WorldWideScience

Sample records for total operating cost

  1. Determining the total cost of reverse supply chain operations for original equipment manufacturers

    DEFF Research Database (Denmark)

    Larsen, Samuel Brüning; Jacobsen, Peter

    2014-01-01

    When original equipment manufacturers (OEM) examine whether or not to invest in a reverse supply chain (RSC), managers need insight into not only the cost savings and new revenue streams the RSC enables, but also the total cost of the RSC itself. Using case study research the study examines what...... cost parameters constitute the total cost (TC) of the RSC. The specific RSC that the study seeks the TC for consists of 1) end-product refurbishing, 2) component refurbishing, and 3) sales of used materials back to original suppliers or independent recyclers for materials recycling....

  2. Evaluation of the Influence of the Logistic Operations Reliability on the Total Costs of a Supply Chain

    Directory of Open Access Journals (Sweden)

    Lukinskiy Valery

    2016-12-01

    Full Text Available Nowadays in logistics integral processes between the material and related flows in supply chains are getting developed more and more. However, in spite of increasing volume of statistical data which reflect the integral processes, the influence evaluation issues of the logistic operations reliability indexes on the total logistics costs remain open and require the corresponding researches implementation.

  3. Cost of post-operative intravenous iron therapy in total lower limb arthroplasty: a retrospective, matched cohort study

    Science.gov (United States)

    Muñoz, Manuel; Gómez-Ramírez, Susana; Martín-Montañez, Elisa; Naveira, Enrique; Seara, Javier; Pavía, José

    2014-01-01

    Background Requirements for allogeneic red cell transfusion after total lower limb arthroplasty are still high (20–50%), and post-operative intravenous iron has been shown to reduce transfusion requirements for this surgery. We performed a cost analysis to ascertain whether this alternative is also likely to be cost-effective. Materials and methods Data from 182 matched-pairs of total lower limb arthroplasty patients, managed with a restrictive transfusion protocol and without (control group) or with post-operative intravenous iron (iron group), were retrospectively reviewed. Acquisition and administration costs of iron (iron sucrose or ferric carboxymaltose) and allogeneic red cell concentrates, haemoglobin measurements, and prolonged stay in hospital were used for blood management cost analysis. Results Patients in the iron group received 600 mg intravenous iron, without clinically relevant incidents, and had a lower allogeneic transfusion rate (11.5% vs 26.4% for the iron and control groups, respectively; p=0.001). The reduction in transfusion rate was more pronounced in anaemic patients (17% vs 40%; p=0.015) than in non-anaemic ones (9.6% vs 21.2%; p=0.011). There were no differences with respect to post-operative infection rate. Patients receiving allogeneic transfusion stayed in hospital longer (+1.9 days [95% CI: 1.2–2.6]). As intravenous iron reduces the allogeneic transfusion rate, both iron formulations were cost-neutral in the different cost scenarios (−25.5 to 62.1 €/patient for iron sucrose, and −51.1 to 64.4 €/patient for ferric carboxymaltose). Discussion In patients presenting with or without pre-operative anaemia, post-operative intravenous iron after total lower limb arthroplasty seems to be safe and is associated with reduced transfusion rates, without incremental costs. For anaemic patients, its efficacy could be increased by associating some other blood-saving method. PMID:24120595

  4. [Fuel Rod Consolidation Project]: The estimated total life cycle cost for the 30-year operation of prototypical consolidation demonstration equipment: Volume 4, Phase 2

    International Nuclear Information System (INIS)

    1987-01-01

    The Total Life Cycle Costs have been developed for the construction, operation and decommissioning of a single line of hot-cell-enclosed production consolidation equipment operating on spent fuel at the rate of 750 MTU/year for 30 years. The cost estimate is for a single production line that is part of an overall facility at either a Monitored Retrievable Storage or a Repository facility. This overall facility would include other capabilities and possibly other consolidation lines. However, no costs were included in the cost estimate for other portions of the plant, except that staff costs include an overhead charge that reflects the overhead support services in an overall facility

  5. Total generating costs: coal and nuclear plants

    International Nuclear Information System (INIS)

    1979-02-01

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

  6. The cost of post-operative shed blood salvage after total knee arthroplasty: an analysis of 1,093 consecutive procedures

    Science.gov (United States)

    Muñoz, Manuel; Ariza, Daniel; Campos, Arturo; Martín-Montañez, Elisa; Pavía, José

    2013-01-01

    Background Requirements for allogeneic red cell transfusion after total knee arthroplasty are still high (20–50%), and salvage and reinfusion of unwashed, filtered post-operative shed blood is an established method for reducing transfusion requirements following this operation. We performed a cost analysis to ascertain whether this alternative is likely to be cost-effective. Materials and methods Data from 1,093 consecutive primary total knee arthroplasties, managed with (reinfusion group, n=763) or without reinfusion of unwashed salvaged blood (control group, n=330), were retrospectively reviewed. The costs of low-vacuum drains, shed blood collection canisters (Bellovac ABT®, Wellspect HealthCare and ConstaVac CBC II®, Stryker), shed blood reinfusion, acquisition and transfusion of allogeneic red cell concentrate, haemoglobin measurements, and prolonged length of hospital stay were used for the blood management cost analysis. Results Patients in the reinfusion group received 152±64 mL of red blood cells from postoperatively salvaged blood, without clinically relevant incidents, and showed a lower allogeneic transfusion rate (24.5% vs 8.5%, for the control and reinfusion groups, respectively; p =0.001). There were no differences in post-operative infection rates. Patients receiving allogeneic transfusions stayed in hospital longer (+1.9 days [95% CI: 1.2 to 2.6]). As reinfusion of unwashed salvaged blood reduced the allogeneic transfusion rate, both reinfusion systems may provide net savings in different cost scenarios (€ 4.6 to € 106/patient for Bellovac ABT, and € −51.9 to € 49.9/patient for ConstaVac CBCII). Discussion Return of unwashed salvaged blood after total knee arthroplasty seems to save costs in patients with pre-operative haemoglobin between 12 and 15 g/dL. It is not cost-saving in patients with a pre-operative haemoglobin >15 g/dL, whereas in those with a pre-operative haemoglobin cost-saving, its efficacy could be increased by

  7. Space Station Freedom operations costs

    Science.gov (United States)

    Accola, Anne L.; Williams, Gregory J.

    1988-01-01

    Measures to reduce the operation costs of the Space Station which can be implemented in the design and development stages are discussed. Operational functions are described in the context of an overall operations concept. The provisions for operations cost responsibilities among the partners in the Space Station program are presented. Cost estimating methodologies and the way in which operations costs affect the design and development process are examined.

  8. Operational resource theory of total quantum coherence

    Science.gov (United States)

    Yang, Si-ren; Yu, Chang-shui

    2018-01-01

    Quantum coherence is an essential feature of quantum mechanics and is an important physical resource in quantum information. Recently, the resource theory of quantum coherence has been established parallel with that of entanglement. In the resource theory, a resource can be well defined if given three ingredients: the free states, the resource, the (restricted) free operations. In this paper, we study the resource theory of coherence in a different light, that is, we consider the total coherence defined by the basis-free coherence maximized among all potential basis. We define the distillable total coherence and the total coherence cost and in both the asymptotic regime and the single-copy regime show the reversible transformation between a state with certain total coherence and the state with the unit reference total coherence. Extensively, we demonstrate that the total coherence can also be completely converted to the total correlation with the equal amount by the free operations. We also provide the alternative understanding of the total coherence, respectively, based on the entanglement and the total correlation in a different way.

  9. Direct cost comparison of totally endoscopic versus open ear surgery.

    Science.gov (United States)

    Patel, N; Mohammadi, A; Jufas, N

    2018-02-01

    Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting. A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques. Totally endoscopic ear surgery has a mean direct cost reduction of AUD$2978.89 per operation from the hospital perspective, when compared to canal wall up mastoidectomy. Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.

  10. Total Cost of Ownership and Cost-to-Serve

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2007-01-01

    Artiklen reviewer den eksisterende litteratur vedrørende økonomistyringsværktøjerne Total Cost of Ownership (TCO) og Cost-to-Serve (CtS). Herefter kortlægges det, hvordan TCO og CtS bidrager til en identificering af direkte omkostninger såvel som indirekte omkostninger henholdsvis up-stream og down...

  11. Procedure for estimating permanent total enclosure costs

    Energy Technology Data Exchange (ETDEWEB)

    Lukey, M E; Prasad, C; Toothman, D A; Kaplan, N

    1999-07-01

    Industries that use add-on control devices must adequately capture emissions before delivering them to the control device. One way to capture emissions is to use permanent total enclosures (PTEs). By definition, an enclosure which meets the US Environmental Protection Agency's five-point criteria is a PTE and has a capture efficiency of 100%. Since costs play an important role in regulatory development, in selection of control equipment, and in control technology evaluations for permitting purposes, EPA has developed a Control Cost Manual for estimating costs of various items of control equipment. EPA's Manual does not contain any methodology for estimating PTE costs. In order to assist environmental regulators and potential users of PTEs, a methodology for estimating PTE costs was developed under contract with EPA, by Pacific Environmental Services, Inc. (PES) and is the subject of this paper. The methodology for estimating PTE costs follows the approach used for other control devices in the Manual. It includes procedures for sizing various components of a PTE and for estimating capital as well as annual costs. It contains verification procedures for demonstrating compliance with EPA's five-point criteria. In addition, procedures are included to determine compliance with Occupational Safety and Health Administration (OSHA) standards. Meeting these standards is an important factor in properly designing PTEs. The methodology is encoded in Microsoft Exel spreadsheets to facilitate cost estimation and PTE verification. Examples are given throughout the methodology development and in the spreadsheets to illustrate the PTE design, verification, and cost estimation procedures.

  12. Total life cycle cost model for electric power stations

    International Nuclear Information System (INIS)

    Cardullo, M.W.

    1995-01-01

    The Total Life Cycle Cost (TLCC) model for electric power stations was developed to provide a technology screening model. The TLCC analysis involves normalizing cost estimates with respect to performance standards and financial assumptions and preparing a profile of all costs over the service life of the power station. These costs when levelized present a value in terms of a utility electricity rate. Comparison of cost and the pricing of the electricity for a utility shows if a valid project exists. Cost components include both internal and external costs. Internal costs are direct costs associated with the purchase, and operation of the power station and include initial capital costs, operating and maintenance costs. External costs result from societal and/or environmental impacts that are external to the marketplace and can include air quality impacts due to emissions, infrastructure costs, and other impacts. The cost stream is summed (current dollars) or discounted (constant dollars) to some base year to yield a overall TLCC of each power station technology on a common basis. While minimizing life cycle cost is an important consideration, it may not always be a preferred method for some utilities who may prefer minimizing capital costs. Such consideration does not always result in technology penetration in a marketplace such as the utility sector. Under various regulatory climates, the utility is likely to heavily weigh initial capital costs while giving limited consideration to other costs such as societal costs. Policy makers considering external costs, such as those resulting from environmental impacts, may reach significantly different conclusions about which technologies are most advantageous to society. The TLCC analysis model for power stations was developed to facilitate consideration of all perspectives

  13. Unit costs of waste management operations

    International Nuclear Information System (INIS)

    Kisieleski, W.E.; Folga, S.M.; Gillette, J.L.; Buehring, W.A.

    1994-04-01

    This report provides estimates of generic costs for the management, disposal, and surveillance of various waste types, from the time they are generated to the end of their institutional control. Costs include monitoring and surveillance costs required after waste disposal. Available data on costs for the treatment, storage, disposal, and transportation of spent nuclear fuel and high-level radioactive, low-level radioactive, transuranic radioactive, hazardous, mixed (low-level radioactive plus hazardous), and sanitary wastes are presented. The costs cover all major elements that contribute to the total system life-cycle (i.e., ''cradle to grave'') cost for each waste type. This total cost is the sum of fixed and variable cost components. Variable costs are affected by operating rates and throughput capacities and vary in direct proportion to changes in the level of activity. Fixed costs remain constant regardless of changes in the amount of waste, operating rates, or throughput capacities. Key factors that influence cost, such as the size and throughput capacity of facilities, are identified. In many cases, ranges of values for the key variables are presented. For some waste types, the planned or estimated costs for storage and disposal, projected to the year 2000, are presented as graphics

  14. Procedure for estimating permanent total enclosure costs

    Energy Technology Data Exchange (ETDEWEB)

    Lukey, M.E.; Prasad, C.; Toothman, D.A.; Kaplan, N.

    1999-07-01

    Industries that use add-on control devices must adequately capture emissions before delivering them to the control device. One way to capture emissions is to use permanent total enclosures (PTEs). By definition, an enclosure which meets the US Environmental Protection Agency's five-point criteria is a PTE and has a capture efficiency of 100%. Since costs play an important role in regulatory development, in selection of control equipment, and in control technology evaluations for permitting purposes, EPA has developed a Control Cost Manual for estimating costs of various items of control equipment. EPA's Manual does not contain any methodology for estimating PTE costs. In order to assist environmental regulators and potential users of PTEs, a methodology for estimating PTE costs was developed under contract with EPA, by Pacific Environmental Services, Inc. (PES) and is the subject of this paper. The methodology for estimating PTE costs follows the approach used for other control devices in the Manual. It includes procedures for sizing various components of a PTE and for estimating capital as well as annual costs. It contains verification procedures for demonstrating compliance with EPA's five-point criteria. In addition, procedures are included to determine compliance with Occupational Safety and Health Administration (OSHA) standards. Meeting these standards is an important factor in properly designing PTEs. The methodology is encoded in Microsoft Exel spreadsheets to facilitate cost estimation and PTE verification. Examples are given throughout the methodology development and in the spreadsheets to illustrate the PTE design, verification, and cost estimation procedures.

  15. The operating cost of electrocoagulation

    Energy Technology Data Exchange (ETDEWEB)

    Donini, J.C.; Kan, J.; Szynkarczuk, J.; Hassan, T.A.; Kar, K.L. (Canadian Centre for Mineral and Energy Technology, Devon, AB (Canada))

    1994-12-01

    The electrocoagulation of kaolinite and bentonite suspensions was studied in a pilot-scale electrocoagulation system to assess the operating cost and efficiency of the process. Factors affecting the operating cost such as formation of passivation layers on electrode plates, flow velocity, and concentration of NaCl in the suspension were examined. The operating costs investigated were the power cost of the electrocoagulation cell and the material cost due to the consumption of the aluminum electrode. Comparison was based on the settling properties of the treated product: turbidity, settling rate, and cake height. Higher NaCl concentration resulted in greater amounts of Al dissolved chemically and electrochemically into the suspension and thus a better clarity of the supernatant of the treated product. Increased flow velocity could reduce significantly the operating cost while improving both clarity of the supernatant and compactness of the sludge volume. The passivation layers developed quickly with time during the electrocoagulation process and more energy became wasted on the layers. 10 refs., 12 figs.

  16. Total cost of ownership: Getting past the 10% solution

    International Nuclear Information System (INIS)

    Anderson, R.F.

    1996-01-01

    As the refining industry strives to succeed in a more-competitive world, some fresh ideas are needed to counter the headlines of plant closings, layoffs, and corporate restructurings. Other industries facing the same pressures have discovered opportunities to reduce cost in a more human and effective manner by using some tools borrowed from the Total Quality process to enhance the procurement process. Experience suggests that the purchase cost is a small fraction of the actual cost of a commodity and is often dwarfed by hidden costs. Discovering and eliminating the hidden costs of variation, nonoptimal operations, and poorly aligned vendor relations is vital to economic survival. The purpose of this paper is to suggest some fresh approaches to vendor-customer relations that can dramatically reduce undesired costs

  17. Droop Scheme With Consideration of Operating Costs

    DEFF Research Database (Denmark)

    Nutkani, I. U.; Loh, Poh Chiang; Blaabjerg, Frede

    2014-01-01

    considered even though they are different for different types of DGs. This letter thus proposes an alternative droop scheme, which can better distinguish the different operating characteristics and objectives of the DGs grouped together in a weighted droop expression. The power sharing arrived in the steady...... state will meet the intended objectives, as demonstrated in the experiment with a defined objective of minimizing the total microgrid operating cost....

  18. Wood fuelled boiler operating costs

    International Nuclear Information System (INIS)

    Sandars, D.L.

    1995-01-01

    This report is a management study into the operating costs of wood-fired boilers. Data obtained from existing wood-fired plant has been analysed and interpreted using the principles of machinery management and the science that underlies the key differences between this fuel and any other. A set of budgeting principles has been developed for the key areas of labour requirement, insurance, maintenance and repair and electricity consumption. Other lesser cost centres such as the provision of shelter and the effects of neglect and accidents have also been considered, and a model constructed. (author)

  19. Optimising costs in WLCG operations

    CERN Document Server

    Pradillo, Mar; Flix, Josep; Forti, Alessandra; Sciabà, Andrea

    2015-01-01

    The Worldwide LHC Computing Grid project (WLCG) provides the computing and storage resources required by the LHC collaborations to store, process and analyse the 50 Petabytes of data annually generated by the LHC. The WLCG operations are coordinated by a distributed team of managers and experts and performed by people at all participating sites and from all the experiments. Several improvements in the WLCG infrastructure have been implemented during the first long LHC shutdown to prepare for the increasing needs of the experiments during Run2 and beyond. However, constraints in funding will affect not only the computing resources but also the available effort for operations. This paper presents the results of a detailed investigation on the allocation of the effort in the different areas of WLCG operations, identifies the most important sources of inefficiency and proposes viable strategies for optimising the operational cost, taking into account the current trends in the evolution of the computing infrastruc...

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

    Science.gov (United States)

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

    2011-02-01

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

  1. The total lifetime costs of smoking

    DEFF Research Database (Denmark)

    Rasmussen, S.R.; Prescott, E.; Sørensen, T.I.A.

    2004-01-01

    Net costs of smoking in a lifetime perspective and, hence, the economic interests in antismoking policies have been questioned. It has been proposed that the health-related costs of smoking are balanced by smaller expenditure due to shorter life expectancy.......Net costs of smoking in a lifetime perspective and, hence, the economic interests in antismoking policies have been questioned. It has been proposed that the health-related costs of smoking are balanced by smaller expenditure due to shorter life expectancy....

  2. Marginal costs for road maintenance and operation - a cost function approach

    OpenAIRE

    Haraldsson, Mattias

    2007-01-01

    Using observational data covering the whole Swedish national road network for the period 1998-2002, this paper estimates a set of maintenance and operation cost functions. It is found that costs for all operation and maintenance measures increase with traffic intensity, with two exceptions; total operation and winter operation measures are fixed cost activities. All other operation and maintenance measures have short run elasticities in the range 0.25-0.60. The impact of an additional vehicle...

  3. Model improves oil field operating cost estimates

    International Nuclear Information System (INIS)

    Glaeser, J.L.

    1996-01-01

    A detailed operating cost model that forecasts operating cost profiles toward the end of a field's life should be constructed for testing depletion strategies and plans for major oil fields. Developing a good understanding of future operating cost trends is important. Incorrectly forecasting the trend can result in bad decision making regarding investments and reservoir operating strategies. Recent projects show that significant operating expense reductions can be made in the latter stages o field depletion without significantly reducing the expected ultimate recoverable reserves. Predicting future operating cost trends is especially important for operators who are currently producing a field and must forecast the economic limit of the property. For reasons presented in this article, it is usually not correct to either assume that operating expense stays fixed in dollar terms throughout the lifetime of a field, nor is it correct to assume that operating costs stay fixed on a dollar per barrel basis

  4. Reverse-total shoulder arthroplasty cost-effectiveness: A quality-adjusted life years comparison with total hip arthroplasty.

    Science.gov (United States)

    Bachman, Daniel; Nyland, John; Krupp, Ryan

    2016-02-18

    To compare reverse-total shoulder arthroplasty (RSA) cost-effectiveness with total hip arthroplasty cost-effectiveness. This study used a stochastic model and decision-making algorithm to compare the cost-effectiveness of RSA and total hip arthroplasty. Fifteen patients underwent pre-operative, and 3, 6, and 12 mo post-operative clinical examinations and Short Form-36 Health Survey completion. Short form-36 Health Survey subscale scores were converted to EuroQual Group Five Dimension Health Outcome scores and compared with historical data from age-matched patients who had undergone total hip arthroplasty. Quality-adjusted life year (QALY) improvements based on life expectancies were calculated. The cost/QALY was $3900 for total hip arthroplasty and $11100 for RSA. After adjusting the model to only include shoulder-specific physical function subscale items, the RSA QALY improved to 2.8 years, and its cost/QALY decreased to $8100. Based on industry accepted standards, cost/QALY estimates supported both RSA and total hip arthroplasty cost-effectiveness. Although total hip arthroplasty remains the quality of life improvement "gold standard" among arthroplasty procedures, cost/QALY estimates identified in this study support the growing use of RSA to improve patient quality of life.

  5. Operating cost model for local service airlines

    Science.gov (United States)

    Anderson, J. L.; Andrastek, D. A.

    1976-01-01

    Several mathematical models now exist which determine the operating economics for a United States trunk airline. These models are valuable in assessing the impact of new aircraft into an airline's fleet. The use of a trunk airline cost model for the local service airline does not result in representative operating costs. A new model is presented which is representative of the operating conditions and resultant costs for the local service airline. The calculated annual direct and indirect operating costs for two multiequipment airlines are compared with their actual operating experience.

  6. The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Palsis, John A; Brehmer, Thomas S; Pellegrini, Vincent D; Drew, Jacob M; Sachs, Barton L

    2018-02-21

    In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods. We compared the methods with respect to the overall costs of hip and knee replacement and the costs for each major cost category. The traditional accounting method resulted in higher cost estimates. The total cost per hip replacement was $22,076 (2014 USD) using traditional accounting and was $12,957 using TDABC. The total cost per knee replacement was $29,488 using traditional accounting and was $16,981 using TDABC. With respect to cost categories, estimates using traditional accounting were greater for hip and knee replacement, respectively, by $3,432 and $5,486 for personnel, by $3,398 and $3,664 for space and equipment, and by $2,289 and $3,357 for indirect costs. Implants and consumables were derived from the actual hospital purchase price; accordingly, both methods produced equivalent results. Substantial cost differences exist between accounting methods. The focus of TDABC only on resources used directly by the patient contrasts with the allocation of all operating costs, including all indirect costs and unused capacity, with traditional accounting. We expect that the true costs of hip and knee replacement care cycles are likely somewhere between estimates derived from traditional accounting methods and TDABC. TDABC offers patient-level granular cost information that better serves in the redesign of care pathways and may lead to more strategic resource-allocation decisions to optimize

  7. An analysis of nuclear plant operating costs: A 1991 update

    International Nuclear Information System (INIS)

    1991-05-01

    This report updates a 1988 Energy Information Administration (EIA) report which examined trends in nonfuel operating costs at the Nation's nuclear power plants. Nonfuel operating costs are comprised of operating and maintenance (O ampersand M) costs and capital expenditures incurred after a plant begins operating. Capital expenditures are typically called ''capital additions'' because the costs are added to the utility's rate base and recovered as a depreciation expense over several years, the number of years being regulated by State Public Utility Commissions. These costs consist of large maintenance expenditures needed to keep a plant operational as well as those needed to make plant modifications mandated by the Nuclear Regulatory Commission (NRC) or implemented at the utility's discretion. The 1988 report found that from 1974 through 1984, the last year for which data were available, nuclear power plant nonfuel operating costs escalated by 14 percent annually in real terms. The objective of the present study was to determine whether trends in nonfuel operating costs have changed since 1984, if there was any change in the underlying factors influencing these costs, and if so, how these changes affect the basic conclusions of the 1988 report. The general trends are encouraging: Total nonfuel operating costs peaked in 1984 and have been lower since that time; O ampersand M costs have been rising, but at a much lower rate than seen from 1974 through 1984; capital additions costs have actually been declining. 9 figs., 12 tabs

  8. Nuclear operating costs are rising exponentially - official

    International Nuclear Information System (INIS)

    Thomas, S.

    1988-01-01

    The Energy Information Agency of the United States Department of Energy has collected data on the operations of nuclear power plants in the United States. A statistical regression analysis was made of this data base. This shows that the escalation in annual, real non-fuel operating costs is such that the operating cost savings made by closing down an old nuclear plant would be sufficient to pay the capital and operating costs of replacing it with a brand new coal-fired plant. The main reason for the increasing operating and maintenance costs is the cost of replacement power i.e. the higher the economic penalty of plant breakdown the more the utility has to spend on maintenance. Another reason is time -not the age of the plant - but the year the data was collected. The economic case for nuclear power is seriously challenged. (U.K.)

  9. The Launch Systems Operations Cost Model

    Science.gov (United States)

    Prince, Frank A.; Hamaker, Joseph W. (Technical Monitor)

    2001-01-01

    One of NASA's primary missions is to reduce the cost of access to space while simultaneously increasing safety. A key component, and one of the least understood, is the recurring operations and support cost for reusable launch systems. In order to predict these costs, NASA, under the leadership of the Independent Program Assessment Office (IPAO), has commissioned the development of a Launch Systems Operations Cost Model (LSOCM). LSOCM is a tool to predict the operations & support (O&S) cost of new and modified reusable (and partially reusable) launch systems. The requirements are to predict the non-recurring cost for the ground infrastructure and the recurring cost of maintaining that infrastructure, performing vehicle logistics, and performing the O&S actions to return the vehicle to flight. In addition, the model must estimate the time required to cycle the vehicle through all of the ground processing activities. The current version of LSOCM is an amalgamation of existing tools, leveraging our understanding of shuttle operations cost with a means of predicting how the maintenance burden will change as the vehicle becomes more aircraft like. The use of the Conceptual Operations Manpower Estimating Tool/Operations Cost Model (COMET/OCM) provides a solid point of departure based on shuttle and expendable launch vehicle (ELV) experience. The incorporation of the Reliability and Maintainability Analysis Tool (RMAT) as expressed by a set of response surface model equations gives a method for estimating how changing launch system characteristics affects cost and cycle time as compared to today's shuttle system. Plans are being made to improve the model. The development team will be spending the next few months devising a structured methodology that will enable verified and validated algorithms to give accurate cost estimates. To assist in this endeavor the LSOCM team is part of an Agency wide effort to combine resources with other cost and operations professionals to

  10. Operating costs on Norwegian fields

    International Nuclear Information System (INIS)

    Sunnevaag, K.; Nansve, A.H.

    1992-09-01

    In this report we summarize some of the findings in a project for A/S Norske Shell, where the objective was to find trends in the development of operating expenditures on the Norwegian Continental Shelf if any, and to explain these. We also present a short compilation of articles on the subject. 23 refs., 13 figs

  11. A Cost Simulation Tool for Estimating the Cost of Operating Government Owned and Operated Ships

    Science.gov (United States)

    1994-09-01

    Horngren , C.T., Foster, G., Datar, S.M., Cost Accounting : A Management Emphasis, Prentice-Hall, Englewood Cliffs, NJ, 1994 IBM Corporation, A Graphical...4. TITLE AND SUBTITLE A COST SIMULATION TOOL FOR 5. FUNDING NUMBERS ESTIMATING THE COST OF OPERATING GOVERNMENT OWNED AND OPERATED SHIPS 6. AUTHOR( S ...normally does not present a problem to the accounting department. The final category, the cost of operating the government owned and operated ships is

  12. Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

    Science.gov (United States)

    Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R

    2011-01-01

    Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.

  13. Naval Reserve Annual Operating Costs

    Science.gov (United States)

    1975-10-29

    C. c ) CPi i 0 0 00 0 le C C.C~r In 1]1 In 00 It .- I to C-38 ’U2 WIX ’W~ - m u. -C-LC m4 C v , v ul FA ?w % -D 1 o r cl jc j, II t %c oK W)i Ir of... platform programs, while Program 11 contains 26 sub-programs each having a separate Reserve program sponsor. The distribution of Program 11 resources is...a mix of specific skills required to bring an active Navy oper-Iating platform to organizational manning. Each SRU is tailored to a specific ship

  14. Economics of human performance and systems total ownership cost.

    Science.gov (United States)

    Onkham, Wilawan; Karwowski, Waldemar; Ahram, Tareq Z

    2012-01-01

    Financial costs of investing in people is associated with training, acquisition, recruiting, and resolving human errors have a significant impact on increased total ownership costs. These costs can also affect the exaggerate budgets and delayed schedules. The study of human performance economical assessment in the system acquisition process enhances the visibility of hidden cost drivers which support program management informed decisions. This paper presents the literature review of human total ownership cost (HTOC) and cost impacts on overall system performance. Economic value assessment models such as cost benefit analysis, risk-cost tradeoff analysis, expected value of utility function analysis (EV), growth readiness matrix, multi-attribute utility technique, and multi-regressions model were introduced to reflect the HTOC and human performance-technology tradeoffs in terms of the dollar value. The human total ownership regression model introduces to address the influencing human performance cost component measurement. Results from this study will increase understanding of relevant cost drivers in the system acquisition process over the long term.

  15. Modeling Operations Costs for Human Exploration Architectures

    Science.gov (United States)

    Shishko, Robert

    2013-01-01

    Operations and support (O&S) costs for human spaceflight have not received the same attention in the cost estimating community as have development costs. This is unfortunate as O&S costs typically comprise a majority of life-cycle costs (LCC) in such programs as the International Space Station (ISS) and the now-cancelled Constellation Program. Recognizing this, the Constellation Program and NASA HQs supported the development of an O&S cost model specifically for human spaceflight. This model, known as the Exploration Architectures Operations Cost Model (ExAOCM), provided the operations cost estimates for a variety of alternative human missions to the moon, Mars, and Near-Earth Objects (NEOs) in architectural studies. ExAOCM is philosophically based on the DoD Architecture Framework (DoDAF) concepts of operational nodes, systems, operational functions, and milestones. This paper presents some of the historical background surrounding the development of the model, and discusses the underlying structure, its unusual user interface, and lastly, previous examples of its use in the aforementioned architectural studies.

  16. evaluation of total annual costs of heat exchanger networks using

    African Journals Online (AJOL)

    user

    after solving the first problem using RPA based heat integration gave a minimum total annual cost (TAC) of $237, ... mathematical programming and non-RPA based Hint software. ... The concept of pinch analysis evolved over the years.

  17. Revitalizing Space Operations through Total Quality Management

    Science.gov (United States)

    Baylis, William T.

    1995-01-01

    The purpose of this paper is to show the reader what total quality management (TQM) is and how to apply TQM in the space systems and management arena. TQM is easily understood, can be implemented in any type of business organization, and works.

  18. A general approach to total repair cost limit replacement policies

    Directory of Open Access Journals (Sweden)

    F. Beichelt

    2014-01-01

    Full Text Available A common replacement policy for technical systems consists in replacing a system by a new one after its economic lifetime, i.e. at that moment when its long-run maintenance cost rate is minimal. However, the strict application of the economic lifetime does not take into account the individual deviations of maintenance cost rates of single systems from the average cost development. Hence, Beichet proposed the total repair cost limit replacement policy: the system is replaced by a new one as soon as its total repair cost reaches or exceeds a given level. He modelled the repair cost development by functions of the Wiener process with drift. Here the same policy is considered under the assumption that the one-dimensional probability distribution of the process describing the repair cost development is given. In the examples analysed, applying the total repair cost limit replacement policy instead of the economic life-time leads to cost savings of between 4% and 30%. Finally, it is illustrated how to include the reliability aspect into the policy.

  19. Total life-cycle cost analysis of conventional and alternative fueled vehicles

    International Nuclear Information System (INIS)

    Cardullo, M.W.

    1993-01-01

    Total Life-Cycle Cost (TLCC) Analysis can indicate whether paying higher capital costs for advanced technology with low operating and/or environmental costs is advantageous over paying lower capital costs for conventional technology with higher operating and/or environmental costs. While minimizing total life-cycle cost is an important consideration, the consumer often identifies non-cost-related benefits or drawbacks that make more expensive options appear more attractive. The consumer is also likely to heavily weigh initial capital costs while giving limited consideration to operating and/or societal costs, whereas policy-makers considering external costs, such as those resulting from environmental impacts, may reach significantly different conclusions about which technologies are most advantageous to society. This paper summarizes a TLCC model which was developed to facilitate consideration of the various factors involved in both individual and societal policy decision making. The model was developed as part of a US Department of Energy Contract and has been revised to reflect changes necessary to make the model more realistic. The model considers capital, operating, salvage, and environmental costs for cars, vans, and buses using conventional and alternative fuels. The model has been developed to operate on an IBM or compatible personal computer platform using the commercial spreadsheet program MicroSoft Excell reg-sign Version 4 for Windows reg-sign and can be easily kept current because its modular structure allows straightforward access to embedded data sets for review and update

  20. Operations and maintenance costs - Selected observations

    International Nuclear Information System (INIS)

    Kirk, M.W.

    1991-01-01

    The operations and maintenance (O and M) costs associated with nuclear power plants have been rising continuously over the past decade. The Nuclear Management and Resources Council (NUMARC) has undertaken an examination of this issue to determine what components of O and M costs are driven by regulatory activity. Observers from various perspectives within the nuclear industry have cited staffing, outages, training, and management structure among others as large contributors to O and M costs. NUMARC is currently analyzing utility cost data to isolate the regulatory components for further action

  1. EOS Operations Systems: EDOS Implemented Changes to Reduce Operations Costs

    Science.gov (United States)

    Cordier, Guy R.; Gomez-Rosa, Carlos; McLemore, Bruce D.

    2007-01-01

    The authors describe in this paper the progress achieved to-date with the reengineering of the Earth Observing System (EOS) Data and Operations System (EDOS), the experience gained in the process and the ensuing reduction of ground systems operations costs. The reengineering effort included a major methodology change, applying to an existing schedule driven system, a data-driven system approach.

  2. AP1000 construction and operating costs

    Energy Technology Data Exchange (ETDEWEB)

    Winters, J.W.; Corletti, M.M. [Westinghouse Electric Corp., Pittsburgh, PA (United States); Thompson, M

    2001-07-01

    Market analysis of the U.S. electricity generating market indicates that the generating cost of competitive new generating capacity must be less than $0.03/kw-hr. When such factors as an attractive return on investment and payback period are considered for a new nuclear electric generating facility, this results in the requirement to have an overnight capital cost of approximately $1000/kw. Industry executives indicate that any new nuclear plant must be able to compete in the de-regulated generation wholesale marketplace and provide a return to the shareholders. Against this standard, the costs of advanced nuclear power plants currently available are still too high. In the United States, the Utility Requirements Document for advanced light water reactor plants included a cost goal that was based on the cost of coal generated electricity at the time the document was written. Since that time, the cost of new generating capacity and the overall operating cost of generating electricity has gone down. This is a result of low natural gas prices, more efficient plants in general and the current record breaking reductions in outage times and operating costs for nuclear plants. The plant designs resulting from the United States advanced light water reactor plant programs received Design Certification from the United States Nuclear Regulatory Commission. Some are being deployed, with variations, in countries other than the United States. But they can not compete today with other sources of central station generation in the United States. (author)

  3. AP1000 construction and operating costs

    International Nuclear Information System (INIS)

    Winters, J.W.; Corletti, M.M.; Thompson, M.

    2001-01-01

    Market analysis of the U.S. electricity generating market indicates that the generating cost of competitive new generating capacity must be less than $0.03/kw-hr. When such factors as an attractive return on investment and payback period are considered for a new nuclear electric generating facility, this results in the requirement to have an overnight capital cost of approximately $1000/kw. Industry executives indicate that any new nuclear plant must be able to compete in the de-regulated generation wholesale marketplace and provide a return to the shareholders. Against this standard, the costs of advanced nuclear power plants currently available are still too high. In the United States, the Utility Requirements Document for advanced light water reactor plants included a cost goal that was based on the cost of coal generated electricity at the time the document was written. Since that time, the cost of new generating capacity and the overall operating cost of generating electricity has gone down. This is a result of low natural gas prices, more efficient plants in general and the current record breaking reductions in outage times and operating costs for nuclear plants. The plant designs resulting from the United States advanced light water reactor plant programs received Design Certification from the United States Nuclear Regulatory Commission. Some are being deployed, with variations, in countries other than the United States. But they can not compete today with other sources of central station generation in the United States. (author)

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

    Science.gov (United States)

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

    2013-01-01

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

  5. Operations and support cost modeling using Markov chains

    Science.gov (United States)

    Unal, Resit

    1989-01-01

    Systems for future missions will be selected with life cycle costs (LCC) as a primary evaluation criterion. This reflects the current realization that only systems which are considered affordable will be built in the future due to the national budget constaints. Such an environment calls for innovative cost modeling techniques which address all of the phases a space system goes through during its life cycle, namely: design and development, fabrication, operations and support; and retirement. A significant portion of the LCC for reusable systems are generated during the operations and support phase (OS). Typically, OS costs can account for 60 to 80 percent of the total LCC. Clearly, OS costs are wholly determined or at least strongly influenced by decisions made during the design and development phases of the project. As a result OS costs need to be considered and estimated early in the conceptual phase. To be effective, an OS cost estimating model needs to account for actual instead of ideal processes by associating cost elements with probabilities. One approach that may be suitable for OS cost modeling is the use of the Markov Chain Process. Markov chains are an important method of probabilistic analysis for operations research analysts but they are rarely used for life cycle cost analysis. This research effort evaluates the use of Markov Chains in LCC analysis by developing OS cost model for a hypothetical reusable space transportation vehicle (HSTV) and suggests further uses of the Markov Chain process as a design-aid tool.

  6. Cost management in a nuclear operating environment

    International Nuclear Information System (INIS)

    Steckel, J.K.; Gruber, C.O.

    1985-01-01

    This paper presents an integrated philosophy and program for managing costs in a nuclear operating environment. The ideas presented here are being used by Pennsyvania Power and Light Company (PPandL) at the Susquehanna Steam Electric Station. Three basic ideas necessary to successful cost management are listed and include: recognize the framework that is needed to ''manage'': treat cost as part of an integrated plan; and apply different techniques to different types of work activities. It is the author's opinion that the technical framework of a successful cost management system must include all work activities but recognize types. Project activities should be managed to a defined scope and authorized cost using a well communicated estimating program, aggressive trending and forecasting, and a change identification process

  7. EVALUATION OF FORWARDER WOOD EXTRACTION COST OF OPERATION

    Directory of Open Access Journals (Sweden)

    Larissa Nunes dos Santos

    2016-03-01

    Full Text Available The objective of this study was to determine the costs of the activity of timber extraction done by forwarders until approximately 30,000 work hours. We used 7 John Deere forwarders, model 1710D with 160 kW engine power. A database provided by a forestry company located in the state of Minas Gerais was used, containing all the information necessary for calculating the operating cost of the machines and for the subsequent sensitivity analysis. The operating cost was obtained by the sum of the fixed and variable costs. For the sensitivity analysis a variation ± 20% of the most representative elements of the total cost of the machine was performed. The result obtained for the average operating cost of the forwarder was US$ 147.80 h-1. Costs for repairs and maintenance, labor, fuel, and depreciation represented approximately 90% of the total cost of the machine. A 10% reduction in their values resulted in a savings of approximately 9% in all years evaluated.

  8. evaluation of total annual costs of heat exchanger networks using

    African Journals Online (AJOL)

    This study presents pinch analysis of some heat exchanger networks (HENs) problems using Hint integration (HINT) software. Three examples reported to have been solved using different approaches by various researchers to obtain the least possible total annual cost (TAC) were solved using the Hint software. In this work ...

  9. Reducing Operating Room Costs Through Real-Time Cost Information Feedback: A Pilot Study.

    Science.gov (United States)

    Tabib, Christian H; Bahler, Clinton D; Hardacker, Thomas J; Ball, Kevin M; Sundaram, Chandru P

    2015-08-01

    To create a protocol for providing real-time operating room (OR) cost feedback to surgeons. We hypothesize that this protocol will reduce costs in a responsible way without sacrificing quality of care. All OR costs were obtained and recorded for robot-assisted partial nephrectomy and laparoscopic donor nephrectomy. Before the beginning of this project, costs pertaining to the 20 most recent cases were analyzed. Items were identified from previous cases as modifiable for replacement or omission. Timely feedback of total OR costs and cost of each item used was provided to the surgeon after each case, and costs were analyzed. A cost analysis of the robot-assisted partial nephrectomy before the washout period indicates expenditures of $5243.04 per case. Ten recommended modifiable items were found to have an average per case cost of $1229.33 representing 23.4% of the total cost. A postwashout period cost analysis found the total OR cost decreased by $899.67 (17.2%) because of changes directly related to the modifiable items. Therefore, 73.2% of the possible identified savings was realized. The same stepwise approach was applied to laparoscopic donor nephrectomies. The average total cost per case before the washout period was $3530.05 with $457.54 attributed to modifiable items. After the washout period, modifiable items costs were reduced by $289.73 (8.0%). No complications occurred in the donor nephrectomy cases while one postoperative complication occurred in the partial nephrectomy group. Providing surgeons with feedback related to OR costs may lead to a change in surgeon behavior and decreased overall costs. Further studies are needed to show equivalence in patient outcomes.

  10. A parametric cost model for estimating operating and support costs of US Navy (non-nuclear) surface ships

    OpenAIRE

    Brandt, James M.

    1999-01-01

    Approved for public release; distribution is unlimited With few effective decision-making tools to assess the affordability of major weapon systems, management of total ownership costs is continually misunderstood. Cost analysis provides a quick and reliable assessment of affordability. Because there is no standardized method for calculating reliable estimates of operating and support (O&S) costs (the principal component of total ownership cost), this thesis formulates a parametric cost mo...

  11. [Preliminary analysis of total cost and life quality for elder patients with femoral neck fracture].

    Science.gov (United States)

    Liu, Haonan; He, Liang; Zhang, Guilin; Gong, Xiaofeng; Li, Ning

    2015-09-01

    To analyze the total cost and life quality of the femoral neck fracture patients who received different surgery and supplement comprehensive data of osteoporotic fracture. One hundred and five patients above 60-year old who were diagnosed femoral neck fracture and received operation in Department of Orthopedics & Traumatology, Beijing Jishuitan Hospital were admitted into our study from August 2013 to December. According to the type of surgery there were 52 and 53 cases in internal fixation (IF) group and hemiarthroplasty (HA) group respectively. At first we collected the medical expense of the patients before and during hospitalization. And then the 1-year medical and non-medical expenses were collected by the cost diary ever 3 months after discharge. At the last follow-up we evaluated the life quality by the EuroQol-5 Dimensions (EQ-5D) and calculated the total cost. Outcome All the patients completed the operation successfully. No nonunion or delayed union cases in IF group, and no cases received revision surgery in both groups. The total average cost was 59 584.9 yuan including 79.1% medical cost and 20.9% non-medical cost. The primary treatment cost accounts for 84.1% of the medical cost. The cost for home care accounts for 90.7% of the non-medical care. The total and medical cost of IF group just account for 40.3% and 38.5% of the HA group and the non-medical showed no significant difference between the 2 groups (P>0.05). In addition the data of life quality and walking capability also showed no significant difference. The main cost for the femoral neck fracture is medical expense in 1-year follow-up. Both surgeries can provide satisfactory outcome, however IF may be more cost-effective compared to the HA because of the less total cost.

  12. TRIUMF: Regional government offers KAON operating costs

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1992-09-15

    After a period of uncertainty, confidence in the major KAON project for the Canadian TRIUMF Laboratory in Vancouver was boosted on 28 May at a rally of about a thousand KAON supporters in downtown Vancouver when the regional government of British Columbia announced its willingness to pay part of KAON's operating costs.

  13. TRIUMF: Regional government offers KAON operating costs

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    After a period of uncertainty, confidence in the major KAON project for the Canadian TRIUMF Laboratory in Vancouver was boosted on 28 May at a rally of about a thousand KAON supporters in downtown Vancouver when the regional government of British Columbia announced its willingness to pay part of KAON's operating costs

  14. Time-driven activity based costing of total knee replacement surgery at a London teaching hospital.

    Science.gov (United States)

    Chen, Alvin; Sabharwal, Sanjeeve; Akhtar, Kashif; Makaram, Navnit; Gupte, Chinmay M

    2015-12-01

    The aim of this study was to conduct a time-driven activity based costing (TDABC) analysis of the clinical pathway for total knee replacement (TKR) and to determine where the major cost drivers lay. The in-patient pathway was prospectively mapped utilising a TDABC model, following 20 TKRs. The mean age for these patients was 73.4 years. All patients were ASA grade I or II and their mean BMI was 30.4. The 14 varus knees had a mean deformity of 5.32° and the six valgus knee had a mean deformity of 10.83°. Timings were prospectively collected as each patient was followed through the TKR pathway. Pre-operative costs including pre-assessment and joint school were £ 163. Total staff costs for admission and the operating theatre were £ 658. Consumables cost for the operating theatre were £ 1862. The average length of stay was 5.25 days at a total cost of £ 910. Trust overheads contributed £ 1651. The overall institutional cost of a 'noncomplex' TKR in patients without substantial medical co-morbidities was estimated to be £ 5422, representing a profit of £ 1065 based on a best practice tariff of £ 6487. The major cost drivers in the TKR pathway were determined to be theatre consumables, corporate overheads, overall ward cost and operating theatre staffing costs. Appropriate discounting of implant costs, reduction in length of stay by adopting an enhanced recovery programme and control of corporate overheads through the use of elective orthopaedic treatment centres are proposed approaches for reducing the overall cost of treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Operating Costs Reducing in MDF Manufacturing Industries

    Directory of Open Access Journals (Sweden)

    José Augusto Coeve Florino

    2014-05-01

    Full Text Available The sustained efforts by electric motors when subjected to cutting, trimming or finishing are directly related to the material being machined and the angle of attack of the tool. Choosing the right tool for this operation depends on an expected result. So the engines behave differently to each operation. The optimization between strength, speed, power, material and type of operation, can be found to reduce operational costs of production, besides determining the exact time to make the set-up of worn tool. The reduction in operating costs is an item of sustainability that outlines the strategic positioning on companies to become competitive in the global marketplace. With the great technological development present today, this issue goes away with the very latest products on the market for professionals who productivity will be dealt with in these modern maintenance equipment such as power quality analyzer, Imager, profile projector and microscope for research. The result of this work is the optimization of the cutting operation and energy consumption thereby demonstrating an optimum point of operation in a case study presented in this work.

  16. Retail clinic utilization associated with lower total cost of care.

    Science.gov (United States)

    Sussman, Andrew; Dunham, Lisette; Snower, Kristen; Hu, Min; Matlin, Olga S; Shrank, William H; Choudhry, Niteesh K; Brennan, Troyen

    2013-04-01

    To better understand the impact of retail clinic use on a patient's annual total cost of care. A propensity score matched-pair, cohort design was used to analyze healthcare spending patterns among CVS Caremark employees in the year following a visit to a MinuteClinic, the retail clinics inside CVS pharmacies. De-identified medical and pharmacy claims for CVS Caremark employees and their dependents who received care at a retail clinic between June 1, 2009, and May 31, 2010, were matched to those of subjects who received care elsewhere. High-dimensional propensity score and greedy matching techniques were used to create a 1-to-1 matched cohort that was analyzed using generalized linear regression models. Individuals using a retail clinic had a lower total cost of care (-$262; 95% confidence interval, -$510 to -$31; P = .025) in the year following their clinic visit than individuals who received care in other settings. This savings was primarily due to lower medical expenses at physicians' offices ($77 savings, P = .008) and hospital inpatient care ($121 savings, P = .049). The 6022 retail clinic users also had 142 (12%) fewer emergency department visits (P = .01), though this was not related to significant cost savings. This study found that retail clinic use was associated with lower overall total cost of care compared with that at alternative sites. Savings may extend beyond the retail clinic visit itself to other types of medical utilization.

  17. Internal Logistics System Selection with Total Cost of Ownership Analysis

    Science.gov (United States)

    Araújo, Inês; Pimentel, Carina; Godina, Radu; Matias, João C. O.

    2017-06-01

    In this paper a methodology was followed in order to support the decision-making of one industrial unit regarding its internal logistics system. The addressed factory was facing issues with their internal logistics approach. Some alternatives were pointed out and a proper total cost of ownership (TCO) analysis was developed. This analysis was taken in order to demonstrate the more cost-effective solution for the internal logistics system. This tool is more and more valued by the companies, due to their willing to reduce the costs that are associated with the way of doing business. Despite the proposal of the best choice for the internal logistics system of the enterprise, this study also intends to present some conclusions about the match between the nature of the industrial unit and the logistics systems that best fit the requirements of those.

  18. PFP total operating efficiency calculation and basis of estimate

    International Nuclear Information System (INIS)

    SINCLAIR, J.C.

    1999-01-01

    The purpose of the Plutonium Finishing Plant (PFP) Total Operating Efficiency Calculation and Basis of Estimate document is to provide the calculated value and basis of estimate for the Total Operating Efficiency (TOE) for the material stabilization operations to be conducted in 234-52 Building. This information will be used to support both the planning and execution of the Plutonium Finishing Plant (PFP) Stabilization and Deactivation Project's (hereafter called the Project) resource-loaded, integrated schedule

  19. En differentieret tilgang til total cost of ownership (TCO)

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2010-01-01

    Økonomistyring er en nødvendig brik i forsøget på at kunne styre dele af eller hele forsyningskæden, og til dette bruges diverse økonomistyringsværktøjer. Denne artikel omhandler økonomistyringsværktøjet 'total cost of ownership', og hvordan dette kan bruges til at forbedre samarbejdet med...

  20. Evaluation of the Total Cost of Ownership of Fuel Cell-Powered Material Handling Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Ramsden, T.

    2013-04-01

    This report discusses an analysis of the total cost of ownership of fuel cell-powered and traditional battery-powered material handling equipment (MHE, or more typically 'forklifts'). A number of fuel cell MHE deployments have received funding support from the federal government. Using data from these government co-funded deployments, DOE's National Renewable Energy Laboratory (NREL) has been evaluating the performance of fuel cells in material handling applications. NREL has assessed the total cost of ownership of fuel cell MHE and compared it to the cost of ownership of traditional battery-powered MHE. As part of its cost of ownership assessment, NREL looked at a range of costs associated with MHE operation, including the capital costs of battery and fuel cell systems, the cost of supporting infrastructure, maintenance costs, warehouse space costs, and labor costs. Considering all these costs, NREL found that fuel cell MHE can have a lower overall cost of ownership than comparable battery-powered MHE.

  1. The cost of trauma operating theatre inefficiency.

    Science.gov (United States)

    Ang, W W; Sabharwal, S; Johannsson, H; Bhattacharya, R; Gupte, C M

    2016-05-01

    The National Health Service (NHS) is currently facing a financial crisis with a projected deficit of £2billion by the end of financial year 2015/16. As operating rooms (OR) are one of the costliest components in secondary care, improving theatre efficiency should be at the forefront of efforts to improve health service efficiency. The objectives of this study were to characterize the causes of trauma OR delays and to estimate the cost of this inefficiency. A 1-month prospective single-centre study in St. Mary's Hospital. Turnaround time (TT) was used as the surrogate parameter to measure theatre efficiency. Factors including patient age, ASA score and presence of surgical and anaesthetic consultant were evaluated to identify positive or negative associations with theatre delays. Inefficiency cost was calculated by multiplying the time wasted with staff capacity costs and opportunity costs, found to be £24.77/minute. The commonest causes for increased TT were delays in sending for patients (50%) and problems with patient transport to the OR (31%). 461 min of delay was observed in 12 days, equivalent to loss of £951.58/theatre/day. Non-statistically significant trends were seen between length of delays and advancing patient age, ASA score and absence of either a senior clinician or an anaesthetic consultant. Interestingly, the trend was not as strong for absence of an anaesthetic consultant. This study found delays in operating TT to represent a sizable cost, with potential efficiency savings based on TT of £347,327/theatre/year. Further study of a larger sample is warranted to better evaluate the identified trends.

  2. Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

    Science.gov (United States)

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

    2018-01-01

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

  3. Control and operation cost optimization of the HISS cryogenic system

    International Nuclear Information System (INIS)

    Porter, J.; Anderson, D.; Bieser, F.

    1984-01-01

    This chapter describes a control strategy for the Heavy Ion Spectrometer System (HISS), which relies upon superconducting coils of cryostable design to provide a particle bending field of 3 tesla. The control strategy has allowed full time unattended operation and significant operating cost reductions. Microprocessor control of flash boiling style LIN circuits has been successful. It is determined that the overall operating cost of most cryogenic systems using closed loop helium systems can be minimized by properly balancing the total heat load between the helium and nitrogen circuits to take advantage of the non-linearity which exists in the power input to 4K refrigeration characteristic. Variable throughput compressors have the advantage of turndown capability at steady state. It is concluded that a hybrid system using digital and analog input for control, data display and alarms enables full time unattended operation

  4. The COST model for calculation of forest operations costs

    NARCIS (Netherlands)

    Ackerman, P.; Belbo, H.; Eliasson, L.; Jong, de J.J.; Lazdins, A.; Lyons, J.

    2014-01-01

    Since the late nineteenth century when high-cost equipment was introduced into forestry there has been a need to calculate the cost of this equipment in more detail with respect to, for example, cost of ownership, cost per hour of production, and cost per production unit. Machine cost calculations

  5. Family of commuting operators for the totally asymmetric exclusion process

    International Nuclear Information System (INIS)

    Golinelli, O; Mallick, K

    2007-01-01

    The algebraic structure underlying the totally asymmetric exclusion process is studied by using the Bethe Ansatz technique. From the properties of the algebra generated by the local jump operators, we explicitly construct the hierarchy of operators (called generalized Hamiltonians) that commute with the Markov operator. The transfer matrix, which is the generating function of these operators, is shown to represent a discrete Markov process with long-range jumps. We give a general combinatorial formula for the connected Hamiltonians obtained by taking the logarithm of the transfer matrix. This formula is proved using a symbolic calculation program for the first ten connected operators

  6. Cost and operational acceptability improvements to gasifiers

    Energy Technology Data Exchange (ETDEWEB)

    Connor, A.

    2003-07-01

    This work reports on the operation of two gasifiers by Biomass Engineering Ltd. in Northern Ireland, and the simplification of their gas conditioning system. Details are given of the high tar destruction levels achieved, the locally available wood waste and pallet wood, and the use of a back-pulsable dry ceramic filtration system for removing trace organics and particulates from the resulting gas prior to gas cooling, final filtration and use in a gas engine. The results of a techno-economic assessment of the original scrubbing system and the new ceramic filtration system indicating cost savings are presented. Further work to optimise the parameters of the filters is planned.

  7. Operational cost minimization in cooling water systems

    Directory of Open Access Journals (Sweden)

    Castro M.M.

    2000-01-01

    Full Text Available In this work, an optimization model that considers thermal and hydraulic interactions is developed for a cooling water system. It is a closed loop consisting of a cooling tower unit, circulation pump, blower and heat exchanger-pipe network. Aside from process disturbances, climatic fluctuations are considered. Model constraints include relations concerning tower performance, air flowrate requirement, make-up flowrate, circulating pump performance, heat load in each cooler, pressure drop constraints and climatic conditions. The objective function is operating cost minimization. Optimization variables are air flowrate, forced water withdrawal upstream the tower, and valve adjustment in each branch. It is found that the most significant operating cost is related to electricity. However, for cooled water temperatures lower than a specific target, there must be a forced withdrawal of circulating water and further makeup to enhance the cooling tower capacity. Additionally, the system is optimized along the months. The results corroborate the fact that the most important variable on cooling tower performance is not the air temperature itself, but its humidity.

  8. Avoided operating costs in thermal generating systems

    International Nuclear Information System (INIS)

    Chowdhury, N.; Billinton, R.; Gupta, R.

    1995-01-01

    A simple and straightforward technique was developed to assess avoided system operating costs associated with non-utility generation (NUG). The technique was based on optimum loading configurations of the committed units both before and after the inclusion of NUG energy. The salient features of the technique were presented in this paper. Assessment of avoided operating cost with deterministic and probabilistic criteria were explained. A time differentiated price system was adopted in the algorithms to reflect the different value placed on purchased price by a utility at different times of the day. The algorithms show the utility effects of dispatchable and non-dispatchable NUG energies. The IEEE Reliability Test System (RTS) was utilized for numerical analysis. Results were illustrated. It was found that sensitivity studies similar to those performed on the IEEE-RTS could be utilized to determine the amount of energy and the time period during which utilities and NUGs can maximize their economic benefits. 7 refs., 5 figs., 1 tab

  9. Seaplane Economics: A Quantitative Cost Comparison of Seaplanes and Land Planes for Sea Base Operations

    National Research Council Canada - National Science Library

    Denz, Thomas; Smith, Stephanie; Shrestha, Rajeev

    2007-01-01

    ...) operating from an air base and concept seaplanes operating from a Sea Base. Using published current and historical data a total cost per flight hour was determined for both land planes and seaplanes...

  10. The Cost of Iraq, Afghanistan, and Other Global War on Terror Operations Since 9/11

    National Research Council Canada - National Science Library

    Belasco, Amy

    2006-01-01

    ...) Congress would have appropriated a total of about $437 billion for military operations, base security, reconstruction, foreign aid, embassy costs, and veterans health care for the three operations initiated since the 9/11 attacks...

  11. The Cost of Iraq, Afghanistan, and Other Global War on Terror Operations Since 9/11

    National Research Council Canada - National Science Library

    Belasco, Amy

    2006-01-01

    Through FY2006, Congress has appropriated a total of about $437 billion for military operations, base security, reconstruction, foreign aid, embassy costs, and veterans health care for the three operations initiated since the 9/11 attacks...

  12. 24 CFR 583.125 - Grants for operating costs.

    Science.gov (United States)

    2010-04-01

    .... Operating costs are those associated with the day-to-day operation of the supportive housing. They also... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Grants for operating costs. 583.125... for operating costs. (a) General. HUD will provide grants to pay a portion (as described in § 583.130...

  13. Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study

    NARCIS (Netherlands)

    P.T.P.W. Burgers (Paul); M. Hoogendoorn (Martine); E.A.C. Van Woensel; R.W. Poolman (Rudolf); M. Bhandari (Mohit); P. Patka (Peter); E.M.M. van Lieshout (Esther)

    2016-01-01

    textabstractSummary: The aim of this study was to determine the total medical costs for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The mean total costs per patient at 2 years of follow-up were €26,399. These results contribute to cost

  14. Managing the total cost of risk exposures through risk mapping techniques

    International Nuclear Information System (INIS)

    Unione, A.J.; Rode, D.M.

    1998-01-01

    In a competitive power market, power producers are exposed to an increasingly broad spectrum of financial risks. The cumulative impact of these financial risks is known collectively as the Total of Cost of Risk. The concept of Total of Cost of Risk presents the business reality of a company's exposure to potentially devastating financial consequences in an integrated and useful way. In this way, a strategy of managing Total Cost of Risk in the most cost effective way can become a means of ensuring long term business health and security. This paper will examine the use of risk mapping as a tool for visually understanding Total Cost of Risk, thus creating an enhanced situational awareness and an integrated basis for risk management decision. The evaluation process, available through the use of risk maps allows the power producers to pro-actively implement prudent business decisions concerning the design, operation and maintenance of power plants. Risk mapping is thus a means for harmonizing operational objectives, such as improved plant reliability, with corporate strategies and goals in terms of an effective risk management program

  15. [Operating cost analysis of anaesthesia: activity based costing (ABC analysis)].

    Science.gov (United States)

    Majstorović, Branislava M; Kastratović, Dragana A; Vučović, Dragan S; Milaković, Branko D; Miličić, Biljana R

    2011-01-01

    Cost of anaesthesiology represent defined measures to determine a precise profile of expenditure estimation of surgical treatment, which is important regarding planning of healthcare activities, prices and budget. In order to determine the actual value of anaestesiological services, we started with the analysis of activity based costing (ABC) analysis. Retrospectively, in 2005 and 2006, we estimated the direct costs of anestesiological services (salaries, drugs, supplying materials and other: analyses and equipment.) of the Institute of Anaesthesia and Resuscitation of the Clinical Centre of Serbia. The group included all anesthetized patients of both sexes and all ages. We compared direct costs with direct expenditure, "each cost object (service or unit)" of the Republican Healthcare Insurance. The Summary data of the Departments of Anaesthesia documented in the database of the Clinical Centre of Serbia. Numerical data were utilized and the numerical data were estimated and analyzed by computer programs Microsoft Office Excel 2003 and SPSS for Windows. We compared using the linear model of direct costs and unit costs of anaesthesiological services from the Costs List of the Republican Healthcare Insurance. Direct costs showed 40% of costs were spent on salaries, (32% on drugs and supplies, and 28% on other costs, such as analyses and equipment. The correlation of the direct costs of anaestesiological services showed a linear correlation with the unit costs of the Republican Healthcare Insurance. During surgery, costs of anaesthesia would increase by 10% the surgical treatment cost of patients. Regarding the actual costs of drugs and supplies, we do not see any possibility of costs reduction. Fixed elements of direct costs provide the possibility of rationalization of resources in anaesthesia.

  16. LIFE Cost of Electricity, Capital and Operating Costs

    International Nuclear Information System (INIS)

    Anklam, T.

    2011-01-01

    Successful commercialization of fusion energy requires economic viability as well as technical and scientific feasibility. To assess economic viability, we have conducted a pre-conceptual level evaluation of LIFE economics. Unit costs are estimated from a combination of bottom-up costs estimates, working with representative vendors, and scaled results from previous studies of fission and fusion plants. An integrated process model of a LIFE power plant was developed to integrate and optimize unit costs and calculate top level metrics such as cost of electricity and power plant capital cost. The scope of this activity was the entire power plant site. Separately, a development program to deliver the required specialized equipment has been assembled. Results show that LIFE power plant cost of electricity and plant capital cost compare favorably to estimates for new-build LWR's, coal and gas - particularly if indicative costs of carbon capture and sequestration are accounted for.

  17. Multiagent-based Distributed Control for Operation Cost Minimization of Droop Controlled DC Microgrid Using Incremental Cost Consensus

    DEFF Research Database (Denmark)

    Li, Chendan; Quintero, Juan Carlos Vasquez; Guerrero, Josep M.

    2015-01-01

    In this paper, a multiagent based distributed control is proposed for DC microgrid to minimize the operation cost. The power of each distributed generator (DG) is dispatched in a distributed manner in a multiagent system by means of voltage scheduling. Every DG unit is taken as an agent......, and they share the load corresponding to the operation cost of all the units in the system with only communication with direct neighbors through incremental cost consensus. The power regulation according to the power reference generated by consensus is implemented through voltage scheduling in local primary...... controllers. Simulation verification shows that total operation cost of the DC microgrid is successfully reduced though the proposed method....

  18. Incidence of Early Post Operative Infection after Primary Total Knee ...

    African Journals Online (AJOL)

    Incidence of Early Post Operative Infection after. Primary Total Knee Arthroplasty at an East African. Centre. Kigera JWM1, Kimpiatu P2. 1. School of Medicine, University of Nairobi. 2. PCEA Kikuyu Hospital. Correspondence to: Dr James Kigera, P.O Box 30197 – 00100 Nairobi. Email: jameskigera@yahoo.co.uk. Abstract.

  19. 42 CFR 417.930 - Initial costs of operation.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Initial costs of operation. 417.930 Section 417.930... PREPAYMENT PLANS Administration of Outstanding Loans and Loan Guarantees § 417.930 Initial costs of operation. Under section 1305 of the PHS, loans and loan guarantees were awarded for initial costs of operation of...

  20. Cost Analysis of Operation Theatre Services at an Apex Tertiary Care Trauma Centre of India.

    Science.gov (United States)

    Siddharth, Vijaydeep; Kumar, Subodh; Vij, Aarti; Gupta, Shakti Kumar

    2015-12-01

    Operating room services are one of the major cost and revenue-generating centres of a hospital. The cost associated with the provisioning of operating department services depends on the resources consumed and the unit costs of those resources. The objective of this study was to calculate the cost of operation theatre services at Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi. The study was carried out at the operation theatre department of Jai Prakash Narayan Apex Trauma Centre (JPNATC), AIIMS from April 2010 to March 2011 after obtaining approval from concerned authorities. This study was observational and descriptive in nature. Traditional (average or gross) costing methodology was used to arrive at the cost for the provisioning of operation theatre (OT) services. Cost was calculated under two heads; as capital and operating cost. Annualised cost of capital assets was calculated according to the methodology prescribed by the World Health Organization and operating costs were taken on actual basis; thereafter, per day cost of OT services was obtained. The average number of surgeries performed in the trauma centre per day is 13. The annual cost of providing operating room services at JPNATC, New Delhi was calculated to be 197,298,704 Indian rupees (INR) (US$ 3,653,679), while the per hour cost was calculated to be INR 22,626.92 (US$ 419). Majority of the expenditures were for human resource (33.63 %) followed by OT capital cost (31.90 %), consumables (29.97 %), engineering maintenance cost (2.55 %), support services operating cost (1.22 %) and support services capital cost (0.73 %). Of the total cost towards the provisioning of OT services, 32.63 % was capital cost while 67.37 % is operating cost. The results of this costing study will help in the future planning of resource allocation within the financial constraints (US$ 1 = INR 54).

  1. Space Infrared Telescope Facility (SIRTF) - Operations concept. [decreasing development and operations cost

    Science.gov (United States)

    Miller, Richard B.

    1992-01-01

    The development and operations costs of the Space IR Telescope Facility (SIRTF) are discussed in the light of minimizing total outlays and optimizing efficiency. The development phase cannot extend into the post-launch segment which is planned to only support system verification and calibration followed by operations with a 70-percent efficiency goal. The importance of reducing the ground-support staff is demonstrated, and the value of the highly sensitive observations to the general astronomical community is described. The Failure Protection Algorithm for the SIRTF is designed for the 5-yr lifetime and the continuous venting of cryogen, and a science driven ground/operations system is described. Attention is given to balancing cost and performance, prototyping during the development phase, incremental development, the utilization of standards, and the integration of ground system/operations with flight system integration and test.

  2. 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.

  3. Cost Savings of Nuclear Power with Total Fuel Reprocessing

    International Nuclear Information System (INIS)

    Solbrig, Charles W.; Benedict, Robert W.

    2006-01-01

    The cost of fast reactor (FR) generated electricity with pyro-processing is estimated in this article. It compares favorably with other forms of energy and is shown to be less than that produced by light water reactors (LWR's). FR's use all the energy in natural uranium whereas LWR's utilize only 0.7% of it. Because of high radioactivity, pyro-processing is not open to weapon material diversion. This technology is ready now. Nuclear power has the same advantage as coal power in that it is not dependent upon a scarce foreign fuel and has the significant additional advantage of not contributing to global warming or air pollution. A jump start on new nuclear plants could rapidly allow electric furnaces to replace home heating oil furnaces and utilize high capacity batteries for hybrid automobiles: both would reduce US reliance on oil. If these were fast reactors fueled by reprocessed fuel, the spent fuel storage problem could also be solved. Costs are derived from assumptions on the LWR's and FR's five cost components: 1) Capital costs: LWR plants cost $106/MWe. FR's cost 25% more. Forty year amortization is used. 2) The annual O and M costs for both plants are 9% of the Capital Costs. 3) LWR fuel costs about 0.0035 $/kWh. Producing FR fuel from spent fuel by pyro-processing must be done in highly shielded hot cells which is costly. However, the five foot thick concrete walls have the advantage of prohibiting diversion. LWR spent fuel must be used as feedstock for the FR initial core load and first two reloads so this FR fuel costs more than LWR fuel. FR fuel costs much less for subsequent core reloads ( 6 /MWe. The annual cost for a 40 year licensed plant would be 2.5 % of this or less if interest is taken into account. All plants will eventually have to replace those components which become radiation damaged. FR's should be designed to replace parts rather than decommission. The LWR costs are estimated to be 2.65 cents/kWh. FR costs are 2.99 cents/kWh for the first

  4. Total Hip Arthroplasty – over 100 years of operative history

    Directory of Open Access Journals (Sweden)

    Stephen Richard Knight

    2011-11-01

    Full Text Available Total hip arthroplasty (THA has completely revolutionised the nature in which the arthritic hip is treated, and is considered to be one of the most successful orthopaedic interventions of its generation (1. With over 100 years of operative history, this review examines the progression of the operation from its origins, together with highlighting the materials and techniques that have contributed to its development. Knowledge of its history contributes to a greater understanding of THA, such as the reasons behind selection of prosthetic materials in certain patient groups, while demonstrating the importance of critically analyzing research to continually determine best operative practice. Finally, we describe current areas of research being undertaken to further advance techniques and improve outcomes.

  5. Financial, operating results, assets total down for OGJ300

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Financial and operating results of the Oil and Gas Journal 300 dropped again in 1992. It was the second consecutive set of declines for OGJ's list of the largest publicly traded, oil and gas producing companies in the U.S. Totals fell from 1991 results in almost all categories for financial and operating performance. Group net income fell sharply in 1992. Large, integrated companies reported sharp earnings declines, many of them related to special charges for restructuring and mandatory accounting changes. In addition, revenues were suppressed by lower crude and product prices below levels of 1991 and a decline in total crude production. This was partially offset by higher prices and demand for natural gas and by increased demand for petroleum products. The paper discusses the economic situation in the petroleum and natural gas industries then gives extensive data on the following: total assets, total income, net income, stockholders' equity, capital spending, worldwide and US liquids production, worldwide and US natural gas production, worldwide and US liquids reserves, worldwide and US natural gas reserves, and US net wells drilled

  6. 19 CFR 10.814 - Direct costs of processing operations.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Direct costs of processing operations. 10.814... Free Trade Agreement Rules of Origin § 10.814 Direct costs of processing operations. (a) Items included. For purposes of § 10.810(b) of this subpart, the words “direct costs of processing operations”, with...

  7. 19 CFR 10.774 - Direct costs of processing operations.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Direct costs of processing operations. 10.774... Free Trade Agreement Rules of Origin § 10.774 Direct costs of processing operations. (a) Items included. For purposes of § 10.770(b) of this subpart, the words “direct costs of processing operations”, with...

  8. Understanding Costs of Care in the Operating Room.

    Science.gov (United States)

    Childers, Christopher P; Maggard-Gibbons, Melinda

    2018-04-18

    Increasing value requires improving quality or decreasing costs. In surgery, estimates for the cost of 1 minute of operating room (OR) time vary widely. No benchmark exists for the cost of OR time, nor has there been a comprehensive assessment of what contributes to OR cost. To calculate the cost of 1 minute of OR time, assess cost by setting and facility characteristics, and ascertain the proportion of costs that are direct and indirect. This cross-sectional and longitudinal analysis examined annual financial disclosure documents from all comparable short-term general and specialty care hospitals in California from fiscal year (FY) 2005 to FY2014 (N = 3044; FY2014, n = 302). The analysis focused on 2 revenue centers: (1) surgery and recovery and (2) ambulatory surgery. Mean cost of 1 minute of OR time, stratified by setting (inpatient vs ambulatory), teaching status, and hospital ownership. The proportion of cost attributable to indirect and direct expenses was identified; direct expenses were further divided into salary, benefits, supplies, and other direct expenses. In FY2014, a total of 175 of 302 facilities (57.9%) were not for profit, 78 (25.8%) were for profit, and 49 (16.2%) were government owned. Thirty facilities (9.9%) were teaching hospitals. The mean (SD) cost for 1 minute of OR time across California hospitals was $37.45 ($16.04) in the inpatient setting and $36.14 ($19.53) in the ambulatory setting (P = .65). There were no differences in mean expenditures when stratifying by ownership or teaching status except that teaching hospitals had lower mean (SD) expenditures than nonteaching hospitals in the inpatient setting ($29.88 [$9.06] vs $38.29 [$16.43]; P = .006). Direct expenses accounted for 54.6% of total expenses ($20.40 of $37.37) in the inpatient setting and 59.1% of total expenses ($20.90 of $35.39) in the ambulatory setting. Wages and benefits accounted for approximately two-thirds of direct expenses (inpatient, $14.00 of $20

  9. The cost of operating with failed fuel at Virginia power

    International Nuclear Information System (INIS)

    Ford, C.A.

    1988-01-01

    Virginia Power has completed a study of the costs incurred due to fuel failures in its pressurized water reactors. This study was prompted by histories of high primary coolant activity and subsequent fuel inspections at the North Anna and Surry power stations. The study included an evaluation of the total costs of fuel failures as well as an evaluation of the economics of postirradiation fuel inspections. The major costs of fuel failures included personnel radiation exposure, permanently discharged failed fuel, radwaste generation, increased labor requirements, containment entry delays due to airborne radioactivity, and ramp rate restrictions. Although fuel failures affect a utility in several other areas, the items evaluated in the study were thought to be the most significant of the costs. The study indicated that performing a postirradiation failed fuel examination can be economically justified at tramp-corrected 131 I levels of > 0.015 μCi/g. The savings to the utility can be on the order of several million dollars. Additionally, the cost penalty of performing a fuel inspection at lower iodine levels is generally in the range of $200,000. This economic penalty is expected to be outweighed by the intangible benefits of operating with a defect-free core

  10. Effect of Resident Involvement on Operative Time and Operating Room Staffing Costs.

    Science.gov (United States)

    Allen, Robert William; Pruitt, Mark; Taaffe, Kevin M

    The operating room (OR) is a major driver of hospital costs; therefore, operative time is an expensive resource. The training of surgical residents must include time spent in the OR, but that experience comes with a cost to the surgeon and hospital. The objective of this article is to determine the effect of surgical resident involvement in the OR on operative time and subsequent hospital labor costs. The Kruskal-Wallis statistical test is used to determine whether or not there is a difference in operative times between 2 groups of cases (with residents and without residents). This difference leads to an increased cost in associated hospital labor costs for the group with the longer operative time. Cases were performed at Greenville Memorial Hospital. Greenville Memorial Hospital is part of the larger healthcare system, Greenville Health System, located in Greenville, SC and is a level 1 trauma center with up to 33 staffed ORs. A total of 84,997 cases were performed at the partnering hospital between January 1st, 2011 and July 31st, 2015. Cases were only chosen for analysis if there was only one CPT code associated with the case and there were more than 5 observations for each group being studied. This article presents a comprehensive retrospective analysis of 29,134 cases covering 246 procedures. The analysis shows that 45 procedures took significantly longer with a resident present in the room. The average increase in operative time was 4.8 minutes and the cost per minute of extra operative time was determined to be $9.57 per minute. OR labor costs at the partnering hospital was found to be $2,257,433, or $492,889 per year. Knowing the affect on operative time and OR costs allows managers to make smart decisions when considering alternative educational and training techniques. In addition, knowing the connection between residents in the room and surgical duration could help provide better estimates of surgical time in the future and increase the predictability of

  11. An analysis of nuclear power plant operating costs

    International Nuclear Information System (INIS)

    1988-01-01

    This report presents the results of a statistical analysis of nonfuel operating costs for nuclear power plants. Most studies of the economic costs of nuclear power have focused on the rapid escalation in the cost of constructing a nuclear power plant. The present analysis found that there has also been substantial escalation in real (inflation-adjusted) nonfuel operating costs. It is important to determine the factors contributing to the escalation in operating costs, not only to understand what has occurred but also to gain insights about future trends in operating costs. There are two types of nonfuel operating costs. The first is routine operating and maintenance expenditures (O and M costs), and the second is large postoperational capital expenditures, or what is typically called ''capital additions.'' O and M costs consist mainly of expenditures on labor, and according to one recently completed study, the majoriy of employees at a nuclear power plant perform maintenance activities. It is generally thought that capital additions costs consist of large maintenance expenditures needed to keep the plants operational, and to make plant modifications (backfits) required by the Nuclear Regulatory Commission (NRC). Many discussions of nuclear power plant operating costs have not considered these capital additions costs, and a major finding of the present study is that these costs are substantial. The objective of this study was to determine why nonfuel operating costs have increased over the past decade. The statistical analysis examined a number of factors that have influenced the escalation in real nonfuel operating costs and these are discussed in this report. 4 figs, 19 tabs

  12. Reducing operational costs through MIPS management

    NARCIS (Netherlands)

    Kwiatkowski, L.M.; Verhoef, C.

    2015-01-01

    We focus on an approach to reducing the costs of running applications. MIPS, which is a traditional acronym for millions of instructions per second, have evolved to become a measurement of processing power and CPU resource consumption. The need for controlling MIPS attributed costs is indispensable

  13. Maintenance and operations cost model for DSN subsystems

    Science.gov (United States)

    Burt, R. W.; Lesh, J. R.

    1977-01-01

    A procedure is described which partitions the recurring costs of the Deep Space Network (DSN) over the individual DSN subsystems. The procedure results in a table showing the maintenance, operations, sustaining engineering and supportive costs for each subsystems.

  14. Life Cycle Costs in Education: Operations & Maintenance Considered.

    Science.gov (United States)

    Moussatche, Helena; Languell-Urquhart, Jennifer; Woodson, Carol

    2000-01-01

    Discusses life cycle cost analysis when deciding on flooring finishes and examines operations and maintenance cost effectiveness relative to hard, resilient, and soft flooring. A chart of evaluated flooring materials' characteristics, appropriate maintenance procedures, and recommended frequency is included. (GR)

  15. Estimating Texas motor vehicle operating costs.

    Science.gov (United States)

    2009-10-01

    A specific Vcost model was developed for Texas conditions based on a sophisticated fuel model for light : duty vehicles, several excellent sources of secondary vehicle cost data, and the ability to measure heavy truck fuel : consumption through both ...

  16. Cost comparison of transcatheter and operative closures of ostium secundum atrial septal defects

    Science.gov (United States)

    O’Byrne, Michael L.; Gillespie, Matthew J.; Shinohara, Russell T.; Dori, Yoav; Rome, Jonathan J.; Glatz, Andrew C.

    2015-01-01

    Background Clinical outcomes for transcatheter and operative closures of atrial septal defects (ASDs) are similar. Economic cost for each method has not been well described. Methods A single-center retrospective cohort study of children and adults cost of operative and transcatheter closures of ASD. A propensity score weight-adjusted multivariate regression model was used in an intention-to-treat analysis. Costs for reintervention and crossover admissions were included in primary analysis. Results A total of 244 subjects were included in the study (64% transcatheter and 36% operative), of which 2% (n = 5) were ≥18 years. Crossover rate from transcatheter to operative group was 3%. Risk of reintervention (P = .66) and 30-day mortality (P = .37) were not significantly different. In a multivariate model, adjusted cost of operative closure was 2012 US $60,992 versus 2012 US $55,841 for transcatheter closure (P cost favoring transcatheter closure were length of stay, medications, and follow-up radiologic and laboratory testing, overcoming higher costs of procedure and echocardiography. Professional costs did not differ. The rate of 30-day readmission was greater in the operative cohort, further increasing the cost advantage of transcatheter closure. Sensitivity analyses demonstrated that costs of follow-up visits influenced relative cost but that device closure remained favorable over a broad range of crossover and reintervention rates. Conclusion For single secundum ASD, cost comparison analysis favors transcatheter closure over the short term. The cost of follow-up regimens influences the cost advantage of transcatheter closure. PMID:25965721

  17. Impact Of Total Quality Management (TQM), Activity Based Costing ...

    African Journals Online (AJOL)

    Time (JIT), and Total Quality Management (TQM) as strategic initiatives lead to improved financial performance in the Turkish textile industry. Strong evidence emerged that there is a strong positive association between using ABC, JIT or TQM ...

  18. Operations and support cost modeling of conceptual space vehicles

    Science.gov (United States)

    Ebeling, Charles

    1994-01-01

    The University of Dayton is pleased to submit this annual report to the National Aeronautics and Space Administration (NASA) Langley Research Center which documents the development of an operations and support (O&S) cost model as part of a larger life cycle cost (LCC) structure. It is intended for use during the conceptual design of new launch vehicles and spacecraft. This research is being conducted under NASA Research Grant NAG-1-1327. This research effort changes the focus from that of the first two years in which a reliability and maintainability model was developed to the initial development of an operations and support life cycle cost model. Cost categories were initially patterned after NASA's three axis work breakdown structure consisting of a configuration axis (vehicle), a function axis, and a cost axis. A revised cost element structure (CES), which is currently under study by NASA, was used to established the basic cost elements used in the model. While the focus of the effort was on operations and maintenance costs and other recurring costs, the computerized model allowed for other cost categories such as RDT&E and production costs to be addressed. Secondary tasks performed concurrent with the development of the costing model included support and upgrades to the reliability and maintainability (R&M) model. The primary result of the current research has been a methodology and a computer implementation of the methodology to provide for timely operations and support cost analysis during the conceptual design activities.

  19. Computerized operating cost model for industrial steam generation

    Energy Technology Data Exchange (ETDEWEB)

    Powers, T.D.

    1983-02-01

    Pending EPA regulations, establishing revised emission levels for industrial boilers are perceived to have an effect on the relative costs of steam production technologies. To aid in the comparison of competitive boiler technologies, the Steam Cost Code was developed which provides levelized steam costs reflecting the effects of a number of key steam cost parameters. The Steam Cost Code is a user interactive FORTRAN program designed to operate on a VAX computer system. The program requires the user to input a number of variables describing the design characteristics, capital costs, and operating conditions for a specific boiler system. Part of the input to the Steam Cost Code is the capital cost of the steam production system. The capital cost is obtained from a program called INDCEPT, developed by Oak Ridge National Laboratory under Department of Energy, Morgantown Energy Technology Center sponsorship.

  20. 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.

  1. Cost effective shift schedules enhance utility operations

    International Nuclear Information System (INIS)

    Coleman, R.M.

    1995-01-01

    This article describes how new shift scheduling concepts can save utility operations millions of dollars every year and yet maintain safety and improve employee morale. The key to scheduling is to define and match the work load. This includes discretionary as well as daily, weekly, and yearly core work loads. In most power plants the overall work load (including maintenance, operations, materials handling, etc.) on day shift is greater than on other shifts, hence an unbalanced schedule would be appropriate

  2. HIGH ECCENTRICITY EOQ TOTAL COST FUNCTION YIELDS JIT RESULTs

    Directory of Open Access Journals (Sweden)

    Willian Roach

    2010-06-01

    Full Text Available No estoque de bens perecíveis, o custo de armazenamento H é muito maior do que o previsto na fórmula clássica do lote econômico do pedido (EOQ. Para bens perecíveis, a função custo total no EOQ é um pico e não uma reta horizontal. Esta forma pontiaguda leva o modelo EOQ a produzir entregas just in time (JIT - resultados semelhantes. O efeito pontiagudo (excentricidade da curva de custo total do lote econômico EOQ depende apenas do custo de armazenamento (H e não da demanda anual (D ou do custo do pedido (S. D e S determinam o nível (altura da curva de custo total do estoque (TC, mas não a forma.

  3. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program: executive summary

    International Nuclear Information System (INIS)

    1985-04-01

    The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's Civilian Radioactive Waste Management Progrram is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 is sufficient to cover the cost of the program. This report is an input into the third evaluation of the adequacy of the fee. The total-system cost for the reference waste-management program in this analysis is estimated to be 24 to 30 billion (1984) dollars. For the sensitivity cases studied in this report, the costs could be as high as 35 billion dollars and as low as 21 billion dollars. Because factors like repository location, the quantity of waste generated, transportation-cask technology, and repository startup dates exert substantial impacts on total-system costs, there are several tradeoffs between these factors, and these tradeoffs can greatly influence the total cost of the program. The total-system cost for the reference program described in this report is higher by 3 to 5 billion dollars, or 15 to 20%, than the cost for the reference program of the TSLCC analysis of April 1984. More than two-thirds of this increase is in the cost of repository construction and operation. These repository costs have increased because of changing design concepts, different assumptions about the effort required to perform the necessary activities, and a change in the source data on which the earlier analysis was based. Development and evaluation costs have similarly increased because of a net addition to the work content. Transportation costs have increased because of different assumptions about repository locations and several characteristics of the transportation system. It is expected that the estimates of total-system costs will continue to change in response to both an evolving program strategy and better definition of the work required to achieve the program objectives

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

    Science.gov (United States)

    Vogl, Matthias

    2014-04-01

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

  5. A Cost Analysis of the Decision to Cannibalize Major Components of the Navy's H-60 Helicopters at the Operational Level

    National Research Council Canada - National Science Library

    Kowalski, Danny

    2000-01-01

    ... often make a decision to cannibalize without considering the total cost of their decision This thesis examines the costs incurred by an operational H-6O helicopter squadron to cannibalize major...

  6. Utilization and cost for animal logging operations

    Science.gov (United States)

    Suraj P. Shrestha; Bobby L. Lanford

    2001-01-01

    Forest harvesting with animals is a labor-intensive operation. Due to the development of efficient machines and high volume demands from the forest products industry, mechanization of logging developed very fast, leaving behind the traditional horse and mule logging. It is expensive to use machines on smaller woodlots, which require frequent moves if mechanically...

  7. Total cost of performing analog-to-digital upgrades

    International Nuclear Information System (INIS)

    Albrigo, T.

    1993-01-01

    The financial well-being of nuclear power plants in the United States is dependent on reducing costs. Rapid advances in industrial technology have created a conundrum for utility executives and their engineering staffs. Digital technology is being touted as beneficial in many ways; however, a number of significant issues have been raised regarding the adequacy and financial viability of digital systems in nuclear power plants. Actual or perceived problems with digital system design, development, and installation have caused significant financial losses for nuclear utilities. This paper provides a list of problems that must be considered in performing an analog-to-digital conversion or for doing a large digital upgrade. It is desirable that the full financial risks associated with these types of upgrades are considered. Specific problems encountered at Palo Verde nuclear generating station are reviewed to emphasize some of the problem areas

  8. Cost of Maple Sap Production for Various Size Tubing Operations

    Science.gov (United States)

    Niel K. Huyler

    2000-01-01

    Reports sap production costs for small (500 to 1,000 taps), medium (1,000 to 5,000), and large (5,000 to 15,000) maple syrup operations that use plastic tubing with vacuum pumping. The average annual operating cost per tap ranged from $4.64 for a 500-tap sugarbush operation to $1.84 for a sugarbush with 10,000 taps. The weighted average was $2.87 per tap or $11.48 per...

  9. Effects of the Length of Stay on the Cost of Total Knee and Total Hip Arthroplasty from 2002 to 2013.

    Science.gov (United States)

    Molloy, Ilda B; Martin, Brook I; Moschetti, Wayne E; Jevsevar, David S

    2017-03-01

    Utilization of total knee and hip arthroplasty has greatly increased in the past decade in the United States; these are among the most expensive procedures in patients with Medicare. Advances in surgical techniques, anesthesia, and care pathways decrease hospital length of stay. We examined how trends in hospital cost were altered by decreases in length of stay. Procedure, demographic, and economic data were collected on 6.4 million admissions for total knee arthroplasty and 2.8 million admissions for total hip arthroplasty from 2002 to 2013 using the National (Nationwide) Inpatient Sample, a component of the Healthcare Cost and Utilization Project. Trends in mean hospital costs and their association with length of stay were estimated using inflation-adjusted, survey-weighted generalized linear regression models, controlling for patient demographic characteristics and comorbidity. From 2002 to 2013, the length of stay decreased from a mean time of 4.06 to 2.97 days for total knee arthroplasty and from 4.06 to 2.75 days for total hip arthroplasty. During the same time period, the mean hospital cost for total knee arthroplasty increased from $14,988 (95% confidence interval [CI], $14,927 to $15,049) in 2002 to $22,837 (95% CI, $22,765 to $22,910) in 2013 (an overall increase of $7,849 or 52.4%). The mean hospital cost for total hip arthroplasty increased from $15,792 (95% CI, $15,706 to $15,878) in 2002 to $23,650 (95% CI, $23,544 to $23,755) in 2013 (an increase of $7,858 or 49.8%). If length of stay were set at the 2002 mean, the growth in cost for total knee arthroplasty would have been 70.8% instead of 52.4% as observed, and the growth in cost for total hip arthroplasty would have been 67.4% instead of 49.8% as observed. Hospital costs for joint replacement increased from 2002 to 2013, but were attenuated by reducing inpatient length of stay. With demographic characteristics showing an upward trend in the utilization of joint arthroplasty, including a shift

  10. The thermodynamic cost of quantum operations

    International Nuclear Information System (INIS)

    Bedingham, D J; Maroney, O J E

    2016-01-01

    The amount of heat generated by computers is rapidly becoming one of the main problems for developing new generations of information technology. The thermodynamics of computation sets the ultimate physical bounds on heat generation. A lower bound is set by the Landauer limit, at which computation becomes thermodynamically reversible. For classical computation there is no physical principle which prevents this limit being reached, and approaches to it are already being experimentally tested. In this paper we show that for quantum computation with a set of signal states satisfying given conditions, there is an unavoidable excess heat generation that renders it inherently thermodynamically irreversible. The Landauer limit cannot, in general, be reached by quantum computers. We show the existence of a lower bound to the heat generated by quantum computing that exceeds that given by the Landauer limit, give the special conditions where this excess cost may be avoided, and provide a protocol for achieving the limiting heat cost when these conditions are met. We also show how classical computing falls within the special conditions. (paper)

  11. Cost-effectiveness of positive contrast and nuclear arthrography in patients who underwent total hip arthroplasty

    International Nuclear Information System (INIS)

    Swan, J.S.; Braunstein, E.M.; Capello, W.; Wellman, H.

    1989-01-01

    The authors have compared the cost effectiveness of contrast arthrography (CA) and nuclear arthrography (NA), in which In-111 chloride is injected with the contrast material, of total hip arthroplasties. Their series included 48 cases of surgically proved loose femoral components. The cost per true-positive result was obtained by taking the total cost of the examinations in surgically proved cases and dividing by the number of true-position cases. The cost of CA was $297 and the cost of NA was $335. For CA, the cost per true positive was $1,018, and for the NA the cost per true positive was $946. In spite of higher initial cost, NA is more cost effective than CA on a cost per true-positive case basis. NA is cost effective in evaluating hip arthroplasties in which there is suspicion of a loose femoral component

  12. Electrochromic Windows: Process and Fabrication Improvements for Lower Total Costs

    Energy Technology Data Exchange (ETDEWEB)

    Mark Burdis; Neil Sbar

    2007-03-31

    The overall goal with respect to the U.S. Department of Energy (DOE) is to achieve significant national energy savings through maximized penetration of EC windows into existing markets so that the largest cumulative energy reduction can be realized. The speed with which EC windows can be introduced and replace current IGU's (and current glazings) is clearly a strong function of cost. Therefore, the aim of this project was to investigate possible improvements to the SageGlass{reg_sign} EC glazing products to facilitate both process and fabrication improvements resulting in lower overall costs. The project was split into four major areas dealing with improvements to the electrochromic layer, the capping layer, defect elimination and general product improvements. Significant advancements have been made in each of the four areas. These can be summarized as follows: (1) Plasma assisted deposition for the electrochromic layer was pursued, and several improvements made to the technology for producing a plasma beam were made. Functional EC devices were produced using the new technology, but there are still questions to be answered regarding the intrinsic properties of the electrochromic films produced by this method. (2) The capping layer work was successfully implemented into the existing SageGlass{reg_sign} product, thereby providing a higher level of transparency and somewhat lower reflectivity than the 'standard' product. (3) Defect elimination is an ongoing effort, but this project spurred some major defect reduction programs, which led to significant improvements in yield, with all the implicit benefits afforded. In particular, major advances were made in the development of a new bus bar application process aimed at reducing the numbers of 'shorts' developed in the finished product, as well as making dramatic improvements in the methods used for tempering the glass, which had previously been seen to produce a defect which appeared as a

  13. Control and operation cost optimization of the HISS cryogenic system

    International Nuclear Information System (INIS)

    Porter, J.; Bieser, F.; Anderson, D.

    1983-08-01

    The Heavy Ion Spectrometer System (HISS) relies upon superconducting coils of cryostable design to provide a maximum particle bending field of 3 tesla. A previous paper describes the cryogenic facility including helium refrigeration and gas management. This paper discusses a control strategy which has allowed full time unattended operation, along with significant nitrogen and power cost reductions. Reduction of liquid nitrogen consumption has been accomplished by making use of the sensible heat available in the cold exhaust gas. Measured nitrogen throughput agrees with calculations for sensible heat utilization of zero to 70%. Calculated consumption saving over this range is 40 liters per hour for conductive losses to the supports only. The measured throughput differential for the total system is higher

  14. Cost of goods sold and total cost of delivery for oral and parenteral vaccine packaging formats.

    Science.gov (United States)

    Sedita, Jeff; Perrella, Stefanie; Morio, Matt; Berbari, Michael; Hsu, Jui-Shan; Saxon, Eugene; Jarrahian, Courtney; Rein-Weston, Annie; Zehrung, Darin

    2018-03-14

    Despite limitations of glass packaging for vaccines, the industry has been slow to implement alternative formats. Polymer containers may address many of these limitations, such as breakage and delamination. However, the ability of polymer containers to achieve cost of goods sold (COGS) and total cost of delivery (TCOD) competitive with that of glass containers is unclear, especially for cost-sensitive low- and lower-middle-income countries. COGS and TCOD models for oral and parenteral vaccine packaging formats were developed based on information from subject matter experts, published literature, and Kenya's comprehensive multiyear plan for immunization. Rotavirus and inactivated poliovirus vaccines (IPV) were used as representative examples of oral and parenteral vaccines, respectively. Packaging technologies evaluated included glass vials, blow-fill-seal (BFS) containers, preformed polymer containers, and compact prefilled auto-disable (CPAD) devices in both BFS and preformed formats. For oral vaccine packaging, BFS multi-monodose (MMD) ampoules were the least expensive format, with a COGS of $0.12 per dose. In comparison, oral single-dose glass vials had a COGS of $0.40. BFS MMD ampoules had the lowest TCOD of oral vaccine containers at $1.19 per dose delivered, and ten-dose glass vials had a TCOD of $1.61 per dose delivered. For parenteral vaccines, the lowest COGS was achieved with ten-dose glass vials at $0.22 per dose. In contrast, preformed CPAD devices had the highest COGS at $0.60 per dose. Ten-dose glass vials achieved the lowest TCOD of the parenteral vaccine formats at $1.56 per dose delivered. Of the polymer containers for parenteral vaccines, BFS MMD ampoules achieved the lowest TCOD at $1.89 per dose delivered, whereas preformed CPAD devices remained the most expensive format, at $2.25 per dose delivered. Given their potential to address the limitations of glass and reduce COGS and TCOD, polymer containers deserve further consideration as alternative

  15. Operations and Maintenance Cost for Stratified Buildings: A Critical Review

    Directory of Open Access Journals (Sweden)

    Che-Ghani Nor Zaimah

    2016-01-01

    Full Text Available Building maintenance is essential in preserving buildings’ appearance and performance. It needs to upkeep the building performance to prolong its value and building life cycle. Malaysia is still lacking in managing cost for building operation and maintenance. It has been found that the cost for housing maintenance is high due to poor maintenance practices. In order to get better understanding on how to manage the cost, this study reviews the contributing factors that affecting operation and maintenance cost of stratified buildings in Malaysia. The research first identified the factors through extensive literature review and scrutinize on factors that affecting and can minimize operation and maintenance cost. This literature review offers insight into building maintenance scenario in Malaysia focusing on the issues and challenges. The study also finds that operation and maintenance cost for housing in Malaysia is still in poor state. Interestingly, this paper revealed that operation and maintenance cost is also influenced by three significant factors like expectation of tenants, building characteristics and building defects. Measures to reduce the housing operation and maintenance cost are also highlighted so that this study can be a stepping stone towards proposing efficient and effective facilities management strategies for affordable housing in future.

  16. The total lifetime health cost savings of smoking cessation to society

    DEFF Research Database (Denmark)

    Rasmussen, Gitte Susanne; Prescott, Eva; Sørensen, Thorkild I A

    2005-01-01

    Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined.......Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined....

  17. Integrating cost management and work management concepts for operations

    International Nuclear Information System (INIS)

    Vanditmars, C.

    1995-01-01

    Development of B C Gas Utility Limited's integrated work and cost management system was described, with emphasis on cost management without reliance on the financial systems, and standard costing and operational side benefits. The objectives of the system were identified as dynamic monitoring and control, and local empowerment. The concept underlying the two systems was explained in detail. In the case of the work management system the ability to manage all work in operations areas was stressed, along with its universal availability. Other benefits expected included improved resource utilization, improved productivity, better control of cost, improved revenue generation, superior customer service, a simplified financial system, and improved employee motivation through empowerment

  18. Contrast in low-cost operational concepts for orbiting satellites

    Science.gov (United States)

    Walyus, Keith D.; Reis, James; Bradley, Arthur J.

    2002-12-01

    Older spacecraft missions, especially those in low Earth orbit with telemetry intensive requirements, required round-the-clock control center staffing. The state of technology relied on control center personnel to continually examine data, make decisions, resolve anomalies, and file reports. Hubble Space Telescope (HST) is a prime example of this description. Technological advancements in hardware and software over the last decade have yielded increases in productivity and operational efficiency, which result in lower cost. The re-engineering effort of HST, which has recently concluded, utilized emerging technology to reduce cost and increase productivity. New missions, of which NASA's Transition Region and Coronal Explorer Satellite (TRACE) is an example, have benefited from recent technological advancements and are more cost-effective than when HST was first launched. During its launch (1998) and early orbit phase, the TRACE Flight Operations Team (FOT) employed continually staffed operations. Yet once the mission entered its nominal phase, the FOT reduced their staffing to standard weekday business hours. Operations were still conducted at night and during the weekends, but these operations occurred autonomously without compromising their high standards for data collections. For the HST, which launched in 1990, reduced cost operations will employ a different operational concept, when the spacecraft enters its low-cost phase after its final servicing mission in 2004. Primarily due to the spacecraft"s design, the HST Project has determined that single-shift operations will introduce unacceptable risks for the amount of dollars saved. More importantly, significant cost-savings can still be achieved by changing the operational concept for the FOT, while still maintaining round-the-clock staffing. It"s important to note that the low-cost solutions obtained for one satellite may not be applicable for other satellites. This paper will contrast the differences between

  19. Cost Analysis In A Multi-Mission Operations Environment

    Science.gov (United States)

    Newhouse, M.; Felton, L.; Bornas, N.; Botts, D.; Roth, K.; Ijames, G.; Montgomery, P.

    2014-01-01

    Spacecraft control centers have evolved from dedicated, single-mission or single missiontype support to multi-mission, service-oriented support for operating a variety of mission types. At the same time, available money for projects is shrinking and competition for new missions is increasing. These factors drive the need for an accurate and flexible model to support estimating service costs for new or extended missions; the cost model in turn drives the need for an accurate and efficient approach to service cost analysis. The National Aeronautics and Space Administration (NASA) Huntsville Operations Support Center (HOSC) at Marshall Space Flight Center (MSFC) provides operations services to a variety of customers around the world. HOSC customers range from launch vehicle test flights; to International Space Station (ISS) payloads; to small, short duration missions; and has included long duration flagship missions. The HOSC recently completed a detailed analysis of service costs as part of the development of a complete service cost model. The cost analysis process required the team to address a number of issues. One of the primary issues involves the difficulty of reverse engineering individual mission costs in a highly efficient multimission environment, along with a related issue of the value of detailed metrics or data to the cost model versus the cost of obtaining accurate data. Another concern is the difficulty of balancing costs between missions of different types and size and extrapolating costs to different mission types. The cost analysis also had to address issues relating to providing shared, cloud-like services in a government environment, and then assigning an uncertainty or risk factor to cost estimates that are based on current technology, but will be executed using future technology. Finally the cost analysis needed to consider how to validate the resulting cost models taking into account the non-homogeneous nature of the available cost data and the

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

    International Nuclear Information System (INIS)

    1996-08-01

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

  1. The Application of Architecture Frameworks to Modelling Exploration Operations Costs

    Science.gov (United States)

    Shishko, Robert

    2006-01-01

    Developments in architectural frameworks and system-of-systems thinking have provided useful constructs for systems engineering. DoDAF concepts, language, and formalisms, in particular, provide a natural way of conceptualizing an operations cost model applicable to NASA's space exploration vision. Not all DoDAF products have meaning or apply to a DoDAF inspired operations cost model, but this paper describes how such DoDAF concepts as nodes, systems, and operational activities relate to the development of a model to estimate exploration operations costs. The paper discusses the specific implementation to the Mission Operations Directorate (MOD) operational functions/activities currently being developed and presents an overview of how this powerful representation can apply to robotic space missions as well.

  2. Capital and operating costs of irradiated natural uranium reprocessing plants

    International Nuclear Information System (INIS)

    Thiriet, L.; Jouannaud, C.; Couture, J.; Duboz, J.

    1966-01-01

    This paper presents first a method of analysing natural uranium reprocessing plants investment costs (method similar to LANG and BACH well known in the fuel oil industry) and their operating costs (analysed according to their economic type). This method helps establishing standard cost structures for these plants, allowing thus comparisons between existing or planned industrial facilities. It also helps evaluating the foreseeable consequences of technical progress. Some results obtained are given, concerning: the investment costs sensitivity to the various technical parameters defining the fuel and their comparison according to the country or the economic area taken into account. Finally, the influence of the plants size on their investment costs is shown. (author) [fr

  3. Determining the Cost-Savings Threshold and Alignment Accuracy of Patient-Specific Instrumentation in Total Ankle Replacements.

    Science.gov (United States)

    Hamid, Kamran S; Matson, Andrew P; Nwachukwu, Benedict U; Scott, Daniel J; Mather, Richard C; DeOrio, James K

    2017-01-01

    Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR). In addition, we aimed to compare postoperative radiographic alignment between PSI and SR. Between August 2014 and September 2015, 87 patients undergoing TAR were enrolled in a prospectively collected TAR database. Patients were divided into cohorts based on PSI vs SR, and operative times were reviewed. Radiographic alignment parameters were retrospectively measured at 6 weeks postoperatively. Time-driven activity-based costing (TDABC) was used to derive direct costs. Cost vs operative time-savings were examined via 2-way sensitivity analysis to determine cost-saving thresholds for PSI applicable to a range of institution types. Cost-saving thresholds defined the price of PSI below which PSI would be cost-saving. A total of 35 PSI and 52 SR cases were evaluated with no significant differences identified in patient characteristics. Operative time from incision to completion of casting in cases without adjunct procedures was 127 minutes with PSI and 161 minutes with SR ( P cost-savings threshold range at our institution of $863 below which PSI pricing would provide net cost-savings. Two-way sensitivity analysis generated a globally applicable cost-savings threshold model based on institution-specific costs and surgeon-specific time-savings. This study demonstrated equivalent postoperative TAR alignment with PSI and SR referencing systems but with a significant decrease in operative time with PSI. Based on TDABC and associated sensitivity analysis, a cost-savings threshold

  4. US nuclear power plant operating cost and experience summaries

    International Nuclear Information System (INIS)

    Kohn, W.E.; Reid, R.L.; White, V.S.

    1998-02-01

    NUREG/CR-6577, U.S. Nuclear Power Plant Operating Cost and Experience Summaries, has been prepared to provide historical operating cost and experience information on U.S. commercial nuclear power plants. Cost incurred after initial construction are characterized as annual production costs, representing fuel and plant operating and maintenance expenses, and capital expenditures related to facility additions/modifications which are included in the plant capital asset base. As discussed in the report, annual data for these two cost categories were obtained from publicly available reports and must be accepted as having different degrees of accuracy and completeness. Treatment of inconclusive and incomplete data is discussed. As an aid to understanding the fluctuations in the cost histories, operating summaries for each nuclear unit are provided. The intent of these summaries is to identify important operating events; refueling, major maintenance, and other significant outages; operating milestones; and significant licensing or enforcement actions. Information used in the summaries is condensed from annual operating reports submitted by the licensees, plant histories contained in Nuclear Power Experience, trade press articles, and the Nuclear Regulatory Commission (NRC) web site (www.nrc.gov)

  5. US nuclear power plant operating cost and experience summaries

    Energy Technology Data Exchange (ETDEWEB)

    Kohn, W.E.; Reid, R.L.; White, V.S.

    1998-02-01

    NUREG/CR-6577, U.S. Nuclear Power Plant Operating Cost and Experience Summaries, has been prepared to provide historical operating cost and experience information on U.S. commercial nuclear power plants. Cost incurred after initial construction are characterized as annual production costs, representing fuel and plant operating and maintenance expenses, and capital expenditures related to facility additions/modifications which are included in the plant capital asset base. As discussed in the report, annual data for these two cost categories were obtained from publicly available reports and must be accepted as having different degrees of accuracy and completeness. Treatment of inconclusive and incomplete data is discussed. As an aid to understanding the fluctuations in the cost histories, operating summaries for each nuclear unit are provided. The intent of these summaries is to identify important operating events; refueling, major maintenance, and other significant outages; operating milestones; and significant licensing or enforcement actions. Information used in the summaries is condensed from annual operating reports submitted by the licensees, plant histories contained in Nuclear Power Experience, trade press articles, and the Nuclear Regulatory Commission (NRC) web site (www.nrc.gov).

  6. Economics of tobacco control research initiative: Operating costs for ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Economics of tobacco control research initiative: Operating costs for capacity building ... (but misinformed) beliefs about the economic benefits of the tobacco industry ... Nutrition, health policy, and ethics in the age of public-private partnerships.

  7. Mobile Offshore Base Operational Utility and Cost Study

    National Research Council Canada - National Science Library

    Greer, William

    2001-01-01

    .... This study responds to the portion of the National Defense Authorization Act for Fiscal Year 2001 that directs the Secretary of Defense to provide an analysis of the operational utility and life cycle costs of the MOB...

  8. Estimating the Costs of Military Operations in Iraq

    National Research Council Canada - National Science Library

    Gilmore, J. M

    2007-01-01

    This testimony, given by J. Michael Gilmore, Assistant Director for National Security, before the Committee on the Budget, United States Senate, discusses the costs of operations in the Iraq theater and issues associated...

  9. Intensive care unit drug costs in the context of total hospital drug expenditures with suggestions for targeted cost containment efforts.

    Science.gov (United States)

    Altawalbeh, Shoroq M; Saul, Melissa I; Seybert, Amy L; Thorpe, Joshua M; Kane-Gill, Sandra L

    2018-04-01

    To assess costs of intensive care unit (ICU) related pharmacotherapy relative to hospital drug expenditures, and to identify potential targets for cost-effectiveness investigations. We offer the unique advantage of comparing ICU drug costs with previously published data a decade earlier to describe changes over time. Financial transactions for all ICU patients during fiscal years (FY) 2009-2012 were retrieved from the hospital's data repository. ICU drug costs were evaluated for each FY. ICU departments' charges were also retrieved and calculated as percentages of total ICU charges. Albumin, prismasate (dialysate), voriconazole, factor VII and alteplase denoted the highest percentages of ICU drug costs. ICU drug costs contributed to an average of 31% (SD 1.0%) of the hospital's total drug costs. ICU drug costs per patient day increased by 5.8% yearly versus 7.8% yearly for non-ICU drugs. This rate was higher for ICU drugs costs at 12% a decade previous. Pharmacy charges contributed to 17.7% of the total ICU charges. Growth rates of costs per year have declined but still drug expenditures in the ICU are consistently a significant driver in this resource intensive environment with a high impact on hospital drug expenditures. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. How do high cost-sharing policies for physician care affect total care costs among people with chronic disease?

    Science.gov (United States)

    Xin, Haichang; Harman, Jeffrey S; Yang, Zhou

    2014-01-01

    This study examines whether high cost-sharing in physician care is associated with a differential impact on total care costs by health status. Total care includes physician care, emergency room (ER) visits and inpatient care. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies are a good strategy for controlling costs among chronically ill patients. This study used the 2007 Medical Expenditure Panel Survey data with a cross-sectional study design. Difference in difference (DID), instrumental variable technique, two-part model, and bootstrap technique were employed to analyze cost data. Chronically ill individuals' probability of reducing any overall care costs was significantly less than healthier individuals (beta = 2.18, p = 0.04), while the integrated DID estimator from split results indicated that going from low cost-sharing to high cost-sharing significantly reduced costs by $12,853.23 more for sick people than for healthy people (95% CI: -$17,582.86, -$8,123.60). This greater cost reduction in total care among sick people likely resulted from greater cost reduction in physician care, and may have come at the expense of jeopardizing health outcomes by depriving patients of needed care. Thus, these policies would be inappropriate in the short run, and unlikely in the long run to control health plans costs among chronically ill individuals. A generous benefit design with low cost-sharing policies in physician care or primary care is recommended for both health plans and chronically ill individuals, to save costs and protect these enrollees' health status.

  11. Estimated Costs of Continuing Operations in Iraq and Other Operations of the Global War on Terrorism

    National Research Council Canada - National Science Library

    Holtz-Eakin, Douglas

    2004-01-01

    At the request of Senator Conrad, the Congressional Budget Office (CBO) has estimated the costs of military operations in Iraq and Afghanistan and other operations associated with the global war on terrorism (GWOT...

  12. The costs and quality of operative training for residents in tympanoplasty type I.

    Science.gov (United States)

    Wang, Mao-Che; Yu, Eric Chen-Hua; Shiao, An-Suey; Liao, Wen-Huei; Liu, Chia-Yu

    2009-05-01

    A teaching hospital would incur more operation room costs on training surgical residents. To evaluate the increased operation time and the increased operation room costs of operations performed by surgical residents. As a model we used a very common surgical otology procedure -- tympanoplasty type I. From January 1, 2004 to December 31, 2004, we included in this study 100 patients who received tympanoplasty type I in Taipei Veterans General Hospital. Fifty-six procedures were performed by a single board-certified surgeon and 44 procedures were performed by residents. We analyzed the operation time and surgical outcomes in these two groups of patients. The operation room cost per minute was obtained by dividing the total operation room expenses by total operation time in the year 2004. The average operation time of residents was 116.47 min, which was significantly longer (pcost USD $40.36 more for each operation performed by residents in terms of operation room costs. The surgical success rate of residents was 81.82%, which was significantly lower (p=0.016) than that of the board-certified surgeon (96.43%).

  13. [A totally implantable venous access device. Implantation in general or local anaesthesia? A retrospective cost analysis].

    Science.gov (United States)

    Schuld, J; Richter, S; Moussavian, M R; Kollmar, O; Schilling, M K

    2009-08-01

    Implantation of venous access port systems can be performed in local or general anesthesia. In spite of the increasing rate of interventionally implanted systems, the surgical cut-down represents a safe alternative. Thus, the question arises whether--in context to the increasing health-economic pressure--open implantation in general anesthesia is still a feasible alternative to implantation in local anesthesia regarding OR efficiency and costs. In a retrospective analysis, 993 patients receiving a totally implantable venous access device between 2001 and 2007 were evaluated regarding OR utilization, turnover times, intraoperative data and costs. Implantations in local (LA) and general anesthesia (GA) were compared. GA was performed in 762 cases (76.6 %), LA was performed in 231 patients (23.3 %). Mean operation time was similar in both groups (LA 47.27 +/- 1.40 min vs. GA 45.41 +/- 0.75 min, p = 0.244). Patients receiving local anesthesia had a significantly shorter stay in the OR unit (LA 95.9 +/- 1.78 min vs. GA 105.92 +/- 0.92 min; p cut (LA 39.57 +/- 0.69 min vs. GA 50.46 +/- 0.52 min; p material costs were significantly lower in the LA group compared with the GA group (LA: 400.72 +/- 8.25 euro vs. GA: 482.86 +/- 6.23 euro; p systems in local anesthesia is superior in comparison to the implantation under general anesthesia regarding procedural times in the OR unit and costs. With the same operation duration, but less personnel and material expenditure, implantation in local anesthesia offers a potential economic advantage by permitting faster changing times. Implantation in GA only should be performed at a special request by the patient or in difficult venous conditions. Georg Thieme Verlag Stuttgart.New York.

  14. Controlling costs without compromising quality: paying hospitals for total knee replacement.

    Science.gov (United States)

    Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

    2010-10-01

    Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

  15. Effect of facility on the operative costs of distal radius fractures.

    Science.gov (United States)

    Mather, Richard C; Wysocki, Robert W; Mack Aldridge, J; Pietrobon, Ricardo; Nunley, James A

    2011-07-01

    The purpose of this study was to investigate whether ambulatory surgery centers can deliver lower-cost care and to identify sources of those cost savings. We performed a cost identification analysis of outpatient volar plating for closed distal radius fractures at a single academic medical center. Multiple costs and time measures were taken from an internal database of 130 consecutive patients and were compared by venue of treatment, either an inpatient facility or an ambulatory, stand-alone surgery facility. The relationships between total cost and operative time and multiple variables, including fracture severity, patient age, gender, comorbidities, use of bone graft, concurrent carpal tunnel release, and surgeon experience, were examined, using multivariate analysis and regression modeling to identify other cost drivers or explanatory variables. The mean operative cost was considerably greater at the inpatient facility ($7,640) than at the outpatient facility ($5,220). Cost drivers of this difference were anesthesia services, post-anesthesia care unit, and operating room costs. Total surgical time, nursing time, set-up, and operative times were 33%, 109%, 105%, and 35% longer, respectively, at the inpatient facility. There was no significant difference between facilities for the additional variables, and none of those variables independently affected cost or operative time. The only predictor of cost and time was facility type. This study supports the use of ambulatory stand-alone surgical facilities to achieve efficient resource utilization in the operative treatment of distal radius fractures. We also identified several specific costs and time measurements that differed between facilities, which can serve as potential targets for tertiary facilities to improve utilization. Economic and Decisional Analysis III. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Mustafa Gökhan Bilgili

    2014-06-01

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

  17. Study of short-haul aircraft operating economics. Phase 2: an analysis of the impact of jet modernization on local service airline operating costs. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Andrastek, D.A.

    1976-05-01

    The objectives of this phase of the study were (1) to assess the 10 year operating cost trends of the local service airlines operating in the 1965 through 1974 period, (2) to glean from these trends the technological and operational parameters which were impacted most significantly by the transition to newer pure jet, short haul transports, and effected by changing fuel prices and cost of living indices, and (3) to develop, construct, and evaluate an operating cost forecasting model which would incorporate those factors which best predicted airline total operating cost behavior over that 10-year period.

  18. Supplier managed inventory in the OEM supply chain : the impact of relationship types on total costs and cost distribution

    NARCIS (Netherlands)

    Nyen, van P.L.M.; Bertrand, J.W.M.; Ooijen, van H.P.G.; Vandaele, N.J.

    2009-01-01

    We investigate the impact of four variants of supplier managed inventory on total costs and cost distribution in a capital goods supply chain consisting of a parts supplier who delivers parts to an original equipment manufacturer’s assembly plant. The four supplier managed inventory variants differ

  19. The adoption of total cost of ownership for sourcing decisions - a structural equations analysis

    NARCIS (Netherlands)

    Wouters, Marc; Anderson, James C.; Wynstra, Finn

    2005-01-01

    This study investigates the adoption of total cost of ownership (TCO) analysis to improve sourcing decisions. TCO can be seen as an application of activity based costing (ABC) that quantifies the costs that are involved in acquiring and using purchased goods or services. TCO supports purchasing

  20. Organizing for low cost space operations - Status and plans

    Science.gov (United States)

    Lee, C.

    1976-01-01

    Design features of the Space Transportation System (vehicle reuse, low cost expendable components, simple payload interfaces, standard support systems) must be matched by economical operational methods to achieve low operating and payload costs. Users will be responsible for their own payloads and will be charged according to the services they require. Efficient use of manpower, simple documentation, simplified test, checkout, and flight planning are firm goals, together with flexibility for quick response to varying user needs. Status of the Shuttle hardware, plans for establishing low cost procedures, and the policy for user charges are discussed.

  1. Association of Hospital Costs With Complications Following Total Gastrectomy for Gastric Adenocarcinoma.

    Science.gov (United States)

    Selby, Luke V; Gennarelli, Renee L; Schnorr, Geoffrey C; Solomon, Stephen B; Schattner, Mark A; Elkin, Elena B; Bach, Peter B; Strong, Vivian E

    2017-10-01

    Postoperative complications are associated with increased hospital costs following major surgery, but the mechanism by which they increase cost and the categories of care that drive this increase are poorly described. To describe the association of postoperative complications with hospital costs following total gastrectomy for gastric adenocarcinoma. This retrospective analysis of a prospectively collected gastric cancer surgery database at a single National Cancer Institute-designated comprehensive cancer center included all patients undergoing curative-intent total gastrectomy for gastric adenocarcinoma between January 2009 and December 2012 and was conducted in 2015 and 2016. Ninety-day normalized postoperative costs. Hospital accounting system costs were normalized to reflect Medicare reimbursement levels using the ratio of hospital costs to Medicare reimbursement and categorized into major cost categories. Differences between costs in Medicare proportional dollars (MP $) can be interpreted as the amount that would be reimbursed to an average hospital by Medicare if it paid differentially based on types and extent of postoperative complications. In total, 120 patients underwent curative-intent total gastrectomy for stage I through III gastric adenocarcinoma between 2009 and 2012. Of these, 79 patients (65.8%) were men, and the median (interquartile range) age was 64 (52-70) years. The 51 patients (42.5%) who underwent an uncomplicated total gastrectomy had a mean (SD) normalized cost of MP $12 330 (MP $2500), predominantly owing to the cost of surgical care (mean [SD] cost, MP $6830 [MP $1600]). The 34 patients (28.3%) who had a major complication had a mean (SD) normalized cost of MP $37 700 (MP $28 090). Surgical care was more expensive in these patients (mean [SD] cost, MP $8970 [MP $2750]) but was a smaller contributor to total cost (24%) owing to increased costs from room and board (mean [SD] cost, MP $11 940 [MP $8820]), consultations (mean [SD

  2. Utilization and cost of log production from animal loging operations

    Science.gov (United States)

    Suraj P. Shrestha; Bobby L. Lanford; Robert B. Rummer; Mark Dubois

    2006-01-01

    Forest harvesting with animals is a labor-intensive operation. It is expensive to use machines on smaller woodlots, which require frequent moves if mechanically logged. So, small logging systems using animals may be more cost effective. In this study, work sampling was used for five animal logging operations in Alabama to measure productive and non-productive time...

  3. 38th Annual Maintenance & Operations Cost Study for Colleges

    Science.gov (United States)

    Agron, Joe

    2009-01-01

    The nation's colleges are feeling the pinch of the economic downturn, and maintenance and operations (M&O) budgets especially are under pressure. This article presents data from the 38th annual Maintenance & Operations Cost Study for colleges that can help one in benchmarking expenditures at one's institution. Data provided only targets two-year…

  4. 38th Annual Maintenance & Operations Cost Study for Schools

    Science.gov (United States)

    Agron, Joe

    2009-01-01

    Despite the worst economic environment in generations, spending by K-12 institutions on maintenance and operations (M&O) held its own--defying historical trends that have shown M&O spending among the most affected in times of budget tightening. This article presents data from the 38th annual Maintenance & Operations Cost Study for…

  5. Cost analysis of operating an all-digital radiology department

    International Nuclear Information System (INIS)

    Arenson, R.L.; Soshadri, S.B.; DeSimone, D.; Hiss, S.S.

    1988-01-01

    Using the current film system as a baseline, this study analyzes the cost of digital acquisition, transmission, archiving, and display of all images generated in our department. Two approaches are considered: (1) conventional x-ray films are digitized with a laser scanning film digitizer; (2) images are captured with a direct digital receptor and no film is created. In both approaches, images from digital modalities are acquired directly from the scanners. The cost of equipment and its maintenance, film, supplies, storage space, operations, personnel, and so forth are analyzed for all approaches. The annual cost of operating the film system is $2.5 million. The estimated annual cost is $2.3 million for the first digital approach, $1.8 million for the second. This analysis demonstrates that these digital approaches can be cost-effective, viable alternatives to film-bases systems

  6. Operating dedicated data centers – is it cost-effective?

    International Nuclear Information System (INIS)

    Ernst, M; Hogue, R; Hollowell, C; Strecker-Kellog, W; Wong, A; Zaytsev, A

    2014-01-01

    The advent of cloud computing centres such as Amazon's EC2 and Google's Computing Engine has elicited comparisons with dedicated computing clusters. Discussions on appropriate usage of cloud resources (both academic and commercial) and costs have ensued. This presentation discusses a detailed analysis of the costs of operating and maintaining the RACF (RHIC and ATLAS Computing Facility) compute cluster at Brookhaven National Lab and compares them with the cost of cloud computing resources under various usage scenarios. An extrapolation of likely future cost effectiveness of dedicated computing resources is also presented.

  7. Nuclear power costs in the build, operate, transfer approach

    International Nuclear Information System (INIS)

    Aybers, M.N.; Sahin, B.

    1990-01-01

    The costs of nuclear power are discussed with special reference to the economic problems faced by developing countries, and the relative merit of a new accounting approach, viz., the build, operate, transfer contract model, which was proposed in Turkey for the Akkuyu nuclear power project, is illustrated. In this context, the general methodology of calculating nuclear power costs is summarized and a capital cost analysis for a 986 MW pressurized water reactor plant is given in terms of constant monetary units for the above contract model and the turnkey contract model. Adjustment of the costs taking into account regional conditions such as inflation and higher interest rates is also indicated. (orig.) [de

  8. Construction and operation costs of constructed wetlands treating wastewater.

    Science.gov (United States)

    Gkika, Dimitra; Gikas, Georgios D; Tsihrintzis, Vassilios A

    2014-01-01

    Design data from nine constructed wetlands (CW) facilities of various capacities (population equivalent (PE)) are used to estimate construction and operation costs, and then to derive empirical equations relating the required facility land area and the construction cost to PE. In addition, comparisons between the costs of CW facilities based on various alternative construction materials, i.e., reinforced concrete and earth structures (covered with either high density polyethylene or clay), are presented in relation to the required area. The results show that earth structures are economically advantageous. The derived equations can be used for providing a preliminary cost estimate of CW facilities for domestic wastewater treatment.

  9. Operating Dedicated Data Centers - Is It Cost-Effective?

    Science.gov (United States)

    Ernst, M.; Hogue, R.; Hollowell, C.; Strecker-Kellog, W.; Wong, A.; Zaytsev, A.

    2014-06-01

    The advent of cloud computing centres such as Amazon's EC2 and Google's Computing Engine has elicited comparisons with dedicated computing clusters. Discussions on appropriate usage of cloud resources (both academic and commercial) and costs have ensued. This presentation discusses a detailed analysis of the costs of operating and maintaining the RACF (RHIC and ATLAS Computing Facility) compute cluster at Brookhaven National Lab and compares them with the cost of cloud computing resources under various usage scenarios. An extrapolation of likely future cost effectiveness of dedicated computing resources is also presented.

  10. Strategies for reducing implant costs in the revision total knee arthroplasty episode of care.

    Science.gov (United States)

    Elbuluk, Ameer M; Old, Andrew B; Bosco, Joseph A; Schwarzkopf, Ran; Iorio, Richard

    2017-12-01

    Implant price has been identified as a significant contributing factor to high costs associated with revision total knee arthroplasty (rTKA). The goal of this study is to analyze the cost of implants used in rTKAs and to compare this pricing with 2 alternative pricing models. Using our institutional database, we identified 52 patients from January 1, 2014 to December 31, 2014. Average cost of components for each case was calculated and compared to the total hospital cost for that admission. Costs for an all-component revision were then compared to a proposed "direct to hospital" (DTH) standardized pricing model and a fixed price revision option. Potential savings were calculated from these figures. On average, 28% of the total hospital cost was spent on implants for rTKA. The average cost for revision of all components was $13,640 and ranged from $3000 to $28,000. On average, this represented 32.7% of the total hospital cost. Direct to hospital implant pricing could potentially save approximately $7000 per rTKA, and the fixed pricing model could provide a further $1000 reduction per rTKA-potentially saving $8000 per case on implants alone. Alternative implant pricing models could help lower the total cost of rTKA, which would allow hospitals to achieve significant cost containment.

  11. A decision-making framework for total ownership cost management of complex systems: A Delphi study

    Science.gov (United States)

    King, Russel J.

    This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.

  12. Cost of enlarged operating zone for an existing Francis runner

    Science.gov (United States)

    Monette, Christine; Marmont, Hugues; Chamberland-Lauzon, Joël; Skagerstrand, Anders; Coutu, André; Carlevi, Jens

    2016-11-01

    Traditionally, hydro power plants have been operated close to best efficiency point, the more stable operating condition for which they have been designed. However, because of changes in the electricity market, many hydro power plants operators wish to operate their machines differently to fulfil those new market needs. New operating conditions can include whole range operation, many start/stops, extensive low load operation, synchronous condenser mode and power/frequency regulation. Many of these new operating conditions may impose more severe fatigue damage than the traditional base load operation close to best efficiency point. Under these conditions, the fatigue life of the runner may be significantly reduced and reparation or replacement cost might occur sooner than expected. In order to design reliable Francis runners for those new challenging operating scenarios, Andritz Hydro has developed various proprietary tools and design rules. These are used within Andritz Hydro to design mechanically robust Francis runners for the operating scenarios fulfilling customer's specifications. To estimate residual life under different operating scenarios of an existing runner designed years ago for best efficiency base load operation, Andritz Hydro's design rules and tools would necessarily lead to conservative results. While the geometry of a new runner can be modified to fulfil all conservative mechanical design rules, the predicted fatigue life of an existing runner under off-design operating conditions may appear rather short because of the conservative safety factor included in the calculations. The most precise and reliable way to calculate residual life of an existing runner under different operating scenarios is to perform a strain gauge measurement campaign on the runner. This paper presents the runner strain gage measurement campaign of a mid-head Francis turbine over all the operating conditions available during the test, the analysis of the measurement signals

  13. Distributed Flexibility Management Targeting Energy Cost and Total Power Limitations in Electricity Distribution Grids

    DEFF Research Database (Denmark)

    Bessler, Sanford; Kemal, Mohammed Seifu; Silva, Nuno

    2018-01-01

    Demand Management uses the interaction and information exchange between multiple control functions in order to achieve goals that can vary in different application contexts. Since there are several stakeholders involved, these may have diverse objectives and even use different architectures...... to actively manage power demand. This paper utilizes an existing distributed demand management architecture in order to provide the following contributions: (1) It develops and evaluates a set of algorithms that combine the optimization of energy costs in scenarios of variable day-ahead prices with the goal...... to improve distribution grid operation reliability, here implemented by a total Power limit. (2) It evaluates the proposed scheme as a distributed system where flexibility information is exchanged with the existing industry standard OpenADR. A Hardware-in-the-Loop testbed realization demonstrates...

  14. Costs and indices for domestic oil and gas field equipment and production operations 1994 through 1997

    International Nuclear Information System (INIS)

    1998-03-01

    This report presents estimated costs and cost indices for domestic oil and natural gas field equipment and production operations for 1994, 1995, 1996, and 1997. The costs of all equipment and services are those in effect during June of each year. The sums (aggregates) of the costs for representative leases by region, depth, and production rate were averaged and indexed. This provides a general measure of the increased or decreased costs from year to year for lease equipment and operations. These general measures do not capture changes in industry-wide costs exactly because of annual variations in the ratio of the total number of oil wells to the total number of gas wells. The detail provided in this report is unavailable elsewhere. The body of this report contains summary tables, and the appendices contain detailed tables. Price changes for oil and gas, changes in taxes on oil and gas revenues, and environmental factors (compliance costs and lease availability) have a significant impact on the number and cost of oil and gas wells drilled. These changes also impact the cost of oil and gas equipment and production operations

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

    Science.gov (United States)

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

    2014-06-01

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

  16. Animal board invited review: Dairy cow lameness expenditures, losses and total cost.

    Science.gov (United States)

    Dolecheck, K; Bewley, J

    2018-03-20

    Lameness is one of the most costly dairy cow diseases, yet adoption of lameness prevention strategies remains low. Low lameness prevention adoption might be attributable to a lack of understanding regarding total lameness costs. In this review, we evaluated the contribution of different expenditures and losses to total lameness costs. Evaluated expenditures included labor for treatment, therapeutic supplies, lameness detection and lameness control and prevention. Evaluated losses included non-saleable milk, reduced milk production, reduced reproductive performance, increased animal death, increased animal culling, disease interrelationships, lameness recurrence and reduced animal welfare. The previous literature on total lameness cost estimates was also summarized. The reviewed studies indicated that previous estimates of total lameness costs are variable and inconsistent in the expenditures and losses they include. Many of the identified expenditure and loss categories require further research to accurately include in total lameness cost estimates. Future research should focus on identifying costs associated with specific lameness conditions, differing lameness severity levels, and differing stages of lactation at onset of lameness to provide better total lameness cost estimates that can be useful for decision making at both the herd and individual cow level.

  17. Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery

    Directory of Open Access Journals (Sweden)

    Wittbrodt ET

    2018-05-01

    Full Text Available Eric T Wittbrodt,1 Tong J Gan,2 Catherine Datto,1 Charles McLeskey,1 Meenal Sinha3 1US Medical Affairs, AstraZeneca, Wilmington, DE, USA; 2Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY, USA; 3Premier Applied Sciences, Premier, Inc., Charlotte, NC, USA Purpose: Constipation is a well-known complication of surgery that can be exacerbated by opioid analgesics. This study evaluated resource utilization and costs associated with opioid-induced constipation (OIC. Patients and methods: This retrospective, observational, and propensity-matched cohort study utilized the Premier Healthcare Database. The study included adults ≥18 years of age undergoing total hip or total knee replacement as inpatients who received an opioid analgesic and were discharged between January 1, 2012, and June 30, 2015. Diagnosis codes identified patients with OIC who were then matched 1:1 to patients without OIC. Generalized linear and logistic regression models were used to compare inpatient resource utilization, total hospital costs, inpatient mortality, and 30-day all-cause readmissions and emergency department visits. Results: Of 788,448 eligible patients, 40,891 (5.2% had OIC. Covariates were well balanced between matched patients with and without OIC (n=40,890 each. In adjusted analyses, patients with OIC had longer hospital lengths of stay (3.6 versus 3.3 days; p<0.001, higher total hospital costs (US$17,479 versus US$16,265; p<0.001, greater risk of intensive care unit admission (odds ratio [OR]=1.12, 95% CI: 1.01–1.24, and increased likelihood of 30-day hospital readmissions (OR=1.16, 95% CI: 1.11–1.22 and emergency department visits (OR=1.38, 95% CI: 1.07–1.79 than patients without OIC. No statistically significant difference was found with inpatient mortality (OR=0.89, 95% CI: 0.59–1.35. Conclusion: OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee

  18. Optimizing power plant cycling operations while reducing generating plant damage and costs

    Energy Technology Data Exchange (ETDEWEB)

    Lefton, S.A.; Besuner, P.H.; Grimsrud, P. [Aptech Engineering Services, Inc., Sunnyvale, CA (United States); Bissel, A. [Electric Supply Board, Dublin (Ireland)

    1998-12-31

    This presentation describes a method for analyzing, quantifying, and minimizing the total cost of fossil, combined cycle, and pumped hydro power plant cycling operation. The method has been developed, refined, and applied during engineering studies at some 160 units in the United States and 8 units at the Irish Electric Supply Board (ESB) generating system. The basic premise of these studies was that utilities are underestimating the cost of cycling operation. The studies showed that the cost of cycling conventional boiler/turbine fossil power plants can range from between $2,500 and $500,000 per start-stop cycle. It was found that utilities typically estimate these costs by factors of 3 to 30 below actual costs and, thus, often significantly underestimate their true cycling costs. Knowledge of the actual, or total, cost of cycling will reduce power production costs by enabling utilities to more accurately dispatch their units to manage unit life expectancies, maintenance strategies and reliability. Utility management responses to these costs are presented and utility cost savings have been demonstrated. (orig.) 7 refs.

  19. Optimizing power plant cycling operations while reducing generating plant damage and costs

    Energy Technology Data Exchange (ETDEWEB)

    Lefton, S A; Besuner, P H; Grimsrud, P [Aptech Engineering Services, Inc., Sunnyvale, CA (United States); Bissel, A [Electric Supply Board, Dublin (Ireland)

    1999-12-31

    This presentation describes a method for analyzing, quantifying, and minimizing the total cost of fossil, combined cycle, and pumped hydro power plant cycling operation. The method has been developed, refined, and applied during engineering studies at some 160 units in the United States and 8 units at the Irish Electric Supply Board (ESB) generating system. The basic premise of these studies was that utilities are underestimating the cost of cycling operation. The studies showed that the cost of cycling conventional boiler/turbine fossil power plants can range from between $2,500 and $500,000 per start-stop cycle. It was found that utilities typically estimate these costs by factors of 3 to 30 below actual costs and, thus, often significantly underestimate their true cycling costs. Knowledge of the actual, or total, cost of cycling will reduce power production costs by enabling utilities to more accurately dispatch their units to manage unit life expectancies, maintenance strategies and reliability. Utility management responses to these costs are presented and utility cost savings have been demonstrated. (orig.) 7 refs.

  20. Cost-effectiveness of Crohn’s disease post-operative care

    Science.gov (United States)

    Wright, Emily K; Kamm, Michael A; Dr Cruz, Peter; Hamilton, Amy L; Ritchie, Kathryn J; Bell, Sally J; Brown, Steven J; Connell, William R; Desmond, Paul V; Liew, Danny

    2016-01-01

    AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection. METHODS: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo. RESULTS: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented. CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated. PMID:27076772

  1. Using value-based total cost of ownership (TCO) measures to inform subsystem trade-offs

    Science.gov (United States)

    Radziwill, Nicole M.; DuPlain, Ronald F.

    2010-07-01

    Total Cost of Ownership (TCO) is a metric from management accounting that helps expose both the direct and indirect costs of a business decision. However, TCO can sometimes be too simplistic for "make vs. buy" decisions (or even choosing between competing design alternatives) when value and extensibility are more critical than total cost. A three-dimensional value-based TCO, which was developed to clarify product decisions for an observatory prior to Final Design Review (FDR), will be presented in this session. This value-based approach incorporates priority of requirements, satisfiability of requirements, and cost, and can be easily applied in any environment.

  2. Operating cost budgeting methods: quantitative methods to improve the process

    Directory of Open Access Journals (Sweden)

    José Olegário Rodrigues da Silva

    Full Text Available Abstract Operating cost forecasts are used in economic feasibility studies of projects and in budgeting process. Studies have pointed out that some companies are not satisfied with the budgeting process and chief executive officers want updates more frequently. In these cases, the main problem lies in the costs versus benefits. Companies seek simple and cheap forecasting methods without, at the same time, conceding in terms of quality of the resulting information. This study aims to compare operating cost forecasting models to identify the ones that are relatively easy to implement and turn out less deviation. For this purpose, we applied ARIMA (autoregressive integrated moving average and distributed dynamic lag models to data from a Brazilian petroleum company. The results suggest that the models have potential application, and that multivariate models fitted better and showed itself a better way to forecast costs than univariate models.

  3. Reducing Operating Costs by Optimizing Space in Facilities

    Science.gov (United States)

    2012-03-01

    Design: Mapping the High Performance Workscape. Jossey-Bass. San Francisco. Berkman, Elliot. (2012). A Conceptual Guide to Statistics using SPSS. Sage ...Cleaning: Includes labor costs for in-house and contract service, payroll , taxes and fringe benefits, plus salaried supervisors and managers, as well as...Labor costs include payroll , taxes and fringe benefits for employees and contracted workers. Personnel include operating engineers, general

  4. Variation in the cost of care for primary total knee arthroplasties.

    Science.gov (United States)

    Haas, Derek A; Kaplan, Robert S

    2017-03-01

    The study examined the cost variation across 29 high-volume US hospitals and their affiliated orthopaedic surgeons for delivering a primary total knee arthroplasty without major complicating conditions. The hospitals had similar patient demographics, and more than 80% of them had statistically-similar Medicare risk-adjusted readmission and complication rates. Hospital and physician personnel costs were calculated using time-driven activity-based costing. Consumable supply costs, such as the prosthetic implant, were calculated using purchase prices, and postacute care costs were measured using either internal costs or external claims as reported by each hospital. Despite having similar patient demographics and readmission and complication rates, the average cost of care for total knee arthroplasty across the hospitals varied by a factor of about 2 to 1. Even after adjusting for differences in internal labor cost rates, the hospital at the 90th percentile of cost spent about twice as much as the one at the 10th percentile of cost. The large variation in costs among sites suggests major and multiple opportunities to transfer knowledge about process and productivity improvements that lower costs while simultaneously maintaining or improving outcomes.

  5. Review of the total system related to operation of nuclear-powered ship

    International Nuclear Information System (INIS)

    Takamasa, Tomoji; Miyashita, Kunio

    2000-01-01

    It is essential to establish a marine reactor having excellent safety and reliability, which is capable of competing economically with conventional ships, and which can be accepted by international society, in order to be prepared for practical application of future nuclear-powered ships. For this purpose, it is important not only to demonstrate a marine reactor using a model or test device to simulate actual operation, but also to establish the environmental requirements for operation of a nuclear-powered ship, such as safety standards that are operationally and internationally common for ships, and to establish a repair base for nuclear-powered ships. Systems research for the practical application of nuclear-powered ships was conducted for five years, fiscal years 1992 through 1996, by a group in the Japan Atomic Energy Research Institute (JAERI), under the project title 'Review of the total system related to operation of nuclear-powered ships.' The project sought to summarize requirements for the practical application of nuclear-powered ships from the standpoint of the need side, e.g., what nuclear-powered ships will be requested, and what functions will be provided under the expected future social environment; to show a complete system concept for the operation of nuclear-powered ships; and to clarify the situations creating demand for nuclear-powered ships, as well as the system and environmental conditions to be established for operation of practical nuclear-powered ships. Study considerations included the size of the operation system for a nuclear-powered ship, a scenario for introducing a nuclear-powered container ship, and economic evolution from the effects on the whole shipping system, based on container ships, of introducing a nuclear-powered ship. The results of these considerations were made the framework for constructing an entire system and evaluating its economy. The treatment and disposal of radioactive waste from a nuclear-powered ship, and the

  6. Economic implications of nuclear operating and maintenance costs

    International Nuclear Information System (INIS)

    Braun, C.

    1994-01-01

    Nuclear operating and maintenance (O and M) costs for U.S. plants have been increasing during the decade of the 1980's. Costs have stabilized over the last five years but have not yet significantly declined. Annual capacity factors have considerably improved during the last eight years and unit O and M costs expressed in Mills Kwh have thus declined. Two other important trends evident over the last five years have been the decline in fossil fuel prices and the transition to deregulated electric utilities market, accelerated with the passage of the 1992 Energy Policy Act. Within the next five years it may be possible for large scale industrial customers to directly contract with electricity generators, by they utilities or independent power producers (IPP's) for supplying their power requirements. The ability of such customers to directly contract with potential supplies based on low cost performance bypassing their local utility, may have significant implications for the structure of the utility industry in the near term and for plant operations. A greater pressure will likely be exerted on all plants, including nuclear to reduce operating costs so as to remain competitive with other power suppliers in their markets. Nuclear O and M costs are likely to be heavily scrutinized for possible savings and reductions. The electric utilities mergers waves and the nuclear industry's initiative on O and M cost control both aim at improving plant economics so as to better compete in the more deregulated environment. In this climate the issues of why nuclear O and M costs have increased, what can be done to reduce costs and what are the implications for advanced reactors design and economics are discussed. 14 figs

  7. Fundamental Drivers of the Cost and Price of Operating Reserves

    Energy Technology Data Exchange (ETDEWEB)

    Hummon, Marissa [National Renewable Energy Lab. (NREL), Golden, CO (United States); Denholm, Paul [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jorgenson, Jennie [National Renewable Energy Lab. (NREL), Golden, CO (United States); Palchak, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Kirby, Brendan [Kirby Consultant; Ma, Ookie [U.S. Department of Energy, Washington, DC (United States)

    2013-07-01

    Operating reserves impose a cost on the electric power system by forcing system operators to keep partially loaded spinning generators available for responding to system contingencies variable demand. In many regions of the United States, thermal power plants provide a large fraction of the operating reserve requirement. Alternative sources of operating reserves, such as demand response and energy storage, may provide more efficient sources of these reserves. However, to estimate the potential value of these services, the cost of reserve services under various grid conditions must first be established. This analysis used a commercial grid simulation tool to evaluate the cost and price of several operating reserve services, including spinning contingency reserves and upward regulation reserves. These reserve products were evaluated in a utility system in the western United States, considering different system flexibilities, renewable energy penetration, and other sensitivities. The analysis demonstrates that the price of operating reserves depend highly on many assumptions regarding the operational flexibility of the generation fleet, including ramp rates and the fraction of fleet available to provide reserves.

  8. Launch vehicle operations cost reduction through artificial intelligence techniques

    Science.gov (United States)

    Davis, Tom C., Jr.

    1988-01-01

    NASA's Kennedy Space Center has attempted to develop AI methods in order to reduce the cost of launch vehicle ground operations as well as to improve the reliability and safety of such operations. Attention is presently given to cost savings estimates for systems involving launch vehicle firing-room software and hardware real-time diagnostics, as well as the nature of configuration control and the real-time autonomous diagnostics of launch-processing systems by these means. Intelligent launch decisions and intelligent weather forecasting are additional applications of AI being considered.

  9. Reduction of Total Ownership Costs (R-TOC) Best Practices Guide

    National Research Council Canada - National Science Library

    Reed, Danny

    2003-01-01

    The purpose of the Reduction of Total Ownership Costs (R-TOC) program is to achieve readiness improvements in weapon systems by improving the reliability of the systems or the efficiency of the processes used to support...

  10. Do illness rating systems predict discharge location, length of stay, and cost after total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Sarah E. Rudasill, BA

    2018-06-01

    Conclusions: These findings suggest that although ASA classifications predict discharge location and SOI scores predict length of stay and total costs, other factors beyond illness rating systems remain stronger predictors of discharge for THA patients.

  11. Minimizing total costs of forest roads with computer-aided design ...

    Indian Academy of Sciences (India)

    imum total road costs, while conforming to design specifications, environmental ..... quality, and enhancing fish and wildlife habitat, an appropriate design ..... Soil, Water and Timber Management: Forest Engineering Solutions in Response to.

  12. Use of predefined biochemical admission profiles does not reduce the number of tests or total cost

    DEFF Research Database (Denmark)

    Pareek, Manan; Haidl, Felix; Folkestad, Lars

    2014-01-01

    The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost.......The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost....

  13. 24 CFR 902.47 - Management operations portion of total PHAS points.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Management operations portion of... Operations § 902.47 Management operations portion of total PHAS points. Of the total 100 points available for a PHAS score, a PHA may receive up to 30 points based on the Management Operations Indicator. ...

  14. Total connectivity speeds research and support of field operations

    International Nuclear Information System (INIS)

    Himes, R.E.; Frost, K.I.; Henry, S.R.; Funkhouser, J.D.

    1992-01-01

    This paper reports that research and field support roles in the oilfield service industry have become increasingly complex in the last 15 years. Experimental apparatus are more dependent on the data-acquisition and processing capabilities of computers as the amount of data generated increases. Therefore, the need to network these computers for data transport has significantly increased. The type of network system selected depends on the goals to be achieved. Incorporation of existing equipment, communication between systems of different architectures, and future expandability are only a few of the necessary attributes. With these in mind, a computer network system was designed and is being implemented. The system combines local- and wide-area networks (LAN's or WAN's) of different protocols to acquire, process, and transport information worldwide. The result is faster development of new products and quicker response in support of field operations

  15. Comparative cost analyses: total flow vs other power conversion systems for the Salton Sea Geothermal Resource

    Energy Technology Data Exchange (ETDEWEB)

    Wright, G.W.

    1978-09-18

    Cost studies were done for Total Flow, double flash, and multistage flash binary systems for electric Energy production from the Salton Sea Geothermal Resource. The purpose was to provide the Department of energy's Division of Geothermal Energy with information by which to judge whether to continue development of the Total Flow system. Results indicate that the Total Flow and double flash systems have capital costs of $1,135 and $1,026 /kW with energy costs of 40.9 and 39.7 mills/kW h respectively. The Total Flow and double flash systems are not distinguishable on a cost basis alone; the multistage flash binary system, with capital cost of $1,343 /kW and energy cost of 46.9 mills/kW h, is significantly more expensive. If oil savings are considered in the total analysis, the Total Flow system could save 30% more oil than the double flash system, $3.5 billion at 1978 oil prices.

  16. Post operation: The changing characteristics of nuclear fuel cycle costs

    International Nuclear Information System (INIS)

    Frank, F.J.

    1986-01-01

    Fundamental changes have occurred in the nuclear fuel cycle. These changes forged by market forces, legislative action, and regulatory climate appear to be a long term characteristic of the nuclear fuel cycle. The nature of these changes and the resulting emerging importance of post-operation and its impact on fuel cycle costs are examined

  17. Cost of Radiotherapy Versus NSAID Administration for Prevention of Heterotopic Ossification After Total Hip Arthroplasty

    International Nuclear Information System (INIS)

    Strauss, Jonathan B.; Chen, Sea S.; Shah, Anand P.; Coon, Alan B.; Dickler, Adam

    2008-01-01

    Purpose: Heterotopic ossification (HO), or abnormal bone formation, is a common sequela of total hip arthroplasty. This abnormal bone can impair joint function and must be surgically removed to restore mobility. HO can be prevented by postoperative nonsteroidal anti-inflammatory drug (NSAID) use or radiotherapy (RT). NSAIDs are associated with multiple toxicities, including gastrointestinal bleeding. Although RT has been shown to be more efficacious than NSAIDs at preventing HO, its cost-effectiveness has been questioned. Methods and Materials: We performed an analysis of the cost of postoperative RT to the hip compared with NSAID administration, taking into account the costs of surgery for HO formation, treatment-induced morbidity, and productivity loss from missed work. The costs of RT, surgical revision, and treatment of gastrointestinal bleeding were estimated using the 2007 Medicare Fee Schedule and inpatient diagnosis-related group codes. The cost of lost wages was estimated using the 2006 median salary data from the U.S. Census Bureau. Results: The cost of administering RT was estimated at $899 vs. $20 for NSAID use. After accounting for the additional costs associated with revision total hip arthroplasty and gastrointestinal bleeding, the corresponding estimated costs were $1,208 vs. $930. Conclusion: If the costs associated with treatment failure and treatment-induced morbidity are considered, the cost of NSAIDs approaches that of RT. Other NSAID morbidities and quality-of-life differences that are difficult to quantify add to the cost of NSAIDs. These considerations have led us to recommend RT as the preferred modality for use in prophylaxis against HO after total hip arthroplasty, even when the cost is considered

  18. Operational strategy and marginal costs in simple trigeneration systems

    International Nuclear Information System (INIS)

    Lozano, M.A.; Carvalho, M.; Serra, L.M.

    2009-01-01

    As a direct result of economic pressures to cut expenses, as well as the legal obligation to reduce emissions, companies and businesses are seeking ways to use energy more efficiently. Trigeneration systems (CHCP: Combined Heating, Cooling and Power generation) allow greater operational flexibility at sites with a variable demand for energy in the form of heating and cooling. This is particularly relevant in buildings where the need for heating is restricted to a few winter months. In summer, the absorption chillers make use of the cogenerated heat to produce chilled water, avoiding waste heat discharge. The operation of a simple trigeneration system is analyzed in this paper. The system is interconnected to the electric utility grid, both to receive electricity and to deliver surplus electricity. For any given demand required by the users, a great number of operating conditions are possible. A linear programming model provides the operational mode with the lowest variable cost. A thermoeconomic analysis, based on marginal production costs, is used to obtain unit costs for internal energy flows and final products as well as to explain the best operational strategy as a function of the demand for energy services and the prices of the resources consumed. (author)

  19. Reducing Development and Operations Costs using NASA's "GMSEC" Systems Architecture

    Science.gov (United States)

    Smith, Dan; Bristow, John; Crouse, Patrick

    2007-01-01

    This viewgraph presentation reviews the role of Goddard Mission Services Evolution Center (GMSEC) in reducing development and operation costs in handling the massive data from NASA missions. The goals of GMSEC systems architecture development are to (1) Simplify integration and development, (2)Facilitate technology infusion over time, (3) Support evolving operational concepts, and (4) All for mix of heritage, COTS and new components. First 3 missions (i.e., Tropical Rainforest Measuring Mission (TRMM), Small Explorer (SMEX) missions - SWAS, TRACE, SAMPEX, and ST5 3-Satellite Constellation System) each selected a different telemetry and command system. These results show that GMSEC's message-bus component-based framework architecture is well proven and provides significant benefits over traditional flight and ground data system designs. The missions benefit through increased set of product options, enhanced automation, lower cost and new mission-enabling operations concept options .

  20. Preliminary estimates of the total-system cost for the restructured program: An addendum to the May 1989 analysis of the total-system life cycle cost for the Civilian Radioactive Waste Management Program

    International Nuclear Information System (INIS)

    1990-12-01

    The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 - a fee levied on electricity generated and sold by commercial nuclear power plants - is sufficient to cover the cost of the program. This report provides cost estimates for the sixth annual evaluation of the adequacy of the fee. The costs contained in this report represent a preliminary analysis of the cost impacts associated with the Secretary of Energy's Report to Congress on Reassessment of the Civilian Radioactive Waste Management Program issued in November 1989. The major elements of the restructured program announced in this report which pertain to the program's life-cycle costs are: a prioritization of the scientific investigations program at the Yucca Mountain candidate site to focus on identification of potentially adverse conditions, a delay in the start of repository operations until 2010, the start of limited waste acceptance at the monitored retrievable storage (MRS) facility in 1998, and the start of waste acceptance at the full-capability MRS facility in 2,000. Based on the restructured program, the total-system cost for the system with a repository at the candidate site at Yucca Mountain in Nevada, a facility for monitored retrievable storage (MRS), and a transportation system is estimated at $26 billion (expressed in constant 1988 dollars). In the event that a second repository is required and is authorized by the Congress, the total-system cost is estimated at $34 to $35 billion, depending on the quantity of spent fuel and high-level waste (HLW) requiring disposal. 17 figs., 17 tabs

  1. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program

    International Nuclear Information System (INIS)

    1989-05-01

    The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 -- a fee levied on electricity generated in commercial nuclear power plants -- is sufficient to cover the cost of the program. This report provides cost estimates for the sixth annual evaluation of the adequacy of the fee and is consistent with the program strategy and plans contained in the DOE's Draft 1988 Mission Plan Amendment. The total-system cost for the system with a repository at Yucca Mountain, Nevada, a facility for monitored retrievable storage (MRS), and a transportation system is estimated at $24 billion (expressed in constant 1988 dollars). In the event that a second repository is required and is authorized by the Congress, the total-system cost is estimated at $31 to $33 billion, depending on the quantity of spent fuel to be disposed of. The $7 billion cost savings for the single-repository system in comparison with the two-repository system is due to the elimination of $3 billion for second-repository development and $7 billion for the second-repository facility. These savings are offset by $2 billion in additional costs at the first repository and $1 billion in combined higher costs for the MRS facility and transportation. 55 refs., 2 figs., 24 tabs

  2. Pre-fracture individual characteristics associated with high total health care costs after hip fracture.

    Science.gov (United States)

    Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E

    2017-03-01

    Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.

  3. The Relationship between Cost Leadership Strategy, Total Quality Management Applications and Financial Performance

    Directory of Open Access Journals (Sweden)

    Ali KURT

    2016-03-01

    Full Text Available Firms need to implement some competition strategies and total quality management applications to overcome the fierce competition among others. The purpose of this study is to show the relationship between cost leadership strategy, total quality management applications and firms’ financial performance with literature review and empirical analysis. 449 questionnaires were conducted to the managers of 142 big firms. The data gathered was assessed with AMOS. As a result, the relationship between cost leadership strategy, total quality management applications and firms’ financial performance has been gathered. In addition, the relationship between TQM applications and financial performance has also been gathered.

  4. Radium removal processes capital and operating cost estimates

    International Nuclear Information System (INIS)

    Kelly, F.J.

    1979-09-01

    An estimate of the fixed capital and operating costs for two alternative processes for the removal of dissolved Ra-226 from uranium mill effluent in Elliot Lake, Ontario is presented. Process 1 consists of barium-radium coprecipitation followed by coagulation, flocculation and sedimentation. Process 2 consists of barium-radium coprecipitation followed by gravity media filtration, sand filter backwashing and sedimentation. Cost estimates were prepared for 18 different plant configurations designed to treat 1000 and 4000 imperial gallons per minute (ig/m) of effluent, 24 hrs per day, 7 days per week and 365 days per year with several equipment options. The estimated fixed capital costs for plants equipped with gravity filters were less than those equipped with circular clarifiers. The capital costs ranged from $552,000 with a flow rate of 1000 ig/m to $2,578,000 with a flow rate of 4000 ig/m. Estimated annual operating costs, based on a plant life of 10 years, ranged from $298,000 with a flow rate of 1000 ig/m to $1,061,000 with a flow rate of 4000 ig/m

  5. Clinical benefit and cost effectiveness of total knee arthroplasty in the older patient

    Directory of Open Access Journals (Sweden)

    Krummenauer F

    2009-02-01

    Full Text Available Abstract Purpose Total knee arthroplasty (TKA is an effective, but also cost-intensive health care procedure for the elderly. Furthermore, bearing demographic changes in Western Europe in mind, TKA-associated financial investment for health care insurers will increase notably and thereby catalyze discussions on ressource allocation to Orthopedic surgery. To derive a quantitative rationale for such discussions within Western Europe's health care systems, a prospective assessment of both the benefit of TKA from a patient's perspective as well as its cost effectiveness from a health care insurer's perspective was implemented. Methods A prospective cost effectiveness trial recruited a total of 65 patients (60% females, who underwent TKA in 2006; median age of patients was 66 years (interquartile range 61 - 74 years. Before and three months after surgery patients were interviewed by means of the EuroQol-5D and the WOMAC questionnaires to assess their individual benefit due to TKA and the subsequent inpatient rehabilitation. Both questionnaires' benefit estimates were transformed into the number of gained quality adjusted life years [QALYs]. Total direct cost estimates for the overall care were based on German DRG and rehabilitation cost rates [€]. The primary clinical endpoint of the investigation was the individual number of QALYs gained by TKA based on the WOMAC interview; the primary health economic endpoint was the marginal cost effectiveness ratio (MCER relating the costs to the associated gain in quality of life [€/QALY]. Results Total direct costs for the overall procedure were estimed 9549 € in median. The WOMAC based interview revealed an overall gain of 4.59 QALYs (interquartile range 2.39 - 6.21 QALYs, resulting in marginal costs of 1795 €/QALY (1488 - 3288 €/QALY. The corresponding EuroQol based estimates were 2.93 QALYs (1.75 - 5.59 QALYs and 3063 €/QALY (1613 - 5291 €/QALY. Logistic regression modelling identified the

  6. Total costs and benefits of biomass in selected regions of the European Union - BioCosts

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, A de; Costa, F B [Coimbra Univ. (Portugal). Inst. de Sistemas e Robotica; Bauen, A [London Univ. (United Kingdom). Div. of Life Sciences; and others

    1998-11-01

    In the BioCosts project, representative biomass-to-electricity and biomass-to-transport-service fuel cycles located at different sites within the European Union have been evaluated concerning their environmental and economic performance. Each case study was compared to a fossil-fuel fired reference case. The case studies examined comprise: utilisation of forestry residues in the Naessjoe circulating fluidized bed combustion plant, Sweden, versus the use of Polish coal in the same plant; utilisation of forestry residues and short-rotation coppice for industrial combined heat and power production in Mangualde, Portugal, versus the use of fuel oil in an engine generating heat and power; production of biogas from manure slurry for municipal combined heat and power generation at Hashoej, Denmark, versus the use of Danish natural gas in the same engine; gasification of woody biomass for combined heat and power generation in Vaernamo, Sweden, and Eggborough, UK, versus the use of coal in the Naessjoe plant mentioned above and a UK power plant; production of cold-pressed rape-seed oil and its use in a cogeneration plant at Weissenburg, Germany, versus the use of diesel fuel in a similar engine; production of rape-seed oil methyl ester and its use for goods transport in Germany, versus the use of diesel fuel in the same fleet of trucks; production of ethyl tertiary butyl ether from sugar beets and sweet sorghum for transport applications in France, versus the use of methyl tertiary butyl ether from fossil sources for the same purpose 130 refs, 25 figs, 42 tabs. Research funded in part by the European Commission in the JOULE III programme

  7. Integrated approach to optimize operation and maintenance costs for operating nuclear power plants

    International Nuclear Information System (INIS)

    2006-06-01

    In the context of increasingly open electricity markets and the 'unbundling' of generating companies from former utility monopolies, an area of major concern is the economic performance of the existing fleet of nuclear power plants. Nuclear power, inevitably, must compete directly with other electricity generation sources. Coping with this competitive pressure is a challenge that the nuclear industry should meet if the nuclear option is to remain a viable one. This competitive environment has significant implications for nuclear plant operations, including, among others, the need for the more cost effective management of plant activities, and the greater use of analytical tools to balance the costs and benefits of proposed activities, in order to optimize operation and maintenance costs, and thus insure the economic competitiveness of existing nuclear power plants. In the framework of the activities on Nuclear Economic Performance Information System (NEPIS), the IAEA embarked in developing guidance on optimization of operation and maintenance costs for nuclear power plants. The report was prepared building on the fundamental that optimization of operation and maintenance costs of a nuclear power plant is a key component of a broader integrated business strategic planning process, having as overall result achievement of organization's business objectives. It provides advice on optimization of O and M costs in the framework of strategic business planning, with additional details on operational planning and controlling. This TECDOC was elaborated in 2004-2005 in the framework of the IAEA's programme on Nuclear Power Plant Operating Performance and Life Cycle Management, with the support of two consultants meetings and one technical meeting and based on contributions provided by participants. It can serve as a useful reference for the management and operation staff within utilities, nuclear power plant operators and regulators and other organizations involved in

  8. Fog-Assisted Operational Cost Reduction for Cloud Data Centers

    OpenAIRE

    Yu, Liang; Jiang, Tao; Zou, Yulong

    2017-01-01

    In this paper, we intend to reduce the operational cost of cloud data centers with the help of fog devices, which can avoid the revenue loss due to wide-area network propagation delay and save network bandwidth cost by serving nearby cloud users. Since fog devices may not be owned by a cloud service provider, they should be compensated for serving the requests of cloud users. When taking economical compensation into consideration, the optimal number of requests processed locally by each fog d...

  9. Cost and radiation exposure optimization of demineralizer operation

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  10. Cost-Effectiveness Analysis of Total Hip Arthroplasty Performed by a Canadian Short-Stay Surgical Team in Ecuador.

    Science.gov (United States)

    Schlegelmilch, Michael; Rashiq, Saifee; Moreau, Barbara; Jarrín, Patricia; Tran, Bach; Chuck, Anderson

    2017-01-01

    Few charitable overseas surgical missions produce cost-effectiveness analyses of their work. We compared the pre- and postoperative health status for 157 total hip arthroplasty (THA) patients operated on from 2007 to 2011 attended by an annual Canadian orthopedic mission to Ecuador to determine the quality-adjusted life years (QALYs) gained. The costs of each mission are known. The cost per surgery was divided by the average lifetime QALYs gained to estimate an incremental cost-effectiveness ratio (ICER) in Canadian dollars per QALY. The average lifetime QALYs (95% CI) gained were 1.46 (1.4-1.5), 2.5 (2.4-2.6), and 2.9 (2.7-3.1) for unilateral, bilateral, and staged (two THAs in different years) operations, respectively. The ICERs were $4,442 for unilateral, $2,939 for bilateral, and $4392 for staged procedures. Seventy percent of the mission budget was spent on the transport and accommodation of volunteers. THA by a Canadian short-stay surgical team was highly cost-effective, according to criteria from the National Institute for Health and Care Excellence and the World Health Organization. We encourage other international missions to provide similar cost-effectiveness data to enable better comparison between mission types and between mission and nonmission care.

  11. Identifying Fixed Support Costs in Air Force Visibility and Management of Operating and Support Costs (VAMOSC).

    Science.gov (United States)

    1983-04-01

    Algorithms I: Overview," Technical Report No. 115-2, Desmatics, Inc., 1983. 6. C. T. Horngren , Cost Accounting : A Managerial Emphasis, Prentice-Hall Inc...CHART NATIONA BUREAUJ OF STAf4DARO-I% 3-A S . . . . . . . . . . I.I i ". ’ 1).N’r1F𔃻I."U FmiXE Sc’pioir COSTS IN A VA,(),C * by Robert L. Gardner Dennis...operations and support (O& S ) costs for Air Force aircraft weapon systems and ground communications-electronics (C-E) systems. Included are fuel, materiel, pay

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

    Science.gov (United States)

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

    2014-06-01

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

  13. Using wide area differential GPS to improve total system error for precision flight operations

    Science.gov (United States)

    Alter, Keith Warren

    Total System Error (TSE) refers to an aircraft's total deviation from the desired flight path. TSE can be divided into Navigational System Error (NSE), the error attributable to the aircraft's navigation system, and Flight Technical Error (FTE), the error attributable to pilot or autopilot control. Improvement in either NSE or FTE reduces TSE and leads to the capability to fly more precise flight trajectories. The Federal Aviation Administration's Wide Area Augmentation System (WAAS) became operational for non-safety critical applications in 2000 and will become operational for safety critical applications in 2002. This navigation service will provide precise 3-D positioning (demonstrated to better than 5 meters horizontal and vertical accuracy) for civil aircraft in the United States. Perhaps more importantly, this navigation system, which provides continuous operation across large regions, enables new flight instrumentation concepts which allow pilots to fly aircraft significantly more precisely, both for straight and curved flight paths. This research investigates the capabilities of some of these new concepts, including the Highway-In-The Sky (HITS) display, which not only improves FTE but also reduces pilot workload when compared to conventional flight instrumentation. Augmentation to the HITS display, including perspective terrain and terrain alerting, improves pilot situational awareness. Flight test results from demonstrations in Juneau, AK, and Lake Tahoe, CA, provide evidence of the overall feasibility of integrated, low-cost flight navigation systems based on these concepts. These systems, requiring no more computational power than current-generation low-end desktop computers, have immediate applicability to general aviation flight from Cessnas to business jets and can support safer and ultimately more economical flight operations. Commercial airlines may also, over time, benefit from these new technologies.

  14. The costs and benefits of embedded generation islanding operation

    Energy Technology Data Exchange (ETDEWEB)

    Castro-Sayas, F.; Clarke, G.D.

    2002-07-01

    This report describes the results of a study commissioned by the UK Department of Trade and Industry to identify the technical, legal and commercial issues of islanded embedded generation and to quantify the costs and benefits. Technical considerations affecting island mode operation include security of supply requirements, the licence duty of distribution network operators (DNOs) to comply with 'group demand' restoration times, 'guaranteed standards' licence requirements governing restoration of supplies to customers, and frequency and voltage control. The economics of islanded embedded generation are discussed and key factors noted.

  15. Bearing Procurement Analysis Method by Total Cost of Ownership Analysis and Reliability Prediction

    Science.gov (United States)

    Trusaji, Wildan; Akbar, Muhammad; Sukoyo; Irianto, Dradjad

    2018-03-01

    In making bearing procurement analysis, price and its reliability must be considered as decision criteria, since price determines the direct cost as acquisition cost and reliability of bearing determine the indirect cost such as maintenance cost. Despite the indirect cost is hard to identify and measured, it has high contribution to overall cost that will be incurred. So, the indirect cost of reliability must be considered when making bearing procurement analysis. This paper tries to explain bearing evaluation method with the total cost of ownership analysis to consider price and maintenance cost as decision criteria. Furthermore, since there is a lack of failure data when bearing evaluation phase is conducted, reliability prediction method is used to predict bearing reliability from its dynamic load rating parameter. With this method, bearing with a higher price but has higher reliability is preferable for long-term planning. But for short-term planning the cheaper one but has lower reliability is preferable. This contextuality can give rise to conflict between stakeholders. Thus, the planning horizon needs to be agreed by all stakeholder before making a procurement decision.

  16. Modeling Optimal Scheduling for Pumping System to Minimize Operation Cost and Enhance Operation Reliability

    Directory of Open Access Journals (Sweden)

    Yin Luo

    2012-01-01

    Full Text Available Traditional pump scheduling models neglect the operation reliability which directly relates with the unscheduled maintenance cost and the wear cost during the operation. Just for this, based on the assumption that the vibration directly relates with the operation reliability and the degree of wear, it could express the operation reliability as the normalization of the vibration level. The characteristic of the vibration with the operation point was studied, it could be concluded that idealized flow versus vibration plot should be a distinct bathtub shape. There is a narrow sweet spot (80 to 100 percent BEP to obtain low vibration levels in this shape, and the vibration also follows similar law with the square of the rotation speed without resonance phenomena. Then, the operation reliability could be modeled as the function of the capacity and rotation speed of the pump and add this function to the traditional model to form the new. And contrast with the tradition method, the result shown that the new model could fix the result produced by the traditional, make the pump operate in low vibration, then the operation reliability could increase and the maintenance cost could decrease.

  17. Operation optimization of a distributed energy system considering energy costs and exergy efficiency

    International Nuclear Information System (INIS)

    Di Somma, M.; Yan, B.; Bianco, N.; Graditi, G.; Luh, P.B.; Mongibello, L.; Naso, V.

    2015-01-01

    Highlights: • Operation optimization model of a Distributed Energy System (DES). • Multi-objective strategy to optimize energy cost and exergy efficiency. • Exergy analysis in building energy supply systems. - Abstract: With the growing demand of energy on a worldwide scale, improving the efficiency of energy resource use has become one of the key challenges. Application of exergy principles in the context of building energy supply systems can achieve rational use of energy resources by taking into account the different quality levels of energy resources as well as those of building demands. This paper is on the operation optimization of a Distributed Energy System (DES). The model involves multiple energy devices that convert a set of primary energy carriers with different energy quality levels to meet given time-varying user demands at different energy quality levels. By promoting the usage of low-temperature energy sources to satisfy low-quality thermal energy demands, the waste of high-quality energy resources can be reduced, thereby improving the overall exergy efficiency. To consider the economic factor as well, a multi-objective linear programming problem is formulated. The Pareto frontier, including the best possible trade-offs between the economic and exergetic objectives, is obtained by minimizing a weighted sum of the total energy cost and total primary exergy input using branch-and-cut. The operation strategies of the DES under different weights for the two objectives are discussed. The operators of DESs can choose the operation strategy from the Pareto frontier based on costs, essential in the short run, and sustainability, crucial in the long run. The contribution of each energy device in reducing energy costs and the total exergy input is also analyzed. In addition, results show that the energy cost can be much reduced and the overall exergy efficiency can be significantly improved by the optimized operation of the DES as compared with the

  18. Time-based analysis of total cost of patient episodes: a case study of hip replacement.

    Science.gov (United States)

    Peltokorpi, Antti; Kujala, Jaakko

    2006-01-01

    Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue. Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year. The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency. Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

  19. Hybrid Cloud Computing Architecture Optimization by Total Cost of Ownership Criterion

    Directory of Open Access Journals (Sweden)

    Elena Valeryevna Makarenko

    2014-12-01

    Full Text Available Achieving the goals of information security is a key factor in the decision to outsource information technology and, in particular, to decide on the migration of organizational data, applications, and other resources to the infrastructure, based on cloud computing. And the key issue in the selection of optimal architecture and the subsequent migration of business applications and data to the cloud organization information environment is the question of the total cost of ownership of IT infrastructure. This paper focuses on solving the problem of minimizing the total cost of ownership cloud.

  20. Total cost estimates for large-scale wind scenarios in UK

    International Nuclear Information System (INIS)

    Dale, Lewis; Milborrow, David; Slark, Richard; Strbac, Goran

    2004-01-01

    The recent UK Energy White Paper suggested that the Government should aim to secure 20% of electricity from renewable sources by 2020. A number of estimates of the extra cost of such a commitment have been made, but these have not necessarily included all the relevant cost components. This analysis sets out to identify these and to calculate the extra cost to the electricity consumer, assuming all the renewable electricity is sourced from wind energy. This enables one of the more controversial issues--the implications of wind intermittency--to be addressed. The basis of the assumptions associated with generating costs, extra balancing costs and distribution and transmission system reinforcement costs are all clearly identified and the total costs of a '20% wind' scenario are compared with a scenario where a similar amount of energy is generated by gas-fired plant. This enables the extra costs of the renewables scenario to be determined. The central estimate of the extra costs to electricity consumers is just over 0.3 p/kW h in current prices (around 5% extra on average domestic unit prices). Sensitivity analyses examine the implications of differing assumptions. The extra cost would rise if the capital costs of wind generation fall slower than anticipated, but would fall if gas prices rise more rapidly than has been assumed, or if wind plant are more productive. Even if it is assumed that wind has no capacity displacement value, the added cost to the electricity consumer rises by less than 0.1 p/kW h. It is concluded that there does not appear to be any technical reason why a substantial proportion of the country's electricity requirements could not be delivered by wind

  1. Total cost of ownership of electric vehicles compared to conventional vehicles: A probabilistic analysis and projection across market segments

    International Nuclear Information System (INIS)

    Wu, Geng; Inderbitzin, Alessandro; Bening, Catharina

    2015-01-01

    While electric vehicles (EV) can perform better than conventional vehicles from an environmental standpoint, consumers perceive them to be more expensive due to their higher capital cost. Recent studies calculated the total cost of ownership (TCO) to evaluate the complete cost for the consumer, focusing on individual vehicle classes, powertrain technologies, or use cases. To provide a comprehensive overview, we built a probabilistic simulation model broad enough to capture most of a national market. Our findings indicate that the comparative cost efficiency of EV increases with the consumer's driving distance and is higher for small than for large vehicles. However, our sensitivity analysis shows that the exact TCO is subject to the development of vehicle and operating costs and thus uncertain. Although the TCO of electric vehicles may become close to or even lower than that of conventional vehicles by 2025, our findings add evidence to past studies showing that the TCO does not reflect how consumers make their purchase decision today. Based on these findings, we discuss policy measures that educate consumers about the TCO of different vehicle types based on their individual preferences. In addition, measures improving the charging infrastructure and further decreasing battery cost are discussed. - Highlights: • Calculates the total cost of ownership across competing vehicle technologies. • Uses Monte Carlo simulation to analyse distributions and probabilities of outcomes. • Contains a comprehensive assessment across the main vehicle classes and use cases. • Indicates that cost efficiency of technology depends on vehicle class and use case. • Derives specific policy measures to facilitate electric vehicle diffusion

  2. Total inpatient treatment costs in patients with severe burns: towards a more accurate reimbursement model.

    Science.gov (United States)

    Mehra, Tarun; Koljonen, Virve; Seifert, Burkhardt; Volbracht, Jörk; Giovanoli, Pietro; Plock, Jan; Moos, Rudolf Maria

    2015-01-01

    Reimbursement systems have difficulties depicting the actual cost of burn treatment, leaving care providers with a significant financial burden. Our aim was to establish a simple and accurate reimbursement model compatible with prospective payment systems. A total of 370 966 electronic medical records of patients discharged in 2012 to 2013 from Swiss university hospitals were reviewed. A total of 828 cases of burns including 109 cases of severe burns were retained. Costs, revenues and earnings for severe and nonsevere burns were analysed and a linear regression model predicting total inpatient treatment costs was established. The median total costs per case for severe burns was tenfold higher than for nonsevere burns (179 949 CHF [167 353 EUR] vs 11 312 CHF [10 520 EUR], interquartile ranges 96 782-328 618 CHF vs 4 874-27 783 CHF, p <0.001). The median of earnings per case for nonsevere burns was 588 CHF (547 EUR) (interquartile range -6 720 - 5 354 CHF) whereas severe burns incurred a large financial loss to care providers, with median earnings of -33 178 CHF (30 856 EUR) (interquartile range -95 533 - 23 662 CHF). Differences were highly significant (p <0.001). Our linear regression model predicting total costs per case with length of stay (LOS) as independent variable had an adjusted R2 of 0.67 (p <0.001 for LOS). Severe burns are systematically underfunded within the Swiss reimbursement system. Flat-rate DRG-based refunds poorly reflect the actual treatment costs. In conclusion, we suggest a reimbursement model based on a per diem rate for treatment of severe burns.

  3. The Relationship between Cost Leadership Strategy, Total Quality Management Applications and Financial Performance

    OpenAIRE

    Ali KURT; Cemal ZEHİR

    2016-01-01

    Firms need to implement some competition strategies and total quality management applications to overcome the fierce competition among others. The purpose of this study is to show the relationship between cost leadership strategy, total quality management applications and firms’ financial performance with literature review and empirical analysis. 449 questionnaires were conducted to the managers of 142 big firms. The data gathered was assessed with AMOS. As a result, the relationship between ...

  4. Methods of projecting operations and maintenance costs for nuclear power plants

    International Nuclear Information System (INIS)

    1995-01-01

    Operations and maintenance cost (OMC) had increased its relative importance to the total generation cost for future nuclear power stations, according to the latest update of the OECD Nuclear Energy Agency (NEA) study on Projected Costs of Generating Electricity (EGC studies). OMC is some 20 to 30% of total generation cost for future nuclear power stations in most NEA member countries. However, nuclear OMC that countries projected in the latest EGC study are spread over a wide range, from 5 to 16 US mills/kWh. In order to understand better the reasons for this wide diversity in nuclear OMC projections, the NEA set up an Expert Group. The focus of this study was on projected OMC that were reported in the past EGC studies, but the Group studied actual OMC experienced from existing units, because knowledge or experience concerning actual OMC certainly influences the choice of assumptions or calculation procedure for estimating OMC for future plants. Cost informations from 14 NEA countries have been analysed on the basis of a standardized framework of detailed components of OMC costs. The rationale for different OMC cost projections reported in previous NEA studies on generation cost is discussed and suggestions are made for future studies on both generation cost and OMC cost. Despite the methodological approach and the reduced extent of differences when excluding exceptional figures, it was not possible fully to clarify the origins and to understand the remaining differences in OMC figures. Several countries which have a long and a good experience of operating nuclear units did not provide sufficient detailed data or did not provide any quantitative data at all. (J.S.). 14 refs., 5 figs., 19 tabs., 4 annexes

  5. Linking the spare parts management with the total costs of ownership: An agenda for future research

    International Nuclear Information System (INIS)

    Duran, O.; Roda, I.; Macchi, M.

    2016-01-01

    Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC). Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view). Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO). Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

  6. Linking the spare parts management with the total costs of ownership: An agenda for future research

    Energy Technology Data Exchange (ETDEWEB)

    Duran, O.; Roda, I.; Macchi, M.

    2016-07-01

    Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC). Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view). Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO). Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

  7. Linking the spare parts management with the total costs of ownership: An agenda for future research

    Directory of Open Access Journals (Sweden)

    Orlando Duran

    2016-12-01

    Full Text Available Purpose: This manuscript explores the link between Spare Parts Management and Total Costs of Ownership or Life Cycle Costs (LCC. Design/methodology/approach: First, this work enumerates the different managerial decisions instances in spare parts management that are present during the life cycle of a physical asset. Second, we analyse how those decision instances could affect the TCO of a physical asset (from the economic point of view. Finally, we propose a conceptual framework for incorporating the spare parts management into a TCO model. Findings: The recent literature lacks discussions on the integration of spare parts management with the Total Costs of Ownership (TCO. Based in an extensive literature revision we can declare that the computation of costs related to spare parts management has been neglected by TCO models. Originality/value: The contribution of this paper is twofold. First, a literature review and identification of a series of spare parts management decision instances and its relationship with TCOs is presented in this paper. Second, a conceptual framework is suggested for linking those decisions instances to a total cost of ownership perspective. Some research questions and future research challenges are presented at the end of this work.

  8. Total hip arthroplasty revision due to infection: a cost analysis approach.

    Science.gov (United States)

    Klouche, S; Sariali, E; Mamoudy, P

    2010-04-01

    The treatment of total hip arthroplasty (THA) infections is long and costly. However,the number of studies in the literature analysing the real cost of THA revision in relation to their etiology, including infection, is limited. The aim of this retrospective study was to determine the cost of revision of infected THA and to compare these costs to those of primary THA and revision of non-infected THA. We performed a retrospective cost analysis for the year 2006 using an identical analytic accounting system in each hospital department (according to internal criteria) based on allotment of direct costs and receipts for each department. From January to December 2006, 424 primary THA, 57 non-infected THA revisions and 40 THA revisions due to infection were performed. The different cost areas of the patient's treatment were identified.This included preoperative medical work-up, medicosurgical management during hospital stay,a second stay in an orthopedic rehabilitation hospital (ORH) and post-hospitalisation antibiotic therapy after revision due to infection, as well as home-based hospitalisation (HH) costs, if this was the selected alternative option. We used the national health insurance fee schedule found in the "Common classification of medical procedures" and the "General nomenclature of professional procedures" applicable in France since September 1, 2005. Hospital costs included direct costs (hospital overhead costs) and indirect costs, (medical, surgical, technical settings and net general service expenses). The calculation of HH costs and ORH costs were based on the average daily charge of these departments. The cost of primary THA was used as the reference.We then compared our surgical costs with those found for the corresponding comparable hospital stay groups (Groupes homogènes de séjour). The average hospital stay (AHS) was 7.5 +/- 1.8 days for primary THA, 8.9 +/- 2.2 days for non-infected revisions and 30.6 +/- 14.9 days for revisions due to infection

  9. A METHOD OF THE MINIMIZING OF THE TOTAL ACQUISITIONS COST WITH THE INCREASING VARIABLE DEMAND

    Directory of Open Access Journals (Sweden)

    ELEONORA IONELA FOCȘAN

    2015-12-01

    Full Text Available Over time, mankind has tried to find different ways of costs reduction. This subject which we are facing more often nowadays, has been detailed studied, without reaching a general model, and also efficient, regarding the costs reduction. Costs reduction entails a number of benefits over the entity, the most important being: increase revenue and default to the profit, increase productivity, a higher level of services / products offered to clients, and last but not least, the risk mitigation of the economic deficit. Therefore, each entity search different modes to obtain most benefits, for the company to succeed in a competitive market. This article supports the companies, trying to make known a new way of minimizing the total cost of acquisitions, by presenting some hypotheses about the increasing variable demand, proving them, and development of formulas for reducing the costs. The hypotheses presented in the model described below, can be maximally exploited to obtain new models of reducing the total cost, according to the modes of the purchase of entities which approach it.

  10. Cost Model for Risk Assessment of Company Operation in Audit

    Directory of Open Access Journals (Sweden)

    S. V.

    2017-12-01

    Full Text Available This article explores the approach to assessing the risk of company activities termination by building a cost model. This model gives auditors information on managers’ understanding of factors influencing change in the value of assets and liabilities, and the methods to identify it in more effective and reliable ways. Based on this information, the auditor can assess the adequacy of use of the assumption on continuity of company operation by management personnel when preparing financial statements. Financial uncertainty entails real manifestations of factors creating risks of the occurrence of costs, revenue losses due their manifestations, which in the long run can be a reason for termination of company operation, and, therefore, need to be foreseen in the auditor’s assessment of the adequacy of use of the continuity assumption when preparing financial statements by company management. The purpose of the study is to explore and develop a methodology for use of cost models to assess the risk of termination of company operation in audit. The issue of methodology for assessing the audit risk through analyzing methods for company valuation has not been dealt with. The review of methodologies for assessing the risks of termination of company operation in course of audit gives grounds for the conclusion that use of cost models can be an effective methodology for identification and assessment of such risks. The analysis of the above methods gives understanding of the existing system for company valuation, integrated into the management system, and the consequences of its use, i. e. comparison of the asset price data with the accounting data and the market value of the asset data. Overvalued or undervalued company assets may be a sign of future sale or liquidation of a company, which may signal on high probability of termination of company operation. A wrong choice or application of valuation methods can be indicative of the risk of non

  11. Total cost of ownership in the services sector: A case study

    NARCIS (Netherlands)

    K. Hurkens (Krisje); W. van der Valk (Wendy); J.Y.F. Wynstra (Finn)

    2006-01-01

    textabstractFew detailed studies exist of the trade-offs to be made when developing a comprehensive, strategically focused total cost of ownership (TCO) model. Moreover, most studies of TCO have been conducted in manufacturing firms, with little or no TCO research directed toward service

  12. Multi-Product Total Cost of Function for Higher Education: A Case of Bible Colleges.

    Science.gov (United States)

    Koshal, Rajindar K.; Koshal, Manjulika; Gupta, Ashok

    2001-01-01

    This study empirically estimates a multiproduct total cost function and output relationship for comprehensive U.S. universities. Statistical results for 184 Bible colleges suggest that there are both economies of scale and of scope in higher education. Additionally, product-specific economies of scope exist for all output levels and activities.…

  13. Costs and benefits of lunar oxygen: Engineering, operations, and economics

    Science.gov (United States)

    Sherwood, Brent; Woodcock, Gordon R.

    1991-01-01

    Oxygen is the most commonly discussed lunar resource. It will certainly not be the easiest to retrieve, but oxygen's fundamental place in propulsion and life support guarantees it continued attention as a prime candidate for early in situ resource utilization (ISRU). The findings are reviewed of recent investigation, sponsored by NASA-Ames, into the kinds of technologies, equipment, and scenarios (the engineering and operations costs) that will be required even to initiate lunar oxygen production. The infrastructure necessary to surround and support a viable oxygen-processing operation is explained. Selected details are used to illustrate the depth of technology challenges, extent of operations burdens, and complexity of decision linkages. Basic assumptions, and resulting timelines and mass manifests, are listed. These findings are combined with state-of-the-art knowledge of lunar and Mars propulsion options in simple economic input/output and internal-rate-of-return models, to compare production costs with performance benefits. Implications for three realistic scales of exploration architecture - expeditionary, aggressive science, and industrialization/settlement - are discussed. Conclusions are reached regarding the contextual conditions within which production of lunar oxygen (LLOX) is a reasonable activity. LLOX appears less useful for Mars missions than previously hoped. Its economical use in low Earth orbit hinges on production of lunar hydrogen as well. LLOX shows promise for lunar ascent/descent use, but that depends strongly on the plant mass required.

  14. Permanent magnet design for magnetic heat pumps using total cost minimization

    Science.gov (United States)

    Teyber, R.; Trevizoli, P. V.; Christiaanse, T. V.; Govindappa, P.; Niknia, I.; Rowe, A.

    2017-11-01

    The active magnetic regenerator (AMR) is an attractive technology for efficient heat pumps and cooling systems. The costs associated with a permanent magnet for near room temperature applications are a central issue which must be solved for broad market implementation. To address this problem, we present a permanent magnet topology optimization to minimize the total cost of cooling using a thermoeconomic cost-rate balance coupled with an AMR model. A genetic algorithm identifies cost-minimizing magnet topologies. For a fixed temperature span of 15 K and 4.2 kg of gadolinium, the optimal magnet configuration provides 3.3 kW of cooling power with a second law efficiency (ηII) of 0.33 using 16.3 kg of permanent magnet material.

  15. Time-driven Activity-based Cost of Fast-Track Total Hip and Knee Arthroplasty

    DEFF Research Database (Denmark)

    Andreasen, Signe E; Holm, Henriette B; Jørgensen, Mira

    2017-01-01

    this between 2 departments with different logistical set-ups. METHODS: Prospective data collection was analyzed using the time-driven activity-based costing method (TDABC) on time consumed by different staff members involved in patient treatment in the perioperative period of fast-track THA and TKA in 2 Danish...... orthopedic departments with standardized fast-track settings, but different logistical set-ups. RESULTS: Length of stay was median 2 days in both departments. TDABC revealed minor differences in the perioperative settings between departments, but the total cost excluding the prosthesis was similar at USD......-track methodology, the result could be a more cost-effective pathway altogether. As THA and TKA are potentially costly procedures and the numbers are increasing in an economical limited environment, the aim of this study is to present baseline detailed economical calculations of fast-track THA and TKA and compare...

  16. Cost Analysis of Total Joint Arthroplasty Readmissions in a Bundled Payment Care Improvement Initiative.

    Science.gov (United States)

    Clair, Andrew J; Evangelista, Perry J; Lajam, Claudette M; Slover, James D; Bosco, Joseph A; Iorio, Richard

    2016-09-01

    The Bundled Payment for Care Improvement (BPCI) Initiative is a Centers for Medicare and Medicaid Services program designed to promote coordinated and efficient care. This study seeks to report costs of readmissions within a 90-day episode of care for BPCI Initiative patients receiving total knee arthroplasty (TKA) or total hip arthroplasty (THA). From January 2013 through December 2013, 1 urban, tertiary, academic orthopedic hospital admitted 664 patients undergoing either primary TKA or THA through the BPCI Initiative. All patients readmitted to our hospital or an outside hospital within 90-days from the index episode were identified. The diagnosis and cost for each readmission were analyzed. Eighty readmissions in 69 of 664 patients (10%) were identified within 90-days. There were 53 readmissions (45 patients) after THA and 27 readmissions (24 patients) after TKA. Surgical complications accounted for 54% of THA readmissions and 44% of TKA readmissions. These complications had an average cost of $36,038 (range, $6375-$60,137) for THA and $38,953 (range, $4790-$104,794) for TKA. Eliminating the TKA outlier of greater than $100,000 yields an average cost of $27,979. Medical complications of THA and TKA had an average cost of $22,775 (range, $5678-$82,940) for THA and $24,183 (range, $3306-$186,069) for TKA. Eliminating the TKA outlier of greater than $100,000 yields an average cost of $11,682. Hospital readmissions after THA and TKA are common and costly. Identifying the causes for readmission and assessing the cost will guide quality improvement efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Analysis operating and maintenance cost of Danish wind turbines in 1993

    International Nuclear Information System (INIS)

    Godtfredsen, F.

    1994-10-01

    A study of operation and maintenance (O and M) cost of Danish wind turbines has been carried out. The study is based on a questionnaire survey by the wind turbine owners association. The study shows a significant decline in the O and M cost from 55 kW machines installed in 1980-87 to modern machines. In 1993, the average total O and M cost for 55 kW and 150 kW turbines was approximately 0.22 DKK/kWh and 0.07 DKK/kWh, respectively. For 150 kW turbines, insurance and administration costs amounted to 0.04 DKK/kWh while repair and maintenance costs came to 0.03 DKK/kWh. In 1993, repair and maintenance cost were significantly higher for older vintages of 55 kW and 150 kW turbines, but it is not possible based on this study to conclude whether increasing O and M costs generally comes with increasing age. The statistical basis of this study is not large enough to conclude whether there are positive scale effects for ST's from 105 kW. Similarly, because of relatively few large WT are older than 10 years, it is not possible based on this study to predict the size of major future repair costs/reinvestments. To estimate the O and M costs more exactly, a larger empirical basis is needed. (au) (8 tabs., 17 ills., 11 refs.)

  18. Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis

    Directory of Open Access Journals (Sweden)

    Ajay Puri

    2012-01-01

    Full Text Available Background: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP. We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods: Eight patients (four males and four females with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5, Ewing′s sarcoma (1, and chondrosarcoma (2. Mean followup was 33 months (9-72 months for all and 40 months (24-72 months in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%. The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

  19. Lower operating cost due to compressed-air recirculation

    Energy Technology Data Exchange (ETDEWEB)

    Schauwecker, F

    1979-01-01

    Compressed air containing dirt and aggressive substances may cause damage in pipelines and pneumatic tools, equipment and systems. In consequence, operating costs can be greatly reduced by cleaning and recirculation of compressed air. Compressed-air driers are among the most common systems used for this purpose. Most of these driers are refrigeration driers; adsorption driers are less common. Refrigeration driers consist of a heat exchanger system, a separation system, and a power-controlled refrigerator. The water vapour concentration is proportional to the air temperature; for this reason, the pressure dew point should be as low as possible, i.e. about 1.5/sup 0/C.

  20. Streamlining: Reducing costs and increasing STS operations effectiveness

    Science.gov (United States)

    Petersburg, R. K.

    1985-01-01

    The development of streamlining as a concept, its inclusion in the space transportation system engineering and operations support (STSEOS) contract, and how it serves as an incentive to management and technical support personnel is discussed. The mechanics of encouraging and processing streamlining suggestions, reviews, feedback to submitters, recognition, and how individual employee performance evaluations are used to motivation are discussed. Several items that were implemented are mentioned. Information reported and the methodology of determining estimated dollar savings are outlined. The overall effect of this activity on the ability of the McDonnell Douglas flight preparation and mission operations team to support a rapidly increasing flight rate without a proportional increase in cost is illustrated.

  1. Economic Dispatch for Operating Cost Minimization under Real Time Pricing in Droop Controlled DC Microgrid

    DEFF Research Database (Denmark)

    Li, Chendan; Federico, de Bosio; Chen, Fang

    2017-01-01

    In this paper, an economic dispatch problem for total operation cost minimization in DC microgrids is formulated. An operating cost is associated with each generator in the microgrid, including the utility grid, combining the cost-efficiency of the system with demand response requirements...... achieving higher control accuracy and faster response. The optimization problem is solved in a heuristic method. In order to test the proposed algorithm, a six-bus droop-controlled DC microgrid is used in the case studies. Simulation results show that under variable renewable energy generation, load...... of the utility. The power flow model is included in the optimization problem, thus the transmission losses can be considered for generation dispatch. By considering the primary (local) control of the grid-forming converters of a microgrid, optimal parameters can be directly applied to this control level, thus...

  2. OPERATIONAL COSTS OF CANAL COMPANIES AND IRRIGATION DISTRICTS IN THE INTERMOUNTAIN REGION

    OpenAIRE

    Wilkins-Wells, John; Lagae, Hubert J.; Anderson, Raymond L.; Anwer, Muhammad Sarfraz

    1999-01-01

    This study reports on the trends of operational costs of farmer owned and operated irrigation enterprises (irrigation districts and canal companies) in five intermountain states. Administrative costs have risen faster then operation and maintenance costs. While salaries of employees have not risen significantly over time, legal costs have greatly escalated.

  3. Impact Of Health Care Delivery System Innovations On Total Cost Of Care.

    Science.gov (United States)

    Smith, Kevin W; Bir, Anupa; Freeman, Nikki L B; Koethe, Benjamin C; Cohen, Julia; Day, Timothy J

    2017-03-01

    Using delivery system innovations to advance health care reform continues to be of widespread interest. However, it is difficult to generalize about the success of specific types of innovations, since they have been examined in only a few studies. To gain a broader perspective, we analyzed the results of forty-three ambulatory care programs funded by the first round of the Center for Medicare and Medicaid Innovation's Health Care Innovations Awards. The innovations' impacts on total cost of care were estimated by independent evaluators using multivariable difference-in-differences models. Through the first two years, most of the innovations did not show a significant effect on total cost of care. Using meta-regression, we assessed the effects on costs of five common components of these innovations. Innovations that used health information technology or community health workers achieved the greatest cost savings. Savings were also relatively large in programs that targeted clinically fragile patients-clinically complex populations at risk for disease progression. While the magnitude of these effects was often substantial, none achieved conventional levels of significance in our analyses. Meta-analyses of a larger number of delivery system innovations are needed to more clearly establish their potential for patient care cost savings. Project HOPE—The People-to-People Health Foundation, Inc.

  4. Using Electromagnetic Algorithm for Total Costs of Sub-contractor Optimization in the Cellular Manufacturing Problem

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Shahriari

    2016-12-01

    Full Text Available In this paper, we present a non-linear binary programing for optimizing a specific cost in cellular manufacturing system in a controlled production condition. The system parameters are determined by the continuous distribution functions. The aim of the presented model is to optimize the total cost of imposed sub-contractors to the manufacturing system by determining how to allocate the machines and parts to each seller. In this system, DM could control the occupation level of each machine in the system. For solving the presented model, we used the electromagnetic meta-heuristic algorithm and Taguchi method for determining the optimal algorithm parameters.

  5. Operational Impacts of Operating Reserve Demand Curves on Production Cost and Reliability: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Krad, Ibrahim; Ibanez, Eduardo; Ela, Erik; Gao, Wenzhong

    2015-10-27

    The electric power industry landscape is continually evolving. As emerging technologies such as wind, solar, electric vehicles, and energy storage systems become more cost-effective and present in the system, traditional power system operating strategies will need to be reevaluated. The presence of wind and solar generation (commonly referred to as variable generation) may result in an increase in the variability and uncertainty of the net load profile. One mechanism to mitigate this is to schedule and dispatch additional operating reserves. These operating reserves aim to ensure that there is enough capacity online in the system to account for the increased variability and uncertainty occurring at finer temporal resolutions. A new operating reserve strategy, referred to as flexibility reserve, has been introduced in some regions. A similar implementation is explored in this paper, and its implications on power system operations are analyzed.

  6. Next-generation nozzle check valve significantly reduces operating costs

    Energy Technology Data Exchange (ETDEWEB)

    Roorda, O. [SMX International, Toronto, ON (Canada)

    2009-01-15

    Check valves perform an important function in preventing reverse flow and protecting plant and mechanical equipment. However, the variety of different types of valves and extreme differences in performance even within one type can change maintenance requirements and life cycle costs, amounting to millions of dollars over the typical 15-year design life of piping components. A next-generation non-slam nozzle check valve which prevents return flow has greatly reduced operating costs by protecting the mechanical equipment in a piping system. This article described the check valve varieties such as the swing check valve, a dual-plate check valve, and nozzle check valves. Advancements in optimized design of a non-slam nozzle check valve were also discussed, with particular reference to computer flow modelling such as computational fluid dynamics; computer stress modelling such as finite element analysis; and flow testing (using rapid prototype development and flow loop testing), both to improve dynamic performance and reduce hydraulic losses. The benefits of maximized dynamic performance and minimized pressure loss from the new designed valve were also outlined. It was concluded that this latest non-slam nozzle check valve design has potential applications in natural gas, liquefied natural gas, and oil pipelines, including subsea applications, as well as refineries, and petrochemical plants among others, and is suitable for horizontal and vertical installation. The result of this next-generation nozzle check valve design is not only superior performance, and effective protection of mechanical equipment but also minimized life cycle costs. 1 fig.

  7. Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up.

    Science.gov (United States)

    Bitsaki, Marina; Koutras, George; Heep, Hansjoerg; Koutras, Christos

    2017-01-01

    Long-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing. We propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden. The estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied. We propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.

  8. 19 CFR 10.178 - Direct costs of processing operations performed in the beneficiary developing country.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Direct costs of processing operations performed in... processing operations performed in the beneficiary developing country. (a) Items included in the direct costs of processing operations. As used in § 10.176, the words “direct costs of processing operations...

  9. Cost per case or total cost? The potential of prevention of hand injuries in young children – Retrospective and prospective studies

    Directory of Open Access Journals (Sweden)

    Carlsson Katarina

    2008-07-01

    Full Text Available Abstract Background Health-care costs for hand and forearm injuries in young children are poorly documented. We examined costs in 533 children injured years 1996–2003. Methods Health-care costs and costs for lost productivity were retrospectively calculated in children from three catchment areas in Sweden. Seven case categories corresponding to alternative prevention strategies were constructed. Results Over time, diminishing number of ward days reduced the health-care cost per case. Among children, the cost of lost productivity due to parental leave was 14 percent of total cost. Fingertip injuries had low median costs but high total costs due to their frequency. Complex injuries by machine or rifle had high costs per case, and despite a low number of cases, total cost was high. Type of injury, surgery and physiotherapy sessions were associated with variations in health-care cost. Low age and ethnic background had a significant effect on number of ward days. Conclusion The costs per hand injury for children were lower compared to adults due to both lower health-care costs and to the fact that parents had comparatively short periods of absence from work. Frequent simple fingertip injuries and rare complex injuries induce high costs for society. Such costs should be related to costs for prevention of these injuries.

  10. Estimated Costs of U.S. Operations in Iraq and Afghanistan and of Other Activities Related to the War on Terrorism

    National Research Council Canada - National Science Library

    Orszag, Peter

    2007-01-01

    .... In addition to totaling the funding provided to date, CBO has projected the total cost over the next 10 years of funding operations in support of the war on terrorism under two scenarios specified by the Chairman...

  11. 12 CFR Appendix K to Part 226 - Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions

    Science.gov (United States)

    2010-01-01

    ... Appendix K to Part 226—Total Annual Loan Cost Rate Computations for Reverse Mortgage Transactions (a... loan cost rate for various transactions, as well as instructions, explanations, and examples for.... (2) Term of the transaction. For purposes of total annual loan cost disclosures, the term of a...

  12. Simulation of worst-case operating conditions for integrated circuits operating in a total dose environment

    International Nuclear Information System (INIS)

    Bhuva, B.L.

    1987-01-01

    Degradations in the circuit performance created by the radiation exposure of integrated circuits are so unique and abnormal that thorough simulation and testing of VLSI circuits is almost impossible, and new ways to estimate the operating performance in a radiation environment must be developed. The principal goal of this work was the development of simulation techniques for radiation effects on semiconductor devices. The mixed-mode simulation approach proved to be the most promising. The switch-level approach is used to identify the failure mechanisms and critical subcircuits responsible for operational failure along with worst-case operating conditions during and after irradiation. For precise simulations of critical subcircuits, SPICE is used. The identification of failure mechanisms enables the circuit designer to improve the circuit's performance and failure-exposure level. Identification of worst-case operating conditions during and after irradiation reduces the complexity of testing VLSI circuits for radiation environments. The results of test circuits for failure simulations using a conventional simulator and the new simulator showed significant time savings using the new simulator. The savings in simulation time proved to be circuit topology-dependent. However, for large circuits, the simulation time proved to be orders of magnitude smaller than simulation time for conventional simulators

  13. Costs of construction, operation and maintenance of nuclear power plants - determinant factors

    International Nuclear Information System (INIS)

    Silva, R.A. da

    1981-01-01

    A study about the construction costs of the Angra-1 nuclear power plant, including direct costs, equipment costs, installation and indirect costs such as: engineering, job-training and administration is presented. The operation and maintenance costs of the Angra-1 nuclear power plant and costs of energy generation are still studied. (E.G.) [pt

  14. Incorporating a total cost perspective intothe purchasing strategy : A case study of amedium sized retail compan

    OpenAIRE

    EKSTRÖM, MARCUS; FAHNEHJELM, CAROLINA

    2016-01-01

    The retail industry is today characterized by downward price pressure, and the increasedcompetition in the industry has led to pressure on profit margins. Purchasing and supply chainmanagement have become areas of increased strategic importance and play a crucial role inthe business performance. This study aims to extend previous literature in these fields byproviding the existing research with an empirical study on how the purchasing strategy canincorporate a total cost perspective of the su...

  15. Template-Directed Instrumentation Reduces Cost and Improves Efficiency for Total Knee Arthroplasty: An Economic Decision Analysis and Pilot Study.

    Science.gov (United States)

    McLawhorn, Alexander S; Carroll, Kaitlin M; Blevins, Jason L; DeNegre, Scott T; Mayman, David J; Jerabek, Seth A

    2015-10-01

    Template-directed instrumentation (TDI) for total knee arthroplasty (TKA) may streamline operating room (OR) workflow and reduce costs by preselecting implants and minimizing instrument tray burden. A decision model simulated the economics of TDI. Sensitivity analyses determined thresholds for model variables to ensure TDI success. A clinical pilot was reviewed. The accuracy of preoperative templates was validated, and 20 consecutive primary TKAs were performed using TDI. The model determined that preoperative component size estimation should be accurate to ±1 implant size for 50% of TKAs to implement TDI. The pilot showed that preoperative template accuracy exceeded 97%. There were statistically significant improvements in OR turnover time and in-room time for TDI compared to an historical cohort of TKAs. TDI reduces costs and improves OR efficiency. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Clinical and cost effectiveness-related aspects of retransfusion in total hip and knee arthroplasty.

    Science.gov (United States)

    Dobosz, Bartłomiej; Dutka, Julian; Dutka, Lukasz; Maleta, Paweł

    2012-01-01

    An increasing demand for blood products forces the rationalisation of management and conservation of blood. The aim of the study is to evaluate the possibility of retransfusion of blood conservation and the cost-effectiveness of this procedure when employed in Total Hip Replacement and Total Knee Arthroplasty. This prospective cohort study involved two groups of patients. Group I comprised 50 patients who underwent blood retransfusion and in several cases had supplementary allogeneic transfusion. Group II, a control group, consisted of 50 patients who did not receive retransfusion. The retransfusion in Group I enabled the recovery of a mean amount of 364.5 ml (± 52.7) of blood in THR patients and 403.8 ml (± 110.7) in TKA patients. Demand for allogeneic blood transfusions in Group I versus Group II was 46% lower in THR patients and 42% lower in TKA patients. The blood recovered for retransfusion is biologically valuable with regard to cellular elements and plasma chemistries. In the costs evaluation, the total savings in Group I were 5,000 PLN. Retransfusion of recuperated blood from postoperative drainage tubing is a simple and safe method that provides clinical and cost-effectiveness advantages.

  17. Feasibility studies to improve plant availability and reduce total installed cost in IGCC plants

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, Kevin [General Electric Company, Houston, TX (United States); Anasti, William [General Electric Company, Houston, TX (United States); Fang, Yichuan [General Electric Company, Houston, TX (United States); Subramanyan, Karthik [General Electric Company, Houston, TX (United States); Leininger, Tom [General Electric Company, Houston, TX (United States); Zemsky, Christine [General Electric Company, Houston, TX (United States)

    2015-03-30

    The main purpose of this project is to look at technologies and philosophies that would help reduce the costs of an Integrated Gasification Combined Cycle (IGCC) plant, increase its availability or do both. GE’s approach to this problem is to consider options in three different areas: 1) technology evaluations and development; 2) constructability approaches; and 3) design and operation methodologies. Five separate tasks were identified that fall under the three areas: Task 2 – Integrated Operations Philosophy; Task 3 – Slip Forming of IGCC Components; Task 4 – Modularization of IGCC Components; Task 5 – Fouling Removal; and Task 6 – Improved Slag Handling. Overall, this project produced results on many fronts. Some of the ideas could be utilized immediately by those seeking to build an IGCC plant in the near future. These include the considerations from the Integrated Operations Philosophy task and the different construction techniques of Slip Forming and Modularization (especially if the proposed site is in a remote location or has a lack of a skilled workforce). Other results include ideas for promising technologies that require further development and testing to realize their full potential and be available for commercial operation. In both areas GE considers this project to be a success in identifying areas outside the core IGCC plant systems that are ripe for cost reduction and ity improvement opportunities.

  18. Changes in Energy Cost and Total External Work of Muscles in Elite Race Walkers Walking at Different Speeds

    Directory of Open Access Journals (Sweden)

    Chwała Wiesław

    2014-12-01

    Full Text Available The aim of the study was to assess energy cost and total external work (total energy depending on the speed of race walking. Another objective was to determine the contribution of external work to total energy cost of walking at technical, threshold and racing speed in elite competitive race walkers.

  19. Some Operational Aspects Relating to Quality Management and Total Quality Management

    OpenAIRE

    Sorin GRESOI; Aurelian DIACONU

    2013-01-01

    The work pass in review a few basic concepts found in quality management focusing on operational aspects of quality assurance in production activity and continue with issues regarding total quality strategy, the vector of competitiveness on the market.

  20. Episode of Care Payments in Total Joint Arthroplasty and Cost Minimization Strategies.

    Science.gov (United States)

    Nwachukwu, Benedict U; O'Donnell, Evan; McLawhorn, Alexander S; Cross, Michael B

    2016-02-01

    Total joint arthroplasty (TJA) is receiving significant attention in the US health care system for cost containment strategies. Specifically, payer organizations have embraced and are implementing bundled payment schemes in TJA. Consequently, hospitals and providers involved in the TJA care cycle have sought to adapt to the new financial pressures imposed by episode of care payment models by analyzing what components of the total "event" of a TJA are most essential to achieve a good outcome after TJA. As part of this review, we analyze and discuss a health economic study by Snow et al. As part of their study, the authors aimed to understand the association between preoperative physical therapy (PT) and post-acute care resource utilization, and its effect on the total cost of care during total joint arthroplasty. The purpose of this current review therefore is to (1) describe and analyze the findings presented by Snow et al. and (2) provide a framework for analyzing and critiquing economic analyses in orthopedic surgery. The study under review, while having important strengths, has several notable limitations that are important to keep in mind when making policy and coverage decisions. We support cautious interpretation and application of study results, and we encourage maintained attention to economic analysis in orthopedics as well as continued care path redesign to maximize value for patients and health care providers.

  1. Simulation-Based Approach to Operating Costs Analysis of Freight Trucking

    Directory of Open Access Journals (Sweden)

    Ozernova Natalja

    2015-12-01

    Full Text Available The article is devoted to the problem of costs uncertainty in road freight transportation services. The article introduces the statistical approach, based on Monte Carlo simulation on spreadsheets, to the analysis of operating costs. The developed model gives an opportunity to estimate operating freight trucking costs under different configuration of cost factors. Important conclusions can be made after running simulations regarding sensitivity to different factors, optimal decisions and variability of operating costs.

  2. Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model.

    Science.gov (United States)

    Tibesku, Carsten O; Hofer, Pamela; Portegies, Wesley; Ruys, C J M; Fennema, Peter

    2013-03-01

    The growing demand for total knee arthroplasty (TKA) associated with the efforts to contain healthcare expenditure by advanced economies necessitates the use of economically effective technologies in TKA. The present analysis based on activity-based costing (ABC) model was carried out to estimate the economic value of patient-matched instrumentation (PMI) compared to standard surgical instrumentation in TKA. The costs of the two approaches, PMI and standard instrumentation in TKA, were determined by the use of ABC which measures the cost of a particular procedure by determining the activities involved and adding the cost of each activity. Improvement in productivity due to increased operating room (OR) turn-around times was determined and potential additional revenue to the hospital by the efficient utilization of gained OR time was estimated. Increased efficiency in the usage of OR and utilization of surgical trays were noted with patient-specific approach. Potential revenues to the hospital were estimated with the use of PMI by efficient utilization of time saved in OR. Additional revenues of 78,240 per year were estimated considering utilization of gained OR time to perform surgeries other than TKA. The analysis suggests that use of PMI in TKA is economically effective when compared to standard instrumentation.

  3. 25 CFR 39.101 - Does ISEF assess the actual cost of school operations?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Does ISEF assess the actual cost of school operations? 39... SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula § 39.101 Does ISEF assess the actual cost of school operations? No. ISEF does not attempt to assess the actual cost of school operations either...

  4. 25 CFR 39.201 - Does ISEF reflect the actual cost of school operations?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Does ISEF reflect the actual cost of school operations... Does ISEF reflect the actual cost of school operations? ISEF does not attempt to assess the actual cost of school operations either at the local school level or in the aggregate nationally. ISEF is a...

  5. Methodology of Evaluation of the Impact of Picking Area Location on the Total Costs of Warehouse

    Directory of Open Access Journals (Sweden)

    Apsalons Raitis

    2017-12-01

    Full Text Available The picking system and the layout of the picking area are the key drivers for the evaluation of a warehouse picking cost. There are five variants for organizing the picking process of orders in a warehouse. The choice of a specific variant depends on the total cost of picking. The picking cost is evaluated within an uninterrupted picking process. It means that no stock out occurs in the time period of the picking process. The storing area and the picking area are created as two separate zones for picking quantities of the customer’s orders; the principle of division of orders is observed strictly. Referring to the locations of stock keeping units (SKU, two approaches of the layout of SKU in the picking area can be estimated. The first one is the single picking location for each single SKU, where replenishment is realized in the picking process. The second one - various picking locations for each single SKU, and the replenishment here is realized just only prior to a picking process or after it. The main benefits of the economy of the picking cost as far as these two approaches are concerned are the shortest picking route in the first case and one common replenishment option in the second case.

  6. A cost and time analysis of laryngology procedures in the endoscopy suite versus the operating room.

    Science.gov (United States)

    Hillel, Alexander T; Ochsner, Matthew C; Johns, Michael M; Klein, Adam M

    2016-06-01

    To assess the costs, charges, reimbursement, and efficiency of performing awake laryngology procedures in an endoscopy suite (ES) compared with like procedures performed in the operating room (OR). Retrospective review of billing records. Cost, charges, and reimbursements for the hospital, surgeon, and anesthesiologist were compared between ES injection laryngoplasty and laser excision procedures and matched case controls in the OR. Time spent in 1) the preoperative unit, 2) the operating or endoscopy suite, and 3) recovery unit were compared between OR and ES procedures. Hospital expenses were significantly less for ES procedures when compared to OR procedures. Reimbursement was similar for ES and OR injection laryngoplasty, though greater for OR laser excisions. Net balance (reimbursement-expenses) was greater for ES procedures. A predictive model of payer costs over a 3-year period showed similar costs for ES and OR laser procedures and reduced costs for ES compared to OR injection laryngoplasty. Times spent preoperatively and the procedure were significantly less for ES procedures. For individual laryngology procedures, the ES reduces time and costs compared to the OR, increasing otolaryngologist and hospital efficiency. This reveals cost and time savings of ES injection laryngoplasty, which occurs at a similar frequency as OR injection laryngoplasty. Given the increased frequency for ES laser procedures, total costs are similar for ES and OR laser excision of papilloma, which usually require repeated procedures. When regulated office space is unavailable, endoscopy rooms represent an alternative setting for unsedated laryngology procedures. NA Laryngoscope, 126:1385-1389, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  7. A cost analysis of operative repair of major laparoscopic bile duct injuries.

    Science.gov (United States)

    Hofmeyr, S; Krige, J E J; Bornman, P C; Beningfield, S J

    2015-06-01

    Major bile duct injuries occur infrequently after laparoscopic cholecystectomy, but may result in life-threatening complications. Few data exist on the financial implications of duct repair. This study calculated the costs of operative repair in a cohort of patients who underwent reconstruction of the bile duct after major ductal injury. To calculate the total in-hospital cost of surgical repair of patients referred with major bile duct injuries. A prospective database was reviewed to identify all patients referred to the University of Cape Town Private Academic Hospital, South Africa, between 2002 and 2013 for assessment and repair of major laparoscopic bile duct injuries. The detailed clinical records and billing information were evaluated to determine all costs from admission to discharge. Total costs for each patient were adjusted for inflation between the year of repair and 2013. Results. Forty-four patients (33 women, 11 men; median age 48 years, range 30 - 78) underwent reconstruction of a major bile duct injury. First-time repairs were performed at a median of 24.5 days (range 1 - 3,662) after initial surgery. Median hospital stay was 15 days (range 6 - 86). Mean cost of repair was ZAR215,711 (range ZAR68,764 - 980,830). Major contributors to cost were theatre expenses (22%), admission to intensive care (21%), radiology (17%) and specialist fees (12%). Admission to a general ward (10%), consumables (7%), pharmacy (5%), endoscopy (3%) and laboratory costs (3%) made up the balance. The cost of repair of a major laparoscopic bile duct injury is substantial owing to prolonged hospitalisation, complex surgicalintervention and intensive imaging requirements.

  8. Supply chain cost improvement opportunities through streamlining cross-border operations

    Directory of Open Access Journals (Sweden)

    Jan Hendrik Havenga

    2013-09-01

    Full Text Available The Cross-Border Road Transport Agency (CBRTA in South Africa aims to encourage and facilitate trade between South Africa and its neighbouring countries. The CBRTA sponsored a study by Stellenbosch University (SU to determine the logistics cost impact of cross-border delays between South Africa and its major neighbouring trading partners, and prioritise opportunities for improvement. SU is the proprietor of both a comprehensive freight demand model and a logistics cost model for South Africa, which enable extractions and extensions of freight flows and related costs for specific purposes. Through the application of these models, the following information is identified and presented in this paper: South Africa’s most important border posts (based on traffic flows; a product profile for imports and exports through these border posts; the modal split (road and rail; the annual logistics costs incurred on the corridors feeding the border posts, as well as the additional costs incurred due to border delays. The research has proved that the streamlining of border-post operations that take a total supply chain view (i.e. of both border operations and those that could be moved from the border is beneficial.

  9. Cost-effectivness analysis of total thyroidectomy vs radioiodine for Graves disease

    Directory of Open Access Journals (Sweden)

    Prokić Anđelka

    2013-01-01

    Full Text Available Among the patients suffering from hyperthyroidism 60-80% have Graves' disease. The initial therapy of Graves's disease are antithyroid drugs. If the remission is not achieved after 12-18 months, the patients should be directed to surgical treatment or to the therapy with radioactive iodine. The aim of this study was to compare cost/effectiveness ratios for radioactive iodine and total thyroidectomy. The analysis was made using Markov model, from the perspective of Republic Fund for Health Insurance in Serbia. Duration of one cycle in the model is six months, and the time horizon is 30 years. Monte Carlo simulation was performed for 1000 virtual patients as well as the analysis of sensitivity with the variation of parameters ± 50%. For total thyroidectomy the insurance should provide 138.389,72 RSD / 57, 83 QALY i.e. 2.393,04 dinars for one quality-adjusted life year, and for radioactive iodine the insurance should provide 110.043,64 RSD / 57,82 QALY i.e. 1.903,37 dinars for one quality-adjusted life year. This economic analysis showed that radioactive iodine has better ratio of costs to clinical effectiveness as opposed to total thyroidectomy.

  10. Estimating truck operating costs for domestic trips – case studies from Greece

    Directory of Open Access Journals (Sweden)

    Sdoukopoulos Eleftherios

    2015-11-01

    Full Text Available The transport sector represents a vital component of national economies and has significant impacts on productivity and social welfare. In 2012, the transport sector in Europe was estimated to account for 3.7% of the European Gross Domestic Product (GDP and 5.1% for employment. Road transport proves to be the predominant mode for moving goods within Europe holding a share of approximately 45.8% in 2012 (in ton-kms. In Greece, the share of road freight transport is significantly higher (98% indicating the importance of this sector for the Greek economy. To this end and considering the existing needs of road freight transport operators in Greece, the objective of this research is to establish an analytical and documented basis for estimating the operating cost of a truck on specific urban or national freight transport routes. To achieve this goal, an extended literature review has been conducted resulting in the identification of the main components comprising the total truck operating cost, which were then updated and validated through a series of personal interviews with selected road freight transport professionals. An excel-based application tool was also developed in order to facilitate operating cost estimates for different cases, through selection of the proper values of the relevant parameters. The resulting tool was used to analyse four test cases, which demonstrate the tool’s usability and applicability. Results from this analysis have been also validated by industry experts and they reflect real-world transport scenarios.

  11. Patterns of pharmacotherapy and health care utilization and costs prior to total hip or total knee replacement in patients with osteoarthritis.

    Science.gov (United States)

    Berger, Ariel; Bozic, Kevin; Stacey, Brett; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

    2011-08-01

    To examine patterns of pharmacotherapy and health care utilization and costs prior to total knee replacement (TKR) or total hip replacement (THR) in patients with osteoarthritis (OA). Using a large US health insurance claims database, we identified all patients with OA who were ages ≥40 years and had undergone TKR or THR between January 1, 2006 and December 31, 2007. Patients with care utilization and costs over the 2-year period preceding surgery. A total of 16,527 patients met all study entry criteria. Their mean ± SD age was 56.6 ± 6.1 years, and 56% of them were women. In the 2 years preceding surgery, 55% of patients received prescription nonsteroidal antiinflammatory drugs, 58% received opioids, and 50% received injections of corticosteroids. The numbers of patients receiving these drugs increased steadily during the presurgery period. The mean ± SD total health care costs in the 2 years preceding surgery were $19,466 ± 29,869, of which outpatient care, inpatient care, and pharmacotherapy represented 45%, 20%, and 20%, respectively. Costs increased from $2,094 in the eighth calendar quarter prior to surgery to $3,100 in the final quarter. Patients with OA who undergo THR or TKR have relatively high levels of use of pain-related pharmacotherapy and high total health care costs in the 2-year period preceding surgery. Levels of utilization and cost increase as the date of surgery approaches. Copyright © 2011 by the American College of Rheumatology.

  12. Deep water tie-back economics capex vs opex and the total costs

    Energy Technology Data Exchange (ETDEWEB)

    Tarlton, Oran D. [Oil States Industries Inc., Arlington, TX (United States)

    2005-07-01

    This paper explores the real cost and time benefits associated with the current, past, and future contracting strategies associated with subsea developments. It looks at the real cost associated with out sourcing engineering development and the impact of engineering, procurement, installation, and construction (EPIC) contracts. Development costs are first and foremost in the minds of operators as a field is analyzed for development potential. The cycle starts with an analysis of the geological information to estimate the potential value in the field. It proceeds to conceptual design where the first development methodology and cost estimates are prepared. If the project is initially viable it will proceed from conceptual design to Front End Engineering and Design (FEED) where a complete development plan is prepared with possible options and recommendations. Engineering companies may as a part of the FEED prepare a Request for Quotation (RFQ) which is sent to potential suppliers. As part of a FEED contract, an engineering company may also review responses to the RFQ and provide recommendations for selected suppliers. Typically large subsea projects are divided into several major categories such as: topsides; subsea production systems; wells; subsea umbilical risers and glow lines (SURF), and commissioning in order to simplify management and procurement. Many times these contracts are awarded as EPIC contracts to further simplify management and internal procurement efforts. A case study is presented which challenges current contracting strategies and presents an option for a lower cost and a better way forward with respect to the short term and a focus on the long term. (author)

  13. Total cost of ownership of CHP SOFC systems: Effect of installation context

    International Nuclear Information System (INIS)

    Arduino, Francesco; Santarelli, Massimo

    2016-01-01

    Solid oxide fuel cells (SOFC) are one of the most interesting between the emerging technologies for energy production. Although some information about the production cost of these devices are already known, their operational cost has not been studied yet with sufficient accuracy. This paper presents a life cycle cost (LCC) analysis of CHP (combined heat and power) SOFC systems performed in hospitals located in various cities of the US and one in Italy. In this study the strong effects of the installation context will be analyzed using a customized use phase model for each location. The cost effectiveness of these devices has been proved without credits in Mondovi (IT), New York (NY) and Minneapolis (MN) where the payback time goes from 10 to 7 years. Considering the credits, it is possible to obtain economic feasibility also in Chicago (IL) and reduce the payback for other cities to values from 4 to 6 years. In other cities like Phoenix (AZ) and Houston (TX) the payback can’t be reached in any case. The life cycle impact assessment analysis has shown how, even in the cities with cleaner electricity grid, there is a reduction in the emissions of both greenhouse gases and pollutants. - Highlights: •Life cycle cost analysis has been performed for CHP SOFC systems. •The strong effects of the installation context have been analyzed. •Economic feasibility has been proven in new york, Minneapolis and Mondovi. •Economic feasibility can’t be reached in phoenix and Houston. •SOFC always provide a reduction in the emissions of greenhouse gases and pollutant.

  14. Operation Cost Minimization of Droop-Controlled DC Microgrids Based on Real-Time Pricing and Optimal Power Flow

    DEFF Research Database (Denmark)

    Li, Chendan; de Bosio, Federico; Chaudhary, Sanjay Kumar

    2015-01-01

    In this paper, an optimal power flow problem is formulated in order to minimize the total operation cost by considering real-time pricing in DC microgrids. Each generation resource in the system, including the utility grid, is modeled in terms of operation cost, which combines the cost...... problem is solved in a heuristic way by using genetic algorithms. In order to test the proposed algorithm, a six-bus droop-controlled DC microgrid is used as a case-study. The obtained simulation results show that under variable renewable generation, load, and electricity prices, the proposed method can...

  15. OpCost: an open-source system for estimating costs of stand-level forest operations

    Science.gov (United States)

    Conor K. Bell; Robert F. Keefe; Jeremy S. Fried

    2017-01-01

    This report describes and documents the OpCost forest operations cost model, a key component of the BioSum analysis framework. OpCost is available in two editions: as a callable module for use with BioSum, and in a stand-alone edition that can be run directly from R. OpCost model logic and assumptions for this open-source tool are explained, references to the...

  16. Total output operation chart optimization of cascade reservoirs and its application

    International Nuclear Information System (INIS)

    Jiang, Zhiqiang; Ji, Changming; Sun, Ping; Wang, Liping; Zhang, Yanke

    2014-01-01

    Highlights: • We propose a new double nested model for cascade reservoirs operation optimization. • We use two methods to extract the output distribution ratio. • The adopted two methods perform better than the widely used methods at present. • Stepwise regression method performs better than mean value method on the whole. - Abstract: With the rapid development of cascade hydropower stations in recent decades, the cascade system composed of multiple reservoirs needs unified operation and management. However, the output distribution problem has not yet been solved reasonably when the total output of cascade system obtained, which makes the full utilization of hydropower resources in cascade reservoirs very difficult. Discriminant criterion method is a traditional and common method to solve the output distribution problem at present, but some shortcomings cannot be ignored in the practical application. In response to the above concern, this paper proposes a new total output operation chart optimization model and a new optimal output distribution model, the two models constitute to a double nested model with the goal of maximizing power generation. This paper takes the cascade reservoirs of Li Xianjiang River in China as an instance to obtain the optimal total output operation chart by the proposed double nested model and the 43 years historical runoff data, progressive searching method and progressive optimality algorithm are used in solving the model. In order to take the obtained total output operation chart into practical operation, mean value method and stepwise regression method are adopted to extract the output distribution ratios on the basis of the optimal simulation intermediate data. By comparing with discriminant criterion method and conventional method, the combined utilization of total output operation chart and output distribution ratios presents better performance in terms of power generation and assurance rate, which proves it is an effective

  17. Social profile and cost analysis of deep infection following total hip replacement surgery

    Directory of Open Access Journals (Sweden)

    Vera Lucia Frazão

    Full Text Available ABSTRACT OBJECTIVE: To characterize the socio-economic and demographic profile of patients undergoing surgery for revision total hip arthroplasty regarding the diagnosis of deep prosthetic infection. METHODS: Twenty patients were retrospectively studied, admitted in the period between 2009 and 2010 by the Hip Surgery Group with the diagnosis of deep prosthetic infection, whose proposed treatment was surgical. This study was carried out in the presence of the patient by completing two forms applied by the social worker of the Group. RESULTS: In a 20-patient sample, 40% were male, 45% were working age, 50% of patients originated from the capital, 85% depended on benefits, 70% were retired, 60% of patients were from this hospital, and 40% were from other services. The average cost of patients to the public system was R$ 55,821.62 per patient and the total spent on treatment of patients in the study exceeded one million Brazilian reals, totalling R$ 1,116,432.40. CONCLUSION: Infection from total hip arthroplasty generates a major expense to the social security system and to the public healthcare system. Physicians must always be alert to the possible risk factors and perioperative care, striving to minimize this complication.

  18. Blood Transfusion During Total Ankle Arthroplasty Is Associated With Increased In-Hospital Complications and Costs.

    Science.gov (United States)

    Ewing, Michael A; Huntley, Samuel R; Baker, Dustin K; Smith, Kenneth S; Hudson, Parke W; McGwin, Gerald; Ponce, Brent A; Johnson, Michael D

    2018-04-01

    Total ankle arthroplasty (TAA) is an increasingly used, effective treatment for end-stage ankle arthritis. Although numerous studies have associated blood transfusion with complications following hip and knee arthroplasty, its effects following TAA are largely unknown. This study uses data from a large, nationally representative database to estimate the association between blood transfusion and inpatient complications and hospital costs following TAA. Using the Nationwide Inpatient Sample (NIS) database from 2004 to 2014, 25 412 patients who underwent TAA were identified, with 286 (1.1%) receiving a blood transfusion. Univariate analysis assessed patient and hospital factors associated with blood transfusion following TAA. Patients requiring blood transfusion were more likely to be female, African American, Medicare recipients, and treated in nonteaching hospitals. Average length of stay for patients following transfusion was 3.0 days longer, while average inpatient cost was increased by approximately 50%. Patients who received blood transfusion were significantly more likely to suffer from congestive heart failure, peripheral vascular disease, hypothyroidism, coagulation disorder, or anemia. Acute renal failure was significantly more common among patients receiving blood transfusion ( P < .001). Blood transfusions following TAA are infrequent and are associated with multiple medical comorbidities, increased complications, longer hospital stays, and increased overall cost. Level III: Retrospective, comparative study.

  19. Total staff costs to implement a decision support system in nursing

    Directory of Open Access Journals (Sweden)

    Valéria Castilho

    2014-01-01

    Full Text Available OBJECTIVE: to identify the direct labor (DL costs to put in practice a decision support system (DSS in nursing at the University Hospital of the University of São Paulo (HU-USP. METHOD: the development of the DSS was mapped in four sub-processes: Conception, Elaboration, Construction and Transition. To calculate the DL, the baseline salary per professional category was added to the five-year additional remuneration, representation fees and social charges, and then divided by the number of hours contracted, resulting in the hour wage/professional, which was multiplied by the time spend on each activity in the sub-processes. RESULTS: the DL cost corresponded to R$ 752,618.56 (100%, R$ 26,000.00 (3.45% of which were funded by a funding agency, while R$ 726,618.56 (96,55% came from Hospital and University resources. CONCLUSION: considering the total DL cost, 72.1% related to staff wages for the informatics consulting company and 27.9% to the DL of professionals at the HU and the School of Nursing.

  20. Trajectory-Based Operations (TBO) Cost Estimation, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The Innovation Laboratory, Inc., proposes to build a tool to estimate airline costs under TBO. This tool includes a cost model that explicitly reasons about traffic...

  1. Operating cost minimization of a radial distribution system in a deregulated electricity market through reconfiguration using NSGA method

    International Nuclear Information System (INIS)

    Chandramohan, S.; Atturulu, Naresh; Devi, R.P. Kumudini; Venkatesh, B.

    2010-01-01

    In the future, mechanisms for trade in ancillary services such as reactive power will be implemented in many deregulated power systems. In such an operating framework, a Distribution Corporation (DisCo) would have to purchase reactive power along with real power from the connected transmission corporation. A DisCo would want to minimize its operating costs by minimizing the total amount of real and reactive power drawn from the connected transmission system. Optimally reconfiguring the network will achieve such a goal. In this work, we use a non-dominated sorting genetic algorithm (NSGA) for reconfiguring a radial DisCo to minimize its operating costs considering real and reactive power costs while maximizing its operating reliability and satisfying the regular operating constraints. This method is tested on sample test systems and reported. (author)

  2. Analysis of capital and operating costs associated with high level waste solidification processes

    International Nuclear Information System (INIS)

    Heckman, R.A.; Kniazewycz, B.G.

    1978-03-01

    An analysis was performed to evaluate the sensitivity of annual operating costs and capital costs of waste solidification processes to various parameters defined by the requirements of a proposed Federal waste repository. Five process methods and waste forms examined were: salt cake, spray calcine, fluidized bed calcine, borosilicate glass, and supercalcine multibarrier. Differential cost estimates of the annual operating and maintenance costs and the capital costs for the five HLW solidification alternates were developed

  3. A Flexible Job Shop Scheduling Problem with Controllable Processing Times to Optimize Total Cost of Delay and Processing

    Directory of Open Access Journals (Sweden)

    Hadi Mokhtari

    2015-11-01

    Full Text Available In this paper, the flexible job shop scheduling problem with machine flexibility and controllable process times is studied. The main idea is that the processing times of operations may be controlled by consumptions of additional resources. The purpose of this paper to find the best trade-off between processing cost and delay cost in order to minimize the total costs. The proposed model, flexible job shop scheduling with controllable processing times (FJCPT, is formulated as an integer non-linear programming (INLP model and then it is converted into an integer linear programming (ILP model. Due to NP-hardness of FJCPT, conventional analytic optimization methods are not efficient. Hence, in order to solve the problem, a Scatter Search (SS, as an efficient metaheuristic method, is developed. To show the effectiveness of the proposed method, numerical experiments are conducted. The efficiency of the proposed algorithm is compared with that of a genetic algorithm (GA available in the literature for solving FJSP problem. The results showed that the proposed SS provide better solutions than the existing GA.

  4. COST 296 scientific results designed for operational use

    Directory of Open Access Journals (Sweden)

    Michael Pezzopane

    2009-06-01

    Full Text Available

    The main objective of the COST 296 Action «Mitigation of Ionospheric Effects on Radio Systems» is the establishment/

    improvement of ionospheric services by coordinating the development of specific algorithms, models,

    and tools capable of operating in a near-real-time mode.

    Key elements of these activities are contributions related to monitoring, modelling, and imaging of customer-relevant

    ionospheric quantities. COST stimulates, coordinates, and supports Europe’s goals of development and

    global cooperation by providing high quality information and knowledge of ionospheric and plasmaspheric conditions

    enabling high quality and reliable operation of radio systems.

    It also provides a platform for sharing such tools as algorithms or models, and for the joint development of advanced

    technologies. It takes advantage of many national and European service initiatives, for example DIAS

    (http://dias.space.noa.gr, SWACI (http://w3swaci.dlr.de, ESWUA (http://www.eswua.ingv.it/ingv, RWC-Warsaw

    (http://www.cbk.waw.pl/rwc, the COST Prompt Ionospheric Database http://www.wdc.rl.ac.uk/cgibin/

    digisondes/cost_database.pl, http://www.izmiran.ru/services, and others.

  5. Quantification of intestinal bacteria, operating cost and performance of fingerlings Nile tilapia subjected to probiotics

    Directory of Open Access Journals (Sweden)

    Nilton Garcia-Marengoni

    2015-05-01

    Full Text Available The use of microorganisms of the genus Bacillus in aquaculture is a nutritional management practice that is rapidly expanding in regions with intensive fish farming. This study aimed to quantify the total bacteria and total coliforms from the intestinal microbiota and estimate the partial operating costs and growth performance of Nile tilapia (Oreochromis niloticus of the GIFT strain. A total of 1,200 post-larvae (24.7 ± 0.50 mg were distributed into 24 aquaria (0.03-m³ capacity within a completely randomized design in 2 x 3 factorial (phase x bacteria, with four replications. Each aquarium, containing 50 post-larvae (sex reversal phase or 30 fish (fingerlings phase, it was considered to be an experimental unit, consisting of three treatments (diet+Bacillus subtilis C-3102, diet+Bacillus cereus var. toyoi and diet without probiotic addition. The quantification of the total bacteria and total coliforms of the intestinal microbiota of tilapia were influenced (P 0.05 by adding probiotics in the diets and no effect of the interaction between phase and bacteria was observed. The weight gain, average daily weight gain, specific growth rate and apparent feed conversion were not affected (P > 0.05 by inclusion of probiotics as part of the diets. The inclusion of B. subtilis and B. cereus as part of diets for Nile tilapia promotes intestinal colonization and improves the survival rate without negatively influencing the feed intake, total biomass, gross revenue and partial operating costs and net revenue. Therefore it recommends the use of these probiotics to growth of tilapia fingerlings Nile, GIFT strain.

  6. Operational costs induced by fluctuating wind power production in Germany and Scandinavia

    DEFF Research Database (Denmark)

    Meibom, Peter; Weber, C.; Barth, R.

    2009-01-01

    Adding wind power generation in a power system changes the operational patterns of the existing units due to the variability and partial predictability of wind power production. For large amounts of wind power production, the expectation is that the specific operational costs (fuel costs, start......-up costs, variable operation and maintenance costs, costs of consuming CO2 emission permits) of the other power plants will increase due to more operation time in part-load and more start-ups. The change in operational costs induced by the wind power production can only be calculated by comparing...... the operational costs in two power system configurations: with wind power production and with alternative wind production having properties such as conventional production, that is, being predictable and less variable. The choice of the characteristics of the alternative production is not straightforward...

  7. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program: Volume 2, Supporting information

    International Nuclear Information System (INIS)

    1987-06-01

    This report provides cost estimates for the fifth evaluation of the adequacy of the fee and is consistent with the program strategy and plans. The total-system cost for the reference cases in the improved-performance system is estimated at $32.1 to $38.2 billion (expressed in constant 1986 collars) over the entire life of the system, or $1.5 to $1.6 billion more than that of the authorized system (i.e., the system without an MRS facility). The current estimate of the total-system cost for the reference cases in the improved-performance system is $3.8 to $5.4 billion higher than the estimate for the same system in the 1986 TSLCC analysis. In the case with the maximum increase, nearly all of the higher cost is due to a $5.2-billion increase in the costs of development and evaluation (D and E); all other system costs are essentially unchanged. The cost difference between the improved-performance system and the authorized system is smaller than the difference estimated in last year's TSLCC analysis. Volume 2 presents the detailed results for the 1987 analysis of the total-system life cycle cost (TSLCC). It consists of four sections: Section A presents the yearly flows of waste between waste-management facilities for the 12 aggregate logistics cases that were studied; Section B presents the annual total-system costs for each of the 30 TSLCC cases by major cost category; Section C presents the annual costs for the disposal of 16,000 canisters of defense high-level waste (DHLW) by major cost category for each of the 30 TSLCC cases; and Section D presents a summary of the cost-allocation factors that were calculated to determine the defense waste share of the total-system costs

  8. The advanced launch system: Application of total quality management principles to low-cost space transportation system development

    Science.gov (United States)

    Wolfe, M. G.; Rothwell, T. G.; Rosenberg, D. A.; Oliver, M. B.

    Recognizing that a major inhibitor of man's rapid expansion of the use of space is the high cost (direct and induced) of space transportation, the U.S. has embarked on a major national program to radically reduce the cost of placing payloads into orbit while, at the same time, making equally radical improvements inlaunch system operability. The program is entitled "The Advanced Launch System" (ALS) and is a joint Department of Defense/National Aeronautics and Space Administration (DoD/NASA) program which will provide launch capability in the post 2000 timeframe. It is currently in Phase II (System Definition), which began in January 1989, and will serve as a major source of U.S. launch system technology over the next several years. The ALS is characterized by a new approach to space system design, development, and operation. The practices that are being implemented by the ALS are expected to affect the management and technical operation of all future launch systems. In this regard, the two most significant initiatives being implemented on the ALS program are the practices of Total Quality Management (TQM) and the Unified Information System (Unis). TQM is a DoD initiative to improve the quality of the DoD acquisition system, contractor management systems, and the technical disciplines associated with the design, development, and operation of major systems. TQM has been mandated for all new programs and affects the way every group within the system currently does business. In order to implement the practices of TQM, new methods are needed. A program on the scale of the ALS generates vast amounts of information which must be used effectively to make sound decisions. Unis is an information network that will connect all ALS participants throughout all phases of the ALS development. Unis is providing support for project management and system design, and in following phases will provide decision support for launch operations, computer integrated manufacturing, automated

  9. A HEDONIC APPROACH TO ESTIMATING OPERATION AND MAINTENANCE COSTS FOR NEW YORK MUNICIPAL WATER SYSTEMS

    OpenAIRE

    Schmit, Todd M.; Boisvert, Richard N.

    1997-01-01

    A hedonic cost function is used to isolate the operation and maintenance costs for water treatments. For small systems, costs are substantial for some technologies, but not for others. When regional differences in input costs are accounted for, small systems located in rural areas may have a cost advantage over similar systems closer to urban centers; however, costs of water treatment to meet Safe Drinking Water Act amendments may still be substantial.

  10. Noninvasive Hemoglobin Monitoring: A Rapid, Reliable, and Cost-Effective Method Following Total Joint Replacement.

    Science.gov (United States)

    Martin, J Ryan; Camp, Christopher L; Stitz, Amber; Young, Ernest Y; Abdel, Matthew P; Taunton, Michael J; Trousdale, Robert T

    2016-03-02

    Noninvasive hemoglobin (nHgb) monitoring was initially introduced in the intensive care setting as a means of rapidly assessing Hgb values without performing a blood draw. We conducted a prospective analysis to compare reliability, cost, and patient preference between nHgb monitoring and invasive Hgb (iHgb) monitoring performed via a traditional blood draw. We enrolled 100 consecutive patients undergoing primary or revision total hip or total knee arthroplasty. On postoperative day 1, nHgb and iHgb values were obtained within thirty minutes of one another. iHgb and nHgb values, cost, patient satisfaction, and the duration of time required to obtain each reading were recorded. The concordance correlation coefficient (CCC) was utilized to evaluate the agreement of the two Hgb measurement methods. Paired t tests and Wilcoxon signed-rank tests were utilized to compare mean Hgb values, time, and pain for all readings. The mean Hgb values did not differ significantly between the two measurement methods: the mean iHgb value (and standard deviation) was 11.3 ± 1.4 g/dL (range, 8.2 to 14.3 g/dL), and the mean nHgb value was 11.5 ± 1.8 g/dL (range, 7.0 to 16.0 g/dL) (p = 0.11). The CCC between the two Hgb methods was 0.69. One hundred percent of the patients with an nHgb value of ≥ 10.5 g/dL had an iHgb value of >8.0 g/dL. The mean time to obtain an Hgb value was 0.9 minute for the nHgb method and 51.1 minutes for the iHgb method (p measurement, resulting in a savings of $26 per Hgb assessment when the noninvasive method is used. Noninvasive Hgb monitoring was found to be more efficient, less expensive, and preferred by patients compared with iHgb monitoring. Providers could consider screening total joint arthroplasty patients with nHgb monitoring and only order iHgb measurement if the nHgb value is protocol had been applied to the first blood draw in our 100 patients, approximately $2000 would have been saved. Extrapolated to the U.S. total joint arthroplasty practice

  11. Clinical Outcomes and 90-Day Costs Following Hemiarthroplasty or Total Hip Arthroplasty for Hip Fracture.

    Science.gov (United States)

    Nichols, Christine I; Vose, Joshua G; Nunley, Ryan M

    2017-09-01

    In the era of bundled payments, many hospitals are responsible for costs from admission through 90 days postdischarge. Although bundled episodes for hip fracture will have a separate target price for the bundle, little is known about the 90-day resource use burden for this patient population. Using Medicare 100% Standard Analytic Files (2010-2014), we identified patients undergoing hemiarthroplasty or total hip arthroplasty (THA). Patients were aged 65 and older with admitting diagnosis of closed hip fracture, no concurrent fractures of the lower limb, and no history of hip surgery in the prior 12 months baseline. Continuous Medicare-only enrollment was required. Complications, resource use, and mortality from admission through 90 days following discharge (follow-up) were summarized. Four cohorts met selection criteria for analysis: (1) hemiarthroplasty diagnosis-related group (DRG) 469 (N = 19,634), (2) hemiarthroplasty DRG 470 (N = 77,744), (3) THA DRG 469 (N = 1686), and (4) THA DRG 470 (N = 9314). All-cause mortality during the study period was 51.6%, 29.5%, 48.1%, and 24.9% with mean 90-day costs of $28,952, $19,243, $29,763, and $18,561, respectively. Most of the patients waited 1 day from admission to surgery (41%-51%). Incidence of an all-cause complication was approximately 70% in each DRG 469 cohort and 14%-16% in each DRG 470 cohort. This study confirms patients with hip fracture are a costly subpopulation. Tailored care pathways to minimize post-acute care resource use are warranted for these patients. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  12. Factors Influencing the Total Inpatient Pharmacy Cost at a Tertiary Hospital in Malaysia: A Retrospective Study

    Science.gov (United States)

    Ali Jadoo, Saad Ahmed

    2018-01-01

    The steady growth of pharmaceutical expenditures is a major concern for health policy makers and health care managers in Malaysia. Our study examined the factors affecting the total inpatient pharmacy cost (TINPC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). In this retrospective study, we used 2011 administration electronic prescriptions records and casemix databases at UKMMC to examine the impact of sociodemographic, diagnostic, and drug variables on the TINPC. Bivariate and multivariate analyses of the factors associated with TINPC were conducted. The mean inpatient pharmacy cost per patient was USD 102.07 (SD = 24.76). In the multivariate analysis, length of stay (LOS; B = 0.349, P < .0005) and severity level III (B = 0.253, P < .0005) were the primary factors affecting the TINPC. For each day increase in the LOS and each increase of a case of severity level III, there was an increase of approximately USD 11.97 and USD 171.53 in the TINPC per year, respectively. Moreover, the number of prescribed items of drugs and supplies was positively associated with the TINPC (B = 0.081, P < .0005). Gender appears to have affected the TINPC; male patients seem to be associated with a higher TINPC than females (mean = 139.55, 95% confidence interval [CI]: 112.97-166.13, P < .001). Surgical procedures were associated with higher cost than medical cases (mean = 87.93, 95% CI: 61.00-114.85, P < .001). Malay (MYR 242.02, SD = 65.37) and Chinese (MYR 214.66, SD = 27.99) ethnicities contributed to a lower TINPC compared with Indian (MYR 613.93, SD = 98.41) and other ethnicities (MYR 578.47, SD = 144.51). A longer hospitalization period accompanied by major complications and comorbidities had the greatest influence on the TINPC. PMID:29436248

  13. Organizational Culture Influence On Total Productive Maintenance (TPM and Operational Performance Using RASCH Model Analysis

    Directory of Open Access Journals (Sweden)

    Mohd Norhasni Mohd Asaad

    2014-02-01

    Full Text Available Abstract. Market globalization, competitive product and services, high economic crises are the most critical factors that influence the success of the manufacturing companies in global market. Therefore it is critical to the manufacturing companies to be efficient in production and lean tool may used to achieve that.  The most frequently used is the Total Preventive Maintenance (TPM, even though there are many studies have been conducted in relation to the TPM but there is limited research in investigating the effects of the TPM on operational performance. However, the result of the studies was not consistent, where TPM practice may have positive and negative impact on operational performance. Among the reason is the culture of the organization that influenced the implementation of TPM and operational performance. Due to that this study attempts to investigate the influence of organizational culture on the TPM implementation and operational performance.  Rasch model is used in this study due to its ability in interpreting and analyzing the ability of respondents in performing the difficult items. The online questionnaires were distributed to 63 randomly selected automotive companies located at Northern Region of Malaysia.  Results of the study revealed that the organizational culture has influenced on the successful implementation of TPM and operational performance. Therefore by the implementation of TPM in outstanding organizational culture can improve operational performance.   Keyword: Total Preventive Maintenance (TPM, Lean manufacturing, Operational performance, Organizational culture, Rasch modeldoi:10.12695/ajtm.2013.6.2.2How to cite this article:Mohd Asaad, M.N and Yusoff, R.Z. (2013. Organizational Culture Influence On Total Productive Maintenance (TPM and Operational Performance Using RASCH Model Analysis . The Asian Journal of Technology Management 6 (2: 72-81. Print ISSN: 1978-6956; Online ISSN: 2089-791X.  doi:10.12695/ajtm

  14. Post-operative telephone review is cost-effective and acceptable to patients.

    LENUS (Irish Health Repository)

    Gray, R T

    2012-02-01

    INTRODUCTION: Patients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital. Our study objectives were to review patients\\' satisfaction, assess cost-effectiveness and compare our practice with other surgical units in Northern Ireland (NI). PATIENTS AND METHODS: Completed telephone follow-up forms were reviewed retrospectively for a three-year period and cost savings calculated. Fifty patients were contacted prospectively by telephone using a questionnaire to assess satisfaction of this follow-up. A postal questionnaire was sent to 68 general and vascular surgeons in NI, assessing individual preferences for patient follow-up. RESULTS: A total of 1378 patients received a telephone review from September 2005 to September 2008. One thousand one hundred and seventy-seven (85.4%) were successfully contacted, while 201 (14.6%) did not respond despite multiple attempts. One hundred and forty-seven respondents (10.7%) required further outpatient follow-up, thereby saving 1231 outpatient reviews, equivalent to pound41,509 per annum. Thirty-nine (78%) patients expected post-operative follow-up, with 29 (58%) expecting this in the outpatient department. However, all patients were satisfied with the nurse-led telephone review. Fifty-three (78%) consultants responded. Those who always, or occasionally, review patients post-operatively varies according to the operation performed, ranging from 2.2% appendicectomy patients to 40.0% for varicose vein surgery. CONCLUSION: Current practice in NI varies, but a significant proportion of patients are not routinely reviewed. This study confirmed that patients expect post-operative follow-up. A nurse-led telephone review service is acceptable to patients, cost-effective and reduces the number of unnecessary outpatient reviews.

  15. 43 CFR 404.55 - Who is responsible for the operation, maintenance, and replacement costs?

    Science.gov (United States)

    2010-10-01

    ... Miscellaneous § 404.55 Who is responsible for the operation, maintenance, and replacement costs? You will be responsible for 100 percent of the operation, maintenance, and replacement costs for any rural water facility... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Who is responsible for the operation...

  16. A maintenance and operations cost model for DSN

    Science.gov (United States)

    Burt, R. W.; Kirkbride, H. L.

    1977-01-01

    A cost model for the DSN is developed which is useful in analyzing the 10-year Life Cycle Cost of the Bent Pipe Project. The philosophy behind the development and the use made of a computer data base are detailed; the applicability of this model to other projects is discussed.

  17. Cost and morbidity analysis of chest port insertion in adults: Outpatient clinic versus operating room placement.

    Science.gov (United States)

    Feo, Claudio F; Ginesu, Giorgio C; Bellini, Alessandro; Cherchi, Giuseppe; Scanu, Antonio M; Cossu, Maria Laura; Fancellu, Alessandro; Porcu, Alberto

    2017-09-01

    Totally implantable venous access devices (TIVADs) represent a convenient way for the administration of medications or nutrients. Traditionally, chest ports have been positioned by surgeons in the operating room, however there has been a transition over the years to port insertion by interventional radiologists in the radiology suite. The optimal method for chest port placement is still under debate. Data on all adult patients undergoing isolated chest port placement at our institution in a 12-year period were retrospectively reviewed. The aim of this cohort study was to compare cost and morbidity for chest port insertion in two different settings: outpatient clinic and operating room. Between 2003 and 2015 a total of 527 chest ports were placed in adult patients. Of them, 262 procedures were performed in the operating room and 265 procedures were undertaken in the outpatient clinic. Patient characteristics were similar and there was no significant difference in early (port was 1270 Euros in the operating room versus 620 Euros in the outpatient clinic. Our results suggest that chest ports can be safely placed in most patients under local anesthesia in the office setting without fluoroscopy or ultrasound guidance. Future randomized controlled studies may evaluate if surgeons or interventional radiologists should routinely perform these procedures in a dedicated office setting and reserve more sophisticated facilities only for patients at high risk of technical failure.

  18. A cost and operational effectiveness analysis of alternative anti-surface warfare platforms

    OpenAIRE

    Skinner, Walter Mark.

    1993-01-01

    Approved for public release; distribution is unlimited. A Cost and Operational Effectiveness Analysis (COEA) is performed for three alternative anti-surface warfare (ASUW) platforms that will conduct operations in multi-service regional scenarios. Estimated program costs, historical cost variances, and measures of operational effectiveness are determined for each COEA alternative, and service life extension effects are examined. The data is merged in a mixed-integer optimization model, MPA...

  19. Effect of pre-operative methylprednisolone on orthostatic hypotension during early mobilization after total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, V; Petersen, P B; Jans, Ø

    2018-01-01

    a standardized mobilization protocol pre-operatively, 6, and 24 h after surgery. Systolic and diastolic arterial pressure and heart rate were measured non-invasively (Nexfin® ). The systemic inflammation was monitored by the C-reactive protein (CRP) response. RESULTS: At 6 h post-operatively, 11 (38%) versus 11......BACKGROUND: Orthostatic hypotension (OH) and intolerance (OI) are common after total hip arthroplasty (THA) and may delay early mobilization. The pathology of OH and OI includes a dysregulated post-operative vasopressor response, by a hitherto unknown mechanism. We hypothesized that OI could...... be related to the inflammatory stress response which is inhibited by steroid administration. Consequently, this study evaluated the effect of a pre-operative high-dose methylprednisolone on OH and OI early after THA. METHODS: Randomized, double-blind, placebo-controlled study in 59 patients undergoing...

  20. Does pre-operative psychological distress affect patient satisfaction after primary total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Nolan John

    2011-06-01

    Full Text Available Abstract Background There are concerns that pre-operative psychological distress might be associated with reduced patient satisfaction after total hip replacement (THR. Methods We investigated this in a multi-centre prospective study between January 1999 and January 2002. We dichotomised the patients into the mentally distressed (MHS ≤ 56 and the not mentally distressed (MHS > 56 groups based on their pre-operative Mental Health Score (MHS of SF36. Results 448 patients (340 not distressed and 108 distressed completed the patient satisfaction survey. Patient satisfaction rate at five year was 96.66% (415/448. There was no difference in patient satisfaction or willingness to have the surgery between the two groups. None of pre-operative variables predicted five year patient satisfaction in logistic regression. Conclusions Patient satisfaction after surgery may not be adversely affected by pre-operative psychological distress.

  1. Use of Quantile Regression to Determine the Impact on Total Health Care Costs of Surgical Site Infections Following Common Ambulatory Procedures.

    Science.gov (United States)

    Olsen, Margaret A; Tian, Fang; Wallace, Anna E; Nickel, Katelin B; Warren, David K; Fraser, Victoria J; Selvam, Nandini; Hamilton, Barton H

    2017-02-01

    To determine the impact of surgical site infections (SSIs) on health care costs following common ambulatory surgical procedures throughout the cost distribution. Data on costs of SSIs following ambulatory surgery are sparse, particularly variation beyond just mean costs. We performed a retrospective cohort study of persons undergoing cholecystectomy, breast-conserving surgery, anterior cruciate ligament reconstruction, and hernia repair from December 31, 2004 to December 31, 2010 using commercial insurer claims data. SSIs within 90 days post-procedure were identified; infections during a hospitalization or requiring surgery were considered serious. We used quantile regression, controlling for patient, operative, and postoperative factors to examine the impact of SSIs on 180-day health care costs throughout the cost distribution. The incidence of serious and nonserious SSIs was 0.8% and 0.2%, respectively, after 21,062 anterior cruciate ligament reconstruction, 0.5% and 0.3% after 57,750 cholecystectomy, 0.6% and 0.5% after 60,681 hernia, and 0.8% and 0.8% after 42,489 breast-conserving surgery procedures. Serious SSIs were associated with significantly higher costs than nonserious SSIs for all 4 procedures throughout the cost distribution. The attributable cost of serious SSIs increased for both cholecystectomy and hernia repair as the quantile of total costs increased ($38,410 for cholecystectomy with serious SSI vs no SSI at the 70th percentile of costs, up to $89,371 at the 90th percentile). SSIs, particularly serious infections resulting in hospitalization or surgical treatment, were associated with significantly increased health care costs after 4 common surgical procedures. Quantile regression illustrated the differential effect of serious SSIs on health care costs at the upper end of the cost distribution.

  2. Cost and Morbidity Analysis of Chest Port Insertion: Interventional Radiology Suite Versus Operating Room.

    Science.gov (United States)

    LaRoy, Jennifer R; White, Sarah B; Jayakrishnan, Thejus; Dybul, Stephanie; Ungerer, Dirk; Turaga, Kiran; Patel, Parag J

    2015-06-01

    To compare complications and cost, from a hospital perspective, of chest port insertions performed in an interventional radiology (IR) suite versus in surgery in an operating room (OR). This study was approved by an institutional review board and is HIPAA compliant. Medical records were retrospectively searched on consecutive chest port placement procedures, in the IR suite and the OR, between October 22, 2010 and February 26, 2013, to determine patients' demographic information and chest port-related complications and/or infections. A total of 478 charts were reviewed (age range: 21-85 years; 309 women, 169 men). Univariate and bivariate analyses were performed to identify risk factors associated with an increased complication rate. Cost data on 149 consecutive Medicare outpatients (100 treated in the IR suite; 49 treated in the OR) who had isolated chest port insertions between March 2012 and February 2013 were obtained for both the operative services and pharmacy. Nonparametric tests for heterogeneity were performed using the Kruskal-Wallis method. Early complications occurred in 9.2% (22 of 239) of the IR patients versus 13.4% (32 of 239) of the OR patients. Of the 478 implanted chest ports, 9 placed in IR and 18 placed in surgery required early removal. Infections from the ports placed in IR versus the OR were 0.25 versus 0.18 infections per 1000 catheters, respectively. Overall mean costs for chest port insertion were significantly higher in the OR, for both room and pharmacy costs (P chest ports in an OR setting was almost twice that of placement in the IR suite. Hospital costs to place a chest port were significantly lower in the IR suite than in the OR, whereas radiology and surgery patients did not show a significantly different rate of complications and/or infections. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  3. Refrigerator Optimal Scheduling to Minimise the Cost of Operation

    Directory of Open Access Journals (Sweden)

    Bálint Roland

    2016-12-01

    Full Text Available The cost optimal scheduling of a household refrigerator is presented in this work. The fundamental approach is the model predictive control methodology applied to the piecewise affine model of the refrigerator.

  4. Reducing Operating Costs and Energy Consumption at Water Utilities

    Science.gov (United States)

    Due to their unique combination of high energy usage and potential for significant savings, utilities are turning to energy-efficient technologies to help save money. Learn about cost and energy saving technologies from this brochure.

  5. Reduced survival for uncemented compared to cemented total hip arthroplasty after operatively treated acetabular fractures.

    Science.gov (United States)

    Clarke-Jenssen, John; Westberg, Marianne; Røise, Olav; Storeggen, Stein Arne Øvre; Bere, Tone; Silberg, Ingunn; Madsen, Jan Erik

    2017-11-01

    Post traumatic arthritis and avascular necrosis of the femoral head are common complications after operatively treated acetabular fractures. This may cause severe disabilities for the patient, necessitating a total hip arthroplasty. Even though an arthroplasty may provide good symptomatic relief, the long-term results are more uncertain and no consensus exists according to preferred prosthetic designs. With this cohort study, we aimed to investigate the medium to long term arthroplasty survival and clinical results of total hip arthroplasty after operatively treated acetabular fractures. We included 52 patients treated with a secondary total hip arthroplasty at a median of 2.4 (0.1-14.1) years after an operatively treated acetabular fracture. The median age was 54 (11-82) years. Cemented arthroplasty was used for 33 patients, 10 patients had an uncemented arthroplasty and 9 patients received a hybrid arthroplasty. Average follow up was 8.0 (SD 5.0) years. Ten-year revision free arthroplasty survival was 79%. Uncemented arthroplasties had a significantly worse 10-year survival of 57%. Arthroplasties performed at a centre without a pelvic fracture service also had a significantly worse 10-years survival of 51%. Cox regression showed similar results with an 8-fold increase in risk of revision for both uncemented arthroplasties and operations performed at a non-pelvic trauma centre. Total hip arthroplasty secondary to an operatively treated acetabular fracture provides good symptomatic relief. These patients are, however, complex cases and are probably best treated at specialist centres with both pelvic trauma surgeons and arthroplasty surgeons proficient in complex revisions present. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. EVALUATION OF COST CENTER OPERATIONS USING ABC METHOD

    OpenAIRE

    Madalina Aurelia GRIGORE; Elena Daniela NICOLAE; George Ciprian GIJU; Daniela MITRAN

    2010-01-01

    The continuous changes appearing in the industrial and economic environment, upgrading of manufacturing technologies, the need to obtain relevant information to facilitate management decision making, have made absolutely necessary the rethinking of the cost calculation system. Both traditional and modern methods used in management accounting for costing is based on cropping the enterprise into responsibility centers. But within the organization is being felt the interdependence that is imposs...

  7. Does antegrade JJ stenting affect the total operative time during laparoscopic pyeloplasty?

    Science.gov (United States)

    Bolat, Mustafa Suat; Çınar, Önder; Akdeniz, Ekrem

    2017-12-01

    We aimed to show the effect of retrograde JJ stenting and intraoperative antegrade JJ stenting techniques on operative time in patients who underwent laparoscopic pyeloplasty. A total of 34 patients were retrospectively investigated (15 male and 19 female) with ureteropelvic junction obstruction. Of the patients stentized under local anesthesia preoperatively, as a part of surgery, 15 were retrogradely stentized at the beginning of the procedure (Group 1), and 19 were antegradely stentized during the procedure (Group 2). A transperitoneal dismembered pyeloplasty technique was performed in all patients. The two groups were retrospectively compared in terms of complications, the mean total operative time, and the mean stenting times. The mean ages of the patients were 31.5±15.5 and 33.2±15.5 years (p=0.09), and the mean body mass indexes were 25.8±5.6 and 26.2.3±8.4 kg/m 2 in Group 1 and Group 2, respectively. The mean total operative times were 128.9±38.9 min and 112.7±21.9 min (p=0.04); the mean stenting times were 12.6±5.4 min and 3.5±2.4 min (p=0.02); and the mean rates of catheterization-to-total surgery times were 0.1 and 0.03 (p=0.01) in Group 1 and 2, respectively. The mean hospital stays and the mean anastomosis times were similar between the two groups (p>0.05). Antegrade JJ stenting during laparoscopic pyeloplasty significantly decreased the total operative time.

  8. Capital and operating cost estimates for high temperature superconducting magnetic energy storage

    International Nuclear Information System (INIS)

    Schoenung, S.M.; Meier, W.R.; Fagaly, R.L.; Heiberger, M.; Stephens, R.B.; Leuer, J.A.; Guzman, R.A.

    1992-01-01

    Capital and operating costs have been estimated for mid-scale (2 to 200 Mwh) superconducting magnetic energy storage (SMES) designed to use high temperature superconductors (HTS). Capital costs are dominated by the cost of superconducting materials. Operating costs, primarily for regeneration, are significantly reduced for HTS-SMES in comparison to low temperature, conventional systems. This cost component is small compared to other O and M and capital components, when levelized annual costs are projected. In this paper, the developments required for HTS-SMES feasibility are discussed

  9. The Cost-Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model.

    Science.gov (United States)

    Barlow, Brian T; McLawhorn, Alexander S; Westrich, Geoffrey H

    2017-05-03

    Dislocation remains a clinically important problem following primary total hip arthroplasty, and it is a common reason for revision total hip arthroplasty. Dual mobility (DM) implants decrease the risk of dislocation but can be more expensive than conventional implants and have idiosyncratic failure mechanisms. The purpose of this study was to investigate the cost-effectiveness of DM implants compared with conventional bearings for primary total hip arthroplasty. Markov model analysis was conducted from the societal perspective with use of direct and indirect costs. Costs, expressed in 2013 U.S. dollars, were derived from the literature, the National Inpatient Sample, and the Centers for Medicare & Medicaid Services. Effectiveness was expressed in quality-adjusted life years (QALYs). The model was populated with health state utilities and state transition probabilities derived from previously published literature. The analysis was performed for a patient's lifetime, and costs and effectiveness were discounted at 3% annually. The principal outcome was the incremental cost-effectiveness ratio (ICER), with a willingness-to-pay threshold of $100,000/QALY. Sensitivity analyses were performed to explore relevant uncertainty. In the base case, DM total hip arthroplasty showed absolute dominance over conventional total hip arthroplasty, with lower accrued costs ($39,008 versus $40,031 U.S. dollars) and higher accrued utility (13.18 versus 13.13 QALYs) indicating cost-savings. DM total hip arthroplasty ceased being cost-saving when its implant costs exceeded those of conventional total hip arthroplasty by $1,023, and the cost-effectiveness threshold for DM implants was $5,287 greater than that for conventional implants. DM was not cost-effective when the annualized incremental probability of revision from any unforeseen failure mechanism or mechanisms exceeded 0.29%. The probability of intraprosthetic dislocation exerted the most influence on model results. This model

  10. Force Structure: Restructuring and Rebuilding the Army Will Cost Billions of Dollars for Equipment but the Total Cost Is Uncertain

    National Research Council Canada - National Science Library

    St. Laurent, Janet A

    2008-01-01

    .... Several factors are contributing to the uncertainties about future costs. First, the Army's $43.6 funding plan for equipping modular units was based on preliminary modular unit designs and did not fully consider the needs of National Guard units...

  11. Expanding the Operational Use of Total Lightning Ahead of GOES-R

    Science.gov (United States)

    Stano, Geoffrey T.; Wood, Lance; Garner, Tim; Nunez, Roland; Kann, Deirdre; Reynolds, James; Rydell, Nezette; Cox, Rob; Bobb, William R.

    2015-01-01

    NASA's Short-term Prediction Research and Transition Center (SPoRT) has been transitioning real-time total lightning observations from ground-based lightning mapping arrays since 2003. This initial effort was with the local Weather Forecast Offices (WFO) that could use the North Alabama Lightning Mapping Array (NALMA). These early collaborations established a strong interest in the use of total lightning for WFO operations. In particular the focus started with warning decision support, but has since expanded to include impact-based decision support and lightning safety. SPoRT has used its experience to establish connections with new lightning mapping arrays as they become available. The GOES-R / JPSS Visiting Scientist Program has enabled SPoRT to conduct visits to new partners and expand the number of operational users with access to total lightning observations. In early 2014, SPoRT conducted the most recent visiting scientist trips to meet with forecast offices that will used the Colorado, Houston, and Langmuir Lab (New Mexico) lightning mapping arrays. In addition, SPoRT met with the corresponding Center Weather Service Units (CWSUs) to expand collaborations with the aviation community. These visits were an opportunity to learn about the forecast needs of each office visited as well as to provide on-site training for the use of total lightning, setting the stage for a real-time assessment during May-July 2014. With five lightning mapping arrays covering multiple geographic locations, the 2014 assessment has demonstrated numerous uses of total lightning in varying situations. Several highlights include a much broader use of total lightning for impact-based decision support ranging from airport weather warnings, supporting fire crews, and protecting large outdoor events. The inclusion of the CWSUs has broadened the operational scope of total lightning, demonstrating how these data can support air traffic management, particularly in the Terminal Radar Approach

  12. Multiagent based Distributed Control for Operation Cost Minimization of Droop Controlled AC Microgrid Using Incremental Cost Consensus

    DEFF Research Database (Denmark)

    Li, Chendan; Firoozabadi, Mehdi Savaghebi; Quintero, Juan Carlos Vasquez

    2015-01-01

    sharing based on the power rating. With various types of distributed generator (DG) units in the system, factors that closely related to the operation cost, such as fuel cost and efficiencies of the generator should be taken into account in order to improve the efficiency of the whole system....... In this paper, a multiagent based distributed method is proposed to minimize operation cost of the AC microgrid. Each DG is acting as an agent which regulates the power individually using proposed frequency scheduling method. Optimal power command is obtained through carefully designed consensus algorithm...... with only light communication between neighboring agents. Case studies verified that the proposed control strategy can effectively reduce the operation cost....

  13. Analysing uncertainty around costs of innovative medical technologies: the case of fibrin sealant (QUIXIL) for total knee replacement.

    NARCIS (Netherlands)

    Steuten, Lotte Maria Gertruda; Vallejo-Torres, Laura; Bastide, Philippe; Buxton, Martin J.

    2009-01-01

    This paper presents a relatively simple cost model comparing the costs of using a commercial fibrin sealant (QUIXIL®) in addition to conventional haemostatic treatment vs. conventional treatment alone in total knee replacement (TKR) surgery, and demonstrates and discusses how one- and two-way

  14. The Cost of Iraq, Afghanistan, and Other Global War on Terror Operations Since 9/11

    National Research Council Canada - National Science Library

    Belasco, Amy

    2007-01-01

    ... of about $610 billion fo for military r operations, b base security security, reconstruction, foreig foreign aid, embassy costs, and veterans health care for the three operations initiated since the 9/11 attacks...

  15. Low-cost USB interface for operant research using Arduino and Visual Basic.

    Science.gov (United States)

    Escobar, Rogelio; Pérez-Herrera, Carlos A

    2015-03-01

    This note describes the design of a low-cost interface using Arduino microcontroller boards and Visual Basic programming for operant conditioning research. The board executes one program in Arduino programming language that polls the state of the inputs and generates outputs in an operant chamber. This program communicates through a USB port with another program written in Visual Basic 2010 Express Edition running on a laptop, desktop, netbook computer, or even a tablet equipped with Windows operating system. The Visual Basic program controls schedules of reinforcement and records real-time data. A single Arduino board can be used to control a total of 52 inputs/output lines, and multiple Arduino boards can be used to control multiple operant chambers. An external power supply and a series of micro relays are required to control 28-V DC devices commonly used in operant chambers. Instructions for downloading and using the programs to generate simple and concurrent schedules of reinforcement are provided. Testing suggests that the interface is reliable, accurate, and could serve as an inexpensive alternative to commercial equipment. © Society for the Experimental Analysis of Behavior.

  16. The application of total quality management principles to spacecraft mission operations

    Science.gov (United States)

    Sweetin, Maury

    1993-03-01

    By now, the philosophies of Total Quality Management have had an impact on every aspect of American industrial life. The trail-blazing work of Deming, Juran, and Crosby, first implemented in Japan, has 're-migrated' across the Pacific and now plays a growing role in America's management culture. While initially considered suited only for a manufacturing environment, TQM has moved rapidly into the 'service' areas of offices, sales forces, and even fast-food restaurants. The next logical step has also been taken - TQM has found its way into virtually all departments of the Federal Government, including NASA. Because of this widespread success, it seems fair to ask whether this new discipline is directly applicable to the profession of spacecraft operations. The results of quality emphasis on OAO Corporation's contract at JPL provide strong support for Total Quality Management as a useful tool in spacecraft operations.

  17. The application of total quality management principles to spacecraft mission operations

    Science.gov (United States)

    Sweetin, Maury

    1993-01-01

    By now, the philosophies of Total Quality Management have had an impact on every aspect of American industrial life. The trail-blazing work of Deming, Juran, and Crosby, first implemented in Japan, has 're-migrated' across the Pacific and now plays a growing role in America's management culture. While initially considered suited only for a manufacturing environment, TQM has moved rapidly into the 'service' areas of offices, sales forces, and even fast-food restaurants. The next logical step has also been taken - TQM has found its way into virtually all departments of the Federal Government, including NASA. Because of this widespread success, it seems fair to ask whether this new discipline is directly applicable to the profession of spacecraft operations. The results of quality emphasis on OAO Corporation's contract at JPL provide strong support for Total Quality Management as a useful tool in spacecraft operations.

  18. Computed tomography for preoperative planning in minimal-invasive total hip arthroplasty: Radiation exposure and cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Huppertz, Alexander, E-mail: Alexander.Huppertz@charite.de [Imaging Science Institute Charite Berlin, Robert-Koch-Platz 7, D-10115 Berlin (Germany); Department of Radiology, Medical Physics, Charite-University Hospitals of Berlin, Chariteplatz 1, D-10117 Berlin (Germany); Radmer, Sebastian, E-mail: s.radmer@immanuel.de [Department of Orthopedic Surgery and Rheumatology, Immanuel-Krankenhaus, Koenigstr. 63, D-14109, Berlin (Germany); Asbach, Patrick, E-mail: Patrick.Asbach@charite.de [Department of Radiology, Medical Physics, Charite-University Hospitals of Berlin, Chariteplatz 1, D-10117 Berlin (Germany); Juran, Ralf, E-mail: ralf.juran@charite.de [Department of Radiology, Medical Physics, Charite-University Hospitals of Berlin, Chariteplatz 1, D-10117 Berlin (Germany); Schwenke, Carsten, E-mail: carsten.schwenke@scossis.de [Biostatistician, Scossis Statistical Consulting, Zeltinger Str. 58G, D-13465 Berlin (Germany); Diederichs, Gerd, E-mail: gerd.diederichs@charite.de [Department of Radiology, Medical Physics, Charite-University Hospitals of Berlin, Chariteplatz 1, D-10117 Berlin (Germany); Hamm, Bernd, E-mail: Bernd.Hamm@charite.de [Department of Radiology, Medical Physics, Charite-University Hospitals of Berlin, Chariteplatz 1, D-10117 Berlin (Germany); Sparmann, Martin, E-mail: m.sparmann@immanuel.de [Department of Orthopedic Surgery and Rheumatology, Immanuel-Krankenhaus, Koenigstr. 63, D-14109, Berlin (Germany)

    2011-06-15

    Computed tomography (CT) was used for preoperative planning of minimal-invasive total hip arthroplasty (THA). 92 patients (50 males, 42 females, mean age 59.5 years) with a mean body-mass-index (BMI) of 26.5 kg/m{sup 2} underwent 64-slice CT to depict the pelvis, the knee and the ankle in three independent acquisitions using combined x-, y-, and z-axis tube current modulation. Arthroplasty planning was performed using 3D-Hip Plan (Symbios, Switzerland) and patient radiation dose exposure was determined. The effects of BMI, gender, and contralateral THA on the effective dose were evaluated by an analysis-of-variance. A process-cost-analysis from the hospital perspective was done. All CT examinations were of sufficient image quality for 3D-THA planning. A mean effective dose of 4.0 mSv (SD 0.9 mSv) modeled by the BMI (p < 0.0001) was calculated. The presence of a contralateral THA (9/92 patients; p = 0.15) and the difference between males and females were not significant (p = 0.08). Personnel involved were the radiologist (4 min), the surgeon (16 min), the radiographer (12 min), and administrative personnel (4 min). A CT operation time of 11 min and direct per-patient costs of 52.80 Euro were recorded. Preoperative CT for THA was associated with a slight and justifiable increase of radiation exposure in comparison to conventional radiographs and low per-patient costs.

  19. Operation and Support Costs for the Department of Defense

    National Research Council Canada - National Science Library

    Pierrot, Lane; Kornfeld, Robert; Mechanic, Robert E; Miller, Michael; Bryton, Eugene; Berger, Michael; Dombey, Bonita; Kostak, William; Lussier, Frances; Moore, David

    1988-01-01

    Operation and support (O&S) funds -- the portion of the Department of Defense (DoD) budget that pays to operate DoD's forces -- have grown an average of about 2 percent per year from 1980 to 1988 in real...

  20. An Evaluation of Intra‑ and Post‑operative Blood Loss in Total Hip ...

    African Journals Online (AJOL)

    2017-05-18

    May 18, 2017 ... Results: The mean intra‑ and post‑operative blood losses were 1222.7 ... To evaluate blood loss after total hip replacement. 2. To evaluate the .... 12.3. 4.2. 0.1. Median. 400.0. 150.0. 20.0. 3.0. Mode. 400.0. 100.0. 0.0. 3.0. SD.

  1. Variation in the cost of care for primary total knee arthroplasties

    Directory of Open Access Journals (Sweden)

    Derek A. Haas, MBA

    2017-03-01

    Conclusions: The large variation in costs among sites suggests major and multiple opportunities to transfer knowledge about process and productivity improvements that lower costs while simultaneously maintaining or improving outcomes.

  2. Operational costs induced by fluctuating wind power production in Germany and Scandinavia

    Energy Technology Data Exchange (ETDEWEB)

    Meibom, P. [Risoe National Lab., DTU, System Analysis Dept., Roskilde (Denmark); Weber, C. [Univ. Duisburg-Essen, Chai og Energy Management (Germany); Barth, R.; Brand, H. [Univ. of Stuttgart, Inst. of Energy Economics and the Rational Use of Energy (Germany)

    2007-05-15

    Adding wind power generation in a power system changes the operational patterns of the existing units due to the variability and unpredictability of wind power production. For large amounts of wind power production the expectation is that the operational costs of the other power plants will increase due to more operation time in part-load and more start-ups. The change in operational costs induced by the wind power production can only be calculated by comparing the operational costs in two power system configurations: with wind power production and with alternative production having properties like conventional production, i.e. being predictable and less variable. The choice of the characteristics of the alternative production is not straight forward and will therefore influence the operational costs induced by wind power production. This paper presents a method for calculating the change in operational costs due to wind power production using a stochastic optimization model covering the power systems in Germany and the Nordic countries. Two cases of alternative production are used to calculate the change in operational costs namely perfectly predictable wind power production enabling calculation of the costs connected to unpredictability, and constant wind power production enabling calculation of the operational costs connected to variability of wind power production. A 2010 case with three different wind power production penetration levels is analysed in the paper. (au)

  3. Skilled Nursing Facility Partnerships May Decrease 90-Day Costs in a Total Joint Arthroplasty Episode Under the Bundled Payments for Care Improvement Initiative.

    Science.gov (United States)

    Behery, Omar A; Kouk, Shalen; Chen, Kevin K; Mullaly, Kathleen A; Bosco, Joseph A; Slover, James D; Iorio, Richard; Schwarzkopf, Ran

    2018-03-01

    The Bundled Payments for Care Improvement initiative was developed to reduce costs associated with total joint arthroplasty through a single payment for all patient care from index admission through a 90-day post-discharge period, including care at skilled nursing facilities (SNFs). The aim of this study is to investigate whether forming partnerships between hospitals and SNFs could lower the post-discharge costs. We hypothesize that institutionally aligned SNFs have lower post-discharge costs than non-aligned SNFs. A cohort of 615 elective, primary total hip and knee arthroplasty subjects discharged to an SNF under the Bundled Payments for Care Improvement from 2014 to 2016 were included in our analysis. Patients were grouped into one of the 3 categories of SNF alignment: group 1: non-partners; group 2: agreement-based partners; group 3: institution-owned partners. Demographics, comorbidities, length of stay (LOS) at SNF, and associated costs during the 90-day post-operative period were compared between the 3 groups. Mean index hospital LOS was statistically shortest in group 3 (mean 2.7 days vs 3.5 for groups 1 and 2, P = .001). SNF LOS was also shortest in group 3 (mean 11 days vs 19 and 21 days in groups 2 and 1 respectively, P Total SNF costs and total 90-day costs were both significantly lower in group 3 compared with groups 1 and 2 (P total 90-day costs, without increased risk of readmissions, compared with other SNFs. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Intra-operative monitoring of the common peroneal nerve during total knee replacement.

    Science.gov (United States)

    Unwin, A J; Thomas, M

    1994-01-01

    We present a method allowing intra-operative monitoring of the common peroneal nerve during total knee arthroplasty using a magnetic stimulator. Previous reports have shown no pre-operative method successful in selecting those patients prone to develop a post-operative palsy. The device, placed beneath the lumbar spine, stimulates the cauda equina; common peroneal nerve function is assessed via the response in extensor digitorum brevis. There is a loss of signal from the nerve with the use of a tourniquet 25 min following its application. The protocol therefore requires that a tourniquet is used at least only for fixation of the prosthetic components. The method is quick, safe, non-invasive and reproducible, and is of use both in at-risk patients and in research work. Images Figure 6. PMID:7837197

  5. Using Excel's Matrix Operations to Facilitate Reciprocal Cost Allocations

    Science.gov (United States)

    Leese, Wallace R.; Kizirian, Tim

    2009-01-01

    The reciprocal method of service department cost allocation requires linear equations to be solved simultaneously. These computations are often so complex as to cause the abandonment of the reciprocal method in favor of the less sophisticated direct or step-down methods. Here is a short example demonstrating how Excel's sometimes unknown matrix…

  6. Efforts to Support Consumer Enrollment Decisions Using Total Cost Estimators: Lessons from the Affordable Care Act’s Marketplaces.

    Science.gov (United States)

    Giovannelli, Justin; Curran, Emily

    2017-02-01

    Issue: Policymakers have sought to improve the shopping experience on the Affordable Care Act’s marketplaces by offering decision support tools that help consumers better understand and compare their health plan options. Cost estimators are one such tool. They are designed to provide consumers a personalized estimate of the total cost--premium, minus subsidy, plus cost-sharing--of their coverage options. Cost estimators were available in most states by the start of the fourth open enrollment period. Goal: To understand the experiences of marketplaces that offer a total cost estimator and the interests and concerns of policymakers from states that are not using them. Methods: Structured interviews with marketplace officials, consumer enrollment assisters, technology vendors, and subject matter experts; analysis of the total cost estimators available on the marketplaces as of October 2016. Key findings and conclusions: Informants strongly supported marketplace adoption of a total cost estimator. Marketplaces that offer an estimator faced a range of design choices and varied significantly in their approaches to resolving them. Interviews suggested a clear need for additional consumer testing and data analysis of tool usage and for sustained outreach to enrollment assisters to encourage greater use of the estimators.

  7. Infrastructure expenditures and costs. Practical guidelines to calculate total infrastructure costs for five modes of transport. Final report

    International Nuclear Information System (INIS)

    2005-11-01

    Transport infrastructures in general, and the Trans European Transport Network (TEN-T) in particular, play an important role in achieving the medium and long-term objectives of the European Union. In view of this, the Commission has recently adopted a revision of the guidelines for the TEN-T. The main consequences of this revision are the need for a better understanding of the investments made by the member states in the TEN-T and the need for ensuring optimal consistency in the reporting by the Members States of such investments. With Regulation number 1108/70 the Council of the European Communities introduced an accounting system for expenditure on infrastructure in respect of transport by rail, road and inland waterways. The purpose of this regulation is to introduce a standard and permanent accounting system for infrastructure expenditures. However maritime and aviation infrastructure were not included. Further, the need for an effective and easy to apply classification for infrastructure investments concerning all five transport modes was still pending. Therefore, DG TREN has commissioned ECORYS Transport and CE Delft to study the expenditures and costs of infrastructure, to propose an adequate classification of expenditures, and to propose a method for translating data on expenditures into data on costs. The objectives of the present study are threefold: To set out a classification of infrastructure expenditures, in order to increase knowledge of expenditures related to transport infrastructures. This classification should support a better understanding of fixed and variable infrastructure costs; To detail the various components of such expenditures for five modes of transportation, which would enable the monitoring of infrastructure expenditures and costs; and to set up a methodology to move from annual series of expenditures to costs, including fixed and variable elements.

  8. 16 CFR 305.5 - Determinations of estimated annual energy consumption, estimated annual operating cost, and...

    Science.gov (United States)

    2010-01-01

    ... consumption, estimated annual operating cost, and energy efficiency rating, and of water use rate. 305.5... RULE CONCERNING DISCLOSURES REGARDING ENERGY CONSUMPTION AND WATER USE OF CERTAIN HOME APPLIANCES AND... § 305.5 Determinations of estimated annual energy consumption, estimated annual operating cost, and...

  9. 42 CFR 412.62 - Federal rates for inpatient operating costs for fiscal year 1984.

    Science.gov (United States)

    2010-10-01

    ... determines national adjusted DRG prospective payment rates for operating costs, for each inpatient hospital... DRG prospective payment rates for inpatient operating costs for such discharges in each region, for... classifications. (1) For purposes of paragraph (e) of this section, the following definitions apply: (i) The term...

  10. 43 CFR 426.23 - Recovery of operation and maintenance (O&M) costs.

    Science.gov (United States)

    2010-10-01

    ... operation and maintenance (O&M) costs. (a) General. All new, amended, and renewed contracts shall provide... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Recovery of operation and maintenance (O&M) costs. 426.23 Section 426.23 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF...

  11. Multiple-factor analysis of the net cost of drilling operations

    Energy Technology Data Exchange (ETDEWEB)

    Karnaushevskaya, Zh I; Kukhtevich, L I; Lisovskaya, G F; Maguryak, N S; Nasinnik, Z A

    1979-01-01

    Basic factors in the rise in net cost of drilling operations are examined in the association ''Ukrneft''. A mathematical model of their net cost is constructed which takes into consideration the given factors. A number of measures are suggested and their specific influence on the decrease in net cost of well construction is defined.

  12. Operating cost guidelines for benchmarking DOE thermal treatment systems for low-level mixed waste

    International Nuclear Information System (INIS)

    Salmon, R.; Loghry, S.L.; Hermes, W.H.

    1994-11-01

    This report presents guidelines for estimating operating costs for use in benchmarking US Department of Energy (DOE) low-level mixed waste thermal treatment systems. The guidelines are based on operating cost experience at the DOE Toxic Substances Control Act (TSCA) mixed waste incinerator at the K-25 Site at Oak Ridge. In presenting these guidelines, it should be made clear at the outset that it is not the intention of this report to present operating cost estimates for new technologies, but only guidelines for estimating such costs

  13. Learning the ABCs: Activity based costing in waste operations

    International Nuclear Information System (INIS)

    Zocher, Marc A.

    1992-01-01

    The United States Department of Energy (DOE) is facing a challenging new national role based on current world events, changing public perception and awareness, and a legacy of wastes generated in the past. Clearly, the DOE must put mechanisms in place to comply with environmental rules, regulations, and good management practices so that public health risk is minimized while programmatic costs are controlled. DOE has begun this process and has developed a Five-Year Plan to describe the activities necessary to comply with both cleanup, or environmental restoration, and waste management of existing waste streams. The focus of this paper is how to best manage the treatment, storage, disposal, and transportation of waste throughout the DOE weapons complex by using Activity Based Costing (ABC) to both plan and control expenditures in DOE Waste Management (WM). The basics of ABC, along with an example, will be detailed. (author)

  14. Development of a Low Cost MQL Setup for Turning Operations

    OpenAIRE

    Islam Sumaiya; Khandoker Noman; Izham Mohamad; Azizi Tengku; Debnath Sujan

    2017-01-01

    In this study, the effect of MQL application on the tool wear, surface roughness and chip formation in turning Aluminum alloy 6061 is investigated. Experiments were carried out by plain turning of an Aluminum bar with varying depth of cut, cutting speeds (spindle speed) and cutting environments (Dry, Wet and MQL). A newly designed, cost efficient and portable MQL setup was developed for this study. For each experimental trial, five passes were carried out in order to promote the formation of ...

  15. Risk and Cost of 90-Day Complications in Morbidly and Superobese Patients After Total Knee Arthroplasty.

    Science.gov (United States)

    Meller, Menachem M; Toossi, Nader; Johanson, Norman A; Gonzalez, Mark H; Son, Min-Sun; Lau, Edmund C

    2016-10-01

    This study investigated the risk and cost of postoperative complications associated with morbid and super obesity after total knee arthroplasty (TKA). A retrospective cohort study was conducted of patients who underwent TKA using Medicare hospital claims data. The International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code V85.4x was used to identify morbidly obese patients (body mass index [BMI] ≥40 kg/m(2)) and superobese patients (BMI ≥50 kg/m(2)) in 2011-2013. Patients without any BMI-related diagnosis codes were used as controls. Twelve complications occurred in the 90-day period after TKA were analyzed using multivariate Cox models, adjusting for patient demographic, morbidity, and institutional factors. In addition, hospital charges and payments were compared from primary surgery through subsequent 90 days. Morbidly obese patients showed a significantly elevated risk in most complications examined, with a 2-fold or higher risk in dislocation and wound dehiscence. In addition, death, periprosthetic joint infection, acute renal failure, and knee revision had significant hazard ratios between 1.5 and 2.0. However, risk of deep vein thrombosis and acute myocardial infarction did not increase for the morbidly obese patients. Superobese patients had significant increase in risk of infection, wound dehiscence, acute renal failures, revisions, death, and readmission compared with patients with BMI 40-49 kg/m(2). Significant dose-response trend was found between the level of BMI and risk for death, dislocation, implant failure, infection, readmission, revision, wound dehiscence, and acute renal failure. Controlling for patient and institutional factors, each TKA had an average total hospital charges of $75,884 among superobese patients, compared to $65,118 for the control group, a difference of $10,767. Medicare payment for the superobese patients was also higher, but only by $2703. Morbidly obese patients pose a significantly

  16. Assessing the Total cost of ownership of ERP systems : Case study analysis on the factors behind customer costs in recent minor implementations

    OpenAIRE

    Rydgård, Göran; Palmberg, Nils

    2010-01-01

    This master’s thesis presents a model for calculating the total cost of ownership (TCO) of relatively small ERP implementations, including two years of running the system. The main factors affecting the cost items in the model are also analyzed, based in part on four case projects that the consultancy company Acando has carried out recently and in part on literature. The case projects were investigated through interviews with key actors in the projects from Acando and the customer, and throug...

  17. A life cycle cost economics model for automation projects with uniformly varying operating costs. [applied to Deep Space Network and Air Force Systems Command

    Science.gov (United States)

    Remer, D. S.

    1977-01-01

    The described mathematical model calculates life-cycle costs for projects with operating costs increasing or decreasing linearly with time. The cost factors involved in the life-cycle cost are considered, and the errors resulting from the assumption of constant rather than uniformly varying operating costs are examined. Parameters in the study range from 2 to 30 years, for project life; 0 to 15% per year, for interest rate; and 5 to 90% of the initial operating cost, for the operating cost gradient. A numerical example is presented.

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

    Science.gov (United States)

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

    2016-08-01

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

  19. Reduce operational cost and extend the life of pipeline infrastructure by automating remote cathodic protection systems

    Energy Technology Data Exchange (ETDEWEB)

    Rosado, Elroy [Freewave Technologies, Inc., Boulder, CO (United States). Latin America

    2009-07-01

    Energy and Pipeline Companies wrestle to control operating costs largely affected by new government regulations, ageing buried metal assets, rising steel prices, expanding pipeline operations, new interference points, HCA encroachment, restrictive land use policies, heightened network security, and an ageing soon-to-retire work force. With operating costs on the rise, seemingly out of control, many CP and Operations Professionals look to past best practices in cost containment through automation. Many companies achieve solid business results through deployment of telemetry and SCADA automation of remote assets and now hope to expand this success to further optimize operations by automating remote cathodic protection systems. This presentation will provide examples of how new remote cathodic protection systems are helping energy and pipeline companies address the growing issue of the aging pipeline infrastructure and reduce their costs while optimizing their operations. (author)

  20. Advanced solar concentrator mass production, operation, and maintenance cost assessment

    Science.gov (United States)

    Niemeyer, W. A.; Bedard, R. J.; Bell, D. M.

    1981-01-01

    The object of this assessment was to estimate the costs of the preliminary design at: production rates of 100 to 1,000,000 concentrators per year; concentrators per aperture diameters of 5, 10, 11, and 15 meters; and various receiver/power conversion package weights. The design of the cellular glass substrate Advanced Solar Concentrator is presented. The concentrator is an 11 meter diameter, two axis tracking, parabolic dish solar concentrator. The reflective surface of this design consists of inner and outer groups of mirror glass/cellular glass gores.

  1. Critical operations capabilities in a high cost environment: a multiple case study

    Science.gov (United States)

    Sansone, C.; Hilletofth, P.; Eriksson, D.

    2018-04-01

    Operations capabilities have been a popular research area for many years and several frameworks have been proposed in the literature. The current frameworks do not take specific contexts into consideration, for instance a high cost environment. This research gap is of particular interest since a manufacturing relocation process has been ongoing the last decades, leading to a huge amount of manufacturing being moved from high to low cost environments. The purpose of this study is to identify critical operations capabilities in a high cost environment. The two research questions were: What are the critical operations capabilities dimensions in a high cost environment? What are the critical operations capabilities in a high cost environment? A multiple case study was conducted and three Swedish manufacturing firms were selected. The study was based on the investigation of an existing framework of operations capabilities. The main dimensions of operations capabilities included in the framework were: cost, quality, delivery, flexibility, service, innovation and environment. Each of the dimensions included two or more operations capabilities. The findings confirmed the validity of the framework and its usefulness in a high cost environment and a new operations capability was revealed (employee flexibility).

  2. Intra-operative reliability of ShapeMatch cutting guide placement in total knee arthroplasty.

    Science.gov (United States)

    Clark, Gavin; Leong, Anthony; McEwen, Peter; Steele, Robert; Tran, Ton; Trivett, Adrian

    2013-01-01

    Custom cutting guides based on pre-operative imaging have been introduced for total knee arthroplasty (TKA). The aim of this prospective cohort study was to assess the reliability of repeated placement of custom cutting guides by multiple surgeons in a group of patients undergoing TKA. Custom cutting guides (ShapeMatch®, Stryker Orthopaedics) were designed from pre-operative MRI scans. The treating surgeon placed each guide on the femur and tibia of each patient three times without pinning the block. The three-dimensional position and orientation of the guide was measured for each repetition using a computer navigation system. The surgeon was blinded to the navigation system display. Data from 24 patients and 6 surgeons were analyzed. Intraclass correlation coefficients for all measurement parameters were in the range 0.889-0.997 (excellent), and all comparisons were statistically significant (p reliable.

  3. The true costs of participatory sanitation: Evidence from community-led total sanitation studies in Ghana and Ethiopia.

    Science.gov (United States)

    Crocker, Jonny; Saywell, Darren; Shields, Katherine F; Kolsky, Pete; Bartram, Jamie

    2017-12-01

    Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behavior-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34-$81.56 per household targeted in Ghana, and $14.15-$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93-$22.36 per household targeted in Ghana, and $2.35-$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behavior-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behavior-change programs. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Is the system really the solution? Operating costs in hospital systems.

    Science.gov (United States)

    Burns, Lawton Robert; McCullough, Jeffrey S; Wholey, Douglas R; Kruse, Gregory; Kralovec, Peter; Muller, Ralph

    2015-06-01

    Hospital system formation has recently accelerated. Executives emphasize scale economies that lower operating costs, a claim unsupported in academic research. Do systems achieve lower costs than freestanding facilities, and, if so, which system types? We test hypotheses about the relationship of cost with membership in systems, larger systems, and centralized and local hub-and-spoke systems. We also test whether these relationships have changed over time. Examining 4,000 U.S. hospitals during 1998 to 2010, we find no evidence that system members exhibit lower costs. However, members of smaller systems are lower cost than larger systems, and hospitals in centralized systems are lower cost than everyone else. There is no evidence that the system's spatial configuration is associated with cost, although national system hospitals exhibit higher costs. Finally, these results hold over time. We conclude that while systems in general may not be the solution to lower costs, some types of systems are. © The Author(s) 2015.

  5. Cost optimization of long-cycle LWR operation

    International Nuclear Information System (INIS)

    Handwerk, C.S.; Driscoll, M.J.; McMahon, M.V.; Todreas, N.E.

    1997-01-01

    The continuing emphasis on improvement of plant capacity factor, as a major means to make nuclear energy more cost competitive in the current deregulatory environment, motivates heightened interest in long intra-refueling intervals and high burnup in LWR units. This study examines the economic implications of these trends, to determine the envelope of profitable fuel management tactics. One batch management is found to be significantly more expensive than two-batch management. Parametric studies were carried out varying the most important input parameters. If ultra-high burnup can be achieved, then n = 3 or even n = 4 management may be preferable. For n = 1 or 2, economic performance declines at higher burnups, hence providing no great incentive for moving further in that direction. Values for n > 2 are also attractive because, for a given burnup target, required enrichment decreases as n increases. This study was limited to average batch burnups below 60,000 MWd/MT

  6. Reduction of operations and maintenance costs at geothermal power plants

    Energy Technology Data Exchange (ETDEWEB)

    Bruton, C.J.; Stevens, C.G.; Rard, J.A.; Kasameyer, P.W. [Lawrence Livermore National Lab., CA (United States)

    1997-12-31

    To reduce chemical costs at geothermal power plants, we are investigating: (a) improved chemical processes associated with H{sub 2}S abatement techniques, and (b) the use of cross dispersive infrared spectrometry to monitor accurately, reliably, and continuously H{sub 2}S emissions from cooling towers. The latter is a new type of infrared optical technology developed by LLNL for non-proliferation verification. Initial work is focused at The Geysers in cooperation with Pacific Gas and Electric. Methods for deploying the spectrometer on-site at The Geysers are being developed. Chemical analysis of solutions involved in H{sub 2}S abatement technologies is continuing to isolate the chemical forms of sulfur produced.

  7. Logistics: An integral part of cost efficient space operations

    Science.gov (United States)

    Montgomery, Ann D.

    1996-01-01

    The logistics of space programs and its history within NASA are discussed, with emphasis on manned space flight and the Space Shuttle program. The lessons learned and the experience gained during these programs are reported on. Key elements of logistics are highlighted, and the problems and issues that can be expected to arise in relation to the support of long-term space operations and future space programs, are discussed. Such missions include the International Space Station program and the reusable launch vehicle. Possible solutions to the problems identified are outlined.

  8. Operating and support costs and affordability of a 324 ship Naval battle force

    OpenAIRE

    Antonucci, Kevin C.

    2011-01-01

    The purpose of this research was to determine both the added operating and support (OandS) costs and affordability of operating and maintaining a future naval battle force of 324 ships as proposed in the Navy's 30-year shipbuilding plan. Cost estimation including regression, 3-year moving averages, point, expert and analogous modeling was used to capture both historical and future OandS costs from FY1991 to FY2024. With an emphasis on the three main cost drivers, (manpower, fuel and maintena...

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

    Science.gov (United States)

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

    2013-10-01

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

  10. 41 CFR 102-33.190 - What are the aircraft operations and ownership costs for which we must account?

    Science.gov (United States)

    2010-07-01

    ... operations and ownership costs for which we must account? 102-33.190 Section 102-33.190 Public Contracts and... Parts Accounting for the Cost of Government Aircraft § 102-33.190 What are the aircraft operations and ownership costs for which we must account? You must account for the operations and ownership costs of your...

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

    Science.gov (United States)

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

    2016-09-01

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

  12. Federal Regulations: Efforts to Estimate Total Costs and Benefits of Rules

    Science.gov (United States)

    2004-04-07

    the Chamber of Commerce , academicians, the media, and others, and is sometimes cited with a high degree of certainty ." For example, some articles...House of Representatives, Feb . 25,2004; and testimony of William P . Kovacs, Vice President, U .S. Chamber of Commerce , before the Subcommittee on Energy...estimated the annual cost to employers of the Family and Medical Leave Act at $825 million, but that the Chamber of Commerce estimated the cost at between $3

  13. Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty.

    Science.gov (United States)

    Hambright, D; Hellman, M; Barrack, R

    2018-01-01

    The aims of this study were to examine the rate at which the positioning of the acetabular component, leg length discrepancy and femoral offset are outside an acceptable range in total hip arthroplasties (THAs) which either do or do not involve the use of intra-operative digital imaging. A retrospective case-control study was undertaken with 50 patients before and 50 patients after the integration of an intra-operative digital imaging system in THA. The demographics of the two groups were comparable for body mass index, age, laterality and the indication for surgery. The digital imaging group had more men than the group without. Surgical data and radiographic parameters, including the inclination and anteversion of the acetabular component, leg length discrepancy, and the difference in femoral offset compared with the contralateral hip were collected and compared, as well as the incidence of altering the position of a component based on the intra-operative image. Digital imaging took a mean of five minutes (2.3 to 14.6) to perform. Intra-operative changes with the use of digital imaging were made for 43 patients (86%), most commonly to adjust leg length and femoral offset. There was a decrease in the incidence of outliers when using intra-operative imaging compared with not using it in regard to leg length discrepancy (20% versus 52%, p = 0.001) and femoral offset inequality (18% versus 44%, p = 0.004). There was also a difference in the incidence of outliers in acetabular inclination (0% versus 7%, p = 0.023) and version (0% versus 4%, p = 0.114) compared with historical results of a high-volume surgeon at the same centre. The use of intra-operative digital imaging in THA improves the accuracy of the positioning of the components at THA without adding a substantial amount of time to the operation. Cite this article: Bone Joint J 2018;100B(1 Supple A):36-43. ©2018 The British Editorial Society of Bone & Joint Surgery.

  14. Cost and Operational Effectiveness Analysis of Aiternative Force Structures for Fulfillment of the United States Marine Corps Operational Support Airlift and Search and Rescue Missions

    National Research Council Canada - National Science Library

    Chase, Eric

    2000-01-01

    This thesis provides a preliminary cost and operational effectiveness analysis of alternative force structures for the United States Marine Corps operational support airlift and search and rescue missions...

  15. SYNERGISTIC EFFECTS OF TOTAL QUALITY MANAGEMENT AND OPERATIONAL RISK MANAGEMENT IN CENTRAL BANKS

    Directory of Open Access Journals (Sweden)

    Radoica Luburić

    2012-12-01

    Full Text Available This paper focuses on two very important and current approaches to management: Total Quality Management (TQM and Operational Risk Management (ORM. As a paradigm of business success, TQM provides the key assumptions for survival, development and success of an organisation, regardless of any limitations whatsoever. ORM, on the other hand, is predetermined to be an irreplaceable managerial tool that enables organisations to survive in any environment. In times of accelerated political, economic and technological changes, frequent natural disasters, acts of terrorism and other external events, a successful risk management has been gaining importance and becomes one of the key competitive advantages of an organisation. The ultimate objective is to make TQM and ORM, as two rather compatible and complementary approaches to risk management, harmonized, efficient and functional in order to get their synergistic effects in an organisation in full swing and practice. Various organisations, and thus central banks as conservative institutions, have an innovative opportunity to timely minimize their operational risk through preventive, comprehensive and synergistic operation of TQM and ORM and thus significantly contribute to improving their business performance.

  16. Development of a Low Cost MQL Setup for Turning Operations

    Directory of Open Access Journals (Sweden)

    Islam Sumaiya

    2017-01-01

    Full Text Available In this study, the effect of MQL application on the tool wear, surface roughness and chip formation in turning Aluminum alloy 6061 is investigated. Experiments were carried out by plain turning of an Aluminum bar with varying depth of cut, cutting speeds (spindle speed and cutting environments (Dry, Wet and MQL. A newly designed, cost efficient and portable MQL setup was developed for this study. For each experimental trial, five passes were carried out in order to promote the formation of tool wear. After each pass, the tool surface was examined under a microscope and the surface roughness was measured using a stylus based surface tester. The extent of tool wear from each pass is measured by using ImageJ software. Chips were collected after the five passes and were physically examined. The newly designed MQL delivery system was successful in delivering a fine mist of lubricant at the cutting point. MQL lubrication provided lower surface roughness and tool wear values compared to wet and dry conditions due to effective temperature reduction and improved lubrication penetration of cutting zones, as well as better chip flushing. Chip formed under MQL conditions had reduced chip thickness due to reduced temperatures. MQL was found to have the greatest positive impact on tool wear and surface roughness parameters based on ANOVA results.

  17. An Analysis of Operational Total Lightning Data During Long-Track Tornadoes

    Science.gov (United States)

    Carcione, Brian C.; Stano, Geoffrey T.

    2012-01-01

    The 27 April 2011 tornado outbreak brought three distinct waves of tornadic thunderstorms to portions of Mississippi, Alabama, Tennessee, and Georgia, striking the Tennessee Valley of north Alabama and southern Tennessee particularly hard. A total of 42 tornado paths were surveyed across the fourteen county area covered by the National Weather Service (NWS) forecast office in Huntsville, Alabama. Ten of these tornadoes were on the ground for at least 20 miles, two had total path lengths over 130 miles, and six tornadoes were classified as violent (EF-4 or EF-5 on the Enhanced Fujita Scale). Many of these tornadoes occurred within the domain of the North Alabama Lightning Mapping Array (NALMA), a ground-based total lightning detection network owned and operated by the NASA Marshall Space Flight Center. Since 2003, the NASA Short-term Prediction Research and Transition Center has supplied data from NALMA in real time to NWS forecast offices in Huntsville, Knoxville/Tri-Cities, Birmingham, and Nashville. Previous research has documented the utility of total lightning information in predicting tornadogenesis, particularly when combined with other remote sensing tools. Basic warning decision-making during events such as 27 April is not the most difficult part of the process; instead, the focus of warning meteorologists shifts to looking for changes in intensity or possible particularly dangerous situations, since doppler radar velocity data often cannot distinguish between weak and strong tornadoes. To that end, this research attempts to determine if any correlation exists between flash densities of the longest-tracked tornadoes over time, and the surveyed wind speeds of the tornadoes. The long-track EF-5 tornado which struck the Hackleburg, Phil Campbell, and Tanner communities in north Alabama was the primary focus of this research due to its intensity and extended life cycle. However, not all tornadoes were available for total lightning analysis due to widespread

  18. Space platforms - A cost effective evolution of Spacelab operation

    Science.gov (United States)

    Stofan, A. J.

    1981-01-01

    The capabilities added to the Shuttle/Spacelab configuration by the addition of the Power Extension Package (PEP), the Power System (PS), and the Science and Applications Space Platforms (SASP) are reviewed with an emphasis on SASP. SASP are intended for placement in orbit by the Shuttle to test new instruments and systems, for clustering of instrumentation, and for servicing, refurbishment, repair, or augmentation by the Shuttle. The PEP permits extended stays in orbit (30 days), and the PS is an orbital solar array and energy storage system acting as a free flying spacecraft. The Shuttle can deliver payloads to the PS or attach to it for extension of the Spacelab operations. Applications of SASP for long term space-based biological experiments are outlined, and the fact that SASP do not increase the required Shuttle in-orbit time is stressed.

  19. Trends in workers compensation costs in a hotel-operating company over a six-year period.

    Science.gov (United States)

    Kelley, C R; Mark, C R

    1995-03-01

    A large Honolulu-based hotel-operating company reviewed its workers compensation costs over the last 6 years. Data retrieved from the company's computerized data base is used to describe trends in injury incidence rate, average cost per claim, average medical cost per claim, and medical expenses as a percentage of total costs. Factors that might have influenced these parameters include company reorganization, employee training and safety programs, changes in the economy, company morale, aggressive case management, and the quality of the adjusting services hired. Cause-and-effect relationships, although suggested, cannot be proven. The data is presented, in this year of imminent workers compensation legislative reform, to increase the available factual data base on which rational and efficacious reform proposals can be developed.

  20. Self-reported Function, Health Resource Use, and Total Health Care Costs Among Medicare Beneficiaries With Glaucoma.

    Science.gov (United States)

    Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; Blumberg, Dana M

    2016-04-01

    The effect of glaucoma on nonglaucomatous medical conditions and resultant secondary health care costs is not well understood. To assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma. Longitudinal observational study of 72,587 Medicare beneficiaries in the general community using the Medicare Current Beneficiary Survey (2004-2009). Coding to extract data started in January 2015, and analyses were performed between May and July 2015. Self-reported health, the use of health care services, adjusted mean annual total health care costs per person, and adjusted mean annual nonoutpatient costs per person. Participants were 72,587 Medicare beneficiaries 65 years or older with (n = 4441) and without (n = 68,146) a glaucoma diagnosis in the year before collection of survey data. Their mean age was 76.9 years, and 43.2% were male. Patients with glaucoma who responded to survey questions on visual disability were stratified into those with (n = 1748) and without (n = 2639) self-reported visual disability. Medicare beneficiaries with glaucoma had higher adjusted odds of inpatient hospitalizations (odds ratio [OR], 1.27; 95% CI, 1.17-1.39; P total health care costs and $2599 (95% CI, $1985-$3212; P total and nonoutpatient medical costs. Perception of vision loss among patients with glaucoma may be associated with depression, falls, and difficulty walking. Reducing the prevalence and severity of glaucoma may result in improvements in associated nonglaucomatous medical conditions and resultant reduction in health care costs.

  1. Application of Activity-Based Costing Management System by Key Success Paths to Promote the Competitive Advantages and Operation Performance

    OpenAIRE

    Mei-Fang Wu; Shu-Li Wang; Feng-Tsung Cheng

    2015-01-01

    Highly developed technology and highly competitive global market highlight the important role of competitive advantages and operation performances in sustainable company operation. Activity-Based Costing (ABC) provides accurate operation cost and operation performance information. Rich literatures provide relevant research with cases study on Activity-Based Costing application, but the research on cause relationship between key success factors and its specific outcome, su...

  2. U.S. Nuclear Power Plant Operating Cost and Experience Summaries

    International Nuclear Information System (INIS)

    Reid, RL

    2003-01-01

    The ''U.S. Nuclear Power Plant Operating Cost and Experience Summaries'' (NUREG/CR-6577, Supp. 2) report has been prepared to provide historical operating cost and experience information on U.S. commercial nuclear power plants during 2000-2001. Costs incurred after initial construction are characterized as annual production costs, which represent fuel and plant operating and maintenance expenses, and capital expenditures related to facility additions/modifications, which are included in the plant capital asset base. As discussed in the report, annual data for these two cost categories were obtained from publicly available reports and must be accepted as having different degrees of accuracy and completeness. Treatment of inconclusive and incomplete data is discussed. As an aid to understanding the fluctuations in the cost histories, operations summaries for each nuclear unit are provided. The intent of these summaries is to identify important operating events; refueling, major maintenance, and other significant outages; operating milestones; and significant licensing or enforcement actions. Information used in the summaries is condensed from operating reports submitted by the licensees, the Nuclear Regulatory Commission (NRC) database for enforcement actions, and outage reports

  3. 47 CFR 36.621 - Study area total unseparated loop cost.

    Science.gov (United States)

    2010-10-01

    ... deducting the accumulated depreciation and noncurrent deferred Federal income taxes attributable to C&WF... by the study area's authorized interstate rate of return. (2) Depreciation expense attributable to C... reported in § 36.611(d). (4) Corporate Operations Expenses, Operating Taxes and the benefits and rent...

  4. An Optimal Operating Strategy for Battery Life Cycle Costs in Electric Vehicles

    Directory of Open Access Journals (Sweden)

    Yinghua Han

    2014-01-01

    Full Text Available Impact on petroleum based vehicles on the environment, cost, and availability of fuel has led to an increased interest in electric vehicle as a means of transportation. Battery is a major component in an electric vehicle. Economic viability of these vehicles depends on the availability of cost-effective batteries. This paper presents a generalized formulation for determining the optimal operating strategy and cost optimization for battery. Assume that the deterioration of the battery is stochastic. Under the assumptions, the proposed operating strategy for battery is formulated as a nonlinear optimization problem considering reliability and failure number. And an explicit expression of the average cost rate is derived for battery lifetime. Results show that the proposed operating strategy enhances the availability and reliability at a low cost.

  5. On-line determination of operating limits incorporating constraint costs and reliability assessment

    International Nuclear Information System (INIS)

    Meisingset, M.; Lovas, G. G.

    1997-01-01

    Problems regarding power system operation following deregulation were discussed. The problems arise as a result of the increased power flow pattern created by deregulation and competitive power markets, resulting in power in excess of N-1, (the capacity of transmission lines available), which in turn creates bottlenecks. In a situation like this, constraint costs and security costs (i.e. the cost of supply interruptions) are incurred as the direct result of the deterministic criteria used in reliability assessment. This paper describes an on-line probabilistic method to determine operating limits based on a trade-off between constraint costs and security costs. The probability of the contingencies depend on the existing weather conditions, which therefore has significant impact on the calculated operating limit. In consequence, the proposed method allows power flow to exceed the N-1 limit during normal weather. Under adverse weather conditions the N-1 criteria should be maintained. 15 refs., 13 figs

  6. Incidence, risk factors and the healthcare cost of falls postdischarge after elective total hip and total knee replacement surgery: protocol for a prospective observational cohort study

    Science.gov (United States)

    Hill, Anne-Marie; Ross-Adjie, Gail; McPhail, Steven M; Monterosso, Leanne; Bulsara, Max; Etherton-Beer, Christopher; Powell, Sarah-Jayne; Hardisty, Gerard

    2016-01-01

    Introduction The number of major joint replacement procedures continues to increase in Australia. The primary aim of this study is to determine the incidence of falls in the first 12 months after discharge from hospital in a cohort of older patients who undergo elective total hip or total knee replacement. Methods and analyses A prospective longitudinal observational cohort study starting in July 2015, enrolling patients aged ≥60 years who are admitted for elective major joint replacement (n=267 total hip replacement, n=267 total knee replacement) and are to be discharged to the community. Participants are followed up for 12 months after hospital discharge. The primary outcome measure is the rate of falls per thousand patient-days. Falls data will be collected by 2 methods: issuing a falls diary to each participant and telephoning participants monthly after discharge. Secondary outcomes include the rate of injurious falls and health-related quality of life. Patient-rated outcomes will be measured using the Oxford Hip or Oxford Knee score. Generalised linear mixed modelling will be used to examine the falls outcomes in the 12 months after discharge and to examine patient and clinical characteristics predictive of falls. An economic evaluation will be conducted to describe the nature of healthcare costs in the first 12 months after elective joint replacement and estimate costs directly attributable to fall events. Ethics and dissemination The results will be disseminated through local site networks and will inform future services to support older people undergoing hip or knee joint replacement and also through peer-reviewed publications and medical conferences. This study has been approved by The University of Notre Dame Australia and local hospital human research ethics committees. Trial registration number ACTRN12615000653561; Pre-results. PMID:27412102

  7. Quantifying the total cost of infrastructure to enable environmentally preferable decisions: the case of urban roadway design

    International Nuclear Information System (INIS)

    Gosse, Conrad A; Clarens, Andres F

    2013-01-01

    Efforts to reduce the environmental impacts of transportation infrastructure have generally overlooked many of the efficiencies that can be obtained by considering the relevant engineering and economic aspects as a system. Here, we present a framework for quantifying the burdens of ground transportation in urban settings that incorporates travel time, vehicle fuel and pavement maintenance costs. A Pareto set of bi-directional lane configurations for two-lane roadways yields non-dominated combinations of lane width, bicycle lanes and curb parking. Probabilistic analysis and microsimulation both show dramatic mobility reductions on road segments of insufficient width for heavy vehicles to pass bicycles without encroaching on oncoming traffic. This delay is positively correlated with uphill grades and increasing traffic volumes and inversely proportional to total pavement width. The response is nonlinear with grade and yields mixed uphill/downhill optimal lane configurations. Increasing bicycle mode share is negatively correlated with total costs and emissions for lane configurations allowing motor vehicles to safely pass bicycles, while the opposite is true for configurations that fail to facilitate passing. Spatial impacts on mobility also dictate that curb parking exhibits significant spatial opportunity costs related to the total cost Pareto curve. The proposed framework provides a means to evaluate relatively inexpensive lane reconfiguration options in response to changing modal share and priorities. These results provide quantitative evidence that efforts to reallocate limited pavement space to bicycles, like those being adopted in several US cities, could appreciably reduce costs for all users. (letter)

  8. Quantifying the total cost of infrastructure to enable environmentally preferable decisions: the case of urban roadway design

    Science.gov (United States)

    Gosse, Conrad A.; Clarens, Andres F.

    2013-03-01

    Efforts to reduce the environmental impacts of transportation infrastructure have generally overlooked many of the efficiencies that can be obtained by considering the relevant engineering and economic aspects as a system. Here, we present a framework for quantifying the burdens of ground transportation in urban settings that incorporates travel time, vehicle fuel and pavement maintenance costs. A Pareto set of bi-directional lane configurations for two-lane roadways yields non-dominated combinations of lane width, bicycle lanes and curb parking. Probabilistic analysis and microsimulation both show dramatic mobility reductions on road segments of insufficient width for heavy vehicles to pass bicycles without encroaching on oncoming traffic. This delay is positively correlated with uphill grades and increasing traffic volumes and inversely proportional to total pavement width. The response is nonlinear with grade and yields mixed uphill/downhill optimal lane configurations. Increasing bicycle mode share is negatively correlated with total costs and emissions for lane configurations allowing motor vehicles to safely pass bicycles, while the opposite is true for configurations that fail to facilitate passing. Spatial impacts on mobility also dictate that curb parking exhibits significant spatial opportunity costs related to the total cost Pareto curve. The proposed framework provides a means to evaluate relatively inexpensive lane reconfiguration options in response to changing modal share and priorities. These results provide quantitative evidence that efforts to reallocate limited pavement space to bicycles, like those being adopted in several US cities, could appreciably reduce costs for all users.

  9. An Analysis of Aviation Maintenance Operations and Supporting Costs, and Cost Capturing Systems

    Science.gov (United States)

    2012-12-04

    the La Mesa Parent Teacher Association. = ^Åèìáëáíáçå=oÉëÉ~êÅÜ=mêçÖê~ã= do^ar^qb=p`elli=lc=_rpfkbpp=C=mr_if`=mlif`v= = - vii -= k^s^i=mlpqdo^ar^qb=p...host.uniroma3.it/facolta/ economia /db/materiali/insegnamenti/588_3930.pdf Cost Analysis Improvement Group (CAIG). (2007). Office of the Secretary of

  10. Guidebook : managing operating costs for rural and small urban public transit systems.

    Science.gov (United States)

    2013-05-01

    This guidebook is a resource for rural and small urban transit agency managers to use in better understanding, predicting, and managing operational costs. Doing so can improve the efficiency, effectiveness, and sustainability of public transit in the...

  11. Optimization of costs of Port Operations in Nigeria: A Scenario For ...

    African Journals Online (AJOL)

    2013-03-01

    Mar 1, 2013 ... +Department of Maritime Management Technology,. Federal ... Abstract. This study attempts to optimize the cost of port operations in Nigeria. ..... Slack. Original Value. Lower. Bound. Upper Bound. Const. 1. 0. 685.7727. 672.

  12. Cost-Effectiveness of Five Commonly Used Prosthesis Brands for Total Knee Replacement in the UK: A Study Using the NJR Dataset.

    Directory of Open Access Journals (Sweden)

    Mark Pennington

    Full Text Available There is a lack of evidence on the effectiveness or cost-effectiveness of alternative brands of prosthesis for total knee replacement (TKR. We compared patient-reported outcomes, revision rates, and costs, and estimated the relative cost-effectiveness of five frequently used cemented brands of unconstrained prostheses with fixed bearings (PFC Sigma, AGC Biomet, Nexgen, Genesis 2, and Triathlon.We used data from three national databases for patients who had a TKR between 2003 and 2012, to estimate the effect of prosthesis brand on post-operative quality of life (QOL (EQ-5D-3L in 53 126 patients at six months. We compared TKR revision rates by brand over 10 years for 239 945 patients. We used a fully probabilistic Markov model to estimate lifetime costs and quality-adjusted life years (QALYs, incremental cost effectiveness ratios (ICERs, and the probability that each prosthesis brand is the most cost effective at alternative thresholds of willingness-to-pay for a QALY gain.Revision rates were lowest with the Nexgen and PFC Sigma (2.5% after 10 years in 70-year-old women. Average lifetime costs were lowest with the AGC Biomet (£9 538; mean post-operative QOL was highest with the Nexgen, which was the most cost-effective brand across all patient subgroups. For example, for 70-year-old men and women, the ICERs for the Nexgen compared to the AGC Biomet were £2 300 per QALY. At realistic cost per QALY thresholds (£10 000 to £30 000, the probabilities that the Nexgen is the most cost-effective brand are about 98%. These results were robust to alternative modelling assumptions.AGC Biomet prostheses are the least costly cemented unconstrained fixed brand for TKR but Nexgen prostheses lead to improved patient outcomes, at low additional cost. These results suggest that Nexgen should be considered as a first choice prosthesis for patients with osteoarthritis who require a TKR.

  13. [Recostruction of Extensive Acetabular Defects by Bioactive Glass Ceramics in Re-operations of Total Endoprostheses.].

    Science.gov (United States)

    Urban, K; Sponer, P

    1998-01-01

    The authors made 37 revisions on account of aseptic loosening of total endoprostheses of the hip joint using bioactive glass ceramics BAS-0 of Lasak Co. Prague. For reconstruction of large defects of the acetabulum they used a combination of different types of anti-protrusion metal baskets and granules from this material. In some instances the glass ceramic material was combined with autologous spongiosa. The longest follow-up period is over 4 years. In no instance loosening of the glass ceramic material occurred or its expulsion. All reconstructed sockets of hip joints were burdened by the patients from the third month after surgery. Harris Hip Score before operation was on average 52. During the last checkups of the patients it reached the level of 86. The authors mention complications associated with the procedure. The advantages and disadvantages of the procedure are discussed. Key words: bioactive glass ceramics, reconstruction of acetabular defect, aseptic loosening of endoprosthesis.

  14. Natural gas domestic market development for total elimination of routine flares in Nigeria's upstream petroleum operations

    International Nuclear Information System (INIS)

    Sonibare, J.A.; Akeredolu, F.A.

    2006-01-01

    Several research findings confirmed that gaseous emissions and thermal radiation emanate from flaring activities during separation of oil from gas in the petroleum upstream operations. This, coupled with identified degradation potential of flares, makes flaring of about 71 million m 3 /day of associated gas a great concern. In this paper, several efforts hitherto made by government and organized private sectors at monetizing associated natural gas being flared on daily basis in Nigeria were reviewed. Domestic market development, if adopted, could eliminate routine gas flaring by 2008, meeting a goal set by Nigerian Government. Various scenarios considered showed that relatively minor amounts of natural gas could be consumed domestically for cooking; the balance would be absorbed by thermal electricity generation. It could lead to total consumption of between 92 and 140 million m 3 /day of natural gas in the country, representing a fraction of the domestic energy market

  15. [Operative treatment strategies for multiple trauma patients : early total care versus damage control].

    Science.gov (United States)

    Klüter, T; Lippross, S; Oestern, S; Weuster, M; Seekamp, A

    2013-09-01

    The treatment of multiple trauma patients is a great challenge for an interdisciplinary team. After preclinical care and subsequent treatment in the emergency room the order of the interventions is prioritized depending of the individual risk stratification. For planning the surgery management it is essential to distinguish between absolutely essential operations to prevent life-threatening situations for the patient and interventions with shiftable indications, depending on the general condition of the patient. All interventions need to be done without causing significant secondary damage to prohibit hyperinflammation and systemic inflammatory response syndrome. The challenge consists in determination of the appropriate treatment at the right point in time. In general the early primary intervention, early total care, is differentiated from the damage control concept.

  16. Operation and maintenance cost data for residential photovoltaic modules/panels

    Science.gov (United States)

    Oster, J. R., Jr.; Zaremski, D. R., Jr.; Albert, E. M.; Hawkins, S. L.

    1980-01-01

    Costs associated with the operation and maintenance of residential photovoltaic modules and arrays are studied. Six basic topics related to operation and maintenance to photovoltaic arrays are investigated: maintenance; cleaning; panel replacement; gasket repair/replacement; wiring repair/replacement; and termination repair/replacement. The effects of the mounting types (rack mount, stand off mount, direct mount and integral mount) and the installation/replacement type (sequential, partial interruption and independent) are identified and described. Methods of reducing maintenance costs are suggested.

  17. Simple Automatic File Exchange (SAFE) to Support Low-Cost Spacecraft Operation via the Internet

    Science.gov (United States)

    Baker, Paul; Repaci, Max; Sames, David

    1998-01-01

    Various issues associated with Simple Automatic File Exchange (SAFE) are presented in viewgraph form. Specific topics include: 1) Packet telemetry, Internet IP networks and cost reduction; 2) Basic functions and technical features of SAFE; 3) Project goals, including low-cost satellite transmission to data centers to be distributed via an Internet; 4) Operations with a replicated file protocol; 5) File exchange operation; 6) Ground stations as gateways; 7) Lessons learned from demonstrations and tests with SAFE; and 8) Feedback and future initiatives.

  18. Reducing Customers’ Total Cost of Ownership Within a Software Supply Network

    NARCIS (Netherlands)

    Slinger, S.R.L.; Rijsemus, W.

    2006-01-01

    This paper describes how the company Cordys avoids the ERP problems from the last 15 years by improving the software release, delivery, deployment, and maintenance processes. These ERP problems, such as costly ERP migrations and highly complex maintenance procedures, are circumvented by the

  19. RANKED SET SAMPLING FOR ECOLOGICAL RESEARCH: ACCOUNTING FOR THE TOTAL COSTS OF SAMPLING

    Science.gov (United States)

    Researchers aim to design environmental studies that optimize precision and allow for generalization of results, while keeping the costs of associated field and laboratory work at a reasonable level. Ranked set sampling is one method to potentially increase precision and reduce ...

  20. Total and Marginal Cost Analysis for a High School Based Bystander Intervention

    Science.gov (United States)

    Bush, Joshua L.; Bush, Heather M.; Coker, Ann L.; Brancato, Candace J.; Clear, Emily R.; Recktenwald, Eileen A.

    2018-01-01

    Costs of providing the Green Dot bystander-based intervention, shown to be effective in the reduction of sexual violence among Kentucky high school students, were estimated based on data from a large cluster-randomized clinical trial. Rape Crisis Center Educators were trained to provide Green Dot curriculum to students. Implementing Green Dot in…

  1. 78 FR 56911 - Notice of Certain Operating Cost Adjustment Factors for 2014

    Science.gov (United States)

    2013-09-16

    ... Cost Adjustment Factors for 2014 AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice establishes operating cost adjustment factors (OCAFs... date on or after February 11, 2014. OCAFs are annual factors used to adjust Section 8 rents renewed...

  2. Operating cost analysis of an annexed ethanol distillery in a rural, landlocked African country

    CSIR Research Space (South Africa)

    Amigun, B

    2011-10-01

    Full Text Available Given the high cost of crude oil, uncertainties regarding future reserves as well as the phenomenon of global warming, alternative fuels such as bioethanol need to be developed and deployed. This work presents an economic analysis (operating cost...

  3. Modelling the Cost Performance of a Given Logistics Network Operating Under Regular and Irregular Conditions

    NARCIS (Netherlands)

    Janic, M.

    2009-01-01

    This paper develops an analytical model for the assessment of the cost performance of a given logistics network operating under regular and irregular (disruptive) conditions. In addition, the paper aims to carry out a sensitivity analysis of this cost with respect to changes of the most influencing

  4. The integrated business information system: using automation to monitor cost-effectiveness of park operations

    Science.gov (United States)

    Dick Stanley; Bruce Jackson

    1995-01-01

    The cost-effectiveness of park operations is often neglected because information is laborious to compile. The information, however, is critical if we are to derive maximum benefit from scarce resources. This paper describes an automated system for calculating cost-effectiveness ratios with minimum effort using data from existing data bases.

  5. A new harvest operation cost model to evaluate forest harvest layout alternatives

    Science.gov (United States)

    Mark M. Clark; Russell D. Meller; Timothy P. McDonald; Chao Chi Ting

    1997-01-01

    The authors develop a new model for harvest operation costs that can be used to evaluate stands for potential harvest. The model is based on felling, extraction, and access costs, and is unique in its consideration of the interaction between harvest area shapes and access roads. The scientists illustrate the model and evaluate the impact of stand size, volume, and road...

  6. Total direct cost, length of hospital stay, institutional discharges and their determinants from rehabilitation settings in stroke patients.

    Science.gov (United States)

    Saxena, S K; Ng, T P; Yong, D; Fong, N P; Gerald, K

    2006-11-01

    Length of hospital stay (LOHS) is the largest determinant of direct cost for stroke care. Institutional discharges (acute care and nursing homes) from rehabilitation settings add to the direct cost. It is important to identify potentially preventable medical and non-medical reasons determining LOHS and institutional discharges to reduce the direct cost of stroke care. The aim of the study was to ascertain the total direct cost, LOHS, frequency of institutional discharges and their determinants from rehabilitation settings. Observational study was conducted on 200 stroke patients in two rehabilitation settings. The patients were examined for various socio-demographic, neurological and clinical variables upon admission to the rehabilitation hospitals. Information on total direct cost and medical complications during hospitalization were also recorded. The outcome variables measured were total direct cost, LOHS and discharges to institutions (acute care and nursing home facility) and their determinants. The mean and median LOHS in our study were 34 days (SD = 18) and 32 days respectively. LOHS and the cost of hospital stay were significantly correlated. The significant variables associated with LOHS on multiple linear regression analysis were: (i) severe functional impairment/functional dependence Barthel Index institutional discharges (22 to acute care and 17 to nursing homes). On multivariate analysis the significant predictors of discharges to institutions from rehabilitation hospitals were medical complications (OR = 4.37; 95% CI 1.01-12.53) and severe functional impairment/functional dependence. (OR = 5.90, 95% CI 2.32-14.98). Length of hospital stay and discharges to institutions from rehabilitation settings are significantly determined by medical complications. Importance of adhering to clinical pathway/protocol for stroke care is further discussed.

  7. Total-variation based velocity inversion with Bregmanized operator splitting algorithm

    Science.gov (United States)

    Zand, Toktam; Gholami, Ali

    2018-04-01

    Many problems in applied geophysics can be formulated as a linear inverse problem. The associated problems, however, are large-scale and ill-conditioned. Therefore, regularization techniques are needed to be employed for solving them and generating a stable and acceptable solution. We consider numerical methods for solving such problems in this paper. In order to tackle the ill-conditioning of the problem we use blockiness as a prior information of the subsurface parameters and formulate the problem as a constrained total variation (TV) regularization. The Bregmanized operator splitting (BOS) algorithm as a combination of the Bregman iteration and the proximal forward backward operator splitting method is developed to solve the arranged problem. Two main advantages of this new algorithm are that no matrix inversion is required and that a discrepancy stopping criterion is used to stop the iterations, which allow efficient solution of large-scale problems. The high performance of the proposed TV regularization method is demonstrated using two different experiments: 1) velocity inversion from (synthetic) seismic data which is based on Born approximation, 2) computing interval velocities from RMS velocities via Dix formula. Numerical examples are presented to verify the feasibility of the proposed method for high-resolution velocity inversion.

  8. Online total organic carbon (TOC) monitoring for water and wastewater treatment plants processes and operations optimization

    Science.gov (United States)

    Assmann, Céline; Scott, Amanda; Biller, Dondra

    2017-08-01

    Organic measurements, such as biological oxygen demand (BOD) and chemical oxygen demand (COD) were developed decades ago in order to measure organics in water. Today, these time-consuming measurements are still used as parameters to check the water treatment quality; however, the time required to generate a result, ranging from hours to days, does not allow COD or BOD to be useful process control parameters - see (1) Standard Method 5210 B; 5-day BOD Test, 1997, and (2) ASTM D1252; COD Test, 2012. Online organic carbon monitoring allows for effective process control because results are generated every few minutes. Though it does not replace BOD or COD measurements still required for compliance reporting, it allows for smart, data-driven and rapid decision-making to improve process control and optimization or meet compliances. Thanks to the smart interpretation of generated data and the capability to now take real-time actions, municipal drinking water and wastewater treatment facility operators can positively impact their OPEX (operational expenditure) efficiencies and their capabilities to meet regulatory requirements. This paper describes how three municipal wastewater and drinking water plants gained process insights, and determined optimization opportunities thanks to the implementation of online total organic carbon (TOC) monitoring.

  9. Impact of standardized clinical assessment and management plans on resource utilization and costs in children after the arterial switch operation.

    Science.gov (United States)

    Rathod, Rahul H; Jurgen, Brittney; Hamershock, Rose A; Friedman, Kevin G; Marshall, Audrey C; Samnaliev, Mihail; Graham, Dionne A; Jenkins, Kathy; Lock, James E; Powell, Andrew J

    2017-12-01

    Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and improve patient outcomes. We created a novel methodology, the SCAMP managed episode of care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch operation (ASO) SCAMP on total costs. All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control group of ASO patients (January 2001 to February 2009). Patients were divided into "younger" (operation while maintaining quality of care. © 2017 Wiley Periodicals, Inc.

  10. Reduced Operating Time but Not Blood Loss With Cruciate Retaining Total Knee Arthroplasty

    Science.gov (United States)

    Vermesan, Dinu; Trocan, Ilie; Prejbeanu, Radu; Poenaru, Dan V; Haragus, Horia; Gratian, Damian; Marrelli, Massimo; Inchingolo, Francesco; Caprio, Monica; Cagiano, Raffaele; Tatullo, Marco

    2015-01-01

    Background There is no consensus regarding the use of retaining or replacing cruciate implants for patients with limited deformity who undergo a total knee replacement. Scope of this paper is to evaluate whether a cruciate sparing total knee replacement could have a reduced operating time compared to a posterior stabilized implant. Methods For this purpose, we performed a randomized study on 50 subjects. All procedures were performed by a single surgeon in the same conditions to minimize bias and only knees with a less than 20 varus deviation and/or maximum 15° fixed flexion contracture were included. Results Surgery time was significantly shorter with the cruciate retaining implant (P = 0.0037). The mean duration for the Vanguard implant was 68.9 (14.7) and for the NexGen II Legacy was 80.2 (11.3). A higher range of motion, but no significant Knee Society Scores at 6 months follow-up, was used as controls. Conclusions In conclusion, both implants had the potential to assure great outcomes. However, if a decision has to be made, choosing a cruciate retaining procedure could significantly reduce the surgical time. When performed under tourniquet, this gain does not lead to reduced blood loss. PMID:25584102

  11. The influence of tourniquet use and operative time on the incidence of deep vein thrombosis in total knee arthroplasty.

    Science.gov (United States)

    Hernandez, Arnaldo José; Almeida, Adriano Marques de; Fávaro, Edmar; Sguizzato, Guilherme Turola

    2012-09-01

    To evaluate the association between tourniquet and total operative time during total knee arthroplasty and the occurrence of deep vein thrombosis. Seventy-eight consecutive patients from our institution underwent cemented total knee arthroplasty for degenerative knee disorders. The pneumatic tourniquet time and total operative time were recorded in minutes. Four categories were established for total tourniquet time: 120 minutes. Three categories were defined for operative time: 150 minutes. Between 7 and 12 days after surgery, the patients underwent ascending venography to evaluate the presence of distal or proximal deep vein thrombosis. We evaluated the association between the tourniquet time and total operative time and the occurrence of deep vein thrombosis after total knee arthroplasty. In total, 33 cases (42.3%) were positive for deep vein thrombosis; 13 (16.7%) cases involved the proximal type. We found no statistically significant difference in tourniquet time or operative time between patients with or without deep vein thrombosis. We did observe a higher frequency of proximal deep vein thrombosis in patients who underwent surgery lasting longer than 120 minutes. The mean total operative time was also higher in patients with proximal deep vein thrombosis. The tourniquet time did not significantly differ in these patients. We concluded that surgery lasting longer than 120 minutes increases the risk of proximal deep vein thrombosis.

  12. Ranking periodic ordering models on the basis of minimizing total inventory cost

    Directory of Open Access Journals (Sweden)

    Mohammadali Keramati

    2015-06-01

    Full Text Available This paper aims to provide proper policies for inventory under uncertain conditions by comparing different inventory policies. To review the efficiency of these algorithms it is necessary to specify the area in which each of them is applied. Therefore, each of the models has been reviewed under different forms of retailing and they are ranked in terms of their expenses. According to the high values of inventories and their impacts on the costs of the companies, the ranking of various models using the simulation annealing algorithm are presented, which indicates that the proposed model of this paper could perform better than other alternative ones. The results also indicate that the suggested algorithm could save from 4 to 29 percent on costs of inventories.

  13. 76 FR 77528 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2011-12-13

    ...In accordance with Section 122(i) of the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los Angeles, California, with the following settling parties: Pick-Your-Part Auto Wrecking; Hayward Associates, LLC; and PNM Properties, LLC. The settlement requires the settling parties to pay a total of $102,161 to the North Hollywood Operable Unit Special Account within the Hazardous Substance Superfund. The settlement also includes a covenant not to sue the settling parties pursuant to Section 107(a) of CERCLA, 42 U.S.C. 9607(a). For thirty (30) days following the date of publication of this notice, the Agency will receive written comments relating to the settlement. The Agency will consider all comments received and may modify or withdraw its consent to the settlement if comments received disclose facts or considerations which indicate that the settlement is inappropriate, improper, or inadequate. The Agency's response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles, CA 90071 and at the EPA Region 9 Superfund Records Center, Mail Stop SFD-7C, 95 Hawthorne Street, Room 403, San Francisco, CA 94105.

  14. 76 FR 79678 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2011-12-22

    ...In accordance with Section 122(i) of the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los Angeles, California, with the following settling parties: Pick-Your-Part Auto Wrecking; Hayward Associates, LLC; and PNM Properties, LLC. The settlement requires the settling parties to pay a total of $102,161 to the North Hollywood Operable Unit Special Account within the Hazardous Substance Superfund. The settlement also includes a covenant not to sue the settling parties pursuant to Section 107(a) of CERCLA, 42 U.S.C. 9607(a). For thirty (30) days following the date of publication of this notice, the Agency will receive written comments relating to the settlement. The Agency will consider all comments received and may modify or withdraw its consent to the settlement if comments received disclose facts or considerations which indicate that the settlement is inappropriate, improper, or inadequate. The Agency's response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles, CA 90071 and at the EPA Region 9 Superfund Records Center, Mail Stop SFD-7C, 95 Hawthorne Street, Room 403, San Francisco, CA 94105.

  15. 77 FR 123 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2012-01-03

    ...In accordance with Section 122(i) of the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (``CERCLA''), 42 U.S.C. 9622(i), notice is hereby given of a proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable Unit of the San Fernando Valley Area 1 Superfund Site, located in the vicinity of Los Angeles, California, with the following settling party: Waste Management Recycling & Disposal Services of California, Inc., dba Bradley Landfill & Recycling Center. The settlement requires the settling party to pay a total of $185,734 to the North Hollywood Operable Unit Special Account within the Hazardous Substance Superfund. The settlement also includes a covenant not to sue the settling party pursuant to Section 107(a) of CERCLA, 42 U.S.C. 9607(a). For thirty (30) days following the date of publication of this notice, the Agency will receive written comments relating to the settlement. The Agency will consider all comments received and may modify or withdraw its consent to the settlement if comments received disclose facts or considerations which indicate that the settlement is inappropriate, improper, or inadequate. The Agency's response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles CA 90071 and at the EPA Region 9 Superfund Records Center, Mail Stop SFD-7C, 95 Hawthorne Street, Room 403, San Francisco, CA 94105.

  16. Implementation of Distance Support (DS) to Reduce Total Ownership Cost (R-TOC)

    Science.gov (United States)

    2012-02-01

    Policy of 22 Mar 2007, states that DS combines people, processes and technology into a collaborative infrastructure regardless of geographic location...Tech Assist Data for Submarine Enterprise 120 FTA Events Performed 164 MH Via On-Si te Support Average Cost Per Event (Based on $60.00 Per Hour...CFFC/Command Policy) 16% Success Rate Overa l l On Al l FTA Events 37% Success Rate On Out-Of-Area Events Average MHs Per Event 19 MH Via DS

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

    OpenAIRE

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

    2014-01-01

    Background: Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS) were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability. Aims: Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system ...

  18. The Penultimate C4ISR Challenge: Reducing Military Manpower and Total Operating Costs

    Science.gov (United States)

    2010-06-01

    ability to better harness the technologies in the transition from sailing ships firing solid cannonballs to turbine -powered dreadnoughts spewing high...Rowe, 1982) 54 Robert Kaplan , “America’s Elegant Decline,” The Atlantic, November 2007. Kaplan’s argument, that the United States is in a period of

  19. Application of total care time and payment per unit time model for physician reimbursement for common general surgery operations.

    Science.gov (United States)

    Chatterjee, Abhishek; Holubar, Stefan D; Figy, Sean; Chen, Lilian; Montagne, Shirley A; Rosen, Joseph M; Desimone, Joseph P

    2012-06-01

    The relative value unit system relies on subjective measures of physician input in the care of patients. A payment per unit time model incorporates surgeon reimbursement to the total care time spent in the operating room, postoperative in-house, and clinic time to define payment per unit time. We aimed to compare common general surgery operations by using the total care time and payment per unit time method in order to demonstrate a more objective measurement for physician reimbursement. Average total physician payment per case was obtained for 5 outpatient operations and 4 inpatient operations in general surgery. Total care time was defined as the sum of operative time, 30 minutes per hospital day, and 30 minutes per office visit for each operation. Payment per unit time was calculated by dividing the physician reimbursement per case by the total care time. Total care time, physician payment per case, and payment per unit time for each type of operation demonstrated that an average payment per time spent for inpatient operations was $455.73 and slightly more at $467.51 for outpatient operations. Partial colectomy with primary anastomosis had the longest total care time (8.98 hours) and the least payment per unit time ($188.52). Laparoscopic gastric bypass had the highest payment per time ($707.30). The total care time and payment per unit time method can be used as an adjunct to compare reimbursement among different operations on an institutional level as well as on a national level. Although many operations have similar payment trends based on time spent by the surgeon, payment differences using this methodology are seen and may be in need of further review. Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Cost-utility analysis comparing radioactive iodine, anti-thyroid drugs and total thyroidectomy for primary treatment of Graves' disease.

    Science.gov (United States)

    Donovan, Peter J; McLeod, Donald S A; Little, Richard; Gordon, Louisa

    2016-12-01

    Little data is in existence about the most cost-effective primary treatment for Graves' disease. We performed a cost-utility analysis comparing radioactive iodine (RAI), anti-thyroid drugs (ATD) and total thyroidectomy (TT) as first-line therapy for Graves' disease in England and Australia. We used a Markov model to compare lifetime costs and benefits (quality-adjusted life-years (QALYs)). The model included efficacy, rates of relapse and major complications associated with each treatment, and alternative second-line therapies. Model parameters were obtained from published literature. One-way sensitivity analyses were conducted. Costs were presented in 2015£ or Australian Dollars (AUD). RAI was the least expensive therapy in both England (£5425; QALYs 34.73) and Australia (AUD5601; 30.97 QALYs). In base case results, in both countries, ATD was a cost-effective alternative to RAI (£16 866; 35.17 QALYs; incremental cost-effectiveness ratio (ICER) £26 279 per QALY gained England; AUD8924; 31.37 QALYs; ICER AUD9687 per QALY gained Australia), while RAI dominated TT (£7115; QALYs 33.93 England; AUD15 668; 30.25 QALYs Australia). In sensitivity analysis, base case results were stable to changes in most cost, transition probabilities and health-relative quality-of-life (HRQoL) weights; however, in England, the results were sensitive to changes in the HRQoL weights of hypothyroidism and euthyroidism on ATD. In this analysis, RAI is the least expensive choice for first-line treatment strategy for Graves' disease. In England and Australia, ATD is likely to be a cost-effective alternative, while TT is unlikely to be cost-effective. Further research into HRQoL in Graves' disease could improve the quality of future studies. © 2016 European Society of Endocrinology.

  1. Operation Cost Minimization of Droop-Controlled AC Microgrids Using Multiagent-Based Distributed Control

    DEFF Research Database (Denmark)

    Li, Chendan; Savaghebi, Mehdi; Guerrero, Josep M.

    2016-01-01

    on the power rating of the power converters. With various primary source for the distributed generator (DG), factors that are closely related to the operation cost, such as fuel cost of the generators and losses should be taken into account in order to improve the efficiency of the whole system. In this paper......, a multiagent-based distributed method is proposed to minimize the operation cost in AC microgrids. In the microgrid, each DG is acting as an agent which regulates the power individually using a novel power regulation method based on frequency scheduling. An optimal power command is obtained through carefully...... designed consensus algorithm by using sparse communication links only among neighbouring agents. Experimental results for different cases verified that the proposed control strategy can effectively reduce the operation cost....

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

    International Nuclear Information System (INIS)

    1994-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-08

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

  4. Reducing capital and operating costs in gas processing, liquefaction, and storage

    Energy Technology Data Exchange (ETDEWEB)

    Krusen, III, L C [Phillips Petroleum Co., Bartlesville, OK (United States). Research Div.

    1997-06-01

    The LNG industry is unanimous that capital costs must be reduced throughout the chain, and especially at the liquefaction facility including associated gas processing and LNG storage. The Ken ai LNG plant provides an example of how both reduced capital and operating costs were attained. This paper will cover cost production strategies that can be applied to liquefaction processes in general, and will than focus on their realization in the Phillips Optimized Cascade LNG process. The paper concludes that reduced LNG plant costs are attainable. (Author).

  5. Reducing capital and operating costs in gas processing, liquefaction, and storage

    International Nuclear Information System (INIS)

    Krusen, L.C. III

    1997-01-01

    The LNG industry is unanimous that capital costs must be reduced throughout the chain, and especially at the liquefaction facility including associated gas processing and LNG storage. The Ken ai LNG plant provides an example of how both reduced capital and operating costs were attained. This paper will cover cost production strategies that can be applied to liquefaction processes in general, and will than focus on their realization in the Phillips Optimized Cascade LNG process. The paper concludes that reduced LNG plant costs are attainable. (Author)

  6. A Total Cost of Ownership Model for Low Temperature PEM Fuel Cells in Combined Heat and Power and Backup Power Applications

    Energy Technology Data Exchange (ETDEWEB)

    University of California, Berkeley; Wei, Max; Lipman, Timothy; Mayyas, Ahmad; Chien, Joshua; Chan, Shuk Han; Gosselin, David; Breunig, Hanna; Stadler, Michael; McKone, Thomas; Beattie, Paul; Chong, Patricia; Colella, Whitney; James, Brian

    2014-06-23

    A total cost of ownership model is described for low temperature proton exchange membrane stationary fuel cell systems for combined heat and power (CHP) applications from 1-250kW and backup power applications from 1-50kW. System designs and functional specifications for these two applications were developed across the range of system power levels. Bottom-up cost estimates were made for balance of plant costs, and detailed direct cost estimates for key fuel cell stack components were derived using design-for-manufacturing-and-assembly techniques. The development of high throughput, automated processes achieving high yield are projected to reduce the cost for fuel cell stacks to the $300/kW level at an annual production volume of 100 MW. Several promising combinations of building types and geographical location in the U.S. were identified for installation of fuel cell CHP systems based on the LBNL modelling tool DER CAM. Life-cycle modelling and externality assessment were done for hotels and hospitals. Reduced electricity demand charges, heating credits and carbon credits can reduce the effective cost of electricity ($/kWhe) by 26-44percent in locations such as Minneapolis, where high carbon intensity electricity from the grid is displaces by a fuel cell system operating on reformate fuel. This project extends the scope of existing cost studies to include externalities and ancillary financial benefits and thus provides a more comprehensive picture of fuel cell system benefits, consistent with a policy and incentive environment that increasingly values these ancillary benefits. The project provides a critical, new modelling capacity and should aid a broad range of policy makers in assessing the integrated costs and benefits of fuel cell systems versus other distributed generation technologies.

  7. Cost of installing and operating an electronic clinical decision support system for maternal health care: case of Tanzania rural primary health centres.

    Science.gov (United States)

    Saronga, Happiness Pius; Dalaba, Maxwell Ayindenaba; Dong, Hengjin; Leshabari, Melkizedeck; Sauerborn, Rainer; Sukums, Felix; Blank, Antje; Kaltschmidt, Jens; Loukanova, Svetla

    2015-04-02

    Poor quality of care is among the causes of high maternal and newborn disease burden in Tanzania. Potential reason for poor quality of care is the existence of a "know-do gap" where by health workers do not perform to the best of their knowledge. An electronic clinical decision support system (CDSS) for maternal health care was piloted in six rural primary health centers of Tanzania to improve performance of health workers by facilitating adherence to World Health Organization (WHO) guidelines and ultimately improve quality of maternal health care. This study aimed at assessing the cost of installing and operating the system in the health centers. This retrospective study was conducted in Lindi, Tanzania. Costs incurred by the project were analyzed using Ingredients approach. These costs broadly included vehicle, computers, furniture, facility, CDSS software, transport, personnel, training, supplies and communication. These were grouped into installation and operation cost; recurrent and capital cost; and fixed and variable cost. We assessed the CDSS in terms of its financial and economic cost implications. We also conducted a sensitivity analysis on the estimations. Total financial cost of CDSS intervention amounted to 185,927.78 USD. 77% of these costs were incurred in the installation phase and included all the activities in preparation for the actual operation of the system for client care. Generally, training made the largest share of costs (33% of total cost and more than half of the recurrent cost) followed by CDSS software- 32% of total cost. There was a difference of 31.4% between the economic and financial costs. 92.5% of economic costs were fixed costs consisting of inputs whose costs do not vary with the volume of activity within a given range. Economic cost per CDSS contact was 52.7 USD but sensitive to discount rate, asset useful life and input cost variations. Our study presents financial and economic cost estimates of installing and operating an

  8. Solar to hydrogen: Compact and cost effective CPV field for rooftop operation and hydrogen production

    KAUST Repository

    Burhan, Muhammad

    2016-11-25

    Current commercial CPV systems are designed as large units which are targeted to be installed in open desert fields with high DNI availability. It appeared that the CPV is among some of those technologies which gained very little attention of people, with less customers and market. For conventional PV systems, the installations at the rooftop of commercial and residential buildings have a significant share in the total installed capacity of PV systems. That is why for most of the countries, the PV installations at the rooftop of commercial and residential buildings are aimed to be increased to half of total installed PV. On the other hand, there is no commercial CPV system available to be suitable for rooftop operation, giving motivation for the development of CPV field of compact systems. This paper discusses the development of a CPV field for the rooftop operation, comprising of compact CPV system with cost effective but highly accurate solar tracking sensor and wireless master slave control. In addition, the performance of the developed CPV systems is evaluated for production of hydrogen, which can be used as energy carrier or energy storage and a maximum solar to hydrogen efficiency of 18% is obtained. However, due to dynamic nature of the weather data and throughout the day variations in the performance of CPV and electrolyser, the solar to hydrogen performance is proposed to be reported as daily and long term average efficiency. The CPV-Hydrogen system showed daily average conversion efficiency of 15%, with solar to hydrogen production rate of 218 kW h/kg.

  9. Assessment and validation of CT scanogram to compare per-operative and post-operative mechanical axis after navigated total knee replacement

    Science.gov (United States)

    Jain, Sunil

    2008-01-01

    Our objective was to assess and validate low-dose computed tomography (CT) scanogram as a post-operative imaging modality to measure the mechanical axis after navigated total knee replacement. A prospective study was performed to compare intra-operative and post-operative mechanical axis after navigated total knee replacements. All consecutive patients who underwent navigated total knee replacement between May and December 2006 were included. The intra-operative final axis was recorded, and post-operatively a CT scanogram of lower limbs was performed. The mechanical axis was measured and compared against the intra-operative measurement. There were 15 patients ranging in age from 57 to 80 (average 70) years. The average final intra-operative axis was 0.56° varus (4° varus to 1.5° valgus) and post-operative CT scanogram axis was 0.52° varus (3.1° varus to 1.8° valgus). The average deviation from final axes to CT scanogram axes was 0.12° valgus with a correlation coefficient of 0.9. Our study suggests that CT scanogram is an imaging modality with reasonable accuracy for measuring mechanical axis despite significantly low radiation. It also confirms a high level of correlation between intra-operative and post-operative mechanical axis after navigated total knee replacement. PMID:18696064

  10. 43 CFR 404.40 - What is the non-Federal share of operation, maintenance, and replacement costs?

    Science.gov (United States)

    2010-10-01

    ... Cost-Sharing § 404.40 What is the non-Federal share of operation, maintenance, and replacement costs? You are required to pay 100 percent of the operation, maintenance, and replacement costs of any rural... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What is the non-Federal share of operation...

  11. 19 CFR 10.197 - Direct costs of processing operations performed in a beneficiary country or countries.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Direct costs of processing operations performed in... TO A REDUCED RATE, ETC. Caribbean Basin Initiative § 10.197 Direct costs of processing operations... operations. As used in § 10.195 and § 10.198, the words “direct costs of processing operations” mean those...

  12. Experiences of operational costs of HPV vaccine delivery strategies in Gavi-supported demonstration projects

    Science.gov (United States)

    Holroyd, Taylor; Nanda, Shreya; Bloem, Paul; Griffiths, Ulla K.; Sidibe, Anissa; Hutubessy, Raymond C. W.

    2017-01-01

    From 2012 to 2016, Gavi, the Vaccine Alliance, provided support for countries to conduct small-scale demonstration projects for the introduction of the human papillomavirus vaccine, with the aim of determining which human papillomavirus vaccine delivery strategies might be effective and sustainable upon national scale-up. This study reports on the operational costs and cost determinants of different vaccination delivery strategies within these projects across twelve countries using a standardized micro-costing tool. The World Health Organization Cervical Cancer Prevention and Control Costing Tool was used to collect costing data, which were then aggregated and analyzed to assess the costs and cost determinants of vaccination. Across the one-year demonstration projects, the average economic and financial costs per dose amounted to US$19.98 (standard deviation ±12.5) and US$8.74 (standard deviation ±5.8), respectively. The greatest activities representing the greatest share of financial costs were social mobilization at approximately 30% (range, 6–67%) and service delivery at about 25% (range, 3–46%). Districts implemented varying combinations of school-based, facility-based, or outreach delivery strategies and experienced wide variation in vaccine coverage, drop-out rates, and service delivery costs, including transportation costs and per diems. Size of target population, number of students per school, and average length of time to reach an outreach post influenced cost per dose. Although the operational costs from demonstration projects are much higher than those of other routine vaccine immunization programs, findings from our analysis suggest that HPV vaccination operational costs will decrease substantially for national introduction. Vaccination costs may be decreased further by annual vaccination, high initial investment in social mobilization, or introducing/strengthening school health programs. Our analysis shows that drivers of cost are dependent on

  13. Modification and Performance Evaluation of a Low Cost Electro-Mechanically Operated Creep Testing Machine

    OpenAIRE

    John J. MOMOH; Lanre Y. SHUAIB-BABATA; Gabriel O. ADELEGAN

    2010-01-01

    Existing mechanically operated tensile and creep testing machine was modified to a low cost, electro-mechanically operated creep testing machine capable of determining the creep properties of aluminum, lead and thermoplastic materials as a function of applied stress, time and temperature. The modification of the testing machine was necessitated by having an electro-mechanically operated creep testing machine as a demonstration model ideal for use and laboratory demonstrations, which will prov...

  14. Leveraging Real-World Evidence in Disease-Management Decision-Making with a Total Cost of Care Estimator.

    Science.gov (United States)

    Nguyen, Thanh-Nghia; Trocio, Jeffrey; Kowal, Stacey; Ferrufino, Cheryl P; Munakata, Julie; South, Dell

    2016-12-01

    Health management is becoming increasingly complex, given a range of care options and the need to balance costs and quality. The ability to measure and understand drivers of costs is critical for healthcare organizations to effectively manage their patient populations. Healthcare decision makers can leverage real-world evidence to explore the value of disease-management interventions in shifting total cost trends. To develop a real-world, evidence-based estimator that examines the impact of disease-management interventions on the total cost of care (TCoC) for a patient population with nonvalvular atrial fibrillation (NVAF). Data were collected from a patient-level real-world evidence data set that uses the IMS PharMetrics Health Plan Claims Database. Pharmacy and medical claims for patients meeting the inclusion or exclusion criteria were combined in longitudinal cohorts with a 180-day preindex and 360-day follow-up period. Descriptive statistics, such as mean and median patient costs and event rates, were derived from a real-world evidence analysis and were used to populate the base-case estimates within the TCoC estimator, an exploratory economic model that was designed to estimate the potential impact of several disease-management activities on the TCoC for a patient population with NVAF. Using Microsoft Excel, the estimator is designed to compare current direct costs of medical care to projected costs by varying assumptions on the impact of disease-management activities and applying the associated changes in cost trends to the affected populations. Disease-management levers are derived from literature-based concepts affecting costs along the NVAF disease continuum. The use of the estimator supports analyses across 4 US geographic regions, age, cost types, and care settings during 1 year. All patients included in the study were continuously enrolled in their health plan (within the IMS PharMetrics Health Plan Claims Database) between July 1, 2010, and June 30

  15. Process-Costing, Job-Order-Costing, Operation Costing (også kaldet Batch Costing og Functional Costing - Når Systemtankegangen ligger til grund for økonomistyringen og dens beslutninger)

    DEFF Research Database (Denmark)

    Nielsen, Steen

    2005-01-01

    De tre begreber process-costing, job-order-costing, operation-costing samt functional-based costing er faktisk historiske begreber som stammer langt tilbage i økonomistyringslitteraturen, faktisk tilbage til Scientific Management bevægelsen fra 20'erne og 30'erne. Man kan derfor ikke sige, at disse...... ordreregnskabet, f.eks. som dette er analyseret hos Palle Hansen og Vagn Madsen. Begrebet operational costing anvendes også, men dette dækker i realiteten over, hvordan og hvilke elementer der indgår i hele virksomhedens regnskabs-information-system. Dvs. at dette mere er et spørgsmål om, hvordan systemerne er...... Aktivitets-Baseret Cost Management systemerne. Det er derfor vigtigt dels at kende sin historie på området, dels at gøre sig klart, om de under visse antagelser stadig har deres berettigelse. De samme begreber har også deres pendant til de danske begreber, afdelings- eller funktionsregnskabet samt...

  16. Premium cost optimization of operational and maintenance of green building in Indonesia using life cycle assessment method

    Science.gov (United States)

    Latief, Yusuf; Berawi, Mohammed Ali; Basten, Van; Budiman, Rachmat; Riswanto

    2017-06-01

    Building has a big impact on the environmental developments. There are three general motives in building, namely the economy, society, and environment. Total completed building construction in Indonesia increased by 116% during 2009 to 2011. It made the energy consumption increased by 11% within the last three years. In fact, 70% of energy consumption is used for electricity needs on commercial buildings which leads to an increase of greenhouse gas emissions by 25%. Green Building cycle costs is known as highly building upfront cost in Indonesia. The purpose of optimization in this research improves building performance with some of green concept alternatives. Research methodology is mixed method of qualitative and quantitative approaches through questionnaire surveys and case study. Assessing the successful of optimization functions in the existing green building is based on the operational and maintenance phase with the Life Cycle Assessment Method. Choosing optimization results were based on the largest efficiency of building life cycle and the most effective cost to refund.

  17. Extending DIII-D Neutral Beam Modulated Operations with a Camac Based Total on Time Interlock

    International Nuclear Information System (INIS)

    Baggest, D.S.; Broesch, J.D.; Phillips, J.C.

    1999-01-01

    A new total-on-time interlock has increased the operational time limits of the Neutral Beam systems at DIII-D. The interlock, called the Neutral Beam On-Time-Limiter (NBOTL), is a custom built CAMAC module utilizing a Xilinx 9572 Complex Programmable Logic Device (CPLD) as its primary circuit. The Neutral Beam Injection Systems are the primary source of auxiliary heating for DIII-D plasma discharges and contain eight sources capable of delivering 20MW of power. The delivered power is typically limited to 3.5 s per source to protect beam-line components, while a DIII-D plasma discharge usually exceeds 5 s. Implemented as a hardware interlock within the neutral beam power supplies, the NBOTL limits the beam injection time. With a continuing emphasis on modulated beam injections, the NBOTL guards against command faults and allows the beam injection to be safely spread over a longer plasma discharge time. The NBOTL design is an example of incorporating modern circuit design techniques (CPLD) within an established format (CAMAC). The CPLD is the heart of the NBOTL and contains 90% of the circuitry, including a loadable, 1 MHz, 28 bit, BCD count down timer, buffers, and CAMAC communication circuitry. This paper discusses the circuit design and implementation. Of particular interest is the melding of flexible modern programmable logic devices with the CAMAC format

  18. Optimum pressure for total-reflux operated thermal diffusion column for isotope separation

    International Nuclear Information System (INIS)

    Yamamoto, Ichiro; Makino, Hitoshi; Kanagawa, Akira

    1990-01-01

    A formula for prediction of the optimum operating pressure P opt of the thermal diffusion columns at total reflux is derived based on the approximate formulae for the column constants which can be evaluated analytically. The formula is expressed explicitly in terms of (1) physical properties of gases to be separated, (2) ratio of radii between hot wire and cold wall of the column, and (3) the ratio of the temperature difference to the cold wall temperature. The result is compared with experimental data; (1) binary monatomic gas systems, (2) multicomponent monatomic gas systems, (3) isotopically substituted polyatomic systems, (4) systems of low atomic or molecular weight, and (5) mixtures of unlike gases; mainly obtained by Rutherford and coworkers. Although the formula is based on the rather rough approximation for the column constants, the optimum pressures predicted by the present formula are in successfully good agreement with the experimental data even for the systems of low atomic or molecular weight and that of mixtures of unlike gases. (author)

  19. Inguinal hernia repair: totally preperitoneal laparoscopic approach versus Stoppa operation: randomized trial of 100 cases.

    Science.gov (United States)

    Champault, G G; Rizk, N; Catheline, J M; Turner, R; Boutelier, P

    1997-12-01

    In a prospective randomized trial comparing the totally preperitoneal (TPP) laparoscopic approach and the Stoppa procedure (open), 100 patients with inguinal hernias (Nyhus IIIA, IIIB, IV) were followed over a 3-year period. Both groups were epidemiologically comparable. In the laparoscopic group, operating time was significantly longer (p = 0.01), but hospital stay (3.2 vs. 7.3 days) and delay in return to work (17 vs. 35 days) were significantly reduced (p = 0.01). Postoperative comfort (less pain) was better (p = 0.001) after laparoscopy. In this group, morbidity was also reduced (4 vs. 20%; p = 0.02). The mean follow-up was 605 days, and 93% of the patients were reviewed at 3 years. There were three (6%) recurrences after TPP, especially at the beginning of the surgeon's learning curve, versus one for the Stoppa procedure (NS). For bilateral hernias, the authors suggest the use of a large prosthesis rather than two small ones to minimize the likelihood of recurrence. In the conditions described, the laparoscopic (TPP) approach to inguinal hernia treatment appears to have the same long-term recurrence rate as the open (Stoppa) procedure but a real advantage in the early postoperative period.

  20. Prediction equation for estimating total daily energy requirements of special operations personnel.

    Science.gov (United States)

    Barringer, N D; Pasiakos, S M; McClung, H L; Crombie, A P; Margolis, L M

    2018-01-01

    Special Operations Forces (SOF) engage in a variety of military tasks with many producing high energy expenditures, leading to undesired energy deficits and loss of body mass. Therefore, the ability to accurately estimate daily energy requirements would be useful for accurate logistical planning. Generate a predictive equation estimating energy requirements of SOF. Retrospective analysis of data collected from SOF personnel engaged in 12 different SOF training scenarios. Energy expenditure and total body water were determined using the doubly-labeled water technique. Physical activity level was determined as daily energy expenditure divided by resting metabolic rate. Physical activity level was broken into quartiles (0 = mission prep, 1 = common warrior tasks, 2 = battle drills, 3 = specialized intense activity) to generate a physical activity factor (PAF). Regression analysis was used to construct two predictive equations (Model A; body mass and PAF, Model B; fat-free mass and PAF) estimating daily energy expenditures. Average measured energy expenditure during SOF training was 4468 (range: 3700 to 6300) Kcal·d- 1 . Regression analysis revealed that physical activity level ( r  = 0.91; P  plan appropriate feeding regimens to meet SOF nutritional requirements across their mission profile.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-09-15

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

  3. Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program.

    Science.gov (United States)

    Pollei, Taylor R; Barrs, David M; Hinni, Michael L; Bansberg, Stephen F; Walter, Logan C

    2013-06-01

    Describe the procedure length difference between surgeries performed by an attending surgeon alone compared with the resident surgeon supervised by the same attending surgeon. Case series with chart review. Tertiary care center and residency program. Six common otolaryngologic procedures performed between August 1994 and May 2012 were divided into 2 cohorts: attending surgeon alone or resident surgeon. This division coincided with our July 2006 initiation of an otolaryngology-head and neck surgery residency program. Operative duration was compared between cohorts with confounding factors controlled. In addition, the direct result of increased surgical length on operating room cost was calculated and applied to departmental and published resident case log report data. Five of the 6 procedures evaluated showed a statistically significant increase in surgery length with resident involvement. Operative time increased 6.8 minutes for a cricopharyngeal myotomy (P = .0097), 11.3 minutes for a tonsillectomy (P operative time difference. Cost of increased surgical time was calculated per surgery and ranged from $286 (cricopharyngeal myotomy) to $2142 (mastoidectomy). When applied to reported national case log averages for graduating residents, this resulted in a significant increase of direct training-related costs. Resident participation in the operating room results in increased surgical length and additional system cost. Although residency is a necessary part of surgical training, associated costs need to be acknowledged.

  4. Process Improvement Project Using Tranexamic Acid Is Cost-Effective in Reducing Blood Loss and Transfusions After Total Hip and Total Knee Arthroplasty.

    Science.gov (United States)

    Demos, Harry A; Lin, Zilan X; Barfield, William R; Wilson, Sylvia H; Robertson, Dawn C; Pellegrini, Vincent D

    2017-08-01

    Tranexamic acid (TXA) has been associated with decreased blood loss and transfusion after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to examine both transfusion utilization and the economic impact of a Process Improvement Project implementing TXA for THA and TKA. After standardization of TXA administration in THA and TKA patients, retrospective data were compared from 12 consecutive months before (group A, n = 336 procedures) and after (group B, n = 436 procedures) project initiation. TXA administration increased with project implementation (group A = 3.57%, group B = 86.01%) and was associated with reductions in perioperative hemoglobin decrement (20.2%), patients transfused (45%), and number of units transfused per patient (61.9%). Cost savings were notable per patient ($128) and annually program wide ($55,884) with the primary THA subgroup contributing the most to the savings. No increase in adverse effects was observed. Standardized administration of TXA is an effective and economically favorable blood-reduction strategy for patients undergoing elective THA or TKA. Although reduction in transfusions with TXA may be greater after TKA, the economic and clinical impact of transfusion reduction is more substantial in THA patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Demonstration of AIRS Total Ozone Products to Operations to Enhance User Readiness

    Science.gov (United States)

    Berndt, Emily; Zavodsky, Bradley; Jedlovec, Gary

    2014-01-01

    Cyclogenesis is a key forecast challenge at operational forecasting centers such as WPC and OPC, so these centers have a particular interest in unique products that can identify key storm features. In some cases, explosively developing extratropical cyclones can produce hurricane force, non-convective winds along the East Coast and north Atlantic as well as the Pacific Ocean, with the potential to cause significant damage to life and property. Therefore, anticipating cyclogenesis for these types of storms is crucial for furthering the NOAA goal of a "Weather Ready Nation". Over the last few years, multispectral imagery (i.e. RGB) products have gained popularity among forecasters. The GOES-R satellite champion at WPC/OPC has regularly evaluated the Air Mass RGB products from GOES Sounder, MODIS, and SEVIRI to aid in forecasting cyclogenesis as part of ongoing collaborations with SPoRT within the framework of the GOES-R Proving Ground. WPC/OPC has used these products to identify regions of stratospheric air associated with tropopause folds that can lead to cyclogenesis and hurricane force winds. RGB products combine multiple channels or channel differences into multi-color imagery in which different colors represent a particular cloud or air mass type. Initial interaction and feedback from forecasters evaluating the legacy Air Mass RGBs revealed some uncertainty regarding what physical processes the qualitative RGB products represent and color interpretation. To enhance forecaster confidence and interpretation of the Air Mass RGB, NASA SPoRT has transitioned a total column ozone product from AIRS retrievals to the WPC/OPC. The use of legacy AIRS demonstrates future JPSS capabilities possible with CrIS or OMPS. Since stratospheric air can be identified by anomalous potential vorticity and warm, dry, ozone-rich air, hyperspectral infrared sounder ozone products can be used in conjunction with the Air Mass RGB for identifying the role of stratospheric air in explosive

  6. What is the Best Strategy to Minimize After-Care Costs for Total Joint Arthroplasty in a Bundled Payment Environment?

    Science.gov (United States)

    Slover, James D; Mullaly, Kathleen A; Payne, Ashley; Iorio, Richard; Bosco, Joseph

    2016-12-01

    The post-acute care strategies after lower extremity total joint arthroplasty including the use of post-acute rehabilitation centers and home therapy services are associated with different costs. Providers in bundled payment programs are incentivized to use the most cost-effective strategies. We used decision analysis to examine the impact of extending the inpatient hospital stay to avoid discharge of patients to a post-acute rehabilitation facility. The results of this decision analysis show that extended acute hospital care for up to 5.2 extra days to allow for home discharge, rather than discharge to a post-acute inpatient facility can be financially preferable, provided quality is not negatively impacted. The data demonstrate that because the cost of additional acute care hospital days is relatively small and because the cost of an extended post-acute inpatient rehabilitation facility is high, keeping patients in the acute facility for a few extra days and then discharging them directly to home may result in an overall lower cost than discharge after a shorter hospital stay to an expensive post-acute facility. However, this approach will have challenges, and future studies are needed to evaluate this change in strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Understanding cost growth during operations of planetary missions: An explanation of changes

    Science.gov (United States)

    McNeill, J. F.; Chapman, E. L.; Sklar, M. E.

    In the development of project cost estimates for interplanetary missions, considerable focus is generally given to the development of cost estimates for the development of ground, flight, and launch systems, i.e., Phases B, C, and D. Depending on the project team, efforts expended to develop cost estimates for operations (Phase E) may be relatively less rigorous than that devoted to estimates for ground and flight systems development. Furthermore, the project team may be challenged to develop a solid estimate of operations cost in the early stages of mission development, e.g., Concept Study Report or Systems Requirement Review (CSR/SRR), Preliminary Design Review (PDR), as mission specific peculiarities that impact cost may not be well understood. In addition, a methodology generally used to develop Phase E cost is engineering build-up, also known as “ grass roots” . Phase E can include cost and schedule risks that are not anticipated at the time of the major milestone reviews prior to launch. If not incorporated into the engineering build-up cost method for Phase E, this may translate into an estimation of the complexity of operations and overall cost estimates that are not mature and at worse, insufficient. As a result, projects may find themselves with thin reserves during cruise and on-orbit operations or project overruns prior to the end of mission. This paper examines a set of interplanetary missions in an effort to better understand the reasons for cost and staffing growth in Phase E. The method used in the study is discussed as well as the major findings summarized as the Phase E Explanation of Change (EoC). Research for the study entailed the review of project materials, including Estimates at Completion (EAC) for Phase E and staffing profiles, major project milestone reviews, e.g., CSR, PDR, Critical Design Review (CDR), the interviewing of select project and mission management, and review of Phase E replan materials. From this work, a detai- ed

  8. Robotic mitral valve operations by experienced surgeons are cost-neutral and durable at 1 year.

    Science.gov (United States)

    Coyan, Garrett; Wei, Lawrence M; Althouse, Andrew; Roberts, Harold G; Schauble, Drew; Murashita, Takashi; Cook, Chris C; Rankin, J Scott; Badhwar, Vinay

    2018-04-12

    Robotic mitral valve surgery has potential advantages in patient satisfaction and 30-day outcome. Cost concerns and repair durability limit wider adoption of robotic technology. This study examined detailed cost differences between robotic and sternotomy techniques in relation to outcomes and durability following robotic mitral program initiation. Between April 2013 and October 2015, 30-day and 1-year outcomes of 328 consecutive patients undergoing robotic or sternotomy mitral valve repair or replacement by experienced surgeons were examined. Multivariable logistic regression informed propensity matching to derive a cohort of 182 patients. Echocardiographic follow-up was completed at 1 year in all robotic patients. Detailed activity-based cost accounting was applied to include direct, semidirect, and indirect costs with special respect to robotic depreciation, maintenance, and supplies. A quantitative analysis of all hospital costs was applied directly to each patient encounter for comparative financial analyses. Mean predicted risk of mortality was similar in both the robotic (n = 91) and sternotomy (n = 91) groups (0.9% vs 0.8%; P > .431). The total costs of robotic mitral operations were similar to those of sternotomy ($27,662 vs $28,241; P = .273). Early direct costs were higher in the robotic group. There was a marked increase in late indirect cost with the sternotomy cohort related to increased length of stay, transfusion requirements, and readmission rates. Robotic repair technique was associated with no echocardiographic recurrence greater than trace to only mild regurgitation at 1 year. Experienced mitral surgeons can initiate a robotic program in a cost-neutral manner that maintains clinical outcome integrity as well as repair durability. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  9. Power plant allocation in East Kalimantan considering total cost and emissions

    Science.gov (United States)

    Muslimin; Utomo, D. S.

    2018-04-01

    The fulfillment of electricity need in East Kalimantan is the responsibility of State Electricity Company/Perusahaan Listrik Negara (PLN). But PLN faces constraints in the lack of generating capacity it has. So the allocation of power loads in East Kalimantan has its own challenges. Additional power supplies from other parties are required. In this study, there are four scenarios tested to meet the electricity needs in East Kalimantan with the goal of minimizing costs and emissions. The first scenario is only by using PLN power plant. The second scenario is by combining PLN + Independent Power Producer (IPP) power plants. The third scenario is by using PLN + Rented power plants. The fourth scenario is by using PLN + Excess capacity generation. Numerical experiment using nonlinear programming is conducted with the help of the solver. The result shows that in the peak load condition, the best combination is scenario 2 (PLN + IPP). While at the lowest load condition, the cheapest scenario is PLN + IPP while the lowest emission is PLN + Rent.

  10. Operations Assessment of Launch Vehicle Architectures using Activity Based Cost Models

    Science.gov (United States)

    Ruiz-Torres, Alex J.; McCleskey, Carey

    2000-01-01

    The growing emphasis on affordability for space transportation systems requires the assessment of new space vehicles for all life cycle activities, from design and development, through manufacturing and operations. This paper addresses the operational assessment of launch vehicles, focusing on modeling the ground support requirements of a vehicle architecture, and estimating the resulting costs and flight rate. This paper proposes the use of Activity Based Costing (ABC) modeling for this assessment. The model uses expert knowledge to determine the activities, the activity times and the activity costs based on vehicle design characteristics. The approach provides several advantages to current approaches to vehicle architecture assessment including easier validation and allowing vehicle designers to understand the cost and cycle time drivers.

  11. A total cost perspective on use of polymeric materials in solar collectors – Importance of environmental performance on suitability

    International Nuclear Information System (INIS)

    Carlsson, Bo; Persson, Helena; Meir, Michaela; Rekstad, John

    2014-01-01

    Highlights: • A polymeric solar collector system was compared with two traditional ones. • It was found the best in terms of climatic performance per solar heat collected. • The differences in climatic cost between the systems compared however are small. • The low climatic cost makes solar heating better compared to natural gas heating. • Use of Ecoindicator 99 for environmental cost makes solar heating even better. - Abstract: To assess the suitability of solar collector systems in which polymeric materials are used versus those in which more traditional materials are used, a case study was undertaken. In this case study a solar heating system with polymeric solar collectors was compared with two equivalent but more traditional solar heating systems: one with flat plate solar collectors and one with evacuated tube solar collectors. To make the comparison, a total cost accounting approach was adopted. The life cycle assessment (LCA) results clearly indicated that the polymeric solar collector system is the best as regards climatic and environmental performance when they are expressed in terms of the IPPC 100 a indicator and the Ecoindicator 99, H/A indicator, respectively. In terms of climatic and environmental costs per amount of solar heat collected, the differences between the three kinds of collector systems were small when compared with existing energy prices. With the present tax rates, it seems unlikely that the differences in environmental and climatic costs will have any significant influence on which system is the most favoured, from a total cost point of view. In the choice between a renewable heat source and a heat source based on the use of a fossil fuel, the conclusion was that for climatic performance to be an important economic factor, the tax or trade rate of carbon dioxide emissions must be increased significantly, given the initial EU carbon dioxide emission trade rate. The rate would need to be at least of the same order of magnitude

  12. Solid Waste Operations Complex W-113: Project cost estimate. Preliminary design report. Volume IV

    International Nuclear Information System (INIS)

    1995-01-01

    This document contains Volume IV of the Preliminary Design Report for the Solid Waste Operations Complex W-113 which is the Project Cost Estimate and construction schedule. The estimate was developed based upon Title 1 material take-offs, budgetary equipment quotes and Raytheon historical in-house data. The W-113 project cost estimate and project construction schedule were integrated together to provide a resource loaded project network

  13. Solar to hydrogen: Compact and cost effective CPV field for rooftop operation and hydrogen production

    KAUST Repository

    Burhan, Muhammad; Oh, Seung Jin; Chua, Kian Jon Ernest; Ng, Kim Choon

    2016-01-01

    installations at the rooftop of commercial and residential buildings are aimed to be increased to half of total installed PV. On the other hand, there is no commercial CPV system available to be suitable for rooftop operation, giving motivation

  14. Can the pre-operative Western Ontario and McMaster score predict patient satisfaction following total hip arthroplasty?

    Science.gov (United States)

    Rogers, B A; Alolabi, B; Carrothers, A D; Kreder, H J; Jenkinson, R J

    2015-02-01

    In this study we evaluated whether pre-operative Western Ontario and McMaster Universities (WOMAC) osteoarthritis scores can predict satisfaction following total hip arthroplasty (THA). Prospective data for a cohort of patients undergoing THA from two large academic centres were collected, and pre-operative and one-year post-operative WOMAC scores and a 25-point satisfaction questionnaire were obtained for 446 patients. Satisfaction scores were dichotomised into either improvement or deterioration. Scatter plots and Spearman's rank correlation coefficient were used to describe the association between pre-operative WOMAC and one-year post-operative WOMAC scores and patient satisfaction. Satisfaction was compared using receiver operating characteristic (ROC) analysis against pre-operative, post-operative and δ WOMAC scores. We found no relationship between pre-operative WOMAC scores and one-year post-operative WOMAC or satisfaction scores, with Spearman's rank correlation coefficients of 0.16 and -0.05, respectively. The ROC analysis showed areas under the curve (AUC) of 0.54 (pre-operative WOMAC), 0.67 (post-operative WOMAC) and 0.43 (δ WOMAC), respectively, for an improvement in satisfaction. We conclude that the pre-operative WOMAC score does not predict the post-operative WOMAC score or patient satisfaction after THA, and that WOMAC scores can therefore not be used to prioritise patient care. ©2015 The British Editorial Society of Bone & Joint Surgery.

  15. The role of information technology (IT) in reducing offshore operating costs

    International Nuclear Information System (INIS)

    Stern, M.J.

    1993-01-01

    The rapid changes in information technology (IT) and its application have helped to improve efficiency and reduce operating costs offshore. Developments in IT itself, in terms of technology, organization and standards together with cultural change have created new opportunities. In the application of IT, the most significant impact on operations costs and effectiveness has come from the use of information throughout the life cycle, and improved telecommunications. This paper describes recent developments in IT and its application, and cites examples where oil companies have derived major benefits

  16. Procedure for estimating nonfuel operation and maintenance costs for large steam-electric power plants

    International Nuclear Information System (INIS)

    Myers, M.L.; Fuller, L.C.

    1979-01-01

    Revised guidelines are presented for estimating annual nonfuel operation and maintenance costs for large steam-electric power plants, specifically light-water-reactor plants and coal-fired plants. Previous guidelines were published in October 1975 in ERDA 76-37, a Procedure for Estimating Nonfuel Operating and Maintenance Costs for Large Steam-Electric Power Plants. Estimates for coal-fired plants include the option of limestone slurry scrubbing for flue gas desulfurization. A computer program, OMCOST, is also presented which covers all plant options

  17. Cost estimates for Operation Desert Shield/Desert Storm: a budgetary analysis

    OpenAIRE

    Johnson, J. Andrew.

    1991-01-01

    Operation Desert Shield/Desert Storm (DS/DS) presented unique challenges for estimating the cost of that conflict. This analysis reviews the cost estimates and methodologies developed for that purpose by DoD, CBO and GAO. It considers the budget climate and the role of foreign cash and in-kind contributions. Finally, it reviews the budgeting innovations used to provide and monitor DS/DS defense spending. At the outset of the crisis, costs were estimated to determine the defense funding requir...

  18. Perceptions of mobile network operators regarding the cost drivers of the South African mobile phone industry

    Directory of Open Access Journals (Sweden)

    Musenga F. Mpwanya

    2016-11-01

    Implications: The findings of this study should assist MNOs in their monitoring of cost drivers and in the identification of cost reduction opportunities, in order to remain effective and efficient in the industry. This study’s findings should help regulating authorities (such as the Department of Communications and the Independent Communication Authority of South Africa [ICASA] to gain insights into the cost drivers of the South African mobile phone industry from the perspective of a network operator, and thus to develop appropriate mobile phone policies.

  19. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

    Science.gov (United States)

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

    2015-12-01

    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  20. Operative delay to laparoscopic cholecystectomy: Racking up the cost of health care.

    Science.gov (United States)

    Schwartz, Diane A; Shah, Adil A; Zogg, Cheryl K; Nicholas, Lauren H; Velopulos, Catherine G; Efron, David T; Schneider, Eric B; Haider, Adil H

    2015-07-01

    Health care providers are increasingly focused on cost containment. One potential target for cost containment is in-hospital management of acute cholecystitis. Ensuring cholecystectomy within 24 hours for cholecystitis could mitigate costs associated with longer hospitalizations. We sought to determine the cost consequences of delaying operative management. The Nationwide Inpatient Sample (2003-2011) was queried for adult patients (≥16 years) who underwent laparoscopic cholecystectomy for a primary diagnosis of acute cholecystitis. Patients who underwent open procedures or endoscopic retrograde cholangiopancreatography were excluded. Generalized linear models (GLMs) were used to analyze costs for each day's delay in surgery. Multivariable analyses adjusted for patient demographics, hospital descriptors, Charlson comorbidity index, mortality, and length of stay. We analyzed 191,032 records. Approximately 65% of the patients underwent surgery within 24 hours of admission. The average cost of care for surgery on the admission day was $11,087. Costs disproportionately increased by 22% on the second hospital day ($13,526), by 37% on the third day ($15,243), by 52% on the fourth day ($16,822), by 64% on the fifth day ($18,196), by 81% on the sixth day ($20,125), and by 100% on the seventh day ($22,250) when compared with the cost of care for procedures performed within 24 hours of admission. Subset analysis of patients discharged 24 hours or earlier from the time of surgery demonstrated similar trends. After controlling for patient- and hospital-related factors, we noted significant costs associated with each day's delay in operative management. Cost containment practices for acute cholecystitis justify consideration of same-day or next-day surgery where the diagnosis is straightforward. Economic and value-based analysis, level III.

  1. Bentall operation, total aortic replacement and mitral valve replacement for a young adult with Marfan syndrome: a case of three-staged operation.

    Science.gov (United States)

    Inui, K; Shimazaki, Y; Watanabe, T; Kuraoka, S; Minowa, T; Miura, M; Oshikiri, S; Toyama, H

    1998-08-01

    In Marfan syndrome, the most common cardiovascular abnormalities are dilatation of the aorta and aortic valve regurgitation in adult patients. Mitral valve dysfunction is the most common cause of morbidity and mortality in infants and children with Marfan syndrome, and is not frequently operated on in adult Marfan patients who undergo surgery for diseases of the aortic root and total aorta. This report describes a successfully three-staged operation for a 24 year-old man with Marfan syndrome who underwent an emergent Bentall operation and aortic arch replacement, total aortic replacement and mitral valve replacement over 2 years. Mitral valve regurgitation was mild but increased after the second operation. The graft was tightly adhesive and invasive to the sternum. Endoscopic view was helpful to avoid graft damage at resternotomy. The postoperative course was uneventful in each operation. Microscopic examination of the mitral valve leaflets showed abnormal increase of mucopolysaccharides, and disruption and fragmentation of elastic fibers.

  2. Operating cost reduction by optimization of I and C backfitting strategy

    International Nuclear Information System (INIS)

    Kraft, Heinz-U.

    2002-01-01

    Full text: The safe and economic operation of a nuclear power plant requires a large scope of automation systems to act properly in combination. The associated maintenance costs, necessary to test these systems periodically and to repair or to replace them partly or completely, are one important factor in the overall operating costs of a nuclear power plant. Reducing these costs by reducing the maintenance effort could decrease the availability of the power plant and by this way increase the operating costs significantly. The minimization of the overall operating costs requires a well-balanced maintenance strategy taking into account all these opposite influences. The replacement of an existing I and C system by a new one reduces the maintenance cost in the long term and increases the plant availability. However, it requires some investments in the short term. On the other hand the repair of an I and C system avoids investments, but it doesn't solve the aging problems. That means maintenance costs will increase in the long term and the plant availability could be decreased. An optimized maintenance strategy can be elaborated on a plant specific base taking into account the residual lifetime of the plant, the properties of the installed I and C systems as well as their influence on the plant availability. As a general result of such an optimization performed by FANP it has been found as a rule that the replacement of I and C systems becomes the most economic way the longer the expected lifetime is and the stronger the I and C system influences, the availability of the plant. (author)

  3. Cost analysis of iliac stenting performed in the operating room and the catheterization lab: A case-control study.

    Science.gov (United States)

    Kim, Sooyeon; Kramer, Sage P; Dugan, Adam J; Minion, David J; Gurley, John C; Davenport, Daniel L; Ferraris, Victor A; Saha, Sibu P

    2016-12-01

    Iliac arterial stenting is performed both in the operating room (OR) and the catheterization lab (CL). To date, no analysis has compared resource utilization between these locations. Consecutive patients (n = 105) treated at a single center were retrospectively analyzed. Patients included adults with chronic, symptomatic iliac artery stenosis with a minimum Rutherford classification (RC) of 3, treated with stents. Exclusion criteria were prior stenting, acute ischemia, or major concomitant procedures. Immediate and two-year outcomes were observed. Patient demographics, perioperative details, physician billings, and hospital costs were recorded. Multivariable regression was used to adjust costs by patient and perioperative cost drivers. Fifty-one procedures (49%) were performed in the OR and 54 (51%) in the CL. Mean age was 57, and 44% were female. Severe cases were more often performed in the OR (RC ≥ 4; 42% vs. 11%, P costs (P costs (P costs but was associated with increased professional fees. Same-stay (5%) and post-discharge reintervention (33%) did not vary by location. The OR was associated with increased length of stay, more ICU admissions, and increased total costs. However, OR patients had more severe disease and therefore often required more aggressive intervention. After controlling for these differences, procedure venue per se was not associated with increased costs, but OR cases incurred increased professional fees due to dual-provider charges. Given the similar clinical results between venues, it seems reasonable to perform most stenting in the CL or utilize conscious sedation in the OR. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Short-radius horizontal well re-entry learning curve: prize, cost and operational experience

    Energy Technology Data Exchange (ETDEWEB)

    Boote, K. [Ocelot Energy Inc., Calgary, AB (Canada); MacDonald, R. [Lauron Engineering Ltd, Calgary, AB (Canada)

    1997-12-01

    Six mature vertical wells in Alberta belonging to Ocelot Energy Inc., were reentered and drilled horizontally. Experiences gained, the modifications made to the drilling program and the rewards in the form of incremental oil, were discussed. Details of pre- and post-performance, operational experiences with exiting the casing, building the curve, overbalance versus underbalanced drilling, motors, directional equipment, setting liners, remedial workovers and the cost of the operation were part of the discussion.

  5. EOS MLS Lessons Learned: Design Ideas for Safer and Lower Cost Operations

    Science.gov (United States)

    Miller, Dominick

    2012-01-01

    The Earth Observing System (EOS) Microwave Limb Sounder (MLS) is a complex instrument with a front end computer and 32 subsystem computers. MLS is one of four instruments on NASA's EOS Aura spacecraft With almost 8 years in orbit, MLS has a few lessons learned which can be applied during the design phase of future instruments to effect better longevity, more robust operations and a significant cost benefit during operations phase.

  6. Enhanced methods for operating refueling station tube-trailers to reduce refueling cost

    Science.gov (United States)

    Elgowainy, Amgad; Reddi, Krishna

    2017-08-22

    A method and apparatus are provided for operating a refueling station including source tube-trailers and at least one compressor to reduce refueling cost. The refueling station includes a gaseous fuel supply source including a plurality of tanks on a tube trailer coupled to a first control unit, and high pressure buffer storage having predefined capacity coupled to a second control unit and the first tanks by a pressure control valve and the first control unit, and at least one compressor. The refueling station is operated at different modes depending on a state of the refueling station at the beginning of each operational mode. The refueling system is assessed at the end of each operational mode to identify the state of the system and select a next mode of operation. The operational modes include consolidating hydrogen, or any gaseous fuel, within the tubes mounted on the trailer.

  7. ROBucket: A low cost operant chamber based on the Arduino microcontroller.

    Science.gov (United States)

    Devarakonda, Kavya; Nguyen, Katrina P; Kravitz, Alexxai V

    2016-06-01

    The operant conditioning chamber is a cornerstone of animal behavioral research. Operant boxes are used to assess learning and motivational behavior in animals, particularly for food and drug reinforcers. However, commercial operant chambers cost several thousands of dollars. We have constructed the Rodent Operant Bucket (ROBucket), an inexpensive and easily assembled open-source operant chamber based on the Arduino microcontroller platform, which can be used to train mice to respond for sucrose solution or other liquid reinforcers. The apparatus contains two nose pokes, a drinking well, and a solenoid-controlled liquid delivery system. ROBucket can run fixed ratio and progressive ratio training schedules, and can be programmed to run more complicated behavioral paradigms. Additional features such as motion sensing and video tracking can be added to the operant chamber through the array of widely available Arduino-compatible sensors. The design files and programming code are open source and available online for others to use.

  8. Integrated batch production and maintenance scheduling for multiple items processed on a deteriorating machine to minimize total production and maintenance costs with due date constraint

    Directory of Open Access Journals (Sweden)

    Zahedi Zahedi

    2016-04-01

    Full Text Available This paper discusses an integrated model of batch production and maintenance scheduling on a deteriorating machine producing multiple items to be delivered at a common due date. The model describes the trade-off between total inventory cost and maintenance cost as the increase of production run length. The production run length is a time bucket between two consecutive preventive maintenance activities. The objective function of the model is to minimize total cost consisting of in process and completed part inventory costs, setup cost, preventive and corrective maintenance costs and rework cost. The problem is to determine the optimal production run length and to schedule the batches obtained from determining the production run length in order to minimize total cost.

  9. The Effect of Infrastructure Sharing in Estimating Operations Cost of Future Space Transportation Systems

    Science.gov (United States)

    Sundaram, Meenakshi

    2005-01-01

    NASA and the aerospace industry are extremely serious about reducing the cost and improving the performance of launch vehicles both manned or unmanned. In the aerospace industry, sharing infrastructure for manufacturing more than one type spacecraft is becoming a trend to achieve economy of scale. An example is the Boeing Decatur facility where both Delta II and Delta IV launch vehicles are made. The author is not sure how Boeing estimates the costs of each spacecraft made in the same facility. Regardless of how a contractor estimates the cost, NASA in its popular cost estimating tool, NASA Air force Cost Modeling (NAFCOM) has to have a method built in to account for the effect of infrastructure sharing. Since there is no provision in the most recent version of NAFCOM2002 to take care of this, it has been found by the Engineering Cost Community at MSFC that the tool overestimates the manufacturing cost by as much as 30%. Therefore, the objective of this study is to develop a methodology to assess the impact of infrastructure sharing so that better operations cost estimates may be made.

  10. Construction and Operation Costs of Wastewater Treatment and Implications for the Paper Industry in China.

    Science.gov (United States)

    Niu, Kunyu; Wu, Jian; Yu, Fang; Guo, Jingli

    2016-11-15

    This paper aims to develop a construction and operation cost model of wastewater treatment for the paper industry in China and explores the main factors that determine these costs. Previous models mainly involved factors relating to the treatment scale and efficiency of treatment facilities for deriving the cost function. We considered the factors more comprehensively by adding a regional variable to represent the economic development level, a corporate ownership factor to represent the plant characteristics, a subsector variable to capture pollutant characteristics, and a detailed-classification technology variable. We applied a unique data set from a national pollution source census for the model simulation. The major findings include the following: (1) Wastewater treatment costs in the paper industry are determined by scale, technology, degree of treatment, ownership, and regional factors; (2) Wastewater treatment costs show a large decreasing scale effect; (3) The current level of pollutant discharge fees is far lower than the marginal treatment costs for meeting the wastewater discharge standard. Key implications are as follows: (1) Cost characteristics and impact factors should be fully recognized when planning or making policies relating to wastewater treatment projects or technology development; (2) There is potential to reduce treatment costs by centralizing wastewater treatment via industrial parks; (3) Wastewater discharge fee rates should be increased; (4) Energy efficient technology should become the future focus of wastewater treatment.

  11. Comparison between local anaesthesia with remifentanil and total intravenous anaesthesia for operative hysteroscopic procedures in day surgery

    DEFF Research Database (Denmark)

    Majholm, B; Bartholdy, J; Clausen, H V

    2012-01-01

    BACKGROUND: /st>This study aimed at comparing total i.v. anaesthesia (TIVA) with monitored anaesthesia care (MAC) during day-surgery operative hysteroscopy regarding: operation time, time to mobilization and discharge, and patient satisfaction. METHODS: /st>Ninety-one healthy women were randomized...... to MAC with paracervical local anaesthesia and remifentanil or to TIVA with propofol and remifentanil. Time from arrival to leaving the operating theatre, time from arrival in the recovery room to mobilization and discharge readiness, and patient satisfaction with MAC and TIVA were observed. RESULTS: /st.......003). CONCLUSIONS: /st>Paracervical local anaesthesia combined with remifentanil is suitable for operative hysteroscopy in day surgery....

  12. The Role of Logistics in Practical Levelized Cost of Energy Reduction Implementation and Government Sponsored Cost Reduction Studies: Day and Night in Offshore Wind Operations and Maintenance Logistics

    DEFF Research Database (Denmark)

    Poulsen, Thomas; Hasager, Charlotte Bay; Jensen, Christian Munk

    2017-01-01

    This paper reveals that logistics make up at least 17% of annual operational expenditure costs for offshore wind farms. Annual operational expenditure is found to vary by a factor of 9.5, making its share of levelized cost of energy for offshore wind range from 13% to 57%. These are key findings...... contrast to the shore-based office personnel who develop studies directing cost reduction efforts. This paper details the company motivation to join industry-wide cost reduction initiatives. A business case for offshore wind operations and maintenance logistics yielding 1% savings in levelized cost...... of a 20-month research project targeting cost reduction initiatives for offshore wind systems. The findings reveal that cost-out measures are difficult to implement due to cultural differences. Implementation efforts are rendered by personnel located offshore in a harsh sea environment which is in stark...

  13. Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement.

    Science.gov (United States)

    Snow, Richard; Granata, Jaymes; Ruhil, Anirudh V S; Vogel, Karen; McShane, Michael; Wasielewski, Ray

    2014-10-01

    Health-care costs following acute hospital care have been identified as a major contributor to regional variation in Medicare spending. This study investigated the associations of preoperative physical therapy and post-acute care resource use and its effect on the total cost of care during primary hip or knee arthroplasty. Historical claims data were analyzed using the Centers for Medicare & Medicaid Services Limited Data Set files for Diagnosis Related Group 470. Analysis included descriptive statistics of patient demographic characteristics, comorbidities, procedures, and post-acute care utilization patterns, which included skilled nursing facility, home health agency, or inpatient rehabilitation facility, during the ninety-day period after a surgical hospitalization. To evaluate the associations, we used bivariate and multivariate techniques focused on post-acute care use and total episode-of-care costs. The Limited Data Set provided 4733 index hip or knee replacement cases for analysis within the thirty-nine-county Medicare hospital referral cluster. Post-acute care utilization was a significant variable in the total cost of care for the ninety-day episode. Overall, 77.0% of patients used post-acute care services after surgery. Post-acute care utilization decreased if preoperative physical therapy was used, with only 54.2% of the preoperative physical therapy cohort using post-acute care services. However, 79.7% of the non-preoperative physical therapy cohort used post-acute care services. After adjusting for demographic characteristics and comorbidities, the use of preoperative physical therapy was associated with a significant 29% reduction in post-acute care use, including an $871 reduction of episode payment driven largely by a reduction in payments for skilled nursing facility ($1093), home health agency ($527), and inpatient rehabilitation ($172). The use of preoperative physical therapy was associated with a 29% decrease in the use of any post-acute care

  14. Use of Tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement

    Directory of Open Access Journals (Sweden)

    Umer Chaudhry Muhammad

    2011-05-01

    Full Text Available Abstract Background & Purpose Allogenic blood transfusion in elective orthopaedic surgery is best avoided owing to its associated risks. Total knee replacement often requires blood transfusion, more so when bilateral surgery is performed. Many strategies are currently being employed to reduce the amount of peri-operative allogenic transfusions. Anti-fibrinolytic compounds such as aminocaproic acid and tranexamic acid have been used systemically in perioperative settings with promising results. This study aimed to evaluate the effectiveness of tranexamic acid in reducing allogenic blood transfusion in total knee replacement surgery. Methodology This was a retrospective cohort study conducted on patients undergoing total knee replacement during the time period November 2005 to November 2008. Study population was 99 patients, of which 70 underwent unilateral and 29 bilateral knee replacement. Forty-seven patients with 62 (49.5% knees (group-I had received tranexamic acid (by surgeon preference while the remaining fifty-two patients with 66 (51.5% knees (group-II had did not received any tranexamic acid either pre- or post-operatively. Results The mean drop in the post-operative haemoglobin concentration in Group-II for unilateral and bilateral cases was 1.79 gm/dl and 2.21 gm/dl, with a mean post-operative drainage of 1828 ml (unilateral and 2695 ml (bilateral. In comparison, the mean drop in the post-op haemoglobin in Group-I was 1.49 gm/dl (unilateral and 1.94 gm/dl (bilateral, with a mean drainage of 826 ml (unilateral and 1288 ml (bilateral (p-value Interpretation Tranexamic acid is effective in reducing post-operative drainage and requirement of blood transfusion after knee replacement.

  15. Estimation of the laser cutting operating cost by support vector regression methodology

    Science.gov (United States)

    Jović, Srđan; Radović, Aleksandar; Šarkoćević, Živče; Petković, Dalibor; Alizamir, Meysam

    2016-09-01

    Laser cutting is a popular manufacturing process utilized to cut various types of materials economically. The operating cost is affected by laser power, cutting speed, assist gas pressure, nozzle diameter and focus point position as well as the workpiece material. In this article, the process factors investigated were: laser power, cutting speed, air pressure and focal point position. The aim of this work is to relate the operating cost to the process parameters mentioned above. CO2 laser cutting of stainless steel of medical grade AISI316L has been investigated. The main goal was to analyze the operating cost through the laser power, cutting speed, air pressure, focal point position and material thickness. Since the laser operating cost is a complex, non-linear task, soft computing optimization algorithms can be used. Intelligent soft computing scheme support vector regression (SVR) was implemented. The performance of the proposed estimator was confirmed with the simulation results. The SVR results are then compared with artificial neural network and genetic programing. According to the results, a greater improvement in estimation accuracy can be achieved through the SVR compared to other soft computing methodologies. The new optimization methods benefit from the soft computing capabilities of global optimization and multiobjective optimization rather than choosing a starting point by trial and error and combining multiple criteria into a single criterion.

  16. Integrated Emission Management strategy for cost-optimal engine-aftertreatment operation

    NARCIS (Netherlands)

    Cloudt, R.P.M.; Willems, F.P.T.

    2011-01-01

    A new cost-based control strategy is presented that optimizes engine-aftertreatment performance under all operating conditions. This Integrated Emission Management strategy minimizes fuel consumption within the set emission limits by on-line adjustment of air management based on the actual state of

  17. Harvest operations for density management: planning requirements, production, costs, stand damage, and recommendations

    Science.gov (United States)

    Loren D. Kellogg; Stephen J. Pilkerton

    2013-01-01

    Since the early 1990s, several studies have been undertaken to determine the planning requirements, productivity, costs, and residual stand damage of harvest operations in thinning treatments designed to promote development of complex forest structure in order to enhance ecological functioning and biological diversity. Th ese studies include the Oregon State...

  18. Analysis of operating costs a Low-Level Mixed Waste Incineration Facility

    International Nuclear Information System (INIS)

    Loghry, S.L.; Salmon, R.; Hermes, W.H.

    1995-01-01

    By definition, mixed wastes contain both chemically hazardous and radioactive components. These components make the treatment and disposal of mixed wastes expensive and highly complex issues because the different regulations which pertain to the two classes of contaminants frequently conflict. One method to dispose of low-level mixed wastes (LLMWs) is by incineration, which volatizes and destroys the organic (and other) hazardous contaminants and also greatly reduces the waste volume. The US Department of Energy currently incinerates liquid LLMW in its Toxic Substances Control Act (TSCA) Incinerator, located at the K-25 Site in Oak Ridge, Tennessee. This incinerator has been fully permitted since 1991 and to date has treated approximately 7 x 10 6 kg of liquid LLMW. This paper presents an analysis of the budgeted operating costs by category (e.g., maintenance, plant operations, sampling and analysis, and utilities) for fiscal year 1994 based on actual operating experience (i.e., a ''bottoms-up'' budget). These costs provide benchmarking guidelines which could be used in comparing incinerator operating costs with those of other technologies designed to dispose of liquid LLMW. A discussion of the current upgrade status and future activities are included in this paper. Capital costs are not addressed

  19. Capital and Operating Cost of Small Arsenic Removal System and their Most Frequent Maintenance Problems

    Science.gov (United States)

    This presentation will first summarize the capital and operating cost of treatment systems by type and size of the systems. The treatment systems include adsorptive media (AM) systems, iron removal (IR), coagulation/filtration (CF), ion exchange (IX) systems, and point-of-use rev...

  20. Instructor guide : managing operating cost for rural and small urban transit systems.

    Science.gov (United States)

    2013-01-01

    The purpose of the workshop is to provide rural and small urban transit managers and staff with tools to analyze, track, predict, and manage operational costs. The workshop will have a beginning and ending general session, and will provide six sessio...

  1. 75 FR 33987 - Disposing of Unneeded Federal Real Estate Increasing Sales Proceeds, Cutting Operating Costs, and...

    Science.gov (United States)

    2010-06-16

    ... operations and maintenance costs. Past attempts at reducing the Federal Government's civilian real property..., save energy and water, and further reduce greenhouse gas pollution, I hereby direct executive... eliminating all forms of Government waste and to leading by example as our Nation transitions to a clean...

  2. Community College Finance: A Cost Analysis of Community College Expenditures Related to Maintenance and Operations

    Science.gov (United States)

    Collins, Michael T.

    2011-01-01

    The purpose of this study is to develop a costing model for maintenance and operations expenditures among 16 single-campus California community college districts and assess the impact of a variety of variables including size of student enrollment, physical plant age, acreage, gross square footage, and general obligation facility bonds on district…

  3. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Science.gov (United States)

    2010-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment system...

  4. Productivity and Cost Analysis of Forest Harvesting Operation in Matang Mangrove Forest, Perak, Malaysia

    Directory of Open Access Journals (Sweden)

    Albert Empawi Tindit

    2017-04-01

    Full Text Available Matang Mangrove Forest is under systematic management since 1902 and still considered as the best managed mangrove forest in the world. This research was conducted to measure the time and productivity of forest harvesting operation and also to analyze the cost and revenue of mangrove forest harvesting operation at Matang mangrove forest. This project had been carried out in cooperation with Seri Sepetang Enterprise, one of the harvesting licenses in Kuala Sepetang, Perak. Data collections were taken in every station starting from standing tree until to the Kiln-Drying jetty. The data then calculated by using the formulas of productivity and cost analysis. As the result, the productivity for felling, bucking and debarking, the manual skidding using wheel-barrow and the water transportation are 1.84 tan/hour, 3.82 tan/hour and 4.64 tan/hour respectively. The cost for each operation of 9 tan log volume for felling, bucking and debarking, the manual skidding using wheel-barrow and the water transportation are RM 56.88, RM 10.80 and RM 36.72 respectively. As the revenue, the company paid RM 260 per 9 tan of log for the in-forest operation (felling, manual skidding and loading to the ship and pay RM 80 per 9 tan for the water transportation, and they gained the net profit of RM 192.32 and RM 43.28 respectively. The average of forest harvesting operation is twice operation in a day (equal with 2 x 9-ton volume of log production a day, so they will gain a double profit. In conclusion, the forest harvesting operation is sustainably managed for supplying the raw material of charcoal industries in Matang mangrove forest. Since, they work manually and spend much energy in this forest harvesting operation, so for further study it recommends to conduct the ergonomics evaluation during forest harvesting operation at Matang Mangrove Forest.

  5. Low-cost management aspects for developing, producing and operating future space transportation systems

    Science.gov (United States)

    Goehlich, Robert A.; Rücker, Udo

    2005-01-01

    It is believed that a potential means for further significant reduction of the recurrent launch cost, which results also in a stimulation of launch rates of small satellites, is to make the launcher reusable, to increase its reliability and to make it suitable for new markets such as mass space tourism. Therefore, not only launching small satellites with expendable rockets on non-regular flights but also with reusable rockets on regular flights should be considered for the long term. However, developing, producing and operating reusable rockets require a fundamental change in the current "business as usual" philosophy. Under current conditions, it might not be possible to develop, to produce or to operate a reusable vehicle fleet economically. The favorite philosophy is based on "smart business" processes adapted by the authors using cost engineering techniques. In the following paper, major strategies for reducing costs are discussed, which are applied for a representative program proposal.

  6. When is it safe to resume driving after total hip and total knee arthroplasty? a meta-analysis of literature on post-operative brake reaction times.

    Science.gov (United States)

    van der Velden, C A; Tolk, J J; Janssen, R P A; Reijman, M

    2017-05-01

    The aim of this study was to assess the current available evidence about when patients might resume driving after elective, primary total hip (THA) or total knee arthroplasty (TKA) undertaken for osteoarthritis (OA). In February 2016, EMBASE, MEDLINE, Web of Science, Scopus, Cochrane, PubMed Publisher, CINAHL, EBSCO and Google Scholar were searched for clinical studies reporting on 'THA', 'TKA', 'car driving', 'reaction time' and 'brake response time'. Two researchers (CAV and JJT) independently screened the titles and abstracts for eligibility and assessed the risk of bias. Both fixed and random effects were used to pool data and calculate mean differences (MD) and 95% confidence intervals (CI) between pre- and post-operative total brake response time (TBRT). A total of 19 studies were included. The assessment of the risk of bias showed that one study was at high risk, six studies at moderate risk and 12 studies at low risk. Meta-analysis of TBRT showed a MD decrease of 25.54 ms (95% CI -32.02 to 83.09) two weeks after right-sided THA, and of 18.19 ms (95% CI -6.13 to 42.50) four weeks after a right-sided TKA, when compared with the pre-operative value. The TBRT returned to baseline two weeks after a right-sided THA and four weeks after a right-sided TKA. These results may serve as guidelines for orthopaedic surgeons when advising patients when to resume driving. However, the advice should be individualised. Cite this article: Bone Joint J 2017;99-B:566-76. ©2017 The British Editorial Society of Bone & Joint Surgery.

  7. (Reportıng of Operation Results In Basis Of Actual Variable Cost)

    OpenAIRE

    Çıkrıkçı, Mustafa; Dabbağoğlu, Kadir

    2007-01-01

    Calculation of production cost is primarily, essential to calculate cost of sales. Production cost is in the field of cost accounting and there are different approaches on calculation of production cost in cost accounting theory. These approaches designate the cost system. A cost system is a combination of cost principle, cost method and cost procedure. Principals consist of full cost and partial cost. Methods consist of actual cost and estimated cost. Procedures consist of order cost and sta...

  8. Imageless navigation total hip arthroplasty – an evaluation of operative time

    Directory of Open Access Journals (Sweden)

    Valsamis Epaminondas Markos

    2018-01-01

    Discussion: This is the first study that demonstrates no added operative time when using imageless navigation in THA, achieved with an improved workflow. The results also demonstrate a very reasonable learning curve.

  9. Cost-effectiveness of cervical total disc replacement vs fusion for the treatment of 2-level symptomatic degenerative disc disease.

    Science.gov (United States)

    Ament, Jared D; Yang, Zhuo; Nunley, Pierce; Stone, Marcus B; Kim, Kee D

    2014-12-01

    Cervical total disc replacement (CTDR) was developed to treat cervical spondylosis, while preserving motion. While anterior cervical discectomy and fusion (ACDF) has been the standard of care for 2-level disease, a randomized clinical trial (RCT) suggested similar outcomes. Cost-effectiveness of this intervention has never been elucidated. To determine the cost-effectiveness of CTDR compared with ACDF. Data were derived from an RCT that followed up 330 patients over 24 months. The original RCT consisted of multi-institutional data including private and academic institutions. Using linear regression for the current study, health states were constructed based on the stratification of the Neck Disability Index and a visual analog scale. Data from the 12-item Short-Form Health Survey questionnaires were transformed into utilities values using the SF-6D mapping algorithm. Costs were calculated by extracting Diagnosis-Related Group codes from institutional billing data and then applying 2012 Medicare reimbursement rates. The costs of complications and return-to-work data were also calculated. A Markov model was built to evaluate quality-adjusted life-years (QALYs) for both treatment groups. The model adopted a third-party payer perspective and applied a 3% annual discount rate. Patients included in the original RCT had to be diagnosed as having radiculopathy or myeloradiculopathy at 2 contiguous levels from C3-C7 that was unresponsive to conservative treatment for at least 6 weeks or demonstrated progressive symptoms. Incremental cost-effectiveness ratio of CTDR compared with ACDF. A strong correlation (R2 = 0.6864; P sensitivity analysis, the incremental cost-effectiveness ratio value stays below the threshold of $50,000 per QALY in most scenarios (range, -$58,194 to $147,862 per QALY). The incremental cost-effectiveness ratio of CTDR compared with traditional ACDF is lower than the commonly accepted threshold of $50,000 per QALY. This remains true with varying input

  10. Evaluation of low-cost commercial-off-the-shelf autopilot systems for SUAS operations

    Science.gov (United States)

    Brown, Calvin Thomas

    With this increase in unmanned aircraft system (UAS) operations, there is a need for a structured process to evaluate different commercially available systems, particularly autopilots. The Remotely Operated Aircraft Management, Interpretation, and Navigation from Ground or ROAMING scale was developed to meet this need. This scale is a modification of the widely accepted Handling Qualities Rating scale developed by George Cooper and Robert Harper Jr. The Cooper-Harper scale allows pilots to rate a vehicle's performance in completing some task. Similarly, the ROAMING scale allows UAS operators to evaluate the management and observability of UAS in completing some task. The standardized evaluative process consists of cost, size, weight, and power (SWAP) analysis, ease of implementation through procedural description of setup, ROAMING scale rating, a slightly modified NASA TLX rating, and comparison of manual operation to autonomous operation of the task. This standard for evaluation of autopilots and their software will lead to better understanding of the workload placed on UAS operators and indicate where improvements to design and operational procedures can be made. An assortment of low-cost commercial-off-the-shelf (COTS) autopilots were selected for use in the development of the evaluation and results of these tests demonstrate the commonalities and differences in these systems.

  11. From Consumption to Prosumption - Operational Cost Optimization for Refrigeration System With Heat Waste Recovery

    DEFF Research Database (Denmark)

    Minko, Tomasz; Garcia, Jesus Lago; Bendtsen, Jan Dimon

    2017-01-01

    Implementation of liquid cooling transforms a refrigeration system into a combined cooling and heating system. Reclaimed heat can be used for building heating purposes or can be sold. Carbon dioxide based refrigeration systems are considered to have a particularly high potential for becoming ecient...... heat energy producers. In this paper a CO2 system that operates in the subcritical region is examined. Modelling approach is presented, and used for operation optimisation by way of non-linear model predictive control techniques. Assuming that the heat is sold when using both objective functions......, it turns out that the system have negative operational cost. In case when Cost Minimization objective function is used daily revenue is about 7:9 [eur], for Prosumption one it is 11:9 [eur]....

  12. Advanced launch system (ALS) - Electrical actuation and power systems improve operability and cost picture

    Science.gov (United States)

    Sundberg, Gale R.

    1990-01-01

    To obtain the Advanced Launch System (ALS) primary goals of reduced costs and improved operability, there must be significant reductions in the launch operations and servicing requirements relative to current vehicle designs and practices. One of the primary methods for achieving these goals is by using vehicle electrrical power system and controls for all aviation and avionics requirements. A brief status review of the ALS and its associated Advanced Development Program is presented to demonstrate maturation of those technologies that will help meet the overall operability and cost goals. The electric power and actuation systems are highlighted as a sdpecific technology ready not only to meet the stringent ALS goals (cryogenic field valves and thrust vector controls with peak power demands to 75 hp), but also those of other launch vehicles, military ans civilian aircraft, lunar/Martian vehicles, and a multitude of comercial applications.

  13. Advanced Launch System (ALS): Electrical actuation and power systems improve operability and cost picture

    Science.gov (United States)

    Sundberg, Gale R.

    1990-01-01

    To obtain the Advanced Launch System (ALS) primary goals of reduced costs and improved operability, there must be significant reductions in the launch operations and servicing requirements relative to current vehicle designs and practices. One of the primary methods for achieving these goals is by using vehicle electrical power system and controls for all actuation and avionics requirements. A brief status review of the ALS and its associated Advanced Development Program is presented to demonstrate maturation of those technologies that will help meet the overall operability and cost goals. The electric power and actuation systems are highlighted as a specific technology ready not only to meet the stringent ALS goals (cryogenic field valves and thrust vector controls with peak power demands to 75 hp), but also those of other launch vehicles, military and civilian aircraft, lunar/Martian vehicles, and a multitude of commercial applications.

  14. Study on the Development of Methodology for Cost Calculations and Financial Planning of Decommissioning Operations

    International Nuclear Information System (INIS)

    2001-12-01

    The following study deals with the development of methodology for cost calculations and financial planning of decommissioning operations. It has been carried out by EDF / FRAMATOME / VUJE / SCK-CEN in the frame of the contract B7-032/2000/291058/MAR/C2 awarded by the European Commission. This study consists of 4 parts. The first task objective is to develop a reliable and transparent methodology for cost assessment and financial planning sufficient precise but without long and in depth investigations and studies. This methodology mainly contains: Calculation methods and algorithms for the elaboration of costs items making up the whole decommissioning cost. Estimated or standard values for the parameters and for the cost factors to be used in the above-mentioned algorithms Financial mechanism to be applied as to establish a financial planning. The second part task is the provision of standard values for the different parameters and costs factors described in the above-mentioned algorithms. This provision of data is based on the own various experience acquired by the members of the working team and on existing international references (databases, publications and reports). As decommissioning operations are spreading over several dozens of years, the scope of this task the description of the financial mechanisms to be applied to the different cost items as to establish a complete financial cost. It takes into account the financial schedule issued in task 1. The scope of this task consists in bringing together in a guideline all the information collected before: algorithms, data and financial mechanisms. (A.L.B.)

  15. The System 80+ standard plant design reduces operations and maintenance costs

    International Nuclear Information System (INIS)

    Chari, D.R.; Robertson, J.E.

    1998-01-01

    To be cost-competitive, nuclear power plants must maximize plant availability and minimize operations and maintenance (O and M) costs. A plant whose design supports these goals will generate more power at less cost and thereby have a lower unit generating cost. The ABB Combustion Engineering Nuclear Systems (ABB-CE) System 80+ Standard Nuclear Power Plant, rated at 1400 megawatts electric (MWe), is designed for high availability at reduced cost. To demonstrate that the duration of refueling outages, the major contributor to plant unavailability, can be shortened, ABB-CE developed a detailed plan that shows a System 80+ plant can safely perform a refueling and maintenance outage in 18 days. This is a significant reduction from the average current U.S. plant outages of 45 days, and is possible due to a two-part outage strategy: use System 80+ advanced system design features and relaxed technical specification (TS) time limits to shift some maintenance from outages to operating periods: and, use System 80+ structural, system, and component features, such as the larger operating floor, permanent pool seal, integral reactor head area cable tray system and missile shield, and longer life reactor coolant pump seals, to reduce the scope and duration of outage maintenance activities. Plant staffing level is the major variable, or controllable contributor to operations costs. ABB-CE worked with the Institute of Nuclear Power Operations (INPO) to perform detailed staffing analyses that show a System 80+ plant can be operated reliably with 30 percent less staff than currently operating nuclear plants of similar size. Safety was not sacrificed when ABB-CE developed the System 80+ refueling outage plan and staffing level. The outage plan was developed utilizing a defense-in-depth concept for shutdown safety. The defense in-depth concept is implemented via systematic control of outage risk evaluation (SCORE) cards. The SCORE cards identify primary and alternate means of

  16. The Transition of Atmospheric Infrared Sounder Total Ozone Products to Operations

    Science.gov (United States)

    Berndt, Emily; Zavodsky, Bradley; Jedlovec, Gary

    2014-01-01

    The National Aeronautics and Space Administration Short-term Prediction Research and Transition Center (NASA SPoRT) has transitioned a total column ozone product from the Atmospheric Infrared Sounder (AIRS) retrievals to the Weather Prediction Center and Ocean Prediction Center. The total column ozone product is used to diagnose regions of warm, dry, ozone-rich, stratospheric air capable of descending to the surface to create high-impact non-convective winds. Over the past year, forecasters have analyzed the Red, Green, Blue (RGB) Air Mass imagery in conjunction with the AIRS total column ozone to aid high wind forecasts. One of the limitations of the total ozone product is that it is difficult for forecasters to determine whether elevated ozone concentrations are related to stratospheric air or climatologically high values of ozone in certain regions. During the summer of 2013, SPoRT created an AIRS ozone anomaly product which calculates the percent of normal ozone based on a global stratospheric ozone mean climatology. With the knowledge that ozone values 125 percent of normal and greater typically represent stratospheric air; the anomaly product can be used with the total column ozone product to confirm regions of stratospheric air. This paper describes the generation of these products along with forecaster feedback concerning the use of the AIRS ozone products in conjunction with the RGB Air Mass product to access the utility and transition of the products.

  17. Operation Cost Minimization of Droop-Controlled AC Microgrids Using Multiagent-Based Distributed Control

    Directory of Open Access Journals (Sweden)

    Chendan Li

    2016-09-01

    Full Text Available Recently, microgrids are attracting increasing research interest as promising technologies to integrate renewable energy resources into the distribution system. Although many works have been done on droop control applied to microgrids, they mainly focus on achieving proportional power sharing based on the power rating of the power converters. With various primary source for the distributed generator (DG, factors that are closely related to the operation cost, such as fuel cost of the generators and losses should be taken into account in order to improve the efficiency of the whole system. In this paper, a multiagent-based distributed method is proposed to minimize the operation cost in AC microgrids. In the microgrid, each DG is acting as an agent which regulates the power individually using a novel power regulation method based on frequency scheduling. An optimal power command is obtained through carefully designed consensus algorithm by using sparse communication links only among neighbouring agents. Experimental results for different cases verified that the proposed control strategy can effectively reduce the operation cost.

  18. Oil prices touch fifty year low - industry gears up for further cuts in operating costs

    International Nuclear Information System (INIS)

    Anon.

    1999-01-01

    International crude oil prices hit a 50-year low (inflation adjusted) in December 1998. Prices are now lower than in 1973 and are expected to remain low for several years; so much so that the future of production activities are under threat. The paper goes on to discuss the UK Government's initiative to tackle the problem and of the activities of the CRINE (Cost Reduction in the New Era) Network to reduce operating costs. The Government Oil and Gas Task Force aimed to develop strategies to reduce the cost base of UK gas and oil operations and recommend action by Government and/or the industry by summer 1999. The concern is that current costs of production on the UK continental shelf will make new offshore development uneconomic. A meeting in January 1999 agreed six key areas for action. The work of the Task Force overlaps that of Crine which, since 1992 has been working to drive down capital costs of developing oil and gas fields by innovative approaches including cooperation between companies. (UK)

  19. A protocol for sustained reduction of Total Parenteral Nutrition and cost savings by improvement of nutritional care in hospitals.

    Science.gov (United States)

    van Schaik, Rian; Van den Abeele, Kurt; Melsens, Glenn; Schepens, Peter; Lanssens, Truus; Vlaemynck, Bernadette; Devisch, Maria; Niewold, Theo A

    2016-10-01

    Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14). A TPN decision tree for follow up of TPN in patients and a TP-EN instruction card for caregivers was introduced, showing TPN/EN introduction schedules based on the energy needs of patients according to EB guidelines, also addressing the risk of refeeding syndrome. TPN patients were monitored by dietitians and TPN usage and costs were presented to the (medical) staff. Screening and treatment of malnourished patients by dietitians is simultaneously ongoing. In 2014 48% of patients, hospitalized for at least 48 h, were screened on malnutrition, 17% of them were diagnosed at risk, 7.9% malnourished and treated by dietitians. TPN usage dropped by 53% and cost savings of 51% were obtained due to 50% decrease of TPN users in 2014 versus 2010. TPN over EN ratio dropped from 2.4 in 2010 to 1.2 in 2014. Sustained improvement of nutritional care and reduction of TPN usage and costs is possible by introduction of procedures embedded in the existing structures. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  20. Monitoring total endotoxin and (1 --> 3)-beta-D-glucan at the air exhaust of concentrated animal feeding operations.

    Science.gov (United States)

    Yang, Xufei; Wang, Xinlei; Zhang, Yuanhui; Lee, Jongmin; Su, Jingwei; Gates, Richard S

    2013-10-01

    Mitigation of bioaerosol emissions from concentrated animal feeding operations (CAFOs) demands knowledge of bioaerosol concentrations feeding into an end-of-pipe air treatment process. The aim of this preliminary study was to measure total endotoxin and (1 --> 3)-beta-glucan concentrations at the air exhaust of 18 commercial CAFOs and to examine their variability with animal operation type (swine farrowing, swine gestation, swine weaning, swine finishing, manure belt laying hen, and tom turkey) and season (cold, mild, and hot). The measured airborne concentrations of total endotoxin ranged from 98 to 23,157 endotoxin units (EU)/m3, and the airborne concentrations of total (1 --> 3)-beta-D-glucan ranged from 2.4 to 537.9 ng/m3. Animal operation type in this study had a significant effect on airborne concentrations of total endotoxin and (1 --> 3)-beta-D-glucan but no significant effect on their concentrations in total suspended particulate (TSP). Both endotoxin and (1 --> 3)-beta-D-glucan attained their highest airborne concentrations in visited tom turkey buildings. Comparatively, season had no significant effect on airborne concentrations of total endotoxin or (1 --> 3)-beta-D-glucan. Endotoxin and (1 --> 3)-beta-glucan concentrations in TSP dust appeared to increase as the weather became warmer, and this seasonal effect was significant in swine buildings. Elevated indoor temperatures in the hot season were considered to facilitate the growth and propagation of bacteria and fungi, thus leading to higher biocomponent concentrations in TSP.

  1. Relation between vitamin D and calcium and post operation hypocalcemia in total thyroidectomy

    Directory of Open Access Journals (Sweden)

    Leila Asefkabiri

    2017-06-01

    Full Text Available Background: Hypocalcemia is one of the most prevalent complications following total thyroidectomy. Over recent years, in addition to hormone parathyroid hormone (PTH, vitamin D has been also studied as a factor causing post-total thyroidectomy hypocalcemia. This survey seeks to study the relationship between the serum level of vitamin D before surgery and during post-total thyroidectomy hypocalcemia. Methods: A group of 57 patients volunteering for total thyroidectomy were studied on Vali-e-Asr Hospital, Tehran, Iran, from March 2013 to March 2015. In all these patients, pre-surgery calcium, vitamin D and parathyroid hormone (PTH as well as the level of calcium during the post-surgery first two days were measured. Based on objectives of this study, the relationship be-tween pre-surgery vitamin D level and post-surgery hypocalcemia was examined. Results: The average age of patients participating in the survey was 24.1±13.3. They included 19 women (33.3% and 38 men, total of 40 patients (70.2%. Their average post-surgery calcium level was 9.2±0.77 milligrams per deciliters (mg/dl and their average vitamin D content before the surgery was 42±12.1 nanomole per liter (nmol/l. The average calcium level before the surgery and the first post-surgery day were meaningfully different in terms of statistics (P0.001. Of 37 patients with pre-surgery vitamin D deficiency, 31 suffered post-surgery second-day hypocalcemia and of 20 patients with vitamin D insufficiency, 18 suffered second-day hypocalcemia. This difference was not statistically meaningful either (P>0.001. Conclusion: The current study showed that the serum level of vitamin D before total thyroidectomy does not have any role in the occurrence of post-surgery hypocalcemia which is almost common after this type of surgery.

  2. High Re-Operation Rates Using Conserve Metal-On-Metal Total Hip Articulations

    DEFF Research Database (Denmark)

    Mogensen, S L; Jakobsen, Thomas; Christoffersen, Hardy

    2016-01-01

    INTRODUCTION: Metal-on-metal hip articulations have been intensely debated after reports of adverse reactions and high failure rates. The aim of this study was to retrospectively evaluate the implant of a metal-on.metal total hip articulation (MOM THA) from a single manufacture in a two-center st......INTRODUCTION: Metal-on-metal hip articulations have been intensely debated after reports of adverse reactions and high failure rates. The aim of this study was to retrospectively evaluate the implant of a metal-on.metal total hip articulation (MOM THA) from a single manufacture in a two...

  3. Energy efficiency improvement: A strong driver for Total operations and R and D

    Energy Technology Data Exchange (ETDEWEB)

    Garnaud, Frederic; Rocher, Anne

    2010-09-15

    Total has implemented an energy efficiency action plan for both producing fields and new projects linked to a dedicated R and D program. The Energy efficiency assessment methodology is described, with an example: base line of the current situation, energy efficiency plan, contribution to best practices at corporate level. A methodology to assess the energy efficiency of a new development has been defined and implemented within Total. This methodology as well as related indicators is presented. Examples of R and D results dedicated to improve energy efficiency in two major areas of future developments are given: sour gas production and deep offshore field architecture.

  4. Installation, Operation, and Maintenance Strategies to Reduce the Cost of Offshore Wind Energy

    Energy Technology Data Exchange (ETDEWEB)

    Maples, B. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Saur, G. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hand, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); van de Pietermen, R. [Energy Research Center of the Netherlands (Netherlands); Obdam, T. [Energy Research Center of the Netherlands (Netherlands)

    2013-07-01

    Currently, installation, operation, and maintenance (IO&M) costs contribute approximately 30% to the LCOE of offshore wind plants. To reduce LCOE while ensuring safety, this paper identifies principal cost drivers associated with IO&M and quantifies their impacts on LCOE. The paper identifies technology improvement opportunities and provides a basis for evaluating innovative engineering and scientific concepts developed subsequently to the study. Through the completion of a case study, an optimum IO&M strategy for a hypothetical offshore wind project is identified.

  5. Total test operation of HSST-100 and planning project in Nagoya

    Energy Technology Data Exchange (ETDEWEB)

    Fujino, Masaaki [Chubu HSST Development Corp., Nagoya (Japan); Mizuma, Takeshi [Traffic Safety and Nuisance Research Inst., Ministry of Transport, Tokyo (Japan)

    1996-12-31

    HSST-100 is an urban mass transit system consisting of normal conductivity magnetic levitation. Its special feature is less noise and vibration. Test running operation has been carried out for the last 4 years in Nagoya. Due to the HSST feasibility Study Committee the HSST-100 system is now ready for commercial use. (HW)

  6. Study of Chromatic parameters of Line, Total, Middle graphs and Graph operators of Bipartite graph

    Science.gov (United States)

    Nagarathinam, R.; Parvathi, N.

    2018-04-01

    Chromatic parameters have been explored on the basis of graph coloring process in which a couple of adjacent nodes receives different colors. But the Grundy and b-coloring executes maximum colors under certain restrictions. In this paper, Chromatic, b-chromatic and Grundy number of some graph operators of bipartite graph has been investigat

  7. Total dose induced increase in input offset voltage in JFET input operational amplifiers

    International Nuclear Information System (INIS)

    Pease, R.L.; Krieg, J.; Gehlhausen, M.; Black, J.

    1999-01-01

    Four different types of commercial JFET input operational amplifiers were irradiated with ionizing radiation under a variety of test conditions. All experienced significant increases in input offset voltage (Vos). Microprobe measurement of the electrical characteristics of the de-coupled input JFETs demonstrates that the increase in Vos is a result of the mismatch of the degraded JFETs. (authors)

  8. An innovative multivariate tool for fuel consumption and costs estimation of agricultural operations

    Directory of Open Access Journals (Sweden)

    Mirko Guerrieri

    2016-12-01

    Full Text Available The estimation of operating costs of agricultural and forestry machineries is a key factor in both planning agricultural policies and farm management. Few works have tried to estimate operating costs and the produced models are normally based on deterministic approaches. Conversely, in the statistical model randomness is present and variable states are not described by unique values, but rather by probability distributions. In this study, for the first time, a multivariate statistical model based on Partial Least Squares (PLS was adopted to predict the fuel consumption and costs of six agricultural operations such as: ploughing, harrowing, fertilization, sowing, weed control and shredding. The prediction was conducted on two steps: first of all few initial selected parameters (time per surface-area unit, maximum engine power, purchase price of the tractor and purchase price of the operating machinery were used to estimate the fuel consumption; then the predicted fuel consumption together with the initial parameters were used to estimate the operational costs. Since the obtained models were based on an input dataset very heterogeneous, these resulted to be extremely efficient and so generalizable and robust. In details the results show prediction values in the test with r always ≥ 0.91. Thus, the approach may results extremely useful for both farmers (in terms of economic advantages and at institutional level (representing an innovative and efficient tool for planning future Rural Development Programmes and the Common Agricultural Policy. In light of these advantages the proposed approach may as well be implemented on a web platform and made available to all the stakeholders.

  9. An innovative multivariate tool for fuel consumption and costs estimation of agricultural operations

    International Nuclear Information System (INIS)

    Guerrieri, M.; Fedrizzi, M.; Antonucci, F.; Pallottino, F.; Sperandio, G.; Pagano, M.; Figorilli, S.; Menesatti, P.; Costa, C.

    2016-01-01

    The estimation of operating costs of agricultural and forestry machineries is a key factor in both planning agricultural policies and farm management. Few works have tried to estimate operating costs and the produced models are normally based on deterministic approaches. Conversely, in the statistical model randomness is present and variable states are not described by unique values, but rather by probability distributions. In this study, for the first time, a multivariate statistical model based on Partial Least Squares (PLS) was adopted to predict the fuel consumption and costs of six agricultural operations such as: ploughing, harrowing, fertilization, sowing, weed control and shredding. The prediction was conducted on two steps: first of all few initial selected parameters (time per surface-area unit, maximum engine power, purchase price of the tractor and purchase price of the operating machinery) were used to estimate the fuel consumption; then the predicted fuel consumption together with the initial parameters were used to estimate the operational costs. Since the obtained models were based on an input dataset very heterogeneous, these resulted to be extremely efficient and so generalizable and robust. In details the results show prediction values in the test with r always ≥ 0.91. Thus, the approach may results extremely useful for both farmers (in terms of economic advantages) and at institutional level (representing an innovative and efficient tool for planning future Rural Development Programmes and the Common Agricultural Policy). In light of these advantages the proposed approach may as well be implemented on a web platform and made available to all the stakeholders.

  10. An innovative multivariate tool for fuel consumption and costs estimation of agricultural operations

    Energy Technology Data Exchange (ETDEWEB)

    Guerrieri, M.; Fedrizzi, M.; Antonucci, F.; Pallottino, F.; Sperandio, G.; Pagano, M.; Figorilli, S.; Menesatti, P.; Costa, C.

    2016-07-01

    The estimation of operating costs of agricultural and forestry machineries is a key factor in both planning agricultural policies and farm management. Few works have tried to estimate operating costs and the produced models are normally based on deterministic approaches. Conversely, in the statistical model randomness is present and variable states are not described by unique values, but rather by probability distributions. In this study, for the first time, a multivariate statistical model based on Partial Least Squares (PLS) was adopted to predict the fuel consumption and costs of six agricultural operations such as: ploughing, harrowing, fertilization, sowing, weed control and shredding. The prediction was conducted on two steps: first of all few initial selected parameters (time per surface-area unit, maximum engine power, purchase price of the tractor and purchase price of the operating machinery) were used to estimate the fuel consumption; then the predicted fuel consumption together with the initial parameters were used to estimate the operational costs. Since the obtained models were based on an input dataset very heterogeneous, these resulted to be extremely efficient and so generalizable and robust. In details the results show prediction values in the test with r always ≥ 0.91. Thus, the approach may results extremely useful for both farmers (in terms of economic advantages) and at institutional level (representing an innovative and efficient tool for planning future Rural Development Programmes and the Common Agricultural Policy). In light of these advantages the proposed approach may as well be implemented on a web platform and made available to all the stakeholders.

  11. Pre-Operative Patient Education is Associated With Decreased Risk of Arthrofibrosis After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Livbjerg, Anna Emilie; Frøkjær, Sara; Simonsen, Ole

    2013-01-01

    The purpose was to investigate risk factors for postoperative stiffness and long-term outcome following manipulation under anaesthesia (MUA). In one of the five Danish regions, all patients in a 4-year period who received MUA following total knee arthroplasty (N=36) were included in two case-cont...

  12. Economics for wind turbines in Denmark. Investments, operation and maintenance costs for selected vintages of turbines

    International Nuclear Information System (INIS)

    Hjuler Jensen, P.; Morthorst, P.E.; Skriver, S.; Rasmussen, M.; Larsen, H.; Hansen, L.H.; Nielsen, P.; Lemming, J.

    2002-10-01

    During the last two decades of operational experience with wind turbines in Denmark, a number of investigations on wind energy economics have been carried out on behalf of the Danish Energy Agency. The aim of this study has been to analyse the development of investments cost, O and M-cost, insurance costs etc. including the economic and technical lifetime of wind turbines. Based on a questionnaire and an existing database, time series for O and M-cost components are established going back to the early 80's. These time series are used to analyse the development of O and M-costs during the lifetime of different turbine sizes and vintages. A major issue of the project is to use the results achieved for older turbines (55kW to 150 kW) to establish an expected development of O and M-costs for newer larger turbines, typically of the 500kW to 750kW sizes. (au)

  13. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program: Volume 1, The analysis and its results

    International Nuclear Information System (INIS)

    1987-06-01

    This report provides cost estimates for the fifth evaluation of the adequacy of the fee and is consistent with the program strategy and plans. The total-system cost for the reference cases in the improved-performance system is estimated at $32.1 to $38.2 billion (expressed in constant 1986 dollars) over the entire life of the system...or $1.5 to $1.6 billion more than that of the authorized system (i.e., the system without an MRS facility). The current estimate of the total-system cost for the reference cases in the improved-performance system is $3.8 to $5.4 billion higher than the estimate for the same system in the 1986 TSLCC analysis. In the case with the maximum increase, nearly all of the higher cost is due to a $5.2-billion increase in the costs of development and evaluation (D and E); all other system costs are essentially unchanged. The cost difference between the improved-performance system and the authorized system is smaller than the difference estimated in last year's TSLCC analysis. Volume 2 presents the detailed results for the 1987 analysis of the total-system life cycle cost (TSLCC). It consists of four sections: Section A presents the yearly flows of waste between waste-management facilities for the 12 aggregate logistics cases that were studied; Section B presents the annual total-system costs for each of the 30 TSLCC cases by major cost category; Section C presents the annual costs for the disposal of 16,000 canisters of defense high-level waste (DHLW) by major cost category for each of the 30 TSLCC cases; and Section D presents a summary of the cost-allocation factors that were calculated to determine the defense waste share of the total-system costs

  14. Low-cost engineering techniques in sustainable operation of a rural clean water plant in thailand

    International Nuclear Information System (INIS)

    Pengchai, P.; Keawkhun, K.; Suwapaet, N.

    2012-01-01

    Problems of water supply in many rural regions of Thailand result from the lack of awareness and financial limitations. Payanghang Clean Water Plant is an example of the rural water plant that has been suffering from the poor operation since 2003. The objective of this study was to modify the operation processes of this water plant to achieve cleaner water and better financial condition. Low-cost engineering techniques, such as the use of floating switches in filtration ponds, the use of water drip system for alum dosing and the addition of Tamarindus indica Linn seed solution was applied. As a result, 76% of turbidity removal efficiency was derived. Although, the difference was not statistically significant at 95% confidence level, higher removal efficiency in comparison with the one before modification (65%) suggested better operation. In the view of financial aspect, l07 dollars (1 baht = 0.0326 U.S. dollar) benefit was obtained from 7 month-operation period. (author)

  15. ISS Operations Cost Reductions Through Automation of Real-Time Planning Tasks

    Science.gov (United States)

    Hall, Timothy A.; Clancey, William J.; McDonald, Aaron; Toschlog, Jason; Tucker, Tyson; Khan, Ahmed; Madrid, Steven (Eric)

    2011-01-01

    In 2007 the Johnson Space Center s Mission Operations Directorate (MOD) management team challenged their organizations to find ways to reduce the cost of operations for supporting the International Space Station (ISS) in the Mission Control Center (MCC). Each MOD organization was asked to define and execute projects that would help them attain cost reductions by 2012. The MOD Operations Division Flight Planning Branch responded to this challenge by launching several software automation projects that would allow them to greatly improve console operations and reduce ISS console staffing and intern reduce operating costs. These tasks ranged from improving the management and integration mission plan changes, to automating the uploading and downloading of information to and from the ISS and the associated ground complex tasks that required multiple decision points. The software solutions leveraged several different technologies including customized web applications and implementation of industry standard web services architecture; as well as engaging a previously TRL 4-5 technology developed by Ames Research Center (ARC) that utilized an intelligent agent-based system to manage and automate file traffic flow, archive data, and generate console logs. These projects to date have allowed the MOD Operations organization to remove one full time (7 x 24 x 365) ISS console position in 2010; with the goal of eliminating a second full time ISS console support position by 2012. The team will also reduce one long range planning console position by 2014. When complete, these Flight Planning Branch projects will account for the elimination of 3 console positions and a reduction in staffing of 11 engineering personnel (EP) for ISS.

  16. Organizational Culture Influence on Total Productive Maintenance (TPM) and Operational Performance Using RASCH Model Analysis

    OpenAIRE

    Mohd Asaad, Mohd Norhasni; Yusoff, Rushami Zien

    2013-01-01

    Abstract. Market globalization, competitive product and services, high economic crises are the most critical factors that influence the success of the manufacturing companies in global market. Therefore it is critical to the manufacturing companies to be efficient in production and lean tool may used to achieve that.  The most frequently used is the Total Preventive Maintenance (TPM), even though there are many studies have been conducted in relation to the TPM but there is limited research i...

  17. Effect of pre-operative neuromuscular training on functional outcome after total knee replacement

    DEFF Research Database (Denmark)

    Huber, Erika O; de Bie, Rob A; Roos, Ewa M.

    2013-01-01

    Total Knee Replacement (TKR) is the standard treatment for patients with severe knee osteoarthritis (OA). Significant improvement in pain and function are seen after TKR and approximately 80% of patients are very satisfied with the outcome. Functional status prior to TKR is a major predictor...... of outcome after the intervention. Thus, improving functional status prior to surgery through exercise may improve after surgery outcome. However, results from several previous trials testing the concept have been inconclusive after surgery....

  18. A cost prediction model for machine operation in multi-field production systems

    Directory of Open Access Journals (Sweden)

    Alessandro Sopegno

    Full Text Available ABSTRACT Capacity planning in agricultural field operations needs to give consideration to the operational system design which involves the selection and dimensioning of production components, such as machinery and equipment. Capacity planning models currently onstream are generally based on average norm data and not on specific farm data which may vary from year to year. In this paper a model is presented for predicting the cost of in-field and transport operations for multiple-field and multiple-crop production systems. A case study from a real production system is presented in order to demonstrate the model’s functionalities and its sensitivity to parameters known to be somewhat imprecise. It was shown that the proposed model can provide operation cost predictions for complex cropping systems where labor and machinery are shared between the various operations which can be individually formulated for each individual crop. By so doing, the model can be used as a decision support system at the strategic level of management of agricultural production systems and specifically for the mid-term design process of systems in terms of labor/machinery and crop selection conforming to the criterion of profitability.

  19. Reducing IT costs and ensuring safe operation with application of the portfolio management

    Directory of Open Access Journals (Sweden)

    Livia Alice Mozsar Kovacsne

    2017-05-01

    Full Text Available Large companies need to give focus on their cost components related to their information technology. Business growths is supported by their IT and hundreds or thousands of applications worldwide. Top level management needs to focus more on their information strategy and the applications they need to manage. A structured and transparent application landscape supports not only the current business but it also enables faster business growth for the future as well. Structuring and organizing the applications related to the various risks supports secure business and information operations within a company. Capturing the applications gives the companies an overview of their information costs and provides the possibility of measurement and control of their IT costs elements. Application portfolio management and information security management are important elements of the corporate strategies.

  20. Impact of digital information and control system platform selection on nuclear power generating plant operating costs

    International Nuclear Information System (INIS)

    Bogard, T.; Radomski, S.; Sterdis, B.; Marta, H.; Bond, V.; Richardson, J.; Ramon, G.; Edvinsson, H.

    1998-01-01

    Information is presented on the benefits of a well-planned information and control systems (I and CS) replacement approach for aging nuclear power generating plants' I and CS. Replacement of an aging I and CS is accompanied by increases in plant profitability. Implementing a structured I and CS replacement with current technology allows improved plant electrical production in parallel with reduced I and CS operations and maintenance cost. Qualitative, quantitative, and enterprise management methods for cost benefit justification are shown to justify a comprehensive approach to I and CS replacement. In addition to the advantages of standard I and CS technologies, examples of new I and CS technologies are shown to add substantial cost benefit justification for I and CS replacements. Focus is upon I and CS replacements at nuclear power plants, however the information is applicable to other types of power generating facilities. (author)

  1. Climate-based policies may increase life-cycle social costs of vehicle fleet operation

    International Nuclear Information System (INIS)

    Emery, Isaac; Mbonimpa, Eric; Thal, Alfred E.

    2017-01-01

    Sustainability guidelines and regulations in the United States often focus exclusively on carbon or petroleum reductions. Though some of these policies have resulted in substantial progress toward their goals, the effects of these efforts on other social and environmental externalities are often ignored. In this study, we examine the life-cycle air pollutant emissions for alternative fuel and vehicle purchase scenarios at a military installation near a typical urban area in the United States (U.S.). We find that scenarios which minimize petroleum use or greenhouse gas emissions do not concomitantly minimize criteria air pollutant emissions. We also employ social cost methodologies to quantify economic externalities due to climate change and health-related air pollutant impacts. Accounting for the social costs of climate change and air pollution from vehicle use reveals that criteria air pollutants may have a greater total impact than greenhouse gas emissions in locations similar to the urban area examined in this study. Use of first-generation biofuels, particularly corn grain ethanol, may reduce net petroleum use at the cost of increased total health impacts. More comprehensive policies may be needed to ensure that sustainability policies result in a net benefit to society. - Highlights: • U.S. energy and transportation policies focus on petroleum use and greenhouse gases. • Use of corn ethanol at a military base in Ohio, U.S. increases total social costs vs. gasoline. • Renewable electricity provides cost-effective climate and health protection. • DOD strategy to improve energy security may damage Americans' health. • More inclusive policies needed to protect health and climate.

  2. Extending total parenteral nutrition hang time in the neonatal intensive care unit: is it safe and cost effective?

    Science.gov (United States)

    Balegar V, Kiran Kumar; Azeem, Mohammad Irfan; Spence, Kaye; Badawi, Nadia

    2013-01-01

    To investigate the effects of prolonging hang time of total parenteral nutrition (TPN) fluid on central line-associated blood stream infection (CLABSI), TPN-related cost and nursing workload. A before-after observational study comparing the practice of hanging TPN bags for 48 h (6 February 2009-5 February 2010) versus 24 h (6 February 2008-5 February 2009) in a tertiary neonatal intensive care unit was conducted. The main outcome measures were CLABSI, TPN-related expenses and nursing workload. One hundred thirty-six infants received 24-h TPN bags and 124 received 48-h TPN bags. Median (inter-quartile range) gestation (37 weeks (33,39) vs. 36 weeks (33,39)), mean (±standard deviation) admission weight of 2442 g (±101) versus 2476 g (±104) and TPN duration (9.7 days (±12.7) vs. 9.9 days (±13.4)) were similar (P > 0.05) between the 24- and 48-h TPN groups. There was no increase in CLABSI with longer hang time (0.8 vs. 0.4 per 1000 line days in the 24-h vs. 48-h group; P < 0.05). Annual cost saving using 48-h TPN was AUD 97,603.00. By using 48-h TPN, 68.3% of nurses indicated that their workload decreased and 80.5% indicated that time spent changing TPN reduced. Extending TPN hang time from 24 to 48 h did not alter CLABSI rate and was associated with a reduced TPN-related cost and perceived nursing workload. Larger randomised controlled trials are needed to more clearly delineate these effects. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  3. Cost-analysis of robotic-assisted laparoscopic hysterectomy versus total abdominal hysterectomy for women with endometrial cancer and atypical complex hyperplasia

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Palle, Connie; Møller, Ann M.

    2016-01-01

    INTRODUCTION: The aim of this study was to analyse the hospital cost of treatment with robotic-assisted laparoscopic hysterectomy and total abdominal hysterectomy for women with endometrial cancer or atypical complex hyperplasia and to identify differences in resource use and cost. MATERIAL...... AND METHODS: This cost analysis was based on two cohorts: women treated with robotic-assisted laparoscopic hysterectomy (n = 202) or with total abdominal hysterectomy (n = 158) at Copenhagen University Hospital, Herlev, Denmark. We conducted an activity-based cost analysis including consumables and healthcare...... professionals' salaries. As cost-drivers we included severe complications, duration of surgery, anesthesia and stay at the post-anesthetic care unit, as well as number of hospital bed-days. Ordinary least-squares regression was used to explore the cost variation. The primary outcome was cost difference...

  4. Energy Hub’s Structural and Operational Optimization for Minimal Energy Usage Costs in Energy Systems

    Directory of Open Access Journals (Sweden)

    Thanh Tung Ha

    2018-03-01

    Full Text Available The structural and optimal operation of an Energy Hub (EH has a tremendous influence on the hub’s performance and reliability. This paper envisions an innovative methodology that prominently increases the synergy between structural and operational optimization and targets system cost affordability. The generalized energy system structure is presented theoretically with all selective hub sub-modules, including electric heater (EHe and solar sources block sub-modules. To minimize energy usage cost, an energy hub is proposed that consists of 12 kinds of elements (i.e., energy resources, conversion, and storage functions and is modeled mathematically in a General Algebraic Modeling System (GAMS, which indicates the optimal hub structure’s corresponding elements with binary variables (0, 1. Simulation results contrast with 144 various scenarios established in all 144 categories of hub structures, in which for each scenario the corresponding optimal operation cost is previously calculated. These case studies demonstrate the effectiveness of the suggested model and methodology. Finally, avenues for future research are also prospected.

  5. Total-system expertise in economically efficient operation of nuclear power plants

    International Nuclear Information System (INIS)

    2000-01-01

    Siemens Nuclear Power GmbH can look back on well over 40 years of experience in developing and constructing nuclear power plants. 23 Power plant units of Siemens design are in operation in five countries, and in autumn this year, another one will start commercial operation, while yet another one is under construction. In comparative international power plant surveys, the Siemens-design systems usually rank in top positions when it comes to comparing systems availability and electric power generation, and Siemens have build a reputation in manufacturing power plants up to the highest safety standards worldwide. Our experience as a manufacturer of turnkey PWR and BWR type reactors, as well as our profound knowledge of international nuclear standardisation, engineering codes and safety guides, has been used and processed to the benefit of the services offered by Siemens, resulting in well-devised service packages, and enhancements and optimisation of our machinery and equipment. Siemens has of course obtained the relevant licenses and certification for all its services and products according to DIN ISO 9001, KTA and ASME standards [de

  6. The implementation methodology of Total Quality Management in health services, as a best practice operation.

    Directory of Open Access Journals (Sweden)

    Theodora Malamou

    2016-09-01

    Full Text Available Total Quality Management – TQM (Total Quality Management-TQM, health services, is a modern management philosophy to improve the quality and efficiency of the organization as a whole, with the involvement of all employees, at all levels. According to the research data, the concept of quality is distinguished in technical, interpersonal quality and hotel infrastructure and focuses on patient satisfaction. The Critical success factors of TQM, organizations for business excellence in continuous competitive changing environment, is the management commitment, customer focus, constant communication with employees, encouragement and reward, education and scientific training, continuous improvement quality of service, interdependent relationships with suppliers, active employee participation, creation of representative indicators, targets and benchmarking, continuous outcome assessment and continuous review, review of program procedures. The purpose of this article is through the review of Greek and international literature, to introduce the methodology of a project TQM, to health services, as everyday best practice, with emphasis on quality of service. According to the literature review, TQM contributes to improving the quality of health services, the cultivation of team spirit, cooperation between health professionals and leadership, with a view to satisfy all. TQM is purely anthropocentric theory of organization and administration. We need comprehensive effort approach to improving the quality of leadership and the introduction of the culture of workers.

  7. COST EFFECTIVE VOC EMISSION CONTROL STARTEGIES FOR MILITARY, AEROSPACE,AND INDUSTRIAL PAINT SPRAY BOOTH OPERATIONS: COMBINING IMPROVED VENTILATION SYSTEMS WITH INNOVATIVE, LOW COST EMISSION CONTROL TECHNOLOGIES

    Science.gov (United States)

    The paper describes a full-scale demonstration program in which several paint booths were modified for recirculation ventilation; the booth exhaust streams are vented to an innovative volatile organic compound (VOC) emission control system having extremely low operating costs. ...

  8. Cost of Operating Central Cancer Registries and Factors That Affect Cost: Findings From an Economic Evaluation of Centers for Disease Control and Prevention National Program of Cancer Registries.

    Science.gov (United States)

    Tangka, Florence K L; Subramanian, Sujha; Beebe, Maggie Cole; Weir, Hannah K; Trebino, Diana; Babcock, Frances; Ewing, Jean

    2016-01-01

    The Centers for Disease Control and Prevention (CDC) evaluated the economics of the National Program of Cancer Registries to provide the CDC, the registries, and policy makers with the economics evidence-base to make optimal decisions about resource allocation. Cancer registry budgets are under increasing threat, and, therefore, systematic assessment of the cost will identify approaches to improve the efficiencies of this vital data collection operation and also justify the funding required to sustain registry operations. To estimate the cost of cancer registry operations and to assess the factors affecting the cost per case reported by National Program of Cancer Registries-funded central cancer registries. We developed a Web-based cost assessment tool to collect 3 years of data (2009-2011) from each National Program of Cancer Registries-funded registry for all actual expenditures for registry activities (including those funded by other sources) and factors affecting registry operations. We used a random-effects regression model to estimate the impact of various factors on cost per cancer case reported. The cost of reporting a cancer case varied across the registries. Central cancer registries that receive high-quality data from reporting sources (as measured by the percentage of records passing automatic edits) and electronic data submissions, and those that collect and report on a large volume of cases had significantly lower cost per case. The volume of cases reported had a large effect, with low-volume registries experiencing much higher cost per case than medium- or high-volume registries. Our results suggest that registries operate with substantial fixed or semivariable costs. Therefore, sharing fixed costs among low-volume contiguous state registries, whenever possible, and centralization of certain processes can result in economies of scale. Approaches to improve quality of data submitted and increasing electronic reporting can also reduce cost.

  9. Patient-specific instrumentation for total knee arthroplasty does not match the pre-operative plan as assessed by intra-operative computer-assisted navigation.

    Science.gov (United States)

    Scholes, Corey; Sahni, Varun; Lustig, Sebastien; Parker, David A; Coolican, Myles R J

    2014-03-01

    The introduction of patient-specific instruments (PSI) for guiding bone cuts could increase the incidence of malalignment in primary total knee arthroplasty. The purpose of this study was to assess the agreement between one type of patient-specific instrumentation (Zimmer PSI) and the pre-operative plan with respect to bone cuts and component alignment during TKR using imageless computer navigation. A consecutive series of 30 femoral and tibial guides were assessed in-theatre by the same surgeon using computer navigation. Following surgical exposure, the PSI cutting guides were placed on the joint surface and alignment assessed using the navigation tracker. The difference between in-theatre data and the pre-operative plan was recorded and analysed. The error between in-theatre measurements and pre-operative plan for the femoral and tibial components exceeded 3° for 3 and 17% of the sample, respectively, while the error for total coronal alignment exceeded 3° for 27% of the sample. The present results indicate that alignment with Zimmer PSI cutting blocks, assessed by imageless navigation, does not match the pre-operative plan in a proportion of cases. To prevent unnecessary increases in the incidence of malalignment in primary TKR, it is recommended that these devices should not be used without objective verification of alignment, either in real-time or with post-operative imaging. Further work is required to identify the source of discrepancies and validate these devices prior to routine use. II.

  10. Alternatives for operational cost reduction in oil pipelines; Alternativas para reducao de custos energeticos operacionais em oleodutos

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Philipe Barroso; Carneiro, Leonardo Motta; Pires, Luis Fernando Goncalves [Pontificia Universidade Catolica do Rio de Janeiro (SIMDUT/DEM/ PUC-Rio), RJ (Brazil). Dept. de Engenharia Mecancia. Nucleo de Simulacao Termo-Hidraulica de Dutos

    2012-07-01

    This paper intends to give a brief overview of some cost reduction alternatives in oil pipelines, to optimize the pipeline operation. Four different alternatives are presented, based on previous studies made on existing pipelines, to demonstrate the response obtained with these solutions. Pipeline operation, especially on mature ones, tends to have a high operational cost, be by tradition, the aging of the installation, change of operational characteristics - such as nominal flow, product, or even flow direction - for which the pipeline wasn't originally designed. The alternatives showed allow for an increase survival time of the pipeline, without resorting to major changes, such as replacement of pipes or adding pumping stations to the system. The alternative studied varies from no implementation cost to high installation cost or operational cost increase, depending on the system and the alternative chosen. From changing the pump arrays during operation or changing the products viscosity with different blends, that represent virtually no cost to the pipeline operation, to the use of VFDs, with a high installation cost or DRA, which increase the operational cost. (author)

  11. Reduction in energy consumption and operating cost in a dried corn warehouse using logistics techniques

    Directory of Open Access Journals (Sweden)

    Korrakot Y. Tippayawong

    2013-06-01

    Full Text Available Corn is one of the major economic crops in Thailand. Corn postharvest operation involves various practices that consume a large amount of energy. Different energy conservation measures have been implemented but logistics consideration is not normally employed. In this work, attempt has been made to demonstrate that logistics techniques can offer a significant reduction in energy and cost. The main objective of this work is to identify and demonstrate possible approaches to improving energy efficiency and reducing operating cost for a dried corn warehouse operator. Three main problems are identified: (i relatively high fuel consumption for internal transfer process, (ii low quality of dried corn, and (iii excess expenditure on outbound transportation. Solutions are proposed and implemented using logistics operations. Improvement is achieved using plant layout and shortest path techniques, resulting in a reduction of almost 50% in energy consumption for the internal transfer process. Installation of an air distributor in the grain storage unit results in a decrease in loss due to poor-quality dried corn from 17% to 10%. Excess expenditure on dried corn distribution is reduced by 6% with application of a global positioning system.

  12. Modification and Performance Evaluation of a Low Cost Electro-Mechanically Operated Creep Testing Machine

    Directory of Open Access Journals (Sweden)

    John J. MOMOH

    2010-12-01

    Full Text Available Existing mechanically operated tensile and creep testing machine was modified to a low cost, electro-mechanically operated creep testing machine capable of determining the creep properties of aluminum, lead and thermoplastic materials as a function of applied stress, time and temperature. The modification of the testing machine was necessitated by having an electro-mechanically operated creep testing machine as a demonstration model ideal for use and laboratory demonstrations, which will provide an economical means of performing standard creep experiments. The experimental result is a more comprehensive understanding of the laboratory experience, as the technology behind the creep testing machine, the test methodology and the response of materials loaded during experiment are explored. The machine provides a low cost solution for Mechanics of Materials laboratories interested in creep testing experiment and demonstration but not capable of funding the acquisition of commercially available creep testing machines. Creep curves of strain versus time on a thermoplastic material were plotted at a stress level of 1.95MPa, 3.25MPa and 4.55MPa and temperature of 20oC, 40oC and 60oC respectively. The machine is satisfactory since it is always ready for operation at any given time.

  13. Production costs and operative margins in electric energy generation from biogas. Full-scale case studies in Italy.

    Science.gov (United States)

    Riva, C; Schievano, A; D'Imporzano, G; Adani, F

    2014-08-01

    The purpose of this study was to observe the economic sustainability of three different biogas full scale plants, fed with different organic matrices: energy crops (EC), manure, agro-industrial (Plants B and C) and organic fraction of municipal solid waste (OFMSW) (Plant A). The plants were observed for one year and total annual biomass feeding, biomass composition and biomass cost (€ Mg(-1)), initial investment cost and plant electric power production were registered. The unit costs of biogas and electric energy (€ Sm(-3)biogas, € kWh(-1)EE) were differently distributed, depending on the type of feed and plant. Plant A showed high management/maintenance cost for OFMSW treatment (0.155 € Sm(-3)biogas, 45% of total cost), Plant B suffered high cost for EC supply (0.130 € Sm(-3)biogas, 49% of total cost) and Plant C showed higher impact on the total costs because of the depreciation charge (0.146 € Sm(-3)biogas, 41% of total costs). The breakeven point for the tariff of electric energy, calculated for the different cases, resulted in the range 120-170 € MWh(-1)EE, depending on fed materials and plant scale. EC had great impact on biomass supply costs and should be reduced, in favor of organic waste and residues; plant scale still heavily influences the production costs. The EU States should drive incentives in dependence of these factors, to further develop this still promising sector. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. The marginal cost of operation: a parameter for evaluating and regulating of the generation work program

    International Nuclear Information System (INIS)

    Lima, W.M.; Mendes, L.N.F.; Almeida Gattass, E. de

    1989-01-01

    The Brazilian Generator System is predominantly hydroelectric, with some reservoirs having a pluri annual regularization, providing a large storage capacity of potential power for the system. This water storage allows the reduction of the alertly effect from the natural flow over the hydraulic resources for electric power production. Due to this structural characteristic, the main operation problem of the system refers to a strategical determination of storage energy utilization and, consequently, the thermal generation level. This paper examines the theoretical concepts referring to the survey of this operation strategies and analyses the factors for improving. These concepts are also extended for the interconnected electric subsystems case, mainly the interchange effect over the operation strategies of each subsystem. Finally, the natural flow sample influence over the marginal cost is analysed, comparing the obtained values with the historical sample and synthetical series of affluence. (C.G.C.). 7 refs, 2 figs, 5 tabs

  15. Server Operation and Virtualization to Save Energy and Cost in Future Sustainable Computing

    Directory of Open Access Journals (Sweden)

    Jun-Ho Huh

    2018-06-01

    Full Text Available Since the introduction of the LTE (Long Term Evolution service, we have lived in a time of expanding amounts of data. The amount of data produced has increased every year with the increase of smart phone distribution in particular. Telecommunication service providers have to struggle to secure sufficient network capacity in order to maintain quick access to necessary data by consumers. Nonetheless, maintaining the maximum capacity and bandwidth at all times requires considerable cost and excessive equipment. Therefore, to solve such a problem, telecommunication service providers need to maintain an appropriate level of network capacity and to provide sustainable service to customers through a quick network development in case of shortage. So far, telecommunication service providers have bought and used the network equipment directly produced by network equipment manufacturers such as Ericsson, Nokia, Cisco, and Samsung. Since the equipment is specialized for networking, which satisfied consumers with their excellent performances, they are very costly because they are developed with advanced technologies. Moreover, it takes much time due to the purchase process wherein the telecommunication service providers place an order and the manufacturer produces and delivers. Accordingly, there are cases that require signaling and two-way data traffic as well as capacity because of the diversity of IoT devices. For these purposes, the need for NFV (Network Function Virtualization is raised. Equipment virtualization is performed so that it is operated on an x86-based compatible server instead of working on the network equipment manufacturer’s dedicated hardware. By operating in some compatible servers, it can reduce the wastage of hardware and cope with the change thanks to quick hardware development. This study proposed an efficient system of reducing cost in network server operation using such NFV technology and found that the cost was reduced by 24

  16. Costs of Clostridium difficile infection in pediatric operations: A propensity score-matching analysis.

    Science.gov (United States)

    Kulaylat, Afif N; Rocourt, Dorothy V; Podany, Abigail B; Engbrecht, Brett W; Twilley, Marianne; Santos, Mary C; Cilley, Robert E; Hollenbeak, Christopher S; Dillon, Peter W

    2017-05-01

    The purpose of this analysis was to assess the burden of Clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care. There were 313,664 patients age 1-18 years who underwent a general thoracic or abdominal procedure in the Kids' Inpatient Database during 2003, 2006, 2009, and 2012. Logistic regression was used to model factors associated with the development of C difficile infection. A propensity score-matching analysis was performed to evaluate the influence of C difficile infection on mortality, duration of stay, and costs in similar patient cohorts. Population weights were used to estimate the national excess burden of C difficile infection on these outcomes. The overall prevalence of C difficile infection in the sampled cohort was 0.30%, with an increasing trend of C difficile infection over time in non-children's hospitals (P difficile infection was associated with younger age, nonelective procedures, increasing comorbidities, and urban teaching hospital status (P difficile infection after operation. After propensity score matching, the mean excess duration of stay and costs attributable to C difficile infection were 5.8 days and $12,801 (P difficile infection is a relatively uncommon but costly complication after pediatric operative procedures. Given the increasing trend of C difficile infection among hospitalized surgical patients, there is substantial opportunity for reduction of inpatient burden and associated costs in this potentially preventable nosocomial infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. ISS Operations Cost Reductions Through Automation of Real-Time Planning Tasks

    Science.gov (United States)

    Hall, Timothy A.

    2011-01-01

    In 2008 the Johnson Space Center s Mission Operations Directorate (MOD) management team challenged their organization to find ways to reduce the costs of International Space station (ISS) console operations in the Mission Control Center (MCC). Each MOD organization was asked to identify projects that would help them attain a goal of a 30% reduction in operating costs by 2012. The MOD Operations and Planning organization responded to this challenge by launching several software automation projects that would allow them to greatly improve ISS console operations and reduce staffing and operating costs. These projects to date have allowed the MOD Operations organization to remove one full time (7 x 24 x 365) ISS console position in 2010; with the plan of eliminating two full time ISS console support positions by 2012. This will account for an overall 10 EP reduction in staffing for the Operations and Planning organization. These automation projects focused on utilizing software to automate many administrative and often repetitive tasks involved with processing ISS planning and daily operations information. This information was exchanged between the ground flight control teams in Houston and around the globe, as well as with the ISS astronaut crew. These tasks ranged from managing mission plan changes from around the globe, to uploading and downloading information to and from the ISS crew, to even more complex tasks that required multiple decision points to process the data, track approvals and deliver it to the correct recipient across network and security boundaries. The software solutions leveraged several different technologies including customized web applications and implementation of industry standard web services architecture between several planning tools; as well as a engaging a previously research level technology (TRL 2-3) developed by Ames Research Center (ARC) that utilized an intelligent agent based system to manage and automate file traffic flow

  18. Should solar photovoltaics be deployed sooner because of long operating life at low, predictable cost?

    International Nuclear Information System (INIS)

    Zweibel, Ken

    2010-01-01

    Governments subsidize the deployment of solar photovoltaics (PV) because PV is deployed for societal purposes. About seven thousand megawatts were deployed in 2009 and over 10,000 are expected in 2010. Yet this is too slow to strongly affect energy and environmental challenges. Faster societal deployment is slowed because PV is perceived to be too costly. Classic economic evaluations would put PV electricity in the range of 15-50 c/kWh, depending on local sunlight and system size. But PV has an unusual, overlooked value: systems can last for a very long time with almost no operating costs, much like, e.g., the Hoover Dam. This long life is rarely taken into account. The private sector cannot use it because far-future cash flow does not add to asset value. But we should not be evaluating PV by business metrics. Governments already make up the difference in return on investment needed to deploy PV. PV deployment is government infrastructure development or direct purchases. Thus the question is: Does the usually unevaluated aspect of long life at predictably low operating costs further motivate governments to deploy more PV, sooner?

  19. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program. Volume 1. The analysis and its results

    International Nuclear Information System (INIS)

    1986-04-01

    The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 is sufficient to cover the cost of the program. This report provides cost estimates for the fourth evaluation of the adequacy of the fee. The total-system cost for the reference authorized-system program is estimated to be 24 to 32 billion (1985) dollars. The total-system cost for the reference improved-performance system is estimated to be 26 to 34 billion dollars. A number of sensitivity cases were analyzed. For the authorized system, the costs for the sensitivity cases studied range from 21 to 39 billion dollars. For the improved-performance system, which includes a facility for monitored retrievable storage, the total-system cost in the sensitivity cases is estimated to be as high as 41 billion dollars. The factors that affect costs more than any other single factor for both the authorized and the improved-performance systems are delays in repository startup. A preliminary analysis of the impact of extending the burnup of nuclear fuel in the reactor was also performed; its results indicate that the impact is insignificant: the total-system cost is essentially unchanged from the comparable constant-burnup cases. The current estimate of the the total-system cost for the reference authorized system is zero to 3 billion dollars (9%) higher than the estimate for the reference system in the January 1985 TSLCC analysis

  20. Autologous Stem Cell Transplantation in Patients With Multiple Myeloma: An Activity-based Costing Analysis, Comparing a Total Inpatient Model Versus an Early Discharge Model.

    Science.gov (United States)

    Martino, Massimo; Console, Giuseppe; Russo, Letteria; Meliado', Antonella; Meliambro, Nicola; Moscato, Tiziana; Irrera, Giuseppe; Messina, Giuseppe; Pontari, Antonella; Morabito, Fortunato

    2017-08-01

    Activity-based costing (ABC) was developed and advocated as a means of overcoming the systematic distortions of traditional cost accounting. We calculated the cost of high-dose chemotherapy and autologous stem cell transplantation (ASCT) in patients with multiple myeloma using the ABC method, through 2 different care models: the total inpatient model (TIM) and the early-discharge outpatient model (EDOM) and compared this with the approved diagnosis related-groups (DRG) Italian tariffs. The TIM and EDOM models involved a total cost of €28,615.15 and €16,499.43, respectively. In the TIM model, the phase with the greatest economic impact was the posttransplant (recovery and hematologic engraftment) with 36.4% of the total cost, whereas in the EDOM model, the phase with the greatest economic impact was the pretransplant (chemo-mobilization, apheresis procedure, cryopreservation, and storage) phase, with 60.4% of total expenses. In an analysis of each episode, the TIM model comprised a higher absorption than the EDOM. In particular, the posttransplant represented 36.4% of the total costs in the TIM and 17.7% in EDOM model, respectively. The estimated reduction in cost per patient using an EDOM model was over €12,115.72. The repayment of the DRG in Calabrian Region for the ASCT procedure is €59,806. Given the real cost of the transplant, the estimated cost saving per patient is €31,190.85 in the TIM model and €43,306.57 in the EDOM model. In conclusion, the actual repayment of the DRG does not correspond to the real cost of the ASCT procedure in Italy. Moreover, using the EDOM, the cost of ASCT is approximately the half of the TIM model. Copyright © 2017 Elsevier Inc. All rights reserved.