but then be rehospitalized for an apneic event, an apparent life-threatening event, or sudden infant death syndrome. The definition of a clinically significant cardiopulmonary event, such events' documentation, and the treatment approach were standardized, and discharge criteria were refined. A prospective, single-center comparison was conducted between a group of premature infants before and after implementation of the standard approach. Data were collected prospectively from August 1, 2005, through July 21, 2006, for the prestandard-approach group and from August 1, 2006, through September 16, 2007, for the standard-approach group. Twenty-two (35%) of the 63 infants in the prestandard-approach group experienced discharge delays because of poor documentation, whereby the clinician could not determine the safety of discharge. This resulted in 59 additional hospital days (mean length-of-stay [LOS] increase, 5.7 days). The standard-approach group of 72 infants experienced no discharge delays and no additional hospital days, and LOS decreased (all p or = 96%. Implementation of a standard approach to the definition of apnea of prematurity and its treatment and documentation decreases LOS and reduces cost.

  4. Field evaluation of the performance and testing costs of a rapid point-of-care test for syphilis in a red-light district of Manaus, Brazil.

    Science.gov (United States)

    Benzaken, A S; Sabidó, M; Galban, E G; Pedroza, V; Vasquez, F; Araújo, A; Peeling, R W; Mayaud, P

    2008-08-01

    To assess the performance, usefulness and cost of a rapid treponemal antibody assay (VisiTect Syphilis) to detect syphilis in high risk populations. People who attended STI clinics in Manaus, Brazil, were screened for syphilis using the fluorescent treponemal antibody absorption (FTA-Abs) test and a non-treponemal test (Venereal Diseases Research Laboratory (VDRL)), and for HIV. Finger prick blood samples were tested with VisiTect Syphilis. The rapid test was evaluated against the reference FTA-Abs and for its usefulness in detecting active syphilis (FTA-Abs and VDRL positive). Operational performance was assessed through providers' and patients' interviews. An economic evaluation was conducted from the provider's perspective. 510 patients (60% men) were enrolled, of whom 13 (2.5%) were HIV-1 seropositive. Syphilis prevalence (FTA-Abs) was 18% and active syphilis prevalence was 7.5%. 11% (57/506) of samples were positive by VisiTect. The sensitivity, specificity, positive and negative predictive values of VisiTect Syphilis were 57% (95% CI 45.8 to 66.7), 99% (95% CI 97.0 to 99.6), 91% (95% CI 80.0 to 96.7) and 91% (95% CI 88.0 to 93.5), respectively. VisiTect Syphilis identified 79% (30/38) of active syphilis cases. The cost per case of syphilis was $16.8 for VDRL, $33.2 for low cost and $56.3 for high cost VisiTect Syphilis; the cost per case of active syphilis was $21.3, $57.5 and $97.6, respectively. Patients identified finger prick pain and preference for venous blood collection as minor barriers to test use. VisiTect Syphilis had low sensitivity in field use and was less cost effective than conventional VDRL. However, rapid and correct identification of a high proportion of active syphilis cases combined with operational characteristics suggest a role in high risk populations.

  5. Cost-effectiveness of a motivational intervention to reduce rapid repeated childbearing in high-risk adolescent mothers: a rebirth of economic and policy considerations.

    Science.gov (United States)

    Barnet, Beth; Rapp, Thomas; DeVoe, Margo; Mullins, C Daniel

    2010-04-01

    To determine the cost-effectiveness of an intervention that successfully reduced rapid repeated births within 2 years of an index birth to adolescent mothers. Randomized, controlled trial conducted from February 2003 to October 2007. Home-based intervention with participants recruited from 5 urban clinics that provide care to low-income African American communities. Two hundred thirty-five pregnant teenagers (n = 235) aged 18 years or younger who were at 24 or more weeks of gestation at recruitment were followed up for 27 months. Participants were randomly assigned to usual care (n = 68) or 1 of 2 home-based interventions conducted by community outreach workers: (1) computer-assisted motivational intervention (CAMI) conducted quarterly with additional visits (CAMI+ [n = 80]) or (2) CAMI only (n = 87), a single-component motivational intervention conducted quarterly. Additional births by 24 months post partum determined from birth certificates, total and weighted mean intervention costs, cost per participant, and incremental cost-effectiveness ratios, defined as cost per prevented repeated birth. Relative to usual care, CAMI significantly reduced repeated births (adjusted odds ratio, 0.47; 95% confidence interval, 0.22-0.97). Mean intervention costs per adolescent were $2064, with incremental cost-effectiveness ratios per prevented repeated birth of $21 895 (unadjusted), $17 388 (adjusted), and $13 687 for a high-risk subgroup termed newly insured (eligible for but not enrolled in public insurance). The CAMI costs and cost-effectiveness compare favorably with other effective programs aimed at preventing repeated teenage births. Replication of these results in broader samples of adolescents would provide policy guidance for what works, for whom, and at what cost.

  6. Impact of rapid methicillin-resistant Staphylococcus aureus polymerase chain reaction testing on mortality and cost effectiveness in hospitalized patients with bacteraemia: a decision model.

    Science.gov (United States)

    Brown, Jack; Paladino, Joseph A

    2010-01-01

    Patients hospitalized with Staphylococcus aureus bacteraemia have an unacceptably high mortality rate. Literature available to date has shown that timely selection of the most appropriate antibacterial may reduce mortality. One tool that may help with this selection is a polymerase chain reaction (PCR) assay that distinguishes methicillin (meticillin)-resistant S. aureus (MRSA) from methicillin-susceptible S. aureus (MSSA) in less than 1 hour. To date, no information is available evaluating the impact of this PCR technique on clinical or economic outcomes. To evaluate the effect of a rapid PCR assay on mortality and economics compared with traditional empiric therapy, using a literature-derived model. A literature search for peer-reviewed European (EU) and US publications regarding treatment regimens, outcomes and costs was conducted. Information detailing the rates of infection, as well as the specificity and sensitivity of a rapid PCR assay (Xpert MRSA/SA Blood Culture PCR) were obtained from the peer-reviewed literature. Sensitivity analysis varied the prevalence rate of MRSA from 5% to 80%, while threshold analysis was applied to the cost of the PCR test. Hospital and testing resource consumption were valued with direct medical costs, adjusted to year 2009 values. Adjusted life-years were determined using US and WHO life tables. The cost-effectiveness ratio was defined as the cost per life-year saved. Incremental cost-effectiveness ratios (ICERs) were calculated to determine the additional cost necessary to produce additional effectiveness. All analyses were performed using TreeAge Software (2008). The mean mortality rates were 23% for patients receiving empiric vancomycin subsequently switched to semi-synthetic penicillin (SSP) for MSSA, 36% for patients receiving empiric vancomycin treatment for MRSA, 59% for patients receiving empiric SSP subsequently switched to vancomycin for MRSA and 12% for patients receiving empiric SSP for MSSA. Furthermore, with an

  7. Calculating the Social Costs of Carbon without knowing preferences : Comment on “A rapid assessment model for understanding the social cost of carbon”

    NARCIS (Netherlands)

    Gerlagh, R.

    The Social Costs of Carbon (SCC) equals the marginal welfare loss associated with one unit of emitted CO2, divided by the marginal welfare gain associated with one unit of consumption. In stochastic assessments, both the nominator and denominator can depend on uncertain parameters; specifically they

  8. Cost-effectiveness analysis of antiviral treatment in the management of seasonal influenza A: point-of-care rapid test versus clinical judgment.

    Science.gov (United States)

    Nshimyumukiza, Léon; Douville, Xavier; Fournier, Diane; Duplantie, Julie; Daher, Rana K; Charlebois, Isabelle; Longtin, Jean; Papenburg, Jesse; Guay, Maryse; Boissinot, Maurice; Bergeron, Michel G; Boudreau, Denis; Gagné, Christian; Rousseau, François; Reinharz, Daniel

    2016-03-01

    A point-of-care rapid test (POCRT) may help early and targeted use of antiviral drugs for the management of influenza A infection. (i) To determine whether antiviral treatment based on a POCRT for influenza A is cost-effective and, (ii) to determine the thresholds of key test parameters (sensitivity, specificity and cost) at which a POCRT based-strategy appears to be cost effective. An hybrid « susceptible, infected, recovered (SIR) » compartmental transmission and Markov decision analytic model was used to simulate the cost-effectiveness of antiviral treatment based on a POCRT for influenza A in the social perspective. Data input parameters used were retrieved from peer-review published studies and government databases. The outcome considered was the incremental cost per life-year saved for one seasonal influenza season. In the base-case analysis, the antiviral treatment based on POCRT saves 2 lives/100,000 person-years and costs $7600 less than the empirical antiviral treatment based on clinical judgment alone, which demonstrates that the POCRT-based strategy is dominant. In one and two way-sensitivity analyses, results were sensitive to the POCRT accuracy and cost, to the vaccination coverage as well as to the prevalence of influenza A. In probabilistic sensitivity analyses, the POCRT strategy is cost-effective in 66% of cases, for a commonly accepted threshold of $50,000 per life-year saved. The influenza antiviral treatment based on POCRT could be cost-effective in specific conditions of performance, price and disease prevalence. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  9. CALCULATING THE SOCIAL COSTS OF CARBON WITHOUT KNOWING PREFERENCES COMMENT ON "A RAPID ASSESSMENT MODEL FOR UNDERSTANDING THE SOCIAL COST OF CARBON"

    OpenAIRE

    REYER GERLAGH

    2014-01-01

    The Social Costs of Carbon (SCC) equals the marginal welfare loss associated with one unit of emitted CO2, divided by the marginal welfare gain associated with one unit of consumption. In stochastic assessments, both the nominator and denominator can depend on uncertain parameters; specifically they depend on the (implicit) scaling of the welfare function with the parameters. I discuss some pitfalls when calculating the expected value or the certainty equivalent of the SCC, and show that a mi...

  10. Dominant Species in Subtropical Forests Could Decrease Photosynthetic N Allocation to Carboxylation and Bioenergetics and Enhance Leaf Construction Costs during Forest Succession.

    Science.gov (United States)

    Xiao, Yihua; Liu, Shirong; Tong, Fuchun; Chen, Bufeng; Kuang, Yuanwen

    2018-01-01

    It is important to understand how eco-physiological characteristics shift in forests when elucidating the mechanisms underlying species replacement and the process of succession and stabilization. In this study, the dominant species at three typical successional stages (early-, mid-, and late-succession) in the subtropical forests of China were selected. At each stage, we compared the leaf construction costs (CC), payback time (PBT), leaf area based N content ( N A ), maximum CO 2 assimilation rate ( P max ), specific leaf area (SLA), photosynthetic nitrogen use efficiency (PNUE), and leaf N allocated to carboxylation ( N C ), and to bioenergetics ( N B ). The relationships between these leaf functional traits were also determined. The results showed that the early-succession forest is characterized with significantly lower leaf CC, PBT, N A , but higher P max , SLA, PNUE, N C , and N B , in relation to the late-succession forest. From the early- to the late-succession forests, the relationship between P max and leaf CC strengthened, whereas the relationships between N B , N C , PNUE, and leaf CC weakened. Thus, the dominant species are able to decrease the allocation of the photosynthetic N fraction to carboxylation and bioenergetics during forest succession. The shift in these leaf functional traits and their linkages might represent a fundamental physiological mechanism that occurs during forest succession and stabilization.

  11. Dominant Species in Subtropical Forests Could Decrease Photosynthetic N Allocation to Carboxylation and Bioenergetics and Enhance Leaf Construction Costs during Forest Succession

    Science.gov (United States)

    Xiao, Yihua; Liu, Shirong; Tong, Fuchun; Chen, Bufeng; Kuang, Yuanwen

    2018-01-01

    It is important to understand how eco-physiological characteristics shift in forests when elucidating the mechanisms underlying species replacement and the process of succession and stabilization. In this study, the dominant species at three typical successional stages (early-, mid-, and late-succession) in the subtropical forests of China were selected. At each stage, we compared the leaf construction costs (CC), payback time (PBT), leaf area based N content (NA), maximum CO2 assimilation rate (Pmax), specific leaf area (SLA), photosynthetic nitrogen use efficiency (PNUE), and leaf N allocated to carboxylation (NC), and to bioenergetics (NB). The relationships between these leaf functional traits were also determined. The results showed that the early-succession forest is characterized with significantly lower leaf CC, PBT, NA, but higher Pmax, SLA, PNUE, NC, and NB, in relation to the late-succession forest. From the early- to the late-succession forests, the relationship between Pmax and leaf CC strengthened, whereas the relationships between NB, NC, PNUE, and leaf CC weakened. Thus, the dominant species are able to decrease the allocation of the photosynthetic N fraction to carboxylation and bioenergetics during forest succession. The shift in these leaf functional traits and their linkages might represent a fundamental physiological mechanism that occurs during forest succession and stabilization. PMID:29472939

  12. Testing of integrated human papillomavirus mRNA decreases colposcopy referrals: could a change in human papillomavirus detection methodology lead to more cost-effective patient care?

    Science.gov (United States)

    Sauter, Jennifer L; Mount, Sharon L; St John, Timothy L; Wojewoda, Christina M; Bryant, Ronald J; Leiman, Gladwyn

    2014-01-01

    This study investigates potential colposcopy referral rates, as per the latest American Society for Colposcopy and Cervical Pathology recommendations, following the change in high-risk human papillomavirus (HR-HPV) detection methodology from Hybrid Capture 2 (HC2) to APTIMA at our institution. Rates of colposcopy referral were compared between two cohorts, each comprising all Pap samples with a diagnosis of atypical squamous cells of undetermined significance (ASCUS) tested for HR-HPV in our laboratory during a 12-month period. Cohorts I and II included Pap samples tested with HC2 (n = 1,856) and APTIMA (n = 1,651), respectively. The rates of quantity not sufficient (QNS) results were determined for all Pap samples during the same time periods. The proportion of HR-HPV-positive Pap samples with an ASCUS diagnosis was significantly lower with APTIMA (42%) than with HC2 (53%; p detection methodology from HC2 to APTIMA has led to a 21% reduction in colposcopy referrals and a 90% decrease in QNS rates at our institution. The new methodology has resulted in more cost-effective patient care and fewer insufficient samples requiring repeat HR-HPV testing.

  13. Rapid dimerization of quercetin through an oxidative mechanism in the presence of serum albumin decreases its ability to induce cytotoxicity in MDA-MB-231 cells

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Anh; Bortolazzo, Anthony [Department of Biological Sciences, San Jose State University, San Jose, CA 95192-0100 (United States); White, J. Brandon, E-mail: Brandon.White@sjsu.edu [Department of Biological Sciences, San Jose State University, San Jose, CA 95192-0100 (United States)

    2012-10-19

    Highlights: Black-Right-Pointing-Pointer Quercetin cannot be detected intracellularly despite killing MDA-MB-231 cells. Black-Right-Pointing-Pointer Quercetin forms a heterodimer through oxidation in media with serum. Black-Right-Pointing-Pointer The quercetin heterodimer does not kill MDA-MB-231 cells. Black-Right-Pointing-Pointer Ascorbic acid stabilizes quercetin increasing cell death in quercetin treated cells. Black-Right-Pointing-Pointer Quercetin, and not a modified form, is responsible for apoptosis and cell death. -- Abstract: Quercetin is a member of the flavonoid family and has been previously shown to have a variety of anti-cancer activities. We and others have reported anti-proliferation, cell cycle arrest, and induction of apoptosis of cancer cells after treatment with quercetin. Quercetin has also been shown to undergo oxidation. However, it is unclear if quercetin or one of its oxidized forms is responsible for cell death. Here we report that quercetin rapidly oxidized in cell culture media to form a dimer. The quercetin dimer is identical to a dimer that is naturally produced by onions. The quercetin dimer and quercetin-3-O-glucopyranoside are unable to cross the cell membrane and do not kill MDA-MB-231 cells. Finally, supplementing the media with ascorbic acid increases quercetin's ability to induce cell death probably by reduction oxidative dimerization. Our results suggest that an unmodified quercetin is the compound that elicits cell death.

  14. Decreased phasic EMG activity during rapid eye movement sleep in treatment-naïve Parkinson's disease: effects of treatment with levodopa and progression of illness.

    Science.gov (United States)

    Garcia-Borreguero, Diego; Caminero, Ana B; De La Llave, Yolanda; Larrosa, Oscar; Barrio, Soledad; Granizo, Juan J; Pareja, Juan A

    2002-09-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is frequently associated with Parkinson's disease (PD) and may anticipate its diagnosis by several years. We assessed the presence of motor dyscontrol during REM sleep in treatment-naïve PD patients and investigated the putative effect of levodopa (L-dopa) treatment on motor activity. Overnight sleep studies were performed on 15 previously untreated PD patients and 14 controls at baseline, again after a 3- to 9-month treatment period with a low dose of L-dopa, and 2 to 5 days after treatment discontinuation (in 8 patients). No differences in sleep parameters were observed across groups or treatment conditions. None of the patients met criteria for RBD at baseline, whereas 5 patients were symptomatic at the time of the second sleep study. A quantitative analysis of electromyographic (EMG) activity during REM sleep showed a lower phasic twitching activity in untreated PD than in controls. However, an increase in both phasic twitching and tonic activity was found after treatment with L-dopa. Discontinuation of treatment resulted in a return to pretreatment values of phasic but not of tonic EMG activity. Thus, the increase in phasic activity seems to depend on the effects of L-dopa, whereas the increase in tonic EMG activity during REM sleep might be caused by other factors such as the progression of disease. Potential implications for the understanding of the relationship between RBD and PD are discussed. Copyright 2002 Movement Disorder Society

  15. Rapid Mapping for Built Heritage at Risk Using Low-Cost and Cots Sensors. a Test in the Duomo Vecchio of San Severino Marche

    Science.gov (United States)

    Calantropio, A.; Colucci, E.; Teppati Losè, L.

    2017-11-01

    In the last years, the researchers in the field of Geomatics have focused their attention in the experimentation and validation of new methodologies and techniques, stressing especially the potential of low-cost and COTS (Commercial Off The Shelf) solutions and sensors. In particular, these tools have been used with purposes of rapid mapping in different contexts (ranging from the construction industry, environmental monitoring, mining activities, etc.). The Built Heritage, due to its intrinsic nature of endangered artefact, can largely benefit from the technological and methodological innovations in this research field. The contribute presented in this paper will highlight these main topics: the rapid mapping of the Built Heritage (in particular the one subjected to different types of risk) using low-cost and COTS solutions. Different sensors and techniques were chosen to be evaluated on a specific test site: the Duomo Vecchio of San Severino Marche (MC - Italy), that was partially affected by the earthquake swarm that hit the area of Central Italy starting from the 24th of August 2016. One of the main aims of this work is to demonstrate how low-cost and COTS sensors can contribute to the documentation of the Built Heritage for its safeguard, for damage assessment in case of disastrous events and operations of restoration and preservation.

  16. Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days

    Directory of Open Access Journals (Sweden)

    Yuki Iijima

    2017-01-01

    Full Text Available A 77-year-old Japanese man presented to our hospital with a 1-month history of low back pain and was diagnosed as having stage IV EGFR mutation-positive lung adenocarcinoma. After treatment with EGFR tyrosine kinase inhibitor and cytotoxic chemotherapy, nivolumab was started as fourth-line therapy. Remarkable regression of the primary tumor was observed, suggesting high anti-tumor activity of nivolumab. We retrospectively investigated the change in circulating tumor DNA (ctDNA variant allele fractions in serial plasma samples before and after the nivolumab therapy. Targeted sequencing analysis showed tumor-derived TP53R249S and EGFRL858R mutations detectable in plasma, and the timing of decrease was only 5 days, much earlier than the appearance of radiological changes. Overall, these results suggest that ctDNA might reflect tumor burden and might be a surrogate marker of the therapeutic efficacy of immune checkpoint therapy.

  17. WHO/ISH total risk approach for primary prevention of cardiovascular disease shows greater decrease in costs for women but not the elderly in Jamaica.

    Science.gov (United States)

    Abdulkadri, Abdullahi O; Tulloch-Reid, Marshall K; Francis, Damian K; Gordon-Strachan, Georgiana M; Younger-Coleman, Novie O; Rocke, Kern D; McFarlane, Shelly R; Cunningham-Myrie, Colette A; Ferguson, Trevor S; Wilks, Rainford J; Anderson, Simon G

    2015-09-01

    To investigate cost savings from and implications of replacing the single risk with a total cardiovascular risk approach in primary prevention of cardiovascular disease (CVD). A cost analysis using data from the 2007-08 Jamaica Health and Lifestyle Survey of 1,432 persons aged 40 years and older with 10-year risk estimated from region-specific World Health Organization/International Society for Hypertension (WHO/ISH) CVD risk charts. The WHO/ISH and local treatment guidelines were used to cost lifestyle changes, medications, and provider visits. Use of the total cardiovascular risk approach was less costly regardless of age. Women showed greater cost disparity. However, if 10-year CVD risk was estimated without measured cholesterol, both approaches resulted in similar costs in men ≥60 years. The annual per capita cost of lifestyle recommendations, critical in the absence of pharmacotherapy, was estimated at US $869.05 for diet and US $80 for physical activity. This represents about a third of the annual income of a minimum wage earner. At the national level, implementation of the WHO/ISH total risk approach could reduce health care costs by US $5 million annually. Cost savings that mainly resulted from reduced care for women may lead to gender disparity in CVD outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. The challenge of rapid diagnosis in oncology: Diagnostic accuracy and cost analysis of a large-scale one-stop breast clinic.

    Science.gov (United States)

    Delaloge, Suzette; Bonastre, Julia; Borget, Isabelle; Garbay, Jean-Rémi; Fontenay, Rachel; Boinon, Diane; Saghatchian, Mahasti; Mathieu, Marie-Christine; Mazouni, Chafika; Rivera, Sofia; Uzan, Catherine; André, Fabrice; Dromain, Clarisse; Boyer, Bruno; Pistilli, Barbara; Azoulay, Sandy; Rimareix, Françoise; Bayou, El-Hadi; Sarfati, Benjamin; Caron, Hélène; Ghouadni, Amal; Leymarie, Nicolas; Canale, Sandra; Mons, Muriel; Arfi-Rouche, Julia; Arnedos, Monica; Suciu, Voichita; Vielh, Philippe; Balleyguier, Corinne

    2016-10-01

    Rapid diagnosis is a key issue in modern oncology, for which one-stop breast clinics are a model. We aimed to assess the diagnosis accuracy and procedure costs of a large-scale one-stop breast clinic. A total of 10,602 individuals with suspect breast lesions attended the Gustave Roussy's regional one-stop breast clinic between 2004 and 2012. The multidisciplinary clinic uses multimodal imaging together with ultrasonography-guided fine needle aspiration for masses and ultrasonography-guided and stereotactic biopsies as needed. Diagnostic accuracy was assessed by comparing one-stop diagnosis to the consolidated diagnosis obtained after surgery or biopsy or long-term monitoring. The medical cost per patient of the care pathway was assessed from patient-level data collected prospectively. Sixty-nine percent of the patients had masses, while 31% had micro-calcifications or other non-mass lesions. In 75% of the cases (87% of masses), an exact diagnosis could be given on the same day. In the base-case analysis (i.e. considering only benign and malignant lesions at one-stop and at consolidated diagnoses), the sensitivity of the one-stop clinic was 98.4%, specificity 99.8%, positive and negative predictive values 99.7% and 99.0%. In the sensitivity analysis (reclassification of suspect, atypical and undetermined lesions), diagnostic sensitivity varied from 90.3% to 98.5% and specificity varied from 94.3% to 99.8%. The mean medical cost per patient of one-stop diagnostic procedure was €420. One-stop breast clinic can provide timely and cost-efficient delivery of highly accurate diagnoses and serve as models of care for multiple settings, including rapid screening-linked diagnosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Fundamental understanding and integration of rapid thermal processing, PECVD, and screen printing for cost-effective, high-efficiency silicon photovoltaic devices

    Science.gov (United States)

    Doshi, Parag Mahendra

    The final hurdle preventing widespread application of photovoltaics is cost-effectiveness. Solar cell efficiencies in the laboratory have reached 24%, but industrial cells, constrained by low-cost, high-throughput processes, are limited to 10-15%. This thesis focuses on industrially relevant technologies such as rapid thermal processing (RTP), PECVD, and screen-printing to simplify and speed up cell processing yet maintain the key features that give high efficiencies in the laboratory. RTP utilizes tungsten-halogen and UV lamps as a source of high energy photons that induce thermal and photophysical effects which can significantly increase the kinetics of semiconductor processes such as diffusion, oxidation, and annealing. PECVD also serves as a promising low-cost candidate for SiN/SiOsb2 antireflection coatings and passivation. Finally, screen printing serves as a very high-throughput technology for contact formation as a low-cost alternative to photolithography. Integration of these technologies into a single cell fabrication sequence, however, revealed the susceptibility to low internal quantum efficiencies in the long and short wavelengths. For example, the inherent rapid cooling during RTP can degrade minority-carrier lifetime and long wavelength response. Lack of knowledge in tailoring RTP emitter diffusion profiles coupled with less than perfect PECVD surface passivation and parasitic SiN absorption was found to limit short wavelength response. Problems like these limited RTP cell efficiencies to only 15.4% prior to this thesis. Through a combination of fundamental understanding of device physics, materials and device characterization, modeling, and cell fabrication these losses were quantified and overcome in this thesis. An in-situ annealing cycle during RTP was optimized to prevent quenching-induced lifetime degradation and to preserve high long wavelength response. Measurement of SiN extinction coefficients to compute parasitic absorption, optimization

  20. A rapid and systematic review of the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity.

    Science.gov (United States)

    O'Meara, S; Riemsma, R; Shirran, L; Mather, L; ter Riet, G

    2001-01-01

    The prevalence of obesity in developed societies is increasing. Obesity is associated with an increased risk of co-morbidity, including cardiovascular disease and diabetes. Following the withdrawal of fenfluramine and dexfenfluramine, interest has focused on a novel anti-obesity drug orlistat. To systematically assess the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity. METHODS - SEARCH STRATEGY: Nineteen electronic databases were searched from inception to June 2000. Additionally, Internet searches were carried out, bibliographies of retrieved articles were examined and submissions were received from the manufacturer of orlistat. METHODS - INCLUSION AND EXCLUSION CRITERIA: Randomised controlled trials (RCTs) evaluating the effectiveness of orlistat used for weight loss or maintenance of weight loss in overweight or obese patients were eligible for inclusion. Primary outcome measures were changes in body weight, fat content or fat distribution. Secondary outcomes were changes in obesity-related risk-factor profiles, such as lipid levels, indicators of glycaemic control and blood pressure. Studies recruiting people with eating disorders such as anorexia nervosa and bulimia nervosa were excluded. METHODS - PROCESS OF STUDY SELECTION: Assessment of titles and abstracts was performed independently by two reviewers. If either reviewer considered a reference to be relevant, the full paper was retrieved. Full papers were assessed against the review selection criteria by two independent reviewers, and disagreements were resolved through discussion. METHODS - DATA EXTRACTION: Data were extracted by one reviewer into structured summary tables and checked by a second reviewer. Any disagreements about data were resolved by discussion. METHODS - QUALITY ASSESSMENT: Each included trial was assessed against a comprehensive checklist for methodological quality. Quality assessment was performed independently by two reviewers with disagreements

  1. A Novel System for Rapid and Cost-Effective Production of Detection and Diagnostic Reagents of West Nile Virus in Plants

    Directory of Open Access Journals (Sweden)

    Junyun He

    2012-01-01

    Full Text Available The threat of West Nile virus (WNV epidemics necessitates the development of a technology platform that can produce reagents to support detection and diagnosis rapidly and inexpensively. A plant expression system is attractive for protein production due to its low-cost and high-scalability nature and its ability to make appropriate posttranslational modifications. Here, we investigated the feasibility of using plants to produce two WNV detection and diagnostic reagents to address the current cost and scalability issues. We demonstrated that WNV DIII antigen and E16 monoclonal antibody are rapidly produced at high levels in two plant species and are easily purified. Furthermore, they are effective in identifying WNV and in detecting human IgM response to WNV infection. E16 mAb does not cross-react with other flaviviruses, therefore, is valuable for improving diagnostic accuracy. This study provides a proof of principle for using plants as a robust and economical system to produce diagnostic reagents for arboviruses.

  2. Dopamine Antagonism Decreases Willingness to Expend Physical, But Not Cognitive, Effort: A Comparison of Two Rodent Cost/Benefit Decision-Making Tasks

    OpenAIRE

    Hosking, Jay G.; Floresco, Stan B.; Winstanley, Catharine A

    2014-01-01

    Successful decision making often requires weighing a given option's costs against its associated benefits, an ability that appears perturbed in virtually every severe mental illness. Animal models of such cost/benefit decision making overwhelmingly implicate mesolimbic dopamine in our willingness to exert effort for a larger reward. Until recently, however, animal models have invariably manipulated the degree of physical effort, whereas human studies of effort have primarily relied on cogniti...

  3. Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review

    Directory of Open Access Journals (Sweden)

    Sergio Garbarino

    2016-08-01

    Full Text Available Sleep disorders are frequent (18%–23% and constitute a major risk factor for psychiatric, cardiovascular, metabolic or hormonal co-morbidity and mortality. Low social status or income, unemployment, life events such as divorce, negative lifestyle habits, and professional requirements (e.g., shift work are often associated with sleep problems. Sleep disorders affect the quality of life and impair both professional and non-professional activities. Excessive daytime drowsiness resulting from sleep disorders impairs efficiency and safety at work or on the road, and increases the risk of accidents. Poor sleep (either professional or voluntary has detrimental effects comparable to those of major sleep disorders, but is often neglected. The high incidence and direct/indirect healthcare and welfare costs of sleep disorders and poor sleep currently constitute a major medical problem. Investigation, monitoring and strategies are needed in order to prevent/reduce the effects of these disorders.

  4. Open microfluidic gel electrophoresis: Rapid and low cost separation and analysis of DNA at the nanoliter scale.

    Science.gov (United States)

    Gutzweiler, Ludwig; Gleichmann, Tobias; Tanguy, Laurent; Koltay, Peter; Zengerle, Roland; Riegger, Lutz

    2017-07-01

    Gel electrophoresis is one of the most applied and standardized tools for separation and analysis of macromolecules and their fragments in academic research and in industry. In this work we present a novel approach for conducting on-demand electrophoretic separations of DNA molecules in open microfluidic (OM) systems on planar polymer substrates. The approach combines advantages of slab gel, capillary- and chip-based methods offering low consumable costs (<0.1$) circumventing cost-intensive microfluidic chip fabrication, short process times (5 min per analysis) and high sensitivity (4 ng/μL dsDNA) combined with reasonable resolution (17 bases). The open microfluidic separation system comprises two opposing reservoirs of 2-4 μL in volume, a semi-contact written gel line acting as separation channel interconnecting the reservoirs and sample injected into the line via non-contact droplet dispensing and thus enabling the precise control of the injection plug and sample concentration. Evaporation is prevented by covering aqueous structures with PCR-grade mineral oil while maintaining surface temperature at 15°C. The liquid gel line exhibits a semi-circular cross section of adaptable width (∼200-600 μm) and height (∼30-80 μm) as well as a typical length of 15-55 mm. Layout of such liquid structures is adaptable on-demand not requiring time consuming and repetitive fabrication steps. The approach was successfully demonstrated by the separation of a standard label-free DNA ladder (100-1000 bp) at 100 V/cm via in-line staining and laser induced fluorescent end-point detection using an automated prototype. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Rapid, portable and cost-effective yeast cell viability and concentration analysis using lensfree on-chip microscopy and machine learning

    KAUST Repository

    Feizi, Alborz

    2016-09-24

    Monitoring yeast cell viability and concentration is important in brewing, baking and biofuel production. However, existing methods of measuring viability and concentration are relatively bulky, tedious and expensive. Here we demonstrate a compact and cost-effective automatic yeast analysis platform (AYAP), which can rapidly measure cell concentration and viability. AYAP is based on digital in-line holography and on-chip microscopy and rapidly images a large field-of-view of 22.5 mm2. This lens-free microscope weighs 70 g and utilizes a partially-coherent illumination source and an opto-electronic image sensor chip. A touch-screen user interface based on a tablet-PC is developed to reconstruct the holographic shadows captured by the image sensor chip and use a support vector machine (SVM) model to automatically classify live and dead cells in a yeast sample stained with methylene blue. In order to quantify its accuracy, we varied the viability and concentration of the cells and compared AYAP\\'s performance with a fluorescence exclusion staining based gold-standard using regression analysis. The results agree very well with this gold-standard method and no significant difference was observed between the two methods within a concentration range of 1.4 × 105 to 1.4 × 106 cells per mL, providing a dynamic range suitable for various applications. This lensfree computational imaging technology that is coupled with machine learning algorithms would be useful for cost-effective and rapid quantification of cell viability and density even in field and resource-poor settings.

  6. Rapid, portable and cost-effective yeast cell viability and concentration analysis using lensfree on-chip microscopy and machine learning.

    Science.gov (United States)

    Feizi, Alborz; Zhang, Yibo; Greenbaum, Alon; Guziak, Alex; Luong, Michelle; Chan, Raymond Yan Lok; Berg, Brandon; Ozkan, Haydar; Luo, Wei; Wu, Michael; Wu, Yichen; Ozcan, Aydogan

    2016-11-01

    Monitoring yeast cell viability and concentration is important in brewing, baking and biofuel production. However, existing methods of measuring viability and concentration are relatively bulky, tedious and expensive. Here we demonstrate a compact and cost-effective automatic yeast analysis platform (AYAP), which can rapidly measure cell concentration and viability. AYAP is based on digital in-line holography and on-chip microscopy and rapidly images a large field-of-view of 22.5 mm2. This lens-free microscope weighs 70 g and utilizes a partially-coherent illumination source and an opto-electronic image sensor chip. A touch-screen user interface based on a tablet-PC is developed to reconstruct the holographic shadows captured by the image sensor chip and use a support vector machine (SVM) model to automatically classify live and dead cells in a yeast sample stained with methylene blue. In order to quantify its accuracy, we varied the viability and concentration of the cells and compared AYAP's performance with a fluorescence exclusion staining based gold-standard using regression analysis. The results agree very well with this gold-standard method and no significant difference was observed between the two methods within a concentration range of 1.4 × 105 to 1.4 × 106 cells per mL, providing a dynamic range suitable for various applications. This lensfree computational imaging technology that is coupled with machine learning algorithms would be useful for cost-effective and rapid quantification of cell viability and density even in field and resource-poor settings.

  7. Combining ASTER multispectral imagery analysis and support vector machines for rapid and cost-effective post-fire assessment: a case study from the Greek wildland fires of 2007

    OpenAIRE

    Petropoulos, G. P.; Knorr, W.; Scholze, M.; Boschetti, L.; Karantounias, G.

    2010-01-01

    Remote sensing is increasingly being used as a cost-effective and practical solution for the rapid evaluation of impacts from wildland fires. The present study investigates the use of the support vector machine (SVM) classification method with multispectral data from the Advanced Spectral Emission and Reflection Radiometer (ASTER) for obtaining a rapid and cost effective post-fire assessment in a Mediterranean setting. A further objective is to perform a detailed intercomparison of available ...

  8. Rapid, low-cost fluorescent assay of β-lactamase-derived antibiotic resistance and related antibiotic susceptibility

    Science.gov (United States)

    Erdem, S. Sibel; Khan, Shazia; Palanisami, Akilan; Hasan, Tayyaba

    2014-10-01

    Antibiotic resistance (AR) is increasingly prevalent in low and middle income countries (LMICs), but the extent of the problem is poorly understood. This lack of knowledge is a critical deficiency, leaving local health authorities essentially blind to AR outbreaks and crippling their ability to provide effective treatment guidelines. The crux of the problem is the lack of microbiology laboratory capacity available in LMICs. To address this unmet need, we demonstrate a rapid and simple test of β-lactamase resistance (the most common form of AR) that uses a modified β-lactam structure decorated with two fluorophores quenched due to their close proximity. When the β-lactam core is cleaved by β-lactamase, the fluorophores dequench, allowing assay speeds of 20 min to be obtained with a simple, streamlined protocol. Furthermore, by testing in competition with antibiotics, the β-lactamase-associated antibiotic susceptibility can also be extracted. This assay can be easily implemented into standard lab work flows to provide near real-time information of β-lactamase resistance, both for epidemiological purposes as well as individualized patient care.

  9. A rapid and low-cost approach to evaluate the allergenicity of herbal injection using HPLC analysis

    Science.gov (United States)

    Yu, Li; Peng, Guoping; Li, Cunyu; Jiang, Baoping; Xu, Haokun; Ding, Ning; Zheng, Yunfeng; Leng, John Q.

    2013-01-01

    Herbal medicines have ever been thought harmless, but it is obviously not true. Many adverse reports emerged with the development of their popular application in the world. Allergic reactions, especially serious immediate hypersensitivity, frequently occurred when herbal injections were used in clinic and made this ever prevailing agent nearly disappear in China. The aim of this study is to establish a rapid and economical method for the prediction of the allergenicity of herbal injections. Ovalbumin (OVA) and four other herbal injections, in which two of them were well known for their allergenicity, were selected to sensitize and stimulate the animals. Serotonin in the animal serum was detected with HPLC to reflect the anaphylactic response and compared with the other cytokines which could mediate the anaphylaxis, including histamine, IgE and β-hexosaminidase. The results suggest that serotonin can be detected quickly and has good correlation with the other allergy-related cytokines. It is a promising way for predicting the allergenicity of the herbal injections and those complicated natural products. PMID:23587872

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

    Directory of Open Access Journals (Sweden)

    Byung-Hyuk Kim

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

  11. Paternal care decreases foraging activity and body condition, but does not impose survival costs to caring males in a Neotropical arachnid.

    Directory of Open Access Journals (Sweden)

    Gustavo S Requena

    Full Text Available Exclusive paternal care is the rarest form of parental investment in nature and theory predicts that the maintenance of this behavior depends on the balance between costs and benefits to males. Our goal was to assess costs of paternal care in the harvestman Iporangaia pustulosa, for which the benefits of this behavior in terms of egg survival have already been demonstrated. We evaluated energetic costs and mortality risks associated to paternal egg-guarding in the field. We quantified foraging activity of males and estimated how their body condition is influenced by the duration of the caring period. Additionally, we conducted a one-year capture-mark-recapture study and estimated apparent survival probabilities of caring and non-caring males to assess potential survival costs of paternal care. Our results indicate that caring males forage less frequently than non-caring individuals (males and females and that their body condition deteriorates over the course of the caring period. Thus, males willing to guard eggs may provide to females a fitness-enhancing gift of cost-free care of their offspring. Caring males, however, did not show lower survival probabilities when compared to both non-caring males and females. Reduction in mortality risks as a result of remaining stationary, combined with the benefits of improving egg survival, may have played an important and previously unsuspected role favoring the evolution of paternal care. Moreover, males exhibiting paternal care could also provide an honest signal of their quality as offspring defenders, and thus female preference for caring males could be responsible for maintaining the trait.

  12. Rapid detection of Salmonella in meat: Comparative and collaborative validation of a non-complex and cost effective pre-PCR protocol

    DEFF Research Database (Denmark)

    Löfström, Charlotta; Hansen, F.; Mansdal, S.

    2011-01-01

    samples using a real-time PCR method. The protocol included incubation in buffered peptone water, centrifugation of an aliquot and a boiling procedure. The validation study included comparative and collaborative trials recommended by the Nordic Organization for Validation of Alternative Methods (Nord......Cost-effective and rapid monitoring of Salmonella in the meat production chain can contribute to food safety. The objective was, for the first time, to validate an easy-to-use pre-PCR sample preparation method based on a simple boiling protocol for screening of Salmonella in meat and carcass swab....../sample for the boiling, magnetic bead-based and NMKL187 methods, respectively. When comparing the boiling method with the magnetic beads, the relative accuracy (AC), relative sensitivity (SE) and relative specificity (SP) were found to be 98%, 102% and 98%, respectively (Cohen’s kappa index 0.95). When comparing results...

  13. Design and Development of an Equipotential Voltage Reference (Grounding) System for a Low-Cost Rapid-Development Modular Spacecraft Architecture

    Science.gov (United States)

    Lukash, James A.; Daley, Earl

    2011-01-01

    This work describes the design and development effort to adapt rapid-development space hardware by creating a ground system using solutions of low complexity, mass, & cost. The Lunar Atmosphere and Dust Environment Explorer (LADEE) spacecraft is based on the modular common spacecraft bus architecture developed at NASA Ames Research Center. The challenge was building upon the existing modular common bus design and development work and improving the LADEE spacecraft design by adding an Equipotential Voltage Reference (EVeR) system, commonly referred to as a ground system. This would aid LADEE in meeting Electromagnetic Environmental Effects (E3) requirements, thereby making the spacecraft more compatible with itself and its space environment. The methods used to adapt existing hardware are presented, including provisions which may be used on future spacecraft.

  14. Nicotine Increases Impulsivity and Decreases Willingness to Exert Cognitive Effort despite Improving Attention in “Slacker” Rats: Insights into Cholinergic Regulation of Cost/Benefit Decision Making

    OpenAIRE

    Hosking, Jay G.; Lam, Fred C. W.; Winstanley, Catharine A

    2014-01-01

    Successful decision making in our daily lives requires weighing an option's costs against its associated benefits. The neuromodulator acetylcholine underlies both the etiology and treatment of a number of illnesses in which decision making is perturbed, including Alzheimer's disease, attention-deficit/hyperactivity disorder, and schizophrenia. Nicotine acts on the cholinergic system and has been touted as a cognitive enhancer by both smokers and some researchers for its attention-boosting eff...

  15. FGFR3 mutation analysis in voided urine samples to decrease cystoscopies and cost in nonmuscle invasive bladder cancer surveillance: a comparison of 3 strategies.

    Science.gov (United States)

    van Kessel, Kim E M; Kompier, Lucie C; de Bekker-Grob, Esther W; Zuiverloon, Tahlita C M; Vergouwe, Yvonne; Zwarthoff, Ellen C; Steyerberg, Ewout W

    2013-05-01

    We determined whether FGFR3 mutation analysis of voided urine samples would be cost-effective to partly replace cystoscopy in the surveillance of patients treated for nonmuscle invasive urothelial carcinoma. In this decision analytical study we analyzed data on 70 Dutch patients with FGFR3 positive primary tumors and a median followup of 8.8 years. Surveillance strategies were compared in a Markov model. Modified surveillance consisted of FGFR3 mutation analysis of voided urine samples every 3 months, and cystoscopy at 3, 12 and 24 months. Standard surveillance was defined as cystoscopy every 3 months and minimal surveillance was defined as cystoscopy at 3, 12 and 24 months. Analysis was stratified for 3 risk profiles, including surveillance after 1) the primary tumor, 2) the first to third recurrence and 3) the fourth recurrence or more. Sensitivity analysis was performed to evaluate the impact of variations in cost, sensitivity and specificity. The probability of no recurrence after 2 years of surveillance after a primary tumor was higher for modified surveillance than for standard and minimal surveillance, eg after primary tumors (95.7% vs 95.0% and 93.9%, respectively). The total cost of surveillance after the primary tumor was lower for minimal and modified surveillance (€2,254 and €2,558, respectively) than for standard surveillance (€5,861). Results were robust to changing inputs over plausible ranges and consistent for each of the 3 risk profiles. Surveillance in which cystoscopy is partly replaced by FGFR3 mutation analysis of urine seems a safe, effective and cost-effective surveillance strategy. Further validation in larger cohorts is required. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. [Operation room management: from degree of utilization to distribution of capacities. Cost reduction without decreasing productivity in the operation room using a new index].

    Science.gov (United States)

    Grote, R; Perschmann, S; Walleneit, A; Sedlacek, B; Leuchtmann, D; Menzel, M

    2008-09-01

    The new index "degree of operation room (OR) utilization" describes the ratio between possible and actual OR utilization with purely surgical time. The possible OR utilization with purely surgical time was calculated by eliminating the time necessary for induction and emergence from anaesthesia, the time necessary for surgical measurements directly before the first incision (i.e. skin disinfection) and directly after the last suture (i.e. wound dressing) of an operation from the time an operating room could theoretically be used with purely surgical times (the theoretical block time). The possibility of distributing block time based on the effectiveness of surgeons and to reduce costs by identifying waste of block time was investigated using the "degree of OR utilization" method. Using our own anaesthesia data base with an average of 12,000 anaesthetic procedures per annum, the degree of OR utilization and the need for additional block time for each clinic performing operative procedures in the OR centre of the hospital were analyzed. The need for additional block time and the costs for additional OR staff (including anaesthesiologists and nurses) were then calculated in US dollars. After redistribution it was possible to reduce the OR capacities and costs for OR staff (including anaesthesiologists and nurses) by a minimum of 280.142 US dollars per year. The application of the new index "degree of OR utilization" enables the OR manager to distribute OR capacities to surgeons with effective use of block time. This leads to cost reduction without minimizing surgical productivity or income and therefore to a higher level of OR efficiency.

  17. Cost-effective and rapid lysis of Saccharomyces cerevisiae cells for quantitative western blot analysis of proteins, including phosphorylated eIF2α.

    Science.gov (United States)

    Lee, Su Jung; Ramesh, Rashmi; de Boor, Valerie; Gebler, Jan M; Silva, Richard C; Sattlegger, Evelyn

    2017-09-01

    The common method for liberating proteins from Saccharomyces cerevisiae cells involves mechanical cell disruption using glass beads and buffer containing inhibitors (protease, phosphatase and/or kinase inhibitors), followed by centrifugation to remove cell debris. This procedure requires the use of costly inhibitors and is laborious, in particular when many samples need to be processed. Also, enzymatic reactions can still occur during harvesting and cell breakage. As a result low-abundance and labile proteins may be degraded, and enzymes such as kinases and phosphatases may still modify proteins during and after cell lysis. We believe that our rapid sample preparation method helps overcome the above issues and offers the following advantages: (a) it is cost-effective, as no inhibitors and breaking buffer are needed; (b) cell breakage is fast (about 15 min) since it only involves a few steps; (c) the use of formaldehyde inactivates endogenous proteases prior to cell lysis, dramatically reducing the risk of protein degradation; (d) centrifugation steps only occur prior to cell lysis, circumventing the problem of losing protein complexes, in particular if cells were treated with formaldehyde intended to stabilize and capture large protein complexes; and (e) since formaldehyde has the potential to instantly terminate protein activity, this method also allows the study of enzymes in live cells, i.e. in their true physiological environment, such as the short-term effect of a drug on enzyme activity. Taken together, the rapid sample preparation procedure provides a more accurate snapshot of the cell's protein content at the time of harvesting. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Decreased Opioid Utilization and Cost at One Year in Chronic Low Back Pain Patients Treated with Transcutaneous Electric Nerve Stimulation (TENS).

    Science.gov (United States)

    Pivec, Robert; Minshall, Michael E; Mistry, Jaydev B; Chughtai, Morad; Elmallah, Randa K; Mont, Michael A

    2015-11-01

    Chronic low back pain (CLBP) may be treated without opioids through the use of transcutaneous electrical nerve stimulation (TENS). However, no study has evaluated its clinical effect and economic impact as measured by opioid utilization and costs. The purpose of this study was to evaluate patients who were given TENS for CLBP compared to a matched group without TENS at one-year follow-up, to determine differences between opioid consumption. Opioid utilization and costs in patients who did and did not receive TENS were extracted from a Medicare supplemental administrative claims database. Patients were selected if they had at least two ICD-9-CM coded claims for low back pain in a three-month period and were then propensity score matched at a 1:1 ratio between patients who received TENS and those who did not. There were 22,913 patients in each group who had a minimum follow-up of one year. There were no significant demographic or comorbidity differences with the exception that TENS patients had more episodes of back pain. Significantly fewer patients in the TENS group required opioids at final follow-up (57.7 vs. 60.3%). TENS patients also had significantly fewer annual per-patient opioid costs compared to non-TENS patients ($169 vs. $192). There were significantly lower event rates in TENS patients compared to non-TENS patients when measured by opioid utilization (characterized by frequency of prescription refills) (3.82 vs. 4.08, respectively) or pharmacy utilization (31.67 vs. 32.25). The TENS group also demonstrated a significantly lower cost of these utilization events ($44 vs. $49) and avoided more opioid events (20.4 events fewer per 100 patients annually). Treatment of CLBP with TENS demonstrated significantly fewer patients requiring opioids, fewer events where a patient required an opioid prescription, and lower per-patient costs. Since TENS is both non-invasive and a non-narcotic, it may potentially allow physicians to be more aggressive in treating CLBP

  19. Costs and cost-effectiveness of periviable care.

    Science.gov (United States)

    Caughey, Aaron B; Burchfield, David J

    2014-02-01

    With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Decreasing returns to capital, the willingness to pay and the willingness to accept compensation, and the limits of cost-benefit analysis

    NARCIS (Netherlands)

    Vermeylen, K.

    2012-01-01

    This paper uses the Kaldor-Hicks compensation principle to compute the present discounted value (PDV) of a non-marginal future event. Three theoretical results stand out: First, decreasing returns to capital create a wedge between the PDV of future generations' willingness to pay (WTP) and the PDV

  1. Joining the in vitro immunization of alpaca lymphocytes and phage display: rapid and cost effective pipeline for sdAb synthesis.

    Science.gov (United States)

    Comor, Lubos; Dolinska, Saskia; Bhide, Katarina; Pulzova, Lucia; Jiménez-Munguía, Irene; Bencurova, Elena; Flachbartova, Zuzana; Potocnakova, Lenka; Kanova, Evelina; Bhide, Mangesh

    2017-01-23

    Camelids possess unique functional heavy chain antibodies, which can be produced and modified in vitro as a single domain antibody (sdAb or nanobody) with full antigen binding ability. Production of sdAb in conventional manner requires active immunization of Camelidae animal, which is laborious, time consuming, costly and in many cases not feasible (e.g. in case of highly toxic or infectious antigens). In this study, we describe an alternative pipeline that includes in vitro stimulation of naïve alpaca B-lymphocytes by antigen of interest (in this case endothelial cell binding domain of OspA of Borrelia) in the presence of recombinant alpaca interleukins 2 and 4, construction of sdAb phage library, selection of antigen specific sdAb expressed on phages (biopanning) and confirmation of binding ability of sdAb to the antigen. By joining the in vitro immunization and the phage display ten unique phage clones carrying sdAb were selected. Out of ten, seven sdAb showed strong antigen binding ability in phage ELISA. Furthermore, two soluble forms of sdAb were produced and their differential antigen binding affinity was measured with bio-layer interferometry. A proposed pipeline has potential to reduce the cost substantially required for maintenance of camelid herd for active immunization. Furthermore, in vitro immunization can be achieved within a week to enrich mRNA copies encoding antigen-specific sdAbs in B cell. This rapid and cost effective pipeline can help researchers to develop efficiently sdAb for diagnostic and therapeutic purposes.

  2. Final report on LDRD project: Low-cost Pd-catalyzed metallization technology for rapid prototyping of electronic substrates and devices

    Energy Technology Data Exchange (ETDEWEB)

    Chen, K.S.; Morgan, W.P.; Zich, J.L.

    1998-02-01

    A low-cost, thermally-activated, palladium-catalyzed metallization process was developed for rapid prototyping of polymeric electronic substrates and devices. The process was successfully applied in producing adhesiveless copper/polyimide laminates with high peel strengths and thick copper coating; copper/polyimide laminates are widely used in fabricating interconnects such as printed wiring boards (PWBs) and flexible circuits. Also successfully metallized using this low-cost metallization process were: (1) scaled-down models of radar-and-communication antenna and waveguide; (2) scaled-down model of pulsed-power-accelerator electrode; (3) three-dimensional micro-porous, open-cell vitreous carbon foams. Moreover, additive patterned metallization was successfully achieved by selectively printing or plotting the catalyst ink only on areas where metallization is desired, and by uniform thermal activation. Additive patterned metallization eliminates the time-consuming, costly and environmentally-unfriendly etching process that is routinely carried out in conventional subtractive patterned metallization. A metallization process via ultraviolet (UV) irradiation activation was also demonstrated. In this process palladium-catalyst solution is first uniformly coated onto the substrate. A masking pattern is used to cover the areas where metallization is not wanted. UV irradiation is applied uniformly to activate the palladium catalyst and to cure the polymer carrier in areas that are not covered by the mask. Metal is then deposited by electroless plating only or by a combination of electroless and electrolytic plating. This UV-activation technique is particularly useful in additive fine-line patterned metallization. Lastly, computer models for electrolytic and electroless plating processes were developed to provide guidance in plating-process design.

  3. Rapid Prototyping Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The ARDEC Rapid Prototyping (RP) Laboratory was established in December 1992 to provide low cost RP capabilities to the ARDEC engineering community. The Stratasys,...

  4. Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs

    Directory of Open Access Journals (Sweden)

    Vitória M

    2011-07-01

    Full Text Available Jean B Nachega1–3, Michael J Mugavero4, Michele Zeier2, Marco Vitória5, Joel E Gallant3,61Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 2Department of Medicine and Centre for Infectious Diseases (CID, Stellenbosch University, Faculty of Health Sciences, Cape Town, South Africa; 3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 4Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 5HIV Department, World Health Organization, Geneva, Switzerland; 6Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Since the advent of highly active antiretroviral therapy (HAART, the treatment of human immunodeficiency virus (HIV infection has become more potent and better tolerated. While the current treatment regimens still have limitations, they are more effective, more convenient, and less toxic than regimens used in the early HAART era, and new agents, formulations and strategies continue to be developed. Simplification of therapy is an option for many patients currently being treated with antiretroviral therapy (ART. The main goals are to reduce pill burden, improve quality of life and enhance medication adherence, while minimizing short- and long-term toxicities, reducing the risk of virologic failure and maximizing cost-effectiveness. ART simplification strategies that are currently used or are under study include the use of once-daily regimens, less toxic drugs, fixed-dose coformulations and induction-maintenance approaches. Improved adherence and persistence have been observed with the adoption of some of these strategies. The role of regimen simplification has implications not only for individual patients, but also for health care policy. With increased interest in ART regimen simplification, it is critical to

  5. Decreased Libido

    Science.gov (United States)

    ... such as those taken for prostate cancer) Excessive alcohol use or recreational drug use Excessive fatigue Systemic illness (such as chronic lung, heart, kidney and liver failure, cancer) Low testosterone (male hypogonadism) Depression Relationship problems What is the treatment for decreased libido? ...

  6. O-antigen and virulence profiling of Shiga toxin-producing Escherichia coli by a rapid and cost-effective DNA microarray colorimetric method

    Directory of Open Access Journals (Sweden)

    Beatriz eQuiñones

    2012-05-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC is a leading cause of foodborne illness worldwide. The present study developed the use of DNA microarrays with the ampliPHOX colorimetric method to rapidly detect and genotype STEC strains. A low-density 30-mer oligonucleotide DNA microarray was designed to target O-antigen gene clusters of eleven E. coli serogroups (O26, O45, O91, O103, O104, O111, O113, O121, O128, O145 and O157 that have been associated with the majority of STEC infections. In addition, the DNA microarray targeted eleven virulence genes, encoding adhesins, cytotoxins, proteases, and receptor proteins, which have been implicated in conferring increased ability to cause disease for STEC. Results from the validation experiments demonstrated that this microarray-based colorimetric method allowed for a rapid and accurate genotyping of STEC reference strains from environmental and clinical sources and from distinct geographical locations. Positive hybridization signals were detected only for probes targeting serotype and virulence genes known to be present in the STEC reference strains. Quantification analysis indicated that the mean pixel intensities of the signal for probes targeting O-antigen or virulence genes were at least three times higher when compared to the background. Furthermore, this microarray-based colorimetric method was then employed to genotype a group of E. coli isolates from watershed sediment and animal fecal samples that were collected from an important region for leafy-vegetable production in the central coast of California. The results indicated an accurate identification of O-type and virulence genes in the tested isolates and confirmed that the ampliPHOX colorimetric method with low density DNA microarrays enabled a fast assessment of the virulence potential of STEC using low-cost reagents and instrumentation.

  7. A rapid and low-cost microscopic observation drug susceptibility assay for detecting TB and MDR-TB among individuals infected by HIV in South India

    Directory of Open Access Journals (Sweden)

    S Solomon

    2013-01-01

    Full Text Available Background: The converging epidemics of HIV and tuberculosis (TB pose one of the greatest public health challenges of our time. Rapid diagnosis of TB is essential in view of its infectious nature, high burden of cases, and emergence of drug resistance. Objective: The purpose of this present study was to evaluate the feasibility of implementing the microscopic observation drug susceptibility (MODS assay, a novel assay for the diagnosis of TB and multi-drug-resistant tuberculosis (MDR-TB directly from sputum specimens, in the Indian setting. Materials and Methods: This study involved a cross-sectional, blinded assessment of the MODS assay on 1036 suspected cases of pulmonary TB in HIV-positive and HIV-negative patients against the radiometric method, BD-BACTEC TB 460 system. Results: Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of the MODS assay in detecting MTB among TB suspected patients were 89.1%, 99.1%, 94.2%, 95.8%, respectively. In addition, in the diagnosis of drug-resistant TB, the MODS assay was 84.2% sensitive for those specimens reporting MDR, 87% sensitivity for those specimens reporting INH mono-resistance, and 100% sensitive for specimens reporting RIF mono-resistance. The median time to detection of TB in the MODS assay versus BACTEC was 9 versus 21 days (P < 0.001. Conclusion: Costing 5 to 10 times lesser than the automated culture methods, the MODS assay has the potential clinical utility as a simple and rapid method. It could be effectively used as an alternative method for diagnosing TB and detection of MDR-TB in a timely and affordable way in resource-limited settings.

  8. A low cost, safe, disposable, rapid and self-sustainable paper-based platform for diagnostic testing: lab-on-paper

    Science.gov (United States)

    Costa, M. N.; Veigas, B.; Jacob, J. M.; Santos, D. S.; Gomes, J.; Baptista, P. V.; Martins, R.; Inácio, J.; Fortunato, E.

    2014-03-01

    There is a strong interest in the use of biopolymers in the electronic and biomedical industries, mainly towards low-cost applications. The possibility of developing entirely new kinds of products based on cellulose is of current interest, in order to enhance and to add new functionalities to conventional paper-based products. We present our results towards the development of paper-based microfluidics for molecular diagnostic testing. Paper properties were evaluated and compared to nitrocellulose, the most commonly used material in lateral flow and other rapid tests. Focusing on the use of paper as a substrate for microfluidic applications, through an eco-friendly wax-printing technology, we present three main and distinct colorimetric approaches: (i) enzymatic reactions (glucose detection); (ii) immunoassays (antibodies anti-Leishmania detection); (iii) nucleic acid sequence identification (Mycobacterium tuberculosis complex detection). Colorimetric glucose quantification was achieved through enzymatic reactions performed within specific zones of the paper-based device. The colouration achieved increased with growing glucose concentration and was highly homogeneous, covering all the surface of the paper reaction zones in a 3D sensor format. These devices showed a major advantage when compared to the 2D lateral flow glucose sensors, where some carryover of the coloured products usually occurs. The detection of anti-Leishmania antibodies in canine sera was conceptually achieved using a paper-based 96-well enzyme-linked immunosorbent assay format. However, optimization is still needed for this test, regarding the efficiency of the immobilization of antigens on the cellulose fibres. The detection of Mycobacterium tuberculosis nucleic acids integrated with a non-cross-linking gold nanoprobe detection scheme was also achieved in a wax-printed 384-well paper-based microplate, by the hybridization with a species-specific probe. The obtained results with the above

  9. A rapid, low-cost, and microfluidic chip-based system for parallel identification of multiple pathogens related to clinical pneumonia.

    Science.gov (United States)

    Huang, Guoliang; Huang, Qin; Xie, Lan; Xiang, Guangxin; Wang, Lei; Xu, Hui; Ma, Li; Luo, Xianbo; Xin, Juan; Zhou, Xinying; Jin, Xiangyu; Zhang, Lei

    2017-07-25

    An air-insulated microfluidic chip was designed for the automatic centrifugal distribution of samples to 24-test cells, enabling the parallel identification of multiple clinical pneumonia-related pathogens in 1.45-μL reactions without cross-contamination in 45 min. A portable nucleic acid analyzer that integrates mechanical, confocal optical, electronic, and software functions was also developed to collect fluorescence data in a Ø3 mm imaging field near the optical diffraction limit for highly sensitive fluorescence detection of nucleic acid amplification in real time. This microfluidic chip-based portable nucleic acid analyzer could detect low abundance nucleic acids present at as few as 10 copies. In a blinded experiment, specific identification of Mycoplasma pneumoniae, Staphylococcus aureus, and methicillin-resistant S. aureus was achieved with 229 clinical patient sputum samples. The total coincidence rate of our system and traditional RT-PCR with an ABI 7500 was 99.56%. Four samples accounting for the 0.44% inconformity were retested by gene sequencing, revealing that our system reported the correct results. This novel microfluidic chip-based detection system is cost-effective, rapid, sensitive, specific, and has a relatively high throughput for parallel identification, which is especially suitable for resource-limited facilities/areas and point-of-care testing.

  10. Low-cost, rapidly-developed, 3D printed in vitro corpus callosum model for mucopolysaccharidosis type I [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Anthony Tabet

    2016-12-01

    Full Text Available The rising prevalence of high throughput screening and the general inability of (1 two dimensional (2D cell culture and (2 in vitro release studies to predict in vivo neurobiological and pharmacokinetic responses in humans has led to greater interest in more realistic three dimensional (3D benchtop platforms. Advantages of 3D human cell culture over its 2D analogue, or even animal models, include taking the effects of microgeometry and long-range topological features into consideration. In the era of personalized medicine, it has become increasingly valuable to screen candidate molecules and synergistic therapeutics at a patient-specific level, in particular for diseases that manifest in highly variable ways. The lack of established standards and the relatively arbitrary choice of probing conditions has limited in vitro drug release to a largely qualitative assessment as opposed to a predictive, quantitative measure of pharmacokinetics and pharmacodynamics in tissue. Here we report the methods used in the rapid, low-cost development of a 3D model of a mucopolysaccharidosis type I patient’s corpus callosum, which may be used for cell culture and drug release. The CAD model is developed from in vivo brain MRI tracing of the corpus callosum using open-source software, printed with poly (lactic-acid on a Makerbot Replicator 5X, UV-sterilized, and coated with poly (lysine for cellular adhesion. Adaptations of material and 3D printer for expanded applications are also discussed.

  11. Low-cost, rapidly-developed, 3D printed in vitro corpus callosum model for mucopolysaccharidosis type I [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Anthony Tabet

    2017-03-01

    Full Text Available The rising prevalence of high throughput screening and the general inability of (1 two dimensional (2D cell culture and (2 in vitro release studies to predict in vivo neurobiological and pharmacokinetic responses in humans has led to greater interest in more realistic three dimensional (3D benchtop platforms. Advantages of 3D human cell culture over its 2D analogue, or even animal models, include taking the effects of microgeometry and long-range topological features into consideration. In the era of personalized medicine, it has become increasingly valuable to screen candidate molecules and synergistic therapeutics at a patient-specific level, in particular for diseases that manifest in highly variable ways. The lack of established standards and the relatively arbitrary choice of probing conditions has limited in vitro drug release to a largely qualitative assessment as opposed to a predictive, quantitative measure of pharmacokinetics and pharmacodynamics in tissue. Here we report the methods used in the rapid, low-cost development of a 3D model of a mucopolysaccharidosis type I patient’s corpus callosum, which may be used for cell culture and drug release. The CAD model is developed from in vivo brain MRI tracing of the corpus callosum using open-source software, printed with poly (lactic-acid on a Makerbot Replicator 5X, UV-sterilized, and coated with poly (lysine for cellular adhesion. Adaptations of material and 3D printer for expanded applications are also discussed.

  12. Paradoxical (REM) Sleep Deprivation Causes a Large and Rapidly Reversible Decrease in Long-Term Potentiation, Synaptic Transmission, Glutamate Receptor Protein Levels, and ERK/MAPK Activation in the Dorsal Hippocampus

    Science.gov (United States)

    Ravassard, Pascal; Pachoud, Bastien; Comte, Jean-Christophe; Mejia-Perez, Camila; Scoté-Blachon, Céline; Gay, Nadine; Claustrat, Bruno; Touret, Monique; Luppi, Pierre-Hervé; Salin, Paul Antoine

    2009-01-01

    Study Objectives: It has been shown that wake (W) and slow wave sleep (SWS) modulate synaptic transmission in neocortical projections. However the impact of paradoxical sleep (PS) quantities on synaptic transmission remains unknown. We examined whether PS modulated the excitatory transmission and expression of glutamate receptor subtypes and phosphorylated extracellular signal-regulated kinases (p-ERK1/2). Design: PS deprivation (PSD) was carried out with the multiple platforms method on adult male Sprague-Dawley rats. LTP, late-LTP, and synaptic transmission were studied in the dorsal and ventral hippocampus of controls, 75-h PSD and 150-min PS rebound (PSR). GluR1 and NR1 protein and mRNA expression were evaluated by western blot and real-time PCR. P-ERK1/2 level was quantified by western blot and immunohistochemistry. Measurement and Results: PSD decreased synaptic transmission and LTP selectively in dorsal CA1 and PSR rescued these deficits. PSD-induced synaptic modifications in CA1 were associated with a decrease in GluR1, NR1, and p-ERK1/2 levels in dorsal CA1 without change in GluR1 and NR1 mRNA expression. Regression analysis shows that LTP is positively correlated with both PS quantities and SWS episodes duration, whereas synaptic transmission and late-LTP are positively correlated with PS quantities and negatively correlated with SWS quantities. Conclusions: These findings unveil previously unrecognized roles of PSD on synaptic transmission and LTP in the dorsal, but not in the ventral, hippocampus. The fact that the decrease in protein expression of GluR1 and NR1 was not associated with a change in mRNA expression of these receptors suggests that a sleep-induced modulation of translational mechanisms occurs in dorsal CA1. Citation: Ravassard P; Pachoud B; Comte JC; Mejia-Perez C; Scoté-Blachon C; Gay N; Claustrat B; Touret M; Luppi PH; Salin PA. Paradoxical (REM) sleep deprivation causes a large and rapidly reversible decrease in long-term potentiation

  13. A low-cost multielectrode system for data acquisition enabling real-time closed-loop processing with rapid recovery from stimulation artifacts

    Directory of Open Access Journals (Sweden)

    John D Rolston

    2009-07-01

    Full Text Available Commercially available data acquisition systems for multielectrode recording from freely moving animals are expensive, often rely on proprietary software, and do not provide detailed, modifiable circuit schematics. When used in conjunction with electrical stimulation, they are prone to prolonged, saturating stimulation artifacts that prevent the recording of short-latency evoked responses. Yet electrical stimulation is integral to many experimental designs, and critical for emerging brain-computer interfacing and neuroprosthetic applications. To address these issues, we developed an easy-to-use, modifiable, and inexpensive system for multielectrode neural recording and stimulation. Setup costs are less than US$10,000 for 64 channels, an order of magnitude lower than comparable commercial systems. Unlike commercial equipment, the system recovers rapidly from stimulation and allows short-latency action potentials (<1 ms post-stimulus to be detected, facilitating closed-loop applications and exposing neural activity that would otherwise remain hidden. To illustrate this capability, evoked activity from microstimulation of the rodent hippocampus is presented. The system is modular, in banks of 16 channels, and flexible in usage: while primarily designed for in vivo use, it can be combined with commercial preamplifiers to record from in vitro multielectrode arrays. The system’s open-source control software, NeuroRighter, is implemented in C#, with an easy-to-use graphical interface. As C# functions in a managed code environment, which may impact performance, analysis was conducted to ensure comparable speed to C++ for this application. Hardware schematics, layout files, and software are freely available. Since maintaining wired headstage connections with freely moving animals is difficult, we describe a new method of electrode-headstage coupling using neodymium magnets.

  14. Evaluation of thermally-modified calcium-rich attapulgite as a low-cost substrate for rapid phosphorus removal in constructed wetlands.

    Science.gov (United States)

    Yin, Hongbin; Yan, Xiaowei; Gu, Xiaohong

    2017-05-15

    The cost-effective and geographically available substrates are vital for the design of constructed wetlands (CWs), especially the saturated subsurface flow CWs, which are deemed as an efficient way to remove the inlet-lake phosphorus concentrations. In this study, phosphorus removal of thermally-treated calcium-rich attapulgite (TCAP) with varied particle sizes (0.2-0.5 mm, 0.5-1 mm and 1-2 mm) was assessed using batch and long-term column experiments to evaluate its feasibility as a CWs substrate. The phosphorus-bound mechanism in TCAP was identified in various initial phosphorus concentrations. Batch studies indicated that more than 95% of P can be rapidly (hydraulic retention time (HRT) exerts great influence on P removal performance and longer HRTs favor the dissolution of CaO in TCAP, consequently increasing the P removal rate. In a 150-day P removal experiment, TCAP removed an average of 93.1%-95.4% of the influent P with a HRT of eight hours. Both the batch and chemical extraction of the P fraction of TCAP showed that the P removed by TCAP was mainly through formation of Ca phosphate precipitation. However, the species of Ca-P precipitation formed might be varied in different phosphorus concentrations. All results indicated that TCAP can be a suitable substrate when used in CWs, and field experiments should be carried out to test its real P removal performance in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Joint Consultation Clinic by Infectious Diseases Specialists and Podiatry team (ID-POD) Compliments the Care of Diabetic Patients with Foot Infections by Reducing Cost and Decreasing Outpatient Clinic Visits

    Science.gov (United States)

    Lingegowda, Pushpalatha Bangalore; Ooi, Say-Tat; Somani, Jyoti; Law, Chelsea; Yeo, Boon Kiak

    2017-01-01

    Abstract Background Management of diabetic foot infections (DFI) is challenging and involves multidisciplinary teams to improve outcomes (1). Appropriate wound care of patients with DFI plays an important role in successfully curing infections and promote wound healing. In Singapore, Infectious Diseases (ID) specialists help in the management of DFI by recommending appropriate antibiotics for infected wounds while wound debridement are managed by Podiatrists (POD). When patients are hospitalized multidisciplinary teams including Vascular Surgery review patients. In the outpatient setting patients have multiple appointments including ID and Endocrinology etc. The time spent and costs incurred by patients for traveling to multiple appointments is considerable. A joint ID-POD clinic was initiated to reduce the cost and inconvenience for patients. Methods A joint weekly clinic was initiated in October’16 and the data was analyzed upto May’17. Finance was involved in deriving costs. The service costs for consultations payable by patients before and after the initiation of the joint clinic were compared. Results First 6 months experience of initiating the joint ID-POD clinic is reported. 35 unique patients had a total of 88 visits. 1/third of the patients had more than 2 visits to the joint clinic. For each visit to the joint clinic the patient paid 25% less compared with having separate clinics. The hospital lowered the service cost for the new clinic by 11%. This was done by minimizing the time involvement of the ID physician. Conclusion Joint ID-POD clinic for managing diabetic patients with foot infections revealed several advantages. Hospital outpatient visits for each patient decreased by 50% for those requiring care of both ID and POD, without compromising care. With the consolidation of care each individual patient had a cost savings of 25% for the joint consultation. This joint clinic while making it convenient for patients has revealed significant cost

  16. Heavy-metal contamination of soils in Saxony/Germany by foundry fumes and low-cost rapid analyses of contaminated soils by XRF

    Science.gov (United States)

    Mucke, D.

    2012-04-01

    Heavy-metal contamination of soils in Saxony/Germany by foundry fumes and low-cost rapid analysis of contaminated soils by XRF Dieter Mucke, Rolf Kumann, Sebastian Baldauf GEOMONTAN Gesellschaft für Geologie und Bergbau mbH&Co.KG, Muldentalstrasse 56, 09603 Rothenfurth, Saxony/Germany For hundreds of years in the Ore Mountains between Bohemia and Saxony silver and other ores are produced and smelted. Sulphide- and sulpharsenide-ores needed to be roasted first. In doing so the sulphide sulphur was oxidised under formation of sulphur dioxide SO2 and arsenide conversed into elemental arsenic and arsenide trioxide As2O3 respectively. Also the metals lead, cadmium and zinc are components of hut smokes, in the field of nickel foundries also nickel. The contents of soils basically reflect the geogenic conditions, which are caused by decomposition- and relocation-effects of the mineralisations, in the area of foundries also with influences by with the hut smokes anthropogenic mobilised elements. The Saxonian Agency for Environment and Geology drafted in 1992 a Soil Investigation Program with the aim of investigation of the contamination of Saxonian soils with arsenic and toxic heavy metals. In order of this Agency GEOMONTAN investigated 1164 measuring points in the grid 4 * 4 km.soil profiles and extracted soil samples for analysis. In the result of the laboratory examinations the Agency edited the "Soil atlas of the Free State of Saxony". 27 elements, pH and PAK are shown in detailed maps and allow in whole Saxony the first assessment of the contamination of soils with arsenic and toxic heavy metals. Each of the investigated soil profiles represent an area of 16 km2. Already by the different use of the districts (agricultural, industrial, urban) restricts representative values. GEOMONTAN in the meantime used at the exploration of a copper deposit in Brandenburg/Germany with approx. 50,000 single tests at drill cores a very fast low-cost method: the X Ray fluorescence

  17. Towards Universal Screening for Toxoplasmosis: Rapid, Cost-effective and Simultaneous Detection of Toxoplasma Anti-IgG, IgM and IgA Antibodies Using Very Small Serum Volumes

    Science.gov (United States)

    No dataset associated with this publication.This dataset is associated with the following publication:Augustine, S. Towards Universal Screening for Toxoplasmosis: Rapid, Cost-effective and Simultaneous Detection of Toxoplasma Anti-IgG, IgM and IgA Antibodies Using Very Small Serum Volumes. JOURNAL OF CLINICAL MICROBIOLOGY. American Society for Microbiology, Washington, DC, USA, 56(7): 1-2, (2016).

  18. Transaction cost analysis of in-clinic versus telehealth consultations for chronic pain: preliminary evidence for rapid and affordable access to interdisciplinary collaborative consultation.

    Science.gov (United States)

    Theodore, Brian R; Whittington, Jan; Towle, Cara; Tauben, David J; Endicott-Popovsky, Barbara; Cahana, Alex; Doorenbos, Ardith Z

    2015-06-01

    With ever increasing mandates to reduce costs and increase the quality of pain management, health care institutions are faced with the challenge of adopting innovative technologies and shifting workflows to provide value-based care. Transaction cost economic analysis can provide comparative evaluation of the consequences of these changes in the delivery of care. The aim of this study was to establish proof-of-concept using transaction cost analysis to examine chronic pain management in-clinic and through telehealth. Participating health care providers were asked to identify and describe two comparable completed transactions for patients with chronic pain: one consultation between patient and specialist in-clinic and the other a telehealth presentation of a patient's case by the primary care provider to a team of pain medicine specialists. Each provider completed two on-site interviews. Focus was on the time, value of time, and labor costs per transaction. Number of steps, time, and costs for providers and patients were identified. Forty-six discrete steps were taken for the in-clinic transaction, and 27 steps were taken for the telehealth transaction. Although similar in costs per patient ($332.89 in-clinic vs. $376.48 telehealth), the costs accrued over 153 business days in-clinic and 4 business days for telehealth. Time elapsed between referral and completion of initial consultation was 72 days in-clinic, 4 days for telehealth. U.S. health care is moving toward the use of more technologies and practices, and the information provided by transaction cost analyses of care delivery for pain management will be important to determine actual cost savings and benefits. Wiley Periodicals, Inc.

  19. Cost Behavior

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    The objective of this dissertation is to investigate determinants and consequences of asymmetric cost behavior. Asymmetric cost behavior arises if the change in costs is different for increases in activity compared to equivalent decreases in activity. In this case, costs are termed “sticky......” if the change is less when activity falls than when activity rises, whereas costs are termed “anti-sticky” if the change is more when activity falls than when activity rises. Understanding such cost behavior is especially relevant for decision-makers and financial analysts that rely on accurate cost information...... to facilitate resource planning and earnings forecasting. As such, this dissertation relates to the topic of firm profitability and the interpretation of cost variability. The dissertation consists of three parts that are written in the form of separate academic papers. The following section briefly summarizes...

  20. Risks and Benefits of Rapid Clozapine Titration.

    Science.gov (United States)

    Lochhead, Jeannie D; Nelson, Michele A; Schneider, Alan L

    2016-05-18

    Clozapine is often considered the gold standard for the treatment of schizophrenia. Clinical guidelines suggest a gradual titration over 2 weeks to reduce the risks of adverse events such as seizures, hypotension, agranulocytosis, and myocarditis. The slow titration often delays time to therapeutic response. This raises the question of whether, in some patients, it may be safe to use a more rapid clozapine titration. The following case illustrates the potential risks associated with the use of multiple antipsychotics and rapid clozapine titration. We present the case of a young man with schizophrenia who developed life threatening neuroleptic malignant syndrome (NMS) during rapid clozapine titration and treatment with multiple antipsychotics. We were unable to find another case in the literature of NMS associated with rapid clozapine titration. This case is meant to urge clinicians to carefully evaluate the risks and benefits of rapid clozapine titration, and to encourage researchers to further evaluate the safety of rapid clozapine titration. Rapid clozapine titration has implications for decreasing health care costs associated with prolonged hospitalizations, and decreasing the emotional suffering associated with uncontrolled symptoms of psychosis. Clozapine is considered the most effective antipsychotic available thus efforts should focus on developing strategies that would allow for safest and most efficient use of clozapine to encourage its utilization for treatment resistance schizophrenia.

  1. Risks and benefits of rapid clozapine titration

    Directory of Open Access Journals (Sweden)

    Jeannie D. Lochhead

    2016-05-01

    Full Text Available Clozapine is often considered the gold standard for the treatment of schizophrenia. Clinical guidelines suggest a gradual titration over 2 weeks to reduce the risks of adverse events such as seizures, hypotension, agranulocytosis, and myocarditis. The slow titration often delays time to therapeutic response. This raises the question of whether, in some patients, it may be safe to use a more rapid clozapine titration. The following case illustrates the potential risks associated with the use of multiple antipsychotics and rapid clozapine titration. We present the case of a young man with schizophrenia who developed life threatening neuroleptic malignant syndrome (NMS during rapid clozapine titration and treatment with multiple antipsychotics. We were unable to find another case in the literature of NMS associated with rapid clozapine titration. This case is meant to urge clinicians to carefully evaluate the risks and benefits of rapid clozapine titration, and to encourage researchers to further evaluate the safety of rapid clozapine titration. Rapid clozapine titration has implications for decreasing health care costs associated with prolonged hospitalizations, and decreasing the emotional suffering associated with uncontrolled symptoms of psychosis. Clozapine is considered the most effective antipsychotic available thus efforts should focus on developing strategies that would allow for safest and most efficient use of clozapine to encourage its utilization for treatment resistance schizophrenia.

  2. The Agile Rapid Global Combat Support (ARGCS) System: A Cost and Benefit Analysis of Including the ARGCS Technologies in the Acquisition of the Enhanced Consolidated Support System (ECASS)

    Science.gov (United States)

    2007-12-01

    Franck and Carmelita Troy in January 2007. Revised in May of 2007, this interim BCA, based on the data then available, offered an assessment of the...www.drivedemand.com/roipart1.html Franck, Raymond and Carmelita Troy, Agile Rapid Global Combat Support, Business Case Analysis, Version 1.0. Naval

  3. Development of a rapid, cost-effective TaqMan Real-Time PCR Assay for identification and differentiation of Coccidioides immitis and Coccidioides posadasii.

    Science.gov (United States)

    Sheff, Kelly W; York, Emily R; Driebe, Elizabeth M; Barker, Bridget M; Rounsley, Steven D; Waddell, Victor G; Beckstrom-Sternberg, Stephen M; Beckstrom-Sternberg, James S; Keim, Paul S; Engelthaler, David M

    2010-05-01

    Coccidioidomycosis is an infection caused by Coccidioides immitis or C. posadasii. We developed a TaqMan real-time PCR assay that rapidly and accurately differentiates the species. This assay can be used as a tool to improve disease surveillance, increase understanding of the natural history of the infection, and assist in clinical differentiation studies.

  4. Rapid, low-cost MR imaging protocol to document central nervous system and sinus abnormalities prior to pediatric hematopoietic stem cell transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Eliane D.; Barbosa, Felipe G. de; Szarf, Gilberto; Lederman, Henrique M. [Universidade Federal de Sao Paulo, Department of Diagnostic Imaging, Sao Paulo (Brazil); Seber, Adriana; Ginani, Valeria C.; Carlesse, Fabianne C.; Gouvea, Roseane V.; Zecchin, Victor G.; Carvalho, Cinthya R. [Universidade Federal de Sao Paulo, Division of Pediatric Oncology, Department of Pediatrics, Sao Paulo (Brazil)

    2011-06-15

    Patients undergoing bone marrow transplant (BMT) are at risk for infectious complications, including those of the sinus. Central nervous system (CNS) abnormalities related to the chemotherapy or radiation that the patient received for the treatment of underlying malignancy or to transplant-related effects are also commonly seen. The only effective way to differentiate pre- and post-transplant causes is to have a baseline evaluation prior to the admission for transplant. The current method used to evaluate these patients is head CT. However, CT is not accurate to demonstrate CNS abnormalities and exposes the patient to radiation. MRI, despite better sensitivity for white matter abnormalities, has not been routinely used because of the higher cost and longer duration of the exam. Therefore, we designed a fast, low-cost and radiation-free MRI-based protocol to simultaneously evaluate sinus and brain abnormalities. (orig.)

  5. O-antigen and virulence profiling of Shiga toxin-producing Escherichia coli by a rapid and cost-effective DNA microarray colorimetric method

    OpenAIRE

    Beatriz eQuiñones; Swimley, Michelle S.; Koh-Eun eNarm; Patel, Ronak N.; Cooley, Michael B.; Mandrell, Robert E.

    2012-01-01

    Shiga toxin-producing Escherichia coli (STEC) is a leading cause of foodborne illness worldwide. The present study developed the use of DNA microarrays with the ampliPHOX colorimetric method to rapidly detect and genotype STEC strains. A low-density 30-mer oligonucleotide DNA microarray was designed to target O-antigen gene clusters of eleven E. coli serogroups (O26, O45, O91, O103, O104, O111, O113, O121, O128, O145 and O157) that have been associated with the majority of STEC infections. ...

  6. Rapid evidence review of the comparative effectiveness, harms, and cost-effectiveness of pharmacogenomics-guided antidepressant treatment versus usual care for major depressive disorder.

    Science.gov (United States)

    Peterson, Kimberly; Dieperink, Eric; Anderson, Johanna; Boundy, Erin; Ferguson, Lauren; Helfand, Mark

    2017-06-01

    This study aims to conduct an evidence review of the effectiveness, harms, and cost-effectiveness of pharmacogenomics-guided antidepressant treatment for major depressive disorder. We searched MEDLINE®, the Cochrane Central Registry of Controlled Trials, and PsycINFO through February 2017. We used prespecified criteria to select studies, abstract data, and rate internal validity and strength of the evidence (PROSPERO number CRD42016036358). We included two randomized trials (RCT), five controlled cohort studies, and six modeling studies of mostly women in their mid-40s with few comorbidities. CNSDose (ABCB1, ABCC1, CYP2C19, CYP2D6, UGT1A1) is the only pharmacogenomics test that significantly improved remission (one additional remitting patient in 12 weeks per three genotyped, 95% CI 1.7 to 3.5) and reduced intolerability in an RCT. ABCB1 genotyping leads to one additional remitting patient in 5 weeks per three genotyped (95% CI 3 to 20), but tolerability was not reported. In an RCT, GeneSight (CYP2D6, CYPC19, CYP1A2, SLC6A4, HTR2A) did not statistically significantly improve remission, and evidence is inconclusive about its tolerability. Evidence is generally low strength because RCTs were few and underpowered. Cost-effectiveness is unclear due to lack of directly observed cost-effectiveness outcomes. We found no studies that evaluated whether pharmacogenomics shortens time to optimal treatment, whether improvements were due to switches to genetically congruent medication, or whether effectiveness varies based on test and patient characteristics. Certain pharmacogenomics tools show promise of improving short-term remission rates in women in their mid-40s with few comorbidities. But, important evidence limitations preclude recommending their widespread use and indicate a need for further research.

  7. A rapid and systematic review and economic evaluation of the clinical and cost-effectiveness of newer drugs for treatment of mania associated with bipolar affective disorder.

    Science.gov (United States)

    Bridle, C; Palmer, S; Bagnall, A-M; Darba, J; Duffy, S; Sculpher, M; Riemsma, R

    2004-05-01

    To evaluate the clinical and cost-effectiveness of quetiapine, olanzapine and valproate semisodium in the treatment of mania associated with bipolar disorder. Electronic databases; industry submissions made to the National Institute for Clinical Excellence. Randomised trials and economic evaluations that evaluated the effectiveness of quetiapine, olanzapine or valproate semisodium in the treatment of mania associated with bipolar disorder were selected for inclusion. Data were extracted by one reviewer into a Microsoft Access database and checked for quality and accuracy by a second. The quality of the cost-effectiveness studies was assessed using a checklist updated from that developed by Drummond and colleagues. Relative risk and mean difference data were presented as Forest plots but only pooled where this made sense clinically and statistically. Studies were grouped by drug and, within each drug, by comparator used. Chi-squared tests of heterogeneity were performed for the outcomes if pooling was indicated. A probabilistic model was developed to estimate costs from the perspective of the NHS, and health outcomes in terms of response rate, based on an improvement of at least 50% in a patient's baseline manic symptoms derived from an interview-based mania assessment scale. The model evaluated the cost-effectiveness of the alternative drugs when used as part of treatment for the acute manic episode only. Eighteen randomised trials met the inclusion criteria. Aspects of three of the quetiapine studies were commercial-in-confidence. The quality of the included trials was limited and overall, key methodological criteria were not met in most trials. Quetiapine, olanzapine and valproate semisodium appear superior to placebo in reducing manic symptoms, but may cause side-effects. There appears to be little difference between these treatments and lithium in terms of effectiveness, but quetiapine is associated with somnolence and weight gain, whereas lithium is associated

  8. Combining ASTER multispectral imagery analysis and support vector machines for rapid and cost-effective post-fire assessment: a case study from the Greek wildland fires of 2007

    Directory of Open Access Journals (Sweden)

    G. P. Petropoulos

    2010-02-01

    Full Text Available Remote sensing is increasingly being used as a cost-effective and practical solution for the rapid evaluation of impacts from wildland fires. The present study investigates the use of the support vector machine (SVM classification method with multispectral data from the Advanced Spectral Emission and Reflection Radiometer (ASTER for obtaining a rapid and cost effective post-fire assessment in a Mediterranean setting. A further objective is to perform a detailed intercomparison of available burnt area datasets for one of the most catastrophic forest fire events that occurred near the Greek capital during the summer of 2007. For this purpose, two ASTER scenes were acquired, one before and one closely after the fire episode. Cartography of the burnt area was obtained by classifying each multi-band ASTER image into a number of discrete classes using the SVM classifier supported by land use/cover information from the CORINE 2000 land nomenclature. Overall verification of the derived thematic maps based on the classification statistics yielded results with a mean overall accuracy of 94.6% and a mean Kappa coefficient of 0.93. In addition, the burnt area estimate derived from the post-fire ASTER image was found to have an average difference of 9.63% from those reported by other operationally-offered burnt area datasets available for the test region.

  9. A single-chamber microbial fuel cell for rapid determination of biochemical oxygen demand using low-cost activated carbon as cathode catalyst.

    Science.gov (United States)

    Wang, Ying; Liu, Xianhua; Wang, Meiyu; Zhang, Pingping; Zong, Yanping; Zhang, Qiufeng

    2017-09-13

    The biochemical oxygen demand (BOD) is widely used for the evaluation of water and wastewater quality. However, the conventional method to measure BOD is time-consuming and requires complicated processes. In this study, a Microbial fuel cell (MFC)-based BOD sensor was developed by using low-cost activated carbon as the cathode catalyst. The sensor was calibrated with an aerated nutrient medium containing sodium acetate as the BOD source. When the sensor was operated with an external resistance of 1 K Ω, linear correlation (R2 = 0.9965) was obtained for BOD concentrations ranging from 80 to 1280 mg/L in a reaction time of 50 h. Besides acetate, glucose/glutamic acid (GGA) and ethanol could also be analyzed by the sensor. In a low concentration range (200 mg/L), the relationship between GGA solution concentration and output voltage was in accord with Monod growth kinetics.

  10. Design and Development of Low Cost, Simple, Rapid and Safe, Modified Field Kits for the Visual Detection and Determination of Arsenic in Drinking Water Samples

    Directory of Open Access Journals (Sweden)

    Y. Anjaneyulu

    2005-08-01

    Full Text Available Arsenic is naturally found in surface and ground waters and the inorganic forms of arsenic are the most toxic forms. The adverse health effects of arsenic may involve the respiratory, gastrointestinal, cardiovascular, nervous, and haematopoietic systems. Arsenic contamination in drinking water is a global problem widely seen in Bangladesh and West Bengal of the Indian sub continent. As there is a great demand for field test kits due to the anticipated reduction of the US EPA arsenic standard from 50ppb to 10ppb a field kit which offers rapid, simple and safe method for precise estimation of arsenic at 10ppb in drinking water samples is developed. Field methods, based on the mercuric-bromide-stain, consist of three different major parts, which are carried out stepwise. The first part of the procedure is to remove serious interference caused by hydrogen sulphide. In commercially available kits either the sulphide is oxidized to sulphate and the excess oxidizing reagent removed prior to the hydride generation step or, the hydrogen sulphide is filtered out by passing the gas stream through a filter impregnated with lead acetate during the hydride generation step. The present method employs cupric chloride in combination with ferric chloride or Fenton’s reagent for the removal of hydrogen sulphide, which is rapid, simple and more efficient. Other interferences at this step of the analyses are normally not expected for drinking water analysis. In the second step, the generation of the arsine gas involves the classical way of using zinc metal and hydrochloric acid, which produce the ‘nascent’ hydrogen, which is the actual reducing agent. Hydrochloric acid can be replaced by sulfamic acid, which is solid and avoids a major disadvantage of having to handle a corrosive liquid in the field. The arsine gas produces a yellowish spot on the reagent paper. Depending on the arsenic content, either, Yellow – H

  11. Rapid, Simple and Cost-Effective Molecular Method to Differentiate the Temperature Sensitive (ts+) MS-H Vaccine Strain and Wild-Type Mycoplasma synoviae Isolates

    Science.gov (United States)

    Kreizinger, Zsuzsa; Sulyok, Kinga Mária; Pásztor, Alexandra; Erdélyi, Károly; Felde, Orsolya; Povazsán, János; Kőrösi, László; Gyuranecz, Miklós

    2015-01-01

    Mycoplasma synoviae infection in chickens and turkeys can cause respiratory disease, infectious synovitis and eggshell apex abnormality; thus it is an economically important pathogen. Control of M. synoviae infection comprises eradication, medication or vaccination. The differentiation of the temperature sensitive (ts+) MS-H vaccine strain from field isolates is crucial during vaccination programs. Melt-curve and agarose gel based mismatch amplification mutation assays (MAMA) are provided in the present study to distinguish between the ts+ MS-H vaccine strain, its non-temperature sensitive re-isolates and wild-type M. synoviae isolates based on the single nucleotide polymorphisms at nt367 and nt629 of the obg gene. The two melt-MAMAs and the two agarose-MAMAs clearly distinguish the ts+ MS-H vaccine strain genotype from its non-temperature sensitive re-isolate genotype and wild-type M. synoviae isolate genotype, and no cross-reactions with other Mycoplasma species infecting birds occur. The sensitivity of the melt-MAMAs and agarose-MAMAs was 103 and 104 copy numbers, respectively. The assays can be performed directly on clinical samples and they can be run simultaneously at the same annealing temperature. The assays can be performed in laboratories with limited facilities, using basic real-time PCR machine or conventional thermocycler coupled with agarose gel electrophoresis. The advantages of the described assays compared with previously used methods are simplicity, sufficient sensitivity, time and cost effectiveness and specificity. PMID:26207635

  12. Have you tried spermine? A rapid and cost-effective method to eliminate dextran sodium sulfate inhibition of PCR and RT-PCR.

    Science.gov (United States)

    Krych, Łukasz; Kot, Witold; Bendtsen, Katja M B; Hansen, Axel K; Vogensen, Finn K; Nielsen, Dennis S

    2018-01-01

    The Dextran Sulfate Sodium (DSS) induced colitis mouse model is commonly used to investigate human inflammatory bowel disease (IBD). Nucleic acid extracts originating from these animals are often contaminated with DSS, which is a strong inhibitor of many enzymatic based molecular biology reactions including PCR and reverse-transcription (RT). Methods for removing DSS from nucleic acids extracts exist for RNA, but no effective protocol for DNA or cDNA is currently available. However, spermine has previously been shown to be an effective agent for counteracting DSS inhibition of polynucleotide kinase, which led to the hypothesis, that spermine could be used to counteract DSS inhibition of PCR and RT. We investigated the means of adding spermine in an adequate concentration to PCR based protocols (including qPCR, two-step RT-qPCR, and amplicon sequencing library preparation) to remove DSS inhibition. Within the range up to 0.01g/L, spermine can be added to PCR/qPCR or RT prophylactically without a significant reduction of reaction efficiency. Addition of spermine at the concentration of 0.08g/L can be used to recover qualitative PCR signal inhibited by DSS in concentrations up to 0.32g/L. For optimal quantitative analysis, the concentration of spermine requires fine adjustment. Hence, we present here a simple fluorometric based method for adjusting the concentration of spermine ensuring an optimal efficiency of the reaction exposed to an unknown concentration of DSS. In conclusion, we demonstrate a cost effective and easy method to counteract DSS inhibition in PCR and two-step RT-qPCR. Fixed or fine-tuned concentrations of spermine can be administered depending on the qualitative or quantitative character of the analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Rapid Quantitative Chiral Amphetamines Liquid Chromatography-Tandem Mass Spectrometry Method in Plasma and Oral Fluid with a Cost-effective Chiral Derivatizing Reagent

    Science.gov (United States)

    Newmeyer, Matthew N.; Concheiro, Marta; Huestis, Marilyn A.

    2014-01-01

    Methamphetamine is a widely abused psychostimulant containing a chiral center. Consumption of over-the-counter and prescription medications may yield positive amphetamines results, but chiral separation of l- and d- methamphetamine and its metabolite amphetamine can help determine whether the source was licit or illicit. We present the first LC-MS/MS method with precolumn derivatization for methamphetamine and amphetamine chiral resolution in plasma and oral fluid collected with the Oral-Eze® and Quantisal™ devices. To 0.5 mL plasma, 0.75 mL Oral-Eze, or 1 mL Quantisal specimen racemic d11-methamphetamine and amphetamine internal standards were added, followed by protein precipitation. Samples were centrifuged and supernatants loaded onto pre-conditioned Phenomenex® Strata™-XC Polymeric Strong Cation solid phase extraction columns. After washing, analytes were eluted with 5% ammonium hydroxide in methanol. The eluate was evaporated to dryness and reconstituted in water. Derivatization was performed with 1-fluoro-2,4-dinitrophenyl-5-l-alanineamide (Marfey's reagent) and heating at 45°C for 1 h. Derivatized enantiomer separations were performed under isocratic conditions (methanol:water, 60:40) with a Phenomenex® Kinetex® 2.6 μm C18 column. Analytes were identified and quantified by two MRM transitions and their ratio on a 3200 QTrap (AB Sciex) mass spectrometer in ESI negative mode. In all three matrices, the method was linear for all enantiomers from 1-500 μg/L, with imprecision and accuracy of ≤11.3% and 85.3-108%, respectively. Extraction efficiencies ranged from 67.4-117% and matrix effects from -17.0-468%, with variation always ≤19.1%. Authentic plasma and OF specimens were collected from an IRB-approved study that included controlled Vicks® VapoInhaler™ administration. The present method is sensitive, selective, economic and rapid (separations accomplished in <10 min), and improves methamphetamine result interpretation. PMID:25065924

  14. Rapid quantitative chiral amphetamines liquid chromatography-tandem mass spectrometry: method in plasma and oral fluid with a cost-effective chiral derivatizing reagent.

    Science.gov (United States)

    Newmeyer, Matthew N; Concheiro, Marta; Huestis, Marilyn A

    2014-09-05

    Methamphetamine is a widely abused psychostimulant containing a chiral center. Consumption of over-the-counter and prescription medications may yield positive amphetamines results, but chiral separation of l- and d-methamphetamine and its metabolite amphetamine can help determine whether the source was licit or illicit. We present the first LC-MS/MS method with precolumn derivatization for methamphetamine and amphetamine chiral resolution in plasma and oral fluid collected with the Oral-Eze(®) and Quantisal™ devices. To 0.5mL plasma, 0.75mL Oral-Eze, or 1mL Quantisal specimen racemic d11-methamphetamine and amphetamine internal standards were added, followed by protein precipitation. Samples were centrifuged and supernatants loaded onto pre-conditioned Phenomenex(®) Strata™-XC Polymeric Strong Cation solid phase extraction columns. After washing, analytes were eluted with 5% ammonium hydroxide in methanol. The eluate was evaporated to dryness and reconstituted in water. Derivatization was performed with 1-fluoro-2,4-dinitrophenyl-5-l-alanineamide (Marfey's reagent) and heating at 45°C for 1h. Derivatized enantiomer separations were performed under isocratic conditions (methanol:water, 60:40) with a Phenomenex(®) Kinetex(®) 2.6μm C18 column. Analytes were identified and quantified by two MRM transitions and their ratio on a 3200 QTrap (AB Sciex) mass spectrometer in ESI negative mode. In all three matrices, the method was linear for all enantiomers from 1 to 500μg/L, with imprecision and accuracy of ≤11.3% and 85.3-108%, respectively. Extraction efficiencies ranged from 67.4 to 117% and matrix effects from -17.0 to 468%, with variation always ≤19.1%. Authentic plasma and OF specimens were collected from an IRB-approved study that included controlled Vicks(®) VapoInhaler™ administration. The present method is sensitive, selective, economic and rapid (separations accomplished in <10min), and improves methamphetamine result interpretation. Published

  15. Rapid Prototyping Reconsidered

    Science.gov (United States)

    Desrosier, James

    2011-01-01

    Continuing educators need additional strategies for developing new programming that can both reduce the time to market and lower the cost of development. Rapid prototyping, a time-compression technique adapted from the high technology industry, represents one such strategy that merits renewed evaluation. Although in higher education rapid…

  16. Budget impact analysis of a breast rapid diagnostic unit.

    Science.gov (United States)

    Elmi, M; Hussein, H; Nofech-Mozes, S; Curpen, B; Leahey, A; Look Hong, N

    2017-06-01

    The Odette Cancer Centre's recent implementation of a rapid diagnostic unit (rdu) for breast lesions has significantly decreased wait times to diagnosis. However, the economic impact of the unit remains unknown. This project defined the development and implementation costs and the operational costs of a breast rdu in a tertiary care facility. From an institutional perspective, a budget impact analysis identified the direct costs associated with the breast rdu. A base-case model was also used to calculate the cost per patient to achieve a diagnosis. Sensitivity analyses computed costs based on variations in key components. Costs are adjusted to 2015 valuations using health care-specific consumer price indices and are reported in Canadian dollars. Initiation cost for the rdu was $366,243. The annual operational cost for support staff was $111,803. The average per-patient clinical cost for achieving a diagnosis was $770. Sensitivity analyses revealed that, if running at maximal institutional capacity, the total annual clinical cost for achieving a diagnosis could range between $136,080 and $702,675. Establishment and maintenance of a breast rdu requires significant investment to achieve reductions in time to diagnosis. Expenditures ought to be interpreted in the context of institutional patient volumes and trade-offs in patient-centred outcomes, including lessened patient anxiety and possibly shorter times to definitive treatment. Our study can be used as a resource-planning tool for future rdus in health care systems wishing to improve diagnostic efficiency.

  17. Use of Optical Imaging Technology in the Validation of a New, Rapid, Cost-Effective Drug Screen as Part of a Tiered In Vivo Screening Paradigm for Development of Drugs To Treat Cutaneous Leishmaniasis.

    Science.gov (United States)

    Caridha, Diana; Parriot, Sandi; Hudson, Thomas H; Lang, Thierry; Ngundam, Franklyn; Leed, Susan; Sena, Jenell; Harris, Michael; O'Neil, Michael; Sciotti, Richard; Read, Lisa; Lecoeur, Herve; Hickman, Mark; Grogl, Max

    2017-04-01

    In any drug discovery and development effort, a reduction in the time of the lead optimization cycle is critical to decrease the time to license and reduce costs. In addition, ethical guidelines call for the more ethical use of animals to minimize the number of animals used and decrease their suffering. Therefore, any effort to develop drugs to treat cutaneous leishmaniasis requires multiple tiers of in vivo testing that start with higher-throughput efficacy assessments and progress to lower-throughput models with the most clinical relevance. Here, we describe the validation of a high-throughput, first-tier, noninvasive model of lesion suppression that uses an in vivo optical imaging technology for the initial screening of compounds. A strong correlation between luciferase activity and the parasite load at up to 18 days postinfection was found. This correlation allows the direct assessment of the effects of drug treatment on parasite burden. We demonstrate that there is a strong correlation between drug efficacy measured on day 18 postinfection and the suppression of lesion size by day 60 postinfection, which allows us to reach an accurate conclusion on drug efficacy in only 18 days. Compounds demonstrating a significant reduction in the bioluminescence signal compared to that in control animals can be tested in lower-throughput, more definitive tests of lesion cure in BALB/c mice and Golden Syrian hamsters (GSH) using Old World and New World parasites. Copyright © 2017 Caridha et al.

  18. RE-COST: Cost and Business Comparisons of Renewable vs. Non-renewable Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Mostajo Veiga, Mercedes; Farina Alvarez, Pablo; Fernandez-Montes Moraleda, Manuel; Kleinsorge, Anne

    2012-07-15

    Based on real plant data, the RE-COST project concludes that in many OECD energy markets, new renewable energy technologies (RET) are close to be competitive with non-RET electricity plants. RET costs are decreasing rapidly, while conventional power plants are affected by lower utilisation rates, volatile coal and gas prices, CO2 pricing, and lower electricity demand than expected. If energy prices would account for air pollution and climate change, renewables would already be the most beneficial for society and business.

  19. Decreasing relative risk premium

    DEFF Research Database (Denmark)

    Hansen, Frank

    2007-01-01

    such that the corresponding relative risk premium is a decreasing function of present wealth, and we determine the set of associated utility functions. We find a new characterization of risk vulnerability and determine a large set of utility functions, closed under summation and composition, which are both risk vulnerable...... and have decreasing relative risk premium. We finally introduce the notion of partial risk neutral preferences on binary lotteries and show that partial risk neutrality is equivalent to preferences with decreasing relative risk premium...

  20. Kato-Katz and Lumbreras rapid sedimentation test to evaluate helminth prevalence in the setting of a school-based deworming program

    OpenAIRE

    Lopez, Martha; Morales, Maria Luisa; Konana, Monisha; Hoyer, Paige; Pineda-Reyes, Roberto; White, Arthur Clinton; Garcia, Hector Hugo; Lescano, Andres Guillermo; Gotuzzo, Eduardo; Cabada, Miguel Mauricio

    2016-01-01

    The sensitivity of the Kato-Katz test is suboptimal for the evaluation of intestinal helminth prevalence. Moreover, during mass deworming, as helminth egg burden decreases, the sensitivity is likely to decrease. The Lumbreras rapid sedimentation (Lumbreras) is a low-cost non-quantitative test, but may provide useful information in low burden areas. We compared the prevalence of intestinal helminth infections assessed by the Kato-Katz and the Lumbreras rapid sedimentation test on 3 stool speci...

  1. Building a rapid response team.

    Science.gov (United States)

    Halvorsen, Lisa; Garolis, Salomeja; Wallace-Scroggs, Allyson; Stenstrom, Judy; Maunder, Richard

    2007-01-01

    The use of rapid response teams is a relatively new approach for decreasing or eliminating codes in acute care hospitals. Based on the principles of a code team for cardiac and/or respiratory arrest in non-critical care units, the rapid response teams have specially trained nursing, respiratory, and medical personnel to respond to calls from general care units to assess and manage decompensating or rapidly changing patients before their conditions escalate to a full code situation. This article describes the processes used to develop a rapid response team, clinical indicators for triggering a rapid response team call, topics addressed in an educational program for the rapid response team members, and methods for evaluating effectiveness of the rapid response team.

  2. Ceramic microfabrication by rapid prototyping process chains

    Indian Academy of Sciences (India)

    To avoid high tooling costs in product development, a rapid prototyping process chain has been established that enables rapid manufacturing of ceramic microcomponents from functional models to small lot series within a short time. This process chain combines the fast and inexpensive supply of master models by rapid ...

  3. Rapid Prototyping

    Science.gov (United States)

    1999-01-01

    Javelin, a Lone Peak Engineering Inc. Company has introduced the SteamRoller(TM) System as a commercial product. The system was designed by Javelin during a Phase II NASA funded small commercial product. The purpose of the invention was to allow automated-feed of flexible ceramic tapes to the Laminated Object Manufacturing rapid prototyping equipment. The ceramic material that Javelin was working with during the Phase II project is silicon nitride. This engineered ceramic material is of interest for space-based component.

  4. Decreasing Relative Risk Premium

    DEFF Research Database (Denmark)

    Hansen, Frank

    We consider the risk premium demanded by a decision maker with wealth x in order to be indifferent between obtaining a new level of wealth y1 with certainty, or to participate in a lottery which either results in unchanged present wealth or a level of wealth y2 > y1. We define the relative risk...... premium as the quotient between the risk premium and the increase in wealth y1–x which the decision maker puts on the line by choosing the lottery in place of receiving y1 with certainty. We study preferences such that the relative risk premium is a decreasing function of present wealth, and we determine...... relative risk premium in the small implies decreasing relative risk premium in the large, and decreasing relative risk premium everywhere implies risk aversion. We finally show that preferences with decreasing relative risk premium may be equivalently expressed in terms of certain preferences on risky...

  5. Evaluation rapide du coût d'un investissement: méthode des modules fonctionnels Quick Evaluation of the Cost of an Investment: the Functional Module Method

    Directory of Open Access Journals (Sweden)

    Bergman J.

    2006-11-01

    'aide d'abaques. Conçue pour être appliquée lors des étapes préliminaires du développement d'un procédé, ou pour l'obtention d'une évaluation rapide, la Méthode des Modules Fonctionnels s'est avérée suffisamment précise pour être aussi utilisée dans l'estimation du coût d'équipements préalablement dimensionnés. The application of statistical multivariate data analysismethods to a wide range of data samples, obtained either directly from private information sources or from a sizing and detailed-estimation software, has led to the development of a new method for the quick evaluation of the cost of an investment. This method is called the Functional Module Method. In the past, several so-called modular design procedures have been proposed. In the present case, however, this is the first attempt known in the field of the use of techniques such as principal-components analysis, principal factor analysis by distance table and multiple linear regression, to develop a modular structure for estimating the cost of an investment. These changes compared to the modular procedure, which has been used to date by the IFP Project Evaluation Department (Manuel d'évaluation économique des procédés, Editions Technip, Paris, 1976, concern the definition and organization of modules capable of being identified in any chemical processing plant. The functional approach in this lcase is based on the unit operating concept of chemical engineering and no longer on a pre-specified equipment basis, for example, so that the so-called functional modules can be created. All that needs to be used is a process flowsheet indicating the principal pieces of equipment; the nature of the products processed; a material balance that is at least overall, and if possible that. is detailed for the essential lines; the mean operating conditions. The results may be obtained either via equations capable of being programmed on a pocket calculator or by using charts, as is described here. The

  6. Decreasing asthma morbidity

    African Journals Online (AJOL)

    1994-12-12

    Dec 12, 1994 ... Apart from the optimal use of drugs, various supplementary methods have been tested to decrease asthma morbidity, usually in patients from reiatively affluent socio-economic backgrounds. A study of additional measures taken in a group of moderate to severe adult asthmatics from very poor socio- ...

  7. Modeling the Coordinated Operation between Bus Rapid Transit and Bus

    Directory of Open Access Journals (Sweden)

    Jiaqing Wu

    2015-01-01

    Full Text Available The coordination between bus rapid transit (BRT and feeder bus service is helpful in improving the operational efficiency and service level of urban public transport system. Therefore, a coordinated operation model of BRT and bus is intended to develop in this paper. The total costs are formulated and optimized by genetic algorithm. Moreover, the skip-stop BRT operation is considered when building the coordinated operation model. A case of the existing bus network in Beijing is studied, the proposed coordinated operation model of BRT and bus is applied, and the optimized headway and costs are obtained. The results show that the coordinated operation model could effectively decrease the total costs of the transit system and the transfer time of passengers. The results also suggest that the coordination between the skip-stop BRT and bus during peak hour is more effective than non-coordination operation.

  8. How Rapid is Rapid Prototyping? Analysis of ESPADON Programme Results

    Directory of Open Access Journals (Sweden)

    Ian D. Alston

    2003-05-01

    Full Text Available New methodologies, engineering processes, and support environments are beginning to emerge for embedded signal processing systems. The main objectives are to enable defence industry to field state-of-the-art products in less time and with lower costs, including retrofits and upgrades, based predominately on commercial off the shelf (COTS components and the model-year concept. One of the cornerstones of the new methodologies is the concept of rapid prototyping. This is the ability to rapidly and seamlessly move from functional design to the architectural design to the implementation, through automatic code generation tools, onto real-time COTS test beds. In this paper, we try to quantify the term “rapid” and provide results, the metrics, from two independent benchmarks, a radar and sonar beamforming application subset. The metrics show that the rapid prototyping process may be sixteen times faster than a conventional process.

  9. Increasing fisheries management options with a flexible cost function

    DEFF Research Database (Denmark)

    Marchal, P.; Horwood, J.

    1998-01-01

    of fishing effort towards the agreed long-term target, a decrease in short-term yields, and an increase in long-term yields. When the weight attached to (iii) is non-zero, the optimization of the cost function provides a non-oscillatory, convergent, and near-linear control. When the weight attached to (iii......This study proposes a dynamic control of fisheries by fishing effort, calculated so as to optimize a novel cost function, over a long period of management, based upon an example of the exploitation of the Celtic Sea cod. This cost function is a flexible weighed compromise between: (i) minimizing...... the variability in fishing effort; (ii) minimizing the variability in yields; (iii) achieving an agreed fishing effort target; and (iv) achieving an agreed yield target. Increasing the weight on the criteria (ii) and (iii), and decreasing the weight on the criteria (i) and (iv), results in a more rapid movement...

  10. Activity-Based Costing: A Cost Management Tool.

    Science.gov (United States)

    Turk, Frederick J.

    1993-01-01

    In college and university administration, overhead costs are often charged to programs indiscriminately, whereas the support activities that underlie those costs remain unanalyzed. It is time for institutions to decrease ineffective use of resources. Activity-based management attributes costs more accurately and can improve efficiency. (MSE)

  11. 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.

  12. Rapid response manufacturing (RRM)

    Energy Technology Data Exchange (ETDEWEB)

    Cain, W.D. [Lockheed Martin Energy Systems, Inc., Oak Ridge, TN (United States); Waddell, W.L. [National Centers for Manufacturing Sciences, Ann Arbor, MI (United States)

    1997-02-18

    US industry is fighting to maintain its competitive edge in the global market place. Today markets fluctuate rapidly. Companies, to survive, have to be able to respond with quick-to-market, improved, high quality, cost efficient products. The way products are developed and brought to market can be improved and made more efficient through the proper incorporation of emerging technologies. The RRM project was established to leverage the expertise and resources of US private industries and federal agencies to develop, integrate, and deploy new technologies that meet critical needs for effective product realization. The RRM program addressed a needed change in the US Manufacturing infrastructure that will ensure US competitiveness in world market typified by mass customization. This project provided the effort needed to define, develop and establish a customizable infrastructure for rapid response product development design and manufacturing. A major project achievement was the development of a broad-based framework for automating and integrating the product and process design and manufacturing activities involved with machined parts. This was accomplished by coordinating and extending the application of feature-based product modeling, knowledge-based systems, integrated data management, and direct manufacturing technologies in a cooperative integrated computing environment. Key technological advancements include a product model that integrates product and process data in a consistent, minimally redundant manner, an advanced computer-aided engineering environment, knowledge-based software aids for design and process planning, and new production technologies to make products directly from design application software.

  13. Utilizing Information Technology to Facilitate Rapid Acquisition

    Science.gov (United States)

    2006-06-01

    ordering systems to facilitate streamlined commercial item acquisitions that reap the benefits of improved efficiency, reduced overall costs, and...PAGES 109 14. SUBJECT TERMS Rapid Acquisition, eCommerce , eProcurement, Information Technology, Contracting, Global Information Network...streamlined commercial item acquisitions that reap the benefits of improved efficiency, reduced overall costs, and timeliness. This thesis

  14. Costs optimization in anaesthesia.

    Science.gov (United States)

    Martelli, Alessandra

    2015-04-27

    The aim of this study is to analyze the direct cost of different anaesthetic techniques used within the Author's hospital setting and compare with costs reported in the literature. Mean cost of drugs and devices used in our local Department of Anaesthesia was considered in the present study. All drugs were supplied by the in-house Pharmacy Service of Parma's General Hospital. All calculation have been made using an hypothetical ASA1 patient weighting 70 kg. The quality of consumption and cost of inhalation anaesthesia with sevoflurane or desflurane at different fresh gas flow were analyzed, and the cost of total venous anaesthesia (TIVA) using propofol and remifentanil with balanced anaesthesia were also analyzed. In addition, direct costs of general, spinal and sciatic-femoral nerve block anaesthesia used for common plastic surgery procedures were assessed. The results of our study show that the cost of inhalational anaesthesia decreases using fresh gas flow below 1L, and the use of desflurane is more expensive. In our Hospital, the cost of TIVA is more or less equivalent to the costs of balanced anaesthesia with sevoflurane in surgical procedure lasting more than five hours. The direct cost was lower for the spinal anaesthesia compared with general anaesthesia and sciatic- femoral nerve block for some surgical procedures. (www.actabiomedica.it).

  15. Implementation of NICE Clinical Guideline 95 for assessment of stable chest pain in a rapid access chest pain clinic reduces the mean number of investigations and cost per patient

    OpenAIRE

    2015-01-01

    Objective In 2010, the National Institute for Health and Care Excellence (NICE) in the UK published Clinical Guideline 95 (CG95) advocating risk stratification of patients using ?CADScore? to guide appropriate cardiac investigations for chest pain of recent onset. Implementation of the guideline in the University College London Hospitals NHS Foundation Trust was evaluated to see if it led to a reduction in the average cost of the diagnostic journey per patient and fewer investigations per pat...

  16. Rapid assessment methodology in NORM measurements from building materials of Uzbekistan.

    Science.gov (United States)

    Safarov, A A; Safarov, A N; Azimov, A N; Darby, I G

    2017-04-01

    Utilizing low cost NaI(Tl) scintillation detector systems we present methodology for the rapid screening of building material samples and the determination of their Radium Equivalent Activity (Raeq). Materials from Uzbekistan as a representative developing country have been measured and a correction coefficient for Radium activity is deduced. The use of the correction coefficient offers the possibility to decrease analysis times thus enabling the express measurement of a large quantity of samples. The reduction in time, cost and the use of inexpensive equipment can democratize the practice of screening NORM in building materials in the international community. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Ecological connectivity networks in rapidly expanding cities.

    Science.gov (United States)

    Nor, Amal Najihah M; Corstanje, Ron; Harris, Jim A; Grafius, Darren R; Siriwardena, Gavin M

    2017-06-01

    Urban expansion increases fragmentation of the landscape. In effect, fragmentation decreases connectivity, causes green space loss and impacts upon the ecology and function of green space. Restoration of the functionality of green space often requires restoring the ecological connectivity of this green space within the city matrix. However, identifying ecological corridors that integrate different structural and functional connectivity of green space remains vague. Assessing connectivity for developing an ecological network by using efficient models is essential to improve these networks under rapid urban expansion. This paper presents a novel methodological approach to assess and model connectivity for the Eurasian tree sparrow (Passer montanus) and Yellow-vented bulbul (Pycnonotus goiavier) in three cities (Kuala Lumpur, Malaysia; Jakarta, Indonesia and Metro Manila, Philippines). The approach identifies potential priority corridors for ecological connectivity networks. The study combined circuit models, connectivity analysis and least-cost models to identify potential corridors by integrating structure and function of green space patches to provide reliable ecological connectivity network models in the cities. Relevant parameters such as landscape resistance and green space structure (vegetation density, patch size and patch distance) were derived from an expert and literature-based approach based on the preference of bird behaviour. The integrated models allowed the assessment of connectivity for both species using different measures of green space structure revealing the potential corridors and least-cost pathways for both bird species at the patch sites. The implementation of improvements to the identified corridors could increase the connectivity of green space. This study provides examples of how combining models can contribute to the improvement of ecological networks in rapidly expanding cities and demonstrates the usefulness of such models for

  18. Tracking Costs

    Science.gov (United States)

    Erickson, Paul W.

    2010-01-01

    Even though there's been a slight reprieve in energy costs, the reality is that the cost of non-renewable energy is increasing, and state education budgets are shrinking. One way to keep energy and operations costs from overshadowing education budgets is to develop a 10-year energy audit plan to eliminate waste. First, facility managers should…

  19. Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study.

    Science.gov (United States)

    Van Minh, Hoang; My, Nguyen Thi Tuyet; Jit, Mark

    2017-05-15

    Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccine introduction. A costing study based on expert panel discussions, interviews and hospital case note reviews was conducted to explore the cost of cervical cancer care. The cost of cervical cancer treatment ranged from US$368 - 11400 depending on the type of hospital and treatment involved. Under Gavi-negotiated prices of US$4.55, HPV vaccination is likely to be very cost-effective with an incremental cost per disability-adjusted life year (DALY) averted in the range US$780 - 1120. However, under list prices for Cervarix and Gardasil in Vietnam, the incremental cost per DALY averted for HPV vaccination can exceed US$8000. HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.

  20. Drug costs developments after patent expiry of enalapril, fluoxetine and ranitidine: a study conducted for the Netherlands.

    Science.gov (United States)

    Boersma, Cornelis; Klok, Rogier M; Bos, Jasper M; Naunton, Mark; van den Berg, Paul B; de Jong-van den Berg, Lolkje T W; Postma, Maarten J

    2005-01-01

    In order to increase price competition, government regulations focus on controlling drug costs. Drug costs after patent expiry are an area of particular interest because the substitution of branded medication with generics represents an opportunity for lowering drug costs. However, drug costs may not decrease after patent expiry, because of a lack of price competition and different national pricing systems. The aim of this study was to investigate the trends in the use of generics after patent expiry for enalapril, fluoxetine and ranitidine and the subsequent changes, if any, in the costs of these medications. A drug-utilisation study was performed using data from a large sample of Dutch pharmacies. Both volumes (measured as defined daily doses [DDD] per 1000 population) as well as drug costs (calculated per DDD) prior to and after patent expiry were calculated. Costs per DDD were compared using trend-line analysis. In addition, the relative market shares of the different trade channels (branded, parallel imported and generic) were compared before and after patent expiry. The costs per DDD decreased for all three drugs and, as expected, these costs decrease more rapidly after patent expiry. Significant differences in the trend lines were found for enalapril and fluoxetine. Despite relatively high reimbursement prices for generics in the Netherlands, this example from the Dutch pharmaceutical market demonstrates the benefit of generic substitution for containing pharmaceutical costs, which contrasts with concerns raised by the Dutch government.

  1. Fuzzy approach to business improvement of holding equipment in the conditions of decreased production range

    Directory of Open Access Journals (Sweden)

    Tadić Branko

    2007-01-01

    Full Text Available In recent years, manufacturing industry has been characterized by a decreased production range and a demand for a rapid change of production programs. In such conditions holding equipment costs are considerably larger. In this paper, we review and analyze possible ways of business improvement concerning holding equipment in specific production conditions characterized by the decreased production range and lack of financial sources for applying systems of assembled and disassembled equipment. Classification of elements and group of elements of those systems is performed by applying a new fuzzy ABC method presented in this paper. Selected optimization criteria describe the performance measures of elements and group of elements of assembled and disassembled equipment whereas their relative weights are not the same. It is assumed that the values of imprecise optimization criteria and their relative weights are described by discrete fuzzy numbers. The developed procedure is illustrated by an example with real input data.

  2. Patient specific ankle-foot orthoses using rapid prototyping

    Directory of Open Access Journals (Sweden)

    Sivak Seth

    2011-01-01

    Full Text Available Abstract Background Prefabricated orthotic devices are currently designed to fit a range of patients and therefore they do not provide individualized comfort and function. Custom-fit orthoses are superior to prefabricated orthotic devices from both of the above-mentioned standpoints. However, creating a custom-fit orthosis is a laborious and time-intensive manual process performed by skilled orthotists. Besides, adjustments made to both prefabricated and custom-fit orthoses are carried out in a qualitative manner. So both comfort and function can potentially suffer considerably. A computerized technique for fabricating patient-specific orthotic devices has the potential to provide excellent comfort and allow for changes in the standard design to meet the specific needs of each patient. Methods In this paper, 3D laser scanning is combined with rapid prototyping to create patient-specific orthoses. A novel process was engineered to utilize patient-specific surface data of the patient anatomy as a digital input, manipulate the surface data to an optimal form using Computer Aided Design (CAD software, and then download the digital output from the CAD software to a rapid prototyping machine for fabrication. Results Two AFOs were rapidly prototyped to demonstrate the proposed process. Gait analysis data of a subject wearing the AFOs indicated that the rapid prototyped AFOs performed comparably to the prefabricated polypropylene design. Conclusions The rapidly prototyped orthoses fabricated in this study provided good fit of the subject's anatomy compared to a prefabricated AFO while delivering comparable function (i.e. mechanical effect on the biomechanics of gait. The rapid fabrication capability is of interest because it has potential for decreasing fabrication time and cost especially when a replacement of the orthosis is required.

  3. Cost considerations

    NARCIS (Netherlands)

    Michiel Ras; Debbie Verbeek-Oudijk; Evelien Eggink

    2013-01-01

    Original title: Lasten onder de loep The Dutch government spends almost 7 billion euros  each year on care for people with intellectual disabilities, and these costs are rising steadily. This report analyses what underlies the increase in costs that occurred between 2007 and 2011. Was

  4. 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/...

  5. Troubleshooting Costs

    Science.gov (United States)

    Kornacki, Jeffrey L.

    Seventy-six million cases of foodborne disease occur each year in the United States alone. Medical and lost productivity costs of the most common pathogens are estimated to be 5.6-9.4 billion. Product recalls, whether from foodborne illness or spoilage, result in added costs to manufacturers in a variety of ways. These may include expenses associated with lawsuits from real or allegedly stricken individuals and lawsuits from shorted customers. Other costs include those associated with efforts involved in finding the source of the contamination and eliminating it and include time when lines are shut down and therefore non-productive, additional non-routine testing, consultant fees, time and personnel required to overhaul the entire food safety system, lost market share to competitors, and the cost associated with redesign of the factory and redesign or acquisition of more hygienic equipment. The cost associated with an effective quality assurance plan is well worth the effort to prevent the situations described.

  6. Development of a cost-efficient novel method for rapid, concurrent genotyping of five common single nucleotide polymorphisms of the brain derived neurotrophic factor (BDNF) gene by tetra-primer amplification refractory mutation system.

    Science.gov (United States)

    Wang, Cathy K; Xu, Michael S; Ross, Colin J; Lo, Ryan; Procyshyn, Ric M; Vila-Rodriguez, Fidel; White, Randall F; Honer, William G; Barr, Alasdair M

    2015-09-01

    Brain derived neurotrophic factor (BDNF) is a molecular trophic factor that plays a key role in neuronal survival and plasticity. Single nucleotide polymorphisms (SNPs) of the BDNF gene have been associated with specific phenotypic traits in a large number of neuropsychiatric disorders and the response to psychotherapeutic medications in patient populations. Nevertheless, due to study differences and occasionally contrasting findings, substantial further research is required to understand in better detail the association between specific BDNF SNPs and these psychiatric disorders. While considerable progress has been made recently in developing advanced genotyping platforms of SNPs, many high-throughput probe- or array-based detection methods currently available are limited by high costs, slow processing times or access to advanced instrumentation. The polymerase chain reaction (PCR)-based, tetra-primer amplification refractory mutation system (T-ARMS) method is a potential alternative technique for detecting SNP genotypes efficiently, quickly, easily, and cheaply. As a tool in psychopathology research, T-ARMS was shown to be capable of detecting five common SNPs in the BDNF gene (rs6265, rs988748, rs11030104, 11757G/C and rs7103411), which are all SNPs with previously demonstrated clinical relevance to schizophrenia and depression. The present technique therefore represents a suitable protocol for many research laboratories to study the genetic correlates of BDNF in psychiatric disorders. Copyright Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  7. The Costs of Participating in a Diabetes Quality Improvement Collaborative: Variation Among Five Clinics.

    Science.gov (United States)

    Sathe, Neha A; Nocon, Robert S; Hughes, Brenna; Peek, Monica E; Chin, Marshall H; Huang, Elbert S

    2016-01-01

    Quality improvement collaboratives (QICs) support rapid testing and implementation of interventions through the collective experience of participating organizations to improve care quality and reduce costs. Although QICs have been societally cost-effective in improving the care of chronic diseases, they may not be adopted by outpatient clinics if their costs are high. Diabetes QICs warrant reexamination as secular trends in the quality of diabetes care, new care guidelines for diabetes, and evolving strategies for quality improvement may have altered implementation costs. The costs over the first four years-from June 2009 through May 2013-of an ongoing diabetes QIC were characterized by activities and over time. The QIC, linking six clinics on Chicago's South Side, tailored interventions to minority populations and built community partnerships. Costs were calculated from clinic surveys regarding activities, labor, and purchases. Data were obtained from five of the six participating clinics. Cost/diabetic patient/year ranged across clinic sites from $6 (largest clinic) to $68 (smallest clinic). Clinics spent 62%-88% of their total QIC costs on labor. The cost/diabetic patient/year changed over time from Year 1 (range across clinics, $5-$51), Year 2 ($11-$84), Year 3 ($4-$57), to Year 4 ($4-$80), with costs peaking at Year 2 for all clinics except Clinic 4, where costs peaked at Year 4. Cost experiences of QICs in clinics were di- verse over time and setting. High per-patient costs may stem from small clinic size, a sicker patient population, and variation in personnel type used. Cost decreases over time may represent increasing organizational learning and efficiency. Sharing resources may have achieved additional cost savings. This practical information can help administrators and policy makers predict, manage, and support costs of QICs as payers increasingly seek high-value health care.

  8. Fitness cost

    DEFF Research Database (Denmark)

    Nielsen, Karen L.; Pedersen, Thomas M.; Udekwu, Klas I.

    2012-01-01

    found significantly independent negative correlations between fitness and the presence of mecA or streptomycin resistance. Mathematical modelling confirmed that fitness costs of the magnitude carried by these isolates could result in the disappearance of MRSA prevalence during a time span similar...... phage types, predominantly only penicillin resistant. We investigated whether isolates of this epidemic were associated with a fitness cost, and we employed a mathematical model to ask whether these fitness costs could have led to the observed reduction in frequency. Bacteraemia isolates of S. aureus...... of each isolate was determined in a growth competition assay with a reference isolate. Significant fitness costs of 215 were determined for the MRSA isolates studied. There was a significant negative correlation between number of antibiotic resistances and relative fitness. Multiple regression analysis...

  9. Phlebotomy for rapid weaning and extubation in COPD patient with secondary polycythemia and respiratory failure

    Directory of Open Access Journals (Sweden)

    Tripathy Swagata

    2010-01-01

    Full Text Available The increased incidence of ventilator-associated complications in patients with chronic obstructive pulmonary disease (COPD necessitates rapid weaning and extubation. The presence of secondary polycythemia in this subgroup increases the incidence of stroke and myocardial infarction due to hyperviscosity and tissue hypoxia. We present a 58-year-old male patient of COPD with secondary polycythemia (hematocrit 64% who had possible hyperviscosity-related complications leading to cardiac arrest after a minor surgical procedure. The patient developed ventilator dependence after recovery. Phlebotomy was done to remove 10% of total blood volume. Symptomatic improvement was dramatic. Improvement in weaning indices like rapid shallow breathing index and PaO 2 /PAO 2 was observed facilitating rapid weaning and early extubation. Monitored, acute phlebotomy is safe and cost-effective. It decreases blood volume and viscosity, increases cardiac output and improves exercise tolerance in patients.

  10. Opportunity cost.

    Science.gov (United States)

    O'Shea, Carolyn

    2011-05-01

    Opportunity cost and trade-off - similar concepts with slightly different meanings and definitions in different fields - are concepts that we were all probably first exposed to as a toddler. For most women however, opportunity cost and trade-off is a part of their daily lives as they try to balance their needs, including their health needs, with the demands of their families, careers and never-ending 'to do' lists.

  11. Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis.

    Science.gov (United States)

    Pfaller, Michael A; Castanheira, Mariana

    2016-01-01

    Candidemia and other forms of candidiasis are associated with considerable excess mortality and costs. Despite the addition of several new antifungal agents with improved spectrum and potency, the frequency of Candida infection and associated mortality have not decreased in the past two decades. The lack of rapid and sensitive diagnostic tests has led to considerable overuse of antifungal agents resulting in increased costs, selection pressure for resistance, unnecessary drug toxicity, and adverse drug interactions. Both the lack of timely diagnostic tests and emergence of antifungal resistance pose considerable problems for antifungal stewardship. Whereas antifungal stewardship with a focus on nosocomial candidiasis should be able to improve the administration of antifungal therapy in terms of drug selection, proper dose and duration, source control and de-escalation therapy, an important parameter, timeliness of antifungal therapy, remains a victim of slow and insensitive diagnostic tests. Fortunately, new proteomic and molecular diagnostic tools are improving the time to species identification and detection. In this review we will describe the potential impact that rapid diagnostic testing and antifungal stewardship can have on the management of nosocomial candidiasis. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Minimizing Costs Can Be Costly

    Directory of Open Access Journals (Sweden)

    Rasmus Rasmussen

    2010-01-01

    Full Text Available A quite common practice, even in academic literature, is to simplify a decision problem and model it as a cost-minimizing problem. In fact, some type of models has been standardized to minimization problems, like Quadratic Assignment Problems (QAPs, where a maximization formulation would be treated as a “generalized” QAP and not solvable by many of the specially designed softwares for QAP. Ignoring revenues when modeling a decision problem works only if costs can be separated from the decisions influencing revenues. More often than we think this is not the case, and minimizing costs will not lead to maximized profit. This will be demonstrated using spreadsheets to solve a small example. The example is also used to demonstrate other pitfalls in network models: the inability to generally balance the problem or allocate costs in advance, and the tendency to anticipate a specific type of solution and thereby make constraints too limiting when formulating the problem.

  13. Determination of the exposition rapidity in the level 49.90 of the reactor building for the decrease in the water level of the spent fuel pool; Determinacion de la rapidez de exposion en el nivel 49.90 del edificio del reactor por la disminucion en el nivel de agua de la alberca de combustible gastado

    Energy Technology Data Exchange (ETDEWEB)

    Mijangos D, Z. E.; Herrera H, S. F.; Cruz G, M. A.; Amador C, C., E-mail: zoedelfin@gmail.com [Comision Federal de Electricidad, Central Nucleoelectrica Laguna Verde, Subgerencia de Ingenieria, Km 44.5 Carretera Cardel-Nautla, 91476 Laguna Verde, Alto Lucero, Veracruz (Mexico)

    2014-10-15

    The fuel assemblies storage in the nuclear power plant of Laguna Verde (NPP-L V) represents a crucial aspect, due to the generated dose by the decay heat of the present radio-nuclides in the assemblies retired of the reactor core, after their useful life. These spent assemblies are located inside the spent fuel pool (SFP), in the level 49.90 m in the Reload Floor of the Reactor building of NPP-L V. This leads to the protection at personnel applying the ALARA (As Low As Reasonably Achievable) criteria, fulfilling the established dose criteria by the Regulator Body the Comision Nacional de Seguridad Nuclear y Salvaguardias (CNSNS). Considering the loss scenario of the cooling system of the SFP, in which the SFP water vaporizes, is important to know the water level in which the limit of effective dose equivalent is fulfilled for the personnel. Also, is important for the instrumentation of the SFP, for the useful life of the same instruments. In this work is obtained the exposition rapidity corresponding to different water levels of SFP in the Reload Floor of NPP-L V, to identify the minimum level of water where the limit of effective dose equivalent is fulfilled of 25 rem s to the personnel, established in the Article 48 of the General Regulation of Radiological Safety of CNSNS and the Chapter 50 Section 67 of the 10-Cfr of Nuclear Regulatory Commission in USA. The water level is also identified where the exposition rapidity is of 15 m R/hr, being the value of the set point of the area radiation monitor D21-Re-N003-1, located to 125 cm over the level 49.90 meters of the Reload Floor of NPP-L V. (Author)

  14. An analysis of rising health care costs.

    Science.gov (United States)

    Thorne, L M

    1992-02-01

    Why are medical costs rising so rapidly? What are the factors involved that influence those costs? Does inflation affect health care costs? Can anything be done? The solutions to these complex issues are not clearly understood. It is clear, however, that the resolutions to these questions must be found quickly. If the causes of rising medical care costs are not promptly diagnosed and treated, we may find our economic health to be in critical condition. This paper attempts to better understand the reasons for increasing health care costs. The role that inflation plays relative to health care costs is investigated.

  15. Prostate treatments, 1MRT o RapidArc; Tratamiento de prostata, IMART o RapidArc?

    Energy Technology Data Exchange (ETDEWEB)

    Castro novais, J.; Ruiz Maqueda, S.; Pardo Perez, E.; Molina Lopez, M. Y.; Cerro Penalver, E.

    2015-07-01

    Techniques that modulate the dose (as IMRT or RapidArcTM) improve dose homogeneity within the target volume decreasing the dose in healthy organs. The aim of this work is to study the dosimetric differences in prostate radiotherapy treatments with IMRT and RapidArcTM. The results of the 109 patients studied show that plans to RapidArcTM have better coverage, compliance and dose gradient outside the target volume. (Author)

  16. Cost Analysis of Implementing Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry Plus Real-Time Antimicrobial Stewardship Intervention for Bloodstream Infections.

    Science.gov (United States)

    Patel, Twisha S; Kaakeh, Rola; Nagel, Jerod L; Newton, Duane W; Stevenson, James G

    2017-01-01

    Studies evaluating rapid diagnostic testing plus stewardship intervention have consistently demonstrated improved clinical outcomes for patients with bloodstream infections. However, the cost of implementing new rapid diagnostic testing can be significant, and such testing usually does not generate additional revenue. There are minimal data evaluating the impact of adding matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for rapid organism identification and dedicating pharmacy stewardship personnel time on the total hospital costs. A cost analysis was performed utilizing patient data generated from the hospital cost accounting system and included additional costs of MALDI-TOF equipment, supplies and personnel, and dedicated pharmacist time for blood culture review and of making interventions to antimicrobial therapy. The cost analysis was performed from a hospital perspective for 3-month blocks before and after implementation of MALDI-TOF plus stewardship intervention. A total of 480 patients with bloodstream infections were included in the analysis: 247 in the preintervention group and 233 in the intervention group. Thirty-day mortality was significantly improved in the intervention group (12% versus 21%, P cost per bloodstream infection was lower in the intervention group ($42,580 versus $45,019). Intensive care unit cost per bloodstream infection accounted for the largest share of the total costs in each group and was also lower in the intervention group ($10,833 versus $13,727). Implementing MALDI-TOF plus stewardship review and intervention decreased mortality for patients with bloodstream infections. Despite the additional costs of implementing MALDI-TOF and of dedicating pharmacy stewardship personnel time to interventions, the total hospital costs decreased by $2,439 per bloodstream infection, for an approximate annual cost savings of $2.34 million. Copyright © 2016 American Society for Microbiology.

  17. Relación costo-efectividad del uso de pruebas rápidas para el diagnóstico de la malaria en la Amazonia peruana Cost-effectiveness ratio of using rapid tests for malaria diagnosis in the Peruvian Amazon

    Directory of Open Access Journals (Sweden)

    Ángel Martín Rosas Aguirre

    2009-05-01

    promotores de salud a otras comunidades con condiciones similares a las estudiadas.OBJECTIVE: To determine the cost-effectiveness ratios of three options for diagnosing malaria at the local health provider in 50 communities near the Peruvian Amazon. METHODS: Calculation of the incremental cost-effectiveness ratios of three options for diagnosing malaria-not using rapid tests, using rapid tests, and accessing microscopy-in patients presenting with fever in 50 communities near Iquitos in the Peruvian Amazon, communities with limited access to microscopy that depend on a network of local health providers. The incremental costs and effects of the two latter options were calculated and compared with the first option (currently in use. By dividing the incremental costs among the incremental effects, the incremental costeffectiveness ratio was calculated. RESULTS: Using rapid tests would save the Ministry of Health of Peru: US$ 191 for each new case of Plasmodium falciparum malaria treated promptly and appropriately; US$ 31 per new case of P. vivax malaria treated promptly and appropriately;US$ 1 051 per case of acute malaria averted; and US$ 17 655 for each death avoided. Access to microscopy by all the communities would generate an additional cost of: US$ 198 per new case of P. falciparum malaria treated promptly and appropriately; US$ 31 per new case of P. vivax malaria treated promptly and appropriately; US$ 1 086 per case of acute malaria averted; and US$ 18 255 for each death avoided. CONCLUSIONS: The use of rapid tests by local health providers can improve the effectiveness of malaria diagnosis in patients with fever in the 50 communities studied, at a cost lower than the current method. The recommendation is to expand the use of rapid tests among the health providers in communities similar to those studied.

  18. Rapid Energy Modeling Workflow Demonstration Project

    Science.gov (United States)

    2014-01-01

    BIM Building Information Model BLCC building life cycle costs BPA Building Performance Analysis CAD computer assisted...utilizes information on operations, geometry, orientation, weather, and materials, generating Three-Dimensional (3D) Building Information Models ( BIM ...executed a demonstration of Rapid Energy Modeling (REM) workflows that employed building information modeling ( BIM ) approaches and

  19. Costly tolerance

    African Journals Online (AJOL)

    2016-07-08

    Jul 8, 2016 ... It shows how this decision is related to the broader context of early twentieth century political life in the Netherlands. (the 'Pacification of 1917'), and it concludes with some thoughts on the costliness of true tolerance. Costly tolerance. Read online: Scan this QR code with your smart phone or mobile device.

  20. Metabolic cost of lateral stabilization during walking in people with incomplete spinal cord injury.

    Science.gov (United States)

    Matsubara, J H; Wu, M; Gordon, K E

    2015-02-01

    People with incomplete spinal cord injury (iSCI) expend considerable energy to walk, which can lead to rapid fatigue and limit community ambulation. Selecting locomotor patterns that enhance lateral stability may contribute to this population's elevated cost of transport. The goal of the current study was to quantify the metabolic energy demands of maintaining lateral stability during gait in people with iSCI. To quantify this metabolic cost, we observed ten individuals with iSCI walking with and without external lateral stabilization. We hypothesized that with external lateral stabilization, people with iSCI would adapt their gait by decreasing step width, which would correspond with a substantial decrease in cost of transport. Our findings support this hypothesis. Subjects significantly (pexternal lateral stabilization compared to unassisted walking. Metabolic cost of transport also decreased significantly (pexternal lateral stabilization. These findings suggest that this population is capable of adapting their gait to meet changing demands placed on balance. The percent reduction in cost of transport when walking with external lateral stabilization was strongly correlated with functional impairment level as assessed by subjects' scores on the Berg Balance Scale (r=0.778) and lower extremity motor score (r=0.728). These relationships suggest that as functional balance and strength decrease, the amount of metabolic energy used to maintain lateral stability during gait will increase. Published by Elsevier B.V.

  1. A life cycle cost economics model for projects with uniformly varying operating costs. [management planning

    Science.gov (United States)

    Remer, D. S.

    1977-01-01

    A mathematical model is developed for calculating the life cycle costs for a project where the operating costs increase or decrease in a linear manner with time. The life cycle cost is shown to be a function of the investment costs, initial operating costs, operating cost gradient, project life time, interest rate for capital and salvage value. The results show that the life cycle cost for a project can be grossly underestimated (or overestimated) if the operating costs increase (or decrease) uniformly over time rather than being constant as is often assumed in project economic evaluations. The following range of variables is examined: (1) project life from 2 to 30 years; (2) interest rate from 0 to 15 percent per year; and (3) operating cost gradient from 5 to 90 percent of the initial operating costs. A numerical example plus tables and graphs is given to help calculate project life cycle costs over a wide range of variables.

  2. Cost-effective and rapid concrete repair techniques.

    Science.gov (United States)

    2016-02-08

    Concrete is a principal component of many transportation structures. While highly durable, a : variety of processes degrade and damage concrete. Replacement is expensive. Many cases : warrant repair instead of replacement. Since many damage processes...

  3. Rapid, cost-effective liquid chromatograghic method for the ...

    African Journals Online (AJOL)

    The method is highly sensitive, with limit of detection of 1 ng/ml. The coefficient of variation for within-day run was less than 4% while that of day-to-day run was less than 6%. There were no interfering peaks from endogenous materials in the serum. The method was validated and used for pharmacokinetic studies ...

  4. Rapid, cost-effective liquid chromatograghic method for the ...

    African Journals Online (AJOL)

    GRACE

    2006-07-03

    Jul 3, 2006 ... Akay C, Ozkan SA, Senturk Z, Cevheroglu S (2002). Simultaneous determination of metronidazole and miconazole in pharmaceutical dosage form by HPLC. Farmaco. Nov.57(11): 953-7. Galmier MJ, Frasey AM, Bastide M, Beyssac E, Petit J, Aiache JM,. Lartigue-Mattei (1998). Simple and sensitive method ...

  5. Decreasing incidence rates of bacteremia

    DEFF Research Database (Denmark)

    Nielsen, Stig Lønberg; Pedersen, C; Jensen, T G

    2014-01-01

    ) and the incidence rate of nosocomial bacteremia decreased by 28.9% from 82.2 to 56.0 (4.2% annually, p Staphylococcus aureus (12.3%), coagulase-negative staphylococci (10.......0%) and Streptococcus pneumoniae (9.1%). Regardless of place of acquisition, the proportion of bacteremias caused by enterococci increased (p

  6. 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......, 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...... conversion factors available from the Stepwise2006 method. Overall, the environmental costs of producing conventional pig meat are estimated to be 1.9 EUR per kg, which are of even larger size than the private costs of 1.4 EUR. In decreasing order of importance, nature occupation has been found...

  7. Calbindins decreased after space flight

    Science.gov (United States)

    Sergeev, I. N.; Rhoten, W. B.; Carney, M. D.

    1996-01-01

    Exposure of the body to microgravity during space flight causes a series of well-documented changes in Ca2+ metabolism, yet the cellular and molecular mechanisms leading to these changes are poorly understood. Calbindins, vitamin D-dependent Ca2+ binding proteins, are believed to have a significant role in maintaining cellular Ca2+ homeostasis. In this study, we used biochemical and immunocytochemical approaches to analyze the expression of calbindin-D28k and calbindin-D9k in kidneys, small intestine, and pancreas of rats flown for 9 d aboard the space shuttle. The effects of microgravity on calbindins in rats from space were compared with synchronous Animal Enclosure Module controls, modeled weightlessness animals (tail suspension), and their controls. Exposure to microgravity resulted in a significant and sustained decrease in calbindin-D28k content in the kidney and calbindin-D9k in the small intestine of flight animals, as measured by enzyme-linked immunosorbent assay (ELISA). Modeled weightlessness animals exhibited a similar decrease in calbindins by ELISA. Immunocytochemistry (ICC) in combination with quantitative computer image analysis was used to measure in situ the expression of calbindins in the kidney and the small intestine, and the expression of insulin in pancreas. There was a large decrease of immunoreactivity in renal distal tubular cell-associated calbindin-D28k and in intestinal absorptive cell-associated calbindin-D9k of space flight and modeled weightlessness animals compared with matched controls. No consistent difference in pancreatic insulin immunoreactivity between space flight, modeled weightlessness, and controls was observed. Regression analysis of results obtained by quantitative ICC and ELISA for space flight, modeled weightlessness animals, and their controls demonstrated a significant correlation. These findings after a short-term exposure to microgravity or modeled weightlessness suggest that a decreased expression of calbindins

  8. Rapid Airplane Parametric Input Design (RAPID)

    Science.gov (United States)

    Smith, Robert E.

    1995-01-01

    RAPID is a methodology and software system to define a class of airplane configurations and directly evaluate surface grids, volume grids, and grid sensitivity on and about the configurations. A distinguishing characteristic which separates RAPID from other airplane surface modellers is that the output grids and grid sensitivity are directly applicable in CFD analysis. A small set of design parameters and grid control parameters govern the process which is incorporated into interactive software for 'real time' visual analysis and into batch software for the application of optimization technology. The computed surface grids and volume grids are suitable for a wide range of Computational Fluid Dynamics (CFD) simulation. The general airplane configuration has wing, fuselage, horizontal tail, and vertical tail components. The double-delta wing and tail components are manifested by solving a fourth order partial differential equation (PDE) subject to Dirichlet and Neumann boundary conditions. The design parameters are incorporated into the boundary conditions and therefore govern the shapes of the surfaces. The PDE solution yields a smooth transition between boundaries. Surface grids suitable for CFD calculation are created by establishing an H-type topology about the configuration and incorporating grid spacing functions in the PDE equation for the lifting components and the fuselage definition equations. User specified grid parameters govern the location and degree of grid concentration. A two-block volume grid about a configuration is calculated using the Control Point Form (CPF) technique. The interactive software, which runs on Silicon Graphics IRIS workstations, allows design parameters to be continuously varied and the resulting surface grid to be observed in real time. The batch software computes both the surface and volume grids and also computes the sensitivity of the output grid with respect to the input design parameters by applying the precompiler tool

  9. Implementation of Additive Rapid Prototyping on Retrofit CNC Mill

    Science.gov (United States)

    Freeform fabrication techniques are gaining popularity as a means of making parts. Layered additive methods are associated with rapid prototyping. Many rapid prototyping methods are commercially proprietary and may cost thousands of dollars. Using a retrofit CNC mill for layered fabrication and C...

  10. Rapid shallow breathing

    Science.gov (United States)

    ... the smallest air passages of the lungs in children ( bronchiolitis ) Pneumonia or other lung infection Transient tachypnea of the newborn Anxiety and panic Other serious lung disease Home Care Rapid, shallow breathing should not be treated at home. It is ...

  11. Rapid Strep Test

    Science.gov (United States)

    ... worse than normal. Your first thoughts turn to strep throat. A rapid strep test in your doctor’s office ... your suspicions.Viruses cause most sore throats. However, strep throat is an infection caused by the Group A ...

  12. Rapid Prototyping and the Human Factors Engineering Process

    Science.gov (United States)

    2016-08-29

    Rapid prototyping and the human factors • • engineering process David Beevis* and Gaetan St Denist *Senior Human Factors Engineer, Defence and...qr-..2. 9 Rapid prototyping or ’virtual prototyping ’ of human-machine interfaces offers the possibility of putting the human operator ’in the loop...8217 without the effort and cost associated with conventional man-in-the-loop simulation. Advocates suggest that rapid prototyping is compatible with

  13. RAPID3? Aptly named!

    Science.gov (United States)

    Berthelot, J-M

    2014-01-01

    The RAPID3 score is the sum of three 0-10 patient self-report scores: pain, functional impairment on MDHAQ, and patient global estimate. It requires 5 seconds for scoring and can be used in all rheumatologic conditions, although it has mostly been used in rheumatoid arthritis where cutoffs for low disease activity (12/30) have been set. A RAPID3 score of ≤ 3/30 with 1 or 0 swollen joints (RAPID3 ≤ 3 + ≤ SJ1) provides remission criteria comparable to Boolean, SDAI, CDAI, and DAS28 remission criteria, in far less time than a formal joint count. RAPID3 performs as well as the DAS28 in separating active drugs from placebos in clinical trials. RAPID3 also predicts subsequent structural disease progression. RAPID3 can be determined at short intervals at home, allowing the determination of the area under the curve of disease activity between two visits and flare detection. However, RAPID3 should not be seen as a substitute for DAS28 and face to face visits in routine care. Monitoring patient status with only self-report information without a rheumatologist's advice (including joints and physical examination, and consideration of imaging and laboratory tests) may indeed be as undesirable for most patients than joint examination without a patient questionnaire. Conversely, combining the RAPID3 and the DAS28 may consist in faster or more sensitive confirmation that a medication is effective. Similarly, better enquiring of most important concerns of patients (pain, functional status and overall opinion on their disorder) should reinforces patients' confidence in their rheumatologist and treatments.

  14. Decreasing Fires in Mediterranean Europe.

    Directory of Open Access Journals (Sweden)

    Marco Turco

    Full Text Available Forest fires are a serious environmental hazard in southern Europe. Quantitative assessment of recent trends in fire statistics is important for assessing the possible shifts induced by climate and other environmental/socioeconomic changes in this area. Here we analyse recent fire trends in Portugal, Spain, southern France, Italy and Greece, building on a homogenized fire database integrating official fire statistics provided by several national/EU agencies. During the period 1985-2011, the total annual burned area (BA displayed a general decreasing trend, with the exception of Portugal, where a heterogeneous signal was found. Considering all countries globally, we found that BA decreased by about 3020 km2 over the 27-year-long study period (i.e. about -66% of the mean historical value. These results are consistent with those obtained on longer time scales when data were available, also yielding predominantly negative trends in Spain and France (1974-2011 and a mixed trend in Portugal (1980-2011. Similar overall results were found for the annual number of fires (NF, which globally decreased by about 12600 in the study period (about -59%, except for Spain where, excluding the provinces along the Mediterranean coast, an upward trend was found for the longer period. We argue that the negative trends can be explained, at least in part, by an increased effort in fire management and prevention after the big fires of the 1980's, while positive trends may be related to recent socioeconomic transformations leading to more hazardous landscape configurations, as well as to the observed warming of recent decades. We stress the importance of fire data homogenization prior to analysis, in order to alleviate spurious effects associated with non-stationarities in the data due to temporal variations in fire detection efforts.

  15. [Socioeconomic Costs of Asthma in the European Union, United States and Canada: A Systematic Review].

    Science.gov (United States)

    Puig-Junoy, Jaume; Pascual-Argenté, Natàlia

    2017-03-09

    Asthma is responsible for a large number of doctor and emergency visits due to exacerbations and inadequate control of the disease, which give rise to very high associated economic costs. The social cost of asthma comprises both the healthcare and non-healthcare costs. The purpose of this study was to analyse up-to-date estimates of the social cost of asthma, with special reference to the influence of level of severity and degree of control. A systematic review of original cost-of-illness studies of asthma published in English or Spanish between January 2004 and December 2014 and indexed in PubMed, IBECS or IME was conducted. 29 cost-of-illness studies of asthma were identified, 21 of which used the societal perspective. Only 10 studies estimated the incremental cost of asthma with a control group, and none of them refers to EU countries. Of these 10, only 4 were regarded as high-quality evidence, insofar as they combined a matched control with regression models. The annual incremental cost of asthma in adults ranged from €416 to €5,317. The incremental healthcare cost of asthma increased with level of severity, from €964 for intermittent asthma to €11,703 for severe persistent asthma in adults. In adults, the incremental non-healthcare cost of asthma ranged from €136 to €3,461. Selected studies in this review show great heterogeneity due to different population characteristics, study designs and valuation methods, which limits their comparability. However, it can be concluded that incremental healthcare costs of asthma, compared to people without asthma, exceeds seven hundred Euros (valued in 2013) in most of the reviwed estimation for several countries. This figure is greater for studies from the United States. The incremental cost per patient increases very rapidly with level of severity and decreases with asthma patient control.

  16. Rapid biosynthesis of cadmium sulfide (CdS) nanoparticles using ...

    African Journals Online (AJOL)

    Cell-associated biosynthesis of cadmium sulfide (CdS) nanoparticles has been reported to be rather slow and costly. In this study, we report on a rapid and low cost biosynthesis of CdS using culture supernatants of Escherichia coli ATCC 8739, Bacillus subtilis ATCC 6633 and Lactobacillus acidophilus DSMZ 20079T.

  17. ABC model and the management of costs

    Directory of Open Access Journals (Sweden)

    Pravdić Predrag

    2016-01-01

    Full Text Available When a company has multiple objectives at the same time, they all must be considered and balanced when making any business decisions. Linking the markets, capital and resources so as to thus ensure the highest yield is, In fact, the search for competitive advantage as a basic condition for survival in a market economy. In highly detailed systems based on the management of costs or ABC (activity based costing systems, the cost of activities often result in erroneous evaluation of aggregate costs of the action. Improvements in information technology and monitoring decrease of technology costs enabled the ABC system to become a feasible system calculating costs in many organizations.

  18. Determination production costs using PBC method

    Directory of Open Access Journals (Sweden)

    Todić Vladimir V.

    2014-01-01

    Full Text Available Basic characteristics of modern markets make requirements in quality increasing, decreasing prices and shortening delivery of products. In the middle of this requirements are production costs for whose determination are developed many traditional and alternative methods including PBC method (Process Based Costing. This method enables precisely locating and calculating indirect production costs, and with determined direct costs enables determination of total production costs. This paper shows usage of PBC method for determination production costs for three forms of processing cutting tools.

  19. Choosing optimal rapid manufacturing process for thin-walled products using expert algorithm

    Directory of Open Access Journals (Sweden)

    Filip Gorski

    2010-10-01

    Full Text Available Choosing right Rapid Prototyping technology is not easy, especially for companies inexperienced with that group of manufacturing techniques. Paper summarizes research focused on creating an algorithm for expert system, helping to choose optimal process and determine its parameters for thin-walled products rapid manufacturing. Research was based upon trial manufacturing of different thin-walled items using various RP technologies. Products were categorized, each category was defined by a set of requirements. Basing on research outcome, main algorithm has been created. Next step was developing detailed algorithms for optimizing particular methods. Implementation of these algorithms brings huge benefit for recipients, including cost reduction, supply time decrease and improvements in information flow.

  20. Lean principles optimize on-time vascular surgery operating room starts and decrease resident work hours.

    Science.gov (United States)

    Warner, Courtney J; Walsh, Daniel B; Horvath, Alexander J; Walsh, Teri R; Herrick, Daniel P; Prentiss, Steven J; Powell, Richard J

    2013-11-01

    Lean process improvement techniques are used in industry to improve efficiency and quality while controlling costs. These techniques are less commonly applied in health care. This study assessed the effectiveness of Lean principles on first case on-time operating room starts and quantified effects on resident work hours. Standard process improvement techniques (DMAIC methodology: define, measure, analyze, improve, control) were used to identify causes of delayed vascular surgery first case starts. Value stream maps and process flow diagrams were created. Process data were analyzed with Pareto and control charts. High-yield changes were identified and simulated in computer and live settings prior to implementation. The primary outcome measure was the proportion of on-time first case starts; secondary outcomes included hospital costs, resident rounding time, and work hours. Data were compared with existing benchmarks. Prior to implementation, 39% of first cases started on time. Process mapping identified late resident arrival in preoperative holding as a cause of delayed first case starts. Resident rounding process inefficiencies were identified and changed through the use of checklists, standardization, and elimination of nonvalue-added activity. Following implementation of process improvements, first case on-time starts improved to 71% at 6 weeks (P = .002). Improvement was sustained with an 86% on-time rate at 1 year (P < .001). Resident rounding time was reduced by 33% (from 70 to 47 minutes). At 9 weeks following implementation, these changes generated an opportunity cost potential of $12,582. Use of Lean principles allowed rapid identification and implementation of perioperative process changes that improved efficiency and resulted in significant cost savings. This improvement was sustained at 1 year. Downstream effects included improved resident efficiency with decreased work hours. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All

  1. Decreasing the Functioning Consumptions of Plastics Injection Moulding Machines

    Science.gov (United States)

    Vasilache, V.; Vasilache, M.; Vasilache, A.

    2017-06-01

    A share of about 75% in the cost of a plastic moulded part is held by the energy consumption of the injection machine. It is the heating system of the plasticising unit which is responsible for the energophague character of the process. The transfer rate from the heating elements to the plasticising cylinder depends hardly on the geometry of the system. A new heating system is designed, replacing the classical systems which are applied on the exterior of the cylinder with an “engrooved system”. Proposed heating system leads to decreasing of energy consumption up to 30 % and maintenance costs up to 10 %. A supplementary possibility to decrease the maintenance costs is to modify the geometry of the injection torpedo. The proposed geometry eliminates the possibility of any breaking or gripping related to the injection torpedo.

  2. Hyperhomocysteinemia decreases bone blood flow

    Directory of Open Access Journals (Sweden)

    Neetu T

    2011-01-01

    Full Text Available Neetu Tyagi*, Thomas P Vacek*, John T Fleming, Jonathan C Vacek, Suresh C TyagiDepartment of Physiology and Biophysics, School of Medicine, University of Louisville, Louisville, KY, USA *These authors have equal authorshipAbstract: Elevated plasma levels of homocysteine (Hcy, known as hyperhomocysteinemia (HHcy, are associated with osteoporosis. A decrease in bone blood flow is a potential cause of compromised bone mechanical properties. Therefore, we hypothesized that HHcy decreases bone blood flow and biomechanical properties. To test this hypothesis, male Sprague–Dawley rats were treated with Hcy (0.67 g/L in drinking water for 8 weeks. Age-matched rats served as controls. At the end of the treatment period, the rats were anesthetized. Blood samples were collected from experimental or control rats. Biochemical turnover markers (body weight, Hcy, vitamin B12, and folate were measured. Systolic blood pressure was measured from the right carotid artery. Tibia blood flow was measured by laser Doppler flow probe. The results indicated that Hcy levels were significantly higher in the Hcy-treated group than in control rats, whereas vitamin B12 levels were lower in the Hcy-treated group compared with control rats. There was no significant difference in folate concentration and blood pressure in Hcy-treated versus control rats. The tibial blood flow index of the control group was significantly higher (0.78 ± 0.09 flow unit compared with the Hcy-treated group (0.51 ± 0.09. The tibial mass was 1.1 ± 0.1 g in the control group and 0.9 ± 0.1 in the Hcy-treated group. The tibia bone density was unchanged in Hcy-treated rats. These results suggest that Hcy causes a reduction in bone blood flow, which contributes to compromised bone biomechanical properties.Keywords: homocysteine, tibia, bone density

  3. High resolution modelling of the decreasing Arctic sea ice

    DEFF Research Database (Denmark)

    Madsen, K. S.; Rasmussen, T. A. S.; Blüthgen, Jonas

    2012-01-01

    , and secondly oceanic oil drift in ice affected conditions. Both investigations are made with the coupled ocean - sea ice model HYCOM-CICE at 10 km resolution, which is also used operationally at DMI and allows detailed studies of sea ice build-up, drift and melt. To investigate the sea ice decrease of the last......The Arctic sea ice cover has been rapidly decreasing and thinning over the last decade, with minimum ice extent in 2007 and almost as low extent in 2011. This study investigates two aspects of the decreasing ice cover; first the large scale thinning and changing dynamics of the polar sea ice...... decade, we have performed a reanalysis simulation of the years 1990-2011, forced with ERA Interim atmospheric data. Thus, the simulation includes both the period before the recent sea ice decrease and the full period of decrease up till today. We will present our model results of the thinning...

  4. Soft Costs Fact Sheet

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-05-01

    This fact sheet is an overview of the systems integration subprogram at the U.S. Department of Energy SunShot Initiative. Soft costs can vary significantly as a result of a fragmented energy marketplace. In the U.S., there are 18,000 jurisdictions and 3,000 utilities with different rules and regulations for how to go solar. The same solar equipment may vary widely in its final installation price due to process and market variations across jurisdictions, creating barriers to rapid industry growth. SunShot supports the development of innovative solutions that enable communities to build their local economies and establish clean energy initiatives that meet their needs, while at the same time creating sustainable solar market conditions.

  5. A New Rapid Simplified Model for Urban Rainstorm Inundation with Low Data Requirements

    Directory of Open Access Journals (Sweden)

    Ji Shen

    2016-11-01

    Full Text Available This paper proposes a new rapid simplified inundation model (NRSIM for flood inundation caused by rainstorms in an urban setting that can simulate the urban rainstorm inundation extent and depth in a data-scarce area. Drainage basins delineated from a floodplain map according to the distribution of the inundation sources serve as the calculation cells of NRSIM. To reduce data requirements and computational costs of the model, the internal topography of each calculation cell is simplified to a circular cone, and a mass conservation equation based on a volume spreading algorithm is established to simulate the interior water filling process. Moreover, an improved D8 algorithm is outlined for the simulation of water spilling between different cells. The performance of NRSIM is evaluated by comparing the simulated results with those from a traditional rapid flood spreading model (TRFSM for various resolutions of digital elevation model (DEM data. The results are as follows: (1 given high-resolution DEM data input, the TRFSM model has better performance in terms of precision than NRSIM; (2 the results from TRFSM are seriously affected by the decrease in DEM data resolution, whereas those from NRSIM are not; and (3 NRSIM always requires less computational time than TRFSM. Apparently, compared with the complex hydrodynamic or traditional rapid flood spreading model, NRSIM has much better applicability and cost-efficiency in real-time urban inundation forecasting for data-sparse areas.

  6. Rapid small lot manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Harrigan, R.W.

    1998-05-09

    The direct connection of information, captured in forms such as CAD databases, to the factory floor is enabling a revolution in manufacturing. Rapid response to very dynamic market conditions is becoming the norm rather than the exception. In order to provide economical rapid fabrication of small numbers of variable products, one must design with manufacturing constraints in mind. In addition, flexible manufacturing systems must be programmed automatically to reduce the time for product change over in the factory and eliminate human errors. Sensor based machine control is needed to adapt idealized, model based machine programs to uncontrolled variables such as the condition of raw materials and fabrication tolerances.

  7. Polyjet technology applications for rapid tooling

    Directory of Open Access Journals (Sweden)

    Udroiu Razvan

    2017-01-01

    Full Text Available Polymer Jetting (PolyJet has proved to be one of the most accurate additive manufacturing technologies, in order to manufacture rapid tools. Rapid Tooling (RT is different from conventional tooling as follow: manufacturing time is shorter, the cost is much less, but the tool life is shorter and tolerances are wider. The purpose of this paper is to make a comparative study between the soft tools (silicon moulds and hard tools (acrylic thermoplastic moulds based on the Polymer Jetting technology. Thus, two types of moulds have been made in order to manufacture a test part. Reaction injection moulding (RIM and casting techniques were used to fill these moulds with resins that simulate the plastic injection materials. Rapid tooling applications, such as indirect tooling and direct tooling, based on PolyJet technology were experimentally investigated.

  8. Transthoracic impedance does not decrease with rapidly repeated countershocks in a swine cardiac arrest model.

    Science.gov (United States)

    Niemann, James T; Garner, Daniel; Lewis, Roger J

    2003-01-01

    Successful defibrillation is dependent upon the delivery of adequate electrical current to the myocardium. One of the major determinant of current flow is transthoracic impedance. Prior work has suggested that impedance falls with repeated shocks during sinus rhythm. The purpose of this study was to evaluate changes in transthoracic impedance with repeated defibrillation shocks in an animal model of cardiac arrest due to ventricular fibrillation (VF). VF was electrically induced in anesthetized swine. After 5 min of untreated VF, monophasic or biphasic waveform defibrillation was attempted using a standard sequence of 'stacked shocks' (200, 300, then 360 J, if necessary) administered via adhesive electrodes. If one of the first three shocks failed to convert VF, conventional CPR was initiated and defibrillation (360 J) attempted 1 min later. Strength-duration curves for delivered voltage and current were measured during each shock and transthoracic impedance calculated. Animals requiring a minimum of four shocks were selected for study inclusion. Impedance data from sequential shocks were analyzed using mixed linear models to account for the repeated-measures design and the variability of the initial impedance of individual animals. Thirteen animals (monophasic waveform, n=7, biphasic waveform, n=6) required at least four shocks to terminate VF (range 4-6). Transthoracic impedance did not change from the first shock in the 13 animals (46+/-8 Omega) to the fourth shock (46+/-9 Omega). In animals receiving more than four shocks, transthoracic impedance likewise did not change significantly from the first to the last shock, which terminated VF. The lack of a significant change in impedance was also observed when animals were analyzed according to defibrillation waveform. Transthoracic impedance does not change significantly with repeated shocks in a VF cardiac arrest model. This is likely due to the lack of reactive skin and soft tissue hyperemia and edema observed in non-arrest models.

  9. Rapid Cycling and Its Treatment

    Science.gov (United States)

    ... Announcements Public Service Announcements Partnering with DBSA Rapid Cycling and its Treatment What is bipolar disorder? Bipolar ... to Depression and Manic Depression . What is rapid cycling? Rapid cycling is defined as four or more ...

  10. Price-Transparency and Cost Accounting

    Science.gov (United States)

    Eakin, Cynthia; Fischer, Katrina

    2015-01-01

    Health care reform is directed toward improving access and quality while containing costs. An essential part of this is improvement of pricing models to more accurately reflect the costs of providing care. Transparent prices that reflect costs are necessary to signal information to consumers and producers. This information is central in a consumer-driven marketplace. The rapid increase in high deductible insurance and other forms of cost sharing incentivizes the search for price information. The organizational ability to measure costs across a cycle of care is an integral component of creating value, and will play a greater role as reimbursements transition to episode-based care, value-based purchasing, and accountable care organization models. This article discusses use of activity-based costing (ABC) to better measure the cost of health care. It describes examples of ABC in health care organizations and discusses impediments to adoption in the United States including cultural and institutional barriers. PMID:25862425

  11. Price-Transparency and Cost Accounting

    Directory of Open Access Journals (Sweden)

    Peter Hilsenrath PhD

    2015-04-01

    Full Text Available Health care reform is directed toward improving access and quality while containing costs. An essential part of this is improvement of pricing models to more accurately reflect the costs of providing care. Transparent prices that reflect costs are necessary to signal information to consumers and producers. This information is central in a consumer-driven marketplace. The rapid increase in high deductible insurance and other forms of cost sharing incentivizes the search for price information. The organizational ability to measure costs across a cycle of care is an integral component of creating value, and will play a greater role as reimbursements transition to episode-based care, value-based purchasing, and accountable care organization models. This article discusses use of activity-based costing (ABC to better measure the cost of health care. It describes examples of ABC in health care organizations and discusses impediments to adoption in the United States including cultural and institutional barriers.

  12. Decreasing seagrass density negatively influences associated fauna.

    Science.gov (United States)

    McCloskey, Rosemary M; Unsworth, Richard K F

    2015-01-01

    Seagrass meadows globally are disappearing at a rapid rate with physical disturbances being one of the major drivers of this habitat loss. Disturbance of seagrass can lead to fragmentation, a reduction in shoot density, canopy height and coverage, and potentially permanent loss of habitat. Despite being such a widespread issue, knowledge of how such small scale change affects the spatial distribution and abundances of motile fauna remains limited. The present study investigated fish and macro faunal community response patterns to a range of habitat variables (shoot length, cover and density), including individual species habitat preferences within a disturbed and patchy intertidal seagrass meadow. Multivariate analysis showed a measurable effect of variable seagrass cover on the abundance and distribution of the fauna, with species specific preferences to both high and low seagrass cover seagrass. The faunal community composition varied significantly with increasing/decreasing cover. The faunal species composition of low cover seagrass was more similar to sandy control plots than to higher cover seagrass. Shannon Wiener Diversity (H') and species richness was significantly higher in high cover seagrass than in low cover seagrass, indicating increasing habitat value as density increases. The results of this study underline how the impacts of small scale disturbances from factors such as anchor damage, boat moorings and intertidal vehicle use on seagrass meadows that reduce shoot density and cover can impact upon associated fauna. These impacts have negative consequences for the delivery of ecosystem services such as the provision of nursery habitat.

  13. Rapid manufacturing for microfluidics

    CSIR Research Space (South Africa)

    Land, K

    2012-10-01

    Full Text Available . Microfluidics is at the forefront of developing solutions for drug discovery, diagnostics (from glucose tests to malaria and TB testing) and environmental diagnostics (E-coli monitoring of drinking water). In order to quickly implement new designs, a rapid...

  14. Rapid Prototyping in PVS

    Science.gov (United States)

    Munoz, Cesar A.; Butler, Ricky (Technical Monitor)

    2003-01-01

    PVSio is a conservative extension to the PVS prelude library that provides basic input/output capabilities to the PVS ground evaluator. It supports rapid prototyping in PVS by enhancing the specification language with built-in constructs for string manipulation, floating point arithmetic, and input/output operations.

  15. Rapid ISS Power Availability Simulator

    Science.gov (United States)

    Downing, Nicholas

    2011-01-01

    The ISS (International Space Station) Power Resource Officers (PROs) needed a tool to automate the calculation of thousands of ISS power availability simulations used to generate power constraint matrices. Each matrix contains 864 cells, and each cell represents a single power simulation that must be run. The tools available to the flight controllers were very operator intensive and not conducive to rapidly running the thousands of simulations necessary to generate the power constraint data. SOLAR is a Java-based tool that leverages commercial-off-the-shelf software (Satellite Toolkit) and an existing in-house ISS EPS model (SPEED) to rapidly perform thousands of power availability simulations. SOLAR has a very modular architecture and consists of a series of plug-ins that are loosely coupled. The modular architecture of the software allows for the easy replacement of the ISS power system model simulator, re-use of the Satellite Toolkit integration code, and separation of the user interface from the core logic. Satellite Toolkit (STK) is used to generate ISS eclipse and insulation times, solar beta angle, position of the solar arrays over time, and the amount of shadowing on the solar arrays, which is then provided to SPEED to calculate power generation forecasts. The power planning turn-around time is reduced from three months to two weeks (83-percent decrease) using SOLAR, and the amount of PRO power planning support effort is reduced by an estimated 30 percent.

  16. Assessing the shelf life of cost-efficient conservation plans for species at risk across gradients of agricultural land use.

    Science.gov (United States)

    Robillard, Cassandra M; Kerr, Jeremy T

    2017-08-01

    High costs of land in agricultural regions warrant spatial prioritization approaches to conservation that explicitly consider land prices to produce protected-area networks that accomplish targets efficiently. However, land-use changes in such regions and delays between plan design and implementation may render optimized plans obsolete before implementation occurs. To measure the shelf life of cost-efficient conservation plans, we simulated a land-acquisition and restoration initiative aimed at conserving species at risk in Canada's farmlands. We accounted for observed changes in land-acquisition costs and in agricultural intensity based on censuses of agriculture taken from 1986 to 2011. For each year of data, we mapped costs and areas of conservation priority designated using Marxan. We compared plans to test for changes through time in the arrangement of high-priority sites and in the total cost of each plan. For acquisition costs, we measured the savings from accounting for prices during site selection. Land-acquisition costs and land-use intensity generally rose over time independent of inflation (24-78%), although rates of change were heterogeneous through space and decreased in some areas. Accounting for spatial variation in land price lowered the cost of conservation plans by 1.73-13.9%, decreased the range of costs by 19-82%, and created unique solutions from which to choose. Despite the rise in plan costs over time, the high conservation priority of particular areas remained consistent. Delaying conservation in these critical areas may compromise what optimized conservation plans can achieve. In the case of Canadian farmland, rapid conservation action is cost-effective, even with moderate levels of uncertainty in how to implement restoration goals. © 2016 Society for Conservation Biology.

  17. Commercial aspects of rapid thermal processing (RTP)

    Energy Technology Data Exchange (ETDEWEB)

    Graham, R.G.; Huffman, D.R. [Ensyn Technologies Inc., Greely, ON (Canada)

    1996-12-31

    In its broadest sense, Rapid Thermal Processing (RTP{sup TM}) covers the conversion of all types of carbonaceous materials to liquid fuels, high quality fuel gases, and chemicals. Scientifically, it is based on the general premise that products which result from the extremely rapid application of heat to a given feedstock are inherently more valuable than those which are produced when heat is applied much more slowly over longer periods of processing time. Commercial RTP{sup TM} activities (including the actual implementation in the market as well as the short-term R and D initiatives) are much narrower in scope, and are focused on the production of high yields of light, non-tarry liquids (i.e. `bio-crude`) from biomass for fuel and chemical markets. Chemicals are of significant interest from an economical point of view since they typically have a higher value than fuel products. Liquid fuels are of interest for many reasons: (1) Liquid fuels do not have to be used immediately after production, such as is the case with hot combustion gases or combustible gases produced via gasification. This allows the decoupling of fuel production from the end-use (ie. the conversion of fuel to energy). (2) The higher energy density of liquid fuels vs. that of fuel gases and solid biomass results in a large reduction in the costs associated with storage and transportation. (3) The costs to retrofit an existing gas or oil fired combustion system are much lower than replacement with a solid fuel combustor. (4) In general, liquid fuel combustion is much more efficient, controllable, and cleaner than the combustion of solid fuels. (5) The production of liquid `bio-crude` permits the removal of ash from the biomass prior to combustion or other end-use applications. (6) Gas or liquid fuel-fired diesel or turbine engines cannot operate commercially on solid fuels. Although wood represents the biomass which is of principal commercial interest (including a vast array of wood residues

  18. Hyperglycemia of Diabetic Rats Decreased by a Glucagon Receptor Antagonist

    Science.gov (United States)

    Johnson, David G.; Ulichny Goebel, Camy; Hruby, Victor J.; Bregman, Marvin D.; Trivedi, Dev

    1982-02-01

    The glucagon analog [l-Nα-trinitrophenylhistidine, 12-homoarginine]-glucagon (THG) was examined for its ability to lower blood glucose concentrations in rats made diabetic with streptozotocin. In vitro, THG is a potent antagonist of glucagon activation of the hepatic adenylate cyclase assay system. Intravenous bolus injections of THG caused rapid decreases (20 to 35 percent) of short duration in blood glucose. Continuous infusion of low concentrations of the inhibitor led to larger sustained decreases in blood glucose (30 to 65 percent). These studies demonstrate that a glucagon receptor antagonist can substantially reduce blood glucose levels in diabetic animals without addition of exogenous insulin.

  19. COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

    Directory of Open Access Journals (Sweden)

    Moisello Anna Maria

    2012-07-01

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

  20. A STUDY OF THE STICKINESS OF COST OF GOODS SOLD AND OPERATING COSTS TO CHANGES IN SALES LEVEL IN IRAN

    OpenAIRE

    NASSIRZADEH Farzaneh; SAEI Mohammad Javad; Mahdi SALEHI; BAYEGI Sayyed Ali Haddad

    2013-01-01

    Increased competition in domestic and foreign markets has made managers to identify their costs structure and behavior better. Cost behavior is a model based on which costs response to changes in level of activity. Having invented stickiness of costs model by Anderson and Janakiraman (2003), managers are able to better predict costs behavior when increases and decreases are occurred in sales. Using above model, this research examines behavior of cost of goods sold as well as general, administ...

  1. Rapid manufacturing facilitated customisation

    OpenAIRE

    Tuck, Christopher John; Hague, Richard; Ruffo, Massimiliano; Ransley, Michelle; Adams, Paul Russell

    2008-01-01

    Abstract This paper describes the production of body-fitting customised seat profiles utilising the following digital methods: three dimensional laser scanning, reverse engineering and Rapid Manufacturing (RM). The seat profiles have been manufactured in order to influence the comfort characteristics of an existing ejector seat manufactured by Martin Baker Aircraft Ltd. The seat, known as Navy Aircrew Common Ejection Seat (NACES), was originally designed with a generic profile. ...

  2. Rapid Detection of Pathogens

    Energy Technology Data Exchange (ETDEWEB)

    David Perlin

    2005-08-14

    Pathogen identification is a crucial first defense against bioterrorism. A major emphasis of our national biodefense strategy is to establish fast, accurate and sensitive assays for diagnosis of infectious diseases agents. Such assays will ensure early and appropriate treatment of infected patients. Rapid diagnostics can also support infection control measures, which monitor and limit the spread of infectious diseases agents. Many select agents are highly transmissible in the early stages of disease, and it is critical to identify infected patients and limit the risk to the remainder of the population and to stem potential panic in the general population. Nucleic acid-based molecular approaches for identification overcome many of the deficiencies associated with conventional culture methods by exploiting both large- and small-scale genomic differences between organisms. PCR-based amplification of highly conserved ribosomal RNA (rRNA) genes, intergenic sequences, and specific toxin genes is currently the most reliable approach for bacterial, fungal and many viral pathogenic agents. When combined with fluorescence-based oligonucleotide detection systems, this approach provides real-time, quantitative, high fidelity analysis capable of single nucleotide allelic discrimination (4). These probe systems offer rapid turn around time (<2 h) and are suitable for high throughput, automated multiplex operations that are critical for clinical diagnostic laboratories. In this pilot program, we have used molecular beacon technology invented at the Public health Research Institute to develop a new generation of molecular probes to rapidly detect important agents of infectious diseases. We have also developed protocols to rapidly extract nucleic acids from a variety of clinical specimen including and blood and tissue to for detection in the molecular assays. This work represented a cooperative research development program between the Kramer-Tyagi/Perlin labs on probe development

  3. Tiber Personal Rapid Transit

    Directory of Open Access Journals (Sweden)

    Diego Carlo D'agostino

    2011-02-01

    Full Text Available The project “Tiber Personal Rapid Transit” have been presented by the author at the Rome City Vision Competition1 2010, an ideas competition, which challenges architects, engineers, designers, students and creatives individuals to develop visionary urban proposals with the intention of stimulating and supporting the contemporary city, in this case Rome. The Tiber PRT proposal tries to answer the competition questions with the definition of a provocative idea: a Personal Rapid transit System on the Tiber river banks. The project is located in the central section of the Tiber river and aims at the renewal of the river banks with the insertion of a Personal Rapid Transit infrastructure. The project area include the riverbank of Tiber from Rome Transtevere RFI station to Piazza del Popolo, an area where main touristic and leisure attractions are located. The intervention area is actually no used by the city users and residents and constitute itself a strong barrier in the heart of the historic city.

  4. COSTS CALCULATION OF TARGET COSTING METHOD

    Directory of Open Access Journals (Sweden)

    Sebastian UNGUREANU

    2014-06-01

    Full Text Available Cost information system plays an important role in every organization in the decision making process. An important task of management is ensuring control of the operations, processes, sectors, and not ultimately on costs. Although in achieving the objectives of an organization compete more control systems (production control, quality control, etc., the cost information system is important because monitors results of the other. Detailed analysis of costs, production cost calculation, quantification of losses, estimate the work efficiency provides a solid basis for financial control. Knowledge of the costs is a decisive factor in taking decisions and planning future activities. Managers are concerned about the costs that will appear in the future, their level underpinning the supply and production decisions as well as price policy. An important factor is the efficiency of cost information system in such a way that the information provided by it may be useful for decisions and planning of the work.

  5. Desulfurization characteristics of rapidly hydrated sorbents with various adhesive carrier particles for a semidry CFB-FGD system.

    Science.gov (United States)

    You, Changfu; Li, Yuan

    2013-03-19

    Semidry flue gas desulfurization (FGD) experiments were conducted using rapidly hydrated sorbents with four different adhesive carrier particles: circulation ash from a circulating fluidized bed boiler (CFBB circulation ash), fly ash from the first electrical field of the electrostatic precipitator of a circulating fluidized bed boiler (CFBB ESP ash), fly ash from a chain boiler (chain boiler ash), and river sand smaller than 1 mm. The influences of various adhesive carrier particles and operating conditions on the desulfurization characteristics of the sorbents were investigated, including sprayed water, reaction temperature, and the ratio of calcium to sulfur (Ca/S). The experimental results indicated that the rapidly hydrated sorbents had better desulfurization characteristics by using adhesive carrier particles which possessed better pore, adhesion, and fluidization characteristics. The desulfurization efficiency of the system increased as the reaction temperature decreased, it improved from 35% to 90% as the mass flow rate of the sprayed water increased from 0 to 10 kg/h, and it increased from 65.6% to 82.7% as Ca/S increased from 1.0 to 2.0. Based on these findings, a new semidry circulating fluidized bed (CFB)-FGD system using rapidly hydrated sorbent was developed. Using the rapidly hydrated sorbent, this system uses a cyclone separator instead of an ESP or a bag filter to recycle the sorbent particles, thereby decreasing the system flow resistance, saving investment and operating costs of the solids collection equipment.

  6. Rapidly variable relatvistic absorption

    Science.gov (United States)

    Parker, M.; Pinto, C.; Fabian, A.; Lohfink, A.; Buisson, D.; Alston, W.; Jiang, J.

    2017-10-01

    I will present results from the 1.5Ms XMM-Newton observing campaign on the most X-ray variable AGN, IRAS 13224-3809. We find a series of nine absorption lines with a velocity of 0.24c from an ultra-fast outflow. For the first time, we are able to see extremely rapid variability of the UFO features, and can link this to the X-ray variability from the inner accretion disk. We find a clear flux dependence of the outflow features, suggesting that the wind is ionized by increasing X-ray emission.

  7. Rapid prototype and test

    Energy Technology Data Exchange (ETDEWEB)

    Gregory, D.L.; Hansche, B.D.

    1996-06-01

    In order to support advanced manufacturing, Sandia has acquired the capability to produce plastic prototypes using stereolithography. Currently, these prototypes are used mainly to verify part geometry and ``fit and form`` checks. This project investigates methods for rapidly testing these plastic prototypes, and inferring from prototype test data actual metal part performance and behavior. Performances examined include static load/stress response, and structural dynamic (modal) and vibration behavior. The integration of advanced non-contacting measurement techniques including scanning laser velocimetry, laser holography, and thermoelasticity into testing of these prototypes is described. Photoelastic properties of the epoxy prototypes to reveal full field stress/strain fields are also explored.

  8. Right-Rapid-Rough

    Science.gov (United States)

    Lawrence, Craig

    2003-01-01

    IDEO (pronounced 'eye-dee-oh') is an international design, engineering, and innovation firm that has developed thousands of products and services for clients across a wide range of industries. Its process and culture attracted the attention of academics, businesses, and journalists around the world, and are the subject of a bestselling book, The Art of Innovation by Tom Kelley. One of the keys to IDEO's success is its use of prototyping as a tool for rapid innovation. This story covers some of IDEO's projects, and gives reasons for why they were successful.

  9. Process-based costing.

    Science.gov (United States)

    Lee, Robert H; Bott, Marjorie J; Forbes, Sarah; Redford, Linda; Swagerty, Daniel L; Taunton, Roma Lee

    2003-01-01

    Understanding how quality improvement affects costs is important. Unfortunately, low-cost, reliable ways of measuring direct costs are scarce. This article builds on the principles of process improvement to develop a costing strategy that meets both criteria. Process-based costing has 4 steps: developing a flowchart, estimating resource use, valuing resources, and calculating direct costs. To illustrate the technique, this article uses it to cost the care planning process in 3 long-term care facilities. We conclude that process-based costing is easy to implement; generates reliable, valid data; and allows nursing managers to assess the costs of new or modified processes.

  10. Life cycle cost analysis rehabilitation costs.

    Science.gov (United States)

    2015-07-01

    This study evaluates data from CDOTs Cost Data books and Pavement Management Program. Cost : indices were used to normalize project data to year 2014. Data analyzed in the study was obtained from : the CDOTs Cost Data books and the Pavement Man...

  11. COST OF QUALITY MANAGEMENT

    OpenAIRE

    Milan Vukčević

    2008-01-01

    Cost of quality are part of structure a total cost of organisation. Cost of quality management is important aspect of successful organization. In this paper, models are analised and key aspects cost of quality are given. Problem a cost of quality management particularly is investigated.

  12. Healthcare costs, buyer alert.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Leiske, Heidi B; Lieske, P Alexander

    2011-05-01

    To assess the direct medical cost perspective versus the societal cost perspective associated with a vitreoretinal intervention. Most insurers, physicians, hospital administrators, legislators and the general public refer to direct medical costs when assessing the costs associated with healthcare interventions. The direct medical cost perspective, which is the same as the third-party insurer cost perspective, includes the costs an insurer might be expected to pay, including those for physicians, hospitals, drugs, durable goods, skilled nursing facilities and others. The societal cost perspective includes direct medical costs; direct nonmedical costs (caregiver, transportation, residence); and indirect medical costs (employment and salary). When assessing the costs associated with a healthcare intervention, the societal cost perspective generally yields a greater financial return-on-investment (ROI) to society and to the gross domestic product than does the utilization of direct medical costs alone. Consequently, the use of societal costs in cost-utility analysis typically results in more cost-effective interventions than when direct medical costs alone are employed. A societal cost perspective is more likely than the third-party insurer cost perspective to demonstrate a greater financial ROI to society.

  13. Rapid mineralocorticoid receptor trafficking.

    Science.gov (United States)

    Gekle, M; Bretschneider, M; Meinel, S; Ruhs, S; Grossmann, C

    2014-03-01

    The mineralocorticoid receptor (MR) is a ligand-dependent transcription factor that physiologically regulates water-electrolyte homeostasis and controls blood pressure. The MR can also elicit inflammatory and remodeling processes in the cardiovascular system and the kidneys, which require the presence of additional pathological factors like for example nitrosative stress. However, the underlying molecular mechanism(s) for pathophysiological MR effects remain(s) elusive. The inactive MR is located in the cytosol associated with chaperone molecules including HSP90. After ligand binding, the MR monomer rapidly translocates into the nucleus while still being associated to HSP90 and after dissociation from HSP90 binds to hormone-response-elements called glucocorticoid response elements (GREs) as a dimer. There are indications that rapid MR trafficking is modulated in the presence of high salt, oxidative or nitrosative stress, hypothetically by induction or posttranslational modifications. Additionally, glucocorticoids and the enzyme 11beta hydroxysteroid dehydrogenase may also influence MR activation. Because MR trafficking and its modulation by micro-milieu factors influence MR cellular localization, it is not only relevant for genomic but also for nongenomic MR effects. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Cost effective solar Inverter

    Directory of Open Access Journals (Sweden)

    Nagarathna M

    2015-06-01

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

  15. Reliable, rapid and simple voltammetric detection of urea nitrate explosive.

    Science.gov (United States)

    Cagan, Avi; Lu, Donglai; Cizek, Karel; La Belle, Jeff; Wang, Joseph

    2008-05-01

    A highly selective and rapid electrochemical assay of the improvised explosive urea nitrate (UN) is reported. The method involves a short ( approximately 10 s) acid-catalyzed reaction of UN with 4-nitrotoluene (NT) followed by a rapid ( approximately 2 s) square-wave voltammetric (SWV) detection of the 2,4-dinitrotoluene (DNT) product. The new protocol offers great promise for a reliable field detection of UN, with significant advantages of speed, sensitivity, portability, simplicity, and cost.

  16. Life Cycle Costing.

    Science.gov (United States)

    McCraley, Thomas L.

    1985-01-01

    Life cycle costing establishes a realistic comparison of the cost of owning and operating products. The formula of initial cost plus maintenance plus operation divided by useful life identifies the best price over the lifetime of the product purchased. (MLF)

  17. Price and cost estimation

    Science.gov (United States)

    Stewart, R. D.

    1979-01-01

    Price and Cost Estimating Program (PACE II) was developed to prepare man-hour and material cost estimates. Versatile and flexible tool significantly reduces computation time and errors and reduces typing and reproduction time involved in preparation of cost estimates.

  18. Life cycle costing with a discount rate

    Science.gov (United States)

    Posner, E. C.

    1978-01-01

    This article studies life cycle costing for a capability needed for the indefinite future, and specifically investigates the dependence of optimal policies on the discount rate chosen. The two costs considered are reprocurement cost and maintenance and operations (M and O) cost. The procurement price is assumed known, and the M and O costs are assumed to be a known function, in fact, a non-decreasing function, of the time since last reprocurement. The problem is to choose the optimum reprocurement time so as to minimize the quotient of the total cost over a reprocurement period divided by the period. Or one could assume a discount rate and try to minimize the total discounted costs into the indefinite future. It is shown that the optimum policy in the presence of a small discount rate hardly depends on the discount rate at all, and leads to essentially the same policy as in the case in which discounting is not considered.

  19. Changing cost of HIV interventions in the context of scaling-up in India.

    Science.gov (United States)

    Dandona, Lalit; Kumar, Sg Prem; Ramesh, Yk; Rao, M Chalapathi; Kumar, A Anod; Marseille, Elliot; Kahn, James G; Dandona, Rakhi

    2008-07-01

    A rapid scaling up of HIV interventions in India is anticipated, but systematic information on how costs of HIV interventions change over time and programme scale is not available to inform planning. We studied the changes in unit costs of two major interventions, voluntary counseling and testing (VCT) and sex worker programmes in the south Indian state of Andhra Pradesh between 2002-2003 and 2005-2006 fiscal years. Economic costs (from the provider perspective) and output data from 17 publicly funded VCT centers and 14 sex worker programmes were collected using standardized methods. We calculated unit costs for each programme in each period and explored possible reasons for the changes seen. In 2005-2006, the VCT centers served 66 445 clients and the sex worker programmes served 32 550. The unit cost of providing VCT dropped over 3 years by half to Indian Rupees (INR) 147.5 (US$3.33) mainly because the number of clients doubled. There was no decrease in the average time spent counseling each client. The unit cost of providing services to sex workers increased 2.4 times over 3 years to INR 1401 (US$31.6) as a result of increases in male condom distribution, staff salaries and training, and treatment for sexually transmitted infections, all suggesting improved services. The unit cost of these two interventions changed dramatically over a 3-year period, but in opposite directions. The current unit cost for VCT in Andhra Pradesh is much lower than the estimated global average for low-income settings. These local longitudinal cost data are useful to inform the currently planned scaling up of HIV interventions in India.

  20. Rapid visual scanning

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, R.D.

    1976-08-01

    A description is given of improvements in equipment and inspection techniques for visual inspection of electronic component assemblies. Comparison devices for enhancing differences between a master and test parts are evaluated. Illumination methods and television inspection developments were investigated. Indexing devices were evaluated and improved optical systems and methods were developed. An effective low-cost television comparison system was built; this system uses techniques such as blinking and subtraction for detecting differences in printed circuit boards. A glare-free illumination system called omnidirectional illumination was also developed and tested. This system reduces eyestrain, and performs very well on all types of surfaces and especially well on highly polished substrates. A low-cost manual indexing system called the Pantograph was designed and tested for quick, precise positioning of small circuit boards. The ultimate inspection system is one in which the inspector is an equipment operator instead of a decision maker. This is the reason for development of an automated comparison system. In this system, a PDP-11 computer controls a digital scanner and software was developed to monitor subtraction, hole location and size, path width, texture analysis, missing components, and feature analysis.

  1. Rapid Refresh (RAP) [13 km

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Rapid Refresh (RAP) numerical weather model took the place of the Rapid Update Cycle (RUC) on May 1, 2012. Run by the National Centers for Environmental...

  2. Rapid Refresh (RAP) [20 km

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Rapid Refresh (RAP) numerical weather model took the place of the Rapid Update Cycle (RUC) on May 1, 2012. Run by the National Centers for Environmental...

  3. Rapid chemical separations

    CERN Document Server

    Trautmann, N

    1976-01-01

    A survey is given on the progress of fast chemical separation procedures during the last few years. Fast, discontinuous separation techniques are illustrated by a procedure for niobium. The use of such techniques for the chemical characterization of the heaviest known elements is described. Other rapid separation methods from aqueous solutions are summarized. The application of the high speed liquid chromatography to the separation of chemically similar elements is outlined. The use of the gas jet recoil transport method for nuclear reaction products and its combination with a continuous solvent extraction technique and with a thermochromatographic separation is presented. Different separation methods in the gas phase are briefly discussed and the attachment of a thermochromatographic technique to an on-line mass separator is shown. (45 refs).

  4. A rapid diagnostic test for schistosomiasis mansoni

    Directory of Open Access Journals (Sweden)

    Clelia Christina Mello-Silva

    2013-12-01

    Full Text Available This article presents an improvement to the Kato-Katz (KK method, making it faster and more efficient for the visualisation of fertile eggs in stool samples. This modified KK method uses sodium acetate formalin as a fixative and reveals the intensity of infection in less than 1 h, reducing the diagnostic time without increasing the cost. This modified method may contribute to future epidemiological studies in both hospitals and the field due to its rapid and precise diagnostic, which allow for immediate treatment.

  5. Acutely decreased thermoregulatory energy expenditure or decreased activity energy expenditure both acutely reduce food intake in mice.

    Directory of Open Access Journals (Sweden)

    Karl J Kaiyala

    Full Text Available Despite the suggestion that reduced energy expenditure may be a key contributor to the obesity pandemic, few studies have tested whether acutely reduced energy expenditure is associated with a compensatory reduction in food intake. The homeostatic mechanisms that control food intake and energy expenditure remain controversial and are thought to act over days to weeks. We evaluated food intake in mice using two models of acutely decreased energy expenditure: 1 increasing ambient temperature to thermoneutrality in mice acclimated to standard laboratory temperature or 2 exercise cessation in mice accustomed to wheel running. Increasing ambient temperature (from 21 °C to 28 °C rapidly decreased energy expenditure, demonstrating that thermoregulatory energy expenditure contributes to both light cycle (40 ± 1% and dark cycle energy expenditure (15 ± 3% at normal ambient temperature (21 °C. Reducing thermoregulatory energy expenditure acutely decreased food intake primarily during the light cycle (65 ± 7%, thus conflicting with the delayed compensation model, but did not alter spontaneous activity. Acute exercise cessation decreased energy expenditure only during the dark cycle (14 ± 2% at 21 °C; 21 ± 4% at 28 °C, while food intake was reduced during the dark cycle (0.9 ± 0.1 g in mice housed at 28 °C, but during the light cycle (0.3 ± 0.1 g in mice housed at 21 °C. Cumulatively, there was a strong correlation between the change in daily energy expenditure and the change in daily food intake (R(2 = 0.51, p<0.01. We conclude that acutely decreased energy expenditure decreases food intake suggesting that energy intake is regulated by metabolic signals that respond rapidly and accurately to reduced energy expenditure.

  6. CALCULATION OF COMPANY COSTS THROUGH THE DIRECT-COSTING CALCULATION METHOD

    Directory of Open Access Journals (Sweden)

    Florin-Constantin DIMA

    2013-06-01

    Full Text Available The cost of production has as its starting point the purchase cost of raw materials and consumables, as well as their processing cost and the calculation of the production cost involves complex aspects. This article is based on the two major concepts of costs calculation, namely the concept of full costs and the concept of partial costs, and it analyses the direct-costing calculation method. Necessity of the Development of calculation methods to ensure rapid determination of the cost of production, and the establishment of indicators broad spectrum of information necessary for making decisions to streamline a business activity conducted by direct-costing method. Direct-costing method appeared in the U.S. for the first time in 1934 (applied by Jonathan Harris and G. Charter Harrison. Subsequently, this method was applied to European countries (England, France, Germany etc.. We stopped on this method because it is considered a modern method of costing. Therefore, we analyzed both advantages and limitations of the method in question

  7. Why Does College Cost So Much?

    Science.gov (United States)

    Archibald, Robert B.; Feldman, David H.

    2010-01-01

    Much of what is written about colleges and universities ties rapidly rising tuition to dysfunctional behavior in the academy. Common targets of dysfunction include prestige games among universities, gold plated amenities, and bloated administration. This book offers a different view. To explain rising college cost, the authors place the higher…

  8. Can Diuretics Decrease Your Potassium Level?

    Science.gov (United States)

    Diseases and Conditions High blood pressure (hypertension) Can diuretics decrease your potassium level? Answers from Sheldon G. Sheps, M.D. Yes, some diuretics — also called water pills — decrease potassium in the ...

  9. Activity-based costing on the example of prune-drying company

    National Research Council Canada - National Science Library

    Popovic, Nikola; Vasilic, Marina

    2014-01-01

    ... the environment companies operate in. Along with this fact, major changes in cost structure occurred, which reflected through the increase of the indirect cost portion, and decrease of direct labor and material costs...

  10. Rapid growth of hydroxyapatite nanoparticles using ultrasonic irradiation.

    Science.gov (United States)

    Rouhani, Parvaneh; Taghavinia, Nima; Rouhani, Shohre

    2010-06-01

    A rapid, environmental friendly and low-cost method to prepare hydroxyapatite nanoparticles is proposed. In this method, hydroxyapatite is produced in a sonicated pseudo-body solution. The sonication time was found effective in the formation of the crystalline phase of nanoparticles. In our experimental condition, 15 min sonication resulted in the most pure hydroxyapatite phase. Also it was shown that growth temperature is a crucial factor and hydroxyapatite crystallizes only at 37 degrees C. The particles formed by sonication were generally smaller and more spherical than those obtained without sonication. Sonication increased the hydroxyapatite crystal growth rate up to 5.5 times compared to non-sonication condition. The comparison between the specific surface area of hydroxyapatite nanoparticles obtained by sonication and without sonication demonstrated that sonication increased the specific surface area from 63 m(2)/g to 107 m(2)/g and decreased the size of nanoparticles from 30 nm to 18 nm. Analysis on the pore structure demonstrated that the fractal structures obtained with and without sonication were considerably different. (c) 2010 Elsevier B.V. All rights reserved.

  11. Improved approach for electric vehicle rapid charging station placement and sizing using Google maps and binary lightning search algorithm.

    Directory of Open Access Journals (Sweden)

    Md Mainul Islam

    Full Text Available The electric vehicle (EV is considered a premium solution to global warming and various types of pollution. Nonetheless, a key concern is the recharging of EV batteries. Therefore, this study proposes a novel approach that considers the costs of transportation loss, buildup, and substation energy loss and that incorporates harmonic power loss into optimal rapid charging station (RCS planning. A novel optimization technique, called binary lightning search algorithm (BLSA, is proposed to solve the optimization problem. BLSA is also applied to a conventional RCS planning method. A comprehensive analysis is conducted to assess the performance of the two RCS planning methods by using the IEEE 34-bus test system as the power grid. The comparative studies show that the proposed BLSA is better than other optimization techniques. The daily total cost in RCS planning of the proposed method, including harmonic power loss, decreases by 10% compared with that of the conventional method.

  12. Improved approach for electric vehicle rapid charging station placement and sizing using Google maps and binary lightning search algorithm.

    Science.gov (United States)

    Islam, Md Mainul; Shareef, Hussain; Mohamed, Azah

    2017-01-01

    The electric vehicle (EV) is considered a premium solution to global warming and various types of pollution. Nonetheless, a key concern is the recharging of EV batteries. Therefore, this study proposes a novel approach that considers the costs of transportation loss, buildup, and substation energy loss and that incorporates harmonic power loss into optimal rapid charging station (RCS) planning. A novel optimization technique, called binary lightning search algorithm (BLSA), is proposed to solve the optimization problem. BLSA is also applied to a conventional RCS planning method. A comprehensive analysis is conducted to assess the performance of the two RCS planning methods by using the IEEE 34-bus test system as the power grid. The comparative studies show that the proposed BLSA is better than other optimization techniques. The daily total cost in RCS planning of the proposed method, including harmonic power loss, decreases by 10% compared with that of the conventional method.

  13. Improved approach for electric vehicle rapid charging station placement and sizing using Google maps and binary lightning search algorithm

    Science.gov (United States)

    Shareef, Hussain; Mohamed, Azah

    2017-01-01

    The electric vehicle (EV) is considered a premium solution to global warming and various types of pollution. Nonetheless, a key concern is the recharging of EV batteries. Therefore, this study proposes a novel approach that considers the costs of transportation loss, buildup, and substation energy loss and that incorporates harmonic power loss into optimal rapid charging station (RCS) planning. A novel optimization technique, called binary lightning search algorithm (BLSA), is proposed to solve the optimization problem. BLSA is also applied to a conventional RCS planning method. A comprehensive analysis is conducted to assess the performance of the two RCS planning methods by using the IEEE 34-bus test system as the power grid. The comparative studies show that the proposed BLSA is better than other optimization techniques. The daily total cost in RCS planning of the proposed method, including harmonic power loss, decreases by 10% compared with that of the conventional method. PMID:29220396

  14. Least-cost Paths - Some Methodological Issues

    Directory of Open Access Journals (Sweden)

    Irmela Herzog

    2014-06-01

    Full Text Available This article deals with methodological issues connected with least-cost path (LCP calculations in archaeology. The number of LCP studies in archaeology has increased rapidly during the last couple of years, but not all of the approaches applied are based on an appropriate model and implementation. Many archaeologists rely on standard GIS software with default settings for calculating LCPs and are not aware of possible alternatives and the pitfalls that are described in this article. After briefly introducing the aims and applications of LCP methods in archaeology, LCP algorithms are discussed. The outcome of the LCP calculations depends not only on the algorithm but also on the cost model, which often includes several cost components. The discussion of the cost components has a focus on slope, because nearly all archaeological LCP studies take this cost component into account and because several methodological issues are connected with slope-based cost models. Other possible cost components are: the load of the walker, vegetation cover, wetlands or other soil properties, travelling and transport on water, water as barrier and as attractor, aspect, altitude, and social or cultural cost components. Eventually, advantages and disadvantages of different ways of combining cost components are presented. Based on the methodological issues I conclude that both validation checks and variations of the model are necessary to analyse the reliability of archaeological LCP results.

  15. Problems of rapid growth.

    Science.gov (United States)

    Kim, T D

    1980-01-01

    South Korea's export-oriented development strategy has achieved a remarkable growth record, but it has also brought 2 different problems: 1) since the country's exports accounted for about 1% of total world export volume, the 1st world has become fearful about Korea's aggressive export drive; and 2) the fact that exports account for over 30% of its total gross national product (GNP) exposes the vulnerability of South Korea's economy itself. South Korea continues to be a poor nation, although it is rated as 1 of the most rapidly growing middle income economies. A World Bank 1978 report shows Korea to be 28th of 58 middle income countries in terms of per capita GNP in 1976. Of 11 newly industrializing countries (NIC), 5 in the European continent are more advanced than the others. A recent emphasis on the basic human needs approach has tended to downgrade the concept of GNP. Korea has only an abundant labor force and is without any natural resources. Consequently, Korea utilized an export-oriented development strategy. Oil requirements are met with imports, and almost all raw materials to be processed into exportable products must be imported. To pay import bills Korea must export and earn foreign exchange. It must be emphasized that foreign trade must always be 2-way traffic. In order to export more to middle income countries like Korea, the countries of the 1st world need to ease their protectionist measures against imports from developing countries.

  16. Rapid Polymer Sequencer

    Science.gov (United States)

    Stolc, Viktor (Inventor); Brock, Matthew W (Inventor)

    2013-01-01

    Method and system for rapid and accurate determination of each of a sequence of unknown polymer components, such as nucleic acid components. A self-assembling monolayer of a selected substance is optionally provided on an interior surface of a pipette tip, and the interior surface is immersed in a selected liquid. A selected electrical field is impressed in a longitudinal direction, or in a transverse direction, in the tip region, a polymer sequence is passed through the tip region, and a change in an electrical current signal is measured as each polymer component passes through the tip region. Each of the measured changes in electrical current signals is compared with a database of reference electrical change signals, with each reference signal corresponding to an identified polymer component, to identify the unknown polymer component with a reference polymer component. The nanopore preferably has a pore inner diameter of no more than about 40 nm and is prepared by heating and pulling a very small section of a glass tubing.

  17. Rapidly rotating red giants

    Science.gov (United States)

    Gehan, Charlotte; Mosser, Benoît; Michel, Eric

    2017-10-01

    Stellar oscillations give seismic information on the internal properties of stars. Red giants are targets of interest since they present mixed modes, wich behave as pressure modes in the convective envelope and as gravity modes in the radiative core. Mixed modes thus directly probe red giant cores, and allow in particular the study of their mean core rotation. The high-quality data obtained by CoRoT and Kepler satellites represent an unprecedented perspective to obtain thousands of measurements of red giant core rotation, in order to improve our understanding of stellar physics in deep stellar interiors. We developed an automated method to obtain such core rotation measurements and validated it for stars on the red giant branch. In this work, we particularly focus on the specific application of this method to red giants having a rapid core rotation. They show complex spectra where it is tricky to disentangle rotational splittings from mixed-mode period spacings. We demonstrate that the method based on the identification of mode crossings is precise and efficient. The determination of the mean core rotation directly derives from the precise measurement of the asymptotic period spacing ΔΠ1 and of the frequency at which the crossing of the rotational components is observed.

  18. SPS cost considerations

    Science.gov (United States)

    Woodcock, G. R.

    1978-01-01

    Recent solar power satellite (SPS) system definition studies have emphasized cost estimation for the operational phase of an SPS program, in order to assess economic practicality of SPS. A cost analysis approach is described. Cost results for a silicon photovoltaic SPS are reported, showing SPS costs from $1700 to $2700 per kilowatt and busbar power costs from 3 cents to 7 cents per kilowatt-hour. Rationales behind the estimates are discussed.

  19. Should Cost Management

    Science.gov (United States)

    2012-02-01

    that notwithstanding any other provision of law , no person shall be subject to a penalty for failing to comply with a collection of information if it...NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Sea Systems Command,Washington Navy Yard,DC,20376 8...Fighters Will Cost Should Cost Management & Cost Target NSRP Requirements 8 Should Cost Management in a Nutshell • Should cost management

  20. OOTW COST TOOLS

    Energy Technology Data Exchange (ETDEWEB)

    HARTLEY, D.S.III; PACKARD, S.L.

    1998-09-01

    This document reports the results of a study of cost tools to support the analysis of Operations Other Than War (OOTW). It recommends the continued development of the Department of Defense (DoD) Contingency Operational Support Tool (COST) as the basic cost analysis tool for 00TWS. It also recommends modifications to be included in future versions of COST and the development of an 00TW mission planning tool to supply valid input for costing.

  1. Inpatient cost of treating osteoporotic fractures in mainland China: a descriptive analysis

    Directory of Open Access Journals (Sweden)

    Yang YC

    2015-04-01

    -day costs of osteoporotic fracture increased rapidly (60% and 89%, respectively between 2008 and 2010. Conclusion: The analysis showed that hospitalization cost increases were associated with increasing per-day hospitalization costs. The proportion of the costs reimbursed by health insurances increased, while the mean absolute patient copayment amounts decreased. The incidence and prevalence of osteoporosis and osteoporosis-related fractures may rise rapidly due to the projected growth of the aged population in mainland China. Therefore, the combination of greater anticipated total fractures and rising hospital costs may lead to a tremendously increased economic burden in the future. Keywords: inpatients, hospital costs, length of stay, osteoporosis burden, mainland China

  2. Total Cost Management: Analyzing Operational Support Costs.

    Science.gov (United States)

    Jenny, Hans J.

    1996-01-01

    Total cost management, an innovation useful in higher education, is best implemented in the institution's support services. Total cost management is the practice of analyzing and improving an institution's financial and qualitative performance when producing a particular product or service, paying attention to the complete work process and all…

  3. Rapid mixing kinetic techniques.

    Science.gov (United States)

    Martin, Stephen R; Schilstra, Maria J

    2013-01-01

    Almost all of the elementary steps in a biochemical reaction scheme are either unimolecular or bimolecular processes that frequently occur on sub-second, often sub-millisecond, time scales. The traditional approach in kinetic studies is to mix two or more reagents and monitor the changes in concentrations with time. Conventional spectrophotometers cannot generally be used to study reactions that are complete within less than about 20 s, as it takes that amount of time to manually mix the reagents and activate the instrument. Rapid mixing techniques, which generally achieve mixing in less than 2 ms, overcome this limitation. This chapter is concerned with the use of these techniques in the study of reactions which reach equilibrium; the application of these methods to the study of enzyme kinetics is described in several excellent texts (Cornish-Bowden, Fundamentals of enzyme kinetics. Portland Press, 1995; Gutfreund, Kinetics for the life sciences. Receptors, transmitters and catalysis. Cambridge University Press, 1995).There are various ways to monitor changes in concentration of reactants, intermediates and products after mixing, but the most common way is to use changes in optical signals (absorbance or fluorescence) which often accompany reactions. Although absorbance can sometimes be used, fluorescence is often preferred because of its greater sensitivity, particularly in monitoring conformational changes. Such methods are continuous with good time resolution but they seldom permit the direct determination of the concentrations of individual species. Alternatively, samples may be taken from the reaction volume, mixed with a chemical quenching agent to stop the reaction, and their contents assessed by techniques such as HPLC. These methods can directly determine the concentrations of different species, but are discontinuous and have a limited time resolution.

  4. Declining agricultural production in rapidly urbanizing semi-arid regions: policy tradeoffs and sustainability indicators

    Science.gov (United States)

    Dozier, André Q.; Arabi, Mazdak; Wostoupal, Benjamin C.; Goemans, Christopher G.; Zhang, Yao; Paustian, Keith

    2017-08-01

    In rapidly urbanizing semi-arid regions, increasing amounts of historically irrigated cropland lies permanently fallowed due to water court policies as agricultural water rights are voluntarily being sold to growing cities. This study develops an integrative framework for assessing the effects of population growth and land use change on agricultural production and evaluating viability of alternative management strategies, including alternative agricultural transfer methods, regional water ownership restrictions, and urban conservation. A partial equilibrium model of a spatially-diverse regional water rights market is built in application of the framework to an exemplary basin. The model represents agricultural producers as profit-maximizing suppliers and municipalities as cost-minimizing consumers of water rights. Results indicate that selling an agricultural water right today is worth up to two times more than 40 years of continued production. All alternative policies that sustain agricultural cropland and crop production decrease total agricultural profitability by diminishing water rights sales revenue, but in doing so, they also decrease municipal water acquisition costs. Defining good indicators and incorporating adequate spatial and temporal detail are critical to properly analyzing policy impacts. To best improve agricultural profit from production and sale of crops, short-term solutions include alternative agricultural transfer methods while long-term solutions incorporate urban conservation.

  5. Cost function estimation

    DEFF Research Database (Denmark)

    Andersen, C K; Andersen, K; Kragh-Sørensen, P

    2000-01-01

    Statistical analysis of cost data is often difficult because of highly skewed data resulting from a few patients who incur high costs relative to the majority of patients. When the objective is to predict the cost for an individual patient, the literature suggests that one should choose...... on these criteria, a two-part model was chosen. In this model, the probability of incurring any costs was estimated using a logistic regression, while the level of the costs was estimated in the second part of the model. The choice of model had a substantial impact on the predicted health care costs, e...... a regression model based on the quality of its predictions. In exploring the econometric issues, the objective of this study was to estimate a cost function in order to estimate the annual health care cost of dementia. Using different models, health care costs were regressed on the degree of dementia, sex, age...

  6. Minimum cost connection networks

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Tvede, Mich

    2015-01-01

    In the present paper we consider the allocation of costs in connection networks. Agents have connection demands in form of pairs of locations they want to have connected. Connections between locations are costly to build. The problem is to allocate costs of networks satisfying all connection...... demands. We use a few axioms to characterize allocation rules that truthfully implement cost minimizing networks satisfying all connection demands in a game where: (1) a central planner announces an allocation rule and a cost estimation rule; (2) every agent reports her own connection demand as well...... as all connection costs; (3) the central planner selects a cost minimizing network satisfying reported connection demands based on the estimated costs; and, (4) the planner allocates the true costs of the selected network. It turns out that an allocation rule satisfies the axioms if and only if relative...

  7. Minimum cost connection networks

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Tvede, Mich

    In the present paper we consider the allocation of cost in connection networks. Agents have connection demands in form of pairs of locations they want to be connected. Connections between locations are costly to build. The problem is to allocate costs of networks satisfying all connection demands....... We use three axioms to characterize allocation rules that truthfully implement cost minimizing networks satisfying all connection demands in a game where: (1) a central planner announces an allocation rule and a cost estimation rule; (2) every agent reports her own connection demand as well as all...... connection costs; and, (3) the central planner selects a cost minimizing network satisfying reported connection demands based on estimated connection costs and allocates true connection costs of the selected network....

  8. Energy cost of balance control during walking decreases with external stabilizer stiffness independent of walking speed

    NARCIS (Netherlands)

    Ijmker, T.; Houdijk, J.H.P.; Lamoth, C.J.C.; Beek, P.J.; van der Woude, L.H.V.

    2013-01-01

    Human walking requires active neuromuscular control to ensure stability in the lateral direction, which inflicts a certain metabolic load. The magnitude of this metabolic load has previously been investigated by means of passive external lateral stabilization via spring-like cords. In the present

  9. Decreasing costs of ground data processing system development using a software product line

    Science.gov (United States)

    Chaffin, Brian

    2005-01-01

    In this paper, I describe software product lines and why a Ground Data Processing System should use one. I also describe how to develop a software product line, using examples from an imaginary Ground Data Processing System.

  10. Primary care as a means of decreasing health care costs | van ...

    African Journals Online (AJOL)

    ... weight management, sufficient exercise, discontinuing smoking habits, stress management, and secondary prevention which involves annual medicals, and a focussed approach of specific screening protocols. Keywords: Primary health care; primary care; managed health care; medical scheme; cardiovascular disease,

  11. Rapid Active Sampling Package

    Science.gov (United States)

    Peters, Gregory

    2010-01-01

    A field-deployable, battery-powered Rapid Active Sampling Package (RASP), originally designed for sampling strong materials during lunar and planetary missions, shows strong utility for terrestrial geological use. The technology is proving to be simple and effective for sampling and processing materials of strength. Although this originally was intended for planetary and lunar applications, the RASP is very useful as a powered hand tool for geologists and the mining industry to quickly sample and process rocks in the field on Earth. The RASP allows geologists to surgically acquire samples of rock for later laboratory analysis. This tool, roughly the size of a wrench, allows the user to cut away swaths of weathering rinds, revealing pristine rock surfaces for observation and subsequent sampling with the same tool. RASPing deeper (.3.5 cm) exposes single rock strata in-situ. Where a geologist fs hammer can only expose unweathered layers of rock, the RASP can do the same, and then has the added ability to capture and process samples into powder with particle sizes less than 150 microns, making it easier for XRD/XRF (x-ray diffraction/x-ray fluorescence). The tool uses a rotating rasp bit (or two counter-rotating bits) that resides inside or above the catch container. The container has an open slot to allow the bit to extend outside the container and to allow cuttings to enter and be caught. When the slot and rasp bit are in contact with a substrate, the bit is plunged into it in a matter of seconds to reach pristine rock. A user in the field may sample a rock multiple times at multiple depths in minutes, instead of having to cut out huge, heavy rock samples for transport back to a lab for analysis. Because of the speed and accuracy of the RASP, hundreds of samples can be taken in one day. RASP-acquired samples are small and easily carried. A user can characterize more area in less time than by using conventional methods. The field-deployable RASP used a Ni

  12. Costing Practices in Healthcare

    DEFF Research Database (Denmark)

    Chapman, Christopher; Kern, Anja; Laguecir, Aziza

    2014-01-01

    The rising cost of healthcare is a globally pressing concern. This makes detailed attention to the way in which costing is carried out of central importance. This article offers a framework for considering the interdependencies between a dominant element of the contemporary healthcare context, i.......e., Diagnosis Related Group (DRG) systems, and costing practices. DRG-based payment systems strongly influence costing practices in multiple ways. In particular, setting DRG tariffs requires highly standardized costing practices linked with specific skill sets from management accountants and brings other...... jurisdictions (e.g., clinical coding) to bear on costing practice. These factors contribute to the fragmentation of the jurisdiction of management accounting....

  13. Rapid Robot Design Validation Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Energid Technologies will create a comprehensive software infrastructure for rapid validation of robotic designs. The software will support push-button validation...

  14. Rapid Robot Design Validation Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Energid Technologies will create a comprehensive software infrastructure for rapid validation of robot designs. The software will support push-button validation...

  15. Optimalization of logistic costs by the controlling approach

    Directory of Open Access Journals (Sweden)

    Katarína Teplická

    2007-10-01

    Full Text Available Article deals with logistic cost problems, their following, reporting and evaluation in the firm. It gives basic information about possible access of the effective decreasing of the logistic cost by the way of controlling access, or evaluation of Balance Score Card. It indicates short algorithm of logistic costs reporting by the way of controlling.

  16. ABC estimation of unit costs for emergency department services.

    Science.gov (United States)

    Holmes, R L; Schroeder, R E

    1996-04-01

    Rapid evolution of the health care industry forces managers to make cost-effective decisions. Typical hospital cost accounting systems do not provide emergency department managers with the information needed, but emergency department settings are so complex and dynamic as to make the more accurate activity-based costing (ABC) system prohibitively expensive. Through judicious use of the available traditional cost accounting information and simple computer spreadsheets. managers may approximate the decision-guiding information that would result from the much more costly and time-consuming implementation of ABC.

  17. Management of Logistics Activities and Costing Approaches

    Directory of Open Access Journals (Sweden)

    İlker KIYMETLİ ŞEN

    2014-06-01

    Full Text Available In recent years, enterprises are required to reconsider the management of logistics activities as a result of developments such as increasing competition, rapid technological development, and the shortening of product life cycles. As a result of globalization, costs of logistics activities have also increased depending on changes in the quality and quantity of logistics activities. According to research on logistics activities, the physical distribution costs of enterprises may reach up to 30% of sales. For this reason, the management of logistics operations and control of costs caused by these activities is a necessity. The increase in costs negatively impact on the financial performance of enterprises, cash flows, profitability and so value of the shares. The aim of this study was to describe the structure of logistics costs and logistics activities to explain the methods used in costing. For this purpose, many studies in the literature were investigated. The aim of this study was to describe the structure of logistics costs and logistics activities to explain the methods used in costing. For this purpose, many studies in the literature were investigated.

  18. 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.

  19. Parametric study of minimal cost SPS systems

    Energy Technology Data Exchange (ETDEWEB)

    Love, A.W.

    1982-01-01

    In this study, a cost function for a single solar power satellite (SPS) system is developed using the recently defined magnetron-powered reference system as a model. By assuming a one-parameter Hansen distribution of microwave energy over the spacetenna, it is shown that the cost of delivered power is a function of only two variables. One is the Hansen parameter, h, while the other is the power density level at which the rectenna intercepts the power beam of the spacetenna. This simplification makes it possible to compute a family of curves of cost per kilowatt versus rectenna intercept level with h as a parameter. These curves all have minima and it is apparent that the current reference system, at $2110/kW, is not a minimum power cost system. For this particular system h is approximately 2.4 and the minimum in the cost function is actually $1990/kW. This 6% decrease in cost of power can be realized by making only one simple change in the design; the rectenna diameter must be decreased in order to intercept the power beam at the -8.3 dB level instead of the -13.6 dB level. Although the absolute minimum cost of power, about $1930/kW, occurs for uniform illumination of the spacetenna (h = 0), it turns out that the system with the least overall total cost occurs for h = 3.2, corresponding to a -27 dB sidelobe level.

  20. Acutely decreased thermoregulatory energy expenditure or decreased activity energy expenditure both acutely reduce food intake in mice.

    Science.gov (United States)

    Kaiyala, Karl J; Morton, Gregory J; Thaler, Joshua P; Meek, Thomas H; Tylee, Tracy; Ogimoto, Kayoko; Wisse, Brent E

    2012-01-01

    Despite the suggestion that reduced energy expenditure may be a key contributor to the obesity pandemic, few studies have tested whether acutely reduced energy expenditure is associated with a compensatory reduction in food intake. The homeostatic mechanisms that control food intake and energy expenditure remain controversial and are thought to act over days to weeks. We evaluated food intake in mice using two models of acutely decreased energy expenditure: 1) increasing ambient temperature to thermoneutrality in mice acclimated to standard laboratory temperature or 2) exercise cessation in mice accustomed to wheel running. Increasing ambient temperature (from 21 °C to 28 °C) rapidly decreased energy expenditure, demonstrating that thermoregulatory energy expenditure contributes to both light cycle (40 ± 1%) and dark cycle energy expenditure (15 ± 3%) at normal ambient temperature (21 °C). Reducing thermoregulatory energy expenditure acutely decreased food intake primarily during the light cycle (65 ± 7%), thus conflicting with the delayed compensation model, but did not alter spontaneous activity. Acute exercise cessation decreased energy expenditure only during the dark cycle (14 ± 2% at 21 °C; 21 ± 4% at 28 °C), while food intake was reduced during the dark cycle (0.9 ± 0.1 g) in mice housed at 28 °C, but during the light cycle (0.3 ± 0.1 g) in mice housed at 21 °C. Cumulatively, there was a strong correlation between the change in daily energy expenditure and the change in daily food intake (R(2) = 0.51, psignals that respond rapidly and accurately to reduced energy expenditure.

  1. Unit Cost Compendium Calculations

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Unit Cost Compendium (UCC) Calculations raw data set was designed to provide for greater accuracy and consistency in the use of unit costs across the USEPA...

  2. Medicare Cost Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor. The cost report contains provider...

  3. External Costs of Transport

    OpenAIRE

    INFRAS, UNIVERSITAT KARLRUHE

    2014-01-01

    This study is an update of a former UIC study on external effects (IFRAS / IWW 2000). It aims at improving the empirical basis of external costs of transport based on the actual state of the art of cost estimation methodologies reflecting also recent studies on external costs of transport on a European level (especially UNITE).The following dimensions are considered:- cost categories- contries- base year- differentiation by means of transport 

  4. Cost-Estimation Program

    Science.gov (United States)

    Cox, Brian

    1995-01-01

    COSTIT computer program estimates cost of electronic design by reading item-list file and file containing cost for each item. Accuracy of cost estimate based on accuracy of cost-list file. Written by use of AWK utility for Sun4-series computers running SunOS 4.x and IBM PC-series and compatible computers running MS-DOS. The Sun version (NPO-19587). PC version (NPO-19157).

  5. Rapid prototyping in medical sciences

    Directory of Open Access Journals (Sweden)

    Ákos Márk Horváth

    2015-09-01

    Full Text Available Even if it sound a bit incredible rapid prototyping (RPT as production method has been used for decades in other professions. Nevertheless medical science just started discover the possibilities of this technology and use the offered benefits of 3D printing. In this paper authors have investigated the pharmaceutical usage of rapid prototyping.

  6. Trends in Institutional Costs.

    Science.gov (United States)

    Kirshstein, Rita J.; And Others

    This report describes the cost of nonprofit undergraduate collegiate education, how that cost has grown throughout the 1980s, and reasons for increases in college costs. The study analyzed multiple data sources to determine that college tuition growth has outpaced general price inflation since about 1980, but the American public believes that the…

  7. Opportunity Cost: A Reexamination

    Science.gov (United States)

    Parkin, Michael

    2016-01-01

    Is opportunity cost an ambiguous and arbitrary concept or a simple, straightforward, and fruitful one? This reexamination of opportunity cost addresses this question, and shows that opportunity cost is an ambiguous concept because "two" definitions are in widespread use. One of the definitions is indeed simple, fruitful, and one that…

  8. Costs of employee turnover

    Directory of Open Access Journals (Sweden)

    Jiří Duda

    2013-01-01

    Full Text Available The aim of this paper is to establish a general methodology for calculating the costs incurred by employee turnover. This paper deals with identification of costs incurred by the departure of an employee, and does not deal with the cost of recruitment of a new employee. Economic calculations are adjusted to the tax policy in the Czech Republic. The costs of employee turnover (according to Bliss, 2012 include the costs of substitution of the unoccupied position, costs of conducting the exit interview and termination of the contract. The cost of an executive’s time to understand the causes of leaving and costs of the leaving employee’s training were also determined. Important factors in the costs of employee turnover also include the loss of knowledge and possibly also a loss of customers. Costs of lost employee and department productiveness represent an important part of the costs of employee turnover, as well. For all of these costs there have been proposed general calculations formulas.

  9. Power Plant Cycling Costs

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, N.; Besuner, P.; Lefton, S.; Agan, D.; Hilleman, D.

    2012-07-01

    This report provides a detailed review of the most up to date data available on power plant cycling costs. The primary objective of this report is to increase awareness of power plant cycling cost, the use of these costs in renewable integration studies and to stimulate debate between policymakers, system dispatchers, plant personnel and power utilities.

  10. Dealer Inventory and the Cost of Immediacy

    DEFF Research Database (Denmark)

    Dick-Nielsen, Jens

    This study shows that the recent 80% decrease in dealer inventories of corporate bonds has increased the cost of immediacy. For safe bonds which are quickly turned over again by dealers the increase is up to 15%, while for risky bonds which are kept on inventory by dealers the increase is up to 100....... The drop in dealer inventories, and thus the rise in transaction costs, is a side-eect of anticipated tighter regulation, primarily Basel III and the Volcker Rule....

  11. Cardiac rehabilitation costs.

    Science.gov (United States)

    Moghei, Mahshid; Turk-Adawi, Karam; Isaranuwatchai, Wanrudee; Sarrafzadegan, Nizal; Oh, Paul; Chessex, Caroline; Grace, Sherry L

    2017-10-01

    Despite the clinical benefits of cardiac rehabilitation (CR) and its cost-effectiveness, it is not widely received. Arguably, capacity could be greatly increased if lower-cost models were implemented. The aims of this review were to describe: the costs associated with CR delivery, approaches to reduce these costs, and associated implications. Upon finalizing the PICO statement, information scientists were enlisted to develop the search strategy of MEDLINE, Embase, CDSR, Google Scholar and Scopus. Citations identified were considered for inclusion by the first author. Extracted cost data were summarized in tabular format and qualitatively synthesized. There is wide variability in the cost of CR delivery around the world, and patients pay out-of-pocket for some or all of services in 55% of countries. Supervised CR costs in high-income countries ranged from PPP$294 (Purchasing Power Parity; 2016 United States Dollars) in the United Kingdom to PPP$12,409 in Italy, and in middle-income countries ranged from PPP$146 in Venezuela to PPP$1095 in Brazil. Costs relate to facilities, personnel, and session dose. Delivering CR using information and communication technology (mean cost PPP$753/patient/program), lowering the dose and using lower-cost personnel and equipment are important strategies to consider in containing costs, however few explicitly low-cost models are available in the literature. More research is needed regarding the costs to deliver CR in community settings, the cost-effectiveness of CR in most countries, and the economic impact of return-to-work with CR participation. A low-cost model of CR should be standardized and tested for efficacy across multiple healthcare systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Cost incentives for doctors

    DEFF Research Database (Denmark)

    Schottmüller, Christoph

    2013-01-01

    If doctors take the costs of treatment into account when prescribing medication, their objectives differ from their patients' objectives because the patients are insured. This misalignment of interests hampers communication between patient and doctor. Giving cost incentives to doctors increases...... welfare if (i) the doctor's examination technology is sufficiently good or (ii) (marginal) costs of treatment are high enough. If the planner can costlessly choose the extent to which doctors take costs into account, he will opt for less than 100%. Optimal health care systems should implement different...... degrees of cost incentives depending on type of disease and/or doctor....

  13. Decreasing Adolescent Swearing in an Instructional Setting.

    Science.gov (United States)

    Trice, Ashton D.; Parker, Frank C.

    1983-01-01

    Excessive use of six obscene words by two adolescents in a resource classroom was reduced using social reinforcement of low rates of behavior and a response cost procedure. Both procedures were effective in reducing swearing in both students and produced short-term maintenance of effects. (Author/CL)

  14. Kato-Katz and Lumbreras rapid sedimentation test to evaluate helminth prevalence in the setting of a school-based deworming program.

    Science.gov (United States)

    Lopez, Martha; Morales, Maria Luisa; Konana, Monisha; Hoyer, Paige; Pineda-Reyes, Roberto; White, Arthur Clinton; Garcia, Hector Hugo; Lescano, Andres Guillermo; Gotuzzo, Eduardo; Cabada, Miguel Mauricio

    2016-05-01

    The sensitivity of the Kato-Katz test is suboptimal for the evaluation of intestinal helminth prevalence. Moreover, during mass deworming, as helminth egg burden decreases, the sensitivity is likely to decrease. The Lumbreras rapid sedimentation (Lumbreras) is a low-cost non-quantitative test, but may provide useful information in low burden areas. We compared the prevalence of intestinal helminth infections assessed by the Kato-Katz and the Lumbreras rapid sedimentation test on 3 stool specimens from each of 1083 children. The sensitivities were compared using the McNemar paired test. Using the combined outcome of the 3 different stool tests as the standard, Kato-Katz had lower sensitivity than Lumbreras rapid sedimentation tests for Ascaris lumbricoides (85.1% vs. 95.1%, p = 0.03), Hymenolepis nana (77.7% vs. 97.9%, p Kato-Katz demonstrated significantly lower sensitivity, missing most T. trichiura, hookworm, and S. stercoralis infections. The combination of Kato-Katz and Lumbreras rapid sedimentation tests enables the detection of more intestinal helminths infections in post-deworming low prevalence areas.

  15. Economic Impact of a New Rapid PCR Assay for Detecting Influenza Virus in an Emergency Department and Hospitalized Patients.

    Science.gov (United States)

    Soto, Marcelo; Sampietro-Colom, Laura; Vilella, Anna; Pantoja, Efraín; Asenjo, María; Arjona, Ruth; Hurtado, Juan Carlos; Trilla, Antoni; Alvarez-Martínez, Míriam José; Mira, Aurea; Vila, Jordi; Marcos, María Angeles

    2016-01-01

    Seasonal influenza causes significant morbidity and mortality and has a substantial economic impact on the healthcare system. The main objective of this study was to compare the cost per patient for a rapid commercial PCR assay (Xpert® Flu) with an in-house real-time PCR test for detecting influenza virus. Community patients with influenza like-illness attending the Emergency Department (ED) as well as hospitalized patients in the Hospital Clínic of Barcelona were included. Costs were evaluated from the perspective of the hospital considering the use of resources directly related to influenza testing and treatment. For the purpose of this study, 366 and 691 patients were tested in 2013 and 2014, respectively. The Xpert® Flu test reduced the mean waiting time for patients in the ED by 9.1 hours and decreased the mean isolation time of hospitalized patients by 23.7 hours. This was associated with a 103€ (or about $113) reduction in the cost per patient tested in the ED and 64€ ($70) per hospitalized patient. Sensitivity analyses showed that Xpert® Flu is likely to be cost-saving in hospitals with different contexts and prices.

  16. Sheet metal forming using rapid prototyped tooling

    Science.gov (United States)

    Park, Young-Bin

    The demand for rapid, low-cost die fabrication and modification technology is greater than ever in sheet metal forming industry. One category of rapid tooling technology involves the application of advanced polymers and composites to fabricate metal forming dies. Despite their advantages in lead time and cost reductions, polymer dies for sheet metal forming applications have several drawbacks. Due to their lack of strength as compared to conventional die materials, the use of polymer dies is often limited to prototype or short-run production. In addition, because the mechanisms by which they fail are not fully understood, the dies are designed on the basis of experience and intuition. The research (1) characterized the mechanical behavior of an advanced polymer composite tooling material, (2) developed a method to predict the failure mode and the life of a polymer die, and (3) established optimal die design guidelines. The focus was on rapid prototyped, aluminum trihydrate(ATH)-filled, polyurethane-based dies in sheet metal forming. The study involved the determination of dominant process parameters based on the finite element analyses of 90° V-die bending and cylindrical cup drawing processes. The effects of process parameters on stress distribution in the die provided guidelines to the modification of die design for achieving the desired die life. The presented parametric study lays the groundwork for providing reliable tool failure prediction and design optimization guidelines for advanced polymer tooling materials in metal forming. In addition, the failure mechanisms were investigated to predict the failure mode and the fatigue life of the die. To establish a fundamental understanding of the fatigue behavior of the polyurethane-based die material, extensive material tests were performed, the microstructure was studied, and the fatigue properties were identified experimentally. The test data were incorporated into the local stress-based fatigue analysis to

  17. Costs of traffic injuries

    DEFF Research Database (Denmark)

    Kruse, Marie

    2015-01-01

    OBJECTIVE: The aim of this study was to analyse the socioeconomic costs of traffic injuries in Denmark, notably the healthcare costs and the productivity costs related to traffic injuries, in a bottom-up, register-based perspective. METHOD: Traffic injury victims were identified using national...... emergency room data and police records. Victims were matched with five controls per case by means of propensity score, nearest-neighbour matching. In the cohort, consisting of the 52 526 individuals that experienced a traffic injury in 2000 and 262 630 matched controls, attributable healthcare costs were...... assessed using Danish national healthcare registers. Productivity costs were computed using duration analysis (Cox regression models). In a subanalysis, cost per severe traffic injury was computed for the 12 995 individuals that experienced a severe injury. RESULTS: The socioeconomic cost of a traffic...

  18. Do mergers really reduce costs? Evidence from hospitals.

    Science.gov (United States)

    Harrison, Teresa D

    2011-01-01

    In this paper, we compare potential and realized cost savings from hospital mergers. Our approach isolates changes in realized cost savings due to different output mixes from systematic changes due to time and also provides a measure of the potential cost savings due to scale economies. Our findings suggest that economies of scale are present for merging hospitals and they realize these cost savings immediately following a merger. However, we also show that over time, cost savings from the merger decrease and the proportion of hospitals experiencing positive cost savings declines.

  19. Análisis de costos de los métodos rápidos para diagnóstico de Tuberculosis multidrogorresistente en diferentes grupos epidemiológicos del Perú Cost analysis of rapid methods for diagnosis of multidrug resistant Tuberculosis in different epidemiologic groups in Perú

    Directory of Open Access Journals (Sweden)

    Lely Solari

    2011-09-01

    Full Text Available Objetivos. Evaluar los costos de tres métodos diagnósticos para susceptibilidad a drogas antituberculosas y comparar el costo por caso de tuberculosis multidrogorresistente (TB MDR diagnosticado con estos (MODS; GRIESS y Genotype MTBDR plus ® en cuatro grupos epidemiológicos en el Perú. Materiales y métodos. En base a cifras programáticas, se dividió a la población en cuatro grupos: pacientes nuevos de Lima/Callao; nuevos de otras provincias; los antes tratados de Lima/Callao y de otras provincias. Se calcularon los costos de cada prueba en base a la metodología estándar utilizada por el Ministerio de Salud, desde la perspectiva de los servicios de salud. Basado en ello, se calculó el costo por paciente TB MDR diagnosticado para cada grupo epidemiológico. Resultados. Los costos estimados por prueba para MODS, GRIESS, y Genotype MTBDR plus ® fueron de 14,83; 15,51 y 176,41 nuevos soles, respectivamente. El costo por paciente TB MDR diagnosticado con GRIESS y MODS fue menor a los 200 nuevos soles en tres de los cuatro grupos. El costo por TB MDR diagnosticado fue de más de 2000 nuevos soles con el Genotype MTBDR plus ® en los dos grupos de pacientes nuevos y, menores a 1000 nuevos soles en los grupos de pacientes antes tratados. Conclusiones. En grupos de alta prevalencia, como son los pacientes antes tratados, los costos por caso diagnosticado de TB MDR con las tres pruebas evaluadas fueron bajos, sin embargo, con la prueba molecular en los grupos de baja prevalencia, fueron elevados. El uso de las pruebas moleculares debe optimizarse en grupos de altas prevalencias.Objectives.To evaluate the costs of three methods for the diagnosis of drug susceptibility in tuberculosis, and to compare the cost per case of Multidrug-resistant tuberculosis (MDR TB diagnosed with these (MODS, GRIESS and Genotype MTBDR plus ® in 4 epidemiologic groups in Peru. Materials and methods.In the basis of programmatic figures, we divided the population in

  20. COSTING A HOSPITAL SERVICE PRODUCT: MARGINAL Vs ABSORPTION COSTING.

    Science.gov (United States)

    Gupta, P K; Parmar, N K

    2001-07-01

    Costing a service product is a challenging but important tool for cost control. Different methods used for costing may provide varying costs and the choice of the method used becomes important. Use of absorption costing and marginal costing method and treatment of labour cost as variable and fixed cost provided different results in the present study of the cost of below knee patellar tendon bearing prosthesis. The study shows that marginal costing should also be done along with the absorption cost as it provides better indicator for cost control.

  1. Rapid prototyping-assisted maxillofacial reconstruction.

    Science.gov (United States)

    Peng, Qian; Tang, Zhangui; Liu, Ousheng; Peng, Zhiwei

    2015-05-01

    Rapid prototyping (RP) technologies have found many uses in dentistry, and especially oral and maxillofacial surgery, due to its ability to promote product development while at the same time reducing cost and depositing a part of any degree of complexity theoretically. This paper provides an overview of RP technologies for maxillofacial reconstruction covering both fundamentals and applications of the technologies. Key fundamentals of RP technologies involving the history, characteristics, and principles are reviewed. A number of RP applications to the main fields of oral and maxillofacial surgery, including restoration of maxillofacial deformities and defects, reduction of functional bone tissues, correction of dento-maxillofacial deformities, and fabrication of maxillofacial prostheses, are discussed. The most remarkable challenges for development of RP-assisted maxillofacial surgery and promising solutions are also elaborated.

  2. Rapid eye-fixation training without eyetracking.

    Science.gov (United States)

    Guzman-Martinez, Emmanuel; Leung, Parkson; Franconeri, Steve; Grabowecky, Marcia; Suzuki, Satoru

    2009-06-01

    Maintenance of stable central eye fixation is crucial for a variety of behavioral, electrophysiological, and neuroimaging experiments. Naive observers in these experiments are not typically accustomed to fixating, either requiring the use of cumbersome and costly eyetracking or producing confounds in results. We devised a flicker display that produced an easily detectable visual phenomenon whenever the eyes moved. A few minutes of training using this display dramatically improved the accuracy of eye fixation while observers performed a demanding spatial attention cuing task. The same amount of training using control displays did not produce significant fixation improvements, and some observers consistently made eye movements to the peripheral attention cue, contaminating the cuing effect. Our results indicate that (1) eye fixation can be rapidly improved in naive observers by providing real-time feedback about eye movements, and (2) our simple flicker technique provides an easy and effective method for providing this feedback.

  3. A Rapid Coliform Detector Project

    Data.gov (United States)

    National Aeronautics and Space Administration — ORBITEC, in collaboration with Lucigen, proposes a rapid genetic detector for spaceflight water systems to enable real-time detection of E-coli with minimal...

  4. Rapid Multiplex Microbial Detector Project

    Data.gov (United States)

    National Aeronautics and Space Administration — ORBITEC, in collaboration with Lucigen, proposes a rapid nucleic acid-based detector for spaceflight water systems to enable simultaneous quantification of multiple...

  5. Monthly Program Cost Report (MPCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Monthly Program Cost Report (MPCR) replaces the Cost Distribution Report (CDR). The MPCR provides summary information about Veterans Affairs operational costs,...

  6. Applied cost allocation

    DEFF Research Database (Denmark)

    Bogetoft, Peter; Hougaard, Jens Leth; Smilgins, Aleksandrs

    2016-01-01

    –Shapley prices. We suggest to overcome such problems by using lexicographic goal programing techniques. Moreover, cost allocation based on the cost function is unable to account for differences between efficient and actual cost. We suggest to employ the notion of rational inefficiency in order to supply a set......This paper deals with empirical computation of Aumann–Shapley cost shares for joint production. We show that if one uses a mathematical programing approach with its non-parametric estimation of the cost function there may be observations in the data set for which we have multiple Aumann...... of assumptions concerning firm behavior. These assumptions enable us to connect inefficient with efficient production and thereby provide consistent ways of allocating the costs arising from inefficiency....

  7. Electric propulsion cost estimation

    Science.gov (United States)

    Palaszewski, B. A.

    1985-01-01

    A parametric cost model for mercury ion propulsion modules is presented. A detailed work breakdown structure is included. Cost estimating relationships were developed for the individual subsystems and the nonhardware items (systems engineering, software, etc.). Solar array and power processor unit (PPU) costs are the significant cost drivers. Simplification of both of these subsystems through applications of advanced technology (lightweight solar arrays and high-efficiency, self-radiating PPUs) can reduce costs. Comparison of the performance and cost of several chemical propulsion systems with the Hg ion module are also presented. For outer-planet missions, advanced solar electric propulsion (ASEP) trip times and O2/H2 propulsion trip times are comparable. A three-year trip time savings over the baselined NTO/MMH propulsion system is possible with ASEP.

  8. 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.

  9. Cost drivers in anesthesia: manpower, technique and other factors.

    Science.gov (United States)

    Schuster, Martin; Standl, Thomas

    2006-04-01

    This article reviews the recent literature on cost drivers in anesthesia with respect to staff, techniques and drug costs, and with special focus on anesthesia workflow in the postanesthesia care unit. Moreover, the costs of post-operative pain management provided by an acute pain service are highlighted. Staff costs represent the main contributor to anesthesia costs in all studies. Therefore, many studies address the reduction of personnel costs, e.g. by using fast-tracking procedures which allow the patients to bypass the postanesthesia care unit. However, postanesthesia care unit bypassing and replacement of anesthesiologists by certified anesthesia nurses were not able to significantly decrease anesthesia costs. If anesthesiologists are reimbursed by surgically controlled time, this time is the main determinator for anesthesia costs and should be carefully monitored. Regional anesthesia techniques can help to reduce costs in the ambulatory setting because of reduced post-operative side-effects and earlier home readiness of the patients. Low gas flow and modern electroencephalographic monitoring can contribute to decreased drug-related costs. Acute pain services are mainly run by anesthesia staff thus increasing the costs in anesthesia departments. However, an acute pain service can reduce costs of surgical procedures significantly. Clear definition of the meaning of cost drivers and of criteria which allow assessment of patients' condition, and peri-operative standard operating procedures are warranted to ensure comparability of economic data in anesthesia.

  10. ACTIVITY - BASED COSTING DESIGNING

    OpenAIRE

    Wioletta Skibiñska; Marta Kad³ubek

    2010-01-01

    The traditional costing system sometimes does not give accurate information about the consumption of different resources and the activities of the organisation. The activity-based costing system is an information-rich costing system which is more and more necessary for the success of many European companies. Base of designing and implementation of an ABC system in the enterprises are presented in the article.

  11. Design to Cost and Life Cycle Cost.

    Science.gov (United States)

    1980-07-01

    plant in Hookset, New Hampshire. It is anticipated that after full amor - tization of the Government investment, a net savings of approximately $15,000...prsividt: IT iLcabil ity’ and audiiting oif lis’ dessigin proci-ss. A cost effet’-ivei Prsoiicuet procss is css, filial it) tlic suiccess sif aI dcsigrr

  12. COST OF ORGANIC PORK PRODUCTION: A SEASONAL ANALYSIS AND NEEDED PRICE PREMIUM FOR CONTINUOUS PRODUCTION

    OpenAIRE

    Kliebenstein, James B.; Hurley, Sean P.; Larson, Ben; Honeyman, Mark

    2004-01-01

    Niche markets of agricultural products are experiencing rapid growth. One such market is organic pork. Organic production typically demands specific production conditions that can be cost increasing. This study evaluates the cost of organic pork production, seasonal differences in costs, and premiums necessary to induce continuous organic pork production. In the past few years, niche marketing has been a rapidly growing phenomenon in agriculture. One area that has experienced dramatic growth ...

  13. RAPID MANUFACTURING SYSTEM OF ORTHOPEDIC IMPLANTS.

    Science.gov (United States)

    Relvas, Carlos; Reis, Joana; Potes, José Alberto Caeiro; Fonseca, Fernando Manuel Ferreira; Simões, José Antonio Oliveira

    2009-01-01

    This study, aimed the development of a methodology for rapid manufacture of orthopedic implants simultaneously with the surgical intervention, considering two potential applications in the fields of orthopedics: the manufacture of anatomically adapted implants and implants for bone loss replacement. This work innovation consists on the capitation of the in situ geometry of the implant by direct capture of the shape using an elastomeric material (polyvinylsiloxane) which allows fine detail and great accuracy of the geometry. After scanning the elastomeric specimen, the implant is obtained by machining using a CNC milling machine programmed with a dedicated CAD/CAM system. After sterilization, the implant is able to be placed on the patient. The concept was developed using low cost technology and commercially available. The system has been tested in an in vivo hip arthroplasty performed on a sheep. The time increase of surgery was 80 minutes being 40 minutes the time of implant manufacturing. The system developed has been tested and the goals defined of the study achieved enabling the rapid manufacture of an implant in a time period compatible with the surgery time.

  14. An intervention to decrease cancer fatalism among rural elders.

    Science.gov (United States)

    Powe, B D; Weinrich, S

    1999-04-01

    To evaluate the effectiveness of a video intervention in decreasing cancer fatalism, increasing knowledge of colorectal cancer, and increasing participation in fecal-occult blood testing (FOBT). Repeated measures, pretest/post-test. Senior citizen centers in a rural southern state. Individuals were selected and assigned to the study group based on the center they attended. Centers were selected and assigned randomly to an intervention (n = 42) or control (n = 28) group. The age of the participants ranged from 52-92 years (X = 75). Pretest measures included the Powe Fatalism inventory, the Colorectal Cancer Knowledge Questionnaire, and the Demographic Data Questionnaire. The intervention group viewed the Medical University of South Carolina's video Telling the Story ... To Live is God's Will, and the control group viewed the American Cancer Society (ACS) video Colorectal Cancer: The Cancer No One Talks About. Hemoccult II kits were distributed to both groups at no cost. Post-test data were collected using the Powe Fatalism Inventory and the Colorectal Cancer Knowledge Questionnaire. Cancer fatalism, knowledge of colorectal cancer, and participation in FOBT. People who viewed the intervention video had a greater decrease in cancer fatalism scores and a greater increase in knowledge of colorectal cancer scores than the control group. Both groups had greater than 60% participation in FOBT. Telling the Story ... To Live is God's Will is an effective, self-contained, cost-effective intervention to decrease cancer fatalism and increase knowledge of colorectal cancer. The video was as effective as the ACS video on colorectal cancer in increasing participation in FOBT among rural elders. But, because Telling the Story ... To Live is God's Will also decreases cancer fatalism and increases knowledge, the potential exists for the increased screening behaviors to be maintained over time. Showing the video in waiting areas of community health centers to facilitate the discussion

  15. Management and cost accounting

    CERN Document Server

    Drury, Colin

    1992-01-01

    This third edition of a textbook on management and cost accounting features coverage of activity-based costing (ABC), advance manufacturing technologies (AMTs), JIT, MRP, target costing, life-cycle costing, strategic management accounting, total quality management and customer profitability analysis. Also included are revised and new end-of-chapter problems taken from past examination papers of CIMA, ACCA and ICAEW. There is increased reference to management accounting in practice, including many of the results of the author's CIMA sponsored survey, and greater emphasis on operational control and performance measurement.

  16. Engine costs for reusability

    Science.gov (United States)

    Schindler, Carla M.; Lansaw, John

    1990-01-01

    The advanced Launch System (ALS) program goals demand an order-of-magnitude reduction in costs over existing launch vehicle propulsion systems. Studies suggest that reusable engines provide cost advantages over expendable propulsion systems. Early studies are quantifying operations costs, and cost sensitivities to engine production and operations variables. ALS production and operations philosophies enhance the potential of an affordable, operationally flexible launch vehicle propulsion system. The assumptions made and criteria set during the initial planning for the operations phase of the ALS highlight the changes for implementing such a system.

  17. Cost model for biobanks.

    Science.gov (United States)

    Gonzalez-Sanchez, M Beatriz; Lopez-Valeiras, Ernesto; Morente, Manuel M; Fernández Lago, Orlando

    2013-10-01

    Current economic conditions and budget constraints in publicly funded biomedical research have brought about a renewed interest in analyzing the cost and economic viability of research infrastructures. However, there are no proposals for specific cost accounting models for these types of organizations in the international scientific literature. The aim of this paper is to present the basis of a cost analysis model useful for any biobank regardless of the human biological samples that it stores for biomedical research. The development of a unique cost model for biobanks can be a complicated task due to the diversity of the biological samples they store. Different types of samples (DNA, tumor tissues, blood, serum, etc.) require different production processes. Nonetheless, the common basic steps of the production process can be identified. Thus, the costs incurred in each step can be analyzed in detail to provide cost information. Six stages and four cost objects were obtained by taking the production processes of biobanks belonging to the Spanish National Biobank Network as a starting point. Templates and examples are provided to help managers to identify and classify the costs involved in their own biobanks to implement the model. The application of this methodology will provide accurate information on cost objects, along with useful information to give an economic value to the stored samples, to analyze the efficiency of the production process and to evaluate the viability of some sample collections.

  18. Avoidable waste management costs

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, K.; Burns, M.; Priebe, S.; Robinson, P.

    1995-01-01

    This report describes the activity based costing method used to acquire variable (volume dependent or avoidable) waste management cost data for routine operations at Department of Energy (DOE) facilities. Waste volumes from environmental restoration, facility stabilization activities, and legacy waste were specifically excluded from this effort. A core team consisting of Idaho National Engineering Laboratory, Los Alamos National Laboratory, Rocky Flats Environmental Technology Site, and Oak Ridge Reservation developed and piloted the methodology, which can be used to determine avoidable waste management costs. The method developed to gather information was based on activity based costing, which is a common industrial engineering technique. Sites submitted separate flow diagrams that showed the progression of work from activity to activity for each waste type or treatability group. Each activity on a flow diagram was described in a narrative, which detailed the scope of the activity. Labor and material costs based on a unit quantity of waste being processed were then summed to generate a total cost for that flow diagram. Cross-complex values were calculated by determining a weighted average for each waste type or treatability group based on the volume generated. This study will provide DOE and contractors with a better understanding of waste management processes and their associated costs. Other potential benefits include providing cost data for sites to perform consistent cost/benefit analysis of waste minimization and pollution prevention (WMIN/PP) options identified during pollution prevention opportunity assessments and providing a means for prioritizing and allocating limited resources for WMIN/PP.

  19. Successfulness of bus rapid transit systems in Asia. Ex-post evaluation

    NARCIS (Netherlands)

    Kogdenko, Nadja

    2010-01-01

    SUMMARY Bus Rapid Transit (BRT) can be defined as “a bus-based mass transit system that delivers fast, comfortable, and cost-effective urban mobility”. It offers the opportunity to create a high-quality mass transit system at affordable costs, which is p

  20. Rosa damascena decreased mortality in adult Drosophila.

    Science.gov (United States)

    Jafari, Mahtab; Zarban, Asghar; Pham, Steven; Wang, Thomas

    2008-03-01

    The effects of a rose-flower extract, Rosa damascena, on the mortality rate of Drosophila melanogaster was evaluated in this study. R. damascena is a potent antioxidant that has many therapeutic uses in addition to its perfuming effects. Supplementing Drosophila with this rose extract resulted in a statistically significant decrease in mortality rate in male and female flies. Moreover, the observed anti-aging effects were not associated with common confounds of anti-aging properties, such as a decrease in fecundity or metabolic rate.

  1. Rapid response manufacturing (RRM). Final CRADA report

    Energy Technology Data Exchange (ETDEWEB)

    Cain, W.D. [Lockheed Martin Energy Systems, Inc., Oak Ridge, TN (United States); Waddell, W.L. [National Centers for Manufacturing Sciences, Ann Arbor, MI (United States)

    1998-02-10

    US industry is fighting to maintain its competitive edge in the global market place. Markets fluctuate rapidly. Companies have to be able to respond quickly with improved, high quality, cost efficient products. Because companies and their suppliers are geographically distributed, rapid product realization is dependent on the development of a secure integrated concurrent engineering environment operating across multiple business entities. The way products are developed and brought to market can be improved and made more efficient through the proper incorporation of emerging technologies implemented in a secure environment. This documents the work done under this CRADA to develop capabilities, which permit the effective application, incorporation, and use of advanced technologies in a secure environment to facilitate the product realization process. Lockheed Martin Energy Systems (LMES), through a CRADA with the National Center for Manufacturing Sciences (NCMS), worked within a consortium of major industrial firms--Ford, General Motors, Texas Instruments, United Technologies, and Eastman Kodak--and several small suppliers of advanced manufacturing technology--MacNeal-Schwendler Corp., Teknowledge Corp., Cimplex Corp., Concentra, Spatial Technology, and Structural Dynamics Research Corp. (SDRC)--to create infrastructure to support the development and implementation of secure engineering environments for Rapid Response Manufacturing. The major accomplishment achieved under this CRADA was the demonstration of a prototypical implementation of a broad-based generic framework for automating and integrating the design-to-manufacturing activities associated with machined parts in a secure NWC compliant environment. Specifically, methods needed to permit the effective application, incorporation, and use of advanced technologies in a secure environment to facilitate the product realization process were developed and demonstrated. An important aspect of this demonstration was

  2. Blood lactate accumulation decreases during the slow component of oxygen uptake without a decrease in muscular efficiency.

    Science.gov (United States)

    O'Connell, J M; Weir, J M; MacIntosh, B R

    2017-05-26

    Pulmonary oxygen uptake ([Formula: see text]) slowly increases during exercise above the anaerobic threshold, and this increase is called the slow component of [Formula: see text]. The mechanism of the increase in [Formula: see text] is assumed to be due to increasing energy cost associated with increasingly inefficient muscle contraction. We hypothesized that the increase in [Formula: see text] would be accompanied by a constant or increasing rate of accumulation of blood lactate, indicating sustained anaerobic metabolism while [Formula: see text] increased. Ten male subjects performed cycle ergometry for 3, 6, and 9 min at a power output representing 60% of the difference between lactate threshold and maximal [Formula: see text] while [Formula: see text] and blood lactate accumulation were measured. Blood lactate accumulation decreased over time, providing the energy equivalent of (mean ± SD) 1586 ± 265, 855 ± 287, and 431 ± 392 ml of [Formula: see text] during 0-3, 3-6, and 6-9 min of exercise, respectively. As duration progressed, [Formula: see text] supplied 86.3 ± 2.0, 93.6 ± 1.9, and 96.8 ± 2.9% of total energy from 0 to 3, 3 to 6, and 6 to 9 min, respectively, while anaerobic contribution decreased. There was no change in total energy cost after 3 min, except that required by ventilatory muscles for the progressive increase in ventilation. The slow component of [Formula: see text] is accompanied by decreasing anaerobic energy contribution beyond 3 min during heavy exercise.

  3. Antiepileptic Drug Titration and Related Health Care Resource Use and Costs.

    Science.gov (United States)

    Fishman, Jesse; Kalilani, Linda; Song, Yan; Swallow, Elyse; Wild, Imane

    2018-02-27

    Unexpected breakthrough seizures resulting from suboptimal antiepileptic drug (AED) dosing during the titration period, as well as adverse events resulting from rapid AED titration, may influence the titration schedule and significantly increase health care resource use (HRU) and health care costs. To assess the relationship between AEDs, HRU, and costs during AED titration and maintenance. Practicing neurologists were recruited from a nationwide panel to provide up to 3 patient records each for this retrospective medical chart review. Patients with epilepsy who were aged ≥ 18 years and had initiated an AED between January 1, 2014, and January 1, 2016, were followed for 6 months from AED initiation. Titration duration was the time from AED initiation to the beginning of treatment maintenance as determined by the physician. Outcomes were epilepsy-specific HRU (hospitalizations, emergency department visits, outpatient visits, physician referral, laboratory testing/diagnostic imaging, and phone calls) and related costs that occurred during the titration or maintenance treatment periods. Of 811 patients, 156, 128, 125, 120, 114, 107, and 61 initiated the following AEDs: levetiracetam, lamotrigine, lacosamide, valproate, topiramate, carbamazepine, and phenytoin, respectively. Most patients (619/803 [77.1%] with complete AED data) received monotherapy. Baseline characteristics were similar across AEDs (mean [SD] age, 36.6 [14.4] years; 59.0% male). Kaplan-Meier estimates of titration duration ranged from 3.3 weeks (phenytoin) to 8.1 weeks (lamotrigine). From titration to maintenance, the overall incidence of HRU per person-month decreased 54.5%-89.3% for each HRU measure except outpatient visits (24.6% decrease). Total epilepsy-related costs decreased from $80.48 to $42.77 per person-month, or 46.9% from titration to maintenance. AED titration periods had higher HRU rates and costs than AED maintenance, suggesting that use of AEDs with shorter titration requirements

  4. What Does it Really Cost? Allocating Indirect Costs.

    Science.gov (United States)

    Snyder, Herbert; Davenport, Elisabeth

    1997-01-01

    Better managerial control in terms of decision making and understanding the costs of a system/service result from allocating indirect costs. Allocation requires a three-step process: selecting cost objectives, pooling related overhead costs, and selecting costs bases to connect the objectives to the pooled costs. Argues that activity-based costing…

  5. A Rapid Process for Fabricating Gas Sensors

    Directory of Open Access Journals (Sweden)

    Chun-Ching Hsiao

    2014-07-01

    Full Text Available Zinc oxide (ZnO is a low-toxicity and environmentally-friendly material applied on devices, sensors or actuators for “green” usage. A porous ZnO film deposited by a rapid process of aerosol deposition (AD was employed as the gas-sensitive material in a CO gas sensor to reduce both manufacturing cost and time, and to further extend the AD application for a large-scale production. The relative resistance change (△R/R of the ZnO gas sensor was used for gas measurement. The fabricated ZnO gas sensors were measured with operating temperatures ranging from 110 °C to 180 °C, and CO concentrations ranging from 100 ppm to 1000 ppm. The sensitivity and the response time presented good performance at increasing operating temperatures and CO concentrations. AD was successfully for applied for making ZnO gas sensors with great potential for achieving high deposition rates at low deposition temperatures, large-scale production and low cost.

  6. Integrating rapid diagnostics and antimicrobial stewardship improves outcomes in patients with antibiotic-resistant Gram-negative bacteremia.

    Science.gov (United States)

    Perez, Katherine K; Olsen, Randall J; Musick, William L; Cernoch, Patricia L; Davis, James R; Peterson, Leif E; Musser, James M

    2014-09-01

    An intervention for Gram-negative bloodstream infections that integrated mass spectrometry technology for rapid diagnosis with antimicrobial stewardship oversight significantly improved patient outcomes and reduced hospital costs. As antibiotic resistance rates continue to grow at an alarming speed, the current study was undertaken to assess the impact of this intervention in a challenging patient population with bloodstream infections caused by antibiotic-resistant Gram-negative bacteria. A total of 153 patients with antibiotic-resistant Gram-negative bacteremia hospitalized prior to the study intervention were compared to 112 patients treated post-implementation. Outcomes assessed included time to optimal antibiotic therapy, time to active treatment when inactive, hospital and intensive care unit length of stay, all-cause 30-day mortality, and total hospital expenditures. Integrating rapid diagnostics with antimicrobial stewardship improved time to optimal antibiotic therapy (80.9 h in the pre-intervention period versus 23.2 h in the intervention period, P Gram-negatives. The intervention decreased hospital and intensive care unit length of stay, total hospital costs, and reduced all-cause 30-day mortality. Copyright © 2014. Published by Elsevier Ltd.

  7. COST OF ADDRESSING TARGETS OF UNEQUAL VALUE

    Energy Technology Data Exchange (ETDEWEB)

    G.H. CANAVAN

    2001-08-01

    The formalism for evaluating first strike costs and incentives for military targeting generalize to include higher value targets. That introduces two new allocations to the usual allocation between missiles and military targets, but they can be performed analytically. As the number of weapons on each side decreases, the optimal fraction of second strike weapons allocated to military values falls. The shift to high value targets is more pronounced below about 1,000 weapons for nominal parameters. Below 500 weapons the first striker's cost of action drops below its cost of inaction. A strike would induce a second strike of about 250 weapons on high value targets. An increase in the first striker's preference for damage to the other's high value targets increases or a decrease in its preference for preventing damage to its own high value targets decreases first strike costs and stability margins. Including defenses complicates allocations slightly. The main effect is increased attrition of second strikes, particularly at larger defenses, which makes it possible to significantly reduce damage to high value targets. At 1,000 weapons, by 300 to 400 interceptors the first striker's costs are reduced to 30% below that of inaction and the number of weapons delivered on the first striker's high value targets is reduced to about 100.

  8. Activity-based costing methodology as tool for costing in hematopathology laboratory.

    Science.gov (United States)

    Gujral, Sumeet; Dongre, Kanchan; Bhindare, Sonal; Subramanian, P G; Narayan, Hkv; Mahajan, Asim; Batura, Rekha; Hingnekar, Chitra; Chabbria, Meenu; Nair, C N

    2010-01-01

    Cost analysis in laboratories represents a necessary phase in their scientific progression. To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL). Activity-based costing (ABC) method is used to calculate per cost test of the hematopathology laboratory. Information is collected from registers, purchase orders, annual maintenance contracts (AMCs), payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC), bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

  9. Rapid Prediction of Configuration Aerodynamics in the ConceptualDesign Phase

    Directory of Open Access Journals (Sweden)

    C. Munro

    2001-01-01

    Full Text Available Conceptual aircraft design is characterised by the requirement to analyse a large number of configurations rapidly and cost effectively. For unusual configurations such as those typified by unmanned combat air vehicles (UCAVs adequately predicting their aerodynamic characteristics through existing empirical methods is fraught with uncertainty. By utilising rapid and low cost experimental tools such as the water tunnel and subscale flight testing it is proposed that the required aerodynamic characteristics can rapidly be acquired with sufficient fidelity for the conceptual design phase. Furthermore, the initial design predictions can to some extent be validated using flight-derived aerodynamic data from subscale flight testing.

  10. Rapid socio-cultural change and health in the Arctic

    DEFF Research Database (Denmark)

    Bjerregaard, P

    2001-01-01

    health and survival have improved but at the expense of mental health. The incidence of tuberculosis and the infant mortality rate have decreased because of improved socioeconomic conditions and health care. Mental health has deteriorated parallel to the rapid modernization of Greenlandic society...

  11. Elevated plasma homocysteine in association with decreased ...

    African Journals Online (AJOL)

    Conclusion: This study showed a significant increase in plasma tHcy coexisting with a decrease in plasma vitamin B12 TC, LDLC and HDLC, in depressed patients. Increased plasma homocysteine could be a sensitive indicator of plasma B vitamin deficiency. Keywords: Cholesterol; Depression; Homocysteine; Tryptophan; ...

  12. Aggregate Unemployment Decreases Individual Returns to Education

    Science.gov (United States)

    Ammermueller, Andreas; Kuckulenz, Anja; Zwick, Thomas

    2009-01-01

    Aggregate unemployment may affect individual returns to education through qualification-specific responses in participation and wage bargaining. This paper shows that an increase in regional unemployment by 1% decreases returns to education by 0.005 percentage points. This implies that higher skilled employees are better sheltered from labour…

  13. Decreasing Smoking Behavior through Subliminal Stimulation Treatments.

    Science.gov (United States)

    Glover, Elbert D.

    1979-01-01

    Determines whether subliminal perception can be used as a means for altering cigarette smoking behavior. Smoking behavior was not altered through subliminal perception as carried out in this study. There was evidence that smoking behavior was altered, but it was an unpredicted change. Some subjects decreased smoking patterns. (Author)

  14. Autoimmune Response Confers Decreased Cardiac Function in ...

    African Journals Online (AJOL)

    Purpose: To explore the effect of autoimmune response on the decreased cardiac function in patients with rheumatic mitral lesion following valve replacement. Methods: In this case-controlled study, 29 patients who had undergone valve replacement as a result of mitral lesion were enrolled (mean age = 48.7 years). Twenty ...

  15. Elevated plasma homocysteine in association with decreased ...

    African Journals Online (AJOL)

    monoamine neurotransmitters and depression of mood.7 A. Elevated plasma homocysteine in association with decreased vitamin. B12, folate, serotonin, lipids and lipoproteins in depressed patients. MO Ebesunun1, HU Eruvulobi1, T Olagunju1, OA Owoeye2. 1Chemical Pathology, Obafemi Awolowo College of Health ...

  16. Decreasing prevalence of social drinkers in Australia.

    Science.gov (United States)

    Callinan, Sarah; Pennay, Amy; Livingston, Michael

    2017-04-01

    There has been a recent decrease in population level alcohol consumption in Australia, particularly in young people. Whether this is due to increasing abstinence or a shift in the way people think about alcohol is not known. The aim of this study is to investigate trends in self-identification of drinker types in Australia from 2001 to 2013 in light of shifting patterns of alcohol consumption in Australia. Five waves of the National Drug Strategy Household Survey from 2001 to 2013 (N=118,416) were used to assess trends in self-identification as a drinker type (non-, ex-, occasional, light, social, heavy and binge drinker). Consumption patterns and demographics of the self-identified groups were also examined. The pattern of self-identification has mostly remained steady over time. The two exceptions to this are a decrease in identification as a social drinker (28% to 22%) and a corresponding increase in identification as a non-drinker (from 19% to 27%). There are few changes over time in the demographic make-up of, or consumption patterns in, the social drinker category with the exception of those over 50, who continue to identify as social drinkers at the same rate. The recent increase in abstinence in Australia seems to be matched by a corresponding decrease in self-identified social drinkers, particularly among those under 50. This indicates that the decrease in consumption is not occurring in those most likely to experience harms. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Preavoidance hypercapnia and decreased hematocrit in micropigs.

    Science.gov (United States)

    Anderson, D E; Fedorova, O V; French, A W

    1996-01-01

    Previous studies found that regular confinement of dogs in an experimental environment preceding onset of an avoidance task was associated with increases in blood pressure and decreases in heart rate and respiration rate that were not prevented by adrenergic antagonists. The present study investigated a) whether divergent changes in blood pressure and heart rate also occur in micropigs preceding onset of an avoidance task, and b) the nature of changes in blood gases, plasma pH, plasma bicarbonate, hematocrit, and plasma electrolytes observed under these conditions. Blood pressure increased and heart rate decreased during 2-h preavoidance periods, whereas both blood pressure and heart rate were elevated during 20-min avoidance periods. During preavoidance periods, pO2, plasma pH, and plasma potassium pCO2 were decreased below home kennel levels during early preavoidance, whereas pCO2 and plasma bicarbonate were persistently increased and hematocrit was persistently decreased for the duration of the preavoidance periods. Each of these changes was reversed during the avoidance sessions. These findings suggest that behaviorally induced hypercapnia might participate in blood pressure regulation via increased renal sodium/hydrogen exchange and renal sodium retention.

  18. Cost in Higher Education

    Science.gov (United States)

    2007-06-01

    standardize methodology and accountability used nationwide by institutions of higher education . The aim is to review existing cost criteria and procedures...task. The objective of this research is to look into the cost structure used presently by two institutions of higher education , namely the Naval

  19. Supply Chain Costing

    DEFF Research Database (Denmark)

    Asmussen, Jesper Normann; Kristensen, Jesper; Wæhrens, Brian Vejrum

    Based Costing (ABC) på et forsyningskædeniveau – heri benævnt Supply Chain Costing (SCC). Udoverdefordelederfindesved ABCtilføjerSCCogså et økonomisk grundlag til det strategiske rationale, der ofte ligger bag opbygningen af virksomhedens forsyningskæde, og kan dermed medvirke til konkret...

  20. COST CONTROL SYSTEM

    Directory of Open Access Journals (Sweden)

    S. V. Маrtseva

    2009-01-01

    Full Text Available The paper considers methodology for formation of product cost while applying «direct-costing» system. It has been shown that the application of the given system permits economically to justify and accurately to determine financial results of an enterprise activity which is planned for the future.

  1. Managing Ongoing EVSE Costs

    Energy Technology Data Exchange (ETDEWEB)

    Hodge, Cabell [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-05

    The costs associated with EVSE begin with picking the best location and unit for the job, but they continue with electricity and network charges through the life of your vehicle. This presentation tells how to balance electricity demand charges and network management costs through smart planning at your program's inception.

  2. Rapid grading of fundus photographs for diabetic retinopathy using crowdsourcing.

    Science.gov (United States)

    Brady, Christopher J; Villanti, Andrea C; Pearson, Jennifer L; Kirchner, Thomas R; Gupta, Omesh P; Shah, Chirag P

    2014-10-30

    Screening for diabetic retinopathy is both effective and cost-effective, but rates of screening compliance remain suboptimal. As screening improves, new methods to deal with screening data may help reduce the human resource needs. Crowdsourcing has been used in many contexts to harness distributed human intelligence for the completion of small tasks including image categorization. Our goal was to develop and validate a novel method for fundus photograph grading. An interface for fundus photo classification was developed for the Amazon Mechanical Turk crowdsourcing platform. We posted 19 expert-graded images for grading by Turkers, with 10 repetitions per photo for an initial proof-of-concept (Phase I). Turkers were paid US $0.10 per image. In Phase II, one prototypical image from each of the four grading categories received 500 unique Turker interpretations. Fifty draws of 1-50 Turkers were then used to estimate the variance in accuracy derived from randomly drawn samples of increasing crowd size to determine the minimum number of Turkers needed to produce valid results. In Phase III, the interface was modified to attempt to improve Turker grading. Across 230 grading instances in the normal versus abnormal arm of Phase I, 187 images (81.3%) were correctly classified by Turkers. Average time to grade each image was 25 seconds, including time to review training images. With the addition of grading categories, time to grade each image increased and percentage of images graded correctly decreased. In Phase II, area under the curve (AUC) of the receiver-operator characteristic (ROC) indicated that sensitivity and specificity were maximized after 7 graders for ratings of normal versus abnormal (AUC=0.98) but was significantly reduced (AUC=0.63) when Turkers were asked to specify the level of severity. With improvements to the interface in Phase III, correctly classified images by the mean Turker grade in four-category grading increased to a maximum of 52.6% (10/19 images

  3. Rapid Prototyping of Field Programmable Gate Array-Based Discrete Cosine Transform Approximations

    Directory of Open Access Journals (Sweden)

    Trevor W. Fox

    2003-05-01

    Full Text Available A method for the rapid design of field programmable gate array (FPGA-based discrete cosine transform (DCT approximations is presented that can be used to control the coding gain, mean square error (MSE, quantization noise, hardware cost, and power consumption by optimizing the coefficient values and datapath wordlengths. Previous DCT design methods can only control the quality of the DCT approximation and estimates of the hardware cost by optimizing the coefficient values. It is shown that it is possible to rapidly prototype FPGA-based DCT approximations with near optimal coding gains that satisfy the MSE, hardware cost, quantization noise, and power consumption specifications.

  4. Cost of stroke

    DEFF Research Database (Denmark)

    Jennum, Poul; Iversen, Helle K; Ibsen, Rikke

    2015-01-01

    BACKGROUND: To estimate the direct and indirect costs of stroke in patients and their partners. DESCRIPTION: Direct and indirect costs were calculated using records from the Danish National Patient Registry from 93,047 ischemic, 26,012 hemorrhagic and 128,824 unspecified stroke patients...... and compared with 364,433, 103,741 and 500,490 matched controls, respectively. RESULTS: Independent of age and gender, stroke patients had significantly higher rates of mortality, health-related contacts, medication use and lower employment, lower income and higher social-transfer payments than controls....... The attributable cost of direct net health care costs after the stroke (general practitioner services, hospital services, and medication) and indirect costs (loss of labor market income) were €10,720, €8,205 and €7,377 for patients, and €989, €1,544 and €1.645 for their partners, over and above that of controls...

  5. High Reliability Pediatric Septic Shock Quality Improvement Initiative and Decreasing Mortality.

    Science.gov (United States)

    Lane, Roni D; Funai, Tomohiko; Reeder, Ron; Larsen, Gitte Y

    2016-10-01

    Septic shock impacts mortality, morbidity, and health care costs. A quality improvement (QI) initiative was launched to improve early recognition and timely treatment of patients with septic shock in a pediatric emergency department (PED). Our primary aim was to describe the longitudinal effectiveness of the program, iterative changes in clinical practice, and associated outcomes. We implemented multiple interventions during our QI initiative (February 2007 to December 2014). Analysis of compliance and outcomes focused on a bundle consisting of: (1) timely antibiotics, (2) intravenous fluids (IVF) for rapid reversal of perfusion abnormalities and/or hypotension. Logistic regression was used to obtain adjusted odds ratios (ORs) for death and pediatric ICU (PICU) admission. A total of 1380 patients were treated for septic shock; 93% met screening criteria at triage. Implementation of the various processes improved timely interventions. One example included implementation of a sepsis order set, after which the mean proportion of patients receiving timely antibiotics increased to its highest rate. The odds of death were 5 times as high for children who did not receive bundle-compliant care (OR, 5.0 [95% Confidence Interval 1.9, 14.3]) compared with those who did (OR, 0.20 [95% Confidence Interval 0.07, 0.53]). Among PICU admitted patients, the odds of mortality were greater for children who presented with abnormal mental status and a higher pediatric index of mortality 2 score. QI methodology improved septic shock program goal adherence and decreased mortality without increasing PICU admissions or PED length of stay over the 8-year period, supporting continued emphasis on early recognition, timely IVF resuscitation, and antibiotic administration. Copyright © 2016 by the American Academy of Pediatrics.

  6. What caused the rapid recovery of the Carrington storm?

    Science.gov (United States)

    Keika, Kunihiro; Ebihara, Yusuke; Kataoka, Ryuho

    2015-05-01

    The geomagnetic storm during the Carrington event, which occurred on 2 September 1859, displayed extremely rapid recovery. The geomagnetic field increased by approximately 650 nT/h at Bombay, India, and by >300 nT/h in 1-h averaged data. Although the rapid recovery is considered due to a sudden increase in the magnetopause current, a sudden decrease of the ring current, or/and a sudden enhancement of the ionospheric currents, this study focuses on the ring current decay. The Carrington rapid recovery had a time constant (approximately 1 h) comparable to the storm development (i.e., decrease in the geomagnetic field), indicating that energy loss from the ring current region is predominantly controlled by E × B convection transport which is responsible for energy input during the storm main phase. This feature has led us to a hypothesis that the flow-out of dense ring current ions and injections of tenuous plasma sheet ions caused the rapid decay of the ring current and in turn the storm rapid recovery. This study examines whether the Carrington rapid recovery can be explained by the flow-out effect. We extend the empirical Burton's model to a model that takes into consideration a sudden change in solar wind density which is correlated with plasma sheet density. We first apply the extended Burton's model to previously observed four intense magnetic storms (Dst minimum solar wind data are available. Using the best fit parameters found by forward modeling, the extended model estimates the recovery of the Carrington storm. The estimate indicates that a solar wind structure with a density bump by approximately 100 cm-3 (and southward interplanetary magnetic field (IMF) of 65 nT and solar wind speed of 1,500 km/s) can cause the rapid recovery under a continuous southward IMF condition. We conclude that the flow-out effect plays a significant role in producing the rapid recovery of the Carrington storm.

  7. Pros, Cons, and Alternatives to Weight Based Cost Estimating

    Science.gov (United States)

    Joyner, Claude R.; Lauriem, Jonathan R.; Levack, Daniel H.; Zapata, Edgar

    2011-01-01

    Many cost estimating tools use weight as a major parameter in projecting the cost. This is often combined with modifying factors such as complexity, technical maturity of design, environment of operation, etc. to increase the fidelity of the estimate. For a set of conceptual designs, all meeting the same requirements, increased weight can be a major driver in increased cost. However, once a design is fixed, increased weight generally decreases cost, while decreased weight generally increases cost - and the relationship is not linear. Alternative approaches to estimating cost without using weight (except perhaps for materials costs) have been attempted to try to produce a tool usable throughout the design process - from concept studies through development. This paper will address the pros and cons of using weight based models for cost estimating, using liquid rocket engines as the example. It will then examine approaches that minimize the impct of weight based cost estimating. The Rocket Engine- Cost Model (RECM) is an attribute based model developed internally by Pratt & Whitney Rocketdyne for NASA. RECM will be presented primarily to show a successful method to use design and programmatic parameters instead of weight to estimate both design and development costs and production costs. An operations model developed by KSC, the Launch and Landing Effects Ground Operations model (LLEGO), will also be discussed.

  8. Economic Rationality of On-Orbit Servicing by Reduction of Transportation Cost

    Science.gov (United States)

    Akiyama, Yasuhiro; Inatani, Yoshifumi

    The costs of transportation from the Earth to the orbit are very high. Decreasing the transportation costs should increase the launch market significantly. However, the objective of transportation costs is ambiguous and few studies have examined the relationship between transportation costs and commercial profits of businesses. On-Orbit Servicing (OOS) is a business that could profit from lower transportation costs, and we quantified the relationship between costs and profitability for this business. Real-coded Adaptive Range Genetic Algorithm optimized the OOS method. The results showed that the revenues generated by OOS would support the outlay required to decrease transportation costs.

  9. Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries.

    Science.gov (United States)

    Marseille, Elliot; Jiwani, Aliya; Raut, Abhishek; Verguet, Stéphane; Walson, Judd; Kahn, James G

    2014-06-26

    This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases. We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer's perspective, discounted costs and DALYs at 3% per year and denominated cost in 2012 US dollars. The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted. Implementation of the IPC in the 10 most cost-effective countries at 15% population coverage would cost US$583 million over 3 years (adjusted costs of US$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15% coverage would cost an adjusted US$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US$119, US$181, US$335, US$1692 and US$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness. IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health

  10. Construction Noise Decreases Reproductive Efficiency in Mice

    Science.gov (United States)

    Rasmussen, Skye; Glickman, Gary; Norinsky, Rada; Quimby, Fred W; Tolwani, Ravi J

    2009-01-01

    Excessive noise is well known to impair rodent health. To better understand the effect of construction noise and to establish effective noise limits during a planned expansion of our vivarium, we analyzed the effects of construction noise on mouse gestation and neonatal growth. Our hypothesis was that high levels of construction noise would reduce the number of live births and retard neonatal growth. Female Swiss Webster mice were individually implanted with 15 B6CBAF1/J embryos and then exposed to 70- and 90-dBA concrete saw cutting noise samples at defined time points during gestation. In addition, groups of mice with litters were exposed to noise at 70, 80, or 90 dBA for 1 h daily during the first week after parturition. Litter size, birth weight, incidence of stillborn pups, and rate of neonatal weight gain were analyzed. Noise decreased reproductive efficiency by decreasing live birth rates and increasing the number of stillborn pups. PMID:19653943

  11. Hemodilution causes decreased compliance in puppies.

    Science.gov (United States)

    Mavroudis, C; Ebert, P A

    1978-09-01

    Cardiopulmonary bypass and hemodilution in the newborn have been associated with increased myocardial edema, which may be due to immature connective tissue formation. Five adult and four puppy dogs were placed on bypass while compliance and ventricular function (intraventricular balloon) were measured during normohemoconcentration (NH) (hematocrit 45.1, osmolality 307) and hemodilution with normal saline (hematocrit 24.7, osmolality 307). Compared with NH, the adult group showed no change in compliance or function after 90 min of hemodilution. The puppy group showed a marked decrease in compliance with hemodilution compared to NH (P sensitive to edema formation than the adult during hemodilution and that filling pressures do not necessarily reflect ventricular performance during the early post-perfusion period when compliance is decreased.

  12. Composites by rapid prototyping technology

    CSIR Research Space (South Africa)

    Kumar, S

    2010-02-01

    Full Text Available powder is a fiber, problems of manufacturing occur. The method has also been used to make Metal Matrix Composite (MMC), e.g Fe and graphite [17], WC-Co [18,19], WC-Co and Cu [20,21], Fe, Ni and TiC [22] etc and Ceramic Matrix Composite (CMC) e.g. Si... of various materials used. Key words: : Rapid Prototyping (RP), Laser, Composites 1 Introduction Rapid Prototyping (RP) initially focussed on polymers. These were later re- placed/supplemented by ceramics, metals and composites. Composites are used in RP...

  13. Decreased Fecundity and Sperm DNA Methylation Patterns

    Science.gov (United States)

    Jenkins, Timothy G.; Aston, Kenneth I.; Meyer, Tyson D.; Hotaling, James M.; Shamsi, Monis B.; Johnstone, Erica B.; Cox, Kyley J.; Stanford, Joseph B.; Porucznik, Christina A.; Carrell, Douglas T.

    2016-01-01

    Objective To evaluate the relationship between epigenetic patterns in sperm and fecundity. Design Prospective study of couples trying to conceive, utilizing semen samples collected through the HOPE study, at the University of Utah. Setting Academic Andrology and IVF Laboratory Patients DNA methylation alterations associated with fecundity were analyzed in 124 semen samples. 27 semen samples from couples who conceived within 2 months of attempting a pregnancy and a total of 29 semen samples from couples who were unable to achieve a pregnancy within 12 months were analyzed to identify regions of interest. Interventions None. Main Outcome Measures Genome-wide assessment of differential sperm DNA methylation and standard semen analysis. Results No differences in sperm count, sperm morphology, or semen volume were observed between the patients achieving a pregnancy within 2 months of study time and those not obtaining a pregnancy within 12 months. However, using data from the Human Methylation 450k array analysis we did identify 2 genomic regions with significantly decreased (FDR <0.01) methylation and 3 genomic regions with significantly increased methylation in the “failure-to-conceive” group. Interestingly, the only two sites where decreased methylation was associated with reduced fecundity are at closely related genes known to be expressed in sperm, HSPA1L and HSPA1B. Conclusions Our data suggest that there are genomic loci where DNA methylation alterations are associated with decreased fecundity. We have thus identified candidate loci for future study to verify these results and investigate the causative or contributory relationship between altered sperm methylation and decreased fecundity. PMID:26453269

  14. Cost and Cost-Effectiveness of Students for Nutrition and eXercise (SNaX).

    Science.gov (United States)

    Ladapo, Joseph A; Bogart, Laura M; Klein, David J; Cowgill, Burton O; Uyeda, Kimberly; Binkle, David G; Stevens, Elizabeth R; Schuster, Mark A

    2016-04-01

    To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Five intervention and 5 control middle schools (mean enrollment, 1520 students) from the Los Angeles Unified School District participated in a randomized controlled trial of SNaX. Acquisition costs for materials and time and wage data for employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined using the ratio of variable costs to program efficacy outcomes. The costs of implementing the program over 5 weeks were $5433.26 per school in fixed costs and $2.11 per student in variable costs, equaling a total cost of $8637.17 per school, or $0.23 per student per day. This investment yielded significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks. The cost-effectiveness of the program, per student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per additional full-priced lunch served, $2.11 per additional reduced-price/free lunch served, and $1.69 per reduction in snacks sold. SNaX demonstrated the feasibility and cost-effectiveness of a middle school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost is modest and unlikely to be a significant barrier to adoption for many schools considering its implementation. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  15. Global mortality from storm surges is decreasing

    Science.gov (United States)

    Bouwer, Laurens M.; Jonkman, Sebastiaan N.

    2018-01-01

    Changes in society’s vulnerability to natural hazards are important to understand, as they determine current and future risks, and the need to improve protection. Very large impacts including high numbers of fatalities occur due to single storm surge flood events. Here, we report on impacts of global coastal storm surge events since the year 1900, based on a compilation of events and data on loss of life. We find that over the past, more than eight thousand people are killed and 1.5 million people are affected annually by storm surges. The occurrence of very substantial loss of life (>10 000 persons) from single events has however decreased over time. Moreover, there is a consistent decrease in event mortality, measured by the fraction of exposed people that are killed, for all global regions, except South East Asia. Average mortality for storm surges is slightly higher than for river floods, but lower than for flash floods. We also find that for the same coastal surge water level, mortality has decreased over time. This indicates that risk reduction efforts have been successful, but need to be continued with projected climate change, increased rates of sea-level rise and urbanisation in coastal zones.

  16. Decreased prefrontal cortical dopamine transmission in alcoholism.

    Science.gov (United States)

    Narendran, Rajesh; Mason, Neale Scott; Paris, Jennifer; Himes, Michael L; Douaihy, Antoine B; Frankle, W Gordon

    2014-08-01

    Basic studies have demonstrated that optimal levels of prefrontal cortical dopamine are critical to various executive functions such as working memory, attention, inhibitory control, and risk/reward decisions, all of which are impaired in addictive disorders such as alcoholism. Based on this and imaging studies of alcoholism that have demonstrated less dopamine in the striatum, the authors hypothesized decreased dopamine transmission in the prefrontal cortex in persons with alcohol dependence. To test this hypothesis, amphetamine and [11C]FLB 457 positron emission tomography were used to measure cortical dopamine transmission in 21 recently abstinent persons with alcohol dependence and 21 matched healthy comparison subjects. [11C]FLB 457 binding potential, specific compared to nondisplaceable uptake (BPND), was measured in subjects with kinetic analysis using the arterial input function both before and after 0.5 mg kg-1 of d-amphetamine. Amphetamine-induced displacement of [11C]FLB 457 binding potential (ΔBPND) was significantly smaller in the cortical regions in the alcohol-dependent group compared with the healthy comparison group. Cortical regions that demonstrated lower dopamine transmission in the alcohol-dependent group included the dorsolateral prefrontal cortex, medial prefrontal cortex, orbital frontal cortex, temporal cortex, and medial temporal lobe. The results of this study, for the first time, unambiguously demonstrate decreased dopamine transmission in the cortex in alcoholism. Further research is necessary to understand the clinical relevance of decreased cortical dopamine as to whether it is related to impaired executive function, relapse, and outcome in alcoholism.

  17. Chemical Feedback From Decreasing Carbon Monoxide Emissions

    Science.gov (United States)

    Gaubert, B.; Worden, H. M.; Arellano, A. F. J.; Emmons, L. K.; Tilmes, S.; Barré, J.; Martinez Alonso, S.; Vitt, F.; Anderson, J. L.; Alkemade, F.; Houweling, S.; Edwards, D. P.

    2017-10-01

    Understanding changes in the burden and growth rate of atmospheric methane (CH4) has been the focus of several recent studies but still lacks scientific consensus. Here we investigate the role of decreasing anthropogenic carbon monoxide (CO) emissions since 2002 on hydroxyl radical (OH) sinks and tropospheric CH4 loss. We quantify this impact by contrasting two model simulations for 2002-2013: (1) a Measurement of the Pollution in the Troposphere (MOPITT) CO reanalysis and (2) a Control-Run without CO assimilation. These simulations are performed with the Community Atmosphere Model with Chemistry of the Community Earth System Model fully coupled chemistry climate model with prescribed CH4 surface concentrations. The assimilation of MOPITT observations constrains the global CO burden, which significantly decreased over this period by 20%. We find that this decrease results to (a) increase in CO chemical production, (b) higher CH4 oxidation by OH, and (c) 8% shorter CH4 lifetime. We elucidate this coupling by a surrogate mechanism for CO-OH-CH4 that is quantified from the full chemistry simulations.

  18. Keratinocyte Apoptosis is Decreased in Psoriatic Epidermis

    Directory of Open Access Journals (Sweden)

    Fatma Eskioğlu

    2009-12-01

    Full Text Available Background and Design: Abnormal differentiation and hyperproliferation of keratinocytes are the hallmarks of psoriasis vulgaris. Although psoriasis vulgaris is generally accepted as a disease of decreased keratinocyte apoptosis, the results are contradictory. The aim of the current study is to investigate whether decreased keratinocyte apoptosis contributes to the formation of a thickened epidermis as increased keratinocyte proliferation. Material and Method: Forty-three untreated psoriasis vulgaris patients and 20 healthy control subjects were included into the study. Biopsy specimens taken from the enrollee were evaluated by immunohistochemical staining for Ki-67 expressions to show the proliferation of keratinocytes and by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL method to show the apoptotic keratinocytes. Results: Apoptotic index (percentage of the TUNEL positive cells was significantly lower in psoriatic epidermis (0.33±0.64 than in normal epidermis (0.75±0.85; whereas Ki-67 index (percentage of positively staining cells for Ki-67 was significantly higher in psoriatic epidermis (30.86±10.49 than in normal epidermis (11.65±2.98, (p=0.021 and p=0.00; respectively. Conclusion: Decreased keratinocyte apoptosis also contribute to increased epidermal thickness in psoriasis as well as increased keratinocyte proliferation.

  19. Rapid Conditioning for the Next Generation Melting System

    Energy Technology Data Exchange (ETDEWEB)

    Rue, David M. [Gas Technology Institute, Des Plaines, IL (United States)

    2015-06-17

    This report describes work on Rapid Conditioning for the Next Generation Melting System under US Department of Energy Contract DE-FC36-06GO16010. The project lead was the Gas Technology Institute (GTI). Partners included Owens Corning and Johns Manville. Cost share for this project was provided by NYSERDA (the New York State Energy Research and Development Authority), Owens Corning, Johns Manville, Owens Illinois, and the US natural gas industry through GTI’s SMP and UTD programs. The overreaching focus of this project was to study and develop rapid refining approaches for segmented glass manufacturing processes using high-intensity melters such as the submerged combustion melter. The objectives of this project were to 1) test and evaluate the most promising approaches to rapidly condition the homogeneous glass produced from the submerged combustion melter, and 2) to design a pilot-scale NGMS system for fiberglass recycle.

  20. Information and the Cost of Capital: An Ex Ante Perspective

    DEFF Research Database (Denmark)

    Christensen, Peter Ove; de la Rosa, Leonidas Enrique; Feltham, Gerald A.

    2010-01-01

    Recent articles have demonstrated that increased public disclosure can decrease firms' cost of capital. The focus has been on the impact of information on the cost of capital subsequent to the release of the information (the ex post cost of capital). We show that the reduction in the ex post cost...... of capital is offset by an equal increase in the cost of capital for the period leading up to the release of the information (the preposterior cost of capital). Thus, within the class of models framing the recent discussion, there is no impact on the ex ante cost of capital covering the full time span...... investors may actually benefit from a higher ex post cost of capital....

  1. Umbilical hernias: the cost of waiting.

    Science.gov (United States)

    Strosberg, David S; Pittman, Matthew; Mikami, Dean

    2017-02-01

    Umbilical hernias are well described in the literature, but its impact on health care is less understood. The purpose of this study was to investigate the effect of non-operative management of umbilical hernias on cost, work absenteeism, and resource utilization. The Truven Health Database, consisting of 279 employers and over 3000 hospitals, was reviewed for all umbilical hernia patients, aged 18-64 who were enrolled in health plans for 12 months prior to surgery and 12 months after surgery. Patients were excluded if they had a recurrence or had been offered a "no surgery" approach within 1 year of the index date. The remaining patients were separated into surgery (open or laparoscopic repair) or no surgery (NS). Post-cost analysis at 90 and 365 days and estimated days off from work were reviewed for each group. The non-surgery cohort had a higher proportion of females and comorbidity index. Adjusted analysis showed significantly higher 90 and 365 costs for the surgery group (p cost difference did decrease over time. NS group had significantly higher estimated days of health-care utilization at both the 90 (1.99 vs. 3.58 p costs compared to open primarily due to higher index procedure costs (p costs were found to be higher in the surgery group, the majority of these were due to the surgery itself. Significantly higher days of health-care utilization and estimated days off work were experienced in the NS group. It is our belief that early operative intervention will lead to decreased costs and resource utilization.

  2. Cost Effectiveness of Candida Polymerase Chain Reaction Detection and Empirical Antifungal Treatment among Patients with Suspected Fungal Peritonitis in the Intensive Care Unit.

    Science.gov (United States)

    Pagès, Arnaud; Iriart, Xavier; Molinier, Laurent; Georges, Bernard; Berry, Antoine; Massip, Patrice; Juillard-Condat, Blandine

    2017-12-01

    Mortality from intra-abdominal candidiasis in intensive care units (ICUs) is high. It takes many days for peritoneal-fluid fungal culture to become positive, and the recommended empirical antifungal therapy involves excessive costs. Polymerase chain reaction (PCR) should produce results more rapidly than fungal culture. To perform a cost-effectiveness analysis of the combination of several diagnostic and therapeutic strategies to manage Candida peritonitis in non-neutropenic adult patients in ICUs. We constructed a decision tree model to evaluate the cost effectiveness. Cost and effectiveness were taken into account in a 1-year time horizon and from the French National Health Insurance perspective. Six strategies were compared: fluconazole or echinocandin as an empirical therapy, plus diagnosis by fungal culture or detection by PCR of all Candida species, or use of PCR to detect most fluconazole-resistant Candida species (i.e., Candida krusei and Candida glabrata). The use of fluconazole empirical treatment and PCR to detect all Candida species is more cost effective than using fluconazole empirical treatment without PCR (incremental cost-effectiveness ratio of €40,055/quality-adjusted life-year). Empirical treatment with echinocandin plus PCR to detect C. krusei and C. glabrata is the most effective strategy, but has an incremental cost-effectiveness ratio of €93,776/quality-adjusted life-year. If the cost of echinocandin decreases, then strategies involving PCR plus empirical echinocandin become more cost-effective. Detection by PCR of all Candida species and of most fluconazole-resistant Candida species could improve the cost-effectiveness of fluconazole and echinocandin given to non-neutropenic patients with suspected peritoneal candidiasis in ICUs. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. [Cost-effectiveness in Dutch mental health care: future because of ROM?

    NARCIS (Netherlands)

    Agthoven, M. van; Kolk, A. van der; Knegtering, H.; Delespaul, P.A.; Arends, J.; Jeurissen, P.P.T.; Krabbe, P.F.M.; Huijsman, R.; Luijk, R.; Beurs, E. de; Hakkaart-van Roijen, L.; Bruggeman, R.

    2015-01-01

    BACKGROUND: The document reporting Dutch mental health care negotiations for 2014 - 2017 calls for a cost decrease based on cost-effectiveness. Thanks to rom, the Dutch mental health care seems well prepared for cost-effectiveness research.
    AIM: Evaluate how valid cost-effectiveness

  4. Review, Selection and Installation of a Rapid Prototype Machine

    Science.gov (United States)

    McEndree, Caryl

    2008-01-01

    The objective of this paper is to impress upon the reader the benefits and advantages of investing in rapid prototyping (additive manufacturing) technology thru the procurement of one or two new rapid prototyping machines and the creation of a new Prototype and Model Lab at the Kennedy Space Center (KSC). This new resource will be available to all of United Space Alliance, LLC (USA), enabling engineers from around the company to pursue a more effective means of communication and design with our co-workers, and our customer, the National Aeronautics and Space Administration (NASA). The Rapid Protoyping/3D printing industry mirrors the transition the CAD industry made several years ago, when companies were trying to justify the expenditure of converting to a 3D based system from a 2D based system. The advantages of using a 3D system seemed to be outweighed by the cost it would take to convert not only legacy 2D drawings into 3D models but the training of personnel to use the 3D CAD software. But the reality was that when a 3D CAD system is employed, it gives engineers a much greater ability to conceive new designs and the ability to engineer new tools and products much more effectively. Rapid Prototyping (RP) is the name given to a host of related technologies that are used to fabricate physical objects directly from Computer Aided Design (CAD) data sources. These methods are generally similar to each other in that they add and bond materials in a layer wise-fashion to form objects, instead of machining away material. The machines used in Rapid Prototyping are also sometimes referred to as Rapid Manufacturing machines due to the fact that some of the parts fabricated in a RP machine can be used as the finished product. The name "Rapid Prototyping" is really a misnomer. It is much more than prototypes and it is not always rapid.

  5. Networks and transaction costs

    DEFF Research Database (Denmark)

    Henning, Christian H.C.A.; Henningsen, Geraldine; Henningsen, Arne

    -multiple output stochastic Ray production function to generate relative shadow prices of three inputs and two outputs traded by farms. At a second stage a structural equation system is derived from the first order conditions of farm’s profit maximization to estimate simultaneously the of commodity specific...... transaction cost functions for all traded farm inputs and outputs. Estimation results based on a sample of 315 Polish farms imply a significant influence of social network structures on farm’s transaction costs. Moreover, estimated transaction costs correspond to a reasonable amount of farm specific shadow...... prices....

  6. The cost of children

    DEFF Research Database (Denmark)

    Nordström, Leif Jonas

    In this paper we estimate the opportunity cost of children. The underlying theoretical model is represented by a household production model. In the empirical analysis, we consider three different cohorts for men and women born between 1955 and 1970. For the women in the two oldest cohorts......, the opportunity cost of two children is estimated to 28-29 per cent of full income, which in monetary units is close to estimated income difference between women employed in the public and private sector. The opportunity cost of fatherhood is generally positive, but only significantly positive for men born...

  7. Value and Transaction Costs

    DEFF Research Database (Denmark)

    Foss, Kirsten; Foss, Nicolai Juul

    2003-01-01

    and capturing propertyrights. We clarify the key role of transaction costs with respect to understandingvalue creation and the limitations and opportunities of strategizing relative tocompetitive forces. The economics of property rights identifies new sources ofvalue creation (i.e., reducing the dissipation......AbstractWe forge linkages between the economics of property rights (Coase, Demsetz,Cheung, Barzel) and strategic management. Property rights to resources consistof the rights to consume, obtain income from, and alienate these resources.Transaction costs are the costs of exchanging, protecting...

  8. Technical measures to decrease heat energy consumption of final customer in multi-apartment buildings according to Energy Efficiency Directive

    National Research Council Canada - National Science Library

    Romanas Savickas; Lauryna Savickienė; Juozas Bielskus

    2015-01-01

    .... This article presents the analysis how these targets could be achieved by the means of individual heat metering by heat cost allocators for every flat thus decreasing an energy consumption for a final consumer...

  9. Developmental evolution facilitates rapid adaptation.

    Science.gov (United States)

    Lin, Hui; Kazlauskas, Romas J; Travisano, Michael

    2017-11-21

    Developmental evolution has frequently been identified as a mode for rapid adaptation, but direct observations of the selective benefits and associated mechanisms of developmental evolution are necessarily challenging to obtain. Here we show rapid evolution of greatly increased rates of dispersal by developmental changes when populations experience stringent selection. Replicate populations of the filamentous fungus Trichoderma citrinoviride underwent 85 serial transfers, under conditions initially favoring growth but not dispersal. T. citrinoviride populations shifted away from multicellular growth toward increased dispersal by producing one thousand times more single-celled asexual conidial spores, three times sooner than the ancestral genotype. Conidia of selected lines also germinated fifty percent faster. Gene expression changed substantially between the ancestral and selected fungi, especially for spore production and growth, demonstrating rapid evolution of tight regulatory control for down-regulation of growth and up-regulation of conidia production between 18 and 24 hours of growth. These changes involved both developmentally fixed and plastic changes in gene expression, showing that complex developmental changes can serve as a mechanism for rapid adaptation.

  10. Multigrade Teaching Rapid Appraisal Procedure.

    Science.gov (United States)

    Nielsen, Dean

    Multigrade classes have been recognized as part of elementary education for many years, but their special needs have been largely ignored. This manual focuses on the survey research that should predate the design of instructional management strategies in multigrade classrooms. It describes rapid and reliable ways to collect information about the…

  11. Rapid thermal processing of semiconductors

    CERN Document Server

    Borisenko, Victor E

    1997-01-01

    Rapid thermal processing has contributed to the development of single wafer cluster processing tools and other innovations in integrated circuit manufacturing environments Borisenko and Hesketh review theoretical and experimental progress in the field, discussing a wide range of materials, processes, and conditions They thoroughly cover the work of international investigators in the field

  12. Furnace for rapid thermal processing

    NARCIS (Netherlands)

    Roozeboom, F.; Duine, P.A.; Sluis, P. van der

    2001-01-01

    A Method (1) for Rapid Thermal Processing of a wafer (7), wherein the wafer (7) is heated by lamps (9), and the heat radiation is reflected by an optical switching device (15,17) which is in the reflecting state during the heating stage. During the cooling stage of the wafer (7), the heat is

  13. Rapid Energy Modeling Workflow Demonstration

    Science.gov (United States)

    2013-10-31

    BIM Building Information Modeling BPA Building Performance Analysis BTU British Thermal Unit CBECS Commercial Building ...geometry, orientation, weather, and materials, generates 3D Building Information Models ( BIM ) guided by satellite views of building footprints and...Rapid Energy Modeling (REM) workflows that employed building information modeling ( BIM ) approaches and conceptual energy analysis.

  14. Portable Diagnostics and Rapid Germination

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, Zachary Spencer [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-12-01

    In the Bioenergy and Defense Department of Sandia National Laboratories, characterization of the BaDx (Bacillus anthracis diagnostic cartridge) was performed and rapid germination chemistry was investigated. BaDx was tested with complex sample matrixes inoculated with Bacillus anthracis, and the trials proved that BaDx will detect Bacillus anthracis in a variety of the medium, such as dirt, serum, blood, milk, and horse fluids. The dimensions of the device were altered to accommodate an E. coli or Listeria lateral flow immunoassay, and using a laser printer, BaDx devices were manufactured to identify E. coli and Listeria. Initial testing with E. coli versions of BaDx indicate that the device will be viable as a portable diagnostic cartridge. The device would be more effective with faster bacteria germination; hence studies were performed the use of rapid germination chemistry. Trials with calcium dipicolinic acid displayed increased cell germination, as shown by control studies using a microplate reader. Upon lyophilization the rapid germination chemistry failed to change growth patterns, indicating that the calcium dipicolinic acid was not solubilized under the conditions tested. Although incompatible with the portable diagnostic device, the experiments proved that the rapid germination chemistry was effective in increasing cell germination.

  15. Accurate decisions in an uncertain world: collective cognition increases true positives while decreasing false positives

    OpenAIRE

    Wolf, Max; Kurvers, Ralf H. J. M.; Ward, Ashley J. W.; Krause, Stefan; Krause, Jens

    2013-01-01

    In a wide range of contexts, including predator avoidance, medical decision-making and security screening, decision accuracy is fundamentally constrained by the trade-off between true and false positives. Increased true positives are possible only at the cost of increased false positives; conversely, decreased false positives are associated with decreased true positives. We use an integrated theoretical and experimental approach to show that a group of decision-makers can overcome this basic ...

  16. Bromelain treatment decreases neutrophil migration to sites of inflammation.

    Science.gov (United States)

    Fitzhugh, David J; Shan, Siqing; Dewhirst, Mark W; Hale, Laura P

    2008-07-01

    Bromelain, a mixture of proteases derived from pineapple stem, has been reported to have therapeutic benefits in a variety of inflammatory diseases, including murine inflammatory bowel disease. The purpose of this work was to understand potential mechanisms for this anti-inflammatory activity. Exposure to bromelain in vitro has been shown to remove a number of cell surface molecules that are vital to leukocyte trafficking, including CD128a/CXCR1 and CD128b/CXCR2 that serve as receptors for the neutrophil chemoattractant IL-8 and its murine homologues. We hypothesized that specific proteolytic removal of CD128 molecules by bromelain would inhibit neutrophil migration to IL-8 and thus decrease acute responses to inflammatory stimuli. Using an in vitro chemotaxis assay, we demonstrated a 40% reduction in migration of bromelain- vs. sham-treated human neutrophils in response to rhIL-8. Migration to the bacterial peptide analog fMLP was unaffected, indicating that bromelain does not induce a global defect in leukocyte migration. In vivo bromelain treatment generated a 50-85% reduction in neutrophil migration in 3 different murine models of leukocyte migration into the inflamed peritoneal cavity. Intravital microscopy demonstrated that although in vivo bromelain treatment transiently decreased leukocyte rolling, its primary long-term effect was abrogation of firm adhesion of leukocytes to blood vessels at the site of inflammation. These changes in adhesion were correlated with rapid re-expression of the bromelain-sensitive CD62L/L-selectin molecules that mediate rolling following in vivo bromelain treatment and minimal re-expression of CD128 over the time period studied. Taken together, these studies demonstrate that bromelain can effectively decrease neutrophil migration to sites of acute inflammation and support the specific removal of the CD128 chemokine receptor as a potential mechanism of action.

  17. Decreased Nocturnal Movements in Patients with Facioscapulohumeral Muscular Dystrophy

    Science.gov (United States)

    Marca, Giacomo Della; Frusciante, Roberto; Dittoni, Serena; Vollono, Catello; Losurdo, Anna; Testani, Elisa; Scarano, Emanuele; Colicchio, Salvatore; Iannaccone, Elisabetta; Tonali, Pietro A.; Ricci, Enzo

    2010-01-01

    Study Objectives: Reduced mobility during sleep characterizes a variety of movement disorders and neuromuscular diseases. Facioscapulohumeral muscular dystrophy (FSHD) is the third most common form of muscular dystrophy in the general population, and people with FSHD have poor sleep quality. The aims of the present study were to evaluate nocturnal motor activity in patients with FSHD by means of videopolysomnography and to verify whether activity was associated with modifications in sleep structure. Methods: We enrolled 32 adult patients affected by genetically confirmed FSHD (18 women and 14 men, mean age 45.1 ± 13.4 years) and 32 matched control subjects, (18 women and 14 men, mean age 45.5 ± 11.4 years). Major body movements (MBM) were scored in videopolygraphic recordings in accordance with established criteria. An MBM index was calculated (number of MBM per hour of sleep). Results: The FSHD group showed a decrease in the MBM index (FSHD: 1.2 ± 1.1; control subjects: 2.3 ± 1.2, analysis of variance F = 13.672; p = 0.008). The sleep pattern of patients with FSHD, as compared with that of controls, was characterized by longer sleep latencies, shorter sleep durations, an increased percentage of wake during sleep, and a decreased percentage of rapid eye movement sleep. In the patient group, the MBM index was inversely correlated with severity of disease (Spearman test: r30 = −0.387; p Marca GD; Frusciante R; Dittoni S; Vollono C; Losurdo A; Testani E; Scarano E; Colicchio S; Iannaccone E; Tonali PA; Ricci E. Decreased nocturnal movements in patients with facioscapulohumeral muscular dystrophy. J Clin Sleep Med 2010;6(3):276-280. PMID:20572422

  18. Music decreases aortic stiffness and wave reflections.

    Science.gov (United States)

    Vlachopoulos, Charalambos; Aggelakas, Angelos; Ioakeimidis, Nikolaos; Xaplanteris, Panagiotis; Terentes-Printzios, Dimitrios; Abdelrasoul, Mahmoud; Lazaros, George; Tousoulis, Dimitris

    2015-05-01

    Music has been related to cardiovascular health and used as adjunct therapy in patients with cardiovascular disease. Aortic stiffness and wave reflections are predictors of cardiovascular risk. We investigated the short-term effect of classical and rock music on arterial stiffness and wave reflections. Twenty healthy individuals (22.5±2.5 years) were studied on three different occasions and listened to a 30-min music track compilation (classical, rock, or no music for the sham procedure). Both classical and rock music resulted in a decrease of carotid-femoral pulse wave velocity (PWV) immediately after the end of music listening (all pclassical or rock music in a more sustained way (nadir by 6.0% and 5.8%, respectively, at time zero post-music listening, all pmusic preference was taken into consideration, both classical and rock music had a more potent effect on PWV in classical aficionados (by 0.20 m/s, p=0.003 and 0.13 m/s, p=0.015, respectively), whereas there was no effect in rock aficionados (all p=NS). Regarding wave reflections, classical music led to a more potent response in classical aficionados (AIx decrease by 9.45%), whereas rock led to a more potent response to rock aficionados (by 10.7%, all pMusic, both classical and rock, decreases aortic stiffness and wave reflections. Effect on aortic stiffness lasts for as long as music is listened to, while classical music has a sustained effect on wave reflections. These findings may have important implications, extending the spectrum of lifestyle modifications that can ameliorate arterial function. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Serum Soluble Corin is Decreased in Stroke.

    Science.gov (United States)

    Peng, Hao; Zhu, Fangfang; Shi, Jijun; Han, Xiujie; Zhou, Dan; Liu, Yan; Zhi, Zhongwen; Zhang, Fuding; Shen, Yun; Ma, Juanjuan; Song, Yulin; Hu, Weidong

    2015-07-01

    Soluble corin was decreased in coronary heart disease. Given the connections between cardiac dysfunction and stroke, circulating corin might be a candidate marker of stroke risk. However, the association between circulating corin and stroke has not yet been studied in humans. Here, we aimed to examine the association in patients wtith stroke and community-based healthy controls. Four hundred eighty-one patients with ischemic stroke, 116 patients with hemorrhagic stroke, and 2498 healthy controls were studied. Serum soluble corin and some conventional risk factors of stroke were examined. Because circulating corin was reported to be varied between men and women, the association between serum soluble corin and stroke was evaluated in men and women, respectively. Patients with ischemic and hemorrhagic stroke had a significantly lower level of serum soluble corin than healthy controls in men and women (all P values, soluble corin were more likely to have ischemic (odds ratio [OR], 4.90; 95% confidence interval, 2.99-8.03) and hemorrhagic (OR, 17.57; 95% confidence interval, 4.85-63.71) stroke than men in the highest quartile. Women in the lowest quartile of serum soluble corin were also more likely to have ischemic (OR, 3.10; 95% confidence interval, 1.76-5.44) and hemorrhagic (OR, 8.54; 95% confidence interval, 2.35-31.02) stroke than women in the highest quartile. ORs of ischemic and hemorrhagic stroke were significantly increased with the decreasing levels of serum soluble corin in men and women (all P values for trend, soluble corin was decreased in patients with stroke compared with healthy controls. Our findings raise the possibility that serum soluble corin may have a pathogenic role in stroke. © 2015 American Heart Association, Inc.

  20. Organization and costs of repurchasing, transportation, warehousing and storage of raspberry fruit

    Directory of Open Access Journals (Sweden)

    Kalanović-Bulatović Branka

    2015-01-01

    Full Text Available Due to its characteristic, apart from nutritive and medical significance, raspberry is particularly important for our country in social and economic terms, since its export attracts foreign currency inflow. Since the quality of raspberry decreases rapidly after picking, it is utterly important that the whole process, from picking to cold storage of fruit, should be rationally organized, thus finally reducing the costs and increasing the production value. For these reasons precisely the research deals with organization of the entire process, from repurchase to cold storage of raspberry fruits, as well as the analysis of pertaining costs. Necessary information for the preparation of the paper has been obtained from cold storage plants engaged in raspberry storage and preservation. Necessary information has been gathered using several methods, viz: observation, interview and content analysis methods. Furthermore, analysis, comparison and calculation methods have also been used in the preparation of the paper. The raspberry fruit repurchase, transport and storage costs range from 1,6 to 1,8 EUR per kg, exclusive of storage (store-housing. To this one should add store-housing costs ranging from 0,009 to 0,013 EUR per kg on a monthly basis. Modern organization of production and communication between producers, repurchasers, processors and exporters is essential in order to decrease fluctuations in repurchase and sales price of fresh raspberry and its products and the improvement of overall financial effect of all links within the chain of this economy activity. Cold storage plants, even if of minor capacities, are beneficial not only for the immediate participants in the producer-buyer chain, but it also makes an important stimulating factor for rural development and economy of the country.

  1. Cost accounting for the radiologist.

    Science.gov (United States)

    Gentili, Amilcare

    2014-05-01

    Cost accounting is the branch of managerial accounting that deals with the analysis of the costs of a product or service. This article reviews methods of classifying and allocating costs and relationships among costs, volume, and revenues. Radiology practices need to know the cost of a procedure or service to determine the selling price of a product, bid on contracts, analyze profitability, and facilitate cost control and cost reduction.

  2. Interannual Change Detection of Mediterranean Seagrasses Using RapidEye Image Time Series

    Directory of Open Access Journals (Sweden)

    Dimosthenis Traganos

    2018-02-01

    Full Text Available Recent research studies have highlighted the decrease in the coverage of Mediterranean seagrasses due to mainly anthropogenic activities. The lack of data on the distribution of these significant aquatic plants complicates the quantification of their decreasing tendency. While Mediterranean seagrasses are declining, satellite remote sensing technology is growing at an unprecedented pace, resulting in a wealth of spaceborne image time series. Here, we exploit recent advances in high spatial resolution sensors and machine learning to study Mediterranean seagrasses. We process a multispectral RapidEye time series between 2011 and 2016 to detect interannual seagrass dynamics in 888 submerged hectares of the Thermaikos Gulf, NW Aegean Sea, Greece (eastern Mediterranean Sea. We assess the extent change of two Mediterranean seagrass species, the dominant Posidonia oceanica and Cymodocea nodosa, following atmospheric and analytical water column correction, as well as machine learning classification, using Random Forests, of the RapidEye time series. Prior corrections are necessary to untangle the initially weak signal of the submerged seagrass habitats from satellite imagery. The central results of this study show that P. oceanica seagrass area has declined by 4.1%, with a trend of −11.2 ha/yr, while C. nodosa seagrass area has increased by 17.7% with a trend of +18 ha/yr throughout the 5-year study period. Trends of change in spatial distribution of seagrasses in the Thermaikos Gulf site are in line with reported trends in the Mediterranean. Our presented methodology could be a time- and cost-effective method toward the quantitative ecological assessment of seagrass dynamics elsewhere in the future. From small meadows to whole coastlines, knowledge of aquatic plant dynamics could resolve decline or growth trends and accurately highlight key units for future restoration, management, and conservation.

  3. Decreasing Human Trafficking through Sex Work Decriminalization.

    Science.gov (United States)

    Albright, Erin; D'Adamo, Kate

    2017-01-01

    In order to decrease human trafficking, health care workers should support the full decriminalization of prostitution. Similar to trafficking in other forms of labor, preventing trafficking in the sex trade requires addressing the different forms of marginalization that create vulnerable communities. By removing punitive laws that prevent reporting of exploitation and abuse, decriminalization allows sex workers to work more safely, thereby reducing marginalization and vulnerability. Decriminalization can also help destigmatize sex work and help resist political, social, and cultural marginalization of sex workers. © 2017 American Medical Association. All Rights Reserved.

  4. Health Clinic Cost Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Independent Rural Health Clinic and Freestanding Federally Qualified Health Center (HCLINIC).This data...

  5. COST 516 Tribology Symposium

    Energy Technology Data Exchange (ETDEWEB)

    Ronkainen, H.; Holmberg, K. [eds.

    1998-11-01

    Cost 516 Tribology action is the first joint European research action focusing on tribology, which originates in the approval of its Memorandum of understanding in February 1994. The COST 516 Tribology Symposium took place in Espoo, Finland from 14th to 15th May 1998. This was the first Symposium of the COST 516 Tribology action. The large number of research contributions at the Symposium, altogether almost SO, and their scientific and technical level, is an indication of the importance and significance of tribology research. The symposium proceedings contain papers in a wide variety of subjects, covering the three categories of the COST 516 Tribology action, namely Grease lubrication (GRIT), Tribology of renewable environmentally adapted lubricants (REAL) and Coatings and surface treatments (CAST). (orig.)

  6. Minocycline Protects against Neurologic Complications of Rapid Correction of Hyponatremia

    Science.gov (United States)

    Soupart, Alain; Pochet, Roland; Brion, Jean Pierre

    2010-01-01

    Osmotic demyelination syndrome is a devastating neurologic condition that occurs after rapid correction of serum sodium in patients with hyponatremia. Pathologic features of this injury include a well-demarcated region of myelin loss, a breakdown of the blood–brain barrier, and infiltration of microglia. The semisynthetic tetracycline minocycline is protective in some animal models of central nervous system injury, including demyelination, suggesting that it may also protect against demyelination resulting from rapid correction of chronic hyponatremia. Using a rat model of osmotic demyelination syndrome, we found that treatment with minocycline significantly decreases brain demyelination, alleviates neurologic manifestations, and reduces mortality associated with rapid correction of hyponatremia. Mechanistically, minocycline decreased the permeability of the blood–brain barrier, inhibited microglial activation, decreased both the expression of IL1α and protein nitrosylation, and reduced the loss of GFAP immunoreactivity. In conclusion, minocycline modifies the course of osmotic demyelination in rats, suggesting its possible therapeutic use in the setting of inadvertent rapid correction of chronic hyponatremia in humans. PMID:21051736

  7. Stop signals decrease choices for palatable foods through decreased food evaluation

    NARCIS (Netherlands)

    Veling, H.P.; Aarts, H.A.G.; Stroebe, W.

    2013-01-01

    The present study explores whether presenting specific palatable foods in close temporal proximity of stop signals in a go/no-go task decreases subsequent evaluations of such foods among participants with a relatively high appetite. Furthermore, we tested whether any decreased evaluations could

  8. High monetary reward rates and caloric rewards decrease temporal persistence.

    Science.gov (United States)

    Fung, Bowen J; Bode, Stefan; Murawski, Carsten

    2017-02-22

    Temporal persistence refers to an individual's capacity to wait for future rewards, while forgoing possible alternatives. This requires a trade-off between the potential value of delayed rewards and opportunity costs, and is relevant to many real-world decisions, such as dieting. Theoretical models have previously suggested that high monetary reward rates, or positive energy balance, may result in decreased temporal persistence. In our study, 50 fasted participants engaged in a temporal persistence task, incentivised with monetary rewards. In alternating blocks of this task, rewards were delivered at delays drawn randomly from distributions with either a lower or higher maximum reward rate. During some blocks participants received either a caloric drink or water. We used survival analysis to estimate participants' probability of quitting conditional on the delay distribution and the consumed liquid. Participants had a higher probability of quitting in blocks with the higher reward rate. Furthermore, participants who consumed the caloric drink had a higher probability of quitting than those who consumed water. Our results support the predictions from the theoretical models, and importantly, suggest that both higher monetary reward rates and physiologically relevant rewards can decrease temporal persistence, which is a crucial determinant for survival in many species. © 2017 The Authors.

  9. Hardwood sawmill downtime costs

    Science.gov (United States)

    Jan Wiedenbeck; Kyle Blackwell

    2003-01-01

    How time flies when you don't pay attention to it. With hardwood sawmill operating costs ranging from $4 to $25 per operating minute ($95/MBF to $335/MBF) and gross profit margins ranging from $0.10/BF to $0.35/BF, five extra minutes of downtime per day will cost a sawmill that produces an average of 20,000 BF per day (5 MMBF annually) between $21 and $73 per day...

  10. Capital cost estimate

    Science.gov (United States)

    1975-01-01

    The capital cost estimate for the nuclear process heat source (NPHS) plant was made by: (1) using costs from the current commercial HTGR for electricity production as a base for items that are essentially the same and (2) development of new estimates for modified or new equipment that is specifically for the process heat application. Results are given in tabular form and cover the total investment required for each process temperature studied.

  11. Sanitary costs of osteoarthritis

    Directory of Open Access Journals (Sweden)

    M. Franceschini

    2011-09-01

    Full Text Available Muscoloskeletal disorders are the first cause of disability and the second cause of permanent disablement in Italy. Osteoarthritis is the most frequent rheumatic disease and affects about 4 million Italians. In spite of that, data concerning social costs are lacking. On account of this lack we measured sanitary costs of 314 patients suffering from osteoarthritis. A retrospective, prevalence- based multicentric study was performed using a bottom-up approach. The study period was 12 months and referred to 1999. Eight percent of patients didn’t take any drug for the treatment of osteoarthritis; NSAIDs were prescribed to 86.9% of patients, analgesics to 29.9%, chondroprotective drugs to 7.6%, and gastroprotective drugs to 36.9%. Total sanitary costs came to 455 € / patient / year: 122 € were spent on diagnostics, 293 € on therapy and 40 € on management of drug-related gastropathy. Since the costs of anti-inflammatory drugs came to 30 € we calculated iatrogenic cost factor of 2.3. Moreover, the study supplied interesting informations about prescriptive habits, which differ in Italy from international guidelines for the medical treatment of OA, about patient management, because of hospitalization, which by itself absorbs 1/3 of resources, and about physiotherapy, which costs twice as much as pharmacological therapy. At last, data analysis gave the cue for suggestions on changing patients’ management.

  12. Statins Decrease Oxidative Stress and ICD Therapies

    Directory of Open Access Journals (Sweden)

    Heather L. Bloom

    2010-01-01

    Full Text Available Recent studies demonstrate that statins decrease ventricular arrhythmias in internal cardioverter defibrillator (ICD patients. The mechanism is unknown, but evidence links increased inflammatory and oxidative states with increased arrhythmias. We hypothesized that statin use decreases oxidation. Methods. 304 subjects with ICDs were surveyed for ventricular arrhythmia. Blood was analyzed for derivatives of reactive oxygen species (DROMs and interleukin-6 (IL-6. Results. Subjects included 252 (83% men, 58% on statins, 20% had ventricular arrhythmias. Average age was 63 years and ejection fraction (EF 20%. ICD implant duration was 29 ± 27 months. Use of statins correlated with lower ICD events (r=0.12, P=.02. Subjects on statins had lower hsCRP (5.2 versus 6.3; P=.05 and DROM levels (373 versus 397; P=.03. Other factors, including IL-6 and EF did not differ between statin and nonstatin use, nor did beta-blocker or antiarrhythmic use. Multivariate cross-correlation analysis demonstrated that DROMs, statins, IL-6 and EF were strongly associated with ICD events. Multivariate regression shows DROMs to be the dominant predictor. Conclusion. ICD event rate correlates with DROMs, a measure of lipid peroxides. Use of statins is associated with reduced DROMs and fewer ICD events, suggesting that statins exert their effect through reducing oxidation.

  13. Feasibility of utilizing the SD BIOLINE Onchocerciasis IgG4 rapid test in onchocerciasis surveillance in Senegal.

    Science.gov (United States)

    Dieye, Yakou; Storey, Helen L; Barrett, Kelsey L; Gerth-Guyette, Emily; Di Giorgio, Laura; Golden, Allison; Faulx, Dunia; Kalnoky, Michael; Ndiaye, Marie Khemesse Ngom; Sy, Ngayo; Mané, Malang; Faye, Babacar; Sarr, Mamadou; Dioukhane, Elhadji Mamadou; Peck, Roger B; Guinot, Philippe; de Los Santos, Tala

    2017-10-01

    As effective onchocerciasis control efforts in Africa transition to elimination efforts, different diagnostic tools are required to support country programs. Senegal, with its long standing, successful control program, is transitioning to using the SD BIOLINE Onchocerciasis IgG4 (Ov16) rapid test over traditional skin snip microscopy. The aim of this study is to demonstrate the feasibility of integrating the Ov16 rapid test into onchocerciasis surveillance activities in Senegal, based on the following attributes of acceptability, usability, and cost. A cross-sectional study was conducted in 13 villages in southeastern Senegal in May 2016. Individuals 5 years and older were invited to participate in a demographic questionnaire, an Ov16 rapid test, a skin snip biopsy, and an acceptability interview. Rapid test technicians were interviewed and a costing analysis was conducted. Of 1,173 participants, 1,169 (99.7%) agreed to the rapid test while 383 (32.7%) agreed to skin snip microscopy. The sero-positivity rate of the rapid test among those tested was 2.6% with zero positives 10 years and younger. None of the 383 skin snips were positive for Ov microfilaria. Community members appreciated that the rapid test was performed quickly, was not painful, and provided reliable results. The total costs for this surveillance activity was $22,272.83, with a cost per test conducted at $3.14 for rapid test, $7.58 for skin snip microscopy, and $13.43 for shared costs. If no participants had refused skin snip microscopy, the total cost per method with shared costs would have been around $16 per person tested. In this area with low onchocerciasis sero-positivity, there was high acceptability and perceived value of the rapid test by community members and technicians. This study provides evidence of the feasibility of implementing the Ov16 rapid test in Senegal and may be informative to other country programs transitioning to Ov16 serologic tools.

  14. A multiplex single nucleotide polymorphism typing assay for detecting mutations that result in decreased fluoroquinolone susceptibility in Salmonella enterica serovars Typhi and Paratyphi A.

    LENUS (Irish Health Repository)

    Song, Yajun

    2010-08-01

    OBJECTIVES: Decreased susceptibility to fluoroquinolones has become a major problem for the successful therapy of human infections caused by Salmonella enterica, especially the life-threatening typhoid and paratyphoid fevers. METHODS: By using Luminex xTAG beads, we developed a rapid, reliable and cost-effective multiplexed genotyping assay for simultaneously detecting 11 mutations in gyrA, gyrB and parE of S. enterica serovars Typhi and Paratyphi A that result in nalidixic acid resistance (Nal(R)) and\\/or decreased susceptibility to fluoroquinolones. RESULTS: This assay yielded unambiguous single nucleotide polymorphism calls on extracted DNA from 292 isolates of Salmonella Typhi (Nal(R) = 223 and Nal(S) = 69) and 106 isolates of Salmonella Paratyphi A (Nal(R) = 24 and Nal(S) = 82). All of the 247 Nal(R) Salmonella Typhi and Salmonella Paratyphi A isolates were found to harbour at least one of the target mutations, with GyrA Phe-83 as the most common one (143\\/223 for Salmonella Typhi and 18\\/24 for Salmonella Paratyphi A). We also identified three GyrB mutations in eight Nal(S) Salmonella Typhi isolates (six for GyrB Phe-464, one for GyrB Leu-465 and one for GyrB Asp-466), and mutations GyrB Phe-464 and GyrB Asp-466 seem to be related to the decreased ciprofloxacin susceptibility phenotype in Salmonella Typhi. This assay can also be used directly on boiled single colonies. CONCLUSIONS: The assay presented here would be useful for clinical and reference laboratories to rapidly screen quinolone-resistant isolates of Salmonella Typhi and Salmonella Paratyphi A, and decipher the underlying genetic changes for epidemiological purposes.

  15. [Estimation of hospital costs of colorectal cancer in Catalonia (Spain)].

    Science.gov (United States)

    Corral, Julieta; Borràs, Josep Maria; Chiarello, Pietro; García-Alzorriz, Enric; Macià, Francesc; Reig, Anna; Mateu de Antonio, Javier; Castells, Xavier; Cots, Francesc

    2015-01-01

    To assess the hospital cost associated with colorectal cancer (CRC) treatment by stage at diagnosis, type of cost and disease phase in a public hospital. A retrospective analysis was conducted of the hospital costs associated with a cohort of 699 patients diagnosed with CRC and treated for this disease between 2000 and 2006 in a teaching hospital and who had a 5-year follow-up from the time of diagnosis. Data were collected from clinical-administrative databases. Mean costs per patient were analysed by stage at diagnosis, cost type and disease phase. The mean cost per patient ranged from 6,573 Euros for patients with a diagnosis of CRC in situ to 36,894 € in those diagnosed in stage III. The main cost components were surgery-inpatient care (59.2%) and chemotherapy (19.4%). Advanced disease stages were associated with a decrease in the relative weight of surgical and inpatient care costs and an increase in chemotherapy costs. This study provides the costs of CRC treatment based on clinical practice, with chemotherapy and surgery accounting for the major cost components. This cost analysis is a baseline study that will provide a useful source of information for future studies on cost-effectiveness and on the budget impact of different therapeutic innovations in Spain. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  16. Farmers' choice of cattle marketing channels under transaction cost ...

    African Journals Online (AJOL)

    They also showed that the probability of selling at auction vs selling to speculators increased with proximity to the auction marketplace and decreased with knowledge of the buyer, suggesting higher opportunity costs of time and efforts associated with selling at auction, and considerable negotiation and monitoring costs ...

  17. Planned special events : cost management and cost recovery

    Science.gov (United States)

    2009-05-01

    This purpose of this primer is to aid jurisdictions and agencies, especially Departments of Transportation, with identifying and managing the costs of planned special events (PSEs) and forming policy for cost recovery. Cost management the effectiv...

  18. Tokamak reactor cost model based on STARFIRE/WILDCAT costing

    Energy Technology Data Exchange (ETDEWEB)

    Evans, K. Jr.

    1983-03-01

    A cost model is presented which is useful for survey and comparative studies of tokamak reactors. The model is heavily based on STARFIRE and WILDCAT costing guidelines, philosophies, and procedures and reproduces the costing for these devices quite accurately.

  19. Decreased transport time to the surgical intensive care unit.

    Science.gov (United States)

    Ko, Ara; Harada, Megan Y; Dhillon, Navpreet K; Patel, Kavita A; Kirillova, Lydia R; Kolus, Riley C; Torbati, Sam; Ley, Eric J

    2017-06-01

    Extended stay in the emergency department (ED) is associated with worse outcomes in critically ill trauma patients. We conducted a human factors analysis to better understand impediments for patient flow when a surgical ICU (SICU bed is available in order to reduce ED LOS. This is a retrospective review of all trauma patients admitted to a protected SICU through the ED during 2011 and 2014. In 2010, a 24-hour protected SICU bed protocol was implemented to make a bed readily available. During 2013 human factors analysis helped to describe flow disruptions; related interventions were introduced to facilitate rapid transport from the ED to SICU. The interventions required the following prior to CT scanning: immediate ICU bed orders placed by the ED physician and ED to ICU personnel communication. Direct transport from the CT scanner to the ICU was mandated. Data including patient demographics, injury severity, ED LOS, ICU LOS, and hospital LOS was collected and compared between 2011 (PRE) and 2014 (POST). A total of 305 trauma patients admitted from the ED to the SICU were analyzed; 174 patients in 2011 (PRE) and 131 in 2014 (POST). Average age was 46 years and patients had a mean admission GCS and injury severity score (ISS) of 12.3 and 15.9, respectively. The cohorts were similar in age, mechanism of injury, initial vital signs, and injury severity. After implementing the human factors interventions, decreases were noted in the mean ED LOS (2.4 v. 3.0 hours, p=0.005) and ICU LOS (4.0 v. 4.8 days, p=0.023). No differences in hospital LOS or mortality were observed. While an open SICU bed protocol may facilitate rapid transport of trauma patients from the ED to the ICU, additional human factors interventions emphasizing improved communication and coordination can further reduce time spent in the ED. Level IV, Economic/Decision. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Does Coordinated Postpartum Care Influence Costs?

    Directory of Open Access Journals (Sweden)

    Elisabeth Zemp

    2017-03-01

    Full Text Available Questions under study: To investigate changes to health insurance costs for post-discharge postpartum care after the introduction of a midwife-led coordinated care model. Methods: The study included mothers and their newborns insured by the Helsana health insurance group in Switzerland and who delivered between January 2012 and May 2013 in the canton of Basel Stadt (BS (intervention canton. We compared monthly post-discharge costs before the launch of a coordinated postpartum care model (control phase, n = 144 to those after its introduction (intervention phase, n = 92. Costs in the intervention canton were also compared to those in five control cantons without a coordinated postpartum care model (cross-sectional control group: n = 7, 767. Results: The average monthly post-discharge costs for mothers remained unchanged in the seven months following the introduction of a coordinated postpartum care model, despite a higher use of midwife services (increasing from 72% to 80%. Likewise, monthly costs did not differ between the intervention canton and five control cantons. In multivariate analyses, the ambulatory costs for mothers were not associated with the post-intervention phase. Cross-sectionally, however, they were positively associated with midwifery use. For children, costs in the post-intervention phase were lower in the first month after hospital discharge compared to the pre-intervention phase (difference of –114 CHF [95%CI –202 CHF to –27 CHF], yet no differences were seen in the cross-sectional comparison. Conclusions: The introduction of a coordinated postpartum care model was associated with decreased costs for neonates in the first month after hospital discharge. Despite increased midwifery use, costs for mothers remained unchanged.

  1. Japanese Cost Accounting Systems - analysis of the cost accounting systems of the Japanese cost accounting standard

    OpenAIRE

    Peter, Winter

    2005-01-01

    This paper aims at providing an insight into Japanese cost accounting. Firstly, the development of cost accounting in Japan is delineated. Subsequently, the cost accounting systems codified in the Japanese cost accounting standard are analysed based on the classification according to Hoitsch/Schmitz. Lastly, a critical appraisal of the cost accounting systems of the Japanese cost accounting standard as well as a comparison to German and American cost accounting systems are conducted.

  2. New Federal Cost Accounting Regulations

    Science.gov (United States)

    Wolff, George J.; Handzo, Joseph J.

    1973-01-01

    Discusses a new set of indirect cost accounting procedures which must be followed by school districts wishing to recover any indirect costs of administering federal grants and contracts. Also discusses the amount of indirect costs that may be recovered, computing indirect costs, classifying project costs, and restricted grants. (Author/DN)

  3. Reducing Life-Cycle Costs.

    Science.gov (United States)

    Roodvoets, David L.

    2003-01-01

    Presents factors to consider when determining roofing life-cycle costs, explaining that costs do not tell the whole story; discussing components that should go into the decision (cost, maintenance, energy use, and environmental costs); and concluding that important elements in reducing life-cycle costs include energy savings through increased…

  4. Applying cost accounting to operating room staffing in otolaryngology: time-driven activity-based costing and outpatient adenotonsillectomy.

    Science.gov (United States)

    Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M

    2015-04-01

    (1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  5. Process-based Cost Estimation for Ramjet/Scramjet Engines

    Science.gov (United States)

    Singh, Brijendra; Torres, Felix; Nesman, Miles; Reynolds, John

    2003-01-01

    Process-based cost estimation plays a key role in effecting cultural change that integrates distributed science, technology and engineering teams to rapidly create innovative and affordable products. Working together, NASA Glenn Research Center and Boeing Canoga Park have developed a methodology of process-based cost estimation bridging the methodologies of high-level parametric models and detailed bottoms-up estimation. The NASA GRC/Boeing CP process-based cost model provides a probabilistic structure of layered cost drivers. High-level inputs characterize mission requirements, system performance, and relevant economic factors. Design alternatives are extracted from a standard, product-specific work breakdown structure to pre-load lower-level cost driver inputs and generate the cost-risk analysis. As product design progresses and matures the lower level more detailed cost drivers can be re-accessed and the projected variation of input values narrowed, thereby generating a progressively more accurate estimate of cost-risk. Incorporated into the process-based cost model are techniques for decision analysis, specifically, the analytic hierarchy process (AHP) and functional utility analysis. Design alternatives may then be evaluated not just on cost-risk, but also user defined performance and schedule criteria. This implementation of full-trade study support contributes significantly to the realization of the integrated development environment. The process-based cost estimation model generates development and manufacturing cost estimates. The development team plans to expand the manufacturing process base from approximately 80 manufacturing processes to over 250 processes. Operation and support cost modeling is also envisioned. Process-based estimation considers the materials, resources, and processes in establishing cost-risk and rather depending on weight as an input, actually estimates weight along with cost and schedule.

  6. Decreases in tanning behaviors following a short online survey: Potential for prevention?

    Directory of Open Access Journals (Sweden)

    Rachel F. Rodgers

    2015-01-01

    Conclusions: Our study presents novel and compelling support for using brief online surveys for decreasing health-risk behaviors such as sunbed use. Such measures are extremely cost-effective and easy to disseminate and implement. Replication and extension of these findings are warranted.

  7. Rising cost of antidotes in the U.S.: cost comparison from 2010 to 2015.

    Science.gov (United States)

    Heindel, Gregory A; Trella, Jeanette D; Osterhoudt, Kevin C

    2017-06-01

    Our poison control center observed a large increase in the cost of many antidotes over the past several years. The high cost of antidotes has previously been cited as a factor leading to inadequate antidote supply at some hospitals. Continued increases in the cost of antidotes may lead to further reductions in antidote supply and represent serious concerns. This research aims to quantify recent trends in the costs of antidotes in the U.S. Antidotes and minimum stocking recommendations were retrieved from published guidelines. RED BOOK Online(®) was used to identify the U.S. average wholesale price (AWP) of each antidote in 2010 and 2015. The AWP in 2010 was adjusted using the U.S. Consumer Price Index to adjust for inflation. The cost of minimum stocking levels for each antidote was calculated and compared between the year 2010 and 2015. The cost of stocking many antidotes demonstrated a large increase in AWP from 2010 to 2015. Of the antidotes evaluated, 15 out of 33 had greater than 50% increase in AWP and 8 out of 33 had greater than $1000 increase in AWP. Only four antidotes demonstrated decreases in AWP greater than 10% and only one antidote had its cost of stocking decrease in AWP by more than $1000. The price increase over the last 5 years may further hinder the willingness of hospitals to stock recommended antidotes at adequate quantities. This may impede timely treatment of patients, and negatively impact poisoning outcomes. The price of many antidotes substantially increased in the United States from 2010 to 2015. Strategies should be investigated to help decrease the cost associated with stocking and use of antidotes, including dose rounding, consignment, and regional sharing.

  8. BENEFITS OF INDIRECT COSTS ALLOCATION WITH COST DRIVERS

    OpenAIRE

    Delia MANEA; Mircea BARBU

    2012-01-01

    Due to the technological developments that has occurred in recent years within the business entities, the cost structure was affected, so that the largest share of the production cost is held by the indirect cost. Traditional management accounting and cost calculation methods allocate indirect cost based on an item which serves as a criterion, key or core distribution. The allocation of indirect cost has the disadvantage of an arbitrary distribution, depending on some basis subjectively chose...

  9. Cost-Effectiveness Analysis in Markets with High Fixed Costs

    OpenAIRE

    David M. Cutler; Marzilli Ericson, Keith M.

    2010-01-01

    We consider how to conduct cost-effectiveness analysis when the social cost of a resource differs from the posted price. From the social perspective, the true cost of a medical intervention is the marginal cost of delivering another unit of a treatment, plus the social cost (deadweight loss) of raising the revenue to fund the treatment. We focus on pharmaceutical prices, which have high markups over marginal cost due to the monopoly power granted to pharmaceutical companies when drugs are und...

  10. Decreasing barriers for nurse practitioner social entrepreneurship.

    Science.gov (United States)

    Sharp, Dayle B; Monsivais, Diane

    2014-10-01

    To describe difficulties associated with the business-related aspects of practice in role transition of rural nurse practitioners (NPs), and to give practice implications. This focused ethnographic study derived data from semi-structured interviews. Participants provided information about rural NP practice ownership and barriers. The sample consisted of 24 rural NPs living throughout the United States. The majority were 51-60 years of age (45%) and females (93%) who had been in rural practice for 1 to over 20 years. NP social entrepreneurs experience difficulties related to scope of practice, business skills, and role conflict. To decrease barriers for NP clinic ownership and management, NPs need to receive education related to financing a rural practice, legal/regulatory practices, strategic planning, leadership, and clinic management. ©2014 American Association of Nurse Practitioners.

  11. Decreased interoceptive accuracy following social exclusion.

    Science.gov (United States)

    Durlik, Caroline; Tsakiris, Manos

    2015-04-01

    The need for social affiliation is one of the most important and fundamental human needs. Unsurprisingly, humans display strong negative reactions to social exclusion. In the present study, we investigated the effect of social exclusion on interoceptive accuracy - accuracy in detecting signals arising inside the body - measured with a heartbeat perception task. We manipulated exclusion using Cyberball, a widely used paradigm of a virtual ball-tossing game, with half of the participants being included during the game and the other half of participants being ostracized during the game. Our results indicated that heartbeat perception accuracy decreased in the excluded, but not in the included, participants. We discuss these results in the context of social and physical pain overlap, as well as in relation to internally versus externally oriented attention. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Targeting communication interventions to decrease caregiver burden.

    Science.gov (United States)

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Oliver, Debra Parker; Demiris, George; Rankin, Anna

    2012-11-01

    To describe family communication patterns that give shape to four types of family caregivers: Manager, Carrier, Partner, and Loner. Case studies of oncology family caregivers and hospice patients selected from data collected as part of a larger, randomized controlled trial aimed at assessing family participation in interdisciplinary team meetings. Each caregiver type demonstrates essential communication traits with nurses and team members; an ability to recognize these caregiver types will facilitate targeted interventions to decrease family oncology caregiver burden. By becoming familiar with caregiver types, oncology nurses will be better able to address family oncology caregiver burden and the conflicts arising from family communication challenges. With an understanding of family communication patterns and its impact on caregiver burden, nurses can aid the patient, family, and team to best optimize all quality-of-life domains for patient and family caregiver. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Paravertebral regional blocks decrease length of stay following surgery for pectus excavatum in children.

    Science.gov (United States)

    Loftus, Patrick D; Elder, Craig T; Russell, Katie W; Spanos, Stephen P; Barnhart, Douglas C; Scaife, Eric R; Skarda, David E; Rollins, Michael D; Meyers, Rebecka L

    2016-01-01

    Management of postoperative pain following repair of pectus excavatum has traditionally included thoracic epidural analgesia, narcotics, and benzodiazepines. We hypothesized that the use of intercostal or paravertebral regional blocks could result in decreased inpatient length of stay (LOS). We conducted a retrospective cohort study of 137 patients (118 Nuss and 19 Ravitch - Nuss and Ravitch patients were analyzed separately) who underwent surgical repair of pectus excavatum with pain management via epidural, intercostal, or paravertebral analgesia from January 2009-December 2012. Measured outcomes included LOS, pain scores, benzodiazepine/narcotic requirements, emesis, professional fees, hospital cost, and total cost. In the Nuss patients, LOS was significantly reduced in the paravertebral group (ppectus excavatum repair was an effective alternative to epidural analgesia resulting in shorter LOS but not a decrease in overall cost. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Rapid scenarios and observed intensities

    OpenAIRE

    Franco Pettenati; Livio Sirovich

    2012-01-01

    After a destructive earthquake, national Governments need to know the approximate amount of damage, the number of casualties, and the financial losses as soon as possible. Rapid scenarios are also used to inform the general public; see the widely used Shakemap package [Wald et al. 1999, 2006] of the US Geological Survey (USGS) and the one modified by the Istituto Nazionale di Geofisica e Vulcanologia (INGV; National Institute of Geophysics and Volcanology), which is reproduced for Figure 1. T...

  15. Rapid synthesis of beta zeolites

    Science.gov (United States)

    Fan, Wei; Chang, Chun -Chih; Dornath, Paul; Wang, Zhuopeng

    2015-08-18

    The invention provides methods for rapidly synthesizing heteroatom containing zeolites including Sn-Beta, Si-Beta, Ti-Beta, Zr-Beta and Fe-Beta. The methods for synthesizing heteroatom zeolites include using well-crystalline zeolite crystals as seeds and using a fluoride-free, caustic medium in a seeded dry-gel conversion method. The Beta zeolite catalysts made by the methods of the invention catalyze both isomerization and dehydration reactions.

  16. Economic Costs and Adaptations for Alternative Regulations of California's Sacramento–San Joaquin Delta

    Directory of Open Access Journals (Sweden)

    Stacy K. Tanaka

    2011-07-01

    Full Text Available Stacy K. Tanaka, Christina R. Connell–Buck, Kaveh Madani, Josue Medellín-Azuara, Jay R. Lund, and Ellen Hanakdoi: http://dx.doi.org/10.15447/sfews.2014v9iss2art4Water exports from California’s Sacramento–San Joaquin Delta are an environmental concern because they reduce net outflows of fresh water from the Delta, and can entrain fish and disrupt flows within the Delta. If exports were no longer pumped from within the Delta, the regulatory issue becomes one of maintaining appropriate flows into and out of the Delta. This paper presents the results of two sets of hydro-economic optimization modeling runs, which were developed to represent a range of modified Delta operations and their economic and operational effects on California’s water supply system. The first set of runs represents decreasing export capacity from the Delta. The second set increases minimum net Delta outflow (MNDO requirements. The hydro-economic model seeks the least–cost statewide water management scheme for water supply, including a wide range of resources and water management options. Results show that reducing exports or increasing MNDO requirements increase annual average statewide water scarcity, scarcity costs, and operating costs (from greater use of desalination, wastewater recycling, water treatment, and pumping. Effects of reduced exports are especially concentrated in agricultural communities in the southern Central Valley because of their loss of access to overall water supply exports and their ability to transfer remaining water to southern California. Increased outflow requirements increase water scarcity and associated costs throughout California. For an equivalent amount of average Delta outflows, statewide costs increase more rapidly when exports alone are reduced than when minimum outflow requirements are increased and effects are more widely distributed statewide.

  17. Rapid scenarios and observed intensities

    Directory of Open Access Journals (Sweden)

    Franco Pettenati

    2012-10-01

    Full Text Available After a destructive earthquake, national Governments need to know the approximate amount of damage, the number of casualties, and the financial losses as soon as possible. Rapid scenarios are also used to inform the general public; see the widely used Shakemap package [Wald et al. 1999, 2006] of the US Geological Survey (USGS and the one modified by the Istituto Nazionale di Geofisica e Vulcanologia (INGV; National Institute of Geophysics and Volcanology, which is reproduced for Figure 1. The general matter of the use of intensities in damage scenarios was discussed in a special session at the 2008 Annual Meeting of the Seismological Society of America (http://www.seismosoc.org/meetings/2008/specialsessions.html, and was also discussed in the NIS-1 session of the European Congress in Moscow, in August 2012 (http://www.esc2012-moscow.org/esc_thematicareas.html. The purposes of the present report are to: (i compare different types of intensities; (ii check two rapid scenarios of intensity; and (iii understand whether the KF formula [Sirovich 1996, Sirovich et al. 2009] can be used as a new 'attenuation' relationship to improve rapid scenarios. […

  18. Rapid diagnosis of mycobacterial infections

    Directory of Open Access Journals (Sweden)

    Michel Drancourt

    2015-01-01

    Full Text Available While pulmonary tuberculosis (PTB remains an important public health issue worldwide, there is an emerging interest in non-tuberculous mycobacteria (NTM which is responsible for opportunistic infections of the respiratory tract as well as other anatomical sites in both developed and developing countries. In this context the one goal of the clinical mycobacteriology laboratories is to provide physicians with an accurate identification of the mycobacterium as rapidly as possible. During the last ten years, several lines of laboratory tools have been developed in order to speed the isolation and identification of mycobacteria from clinical specimens. Chiefly, the composition of culture medium was renewed along with the protocol of incubation in order to recover Mycobacterium tuberculosis (MTB micro-colonies as soon as 48 h after the inoculation of the specimen. MALDI-TOF rapid identification is clearly the tool to be implemented in the laboratory for the rapid identification of the micro-colonies. Also, molecular tools and genomics are necessary in order to depict new mycobacteria species, including those of the Mycobacterium abscessus complex and the Mycobacterium avium complex. All these tools and their connections will be presented during this conference.

  19. 2015 South Carolina PV soft cost and workforce development Part I. Initial survey results

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Elise B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Edwards, Thomas B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-05-01

    The South Carolina solar industry has surged over the past two years, largely due to the implementation of Act 236, and continues to grow at a rapid pace. At the beginning of 2014, there was little more than 3MW total spread across the state, but by the end of 2021, that state solar industry will have grown to over 300MW across all sectors. Prior to this study, there has been little publically available information on the solar industry in SC and throughout the Southeastern US. This makes SC a key case study of an emerging market, enabling the development of regional best practices in order to decrease associated costs and increase deployment.

  20. Cost object in accounting

    Directory of Open Access Journals (Sweden)

    Gertruda Świderska

    2016-07-01

    Full Text Available In Polish literature in the field of accounting there are many synonymous terms such as the object of cost calculation, cost unit, or cost driver. Their definitions are often very similar, and their use in certain cir-cumstances unclear. This article aims to answer the question whether the term costs object meaning „something whose cost is of interest to accounting information users”, can replace previously used terms. The analysis applies to literature in Polish, in which different schools have developed their own terms, which is connected with the tradition of schools of accounting in Poland and the evolution of the con-cepts. The analysis aims to verify the hypothesis that for many synonymous terms used in publications in the field of accounting a universal solution can be proposed, taking into account the technological pro-gress and changing user needs. The research methods used include a systematic review of literature in Polish from the period 1966 to 2016 and an analysis of the terms.