Costs and cost-effectiveness of malaria control interventions - a systematic review

PubMed Central

2011-01-01

Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment (IPT), diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54) for ITNs, $6.70 (range $2.22-$12.85) for IRS, $0.60 (range $0.48-$1.08) for IPT in infants, $4.03 (range $1.25-$11.80) for IPT in children, and $2.06 (range $0.47-$3.36) for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34). The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65) and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87). Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110) for ITNs, $143 (range $135-$150) for IRS, and

[Analysis of Cost-effectiveness of screening for breast cancer with conventional mammography, digital and magnetic resonance imaging].

PubMed

Peregrino, Antonio Augusto de Freitas; Vianna, Cid Manso de Mello; de Almeida, Carlos Eduardo Veloso; Gonzáles, Gabriela Bittencourt; Machado, Samara Cristina Ferreira; Costa e Silva, Frances Valéria; Rodrigues, Marcus Paulo da Silva

2012-01-01

A cost-effectiveness analysis was conducted in screening for breast cancer. The use of conventional mammography, digital and magnetic resonance imaging were compared with natural disease history as a baseline. A Markov model projected breast cancer in a group of 100,000 women for a 30 year period, with screening every two years. Four distinct scenarios were modeled: (1) the natural history of breast cancer, as a baseline, (2) conventional film mammography, (3) digital mammography and (4) magnetic resonance imaging. The costs of the scenarios modeled ranged from R$ 194.216,68 for natural history, to R$ 48.614.338,31, for screening with magnetic resonance imaging. The difference in effectiveness between the interventions ranged from 300 to 78.000 years of life gained in the cohort. The ratio of incremental cost-effectiveness in terms of cost per life-year gains, conventional mammographic screening has produced an extra year for R$ 13.573,07. The ICER of magnetic resonance imaging was R$ 2.904.328,88, compared to no screening. In conclusion, it is more cost-effective to perform the screening with conventional mammography than other technological interventions.

Digital Flight Control System Redundancy Study

DTIC Science & Technology

1974-07-01

has its own separate power supr, y . d. Digital Processor The digital processor consists of the followdnq components: (1) Program Counter - This...1-3 Yaw Axis Control 108 1-4 Autothrottle (Airspeed Hold Mode) 109 1-5 Approach Power Compensation 110 1-6 Glideslope Flare 111 I-7 Glideslope Track...considsred to the extent that they imposed constraints on the candidate con- figurations. Cost, size, weight, power , maintainability, survivability and

Potential Cost Savings of Contrast-Enhanced Digital Mammography.

PubMed

Patel, Bhavika K; Gray, Richard J; Pockaj, Barbara A

2017-06-01

The purpose of this article is to discuss whether the sensitivity and specificity of contrast-enhanced digital mammography (CEDM) render it a viable diagnostic alternative to breast MRI. That CEDM couples low-energy images (comparable to the diagnostic quality of standard mammography) and subtracted contrast-enhanced mammograms make it a cost-effective modality and a realistic substitute for the more costly breast MRI.

Cost-effectiveness of digital mammography screening before the age of 50 in The Netherlands.

PubMed

Sankatsing, Valérie D V; Heijnsdijk, Eveline A M; van Luijt, Paula A; van Ravesteyn, Nicolien T; Fracheboud, Jacques; de Koning, Harry J

2015-10-15

In the Netherlands, routine mammography screening starts at age 50. This starting age may have to be reconsidered because of the increasing breast cancer incidence among women aged 40 to 49 and the recent implementation of digital mammography. We assessed the cost-effectiveness of digital mammography screening that starts between age 40 and 49, using a microsimulation model. Women were screened before age 50, in addition to the current programme (biennial 50-74). Screening strategies varied in starting age (between 40 and 50) and frequency (annual or biennial). The numbers of breast cancers diagnosed, life-years gained (LYG) and breast cancer deaths averted were predicted and incremental cost-effectiveness ratios (ICERs) were calculated to compare screening scenarios. Biennial screening from age 50 to 74 (current strategy) was estimated to gain 157 life years per 1,000 women with lifelong follow-up, compared to a situation without screening, and cost €3,376/LYG (3.5% discounted). Additional screening increased the number of LYG, compared to no screening, ranging from 168 to 242. The costs to generate one additional LYG (i.e., ICER), comparing a screening strategy to the less intensive alternative, were estimated at €5,329 (biennial 48-74 vs. current strategy), €7,628 (biennial 45-74 vs. biennial 48-74), €10,826 (biennial 40-74 vs. biennial 45-74) and €18,759 (annual 40-49 + biennial 50-74 vs. biennial 40-74). Other strategies (49 + biennial 50-74 and annual 45-49 + biennial 50-74) resulted in less favourable ICERs. These findings show that extending the Dutch screening programme by screening between age 40 and 49 is cost-effective, particularly for biennial strategies. © 2015 UICC.

Accurate and cost-effective MTF measurement system for lens modules of digital cameras

NASA Astrophysics Data System (ADS)

Chang, Gao-Wei; Liao, Chia-Cheng; Yeh, Zong-Mu

2007-01-01

For many years, the widening use of digital imaging products, e.g., digital cameras, has given rise to much attention in the market of consumer electronics. However, it is important to measure and enhance the imaging performance of the digital ones, compared to that of conventional cameras (with photographic films). For example, the effect of diffraction arising from the miniaturization of the optical modules tends to decrease the image resolution. As a figure of merit, modulation transfer function (MTF) has been broadly employed to estimate the image quality. Therefore, the objective of this paper is to design and implement an accurate and cost-effective MTF measurement system for the digital camera. Once the MTF of the sensor array is provided, that of the optical module can be then obtained. In this approach, a spatial light modulator (SLM) is employed to modulate the spatial frequency of light emitted from the light-source. The modulated light going through the camera under test is consecutively detected by the sensors. The corresponding images formed from the camera are acquired by a computer and then, they are processed by an algorithm for computing the MTF. Finally, through the investigation on the measurement accuracy from various methods, such as from bar-target and spread-function methods, it appears that our approach gives quite satisfactory results.

Flight test of a full authority Digital Electronic Engine Control system in an F-15 aircraft

NASA Technical Reports Server (NTRS)

Barrett, W. J.; Rembold, J. P.; Burcham, F. W.; Myers, L.

1981-01-01

The Digital Electronic Engine Control (DEEC) system considered is a relatively low cost digital full authority control system containing selectively redundant components and fault detection logic with capability for accommodating faults to various levels of operational capability. The DEEC digital control system is built around a 16-bit, 1.2 microsecond cycle time, CMOS microprocessor, microcomputer system with approximately 14 K of available memory. Attention is given to the control mode, component bench testing, closed loop bench testing, a failure mode and effects analysis, sea-level engine testing, simulated altitude engine testing, flight testing, the data system, cockpit, and real time display.

Cost Analysis of a Digital Health Care Model in Sweden.

PubMed

Ekman, Björn

2017-09-22

Digital technologies in health care are expected to increase in scope and to affect ever more parts of the health care system. It is important to enhance the knowledge of whether new digital methods and innovations provide value for money compared with traditional models of care. The objective of the study was to evaluate whether a digital health care model for primary care is a less costly alternative compared with traditional in-office primary care in Sweden. Cost data for the two care models were collected and analyzed to obtain a measure in local currency per care contact. The comparison showed that the total economic cost of a digital consultation is 1960 Swedish krona (SEK) (SEK100 = US$11.29; February 2017) compared with SEK3348 for a traditional consultation at a health care clinic. Cost differences arose on both the provider side and on the user side. The digital health care model may be a less costly alternative to the traditional health care model. Depending on the rate of digital substitution, gross economic cost savings of between SEK1 billion and SEK10 billion per year could be realized if more digital consultations were made. Further studies are needed to validate the findings, assess the types of care most suitable for digital care, and also to obtain various quality-adjusted outcome measures.

The effects of lightning on digital flight control systems

NASA Technical Reports Server (NTRS)

Plumer, J. A.; Malloy, W. A.; Craft, J. B.

1976-01-01

Present practices in lightning protection of aircraft deal primarily with the direct effects of lightning, such as structural damage and ignition of fuel vapors. There is increasing evidence of troublesome electromagnetic effects, however, in aircraft employing solid-state microelectronics in critical navigation, instrumentation and control functions. The potential impact of these indirect effects on critical systems such as digital fly by wire (DFBW) flight controls was studied. The results indicate a need for positive steps to be taken during the design of future fly by wire systems to minimize the possibility of hazardous effects from lightning.

Digital Breast Tomosynthesis: Cost-Effectiveness of Using Private and Medicare Insurance in Community-Based Health Care Facilities.

PubMed

Hunter, Sara A; Morris, Colleen; Nelson, Karl; Snyder, Brandon J; Poulton, Thomas B

2017-05-01

The purpose of this study was to determine whether digital breast tomosynthesis (DBT) is a cost-effective alternative to full-field digital mammography (FFDM) for both Medicare and privately insured patients undergoing screening mammography. A retrospective data analysis was performed between July 15, 2013, and July 14, 2014, with data on women presenting for screening mammography that included any additional radiologic workup (n = 6319). Patients chose to undergo DBT or FFDM on the basis of personal preference, physician suggestion, and cost difference. The summation of findings over the 1-year period were used to calculate recall rates, cancer detection rates, and billing costs for a regional private insurer and Medicare. Data from the 6319 patients who participated were divided: 3655 patients underwent DBT, and 2664 underwent FFDM during the year of screening. Private insurance billing cost $2.9 million, and Medicare cost $1.2 million for screening, follow-up imaging, and radiologic procedures. Per-person costs were approximately $40 higher for the DBT group using both forms of insurance. However, cost per cancer detected was lower in the DBT group for both private and governmental insurance, leading to potentially $3.7 million and $899,000 saved per 100 cancers found. After standardization of the difference in cancer detection rates between the two groups, DBT was a cost-equivalent alternative to FFDM for private insurance billing but was a cost-inefficient alternative with respect to Medicare costs. In a community-based setting, DBT is a cost-equivalent or potentially cost-effective alternative to FFDM and has the capacity for improving cancer detection and recall rates.

Digital control of magnetic bearings in a cryogenic cooler

NASA Technical Reports Server (NTRS)

Feeley, J.; Law, A.; Lind, F.

1990-01-01

This paper describes the design of a digital control system for control of magnetic bearings used in a spaceborne cryogenic cooler. The cooler was developed by Philips Laboratories for the NASA Goddard Space Flight Center. Six magnetic bearing assemblies are used to levitate the piston, displacer, and counter-balance of the cooler. The piston and displacer are driven by linear motors in accordance with Stirling cycle thermodynamic principles to produce the desired cooling effect. The counter-balance is driven by a third linear motor to cancel motion induced forces that would otherwise be transmitted to the spacecraft. An analog control system is currently used for bearing control. The purpose of this project is to investigate the possibilities for improved performance using digital control. Areas for potential improvement include transient and steady state control characteristics, robustness, reliability, adaptability, alternate control modes, size, weight, and cost. The present control system is targeted for the Intel 80196 microcontroller family. The eventual introduction of application specific integrated circuit (ASIC) technology to this problem may produce a unique and elegant solution both here and in related industrial problems.

Cost-Effectiveness of Intensive versus Standard Blood-Pressure Control.

PubMed

Bress, Adam P; Bellows, Brandon K; King, Jordan B; Hess, Rachel; Beddhu, Srinivasan; Zhang, Zugui; Berlowitz, Dan R; Conroy, Molly B; Fine, Larry; Oparil, Suzanne; Morisky, Donald E; Kazis, Lewis E; Ruiz-Negrón, Natalia; Powell, Jamie; Tamariz, Leonardo; Whittle, Jeff; Wright, Jackson T; Supiano, Mark A; Cheung, Alfred K; Weintraub, William S; Moran, Andrew E

2017-08-24

In the Systolic Blood Pressure Intervention Trial (SPRINT), adults at high risk for cardiovascular disease who received intensive systolic blood-pressure control (target, <120 mm Hg) had significantly lower rates of death and cardiovascular disease events than did those who received standard control (target, <140 mm Hg). On the basis of these data, we wanted to determine the lifetime health benefits and health care costs associated with intensive control versus standard control. We used a microsimulation model to apply SPRINT treatment effects and health care costs from national sources to a hypothetical cohort of SPRINT-eligible adults. The model projected lifetime costs of treatment and monitoring in patients with hypertension, cardiovascular disease events and subsequent treatment costs, treatment-related risks of serious adverse events and subsequent costs, and quality-adjusted life-years (QALYs) for intensive control versus standard control of systolic blood pressure. We determined that the mean number of QALYs would be 0.27 higher among patients who received intensive control than among those who received standard control and would cost approximately $47,000 more per QALY gained if there were a reduction in adherence and treatment effects after 5 years; the cost would be approximately $28,000 more per QALY gained if the treatment effects persisted for the remaining lifetime of the patient. Most simulation results indicated that intensive treatment would be cost-effective (51 to 79% below the willingness-to-pay threshold of $50,000 per QALY and 76 to 93% below the threshold of $100,000 per QALY), regardless of whether treatment effects were reduced after 5 years or persisted for the remaining lifetime. In this simulation study, intensive systolic blood-pressure control prevented cardiovascular disease events and prolonged life and did so at levels below common willingness-to-pay thresholds per QALY, regardless of whether benefits were reduced after 5 years or

Benefits, harms, and costs for breast cancer screening after US implementation of digital mammography.

PubMed

Stout, Natasha K; Lee, Sandra J; Schechter, Clyde B; Kerlikowske, Karla; Alagoz, Oguzhan; Berry, Donald; Buist, Diana S M; Cevik, Mucahit; Chisholm, Gary; de Koning, Harry J; Huang, Hui; Hubbard, Rebecca A; Miglioretti, Diana L; Munsell, Mark F; Trentham-Dietz, Amy; van Ravesteyn, Nicolien T; Tosteson, Anna N A; Mandelblatt, Jeanne S

2014-06-01

Compared with film, digital mammography has superior sensitivity but lower specificity for women aged 40 to 49 years and women with dense breasts. Digital has replaced film in virtually all US facilities, but overall population health and cost from use of this technology are unclear. Using five independent models, we compared digital screening strategies starting at age 40 or 50 years applied annually, biennially, or based on density with biennial film screening from ages 50 to 74 years and with no screening. Common data elements included cancer incidence and test performance, both modified by breast density. Lifetime outcomes included mortality, quality-adjusted life-years, and screening and treatment costs. For every 1000 women screened biennially from age 50 to 74 years, switching to digital from film yielded a median within-model improvement of 2 life-years, 0.27 additional deaths averted, 220 additional false-positive results, and $0.35 million more in costs. For an individual woman, this translates to a health gain of 0.73 days. Extending biennial digital screening to women ages 40 to 49 years was cost-effective, although results were sensitive to quality-of-life decrements related to screening and false positives. Targeting annual screening by density yielded similar outcomes to targeting by age. Annual screening approaches could increase costs to $5.26 million per 1000 women, in part because of higher numbers of screens and false positives, and were not efficient or cost-effective. The transition to digital breast cancer screening in the United States increased total costs for small added health benefits. The value of digital mammography screening among women aged 40 to 49 years depends on women's preferences regarding false positives. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

A low cost, high performance remotely controlled backhoe/excavator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rizzo, J.

1995-12-31

This paper addresses a state of the art, low cost, remotely controlled backhoe/excavator system for remediation use at hazardous waste sites. The all weather, all terrain, Remote Dig-It is based on a simple, proven construction platform and incorporates state of the art sensors, control, telemetry and other subsystems derived from advanced underwater remotely operated vehicle systems. The system can be towed to a site without the use of a trailer, manually operated by an on board operator or operated via a fiber optic or optional RF communications link by a remotely positioned operator. A proportional control system is piggy backedmore » onto the standard manual control system. The control system improves manual operation, allows rapid manual/remote mode selection and provides fine manual or remote control of all functions. The system incorporates up to 4 separate video links, acoustic obstacle proximity sensors, and stereo audio pickups and an optional differential GPS navigation. Video system options include electronic panning and tilting within a distortion-corrected wide angle field of view. The backhoe/excavator subsystem has a quick disconnect interface feature which allows its use as a manipulator with a wide variety of end effectors and tools. The Remote Dig-It was developed to respond to the need for a low-cost, effective remediation system for use at sites containing hazardous materials. The prototype system was independently evaluated for this purpose by the Army at the Jefferson Proving Ground where it surpassed all performance goals. At the time of this writing, the Remote Dig-It system is currently the only backhoe/excavator which met the Army`s goals for remediation systems for use at hazardous waste sites and it costs a fraction of any known competing offerings.« less

Selecting a software development methodology. [of digital flight control systems

NASA Technical Reports Server (NTRS)

Jones, R. E.

1981-01-01

The state of the art analytical techniques for the development and verification of digital flight control software is studied and a practical designer oriented development and verification methodology is produced. The effectiveness of the analytic techniques chosen for the development and verification methodology are assessed both technically and financially. Technical assessments analyze the error preventing and detecting capabilities of the chosen technique in all of the pertinent software development phases. Financial assessments describe the cost impact of using the techniques, specifically, the cost of implementing and applying the techniques as well as the relizable cost savings. Both the technical and financial assessment are quantitative where possible. In the case of techniques which cannot be quantitatively assessed, qualitative judgements are expressed about the effectiveness and cost of the techniques. The reasons why quantitative assessments are not possible will be documented.

Experience with synchronous and asynchronous digital control systems

NASA Technical Reports Server (NTRS)

Regenie, V. A.; Chacon, C. V.; Lock, W. P.

1986-01-01

Flight control systems have undergone a revolution since the days of simple mechanical linkages; presently the most advanced systems are full-authority, full-time digital systems controlling unstable aircraft. With the use of advanced control systems, the aerodynamic design can incorporate features that allow greater performance and fuel savings, as can be seen on the new Airbus design and advanced tactical fighter concepts. These advanced aircraft will be and are relying on the flight control system to provide the stability and handling qualities required for safe flight and to allow the pilot to control the aircraft. Various design philosophies have been proposed and followed to investigate system architectures for these advanced flight control systems. One major area of discussion is whether a multichannel digital control system should be synchronous or asynchronous. This paper addressed the flight experience at the Dryden Flight Research Facility of NASA's Ames Research Center with both synchronous and asynchronous digital flight control systems. Four different flight control systems are evaluated against criteria such as software reliability, cost increases, and schedule delays.

Controlling Healthcare Costs: Just Cost Effectiveness or "Just" Cost Effectiveness?

PubMed

Fleck, Leonard M

2018-04-01

Meeting healthcare needs is a matter of social justice. Healthcare needs are virtually limitless; however, resources, such as money, for meeting those needs, are limited. How then should we (just and caring citizens and policymakers in such a society) decide which needs must be met as a matter of justice with those limited resources? One reasonable response would be that we should use cost effectiveness as our primary criterion for making those choices. This article argues instead that cost-effectiveness considerations must be constrained by considerations of healthcare justice. The goal of this article will be to provide a preliminary account of how we might distinguish just from unjust or insufficiently just applications of cost-effectiveness analysis to some healthcare rationing problems; specifically, problems related to extraordinarily expensive targeted cancer therapies. Unconstrained compassionate appeals for resources for the medically least well-off cancer patients will be neither just nor cost effective.

Feature Integration and Task Switching: Diminished Switch Costs after Controlling for Stimulus, Response, and Cue Repetitions

PubMed Central

Schmidt, James R.; Liefooghe, Baptist

2016-01-01

This report presents data from two versions of the task switching procedure in which the separate influence of stimulus repetitions, response key repetitions, conceptual response repetitions, cue repetitions, task repetitions, and congruency are considered. Experiment 1 used a simple alternating runs procedure with parity judgments of digits and consonant/vowel decisions of letters as the two tasks. Results revealed sizable effects of stimulus and response repetitions, and controlling for these effects reduced the switch cost. Experiment 2 was a cued version of the task switch paradigm with parity and magnitude judgments of digits as the two tasks. Results again revealed large effects of stimulus and response repetitions, in addition to cue repetition effects. Controlling for these effects again reduced the switch cost. Congruency did not interact with our novel “unbiased” measure of switch costs. We discuss how the task switch paradigm might be thought of as a more complex version of the feature integration paradigm and propose an episodic learning account of the effect. We further consider to what extent appeals to higher-order control processes might be unnecessary and propose that controls for feature integration biases should be standard practice in task switching experiments. PMID:26964102

Digital robust active control law synthesis for large order systems using constrained optimization

NASA Technical Reports Server (NTRS)

Mukhopadhyay, Vivek

1987-01-01

This paper presents a direct digital control law synthesis procedure for a large order, sampled data, linear feedback system using constrained optimization techniques to meet multiple design requirements. A linear quadratic Gaussian type cost function is minimized while satisfying a set of constraints on the design loads and responses. General expressions for gradients of the cost function and constraints, with respect to the digital control law design variables are derived analytically and computed by solving a set of discrete Liapunov equations. The designer can choose the structure of the control law and the design variables, hence a stable classical control law as well as an estimator-based full or reduced order control law can be used as an initial starting point. Selected design responses can be treated as constraints instead of lumping them into the cost function. This feature can be used to modify a control law, to meet individual root mean square response limitations as well as minimum single value restrictions. Low order, robust digital control laws were synthesized for gust load alleviation of a flexible remotely piloted drone aircraft.

Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis.

PubMed

Lo, Nathan C; Gurarie, David; Yoon, Nara; Coulibaly, Jean T; Bendavid, Eran; Andrews, Jason R; King, Charles H

2018-01-23

Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and cost-effectiveness of various snail control strategies. We extended previously published dynamic, age-structured transmission and cost-effectiveness models to simulate mass drug administration (MDA) and focal snail control interventions against Schistosoma haematobium across a range of low-prevalence (5-20%) and high-prevalence (25-50%) rural Kenyan communities. We simulated strategies over a 10-year period of MDA targeting school children or entire communities, snail control, and combined strategies. We measured incremental cost-effectiveness in 2016 US dollars per disability-adjusted life year and defined a strategy as optimally cost-effective when maximizing health gains (averted disability-adjusted life years) with an incremental cost-effectiveness below a Kenya-specific economic threshold. In both low- and high-prevalence settings, community-wide MDA with additional snail control reduced total disability by an additional 40% compared with school-based MDA alone. The optimally cost-effective scenario included the addition of snail control to MDA in over 95% of simulations. These results support inclusion of snail control in global guidelines and national schistosomiasis control strategies for optimal disease control, especially in settings with high prevalence, "hot spots" of transmission, and noncompliance to MDA. Copyright © 2018 the Author(s). Published by PNAS.

Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis

PubMed Central

Yoon, Nara; Coulibaly, Jean T.; Bendavid, Eran; Andrews, Jason R.; King, Charles H.

2018-01-01

Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and cost-effectiveness of various snail control strategies. We extended previously published dynamic, age-structured transmission and cost-effectiveness models to simulate mass drug administration (MDA) and focal snail control interventions against Schistosoma haematobium across a range of low-prevalence (5–20%) and high-prevalence (25–50%) rural Kenyan communities. We simulated strategies over a 10-year period of MDA targeting school children or entire communities, snail control, and combined strategies. We measured incremental cost-effectiveness in 2016 US dollars per disability-adjusted life year and defined a strategy as optimally cost-effective when maximizing health gains (averted disability-adjusted life years) with an incremental cost-effectiveness below a Kenya-specific economic threshold. In both low- and high-prevalence settings, community-wide MDA with additional snail control reduced total disability by an additional 40% compared with school-based MDA alone. The optimally cost-effective scenario included the addition of snail control to MDA in over 95% of simulations. These results support inclusion of snail control in global guidelines and national schistosomiasis control strategies for optimal disease control, especially in settings with high prevalence, “hot spots” of transmission, and noncompliance to MDA. PMID:29301964

A digital flight control system verification laboratory

NASA Technical Reports Server (NTRS)

De Feo, P.; Saib, S.

1982-01-01

A NASA/FAA program has been established for the verification and validation of digital flight control systems (DFCS), with the primary objective being the development and analysis of automated verification tools. In order to enhance the capabilities, effectiveness, and ease of using the test environment, software verification tools can be applied. Tool design includes a static analyzer, an assertion generator, a symbolic executor, a dynamic analysis instrument, and an automated documentation generator. Static and dynamic tools are integrated with error detection capabilities, resulting in a facility which analyzes a representative testbed of DFCS software. Future investigations will ensue particularly in the areas of increase in the number of software test tools, and a cost effectiveness assessment.

Digital electronic engine control history

NASA Technical Reports Server (NTRS)

Putnam, T. W.

1984-01-01

Full authority digital electronic engine controls (DEECs) were studied, developed, and ground tested because of projected benefits in operability, improved performance, reduced maintenance, improved reliability, and lower life cycle costs. The issues of operability and improved performance, however, are assessed in a flight test program. The DEEC on a F100 engine in an F-15 aircraft was demonstrated and evaluated. The events leading to the flight test program are chronicled and important management and technical results are identified.

Cost analysis of a project to digitize classic articles in neurosurgery*

PubMed Central

Bauer, Kathleen

2002-01-01

In summer 2000, the Cushing/Whitney Medical Library at Yale University began a demonstration project to digitize classic articles in neurosurgery from the late 1800s and early 1900s. The objective of the first phase of the project was to measure the time and costs involved in digitization, and those results are reported here. In the second phase, metadata will be added to the digitized articles, and the project will be publicized. Thirteen articles were scanned using optical character recognition (OCR) software, and the resulting text files were carefully proofread. Time for photocopying, scanning, and proofreading were recorded. This project achieved an average cost per item (total pages plus images) of $4.12, a figure at the high end of average costs found in other studies. This project experienced high costs for two reasons. First, the articles contained many images, which required extra processing. Second, the older fonts and the poor condition of many of these articles complicated the OCR process. The average article cost $84.46 to digitize. Although costs were high, the selection of historically important articles maximized the benefit gained from the investment in digitization. PMID:11999182

Cost analysis of a project to digitize classic articles in neurosurgery.

PubMed

Bauer, Kathleen

2002-04-01

In summer 2000, the Cushing/Whitney Medical Library at Yale University began a demonstration project to digitize classic articles in neurosurgery from the late 1800s and early 1900s. The objective of the first phase of the project was to measure the time and costs involved in digitization, and those results are reported here. In the second phase, metadata will be added to the digitized articles, and the project will be publicized. Thirteen articles were scanned using optical character recognition (OCR) software, and the resulting text files were carefully proofread. Time for photocopying, scanning, and proofreading were recorded. This project achieved an average cost per item (total pages plus images) of $4.12, a figure at the high end of average costs found in other studies. This project experienced high costs for two reasons. First, the articles contained many images, which required extra processing. Second, the older fonts and the poor condition of many of these articles complicated the OCR process. The average article cost $84.46 to digitize. Although costs were high, the selection of historically important articles maximized the benefit gained from the investment in digitization.

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction.

PubMed

Fast, Shannon M; González, Marta C; Markuzon, Natasha

2015-01-01

Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response. The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy.

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction

PubMed Central

Fast, Shannon M.; González, Marta C.; Markuzon, Natasha

2015-01-01

Background Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. Methodology The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response. Conclusions The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy. PMID:26288274

Digital redesign of anti-wind-up controller for cascaded analog system.

PubMed

Chen, Y S; Tsai, J S H; Shieh, L S; Moussighi, M M

2003-01-01

The cascaded conventional anti-wind-up (CAW) design method for integral controller is discussed. Then, the prediction-based digital redesign methodology is utilized to find the new pulse amplitude modulated (PAM) digital controller for effective digital control of the analog plant with input saturation constraint. The desired digital controller is determined from existing or pre-designed CAW analog controller. The proposed method provides a novel methodology for indirect digital design of a continuous-time unity output-feedback system with a cascaded analog controller as in the case of PID controllers for industrial control processes with the presence of actuator saturations. It enables us to implement an existing or pre-designed cascaded CAW analog controller via a digital controller effectively.

Development of a compact and cost effective multi-input digital signal processing system

NASA Astrophysics Data System (ADS)

Darvish-Molla, Sahar; Chin, Kenrick; Prestwich, William V.; Byun, Soo Hyun

2018-01-01

A prototype digital signal processing system (DSP) was developed using a microcontroller interfaced with a 12-bit sampling ADC, which offers a considerably inexpensive solution for processing multiple detectors with high throughput. After digitization of the incoming pulses, in order to maximize the output counting rate, a simple algorithm was employed for pulse height analysis. Moreover, an algorithm aiming at the real-time pulse pile-up deconvolution was implemented. The system was tested using a NaI(Tl) detector in comparison with a traditional analogue and commercial digital systems for a variety of count rates. The performance of the prototype system was consistently superior to the analogue and the commercial digital systems up to the input count rate of 61 kcps while was slightly inferior to the commercial digital system but still superior to the analogue system in the higher input rates. Considering overall cost, size and flexibility, this custom made multi-input digital signal processing system (MMI-DSP) was the best reliable choice for the purpose of the 2D microdosimetric data collection, or for any measurement in which simultaneous multi-data collection is required.

Digital Control Technologies for Modular DC-DC Converters

NASA Technical Reports Server (NTRS)

Button, Robert M.; Kascak, Peter E.; Lebron-Velilla, Ramon

2002-01-01

Recent trends in aerospace Power Management and Distribution (PMAD) systems focus on using commercial off-the-shelf (COTS) components as standard building blocks. This move to more modular designs has been driven by a desire to reduce costs and development times, but is also due to the impressive power density and efficiency numbers achieved by today's commercial DC-DC converters. However, the PMAD designer quickly learns of the hidden "costs" of using COTS converters. The most significant cost is the required addition of external input filters to meet strict electromagnetic interference (MIAMI) requirements for space systems. In fact, the high power density numbers achieved by the commercial manufacturers are greatly due to the lack of necessary input filters included in the COTS module. The NASA Glenn Research Center is currently pursuing a digital control technology that addresses this problem with modular DC-DC converters. This paper presents the digital control technologies that have been developed to greatly reduce the input filter requirements for paralleled, modular DC-DC converters. Initial test result show that the input filter's inductor size was reduced by 75 percent, and the capacitor size was reduced by 94 percent while maintaining the same power quality specifications.

Highly integrated digital electronic control: Digital flight control, aircraft model identification, and adaptive engine control

NASA Technical Reports Server (NTRS)

Baer-Riedhart, Jennifer L.; Landy, Robert J.

1987-01-01

The highly integrated digital electronic control (HIDEC) program at NASA Ames Research Center, Dryden Flight Research Facility is a multiphase flight research program to quantify the benefits of promising integrated control systems. McDonnell Aircraft Company is the prime contractor, with United Technologies Pratt and Whitney Aircraft, and Lear Siegler Incorporated as major subcontractors. The NASA F-15A testbed aircraft was modified by the HIDEC program by installing a digital electronic flight control system (DEFCS) and replacing the standard F100 (Arab 3) engines with F100 engine model derivative (EMD) engines equipped with digital electronic engine controls (DEEC), and integrating the DEEC's and DEFCS. The modified aircraft provides the capability for testing many integrated control modes involving the flight controls, engine controls, and inlet controls. This paper focuses on the first two phases of the HIDEC program, which are the digital flight control system/aircraft model identification (DEFCS/AMI) phase and the adaptive engine control system (ADECS) phase.

Field Programmable Gate Array for Implementation of Redundant Advanced Digital Feedback Control

NASA Technical Reports Server (NTRS)

King, K. D.

2003-01-01

The goal of this effort was to develop a digital motor controller using field programmable gate arrays (FPGAs). This is a more rugged approach than a conventional microprocessor digital controller. FPGAs typically have higher radiation (rad) tolerance than both the microprocessor and memory required for a conventional digital controller. Furthermore, FPGAs can typically operate at higher speeds. (While speed is usually not an issue for motor controllers, it can be for other system controllers.) Other than motor power, only a 3.3-V digital power supply was used in the controller; no analog bias supplies were used. Since most of the circuit was implemented in the FPGA, no additional parts were needed other than the power transistors to drive the motor. The benefits that FPGAs provide over conventional designs-lower power and fewer parts-allow for smaller packaging and reduced weight and cost.

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

PubMed

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

2016-01-01

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

Cost-effectiveness of digital subtraction angiography in the setting of computed tomographic angiography negative subarachnoid hemorrhage.

PubMed

Jethwa, Pinakin R; Punia, Vineet; Patel, Tapan D; Duffis, E Jesus; Gandhi, Chirag D; Prestigiacomo, Charles J

2013-04-01

Recent studies have documented the high sensitivity of computed tomography angiography (CTA) in detecting a ruptured aneurysm in the presence of acute subarachnoid hemorrhage (SAH). The practice of digital subtraction angiography (DSA) when CTA does not reveal an aneurysm has thus been called into question. We examined this dilemma from a cost-effectiveness perspective by using current decision analysis techniques. A decision tree was created with the use of TreeAge Pro Suite 2012; in 1 arm, a CTA-negative SAH was followed up with DSA; in the other arm, patients were observed without further imaging. Based on literature review, costs and utilities were assigned to each potential outcome. Base-case and sensitivity analyses were performed to determine the cost-effectiveness of each strategy. A Monte Carlo simulation was then conducted by sampling each variable over a plausible distribution to evaluate the robustness of the model. With the use of a negative predictive value of 95.7% for CTA, observation was found to be the most cost-effective strategy ($6737/Quality Adjusted Life Year [QALY] vs $8460/QALY) in the base-case analysis. One-way sensitivity analysis demonstrated that DSA became the more cost-effective option if the negative predictive value of CTA fell below 93.72%. The Monte Carlo simulation produced an incremental cost-effectiveness ratio of $83 083/QALY. At the conventional willingness-to-pay threshold of $50 000/QALY, observation was the more cost-effective strategy in 83.6% of simulations. The decision to perform a DSA in CTA-negative SAH depends strongly on the sensitivity of CTA, and therefore must be evaluated at each center treating these types of patients. Given the high sensitivity of CTA reported in the current literature, performing DSA on all patients with CTA negative SAH may not be cost-effective at every institution.

Cost-Effectiveness Analysis of Breast Cancer Control Interventions in Peru

PubMed Central

Zelle, Sten G.; Vidaurre, Tatiana; Abugattas, Julio E.; Manrique, Javier E.; Sarria, Gustavo; Jeronimo, José; Seinfeld, Janice N.; Lauer, Jeremy A.; Sepulveda, Cecilia R.; Venegas, Diego; Baltussen, Rob

2013-01-01

Objectives In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant for the Peruvian context. Methods We performed a cost-effectiveness analysis (CEA) according to WHO-CHOICE guidelines, from a healthcare perspective. Different screening, early detection, palliative, and treatment interventions were evaluated using mathematical modeling. Effectiveness estimates were based on observational studies, modeling, and on information from Instituto Nacional de Enfermedades Neoplásicas (INEN). Resource utilizations and unit costs were based on estimates from INEN and observational studies. Cost-effectiveness estimates are in 2012 United States dollars (US$) per disability adjusted life year (DALY) averted. Results The current breast cancer program in Peru ($8,426 per DALY averted) could be improved through implementing triennial or biennial screening strategies. These strategies seem the most cost-effective in Peru, particularly when mobile mammography is applied (from $4,125 per DALY averted), or when both CBE screening and mammography screening are combined (from $4,239 per DALY averted). Triennially, these interventions costs between $63 million and $72 million per year. Late stage treatment, trastuzumab therapy and annual screening strategies are the least cost-effective. Conclusions Our analysis suggests that breast cancer control in Peru should be oriented towards early detection through combining fixed and mobile mammography screening (age 45-69) triennially. However, a phased introduction of triennial CBE screening (age 40-69) with upfront FNA in non-urban settings, and both CBE (age 40-49) and fixed mammography screening (age 50-69) in urban settings, seems a more feasible option and is also cost-effective. The implementation of this

Cost-effectiveness analysis of breast cancer control interventions in Peru.

PubMed

Zelle, Sten G; Vidaurre, Tatiana; Abugattas, Julio E; Manrique, Javier E; Sarria, Gustavo; Jeronimo, José; Seinfeld, Janice N; Lauer, Jeremy A; Sepulveda, Cecilia R; Venegas, Diego; Baltussen, Rob

2013-01-01

In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant for the Peruvian context. We performed a cost-effectiveness analysis (CEA) according to WHO-CHOICE guidelines, from a healthcare perspective. Different screening, early detection, palliative, and treatment interventions were evaluated using mathematical modeling. Effectiveness estimates were based on observational studies, modeling, and on information from Instituto Nacional de Enfermedades Neoplásicas (INEN). Resource utilizations and unit costs were based on estimates from INEN and observational studies. Cost-effectiveness estimates are in 2012 United States dollars (US$) per disability adjusted life year (DALY) averted. The current breast cancer program in Peru ($8,426 per DALY averted) could be improved through implementing triennial or biennial screening strategies. These strategies seem the most cost-effective in Peru, particularly when mobile mammography is applied (from $4,125 per DALY averted), or when both CBE screening and mammography screening are combined (from $4,239 per DALY averted). Triennially, these interventions costs between $63 million and $72 million per year. Late stage treatment, trastuzumab therapy and annual screening strategies are the least cost-effective. Our analysis suggests that breast cancer control in Peru should be oriented towards early detection through combining fixed and mobile mammography screening (age 45-69) triennially. However, a phased introduction of triennial CBE screening (age 40-69) with upfront FNA in non-urban settings, and both CBE (age 40-49) and fixed mammography screening (age 50-69) in urban settings, seems a more feasible option and is also cost-effective. The implementation of this intervention is only meaningful if

Digital flight control research

NASA Technical Reports Server (NTRS)

Potter, J. E.; Stern, R. G.; Smith, T. B.; Sinha, P.

1974-01-01

The results of studies which were undertaken to contribute to the design of digital flight control systems, particularly for transport aircraft are presented. In addition to the overall design considerations for a digital flight control system, the following topics are discussed in detail: (1) aircraft attitude reference system design, (2) the digital computer configuration, (3) the design of a typical digital autopilot for transport aircraft, and (4) a hybrid flight simulator.

Cost-effective malaria control in Brazil. Cost-effectiveness of a Malaria Control Program in the Amazon Basin of Brazil, 1988-1996.

PubMed

Akhavan, D; Musgrove, P; Abrantes, A; d'A Gusmão, R

1999-11-01

Malaria transmission was controlled elsewhere in Brazil by 1980, but in the Amazon Basin cases increased steadily until 1989, to almost half a million a year and the coefficient of mortality quadrupled in 1977-1988. The government's malaria control program almost collapsed financially in 1987-1989 and underwent a turbulent reorganization in 1991-1993. A World Bank project supported the program from late 1989 to mid-1996, and in 1992-1993, with help from the Pan American Health Organization, facilitated a change toward earlier and more aggressive case treatment and more concentrated vector control. The epidemic stopped expanding in 1990-1991 and reversed in 1992-1996. The total cost of the program from 1989 through mid-1996 was US$616 million: US$526 million for prevention and US$90 million for treatment. Compared to what would have happened in the absence of the program, nearly two million cases of malaria and 231,000 deaths were prevented; the lives saved were due almost equally to preventing infection and to case treatment. Converting the savings in lives and in morbidity into Disability-Adjusted Life Years yields almost nine million DALYs, 5.1 million from treatment and 3.9 million from prevention. Nearly all the gain came from controlling deaths and therefore from controlling falciparum. The overall cost-effectiveness was US$2672 per life saved or US$69 per DALY, which is low compared to most previous estimates and compares favorably to many other disease control interventions. Contrary to much previous experience, case treatment appears more cost-effective than vector control, particularly where falciparum is prevalent and unfocussed insecticide spraying is relatively ineffective. Halting the epidemic by better targeted vector control and emphasizing treatment paid off in much reduced mortality from malaria and in significantly lower costs per life saved.

Experience with synchronous and asynchronous digital control systems. [for flight

NASA Technical Reports Server (NTRS)

Regenie, Victoria A.; Chacon, Claude V.; Lock, Wilton P.

1986-01-01

Flight control systems have undergone a revolution since the days of simple mechanical linkages; presently the most advanced systems are full-authority, full-time digital systems controlling unstable aircraft. With the use of advanced control systems, the aerodynamic design can incorporate features that allow greater performance and fuel savings, as can be seen on the new Airbus design and advanced tactical fighter concepts. These advanced aircraft will be and are relying on the flight control system to provide the stability and handling qualities required for safe flight and to allow the pilot to control the aircraft. Various design philosophies have been proposed and followed to investigate system architectures for these advanced flight control systems. One major area of discussion is whether a multichannel digital control system should be synchronous or asynchronous. This paper addressed the flight experience at the Dryden Flight Research Facility of NASA's Ames Research Center with both synchronous and asynchronous digital flight control systems. Four different flight control systems are evaluated against criteria such as software reliability, cost increases, and schedule delays.

Cost-effectiveness of a smokeless tobacco control mass media campaign in India.

PubMed

Murukutla, Nandita; Yan, Hongjin; Wang, Shuo; Negi, Nalin Singh; Kotov, Alexey; Mullin, Sandra; Goodchild, Mark

2017-08-10

Tobacco control mass media campaigns are cost-effective in reducing tobacco consumption in high-income countries, but similar evidence from low-income countries is limited. An evaluation of a 2009 smokeless tobacco control mass media campaign in India provided an opportunity to test its cost-effectiveness. Campaign evaluation data from a nationally representative household survey of 2898 smokeless tobacco users were compared with campaign costs in a standard cost-effectiveness methodology. Costs and effects of the Surgeon campaign were compared with the status quo to calculate the cost per campaign-attributable benefit, including quit attempts, permanent quits and tobacco-related deaths averted. Sensitivity analyses at varied CIs and tobacco-related mortality risk were conducted. The Surgeon campaign was found to be highly cost-effective. It successfully generated 17 259 148 additional quit attempts, 431 479 permanent quits and 120 814 deaths averted. The cost per benefit was US$0.06 per quit attempt, US$2.6 per permanent quit and US$9.2 per death averted. The campaign continued to be cost-effective in sensitivity analyses. This study suggests that tobacco control mass media campaigns can be cost-effective and economically justified in low-income and middle-income countries. It holds significant policy implications, calling for sustained investment in evidence-based mass media campaigns as part of a comprehensive tobacco control strategy. © 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.

Comparative effectiveness of combined digital mammography and tomosynthesis screening for women with dense breasts.

PubMed

Lee, Christoph I; Cevik, Mucahit; Alagoz, Oguzhan; Sprague, Brian L; Tosteson, Anna N A; Miglioretti, Diana L; Kerlikowske, Karla; Stout, Natasha K; Jarvik, Jeffrey G; Ramsey, Scott D; Lehman, Constance D

2015-03-01

To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. An established, discrete-event breast cancer simulation model was used to estimate the comparative clinical effectiveness and cost-effectiveness of biennial screening with both digital mammography and tomosynthesis versus digital mammography alone among U.S. women aged 50-74 years with dense breasts from a federal payer perspective and a lifetime horizon. Input values were estimated for test performance, costs, and health state utilities from the National Cancer Institute Breast Cancer Surveillance Consortium, Medicare reimbursement rates, and medical literature. Sensitivity analyses were performed to determine the implications of varying key model parameters, including combined screening sensitivity and specificity, transient utility decrement of diagnostic work-up, and additional cost of tomosynthesis. For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis. Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50-74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations vs $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice.

Analysis and design of digital output interface devices for gas turbine electronic controls

NASA Technical Reports Server (NTRS)

Newirth, D. M.; Koenig, E. W.

1976-01-01

A trade study was performed on twenty-one digital output interface schemes for gas turbine electronic controls to select the most promising scheme based on criteria of reliability, performance, cost, and sampling requirements. The most promising scheme, a digital effector with optical feedback of the fuel metering valve position, was designed.

Pilot production system cost/benefit analysis: Digital document storage project

NASA Technical Reports Server (NTRS)

1989-01-01

The Digital Document Storage (DDS)/Pilot Production System (PPS) will provide cost effective electronic document storage, retrieval, hard copy reproduction, and remote access for users of NASA Technical Reports. The DDS/PPS will result in major benefits, such as improved document reproduction quality within a shorter time frame than is currently possible. In addition, the DDS/PPS will provide an important strategic value through the construction of a digital document archive. It is highly recommended that NASA proceed with the DDS Prototype System and a rapid prototyping development methodology in order to validate recent working assumptions upon which the success of the DDS/PPS is dependent.

Sea-level evaluation of digitally implemented turbojet engine control functions

NASA Technical Reports Server (NTRS)

Arpasi, D. J.; Cwynar, D. S.; Wallhagen, R. E.

1972-01-01

The standard hydromechanical control system of a turbojet engine was replaced with a digital control system that implemented the same control laws. A detailed discussion of the digital control system in use with the engine is presented. The engine was operated in a sea-level test stand. The effects of control update interval are defined, and a method for extending this interval by using digital compensation is discussed.

Effects of a 12-Week Digital Care Program for Chronic Knee Pain on Pain, Mobility, and Surgery Risk: Randomized Controlled Trial

PubMed Central

Erhart-Hledik, Jennifer C; Perez, Daniel A; Hunter, Simon

2018-01-01

.3, P=.002), as well as a significantly greater improvement in physical function (7.2, 95% CI 3.0 to 11.5, P=.001). This was also reflected in the secondary outcomes VAS pain (12.3, 95% CI 5.4 to 19.1, P<.001) and VAS stiffness (13.4, 95% CI 5.6 to 21.1, P=.001). Participants’ self-reported likelihood (from 0% to 100%) of having surgery also reduced more strongly in the digital care program group compared to the control group over the next 1 year (–9.4 percentage points, pp, 95% CI –16.6 to –2.2, P=.01), 2 years (–11.3 pp, 95% CI –20.1 to –2.5, P=.01), and 5 years (–14.6 pp, 95% CI –23.6 to –5.5, P=.002). Interest in surgery (from 0 to 10) also reduced more so in the digital care program compared to control group (–1.0, 95% CI –1.7 to –0.2, P=.01). Participants’ understanding of the condition and treatment options (on a scale from 0 to 4) increased more substantially for participants in the digital care program than those in the control group (0.9, 95% CI 0.6 to 1.3, P<.001). In an analysis on participants that completed the intervention (per protocol analysis) all primary and secondary outcomes remained significant at greater effect magnitudes compared to intention to treat, with those completing the program showing a 61% (95% CI 48 to 74) reduction in VAS pain compared to 21% (95% CI 5 to 38) in the control group (P<.001). Accounting for the cost of administering the program, we estimate net cost savings on surgery alone of US $4340 over 1 year and $7900 over 5 years for those participants completing the digital care program compared to those in the control group receiving treatment-as-usual. In an exploratory subgroup analysis including only participants exhibiting clinical symptoms of osteoarthritis the program proved equally effective. Conclusions This trial provides strong evidence that a comprehensive 12-week digital care program for chronic knee pain, including osteoarthritis, yields significantly improved outcomes for pain, physical

Effects of a 12-Week Digital Care Program for Chronic Knee Pain on Pain, Mobility, and Surgery Risk: Randomized Controlled Trial.

PubMed

Mecklenburg, Gabriel; Smittenaar, Peter; Erhart-Hledik, Jennifer C; Perez, Daniel A; Hunter, Simon

2018-04-25

significantly greater improvement in physical function (7.2, 95% CI 3.0 to 11.5, P=.001). This was also reflected in the secondary outcomes VAS pain (12.3, 95% CI 5.4 to 19.1, P<.001) and VAS stiffness (13.4, 95% CI 5.6 to 21.1, P=.001). Participants' self-reported likelihood (from 0% to 100%) of having surgery also reduced more strongly in the digital care program group compared to the control group over the next 1 year (-9.4 percentage points, pp, 95% CI -16.6 to -2.2, P=.01), 2 years (-11.3 pp, 95% CI -20.1 to -2.5, P=.01), and 5 years (-14.6 pp, 95% CI -23.6 to -5.5, P=.002). Interest in surgery (from 0 to 10) also reduced more so in the digital care program compared to control group (-1.0, 95% CI -1.7 to -0.2, P=.01). Participants' understanding of the condition and treatment options (on a scale from 0 to 4) increased more substantially for participants in the digital care program than those in the control group (0.9, 95% CI 0.6 to 1.3, P<.001). In an analysis on participants that completed the intervention (per protocol analysis) all primary and secondary outcomes remained significant at greater effect magnitudes compared to intention to treat, with those completing the program showing a 61% (95% CI 48 to 74) reduction in VAS pain compared to 21% (95% CI 5 to 38) in the control group (P<.001). Accounting for the cost of administering the program, we estimate net cost savings on surgery alone of US $4340 over 1 year and $7900 over 5 years for those participants completing the digital care program compared to those in the control group receiving treatment-as-usual. In an exploratory subgroup analysis including only participants exhibiting clinical symptoms of osteoarthritis the program proved equally effective. This trial provides strong evidence that a comprehensive 12-week digital care program for chronic knee pain, including osteoarthritis, yields significantly improved outcomes for pain, physical function, stiffness, surgery risk, and understanding of the condition

Precision digital control systems

NASA Astrophysics Data System (ADS)

Vyskub, V. G.; Rozov, B. S.; Savelev, V. I.

This book is concerned with the characteristics of digital control systems of great accuracy. A classification of such systems is considered along with aspects of stabilization, programmable control applications, digital tracking systems and servomechanisms, and precision systems for the control of a scanning laser beam. Other topics explored are related to systems of proportional control, linear devices and methods for increasing precision, approaches for further decreasing the response time in the case of high-speed operation, possibilities for the implementation of a logical control law, and methods for the study of precision digital control systems. A description is presented of precision automatic control systems which make use of electronic computers, taking into account the existing possibilities for an employment of computers in automatic control systems, approaches and studies required for including a computer in such control systems, and an analysis of the structure of automatic control systems with computers. Attention is also given to functional blocks in the considered systems.

Control Strategy Tool (CoST)

EPA Pesticide Factsheets

The EPA Control Strategy Tool (CoST) is a software tool for projecting potential future control scenarios, their effects on emissions and estimated costs. This tool uses the NEI and the Control Measures Dataset as key inputs. CoST outputs are projections of future control scenarios.

Cost-Effectiveness of Interventions to Prevent and Control Diabetes Mellitus: A Systematic Review

PubMed Central

Li, Rui; Zhang, Ping; Barker, Lawrence E.; Chowdhury, Farah M.; Zhang, Xuanping

2010-01-01

OBJECTIVE To synthesize the cost-effectiveness (CE) of interventions to prevent and control diabetes, its complications, and comorbidities. RESEARCH DESIGN AND METHODS We conducted a systematic review of literature on the CE of diabetes interventions recommended by the American Diabetes Association (ADA) and published between January 1985 and May 2008. We categorized the strength of evidence about the CE of an intervention as strong, supportive, or uncertain. CEs were classified as cost saving (more health benefit at a lower cost), very cost-effective (≤$25,000 per life year gained [LYG] or quality-adjusted life year [QALY]), cost-effective ($25,001 to $50,000 per LYG or QALY), marginally cost-effective ($50,001 to $100,000 per LYG or QALY), or not cost-effective (>$100,000 per LYG or QALY). The CE classification of an intervention was reported separately by country setting (U.S. or other developed countries) if CE varied by where the intervention was implemented. Costs were measured in 2007 U.S. dollars. RESULTS Fifty-six studies from 20 countries met the inclusion criteria. A large majority of the ADA recommended interventions are cost-effective. We found strong evidence to classify the following interventions as cost saving or very cost-effective: (I) Cost saving— 1) ACE inhibitor (ACEI) therapy for intensive hypertension control compared with standard hypertension control; 2) ACEI or angiotensin receptor blocker (ARB) therapy to prevent end-stage renal disease (ESRD) compared with no ACEI or ARB treatment; 3) early irbesartan therapy (at the microalbuminuria stage) to prevent ESRD compared with later treatment (at the macroalbuminuria stage); 4) comprehensive foot care to prevent ulcers compared with usual care; 5) multi-component interventions for diabetic risk factor control and early detection of complications compared with conventional insulin therapy for persons with type 1 diabetes; and 6) multi-component interventions for diabetic risk factor control

Noise Source Visualization Using a Digital Voice Recorder and Low-Cost Sensors

PubMed Central

Cho, Yong Thung

2018-01-01

Accurate sound visualization of noise sources is required for optimal noise control. Typically, noise measurement systems require microphones, an analog-digital converter, cables, a data acquisition system, etc., which may not be affordable for potential users. Also, many such systems are not highly portable and may not be convenient for travel. Handheld personal electronic devices such as smartphones and digital voice recorders with relatively lower costs and higher performance have become widely available recently. Even though such devices are highly portable, directly implementing them for noise measurement may lead to erroneous results since such equipment was originally designed for voice recording. In this study, external microphones were connected to a digital voice recorder to conduct measurements and the input received was processed for noise visualization. In this way, a low cost, compact sound visualization system was designed and introduced to visualize two actual noise sources for verification with different characteristics: an enclosed loud speaker and a small air compressor. Reasonable accuracy of noise visualization for these two sources was shown over a relatively wide frequency range. This very affordable and compact sound visualization system can be used for many actual noise visualization applications in addition to educational purposes. PMID:29614038

Cost-Effectiveness of Chagas Disease Vector Control Strategies in Northwestern Argentina

PubMed Central

Vazquez-Prokopec, Gonzalo M.; Spillmann, Cynthia; Zaidenberg, Mario; Kitron, Uriel; Gürtler, Ricardo E.

2009-01-01

Background Control and prevention of Chagas disease rely mostly on residual spraying of insecticides. In Argentina, vector control shifted from a vertical to a fully horizontal strategy based on community participation between 1992 and 2004. The effects of such strategy on Triatoma infestans, the main domestic vector, and on disease transmission have not been assessed. Methods and Findings Based on retrospective (1993–2004) records from the Argentinean Ministry of Health for the Moreno Department, Northwestern Argentina, we performed a cost-effectiveness (CE) analysis and compared the observed CE of the fully horizontal vector control strategy with the expected CE for a vertical or a mixed (i.e., vertical attack phase followed by horizontal surveillance) strategy. Total direct costs (in 2004 US$) of the horizontal and mixed strategies were, respectively, 3.3 and 1.7 times lower than the costs of the vertical strategy, due to reductions in personnel costs. The estimated CE ratios for the vertical, mixed and horizontal strategies were US$132, US$82 and US$45 per averted human case, respectively. When per diems were excluded from the costs (i.e., simulating the decentralization of control activities), the CE of vertical, mixed and horizontal strategies was reduced to US$60, US$42 and US$32 per averted case, respectively. Conclusions and Significance The mixed strategy would have averted between 1.6 and 4.0 times more human cases than the fully horizontal strategy, and would have been the most cost-effective option to interrupt parasite transmission in the Department. In rural and dispersed areas where waning vertical vector programs cannot accomplish full insecticide coverage, alternative strategies need to be developed. If properly implemented, community participation represents not only the most appealing but also the most cost-effective alternative to accomplish such objectives. PMID:19156190

Digital control of diode laser for atmospheric spectroscopy

NASA Technical Reports Server (NTRS)

Menzies, R. T.; Rutledge, C. W. (Inventor)

1985-01-01

A system is described for remote absorption spectroscopy of trace species using a diode laser tunable over a useful spectral region of 50 to 200 cm(-1) by control of diode laser temperature over range from 15 K to 100 K, and tunable over a smaller region of typically 0.1 to 10 cm(-1) by control of the diode laser current over a range from 0 to 2 amps. Diode laser temperature and current set points are transmitted to the instrument in digital form and stored in memory for retrieval under control of a microprocessor during measurements. The laser diode current is determined by a digital to analog converter through a field effect transistor for a high degree of ambient temperature stability, while the laser diode temperature is determined by set points entered into a digital to analog converter under control of the microprocessor. Temperature of the laser diode is sensed by a sensor diode to provide negative feedback to the temperature control circuit that responds to the temperature control digital to analog converter.

Floating-point system quantization errors in digital control systems

NASA Technical Reports Server (NTRS)

Phillips, C. L.

1973-01-01

The results are reported of research into the effects on system operation of signal quantization in a digital control system. The investigation considered digital controllers (filters) operating in floating-point arithmetic in either open-loop or closed-loop systems. An error analysis technique is developed, and is implemented by a digital computer program that is based on a digital simulation of the system. As an output the program gives the programing form required for minimum system quantization errors (either maximum of rms errors), and the maximum and rms errors that appear in the system output for a given bit configuration. The program can be integrated into existing digital simulations of a system.

Digital identification of cartographic control points

NASA Technical Reports Server (NTRS)

Gaskell, R. W.

1988-01-01

Techniques have been developed for the sub-pixel location of control points in satellite images returned by the Voyager spacecraft. The procedure uses digital imaging data in the neighborhood of the point to form a multipicture model of a piece of the surface. Comparison of this model with the digital image in each picture determines the control point locations to about a tenth of a pixel. At this level of precision, previously insignificant effects must be considered, including chromatic aberration, high level imaging distortions, and systematic errors due to navigation uncertainties. Use of these methods in the study of Jupiter's satellite Io has proven very fruitful.

Cost-Effectiveness of Tight Control of Inflammation in Early Psoriatic Arthritis: Economic Analysis of a Multicenter Randomized Controlled Trial.

PubMed

O'Dwyer, John L; Meads, David M; Hulme, Claire T; Mcparland, Lucy; Brown, Sarah; Coates, Laura C; Moverley, Anna R; Emery, Paul; Conaghan, Philip G; Helliwell, Philip S

2018-03-01

Treat-to-target approaches have proved to be effective in rheumatoid arthritis, but have not been studied in psoriatic arthritis (PsA). This study was undertaken to examine the cost-effectiveness of tight control (TC) of inflammation in early PsA compared to standard care. Cost-effectiveness analyses were undertaken alongside a UK-based, open-label, multicenter, randomized controlled trial. Taking the perspective of the health care sector, effectiveness was measured using the 3-level EuroQol 5-domain, which allows for the calculation of quality-adjusted life-years (QALYs). Incremental cost-effectiveness ratios (ICERs) are presented, which represent the additional cost per QALY gained over a 48-week time horizon. Sensitivity analyses are presented assessing the impact of variations in the analytical approach and assumptions on the cost-effectiveness estimates. The mean cost and QALYs were higher in the TC group: £4,198 versus £2,000 and 0.602 versus 0.561. These values yielded an ICER of £53,948 per QALY. Bootstrapped uncertainty analysis suggests that the TC has a 0.07 probability of being cost-effective at a £20,000 threshold. Stratified analysis suggests that with certain costs being controlled, an ICER of £24,639 can be calculated for patients with a higher degree of disease severity. A tight control strategy to treat PsA is an effective intervention in the treatment pathway; however, this study does not find tight control to be cost-effective in most analyses. Lower drug prices, targeting polyarthritis patients, or reducing the frequency of rheumatology visits may improve value for money metrics in future studies. © 2017, American College of Rheumatology.

Low cost voice compression for mobile digital radios

NASA Technical Reports Server (NTRS)

Omura, J. K.

1985-01-01

A new technique for low cost rubust voice compression at 4800 bits per second was studied. The approach was based on using a cascade of digital biquad adaptive filters with simplified multipulse excitation followed by simple bit sequence compression.

Concurrent Development and Cost-Benefit Analysis of Paper-Based and Digitized Instructional Material.

ERIC Educational Resources Information Center

Annand, David

2002-01-01

Describes the simultaneous development of paper-based and digitized versions of a textbook and related instructional material used in an undergraduate, independent study, distance education course at Athabasca University (Canada). Used break-even analysis as an initial evaluation measure to determine cost-effectiveness, and discusses the next…

Can digital pathology result in cost savings? A financial projection for digital pathology implementation at a large integrated health care organization.

PubMed

Ho, Jonhan; Ahlers, Stefan M; Stratman, Curtis; Aridor, Orly; Pantanowitz, Liron; Fine, Jeffrey L; Kuzmishin, John A; Montalto, Michael C; Parwani, Anil V

2014-01-01

Digital pathology offers potential improvements in workflow and interpretive accuracy. Although currently digital pathology is commonly used for research and education, its clinical use has been limited to niche applications such as frozen sections and remote second opinion consultations. This is mainly due to regulatory hurdles, but also to a dearth of data supporting a positive economic cost-benefit. Large scale adoption of digital pathology and the integration of digital slides into the routine anatomic/surgical pathology "slide less" clinical workflow will occur only if digital pathology will offer a quantifiable benefit, which could come in the form of more efficient and/or higher quality care. As a large academic-based health care organization expecting to adopt digital pathology for primary diagnosis upon its regulatory approval, our institution estimated potential operational cost savings offered by the implementation of an enterprise-wide digital pathology system (DPS). Projected cost savings were calculated for the first 5 years following implementation of a DPS based on operational data collected from the pathology department. Projected savings were based on two factors: (1) Productivity and lab consolidation savings; and (2) avoided treatment costs due to improvements in the accuracy of cancer diagnoses among nonsubspecialty pathologists. Detailed analyses of incremental treatment costs due to interpretive errors, resulting in either a false positive or false negative diagnosis, was performed for melanoma and breast cancer and extrapolated to 10 other common cancers. When phased in over 5-years, total cost savings based on anticipated improvements in pathology productivity and histology lab consolidation were estimated at $12.4 million for an institution with 219,000 annual accessions. The main contributing factors to these savings were gains in pathologist clinical full-time equivalent capacity impacted by improved pathologist productivity and workload

Can Digital Pathology Result In Cost Savings? A Financial Projection For Digital Pathology Implementation At A Large Integrated Health Care Organization

PubMed Central

Ho, Jonhan; Ahlers, Stefan M.; Stratman, Curtis; Aridor, Orly; Pantanowitz, Liron; Fine, Jeffrey L.; Kuzmishin, John A.; Montalto, Michael C.; Parwani, Anil V.

2014-01-01

Background: Digital pathology offers potential improvements in workflow and interpretive accuracy. Although currently digital pathology is commonly used for research and education, its clinical use has been limited to niche applications such as frozen sections and remote second opinion consultations. This is mainly due to regulatory hurdles, but also to a dearth of data supporting a positive economic cost-benefit. Large scale adoption of digital pathology and the integration of digital slides into the routine anatomic/surgical pathology “slide less” clinical workflow will occur only if digital pathology will offer a quantifiable benefit, which could come in the form of more efficient and/or higher quality care. Aim: As a large academic-based health care organization expecting to adopt digital pathology for primary diagnosis upon its regulatory approval, our institution estimated potential operational cost savings offered by the implementation of an enterprise-wide digital pathology system (DPS). Methods: Projected cost savings were calculated for the first 5 years following implementation of a DPS based on operational data collected from the pathology department. Projected savings were based on two factors: (1) Productivity and lab consolidation savings; and (2) avoided treatment costs due to improvements in the accuracy of cancer diagnoses among nonsubspecialty pathologists. Detailed analyses of incremental treatment costs due to interpretive errors, resulting in either a false positive or false negative diagnosis, was performed for melanoma and breast cancer and extrapolated to 10 other common cancers. Results: When phased in over 5-years, total cost savings based on anticipated improvements in pathology productivity and histology lab consolidation were estimated at $12.4 million for an institution with 219,000 annual accessions. The main contributing factors to these savings were gains in pathologist clinical full-time equivalent capacity impacted by

Digitally controlled distributed phase shifter

DOEpatents

Hietala, V.M.; Kravitz, S.H.; Vawter, G.A.

1993-08-17

A digitally controlled distributed phase shifter is comprised of N phase shifters. Digital control is achieved by using N binary length-weighted electrodes located on the top surface of a waveguide. A control terminal is attached to each electrode thereby allowing the application of a control signal. The control signal is either one or two discrete bias voltages. The application of the discrete bias voltages changes the modal index of a portion of the waveguide that corresponds to a length of the electrode to which the bias voltage is applied, thereby causing the phase to change through the underlying portion of the waveguide. The digitally controlled distributed phase shift network has a total phase shift comprised of the sum of the individual phase shifters.

Digitally controlled distributed phase shifter

DOEpatents

Hietala, Vincent M.; Kravitz, Stanley H.; Vawter, Gregory A.

1993-01-01

A digitally controlled distributed phase shifter is comprised of N phase shifters. Digital control is achieved by using N binary length-weighted electrodes located on the top surface of a waveguide. A control terminal is attached to each electrode thereby allowing the application of a control signal. The control signal is either one or two discrete bias voltages. The application of the discrete bias voltages changes the modal index of a portion of the waveguide that corresponds to a length of the electrode to which the bias voltage is applied, thereby causing the phase to change through the underlying portion of the waveguide. The digitally controlled distributed phase shift network has a total phase shift comprised of the sum of the individual phase shifters.

Evaluating Multi-Input/Multi-Output Digital Control Systems

NASA Technical Reports Server (NTRS)

Pototzky, Anthony S.; Wieseman, Carol D.; Hoadley, Sherwood T.; Mukhopadhyay, Vivek

1994-01-01

Controller-performance-evaluation (CPE) methodology for multi-input/multi-output (MIMO) digital control systems developed. Procedures identify potentially destabilizing controllers and confirm satisfactory performance of stabilizing ones. Methodology generic and used in many types of multi-loop digital-controller applications, including digital flight-control systems, digitally controlled spacecraft structures, and actively controlled wind-tunnel models. Also applicable to other complex, highly dynamic digital controllers, such as those in high-performance robot systems.

Cost-effectiveness of the Health X Project for tuberculosis control in China.

PubMed

Wang, W-B; Zhang, H; Petzold, M; Zhao, Q; Xu, B; Zhao, G-M

2014-08-01

Between 2002 and 2008, China's National Tuberculosis Control Programme created the Health X Project, financed in part by a World Bank loan, with additional funding from the UK Department for International Development. To assess the cost-effectiveness of the Project and its impact from a financial point of view on tuberculosis (TB) control in China. A decision-analytic model was used to evaluate the cost-effectiveness of the Project. Sensitivity analysis was used to assess the impact of different scenarios and assumptions on results. The primary outcome of the study was cost per disability-adjusted life-year (DALY) saved and incremental DALYs saved. In comparison with alternative scenario 1, the Project detected 1.6 million additional cases, 44 000 deaths were prevented and a total of 18.4 million DALYs saved. The Project strategies cost approximately Chinese yuan (CNY) 953 per DALY saved (vs. CNY1140 in the control areas), and saved an estimated CNY17.5 billion in comparison with the unchanged alternative scenario (scenario 1) or CNY10.8 billion with the control scenario (scenario 2). The Project strategies were affordable and of comparable cost-effectiveness to those of other developing countries. The results also provide strong support for the existing policy of scaling up DOTS in China.

Application of digital control techniques for satellite medium power DC-DC converters

NASA Astrophysics Data System (ADS)

Skup, Konrad R.; Grudzinski, Pawel; Nowosielski, Witold; Orleanski, Piotr; Wawrzaszek, Roman

2010-09-01

The objective of this paper is to present a work concerning a digital control loop system for satellite medium power DC-DC converters that is done in Space Research Centre. The whole control process of a described power converter bases on a high speed digital signal processing. The paper presents a development of a FPGA digital controller for voltage mode stabilization that was implemented using VHDL. The described controllers are a classical digital PID controller and a bang-bang controller. The used converter for testing is a simple model of 5-20 W, 200 kHz buck power converter. A high resolution digital PWM approach is presented. Additionally a simple and effective solution of filtering of an analog-to-digital converter output is presented.

One Health approach to cost-effective rabies control in India.

PubMed

Fitzpatrick, Meagan C; Shah, Hiral A; Pandey, Abhishek; Bilinski, Alyssa M; Kakkar, Manish; Clark, Andrew D; Townsend, Jeffrey P; Abbas, Syed Shahid; Galvani, Alison P

2016-12-20

Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a "One Health" committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond.

One Health approach to cost-effective rabies control in India

PubMed Central

Shah, Hiral A.; Pandey, Abhishek; Bilinski, Alyssa M.; Kakkar, Manish; Clark, Andrew D.; Galvani, Alison P.

2016-01-01

Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a “One Health” committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond. PMID:27994161

The Effectiveness of Low-Cost Tele-Lecturing.

ERIC Educational Resources Information Center

Muta, Hiromitsu; Kikuta, Reiko; Hamano, Takashi; Maesako, Takanori

1997-01-01

Compares distance education using PictureTel, a compressed-digital-video system via telephone lines (audio and visual interactive communication) in terms of its costs and effectiveness with traditional in-class education. Costing less than half the traditional approach, the study suggested distance education would be economical if used frequently.…

Efficacy and cost-effectiveness of environmental management for malaria control.

PubMed

Utzinger, J; Tozan, Y; Singer, B H

2001-09-01

Roll back malaria (RBM) aims at halving the current burden of the disease by the year 2010. The focus is on sub-Saharan Africa, and it is proposed to implement efficacious and cost-effective control strategies. But the evidence base of such information is scarce, and a notable missing element is the discussion of the potential of environmental management. We reviewed the literature and identified multiple malaria control programmes that incorporated environmental management as the central feature. Prominent among them are programmes launched in 1929 and implemented for two decades at copper mining communities in Zambia. The full package of control measures consisted of vegetation clearance, modification of river boundaries, draining swamps, oil application to open water bodies and house screening. Part of the population also was given quinine and was sleeping under mosquito nets. Monthly malaria incidence rates and vector densities were used for surveillance and adaptive tuning of the environmental management strategies to achieve a high level of performance. Within 3-5 years, malaria-related mortality, morbidity and incidence rates were reduced by 70-95%. Over the entire 20 years of implementation, the programme had averted an estimated 4173 deaths and 161,205 malaria attacks. The estimated costs per death and malaria attack averted were US$ 858 and US$ 22.20, respectively. Over the initial 3-5 years start-up period, analogous to the short-duration of cost-effectiveness analyses of current studies, we estimated that the costs per disability adjusted life year (DALY) averted were US$ 524-591. However, the strategy has a track record of becoming cost-effective in the longer term, as maintenance costs were much lower: US$ 22-92 per DALY averted. In view of fewer adverse ecological effects, increased sustainability and better uses of local resources and knowledge, environmental management--integrated with pharmacological, insecticidal and bednet interventions

Modeling of Control Costs, Emissions, and Control Retrofits for Cost Effectiveness and Feasibility Analyses

EPA Pesticide Factsheets

Learn about EPA’s use of the Integrated Planning Model (IPM) to develop estimates of SO2 and NOx emission control costs, projections of futureemissions, and projections of capacity of future control retrofits, assuming controls on EGUs.

[Evaluation on cost-effectiveness of snail control project by environmental modification in hilly regions].

PubMed

Li, Shui-Ming; Chen, Shi-Jun; Wu, Xiao-Jun; Chen, Xi-Qing; Zhang, Rong-Ping; Zhang, Jian-Rong

2011-02-01

To evaluate the cost-effectiveness of the snail control project by environmental modification in order to provide the evidence for quickly interrupting the transmission of schistosomiasis in hilly regions. Field investigations were carried out. The changes of the snail habitat areas were compared before and after the snail control project. The direct costs of the snail control were calculated. The reduction rates of snail area and snail density were regarded as the evaluation indexes of the effectiveness. The costs for reduction of 1% of snail area and 1% of snail density were used as the unit for cost-effectiveness analysis. After the 15 projects were implemented, there were no snails in 12 areas. The reduction rates of snail areas were 72.22% to 100%. The reduction rates of the snail area and density were both 100% in the areas with digging new ditches to fill up the old ones and building reservoirs. The total cost of 15 projects was 1 450 800 Yuan. The average cost per unit was 0.56 Yuan/m2. After the snail control project by digging new ditches to fill up the old ones was implemented, the costs of snail area and density decreased by one unit were 300 -700 Yuan, by building reservoirs, the costs were 600 -2 600 Yuan, by building fishpond, the costs were 1 200 - 1 500 Yuan, by watershed comprehensive measures, the costs were 900 - 2 700 Yuan. The cost of digging new ditches to fill up the old ones was significantly lower than that of building reservoirs or watershed comprehensive measures, but there was no significant difference between building reservoirs and watershed comprehensive measures. In hilly regions, the implementation of snail control project by environmental modification combined with construction of water conservancy is effective, and the cost-effectiveness of the snail control with digging new ditches to fill up the old ones is excellent.

Optical Disk for Digital Storage and Retrieval Systems.

ERIC Educational Resources Information Center

Rose, Denis A.

1983-01-01

Availability of low-cost digital optical disks will revolutionize storage and retrieval systems over next decade. Three major factors will effect this change: availability of disks and controllers at low-cost and in plentiful supply; availability of low-cost and better output means for system users; and more flexible, less expensive communication…

Cost-Effectiveness of a Physician-Pharmacist Collaboration Intervention to Improve Blood Pressure Control.

PubMed

Polgreen, Linnea A; Han, Jayoung; Carter, Barry L; Ardery, Gail P; Coffey, Christopher S; Chrischilles, Elizabeth A; James, Paul A

2015-12-01

Previous studies have demonstrated the cost-effectiveness of physician-pharmacist collaborations to improve hypertension control. However, most studies have limited generalizability, lacking minority and low-income populations. The Collaboration Among Pharmacist and Physicians to Improve Blood Pressure Now (CAPTION) trial randomized 625 patients from 32 medical offices in 15 states. Each office had an existing clinical pharmacist on staff. Pharmacists in intervention offices communicated with patients and made recommendations to physicians about changes in therapy. Demographic information, blood pressure (BP), medications, and physician visits were recorded. In addition, pharmacists tracked time spent with each patient. Costs were assigned to medications and pharmacist and physician time. Cost-effectiveness ratios were calculated based on changes in BP measurements and hypertension control rates. Thirty-eight percent of patients were black, 14% were Hispanic, and 49% had annual income <$25 000. At 9 months, average systolic BP was 6.1 mm Hg lower (±3.5), diastolic was 2.9 mm Hg lower (±1.9), and the percentage of patients with controlled hypertension was 43% in the intervention group and 34% in the control group. Total costs for the intervention group were $1462.87 (±132.51) and $1259.94 (±183.30) for the control group, a difference of $202.93. The cost to lower BP by 1 mm Hg was $33.27 for systolic BP and $69.98 for diastolic BP. The cost to increase the rate of hypertension control by 1 percentage point in the study population was $22.55. Our results highlight the cost-effectiveness of a clinical pharmacy intervention for hypertension control in primary care settings. © 2015 American Heart Association, Inc.

Cost and cost-effectiveness of nationwide school-based helminth control in Uganda

PubMed Central

BROOKER, SIMON; KABATEREINE, NARCIS B; FLEMING, FIONA; DEVLIN, NANCY

2009-01-01

Estimates of cost and cost-effectiveness are typically based on a limited number of small-scale studies with no investigation of the existence of economies to scale or intra-country variation in cost and cost-effectiveness. This information gap hinders the efficient allocation of health care resources and the ability to generalize estimates to other settings. The current study investigates the intra-country variation in the cost and cost-effectiveness of nationwide school-based treatment of helminth (worm) infection in Uganda. Programme cost data were collected through semi-structured interviews with districts officials and from accounting records in six of the 23 intervention districts. Both financial and economic costs were assessed. Costs were estimated on the basis of cost in US$ per schoolchild treated and an incremental cost effectiveness ratio (cost in US$ per case of anaemia averted) was used to evaluate programme cost-effectiveness. Sensitivity analysis was performed to assess the effect of discount rate and drug price. The overall economic cost per child treated in the six districts was US$ 0.54 and the cost-effectiveness was US$ 3.19 per case of anaemia averted. Analysis indicated that estimates of both cost and cost-effectiveness differ markedly with the total number of children which received treatment, indicating economies of scale. There was also substantial variation between districts in the cost per individual treated (US$ 0.41-0.91) and cost per anaemia case averted (US$ 1.70-9.51). Independent variables were shown to be statistically associated with both sets of estimates. This study highlights the potential bias in transferring data across settings without understanding the nature of observed variations. PMID:18024966

Cost-effectiveness of community health workers in tuberculosis control in Bangladesh.

PubMed Central

Islam, Md Akramul; Wakai, Susumu; Ishikawa, Nobukatsu; Chowdhury, A. M. R.; Vaughan, J. Patrick

2002-01-01

OBJECTIVE: To compare the cost-effectiveness of the tuberculosis (TB) programme run by the Bangladesh Rural Advancement Committee (BRAC), which uses community health workers (CHWs), with that of the government TB programme which does not use CHWs. METHODS: TB control statistics and cost data for July 1996 - June 1997 were collected from both government and BRAC thanas (subdistricts) in rural Bangladesh. To measure the cost per patient cured, total costs were divided by the total number of patients cured. FINDINGS: In the BRAC and government areas, respectively, a total of 186 and 185 TB patients were identified over one year, with cure rates among sputum-positive patients of 84% and 82%. However, the cost per patient cured was US$ 64 in the BRAC area compared to US$ 96 in the government area. CONCLUSION: The government programme was 50% more expensive for similar outcomes. Although both the BRAC and government TB control programmes appeared to achieve satisfactory cure rates using DOTS (a five-point strategy), the involvement of CHWs was found to be more cost-effective in rural Bangladesh. With the same budget, the BRAC programme could cure three TB patients for every two in the government programme. PMID:12132000

The x-ray light valve: a potentially low-cost, digital radiographic imaging system-concept and implementation considerations.

PubMed

Webster, Christie Ann; Koprinarov, Ivaylo; Germann, Stephen; Rowlands, J A

2008-03-01

New x-ray radiographic systems based on large-area flat-panel technology have revolutionized our capability to produce digital x-ray images. However, these imagers are extraordinarily expensive compared to the systems they are replacing. Hence, there is a need for a low-cost digital imaging system for general applications in radiology. A novel potentially low-cost radiographic imaging system based on established technologies is proposed-the X-Ray Light Valve (XLV). This is a potentially high-quality digital x-ray detector made of a photoconducting layer and a liquid-crystal cell, physically coupled in a sandwich structure. Upon exposure to x rays, charge is collected on the surface of the photoconductor. This causes a change in the optical properties of the liquid-crystal cell and a visible image is generated. Subsequently, it is digitized by a scanned optical imager. The image formation is based on controlled modulation of light from an external source. The operation and practical implementation of the XLV system are described. The potential performance of the complete system and issues related to sensitivity, spatial resolution, noise, and speed are discussed. The feasibility of clinical use of an XLV device based on amorphous selenium (a-Se) as the photoconductor and a reflective electrically controlled birefringence cell is analyzed. The results of our analysis indicate that the XLV can potentially be adapted to a wide variety of radiographic tasks.

Dithering Digital Ripple Correlation Control for Photovoltaic Maximum Power Point Tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barth, C; Pilawa-Podgurski, RCN

This study demonstrates a new method for rapid and precise maximum power point tracking in photovoltaic (PV) applications using dithered PWM control. Constraints imposed by efficiency, cost, and component size limit the available PWM resolution of a power converter, and may in turn limit the MPP tracking efficiency of the PV system. In these scenarios, PWM dithering can be used to improve average PWM resolution. In this study, we present a control technique that uses ripple correlation control (RCC) on the dithering ripple, thereby achieving simultaneous fast tracking speed and high tracking accuracy. Moreover, the proposed method solves some ofmore » the practical challenges that have to date limited the effectiveness of RCC in solar PV applications. We present a theoretical derivation of the principles behind dithering digital ripple correlation control, as well as experimental results that show excellent tracking speed and accuracy with basic hardware requirements.« less

Cost effectiveness of tobacco control policies in Vietnam: the case of population-level interventions.

PubMed

Higashi, Hideki; Truong, Khoa D; Barendregt, Jan J; Nguyen, Phuong K; Vuong, Mai L; Nguyen, Thuy T; Hoang, Phuong T; Wallace, Angela L; Tran, Tien V; Le, Cuong Q; Doran, Christopher M

2011-05-01

Tobacco smoking is one of the leading public health problems in the world. It is also possible to prevent and/or reduce the harm from tobacco use through the use of cost-effective tobacco control measures. However, most of this evidence comes from developed countries and little research has been conducted on this issue in developing countries. The objective of this study was to analyse the cost effectiveness of four population-level tobacco control interventions in Vietnam. Four tobacco control interventions were evaluated: excise tax increase; graphic warning labels on cigarette packs; mass media campaigns; and smoking bans (in public or in work places). A multi-state life table model was constructed in Microsoft® Excel to examine the cost effectiveness of the tobacco control intervention options. A government perspective was adopted, with costing conducted using a bottom-up approach. Health improvement was considered in terms of disability-adjusted life-years (DALYs) averted. All assumptions were subject to sensitivity and uncertainty analysis. All the interventions fell within the definition of being very cost effective according to the threshold level suggested by the WHO (i.e. cost-effective option, followed by excise tax increases, mass media campaigns, public smoking bans and work place smoking bans. If the cost offset was included in the analysis, all interventions would provide cost savings to the government health sector. All four interventions to reduce the harm from tobacco use appear to be highly cost effective and should be considered as priorities in the context of Vietnam. The government may initially consider graphic warning labels and tax increase, followed by other interventions.

[Cost-effectiveness and cost-benefit analysis on the integrated schistosomiasis control strategies with emphasis on infection source in Poyang Lake region].

PubMed

Lin, Dan-Dan; Zeng, Xiao-Jun; Chen, Hong-Gen; Hong, Xian-Lin; Tao, Bo; Li, Yi-Feng; Xiong, Ji-Jie; Zhou, Xiao-Nong

2009-08-01

To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. The integrated

Evaluation of a high response electrohydraulic digital control valve

NASA Technical Reports Server (NTRS)

Anderson, R. L.

1973-01-01

The application is described of a digital control valve on an electrohydraulic servo actuator. The digital control problem is discussed in general as well as the design and evaluation of a breadboard actuator. The evaluation revealed a number of problems associated with matching the valve to a hydraulic load. The problems were related to lost motion resulting from bulk modulus and leakage. These problems were effectively minimized in the breadboard actuator by maintaining a 1000 psi back pressure on the valve circuit and thereby improving the effective bulk modulus.

Digital flight control systems

NASA Technical Reports Server (NTRS)

Caglayan, A. K.; Vanlandingham, H. F.

1977-01-01

The design of stable feedback control laws for sampled-data systems with variable rate sampling was investigated. These types of sampled-data systems arise naturally in digital flight control systems which use digital actuators where it is desirable to decrease the number of control computer output commands in order to save wear and tear of the associated equipment. The design of aircraft control systems which are optimally tolerant of sensor and actuator failures was also studied. Detection of the failed sensor or actuator must be resolved and if the estimate of the state is used in the control law, then it is also desirable to have an estimator which will give the optimal state estimate even under the failed conditions.

Cost-effective control strategies for animal and zoonotic diseases in pastoralist populations.

PubMed

Zinsstag, J; Abakar, M F; Ibrahim, M; Tschopp, R; Crump, L; Bonfoh, B; Schelling, E

2016-11-01

Animal diseases and zoonoses abound among pastoralist livestock, which is composed of cattle, sheep, goats, yak, camels, llamas, reindeer, horses and donkeys. There is endemic and, periodically, epidemic transmission of highly contagious viral and bacterial diseases in Africa, Asia and Latin America. Pastoralist livestock is often multiparasitised with endo- and ectoparasites, as well as being affected by vectorborne viral and protozoal diseases. Pastoral livestock can be a reservoir of such diseases and can also, conversely, be at risk from exposure to wildlife reservoirs. Public and private animal health services currently underperform in almost all pastoral areas due to structural reforms and lack of income, as indicated in assessments of national Veterinary Services by the World Organisation for Animal Health. Control of infectious disease in industrialised countries has been achieved through large-scale public funding of control measures and compensation for culled stock. Such means are not available in pastoralist areas of most low- and middle-income countries (LMICs). While the cost-effectiveness and profitability of the control of animal diseases and zoonoses is less of a consideration for industrialised countries, in the experience of the authors, understanding the economic implications of a control programme is a prerequisite for successful attempts to improve animal health in LMICs. The incremental costs of animal disease control can potentially be shared using crosssector assessments, integrated control, and regional coordination efforts to mitigate transboundary disease risks. In this paper, the authors discuss cost-effective animal disease and zoonoses control in LMICs. It illustrates frameworks and examples of integrated control and cross-sector economics, showing conditions under which these diseases could be controlled in a cost-effective way.

Model predictive controller design for boost DC-DC converter using T-S fuzzy cost function

NASA Astrophysics Data System (ADS)

Seo, Sang-Wha; Kim, Yong; Choi, Han Ho

2017-11-01

This paper proposes a Takagi-Sugeno (T-S) fuzzy method to select cost function weights of finite control set model predictive DC-DC converter control algorithms. The proposed method updates the cost function weights at every sample time by using T-S type fuzzy rules derived from the common optimal control engineering knowledge that a state or input variable with an excessively large magnitude can be penalised by increasing the weight corresponding to the variable. The best control input is determined via the online optimisation of the T-S fuzzy cost function for all the possible control input sequences. This paper implements the proposed model predictive control algorithm in real time on a Texas Instruments TMS320F28335 floating-point Digital Signal Processor (DSP). Some experimental results are given to illuminate the practicality and effectiveness of the proposed control system under several operating conditions. The results verify that our method can yield not only good transient and steady-state responses (fast recovery time, small overshoot, zero steady-state error, etc.) but also insensitiveness to abrupt load or input voltage parameter variations.

Costs and Effects of Abdominal versus Laparoscopic Hysterectomy: Systematic Review of Controlled Trials

PubMed Central

Bijen, Claudia B. M.; Vermeulen, Karin M.; Mourits, Marian J. E.; de Bock, Geertruida H.

2009-01-01

Objective Comparative evaluation of costs and effects of laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH). Data sources Controlled trials from Cochrane Central register of controlled trials, Medline, Embase and prospective trial registers. Selection of studies Twelve (randomized) controlled studies including the search terms costs, laparoscopy, laparotomy and hysterectomy were identified. Methods The type of cost analysis, perspective of cost analyses and separate cost components were assessed. The direct and indirect costs were extracted from the original studies. For the cost estimation, hospital stay and procedure costs were selected as most important cost drivers. As main outcome the major complication rate was taken. Findings Analysis was performed on 2226 patients, of which 1013 (45.5%) in the LH group and 1213 (54.5%) in the AH group. Five studies scored ≥10 points (out of 19) for methodological quality. The reported total direct costs in the LH group ($63,997) were 6.1% higher than the AH group ($60,114). The reported total indirect costs of the LH group ($1,609) were half of the total indirect in the AH group ($3,139). The estimated mean major complication rate in the LH group (14.3%) was lower than in the AH group (15.9%). The estimated total costs in the LH group were $3,884 versus $3,312 in the AH group. The incremental costs for reducing one patient with major complication(s) in the LH group compared to the AH group was $35,750. Conclusions The shorter hospital stay in the LH group compensates for the increased procedure costs, with less morbidity. LH points in the direction of cost effectiveness, however further research is warranted with a broader costs perspective including long term effects as societal benefit, quality of life and survival. PMID:19806210

Diagnostic value and cost-effectiveness of good quality digital images accompanying electronic referrals for suspected skin malignancies.

PubMed

Ng, Michael F Y; Stevenson, J Howard

2011-04-01

The aim of this study was to investigate the outcome and cost-effectiveness of good and poor quality photographs accompanying the electronic referrals for suspected skin malignancies. A retrospective study of 100 patients, divided into 2 groups, 50 with good quality photographs and 50 with poor quality photographs. Patients with no digital images, or who failed to attend, or patients with incomplete notes were excluded from the study. The treatment pathway, waiting times, and estimated cost between the 2 groups were compared. Good photographs were more likely to be treated at the 1-Stop Clinic (P = 0.05). Good images had a better positive predictive value than poor quality images (62.55% vs. 42.86%). Good quality images are more accurate than poor quality images in triaging of patients, and thus more effective in facilitating the treatment of malignant lesions timely. Good quality photographs allow a delayed appropriate treatment of benign lesions. This increases the safety for patients in a queue in a rationed health care system, and improves patient flow.

Effective tree hazard control on forested recreation sites...losses and protection costs evaluated

Treesearch

Lee A. Paine

1967-01-01

Effectiveness of hazard control was evaluated by analyzing data on tree failures, accidents, and control costs on California recreation sites. Results indicate that reduction of limb hazard in oaks and bole hazard in conifers is the most effective form of control. Least effective is limb hazard reduction in conifers. After hazard control goals or control budgets have...

Digital nerve injuries: epidemiology, results, costs, and impact on daily life.

PubMed

Thorsén, Frida; Rosberg, Hans-Eric; Steen Carlsson, Katarina; Dahlin, Lars B

2012-09-01

Epidemiology, results of treatment, impact on activity of daily living (ADL), and costs for treatment of digital nerve injuries have not been considered consistently. Case notes of patients of 0-99 years of age living in Malmö municipality, Sweden, who presented with a digital nerve injury and were referred to the Department of Hand Surgery in 1995-2005 were analysed retrospectively. The incidence was 6.2/100 000 inhabitants and year. Most commonly men (75%; median age 29 years) were injured. Isolated nerve injuries and concomitant tendon injuries were equally common. The direct costs (hospital stay, operation, outpatient visits, visits to a nurse and/or a hand therapist) for a concomitant tendon injury was almost double compared with an isolated digital nerve injury (6136 EUR [range, 744-29 689 EUR] vs 2653 EUR [range, 468-6949 EUR]). More than 50% of the patients who worked were injured at work and 79% lost time from work (median 59 days [range 3-337]). Permanent nerve dysfunction for the individual patient with ADL problems and subjective complaints of fumbleness, cold sensitivity, and pain occur in the patients despite surgery. It is concluded that digital nerve injuries, often considered as a minor injury and that affect young people at productive age, cause costs, and disability. Focus should be directed against prevention of the injury and to improve nerve regeneration from different aspects.

Controlling air pollution from passenger ferries: cost-effectiveness of seven technological options.

PubMed

Farrell, Alexander E; Corbett, James J; Winebrake, James J

2002-12-01

Continued interest in improving air quality in the United States along with renewed interest in the expansion of urban passenger ferry service has created concern about air pollution from ferry vessels. This paper presents a methodology for estimating the air pollution emissions from passenger ferries and the costs of emissions control strategies. The methodology is used to estimate the emissions and costs of retrofitting or re-powering ferries with seven technological options (combinations of propulsion and emission control systems) onto three vessels currently in service in San Francisco Bay. The technologies include improved engine design, cleaner fuels (including natural gas), and exhaust gas cleanup devices. The three vessels span a range of ages and technologies, from a 25-year-old monohull to a modern, high-speed catamaran built only four years ago. By looking at a range of technologies, vessel designs, and service conditions, a sense of the broader implications of controlling emissions from passenger ferries across a range of vessels and service profiles is provided. Tier 2-certified engines are the most cost-effective choice, but all options are cost-effective relative to other emission control strategies already in place in the transportation system.

Economic evaluation of public-private mix for tuberculosis care and control, India. Part II. Cost and cost-effectiveness.

PubMed

Pantoja, A; Lönnroth, K; Lal, S S; Chauhan, L S; Uplekar, M; Padma, M R; Unnikrishnan, K P; Rajesh, J; Kumar, P; Sahu, S; Wares, F; Floyd, K

2009-06-01

Bangalore City, India. To assess the cost and cost-effectiveness of public-private mix (PPM) for tuberculosis (TB) care and control when implemented on a large scale. DOTS implementation under the Revised National TB Control Programme (RNTCP) began in 1999, PPM was introduced in mid-2001 and a second phase of intensified PPM began in 2003. Data on the costs and effects of TB treatment from 1999 to 2005 were collected and used to compare the two distinct phases of PPM with a scenario of no PPM. Costs were assessed in 2005 $US for public and private providers, patients and patient attendants. Sources of data included expenditure records, medical records, interviews with staff and patient surveys. Effectiveness was measured as the number of cases successfully treated. When PPM was implemented, total provider costs increased in proportion to the number of successfully treated TB cases. The average cost per patient treated from the provider perspective when PPM was implemented was stable, at US$69, in the intensified phase compared with US$71 pre-PPM. PPM resulted in the shift of an estimated 7200 patients from non-DOTS to DOTS treatment over 5 years. PPM implementation substantially reduced costs to patients, such that the average societal cost per patient successfully treated fell from US$154 to US$132 in the 4 years following the initiation of PPM. Implementation of PPM on a large scale in an urban setting can be cost-effective, and considerably reduces the financial burden of TB for patients.

Using counterfactuals to evaluate the cost-effectiveness of controlling biological invasions.

PubMed

McConnachie, Matthew M; van Wilgen, Brian W; Ferraro, Paul J; Forsyth, Aurelia T; Richardson, David M; Gaertner, Mirijam; Cowling, Richard M

2016-03-01

Prioritizing limited conservation funds for controlling biological invasions requires accurate estimates of the effectiveness of interventions to remove invasive species and their cost-effectiveness (cost per unit area or individual). Despite billions of dollars spent controlling biological invasions worldwide, it is unclear whether those efforts are effective, and cost-effective. The paucity of evidence results from the difficulty in measuring the effect of invasive species removal: a researcher must estimate the difference in outcomes (e.g. invasive species cover) between where the removal program intervened and what might have been observed if the program had not intervened. In the program evaluation literature, this is called a counterfactual analysis, which formally compares what actually happened and what would have happened in the absence of an intervention. When program implementation is not randomized, estimating counterfactual outcomes is especially difficult. We show how a thorough understanding of program implementation, combined with a matching empirical design can improve the way counterfactual outcomes are estimated in nonexperimental contexts. As a practical demonstration, we estimated the cost-effectiveness of South Africa's Working for Water program, arguably the world's most ambitious invasive species control program, in removing invasive alien trees from different land use types, across a large area in the Cape Floristic Region. We estimated that the proportion of the treatment area covered by invasive trees would have been 49% higher (5.5% instead of 2.7% of the grid cells occupied) had the program not intervened. Our estimates of cost per hectare to remove invasive species, however, are three to five times higher than the predictions made when the program was initiated. Had there been no control (counter-factual), invasive trees would have spread on untransformed land, but not on land parcels containing plantations or land transformed by

Evaluation of Digital Checklists for Command and Control Operations

DTIC Science & Technology

2016-01-01

EVALUATION OF DIGITAL CHECKLISTS FOR COMMAND AND CONTROL OPERATIONS Christopher K. McClernon 1 , Victor S. Finomore 2 , Terence S. Andre 3...the potential effectiveness of a digital system that could take the place of the paper system that is currently being used. A between groups...assessments of each system were analyzed and compared. The data showed that a linear digital checklist takes a longer amount of time than both a paper

A Cost-Effectiveness Tool for Informing Policies on Zika Virus Control.

PubMed

Alfaro-Murillo, Jorge A; Parpia, Alyssa S; Fitzpatrick, Meagan C; Tamagnan, Jules A; Medlock, Jan; Ndeffo-Mbah, Martial L; Fish, Durland; Ávila-Agüero, María L; Marín, Rodrigo; Ko, Albert I; Galvani, Alison P

2016-05-01

As Zika virus continues to spread, decisions regarding resource allocations to control the outbreak underscore the need for a tool to weigh policies according to their cost and the health burden they could avert. For example, to combat the current Zika outbreak the US President requested the allocation of $1.8 billion from Congress in February 2016. Illustrated through an interactive tool, we evaluated how the number of Zika cases averted, the period during pregnancy in which Zika infection poses a risk of microcephaly, and probabilities of microcephaly and Guillain-Barré Syndrome (GBS) impact the cost at which an intervention is cost-effective. From Northeast Brazilian microcephaly incidence data, we estimated the probability of microcephaly in infants born to Zika-infected women (0.49% to 2.10%). We also estimated the probability of GBS arising from Zika infections in Brazil (0.02% to 0.06%) and Colombia (0.08%). We calculated that each microcephaly and GBS case incurs the loss of 29.95 DALYs and 1.25 DALYs per case, as well as direct medical costs for Latin America and the Caribbean of $91,102 and $28,818, respectively. We demonstrated the utility of our cost-effectiveness tool with examples evaluating funding commitments by Costa Rica and Brazil, the US presidential proposal, and the novel approach of genetically modified mosquitoes. Our analyses indicate that the commitments and the proposal are likely to be cost-effective, whereas the cost-effectiveness of genetically modified mosquitoes depends on the country of implementation. Current estimates from our tool suggest that the health burden from microcephaly and GBS warrants substantial expenditures focused on Zika virus control. Our results justify the funding committed in Costa Rica and Brazil and many aspects of the budget outlined in the US president's proposal. As data continue to be collected, new parameter estimates can be customized in real-time within our user-friendly tool to provide updated

Cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry meat food supply.

PubMed

Lake, Robin J; Horn, Beverley J; Dunn, Alex H; Parris, Ruth; Green, F Terri; McNickle, Don C

2013-07-01

An analysis of the cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry supply examined a series of interventions. Effectiveness was evaluated in terms of reduced health burden measured by disability-adjusted life years (DALYs). Costs of implementation were estimated from the value of cost elements, determined by discussions with industry. Benefits were estimated by changing the inputs to a poultry food chain quantitative risk model. Proportional reductions in the number of predicted Campylobacter infections were converted into reductions in the burden of disease measured in DALYs. Cost-effectiveness ratios were calculated for each intervention, as cost per DALY reduction and the ratios compared. The results suggest that the most cost-effective interventions (lowest ratios) are at the primary processing stage. Potential phage-based controls in broiler houses were also highly cost-effective. This study is limited by the ability to quantify costs of implementation and assumptions required to estimate health benefits, but it supports the implementation of interventions at the primary processing stage as providing the greatest quantum of benefit and lowest cost-effectiveness ratios.

Low cost 3D scanning process using digital image processing

NASA Astrophysics Data System (ADS)

Aguilar, David; Romero, Carlos; Martínez, Fernando

2017-02-01

This paper shows the design and building of a low cost 3D scanner, able to digitize solid objects through contactless data acquisition, using active object reflection. 3D scanners are used in different applications such as: science, engineering, entertainment, etc; these are classified in: contact scanners and contactless ones, where the last ones are often the most used but they are expensive. This low-cost prototype is done through a vertical scanning of the object using a fixed camera and a mobile horizontal laser light, which is deformed depending on the 3-dimensional surface of the solid. Using digital image processing an analysis of the deformation detected by the camera was done; it allows determining the 3D coordinates using triangulation. The obtained information is processed by a Matlab script, which gives to the user a point cloud corresponding to each horizontal scanning done. The obtained results show an acceptable quality and significant details of digitalized objects, making this prototype (built on LEGO Mindstorms NXT kit) a versatile and cheap tool, which can be used for many applications, mainly by engineering students.

Research in digital adaptive flight controllers

NASA Technical Reports Server (NTRS)

Kaufman, H.

1976-01-01

A design study of adaptive control logic suitable for implementation in modern airborne digital flight computers was conducted. Both explicit controllers which directly utilize parameter identification and implicit controllers which do not require identification were considered. Extensive analytical and simulation efforts resulted in the recommendation of two explicit digital adaptive flight controllers. Interface weighted least squares estimation procedures with control logic were developed using either optimal regulator theory or with control logic based upon single stage performance indices.

Impact and cost-effectiveness of a comprehensive Schistosomiasis japonica control program in the Poyang Lake region of China.

PubMed

Yu, Qing; Zhao, Geng-Ming; Hong, Xian-Lin; Lutz, Eric A; Guo, Jia-Gang

2013-11-28

Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003-2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%-544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%-1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence.

Effects of the ACA on Health Care Cost Containment.

PubMed

Weiner, Janet; Marks, Clifford; Pauly, Mark

2017-02-01

This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to "bend the cost curve." Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.

Low Cost Digital Vibration Meter.

PubMed

Payne, W Vance; Geist, Jon

2007-01-01

This report describes the development of a low cost, digital Micro Electro Mechanical System (MEMS) vibration meter that reports an approximation to the RMS acceleration of the vibration to which the vibration meter is subjected. The major mechanical element of this vibration meter is a cantilever beam, which is on the order of 500 µm in length, with a piezoresistor deposited at its base. Vibration of the device in the plane perpendicular to the cantilever beam causes it to bend, which produces a measurable change in the resistance of a piezoresistor. These changes in resistance along with a unique signal-processing scheme are used to determine an approximation to the RMS acceleration sensed by the device.

Low Cost Digital Vibration Meter

PubMed Central

Payne, W. Vance; Geist, Jon

2007-01-01

This report describes the development of a low cost, digital Micro Electro Mechanical System (MEMS) vibration meter that reports an approximation to the RMS acceleration of the vibration to which the vibration meter is subjected. The major mechanical element of this vibration meter is a cantilever beam, which is on the order of 500 µm in length, with a piezoresistor deposited at its base. Vibration of the device in the plane perpendicular to the cantilever beam causes it to bend, which produces a measurable change in the resistance of a piezoresistor. These changes in resistance along with a unique signal-processing scheme are used to determine an approximation to the RMS acceleration sensed by the device. PMID:27110459

Digital control of the Kuiper Airborne Observatory telescope

NASA Technical Reports Server (NTRS)

Mccormack, Ann C.; Snyder, Philip K.

1989-01-01

The feasibility of using a digital controller to stabilize a telescope mounted in an airplane is investigated. The telescope is a 30 in. infrared telescope mounted aboard a NASA C-141 aircraft known as the Kuiper Airborne Observatory. Current efforts to refurbish the 14-year-old compensation system have led to considering a digital controller. A typical digital controller is modeled and added into the telescope system model. This model is simulated on a computer to generate the Bode plots and time responses which determine system stability and performance parameters. Important aspects of digital control system hardware are discussed. A summary of the findings shows that a digital control system would result in satisfactory telescope performance.

Formulation of a strategy for monitoring control integrity in critical digital control systems

NASA Technical Reports Server (NTRS)

Belcastro, Celeste M.; Fischl, Robert; Kam, Moshe

1991-01-01

Advanced aircraft will require flight critical computer systems for stability augmentation as well as guidance and control that must perform reliably in adverse, as well as nominal, operating environments. Digital system upset is a functional error mode that can occur in electromagnetically harsh environments, involves no component damage, can occur simultaneously in all channels of a redundant control computer, and is software dependent. A strategy is presented for dynamic upset detection to be used in the evaluation of critical digital controllers during the design and/or validation phases of development. Critical controllers must be able to be used in adverse environments that result from disturbances caused by an electromagnetic source such as lightning, high intensity radiated field (HIRF), and nuclear electromagnetic pulses (NEMP). The upset detection strategy presented provides dynamic monitoring of a given control computer for degraded functional integrity that can result from redundancy management errors and control command calculation error that could occur in an electromagnetically harsh operating environment. The use is discussed of Kalman filtering, data fusion, and decision theory in monitoring a given digital controller for control calculation errors, redundancy management errors, and control effectiveness.

Programmable Digital Controller

NASA Technical Reports Server (NTRS)

Wassick, Gregory J.

2012-01-01

An existing three-channel analog servo loop controller has been redesigned for piezoelectric-transducer-based (PZT-based) etalon control applications to a digital servo loop controller. This change offers several improvements over the previous analog controller, including software control over proportional-integral-derivative (PID) parameters, inclusion of other data of interest such as temperature and pressure in the control laws, improved ability to compensate for PZT hysteresis and mechanical mount fluctuations, ability to provide pre-programmed scanning and stepping routines, improved user interface, expanded data acquisition, and reduced size, weight, and power.

Review of innovations in digital health technology to promote weight control.

PubMed

Thomas, J Graham; Bond, Dale S

2014-01-01

Advances in technology have contributed to the obesity epidemic and worsened health by reducing opportunities for physical activity and by the proliferation of inexpensive calorie-dense foods. However, much of the same technology can be used to counter these troublesome trends by fostering the development and maintenance of healthy eating and physical activity habits. In contrast to intensive face-to-face treatments, technology-based interventions also have the potential to reach large numbers of individuals at low cost. The purpose of this review is to discuss studies in which digital technology has been used for behavioral weight control, report on advances in consumer technology that are widely adopted but insufficiently tested, and explore potential future directions for both. Web-based, mobile (eg, smartphone), virtual reality, and gaming technologies are the focus of discussion. The best evidence exists to support the use of digital technology for self-monitoring of weight-related behaviors and outcomes. However, studies are underway that will provide additional, important information regarding how best to apply digital technology for behavioral weight control.

Impact and Cost-Effectiveness of a Comprehensive Schistosomiasis japonica Control Program in the Poyang Lake Region of China

PubMed Central

Yu, Qing; Zhao, Geng-Ming; Hong, Xian-Lin; Lutz, Eric A.; Guo, Jia-Gang

2013-01-01

Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003–2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%–544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%–1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence. PMID:24287861

The Cost-Effectiveness of Low-Cost Essential Antihypertensive Medicines for Hypertension Control in China: A Modelling Study.

PubMed

Gu, Dongfeng; He, Jiang; Coxson, Pamela G; Rasmussen, Petra W; Huang, Chen; Thanataveerat, Anusorn; Tzong, Keane Y; Xiong, Juyang; Wang, Miao; Zhao, Dong; Goldman, Lee; Moran, Andrew E

2015-08-01

Hypertension is China's leading cardiovascular disease risk factor. Improved hypertension control in China would result in result in enormous health gains in the world's largest population. A computer simulation model projected the cost-effectiveness of hypertension treatment in Chinese adults, assuming a range of essential medicines list drug costs. The Cardiovascular Disease Policy Model-China, a Markov-style computer simulation model, simulated hypertension screening, essential medicines program implementation, hypertension control program administration, drug treatment and monitoring costs, disease-related costs, and quality-adjusted life years (QALYs) gained by preventing cardiovascular disease or lost because of drug side effects in untreated hypertensive adults aged 35-84 y over 2015-2025. Cost-effectiveness was assessed in cardiovascular disease patients (secondary prevention) and for two blood pressure ranges in primary prevention (stage one, 140-159/90-99 mm Hg; stage two, ≥160/≥100 mm Hg). Treatment of isolated systolic hypertension and combined systolic and diastolic hypertension were modeled as a reduction in systolic blood pressure; treatment of isolated diastolic hypertension was modeled as a reduction in diastolic blood pressure. One-way and probabilistic sensitivity analyses explored ranges of antihypertensive drug effectiveness and costs, monitoring frequency, medication adherence, side effect severity, background hypertension prevalence, antihypertensive medication treatment, case fatality, incidence and prevalence, and cardiovascular disease treatment costs. Median antihypertensive costs from Shanghai and Yunnan province were entered into the model in order to estimate the effects of very low and high drug prices. Incremental cost-effectiveness ratios less than the per capita gross domestic product of China (11,900 international dollars [Int$] in 2015) were considered cost-effective. Treating hypertensive adults with prior cardiovascular

Cost-Effective Control Systems for Colleges and Universities: A New Paradigm.

ERIC Educational Resources Information Center

Hubbell, Loren Loomis; Dougherty, Jennifer Dowling

This report addresses the issue of maintaining adequate controls within a streamlined or restructured financial affairs environment at an institution of higher education. It presents a new paradigm for control structures designed to more effectively meet administrators' needs--both in terms of cost and risk management. The first section: (1)…

Cost--effectiveness analysis of salpingectomy prior to IVF, based on a randomized controlled trial.

PubMed

Strandell, Annika; Lindhard, Anette; Eckerlund, Ingemar

2005-12-01

In patients with ultrasound-visible hydrosalpinges, salpingectomy prior to IVF increases the chance of a live birth. This study compared the cost-effectiveness of this strategy (intervention) with that of optional salpingectomy after a failed cycle (control). Data from a Scandinavian randomized controlled trial were used to calculate the individual number of treatments and their outcomes. Only patients with ultrasound-visible hydrosalpinges were considered in the main analysis, and a maximum of three fresh cycles were included. The costs for surgical procedures, IVF treatment, medication, complications, management of pregnancy and delivery as well as of early pregnancy losses were calculated from standardized hospital charges. Among the 51 patients in the intervention group, the live birth rate was 60.8% compared with 40.9% in 44 controls. The average cost per patient was 13,943 euro and 12,091 euro, respectively. Thus, the average cost per live birth was 22,823 euro in the intervention group and 29,517 euro in the control group. The incremental cost-effectiveness ratio for adopting the intervention strategy was estimated at 9306 euro. The incremental cost to achieve the higher birth rate of the intervention strategy seems reasonable.

Digital robust active control law synthesis for large order flexible structure using parameter optimization

NASA Technical Reports Server (NTRS)

Mukhopadhyay, V.

1988-01-01

A generic procedure for the parameter optimization of a digital control law for a large-order flexible flight vehicle or large space structure modeled as a sampled data system is presented. A linear quadratic Guassian type cost function was minimized, while satisfying a set of constraints on the steady-state rms values of selected design responses, using a constrained optimization technique to meet multiple design requirements. Analytical expressions for the gradients of the cost function and the design constraints on mean square responses with respect to the control law design variables are presented.

What can formal methods offer to digital flight control systems design

NASA Technical Reports Server (NTRS)

Good, Donald I.

1990-01-01

Formal methods research begins to produce methods which will enable mathematic modeling of the physical behavior of digital hardware and software systems. The development of these methods directly supports the NASA mission of increasing the scope and effectiveness of flight system modeling capabilities. The conventional, continuous mathematics that is used extensively in modeling flight systems is not adequate for accurate modeling of digital systems. Therefore, the current practice of digital flight control system design has not had the benefits of extensive mathematical modeling which are common in other parts of flight system engineering. Formal methods research shows that by using discrete mathematics, very accurate modeling of digital systems is possible. These discrete modeling methods will bring the traditional benefits of modeling to digital hardware and hardware design. Sound reasoning about accurate mathematical models of flight control systems can be an important part of reducing risk of unsafe flight control.

Digital flight control actuation system study

NASA Technical Reports Server (NTRS)

Rossing, R.; Hupp, R.

1974-01-01

Flight control actuators and feedback sensors suitable for use in a redundant digital flight control system were examined. The most appropriate design approach for an advanced digital flight control actuation system for development and use in a fly-by-wire system was selected. The concept which was selected consisted of a PM torque motor direct drive. The selected system is compatible with concurrent and independent development efforts on the computer system and the control law mechanizations.

Development of a Digital Control for the Phase Contrast Imaging Alignment Feedback System

NASA Astrophysics Data System (ADS)

Hirata, M.; Marinoni, A.; Rost, J. C.; Davis, E. M.; Porkolab, M.

2016-10-01

The Phase Contrast Imaging diagnostic is an internal reference interferometer that images density fluctuations on a 32-element linear detector array. Since proper operation of the system requires accurate alignment of a CO2 laser beam on a phase plate, beam motion due to vibrations of the DIII-D vessel need to be compensated up to 1 kHz. The feedback network controlling the steering mirrors currently uses a linear analog controller, but a digital controller can provide improved stability performance and flexibility. A prototype was developed using an Arduino Due, a low-cost microcontroller, to assess performance capabilities. Digital control parameters will be developed based on the measured frequency and phase response of the physical components. Finally, testing of the digital feedback system and the required revisions will be done to achieve successful performance. This upgrade to the linear analog controller is expected to be used routinely on similar diagnostics in fusion devices, especially in view of restricted access to the machine hall. Work supported in part by the US Department of Energy under DE-FG02-94ER54235, DE-FC02-04ER54698, and the Science Undergraduate Laboratory Internships Program (SULI).

Cost-effective FITL technologies for small business and residential customers

NASA Astrophysics Data System (ADS)

Andersen, Niels E.; Woolnough, Peter; Seidenberg, Juergen; Ferreira, Mario F. S.

1995-02-01

FIRST is a RACE project where 5 main European telecoms operators, 4 equipment manufacturers and one university have joined up to define and test in a field trial in Portugal a cost effective Optical Access Network. The main design target has been a system which gives cost effective provision of wideband services for small and medium business customers. The system however, incorporates provision of telephone, ISDN and analog and digital video for residential customers as well. Technologies have been chosen with the objective of providing a simple, robust and flexible system where initial deployment costs are low and closely related to the service take up. The paper describes the main technical features of the system and network applications which shows how the system may be introduced in network planning. The system is based on Passive Optical Network technology where video is distributed in the 1550 nm window and telecoms services transmitted at 1300 nm in full duplex mode. The telecoms system provides high capacity, flexibility in loop length and robustness towards outside plant performance. The Subcarrier Multiple Access (SCMA) method is used for upstream transmission of bi-directional telecoms services. SCMA has advantages compared to the Time Division Multiple Access technology used in other systems. Bandwidth/cost tradeoff is better and the lower requirements to the outside plant increases the overall cost benefit. Optical beat noise due to overlapping of laser spectra which may be a problem for this technology has been addressed with success through the use of a suitable modulation and control technique. This technology is further validated in the field trial. The video system provides cost effective long distance transmission on standard fiber with externally modulated lasers and cascaded amplifiers. Coexistence of analog and digital video on one fiber with different modulation schemes i.e. BPSK, QPSK and 64 QAM have been validated. Total life cycle cost

Old/New Effect of Digital Memory Retrieval in Chinese Dyscalculia.

PubMed

Wang, Enguo; Du, Chenguang; Ma, Yujun

This study reports the neurophysiological and behavioral correlates of digital memory retrieval features in Chinese individuals with and without dyscalculia. A total of 18 children with dyscalculia (ages 11.5-13.5) and 18 controls were tested, and their event-related potentials were digitally recorded simultaneously with behavior measurement. Behavioral data showed that the dyscalculia group had lower hit rates and higher false rates than the control group. The electroencephalography results showed that both groups had a significant old/new effect and that this effect was greater in the control group. In the 300 to 400 ms processing stages, both groups showed significant differences in digital memory retrieval in the frontal regions. In the 400 to 500 and 500 to 600 ms epochs, the old/new effect in the control group was significantly greater than it was in the dyscalculia group at the frontal, central, and parietal regions. In the 600 to 700 ms processing stages, both groups showed significant differences in digital memory retrieval in the frontal, central, parietal, and occipital regions. These results suggest that individuals with dyscalculia exhibit impaired digital memory retrieval. Extraction failure may be an important cause of calculation difficulties.

Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41)

PubMed Central

Gray, Alastair; Raikou, Maria; McGuire, Alistair; Fenn, Paul; Stevens, Richard; Cull, Carole; Stratton, Irene; Adler, Amanda; Holman, Rury; Turner, Robert

2000-01-01

Objective To estimate the cost effectiveness of conventional versus intensive blood glucose control in patients with type 2 diabetes. Design Incremental cost effectiveness analysis alongside randomised controlled trial. Setting 23 UK hospital clinic based study centres. Participants 3867 patients with newly diagnosed type 2 diabetes (mean age 53 years). Interventions Conventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin. Main outcome measures Incremental cost per event-free year gained within the trial period. Results Intensive glucose control increased trial treatment costs by £695 (95% confidence interval £555 to £836) per patient but reduced the cost of complications by £957 (£233 to £1681) compared with conventional management. If standard practice visit patterns were assumed rather than trial conditions, the incremental cost of intensive management was £478 (−£275 to £1232) per patient. The within trial event-free time gained in the intensive group was 0.60 (0.12 to 1.10) years and the lifetime gain 1.14 (0.69 to 1.61) years. The incremental cost per event-free year gained was £1166 (costs and effects discounted at 6% a year) and £563 (costs discounted at 6% a year and effects not discounted). Conclusions Intensive blood glucose control in patients with type 2 diabetes significantly increased treatment costs but substantially reduced the cost of complications and increased the time free of complications. PMID:10818026

Digital IAPT: the effectiveness & cost-effectiveness of internet-delivered interventions for depression and anxiety disorders in the Improving Access to Psychological Therapies programme: study protocol for a randomised control trial.

PubMed

Richards, Derek; Duffy, Daniel; Blackburn, Brid; Earley, Caroline; Enrique, Angel; Palacios, Jorge; Franklin, Matthew; Clarke, Gabriella; Sollesse, Sarah; Connell, Sarah; Timulak, Ladislav

2018-03-02

Depression and anxiety are common mental health disorders worldwide. The UK's Improving Access to Psychological Therapies (IAPT) programme is part of the National Health Service (NHS) designed to provide a stepped care approach to treating people with anxiety and depressive disorders. Cognitive Behavioural Therapy (CBT) is widely used, with computerised and internet-delivered cognitive behavioural therapy (cCBT and iCBT, respectively) being a suitable IAPT approved treatment alternative for step 2, low- intensity treatment. iCBT has accumulated a large empirical base for treating depression and anxiety disorders. However, the cost-effectiveness and impact of these interventions in the longer-term is not routinely assessed by IAPT services. The current study aims to evaluate the clinical and cost-effectiveness of internet-delivered interventions for symptoms of depression and anxiety disorders in IAPT. The study is a parallel-groups, randomised controlled trial examining the effectiveness and cost-effectiveness of iCBT interventions for depression and anxiety disorders, against a waitlist control group. The iCBT treatments are of 8 weeks duration and will be supported by regular post-session feedback by Psychological Wellbeing Practitioners. Assessments will be conducted at baseline, during, and at the end of the 8-week treatment and at 3, 6, 9, and 12-month follow-up. A diagnostic interview will be employed at baseline and 3-month follow-up. Participants in the waitlist control group will complete measures at baseline and week 8, at which point they will receive access to the treatment. All adult users of the Berkshire NHS Trust IAPT Talking Therapies Step 2 services will be approached to participate and measured against set eligibility criteria. Primary outcome measures will assess anxiety and depressive symptoms using the GAD-7 and PHQ-9, respectively. Secondary outcome measures will allow for the evaluation of long-term outcomes, mediators and moderators of

Dynamical beam manipulation based on 2-bit digitally-controlled coding metasurface.

PubMed

Huang, Cheng; Sun, Bo; Pan, Wenbo; Cui, Jianhua; Wu, Xiaoyu; Luo, Xiangang

2017-02-08

Recently, a concept of digital metamaterials has been proposed to manipulate field distribution through proper spatial mixtures of digital metamaterial bits. Here, we present a design of 2-bit digitally-controlled coding metasurface that can effectively modulate the scattered electromagnetic wave and realize different far-field beams. Each meta-atom of this metasurface integrates two pin diodes, and by tuning their operating states, the metasurface has four phase responses of 0, π/2, π, and 3π/2, corresponding to four basic digital elements "00", "01", "10", and "11", respectively. By designing the coding sequence of the above digital element array, the reflected beam can be arbitrarily controlled. The proposed 2-bit digital metasurface has been demonstrated to possess capability of achieving beam deflection, multi-beam and beam diffusion, and the dynamical switching of these different scattering patterns is completed by a programmable electric source.

The B-747 flight control system maintenance and reliability data base for cost effectiveness tradeoff studies

NASA Technical Reports Server (NTRS)

1982-01-01

Primary and automatic flight controls are combined for a total flight control reliability and maintenance cost data base using information from two previous reports and additional cost data gathered from a major airline. A comparison of the current B-747 flight control system effects on reliability and operating cost with that of a B-747 designed for an active control wing load alleviation system is provided.

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania.

PubMed

Ngalesoni, Frida; Ruhago, George; Mayige, Mary; Oliveira, Tiago Cravo; Robberstad, Bjarne; Norheim, Ole Frithjof; Higashi, Hideki

2017-01-01

Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania. A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs) averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters. Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively. Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government's ability to implement these interventions.

A telerobotic digital controller system

NASA Technical Reports Server (NTRS)

Brown, Richard J.

1992-01-01

This system is a network of joint mounted dual axes digital servo-controllers (DDSC), providing control of various joints and end effectors of different robotic systems. This report provides description of and user required information for the Digital Controller System Network (DSCN) and, in particular, the DDSC, Model DDSC-2, developed to perform the controller functions. The DDSC can control 3 phase brushless or brush type DC motors, requiring up to 8 amps. Only four wires, two for power and 2 for serial communication, are required, except for local sensor and motor connections. This highly capable, very flexible, programmable servo-controller, contained on a single, compact printed circuit board measuring only 4.5 x 5.1 inches, is applicable to control systems of all types from sub-arc second precision pointing to control of robotic joints and end effectors. This document concentrates on the robotic applications for the DDSC.

Cost-effectiveness analyses for mirtazapine and sertraline in dementia: randomised controlled trial.

PubMed

Romeo, Renee; Knapp, Martin; Hellier, Jennifer; Dewey, Michael; Ballard, Clive; Baldwin, Robert; Bentham, Peter; Burns, Alistair; Fox, Chris; Holmes, Clive; Katona, Cornelius; Lawton, Claire; Lindesay, James; Livingston, Gill; McCrae, Niall; Moniz-Cook, Esme; Murray, Joanna; Nurock, Shirley; O'Brien, John; Poppe, Michaela; Thomas, Alan; Walwyn, Rebecca; Wilson, Kenneth; Banerjee, Sube

2013-02-01

Depression is a common and costly comorbidity in dementia. There are very few data on the cost-effectiveness of antidepressants for depression in dementia and their effects on carer outcomes. To evaluate the cost-effectiveness of sertraline and mirtazapine compared with placebo for depression in dementia. A pragmatic, multicentre, randomised placebo-controlled trial with a parallel cost-effectiveness analysis (trial registration: ISRCTN88882979 and EudraCT 2006-000105-38). The primary cost-effectiveness analysis compared differences in treatment costs for patients receiving sertraline, mirtazapine or placebo with differences in effectiveness measured by the primary outcome, total Cornell Scale for Depression in Dementia (CSDD) score, over two time periods: 0-13 weeks and 0-39 weeks. The secondary evaluation was a cost-utility analysis using quality-adjusted life years (QALYs) computed from the Euro-Qual (EQ-5D) and societal weights over those same periods. There were 339 participants randomised and 326 with costs data (111 placebo, 107 sertraline, 108 mirtazapine). For the primary outcome, decrease in depression, mirtazapine and sertraline were not cost-effective compared with placebo. However, examining secondary outcomes, the time spent by unpaid carers caring for participants in the mirtazapine group was almost half that for patients receiving placebo (6.74 v. 12.27 hours per week) or sertraline (6.74 v. 12.32 hours per week). Informal care costs over 39 weeks were £1510 and £1522 less for the mirtazapine group compared with placebo and sertraline respectively. In terms of reducing depression, mirtazapine and sertraline were not cost-effective for treating depression in dementia. However, mirtazapine does appear likely to have been cost-effective if costing includes the impact on unpaid carers and with quality of life included in the outcome. Unpaid (family) carer costs were lower with mirtazapine than sertraline or placebo. This may have been mediated via the

Global and regional estimates of the effectiveness and cost-effectiveness of price increases and other tobacco control policies.

PubMed

Ranson, M Kent; Jha, Prabhat; Chaloupka, Frank J; Nguyen, Son N

2002-08-01

The objective of this study was to provide conservative estimates of the global and regional effectiveness and cost-effectiveness of tobacco control policies. Using a static model of the cohort of smokers alive in 1995, we estimated the number of smoking-attributable deaths that could be averted by: (1) price increases, (2) nicotine replacement therapy (NRT), and (3) a package of non-price interventions other than NRT. We calculated the cost-effectiveness of these policy interventions by weighing the approximate public-sector costs against the years of healthy life saved, measured in disability-adjusted life years, or DALYs. Even with deliberately conservative assumptions, tax increases that would raise the real price of cigarettes by 10% worldwide would prevent between 5 and 16 million tobacco-related deaths, and could cost 3-70 US dollars per DALY saved in low-income and middle-income regions. NRT and a package of non-price interventions other than NRT are also cost-effective in low-income and middle-income regions, at 280-870 US dollars per DALY and 36-710 US dollars per DALY, respectively. In high-income countries, price increases were found to have a cost-effectiveness of 83-2771 US dollars per DALY, NRT 750-7206 US dollars per DALY and other non-price interventions 696-13,924 US dollars per DALY. Tobacco control policies, particularly tax increases on cigarettes, are cost-effective relative to other health interventions. Our estimates are subject to considerable variation in actual settings; thus, local cost-effectiveness studies are required to guide local policy.

Dynamical beam manipulation based on 2-bit digitally-controlled coding metasurface

PubMed Central

Huang, Cheng; Sun, Bo; Pan, Wenbo; Cui, Jianhua; Wu, Xiaoyu; Luo, Xiangang

2017-01-01

Recently, a concept of digital metamaterials has been proposed to manipulate field distribution through proper spatial mixtures of digital metamaterial bits. Here, we present a design of 2-bit digitally-controlled coding metasurface that can effectively modulate the scattered electromagnetic wave and realize different far-field beams. Each meta-atom of this metasurface integrates two pin diodes, and by tuning their operating states, the metasurface has four phase responses of 0, π/2, π, and 3π/2, corresponding to four basic digital elements “00”, “01”, “10”, and “11”, respectively. By designing the coding sequence of the above digital element array, the reflected beam can be arbitrarily controlled. The proposed 2-bit digital metasurface has been demonstrated to possess capability of achieving beam deflection, multi-beam and beam diffusion, and the dynamical switching of these different scattering patterns is completed by a programmable electric source. PMID:28176870

Cost-Effectiveness of Wisconsin TEAM Model for Improving Adherence and Hypertension Control in Black Patients

PubMed Central

Shireman, Theresa I.; Svarstad, Bonnie L.

2016-01-01

Objective To assess the cost-effectiveness of the 6-month Team Education and Adherence Monitoring (TEAM) intervention for black patients with hypertension in community pharmacies using prospectively collected cost data. Design Cost-effectiveness analysis of a cluster-randomized trial. Setting 28 chain pharmacies in five Wisconsin cities from December 2006 to February 2009. Participants 576 black patients with uncontrolled hypertension Intervention Pharmacists and pharmacy technicians using novel tools for improving adherence and feedback to patients and physicians as compared to information only control group. Main outcome measure(s) Incremental cost analysis of variable costs from the pharmacy perspective captured prospectively at the participant level. Outcomes (effect measures) were 6-month refill adherence, changes in SBP and DBP, and proportion of patients achieving BP control. Results Mean cost of intervention personnel time and tools was $104.8± 45.2. Incremental variable costs per mmHg decrease in SBP and DBP were $22.2 ± 16.3 and $66.0 ± 228.4, respectively. The cost of helping one more person achieve the BP goal (< 140/90) was $665.2 ± 265.2; the cost of helping one more person achieve good refill adherence was $463.3 ± 110.7. Prescription drug costs were higher for the TEAM group ($392.8, SD = 396.3 versus $307.0, SD = 295.2, p = 0.02). The start-up cost for pharmacy furniture, equipment, and privacy screen was $168 per pharmacy. Conclusions Our randomized, practice based intervention demonstrated that community pharmacists can implement a cost-effective intervention to improve hypertension control in blacks. This approach imposes a nominal expense at the pharmacy level, can be integrated into the ongoing pharmacist-patient relationship, and can enhance clinical and behavioral outcomes. PMID:27184784

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania

PubMed Central

Ngalesoni, Frida; Ruhago, George; Mayige, Mary; Oliveira, Tiago Cravo; Robberstad, Bjarne; Norheim, Ole Frithjof; Higashi, Hideki

2017-01-01

Background Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. Aims We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania. Materials and methods A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs) averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters. Results Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively. Conclusions Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government’s ability to implement these interventions. PMID:28767722

Army/NASA small turboshaft engine digital controls research program

NASA Technical Reports Server (NTRS)

Sellers, J. F.; Baez, A. N.

1981-01-01

The emphasis of a program to conduct digital controls research for small turboshaft engines is on engine test evaluation of advanced control logic using a flexible microprocessor based digital control system designed specifically for research on advanced control logic. Control software is stored in programmable memory. New control algorithms may be stored in a floppy disk and loaded directly into memory. This feature facilitates comparative evaluation of different advanced control modes. The central processor in the digital control is an Intel 8086 16 bit microprocessor. Control software is programmed in assembly language. Software checkout is accomplished prior to engine test by connecting the digital control to a real time hybrid computer simulation of the engine. The engine currently installed in the facility has a hydromechanical control modified to allow electrohydraulic fuel metering and VG actuation by the digital control. Simulation results are presented which show that the modern control reduces the transient rotor speed droop caused by unanticipated load changes such as cyclic pitch or wind gust transients.

Test and control computer user's guide for a digital beam former test system

NASA Technical Reports Server (NTRS)

Alexovich, Robert E.; Mallasch, Paul G.

1992-01-01

A Digital Beam Former Test System was developed to determine the effects of noise, interferers and distortions, and digital implementations of beam forming as applied to the Tracking and Data Relay Satellite 2 (TDRS 2) architectures. The investigation of digital beam forming with application to TDRS 2 architectures, as described in TDRS 2 advanced concept design studies, was conducted by the NASA/Lewis Research Center for NASA/Goddard Space Flight Center. A Test and Control Computer (TCC) was used as the main controlling element of the digital Beam Former Test System. The Test and Control Computer User's Guide for a Digital Beam Former Test System provides an organized description of the Digital Beam Former Test System commands. It is written for users who wish to conduct tests of the Digital Beam forming Test processor using the TCC. The document describes the function, use, and syntax of the TCC commands available to the user while summarizing and demonstrating the use of the commands wtihin DOS batch files.

A Cost-Effective Atomic Force Microscope for Undergraduate Control Laboratories

ERIC Educational Resources Information Center

Jones, C. N.; Goncalves, J.

2010-01-01

This paper presents a simple, cost-effective and robust atomic force microscope (AFM), which has been purposely designed and built for use as a teaching aid in undergraduate controls labs. The guiding design principle is to have all components be open and visible to the students, so the inner functioning of the microscope has been made clear to…

Digital control of highly augmented combat rotorcraft

NASA Technical Reports Server (NTRS)

Tischler, Mark B.

1987-01-01

Proposed concepts for the next generation of combat helicopters are to be embodied in a complex, highly maneuverable, multiroled vehicle with avionics systems. Single pilot and nap-of-the-Earth operations require handling qualities which minimize the involvement of the pilot in basic stabilization tasks. To meet these requirements will demand a full authority, high-gain, multimode, multiply-redundant, digital flight-control system. The gap between these requirements and current low-authority, low-bandwidth operational rotorcraft flight-control technology is considerable. This research aims at smoothing the transition between current technology and advanced concept requirements. The state of the art of high-bandwidth digital flight-control systems are reviewed; areas of specific concern for flight-control systems of modern combat are exposed; and the important concepts are illustrated in design and analysis of high-gain, digital systems with a detailed case study involving a current rotorcraft system. Approximate and exact methods are explained and illustrated for treating the important concerns which are unique to digital systems.

A monitor for the laboratory evaluation of control integrity in digital control systems operating in harsh electromagnetic environments

NASA Technical Reports Server (NTRS)

Belcastro, Celeste M.; Fischl, Robert; Kam, Moshe

1992-01-01

This paper presents a strategy for dynamically monitoring digital controllers in the laboratory for susceptibility to electromagnetic disturbances that compromise control integrity. The integrity of digital control systems operating in harsh electromagnetic environments can be compromised by upsets caused by induced transient electrical signals. Digital system upset is a functional error mode that involves no component damage, can occur simultaneously in all channels of a redundant control computer, and is software dependent. The motivation for this work is the need to develop tools and techniques that can be used in the laboratory to validate and/or certify critical aircraft controllers operating in electromagnetically adverse environments that result from lightning, high-intensity radiated fields (HIRF), and nuclear electromagnetic pulses (NEMP). The detection strategy presented in this paper provides dynamic monitoring of a given control computer for degraded functional integrity resulting from redundancy management errors, control calculation errors, and control correctness/effectiveness errors. In particular, this paper discusses the use of Kalman filtering, data fusion, and statistical decision theory in monitoring a given digital controller for control calculation errors.

Switch Costs Occur at Lemma Stage When Bilinguals Name Digits: Evidence from Language-Switching and Event-Related Potentials.

PubMed

Chang, Song; Xie, Jiushu; Li, Li; Wang, Ruiming; Liu, Ming

2016-01-01

Switch costs are generally found in language switching tasks. However, the locus where switch costs occur during bilingual language production remains unclear. Several studies that used a cued language-switching paradigm have attempted to investigate this question in bilingual language production, but researchers have not reached a consensus. Moreover, we are interested in where switch costs occur when language selection occurs after lemma activation. Previous studies have not investigated this question because most previous studies presented language cues before or along with the stimuli. Therefore, we used a modified cued language-switching paradigm with a combined event-related potentials (ERPs) technique to explore the locus of switch costs during bilingual language production. The cue and stimulus were separated and presented in two different presentation sequences in which Indonesian-Chinese bilingual speakers were instructed to name digits in their L1 or L2 according to the color of the cue. The ERPs related to the cue and stimulus for two presentation sequences were measured. In the stimulus-cue sequence, the analysis that was time-locked to cues revealed a reversed switch cost as early as 220 ms after the cue onset; furthermore, a switch cost was shown in L1 with a late stage post-cue onset. The results suggested that when language selection occurred after lemma activation, the switch costs mainly occurred at the lemma selection stage. In the cue-stimulus sequence, the analysis that was time-locked to cues did not reveal significant main effects of switching, whereas the analysis that was time-locked to digits yielded a switch cost, again indicating that switch costs mainly occurred at the lemma selection stage rather than at the language task schema competition stage. Overall, our results indicated that when bilinguals spoke digits aloud in the language switching task, switch costs mainly occurred at the lemma selection stage.

A biodegradable colorimetric film for rapid low-cost field determination of formaldehyde contamination by digital image colorimetry.

PubMed

Wongniramaikul, Worawit; Limsakul, Wadcharawadee; Choodum, Aree

2018-05-30

A biodegradable colorimetric film was fabricated on the lid of portable tube for in-tube formaldehyde detection. Based on the entrapment of colorimetric reagents within a thin film of tapioca starch, the yellow reaction product was observed with formaldehyde. Intensity of the blue channel from the digital image of yellow product showed a linear relationship in the range of 0-25 mg L -1 with low detection limit of 0.7 ± 0.1 mg L -1 . Inter-day precision of 0.61-3.10%RSD were obtained with less than 4.2% relative error from control samples. The developed method was applied for various food samples in Phuket and formaldehyde concentration range was non-detectable to 1.413 mg kg -1 . The quantified concentrations of formaldehyde in fish and squid samples provided relative errors of -7.7% and +10.8% compared to spectrophotometry. This low cost sensor (∼0.04 USD/test) with digital image colorimetry was thus an effective alternative for formaldehyde detection in food sample. Copyright © 2018 Elsevier Ltd. All rights reserved.

An educational intervention to improve cost-effective care among medicine housestaff: a randomized controlled trial.

PubMed

Sommers, Benjamin D; Desai, Nihar; Fiskio, Julie; Licurse, Adam; Thorndike, Mary; Katz, Joel T; Bates, David W

2012-06-01

High medical costs create significant burdens. Research indicates that doctors have little awareness of costs. This study tested whether a brief educational intervention could increase residents' awareness of cost-effectiveness and reduce costs without negatively affecting patient outcomes. The authors conducted a clustered randomized controlled trial of 33 teams (96 residents) at an internal medicine residency program (2009-2010). The intervention was a 45-minute teaching session; residents reviewed the hospital bill of a patient for whom they had cared and discussed reducing unnecessary costs. Primary outcomes were laboratory, pharmacy, radiology, and total hospital costs per admission. Secondary measures were length of stay (LOS), intensive care unit (ICU) admission, 30-day readmission, and 30-day mortality. Multivariate adjustment controlled for patient demographics and health. A follow-up survey assessed resident attitudes three months later. Among 1,194 patients, there were no significant cost differences between intervention and control groups. In the intervention group, 30-day readmission was higher (adjusted odds ratio 1.51, P = .010). There was no effect on LOS or the composite outcome of readmission, mortality, and ICU transfer. In a subgroup analysis of 835 patients newly admitted during the study, the intervention group incurred $163 lower adjusted lab costs per admission (P = .046). The follow-up survey indicated persistent differences in residents' exposure to concepts of cost-effectiveness (P = .041). A brief intervention featuring a discussion of hospital bills can fill a gap in resident education and reduce laboratory costs for a subset of patients, but may increase readmission risk.

Cost effectiveness and cost utility of preventing trachomatous visual impairment: lessons from 30 years of trachoma control in Burma.

PubMed Central

Evans, T G; Ranson, M K; Kyaw, T A; Ko, C K

1996-01-01

AIMS/BACKGROUND: This paper reports on the findings of a cost and effectiveness study of the trachoma control programme (TCP) in Burma. The TCP began in 1964 employing non-surgical interventions (community education and mass treatment with topical antibiotics) and surgical correction of trichiasis. METHODS: Fixed and variable costs of the TCP are assessed over 30 years (1964-93) and apportioned to either surgical or non-surgical interventions. The change in the prevalence of trachoma blindness during this period is used to calculate cases of visual impairment prevented by the TCP. The years of life saved because of premature mortality averted and from living in a handicapped state are added to yield a single measure of utility called handicap adjusted life years (HALYs). RESULTS: The cost effectiveness of the TCP is $54 per case of visual impairment prevented: $193 and $47 for surgical and non-surgical interventions respectively. The cost utility of the TCP is $4 per HALY averted: $10 and $3 for surgical and non-surgical interventions respectively. Results are highly sensitive to the 1965 prevalence of blindness, the choice of discount rate, and the effectiveness of both interventions. CONCLUSIONS: Thirty years of trachoma control in Burma are associated with a remarkable decline in trachomatous blindness. Both surgical and non-surgical interventions are cost effective means of preventing trachomatous visual impairment. Discussion focuses on methodological limitations and implications for research and policy. PMID:8976698

Modelling and Optimal Control of Typhoid Fever Disease with Cost-Effective Strategies.

PubMed

Tilahun, Getachew Teshome; Makinde, Oluwole Daniel; Malonza, David

2017-01-01

We propose and analyze a compartmental nonlinear deterministic mathematical model for the typhoid fever outbreak and optimal control strategies in a community with varying population. The model is studied qualitatively using stability theory of differential equations and the basic reproductive number that represents the epidemic indicator is obtained from the largest eigenvalue of the next-generation matrix. Both local and global asymptotic stability conditions for disease-free and endemic equilibria are determined. The model exhibits a forward transcritical bifurcation and the sensitivity analysis is performed. The optimal control problem is designed by applying Pontryagin maximum principle with three control strategies, namely, the prevention strategy through sanitation, proper hygiene, and vaccination; the treatment strategy through application of appropriate medicine; and the screening of the carriers. The cost functional accounts for the cost involved in prevention, screening, and treatment together with the total number of the infected persons averted. Numerical results for the typhoid outbreak dynamics and its optimal control revealed that a combination of prevention and treatment is the best cost-effective strategy to eradicate the disease.

Digital Electronic Engine Control (DEEC) Flight Evaluation in an F-15 Airplane

NASA Technical Reports Server (NTRS)

1984-01-01

Flight evaluation in an F-15 aircraft by digital electronic engine control (DEEC) was investigated. Topics discussed include: system description, F100 engine tests, effects of inlet distortion on static pressure probe, flight tests, digital electronic engine control fault detection and accommodation flight evaluation, flight evaluation of a hydromechanical backup control, augmentor transient capability of an F100 engine, investigation of nozzle instability, real time in flight thrust calculation, and control technology for future aircraft propulsion systems. It is shown that the DEEC system is a powerful and flexible controller for the F100 engine.

Chromatic aberration correction: an enhancement to the calibration of low-cost digital dermoscopes.

PubMed

Wighton, Paul; Lee, Tim K; Lui, Harvey; McLean, David; Atkins, M Stella

2011-08-01

We present a method for calibrating low-cost digital dermoscopes that corrects for color and inconsistent lighting and also corrects for chromatic aberration. Chromatic aberration is a form of radial distortion that often occurs in inexpensive digital dermoscopes and creates red and blue halo-like effects on edges. Being radial in nature, distortions due to chromatic aberration are not constant across the image, but rather vary in both magnitude and direction. As a result, distortions are not only visually distracting but could also mislead automated characterization techniques. Two low-cost dermoscopes, based on different consumer-grade cameras, were tested. Color is corrected by imaging a reference and applying singular value decomposition to determine the transformation required to ensure accurate color reproduction. Lighting is corrected by imaging a uniform surface and creating lighting correction maps. Chromatic aberration is corrected using a second-order radial distortion model. Our results for color and lighting calibration are consistent with previously published results, while distortions due to chromatic aberration can be reduced by 42-47% in the two systems considered. The disadvantages of inexpensive dermoscopy can be quickly substantially mitigated with a suitable calibration procedure. © 2011 John Wiley & Sons A/S.

The costs and effects of contrast-enhanced magnetic resonance angiography and digital substraction angiography on quality of life in patients with peripheral arterial disease.

PubMed

Bosma, Jan; Dijksman, Lea M; Lam, Kayan; Wisselink, Willem; van Swijndregt, Alexander D Montauban; Vahl, Anco

2014-04-01

Contrast-enhanced magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (DSA) both have a high diagnostic performance in the imaging of peripheral arterial occlusive disease (PAOD). However, little is known about the effects of initial, preoperative imaging using MRA or DSA on quality of life (QoL) in relation to costs (cost-utility). To compare cost-utility of treatment strategies using either MRA or DSA as the principal imaging tool, related to QoL, in patients with PAOD. In a prospective subgroup analysis of patients randomized between MRA and DSA (n = 79) for preoperative imaging, QoL questionnaires (SF-36) were obtained at randomization and at 4-month follow-up. Cost-effectiveness from hospital perspective was subsequently compared between groups and the difference in gained or lost QoL per € spent assessed using bootstrap analysis. No difference in quality of life was found. A treatment trajectory employing MRA as the principal imaging modality was almost 20% cheaper, leading to a better cost-utility ratio in favor of MRA. A treatment plan for peripheral arterial occlusive disease employing MRA versus DSA as the principal imaging modality yields a better cost/QoL ratio for MRA.

Cost effectiveness analysis of elementary school-located vaccination against influenza--results from a randomized controlled trial.

PubMed

Yoo, Byung-Kwang; Humiston, Sharon G; Szilagyi, Peter G; Schaffer, Stanley J; Long, Christine; Kolasa, Maureen

2013-04-19

School-located vaccination against influenza (SLV-I) has been suggested to help meet the need for annual vaccination of large numbers of school-aged children with seasonal influenza vaccine. However, little is known about the cost and cost-effectiveness of SLV-I. We conducted a cost-analysis and a cost-effectiveness analysis based on a randomized controlled trial (RCT) of an SLV-I program implemented in Monroe County, New York during the 2009-2010 vaccination season. We hypothesized that SLV-I is more cost effective, or less-costly, compared to a conventional, office-located influenza vaccination delivery. First and second SLV-I clinics were offered in 21 intervention elementary schools (n=9027 children) with standard of care (no SLV-I) in 11 control schools (n=4534 children). The direct costs, to purchase and administer vaccines, were estimated from our RCT. The effectiveness measure, receipt of ≥1 dose of influenza vaccine, was 13.2 percentage points higher in SLV-I schools than control schools. The school costs ($9.16/dose in 2009 dollars) plus project costs ($23.00/dose) plus vendor costs excluding vaccine purchase ($19.89/dose) was higher in direct costs ($52.05/dose) than the previously reported mean/median cost [$38.23/$21.44 per dose] for providing influenza vaccination in pediatric practices. However SLV-I averted parent costs to visit medical practices ($35.08 per vaccine). Combining direct and averted costs through Monte Carlo Simulation, SLV-I costs were $19.26/dose in net costs, which is below practice-based influenza vaccination costs. The incremental cost-effectiveness ratio (ICER) was estimated to be $92.50 or $38.59 (also including averted parent costs). When additionally accounting for the costs averted by disease prevention (i.e., both reduced disease transmission to household members and reduced loss of productivity from caring for a sick child), the SLV-I model appears to be cost-saving to society, compared to "no vaccination". Our findings

A Low-Cost Digital Microscope with Real-Time Fluorescent Imaging Capability.

PubMed

Hasan, Md Mehedi; Alam, Mohammad Wajih; Wahid, Khan A; Miah, Sayem; Lukong, Kiven Erique

2016-01-01

This paper describes the development of a prototype of a low-cost digital fluorescent microscope built from commercial off-the-shelf (COTS) components. The prototype was tested to detect malignant tumor cells taken from a living organism in a preclinical setting. This experiment was accomplished by using Alexa Fluor 488 conjugate dye attached to the cancer cells. Our prototype utilizes a torch along with an excitation filter as a light source for fluorophore excitation, a dichroic mirror to reflect the excitation and pass the emitted green light from the sample under test and a barrier filter to permit only appropriate wavelength. The system is designed out of a microscope using its optical zooming property and an assembly of exciter filter, dichroic mirror and transmitter filter. The microscope is connected to a computer or laptop through universal serial bus (USB) that allows real-time transmission of captured florescence images; this also offers real-time control of the microscope. The designed system has comparable features of high-end commercial fluorescent microscopes while reducing cost, power, weight and size.

A Low-Cost Digital Microscope with Real-Time Fluorescent Imaging Capability

PubMed Central

Hasan, Md. Mehedi; Wahid, Khan A.; Miah, Sayem; Lukong, Kiven Erique

2016-01-01

This paper describes the development of a prototype of a low-cost digital fluorescent microscope built from commercial off-the-shelf (COTS) components. The prototype was tested to detect malignant tumor cells taken from a living organism in a preclinical setting. This experiment was accomplished by using Alexa Fluor 488 conjugate dye attached to the cancer cells. Our prototype utilizes a torch along with an excitation filter as a light source for fluorophore excitation, a dichroic mirror to reflect the excitation and pass the emitted green light from the sample under test and a barrier filter to permit only appropriate wavelength. The system is designed out of a microscope using its optical zooming property and an assembly of exciter filter, dichroic mirror and transmitter filter. The microscope is connected to a computer or laptop through universal serial bus (USB) that allows real-time transmission of captured florescence images; this also offers real-time control of the microscope. The designed system has comparable features of high-end commercial fluorescent microscopes while reducing cost, power, weight and size. PMID:27977709

Cost-effectiveness of condom uterine balloon tamponade to control severe postpartum hemorrhage in Kenya.

PubMed

Mvundura, Mercy; Kokonya, Donald; Abu-Haydar, Elizabeth; Okoth, Eunice; Herrick, Tara; Mukabi, James; Carlson, Lucas; Oguttu, Monica; Burke, Thomas

2017-05-01

To evaluate the cost-effectiveness of condom uterine balloon tamponade (UBT) for control of severe postpartum hemorrhage (PPH) due to uterine atony versus standard PPH care in Kenya. A cross-sectional analysis was conducted using cost data collected from 30 facilities in Western Kenya from April 15 to July 16, 2015. Effectiveness data were derived from the published literature. The modeling analysis was performed from the health-system perspective for a cohort of women who gave birth in 2015. Sensitivity analyses tested the robustness of model estimates. Costs were in 2015 US dollars. Compared with standard care with no uterine packing, condom UBT could prevent 1255 hospital transfers, 430 hysterectomies, and 44 maternal deaths. At $5 or $15 per UBT device, the incremental cost per disability-adjusted life year (DALY) averted was $26 or $40, respectively. If uterine packing was assumed to be done with standard care, the cost per DALY averted was $164 when the UBT price was $5 and $199 when the price was $15. Condom UBT was a highly cost-effective intervention for controlling severe PPH. This finding remained robust even when key model inputs were varied by wide margins. © 2017 International Federation of Gynecology and Obstetrics.

Demonstration of Standard HVAC Single-Loop Digital Control Systems

DTIC Science & Technology

1993-01-01

AD-A265 372 T N FEAP-TR-FE-93/05 REPORT January 1993 FACILITIES ENGINEERING APPLICATIONS PROGRAM Demonstration of Standard HVAC Single-Loop Digital...AND DATES COVERED January 1993 Final 4. TITLE AND SUBTITLE [5. FUNDING NUMBERS Demonstration of Standard HVAC Single-Loop Digital Control Systems FEAP...conditioning ( HVAC ) control systems provide guidance on designing and specifying standard HVAC control systems that use single-loop digital controllers

Cost-effectiveness of angiographic imaging in isolated perimesencephalic subarachnoid hemorrhage.

PubMed

Kalra, Vivek B; Wu, Xiao; Forman, Howard P; Malhotra, Ajay

2014-12-01

The purpose of this study is to perform a comprehensive cost-effectiveness analysis of all possible permutations of computed tomographic angiography (CTA) and digital subtraction angiography imaging strategies for both initial diagnosis and follow-up imaging in patients with perimesencephalic subarachnoid hemorrhage on noncontrast CT. Each possible imaging strategy was evaluated in a decision tree created with TreeAge Pro Suite 2014, with parameters derived from a meta-analysis of 40 studies and literature values. Base case and sensitivity analyses were performed to assess the cost-effectiveness of each strategy. A Monte Carlo simulation was conducted with distributional variables to evaluate the robustness of the optimal strategy. The base case scenario showed performing initial CTA with no follow-up angiographic studies in patients with perimesencephalic subarachnoid hemorrhage to be the most cost-effective strategy ($5422/quality adjusted life year). Using a willingness-to-pay threshold of $50 000/quality adjusted life year, the most cost-effective strategy based on net monetary benefit is CTA with no follow-up when the sensitivity of initial CTA is >97.9%, and CTA with CTA follow-up otherwise. The Monte Carlo simulation reported CTA with no follow-up to be the optimal strategy at willingness-to-pay of $50 000 in 99.99% of the iterations. Digital subtraction angiography, whether at initial diagnosis or as part of follow-up imaging, is never the optimal strategy in our model. CTA without follow-up imaging is the optimal strategy for evaluation of patients with perimesencephalic subarachnoid hemorrhage when modern CT scanners and a strict definition of perimesencephalic subarachnoid hemorrhage are used. Digital subtraction angiography and follow-up imaging are not optimal as they carry complications and associated costs. © 2014 American Heart Association, Inc.

Development and flight test experiences with a flight-crucial digital control system

NASA Technical Reports Server (NTRS)

Mackall, Dale A.

1988-01-01

Engineers and scientists in the advanced fighter technology integration (AFTI) F-16 program investigated the integration of emerging technologies into an advanced fighter aircraft. AFTI's three major technologies included: flight-crucial digital control, decoupled aircraft flight control, and integration of avionics, flight control, and pilot displays. In addition to investigating improvements in fighter performance, researchers studied the generic problems confronting the designers of highly integrated flight-crucial digital control. An overview is provided of both the advantages and problems of integration digital control systems. Also, an examination of the specification, design, qualification, and flight test life-cycle phase is provided. An overview is given of the fault-tolerant design, multimoded decoupled flight control laws, and integrated avionics design. The approach to qualifying the software and system designs is discussed, and the effects of design choices on system qualification are highlighted.

Implementation of Adaptive Digital Controllers on Programmable Logic Devices

NASA Technical Reports Server (NTRS)

Gwaltney, David A.; King, Kenneth D.; Smith, Keary J.; Monenegro, Justino (Technical Monitor)

2002-01-01

Much has been made of the capabilities of FPGA's (Field Programmable Gate Arrays) in the hardware implementation of fast digital signal processing. Such capability also makes an FPGA a suitable platform for the digital implementation of closed loop controllers. Other researchers have implemented a variety of closed-loop digital controllers on FPGA's. Some of these controllers include the widely used proportional-integral-derivative (PID) controller, state space controllers, neural network and fuzzy logic based controllers. There are myriad advantages to utilizing an FPGA for discrete-time control functions which include the capability for reconfiguration when SRAM-based FPGA's are employed, fast parallel implementation of multiple control loops and implementations that can meet space level radiation tolerance requirements in a compact form-factor. Generally, a software implementation on a DSP (Digital Signal Processor) or microcontroller is used to implement digital controllers. At Marshall Space Flight Center, the Control Electronics Group has been studying adaptive discrete-time control of motor driven actuator systems using digital signal processor (DSP) devices. While small form factor, commercial DSP devices are now available with event capture, data conversion, pulse width modulated (PWM) outputs and communication peripherals, these devices are not currently available in designs and packages which meet space level radiation requirements. In general, very few DSP devices are produced that are designed to meet any level of radiation tolerance or hardness. The goal of this effort is to create a fully digital, flight ready controller design that utilizes an FPGA for implementation of signal conditioning for control feedback signals, generation of commands to the controlled system, and hardware insertion of adaptive control algorithm approaches. An alternative is required for compact implementation of such functionality to withstand the harsh environment

Digital control system for space structure dampers

NASA Technical Reports Server (NTRS)

Haviland, J. K.

1985-01-01

A digital controller was developed using an SKD-51 System Design Kit, which incorporates an 8031 microcontroller. The necessary interfaces were installed in the wire wrap area of the SKD-51 and a pulse width modulator was developed to drive the coil of the actuator. Also, control equations were developed, using floating-point arithmetic. The design of the digital control system is emphasized, and it is shown that, provided certain rules are followed, an adequate design can be achieved. It is recommended that the so-called w-plane design method be used, and that the time elapsed before output of the up-dated coil-force signal be kept as small as possible. However, the cycle time for the controller should be watched carefully, because very small values for this time can lead to digital noise.

Digital Controller For Acoustic Levitation

NASA Technical Reports Server (NTRS)

Tarver, D. Kent

1989-01-01

Acoustic driver digitally controls sound fields along three axes. Allows computerized acoustic levitation and manipulation of small objects for such purposes as containerless processing and nuclear-fusion power experiments. Also used for controlling motion of vibration-testing tables in three dimensions.

Aircraft digital flight control technical review

NASA Technical Reports Server (NTRS)

Davenport, Otha B.; Leggett, David B.

1993-01-01

The Aircraft Digital Flight Control Technical Review was initiated by two pilot induced oscillation (PIO) incidents in the spring and summer of 1992. Maj. Gen. Franklin (PEO) wondered why the Air Force development process for digital flight control systems was not preventing PIO problems. Consequently, a technical review team was formed to examine the development process and determine why PIO problems continued to occur. The team was also to identify the 'best practices' used in the various programs. The charter of the team was to focus on the PIO problem, assess the current development process, and document the 'best practices.' The team reviewed all major USAF aircraft programs with digital flight controls, specifically, the F-15E, F-16C/D, F-22, F-111, C-17, and B-2. The team interviewed contractor, System Program Office (SPO), and Combined Test Force (CTF) personnel on these programs. The team also went to NAS Patuxent River to interview USN personnel about the F/A-18 program. The team also reviewed experimental USAF and NASA systems with digital flight control systems: X-29, X-31, F-15 STOL and Maneuver Technology Demonstrator (SMTD), and the Variable In-Flight Stability Test Aircraft (VISTA). The team also discussed the problem with other experts in the field including Ralph Smith and personnel from Calspan. The major conclusions and recommendations from the review are presented.

Cost-effective ways of delivering enquiry services: a rapid review.

PubMed

Sutton, Anthea; Grant, Maria J

2011-12-01

In the recent times of recession and budget cuts, it is more important than ever for library and information services to deliver cost-effective services. This rapid review aims to examine the evidence for the most cost-effective ways of delivering enquiry services. A literature search was conducted on LISA (Library and Information Sciences Abstracts) and MEDLINE. Searches were limited to 2007 onwards. Eight studies met the inclusion criteria. The studies covered hospital and academic libraries in the USA and Canada. Services analysed were 'point-of-care' librarian consultations, staffing models for reference desks and virtual/digital reference services. Transferable lessons, relevant to health library and information services generally, can be drawn from this rapid review. These suggest that 'point-of-care' librarians for primary care practitioners are a cost-effective way of answering questions. Reference desks can be cost-effectively staffed by student employees or general reference staff, although librarian referral must be provided for more complex and subject-specific enquiries. However, it is not possible to draw any conclusions on virtual/digital reference services because of the limited literature available. Further case analysis studies measuring specific services, particularly enquiry services within a health library and information context, are required. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

A compact high-definition low-cost digital stereoscopic video camera for rapid robotic surgery development.

PubMed

Carlson, Jay; Kowalczuk, Jędrzej; Psota, Eric; Pérez, Lance C

2012-01-01

Robotic surgical platforms require vision feedback systems, which often consist of low-resolution, expensive, single-imager analog cameras. These systems are retooled for 3D display by simply doubling the cameras and outboard control units. Here, a fully-integrated digital stereoscopic video camera employing high-definition sensors and a class-compliant USB video interface is presented. This system can be used with low-cost PC hardware and consumer-level 3D displays for tele-medical surgical applications including military medical support, disaster relief, and space exploration.

47 CFR 73.9001 - Redistribution control of digital television broadcasts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Redistribution control of digital television... RADIO SERVICES RADIO BROADCAST SERVICES Digital Broadcast Television Redistribution Control § 73.9001 Redistribution control of digital television broadcasts. Licensees of TV broadcast stations may utilize the...

The use of low cost compact cameras with focus stacking functionality in entomological digitization projects

PubMed Central

Mertens, Jan E.J.; Roie, Martijn Van; Merckx, Jonas; Dekoninck, Wouter

2017-01-01

Abstract Digitization of specimen collections has become a key priority of many natural history museums. The camera systems built for this purpose are expensive, providing a barrier in institutes with limited funding, and therefore hampering progress. An assessment is made on whether a low cost compact camera with image stacking functionality can help expedite the digitization process in large museums or provide smaller institutes and amateur entomologists with the means to digitize their collections. Images of a professional setup were compared with the Olympus Stylus TG-4 Tough, a low-cost compact camera with internal focus stacking functions. Parameters considered include image quality, digitization speed, price, and ease-of-use. The compact camera’s image quality, although inferior to the professional setup, is exceptional considering its fourfold lower price point. Producing the image slices in the compact camera is a matter of seconds and when optimal image quality is less of a priority, the internal stacking function omits the need for dedicated stacking software altogether, further decreasing the cost and speeding up the process. In general, it is found that, aware of its limitations, this compact camera is capable of digitizing entomological collections with sufficient quality. As technology advances, more institutes and amateur entomologists will be able to easily and affordably catalogue their specimens. PMID:29134038

47 CFR 97.221 - Automatically controlled digital station.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Automatically controlled digital station. 97.221 Section 97.221 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AMATEUR RADIO SERVICE Special Operations § 97.221 Automatically controlled digital...

Cost-effectiveness of an exercise intervention program in perimenopausal women: the Fitness League Against MENopause COst (FLAMENCO) randomized controlled trial.

PubMed

Carbonell-Baeza, Ana; Soriano-Maldonado, Alberto; Gallo, Francisco Javier; López del Amo, María Puerto; Ruiz-Cabello, Pilar; Andrade, Ana; Borges-Cosic, Milkana; Peces-Rama, Antonio Rubén; Spacírová, Zuzana; Álvarez-Gallardo, Inmaculada C; García-Mochón, Leticia; Segura-Jiménez, Víctor; Estévez-López, Fernando; Camiletti-Moirón, Daniel; Martín-Martín, Jose Jesús; Aranda, Pilar; Delgado-Fernández, Manuel; Aparicio, Virginia A

2015-06-17

The high prevalence of women that do not reach the recommended level of physical activity is worrisome. A sedentary lifestyle has negative consequences on health status and increases health care costs. The main objective of this project is to assess the cost-effectiveness of a primary care-based exercise intervention in perimenopausal women. The present study is a Randomized Controlled Trial. A total of 150 eligible women will be recruited and randomly assigned to either a 16-week exercise intervention (3 sessions/week), or to usual care (control) group. The primary outcome measure is the incremental cost-effectiveness ratio. The secondary outcome measures are: i) socio-demographic and clinical information; ii) body composition; iii) dietary patterns; iv) glycaemic and lipid profile; v) physical fitness; vi) physical activity and sedentary behaviour; vii) sleep quality; viii) quality of life, mental health and positive health; ix) menopause symptoms. All outcomes will be assessed at baseline and post intervention. The data will be analysed on an intention-to-treat basis and per protocol. In addition, we will conduct a cost effectiveness analysis from a health system perspective. The intervention designed is feasible and if it proves to be clinically and cost effective, it can be easily transferred to other similar contexts. Consequently, the findings of this project might help the Health Systems to identify strategies for primary prevention and health promotion as well as to reduce health care requirements and costs. ClinicalTrials.gov Identifier: NCT02358109. Date of registration: 05/02/2015.

Modeling the Cost Effectiveness of Malaria Control Interventions in the Highlands of Western Kenya

PubMed Central

Stuckey, Erin M.; Stevenson, Jennifer; Galactionova, Katya; Baidjoe, Amrish Y.; Bousema, Teun; Odongo, Wycliffe; Kariuki, Simon; Drakeley, Chris; Smith, Thomas A.; Cox, Jonathan; Chitnis, Nakul

2014-01-01

Introduction Tools that allow for in silico optimization of available malaria control strategies can assist the decision-making process for prioritizing interventions. The OpenMalaria stochastic simulation modeling platform can be applied to simulate the impact of interventions singly and in combination as implemented in Rachuonyo South District, western Kenya, to support this goal. Methods Combinations of malaria interventions were simulated using a previously-published, validated model of malaria epidemiology and control in the study area. An economic model of the costs of case management and malaria control interventions in Kenya was applied to simulation results and cost-effectiveness of each intervention combination compared to the corresponding simulated outputs of a scenario without interventions. Uncertainty was evaluated by varying health system and intervention delivery parameters. Results The intervention strategy with the greatest simulated health impact employed long lasting insecticide treated net (LLIN) use by 80% of the population, 90% of households covered by indoor residual spraying (IRS) with deployment starting in April, and intermittent screen and treat (IST) of school children using Artemether lumefantrine (AL) with 80% coverage twice per term. However, the current malaria control strategy in the study area including LLIN use of 56% and IRS coverage of 70% was the most cost effective at reducing disability-adjusted life years (DALYs) over a five year period. Conclusions All the simulated intervention combinations can be considered cost effective in the context of available resources for health in Kenya. Increasing coverage of vector control interventions has a larger simulated impact compared to adding IST to the current implementation strategy, suggesting that transmission in the study area is not at a level to warrant replacing vector control to a school-based screen and treat program. These results have the potential to assist malaria

Modeling the cost effectiveness of malaria control interventions in the highlands of western Kenya.

PubMed

Stuckey, Erin M; Stevenson, Jennifer; Galactionova, Katya; Baidjoe, Amrish Y; Bousema, Teun; Odongo, Wycliffe; Kariuki, Simon; Drakeley, Chris; Smith, Thomas A; Cox, Jonathan; Chitnis, Nakul

2014-01-01

Tools that allow for in silico optimization of available malaria control strategies can assist the decision-making process for prioritizing interventions. The OpenMalaria stochastic simulation modeling platform can be applied to simulate the impact of interventions singly and in combination as implemented in Rachuonyo South District, western Kenya, to support this goal. Combinations of malaria interventions were simulated using a previously-published, validated model of malaria epidemiology and control in the study area. An economic model of the costs of case management and malaria control interventions in Kenya was applied to simulation results and cost-effectiveness of each intervention combination compared to the corresponding simulated outputs of a scenario without interventions. Uncertainty was evaluated by varying health system and intervention delivery parameters. The intervention strategy with the greatest simulated health impact employed long lasting insecticide treated net (LLIN) use by 80% of the population, 90% of households covered by indoor residual spraying (IRS) with deployment starting in April, and intermittent screen and treat (IST) of school children using Artemether lumefantrine (AL) with 80% coverage twice per term. However, the current malaria control strategy in the study area including LLIN use of 56% and IRS coverage of 70% was the most cost effective at reducing disability-adjusted life years (DALYs) over a five year period. All the simulated intervention combinations can be considered cost effective in the context of available resources for health in Kenya. Increasing coverage of vector control interventions has a larger simulated impact compared to adding IST to the current implementation strategy, suggesting that transmission in the study area is not at a level to warrant replacing vector control to a school-based screen and treat program. These results have the potential to assist malaria control program managers in the study area in

A low-cost digital filing system for echocardiography data with MPEG4 compression and its application to remote diagnosis.

PubMed

Umeda, Akira; Iwata, Yasushi; Okada, Yasumasa; Shimada, Megumi; Baba, Akiyasu; Minatogawa, Yasuyuki; Yamada, Takayasu; Chino, Masao; Watanabe, Takafumi; Akaishi, Makoto

2004-12-01

The high cost of digital echocardiographs and the large size of data files hinder the adoption of remote diagnosis of digitized echocardiography data. We have developed a low-cost digital filing system for echocardiography data. In this system, data from a conventional analog echocardiograph are captured using a personal computer (PC) equipped with an analog-to-digital converter board. Motion picture data are promptly compressed using a moving pictures expert group (MPEG) 4 codec. The digitized data with preliminary reports obtained in a rural hospital are then sent to cardiologists at distant urban general hospitals via the internet. The cardiologists can evaluate the data using widely available movie-viewing software (Windows Media Player). The diagnostic accuracy of this double-check system was confirmed by comparison with ordinary super-VHS videotapes. We have demonstrated that digitization of echocardiography data from a conventional analog echocardiograph and MPEG 4 compression can be performed using an ordinary PC-based system, and that this system enables highly efficient digital storage and remote diagnosis at low cost.

Digital HF communications for the polar regions - a low-cost alternative to satellite?

NASA Astrophysics Data System (ADS)

Prior-Jones, Michael; Warrington, Mike

2010-05-01

Digital HF communications for the polar regions - a low-cost alternative to satellite? Prior-Jones, M.R. and Warrington, E. M Communications within the polar regions pose unique technical challenges, due to the physical isolation, lack of infrastructure and extreme weather conditions. Geostationary satellite links are widely used, but they cannot function poleward of 80 degrees due to the curvature of the Earth. Low-earth-orbit systems like Iridium and ARGOS will function all the way to the poles. However, they are expensive, particularly for experiments requiring long time-series. Transferring data by Iridium satellite phone costs of the order of 60USD per megabyte. HF (i.e. 3-30 MHz) radio signals propagate via the ionosphere, allowing long distance transmission beyond the horizon. Ranges of thousands of kilometres can be easily achieved with relatively low transmission powers when propagation is favourable. The polar ionosphere is, however, a challenging environment for radio signals - the signals often reflect from multiple regions of the ionosphere and by multiple hops with intermediate ground reflections producing multipath effects. As the ionosphere is moving, these signals are also subject to very significant Doppler shifts that add to the complexity of the environment. These effects may make data communications at polar latitudes difficult or impossible at times and often only at low data rates. In this paper we discuss our experiments to use modern signal-processing and modulation techniques for digital transmission on HF, offering a similar speed to satellite but without paying the high cost of satellite airtime. Using an HF channel simulator developed by Warrington et al based on measurements of propagation at high latitudes, we have tested the performance of an OFDM-based modem derived from the Digital Radio Mondiale standard used for digital HF broadcasting and found that it outperforms current military modems developed by NATO (STANAG 4285 and 4539

Cost-effectiveness of a nurse practitioner-family physician model of care in a nursing home: controlled before and after study.

PubMed

Lacny, Sarah; Zarrabi, Mahmood; Martin-Misener, Ruth; Donald, Faith; Sketris, Ingrid; Murphy, Andrea L; DiCenso, Alba; Marshall, Deborah A

2016-09-01

To examine the cost-effectiveness of a nurse practitioner-family physician model of care compared with family physician-only care in a Canadian nursing home. As demand for long-term care increases, alternative care models including nurse practitioners are being explored. Cost-effectiveness analysis using a controlled before-after design. The study included an 18-month 'before' period (2005-2006) and a 21-month 'after' time period (2007-2009). Data were abstracted from charts from 2008-2010. We calculated incremental cost-effectiveness ratios comparing the intervention (nurse practitioner-family physician model; n = 45) to internal (n = 65), external (n = 70) and combined internal/external family physician-only control groups, measured as the change in healthcare costs divided by the change in emergency department transfers/person-month. We assessed joint uncertainty around costs and effects using non-parametric bootstrapping and cost-effectiveness acceptability curves. Point estimates of the incremental cost-effectiveness ratio demonstrated the nurse practitioner-family physician model dominated the internal and combined control groups (i.e. was associated with smaller increases in costs and emergency department transfers/person-month). Compared with the external control, the intervention resulted in a smaller increase in costs and larger increase in emergency department transfers. Using a willingness-to-pay threshold of $1000 CAD/emergency department transfer, the probability the intervention was cost-effective compared with the internal, external and combined control groups was 26%, 21% and 25%. Due to uncertainty around the distribution of costs and effects, we were unable to make a definitive conclusion regarding the cost-effectiveness of the nurse practitioner-family physician model; however, these results suggest benefits that could be confirmed in a larger study. © 2016 John Wiley & Sons Ltd.

Implementation of Adaptive Digital Controllers on Programmable Logic Devices

NASA Technical Reports Server (NTRS)

Gwaltney, David A.; King, Kenneth D.; Smith, Keary J.; Montenegro, Justino (Technical Monitor)

2002-01-01

Much has been made of the capabilities of Field Programmable Gate Arrays (FPGA's) in the hardware implementation of fast digital signal processing functions. Such capability also makes an FPGA a suitable platform for the digital implementation of closed loop controllers. Other researchers have implemented a variety of closed-loop digital controllers on FPGA's. Some of these controllers include the widely used Proportional-Integral-Derivative (PID) controller, state space controllers, neural network and fuzzy logic based controllers. There are myriad advantages to utilizing an FPGA for discrete-time control functions which include the capability for reconfiguration when SRAM- based FPGA's are employed, fast parallel implementation of multiple control loops and implementations that can meet space level radiation tolerance requirements in a compact form-factor. Generally, a software implementation on a Digital Signal Processor (DSP) device or microcontroller is used to implement digital controllers. At Marshall Space Flight Center, the Control Electronics Group has been studying adaptive discrete-time control of motor driven actuator systems using DSP devices. While small form factor, commercial DSP devices are now available with event capture, data conversion, Pulse Width Modulated (PWM) outputs and communication peripherals, these devices are not currently available in designs and packages which meet space level radiation requirements. In general, very few DSP devices are produced that are designed to meet any level of radiation tolerance or hardness. An alternative is required for compact implementation of such functionality to withstand the harsh environment encountered on spacemap. The goal of this effort is to create a fully digital, flight ready controller design that utilizes an FPGA for implementation of signal conditioning for control feedback signals, generation of commands to the controlled system, and hardware insertion of adaptive-control algorithm

Digital Mammography and Digital Breast Tomosynthesis.

PubMed

Moseley, Tanya W

2016-06-01

Breast imaging technology has advanced significantly from the 1930s until the present. American women have a 1 in 8 chance of developing breast cancer. Mammography has been proven in multiple clinical trials to reduce breast cancer mortality. Although a mainstay of breast imaging and improved from film-screen mammography, digital mammography is not a perfect examination. Overlapping obscuring breast tissue limits mammographic interpretation. Breast digital tomosynthesis reduces and/or eliminates overlapping obscuring breast tissue. Although there are some disadvantages with digital breast tomosynthesis, this relatively lost-cost technology may be used effectively in the screening and diagnostic settings.

Comparison of digital controllers used in magnetic suspension and balance systems

NASA Technical Reports Server (NTRS)

Kilgore, William A.

1990-01-01

Dynamic systems that were once controlled by analog circuits are now controlled by digital computers. Presented is a comparison of the digital controllers presently used with magnetic suspension and balance systems. The overall responses of the systems are compared using a computer simulation of the magnetic suspension and balance system and the digital controllers. The comparisons include responses to both simulated force and position inputs. A preferred digital controller is determined from the simulated responses.

Propulsion control experience used in the Highly Integrated Digital Electronic Control (HIDEC) program

NASA Technical Reports Server (NTRS)

Myers, L. P.; Burcham, F. W., Jr.

1984-01-01

The highly integrated digital electronic control (HIDEC) program will integrate the propulsion and flight control systems on an F-15 airplane at NASA Ames Research Center's Dryden Flight Research Facility. Ames-Dryden has conducted several propulsion control programs that have contributed to the HIDEC program. The digital electronic engine control (DEEC) flight evaluation investigated the performance and operability of the F100 engine equipped with a full-authority digital electronic control system. Investigations of nozzle instability, fault detection and accommodation, and augmentor transient capability provided important information for the HIDEC program. The F100 engine model derivative (EMD) was also flown in the F-15 airplane, and airplane performance was significantly improved. A throttle response problem was found and solved with a software fix to the control logic. For the HIDEC program, the F100 EMD engines equipped with DEEC controls will be integrated with the digital flight control system. The control modes to be implemented are an integrated flightpath management mode and an integrated adaptive engine control system mode. The engine control experience that will be used in the HIDEC program is discussed.

An economic evaluation of a video- and text-based computer-tailored intervention for smoking cessation: a cost-effectiveness and cost-utility analysis of a randomized controlled trial.

PubMed

Stanczyk, Nicola E; Smit, Eline S; Schulz, Daniela N; de Vries, Hein; Bolman, Catherine; Muris, Jean W M; Evers, Silvia M A A

2014-01-01

Although evidence exists for the effectiveness of web-based smoking cessation interventions, information about the cost-effectiveness of these interventions is limited. The study investigated the cost-effectiveness and cost-utility of two web-based computer-tailored (CT) smoking cessation interventions (video- vs. text-based CT) compared to a control condition that received general text-based advice. In a randomized controlled trial, respondents were allocated to the video-based condition (N = 670), the text-based condition (N = 708) or the control condition (N = 721). Societal costs, smoking status, and quality-adjusted life years (QALYs; EQ-5D-3L) were assessed at baseline, six-and twelve-month follow-up. The incremental costs per abstinent respondent and per QALYs gained were calculated. To account for uncertainty, bootstrapping techniques and sensitivity analyses were carried out. No significant differences were found in the three conditions regarding demographics, baseline values of outcomes and societal costs over the three months prior to baseline. Analyses using prolonged abstinence as outcome measure indicated that from a willingness to pay of €1,500, the video-based intervention was likely to be the most cost-effective treatment, whereas from a willingness to pay of €50,400, the text-based intervention was likely to be the most cost-effective. With regard to cost-utilities, when quality of life was used as outcome measure, the control condition had the highest probability of being the most preferable treatment. Sensitivity analyses yielded comparable results. The video-based CT smoking cessation intervention was the most cost-effective treatment for smoking abstinence after twelve months, varying the willingness to pay per abstinent respondent from €0 up to €80,000. With regard to cost-utility, the control condition seemed to be the most preferable treatment. Probably, more time will be required to assess changes in quality of life

Digitally gain controlled linear high voltage amplifier for laboratory applications.

PubMed

Koçum, C

2011-08-01

The design of a digitally gain controlled high-voltage non-inverting bipolar linear amplifier is presented. This cost efficient and relatively simple circuit has stable operation range from dc to 90 kHz under the load of 10 kΩ and 39 pF. The amplifier can swing up to 360 V(pp) under these conditions and it has 2.5 μs rise time. The gain can be changed by the aid of JFETs. The amplifiers have been realized using a combination of operational amplifiers and high-voltage discrete bipolar junction transistors. The circuit details and performance characteristics are discussed.

Remote interferometry by digital holography for shape control

NASA Astrophysics Data System (ADS)

Baumbach, Torsten; Osten, Wolfgang; Falldorf, Claas; Jueptner, Werner P. O.

2002-06-01

Modern production requires more and more effective methods for the inspection and quality control at the production place. Outsourcing and globalization result in possible large distances between co-operating partners. This may cause serious problems with respect to the just-in-time exchange of information and the response to possible violations of quality standards. Consequently new challenges arise for optical measurement techniques especially in the field of industrial shape control. A possible solution for these problems can be delivered by a technique that stores optically the full 3D information of the objects to be compared and where the data can be transported over large distances. In this paper we describe the progress in implementing a new technique for the direct comparison of the shape and deformation of two objects with different microstructure where it is not necessary that both samples are located at the same place. This is done by creating a coherent mask for the illumination of the sample object. The coherent mask is created by Digital Holography to enable the instant access to the complete optical information of the master object at any wanted place. The transmission of the digital master holograms to this place can be done via digital telecommunication networks. The comparison can be done in a digital or analogue way. Both methods result in a disappearance of the object shape and the appearance of the shape or deformation difference between the two objects only. The analogue reconstruction of the holograms with a liquid crystal spatial light modulator can be done by using the light modulator as an intensity modulator or as an phase modulator. The reconstruction technique and the space bandwidth of the light modulator will influence the quality of the result. Therefore the paper describes the progress in applying modern spatial light modulators and digital cameras for the effective storage and optical reconstruction of coherent masks.

Validity and reliability of a low-cost digital dynamometer for measuring isometric strength of lower limb.

PubMed

Romero-Franco, Natalia; Jiménez-Reyes, Pedro; Montaño-Munuera, Juan A

2017-11-01

Lower limb isometric strength is a key parameter to monitor the training process or recognise muscle weakness and injury risk. However, valid and reliable methods to evaluate it often require high-cost tools. The aim of this study was to analyse the concurrent validity and reliability of a low-cost digital dynamometer for measuring isometric strength in lower limb. Eleven physically active and healthy participants performed maximal isometric strength for: flexion and extension of ankle, flexion and extension of knee, flexion, extension, adduction, abduction, internal and external rotation of hip. Data obtained by the digital dynamometer were compared with the isokinetic dynamometer to examine its concurrent validity. Data obtained by the digital dynamometer from 2 different evaluators and 2 different sessions were compared to examine its inter-rater and intra-rater reliability. Intra-class correlation (ICC) for validity was excellent in every movement (ICC > 0.9). Intra and inter-tester reliability was excellent for all the movements assessed (ICC > 0.75). The low-cost digital dynamometer demonstrated strong concurrent validity and excellent intra and inter-tester reliability for assessing isometric strength in the main lower limb movements.

F-15 digital electronic engine control system description

NASA Technical Reports Server (NTRS)

Myers, L. P.

1984-01-01

A digital electronic engine control (DEEC) was developed for use on the F100-PW-100 turbofan engine. This control system has full authority control, capable of moving all the controlled variables over their full ranges. The digital computational electronics and fault detection and accomodation logic maintains safe engine operation. A hydromechanical backup control (BUC) is an integral part of the fuel metering unit and provides gas generator control at a reduced performance level in the event of an electronics failure. The DEEC's features, hardware, and major logic diagrams are described.

Digital Signal Processing and Control for the Study of Gene Networks

NASA Astrophysics Data System (ADS)

Shin, Yong-Jun

2016-04-01

Thanks to the digital revolution, digital signal processing and control has been widely used in many areas of science and engineering today. It provides practical and powerful tools to model, simulate, analyze, design, measure, and control complex and dynamic systems such as robots and aircrafts. Gene networks are also complex dynamic systems which can be studied via digital signal processing and control. Unlike conventional computational methods, this approach is capable of not only modeling but also controlling gene networks since the experimental environment is mostly digital today. The overall aim of this article is to introduce digital signal processing and control as a useful tool for the study of gene networks.

Digital Signal Processing and Control for the Study of Gene Networks.

PubMed

Shin, Yong-Jun

2016-04-22

Thanks to the digital revolution, digital signal processing and control has been widely used in many areas of science and engineering today. It provides practical and powerful tools to model, simulate, analyze, design, measure, and control complex and dynamic systems such as robots and aircrafts. Gene networks are also complex dynamic systems which can be studied via digital signal processing and control. Unlike conventional computational methods, this approach is capable of not only modeling but also controlling gene networks since the experimental environment is mostly digital today. The overall aim of this article is to introduce digital signal processing and control as a useful tool for the study of gene networks.

Active flutter suppression using optical output feedback digital controllers

NASA Technical Reports Server (NTRS)

1982-01-01

A method for synthesizing digital active flutter suppression controllers using the concept of optimal output feedback is presented. A convergent algorithm is employed to determine constrained control law parameters that minimize an infinite time discrete quadratic performance index. Low order compensator dynamics are included in the control law and the compensator parameters are computed along with the output feedback gain as part of the optimization process. An input noise adjustment procedure is used to improve the stability margins of the digital active flutter controller. Sample rate variation, prefilter pole variation, control structure variation and gain scheduling are discussed. A digital control law which accommodates computation delay can stabilize the wing with reasonable rms performance and adequate stability margins.

Recruitment of healthy participants for studies on risks for alcoholism: effectiveness of random digit dialling.

PubMed

Sorocco, Kristen H; Vincent, Andrea S; Collins, Frank L; Johnson, Christine A; Lovallo, William R

2006-01-01

To compare the effectiveness of two strategies for recruiting healthy research volunteers. Demographic characteristics and recruitment costs of participants who completed a laboratory study examining risk factors for alcoholism recruited through random digit dialling (N = 11) and community advertisements (N = 102) were compared. Advertisement yielded a more representative sample [76% Caucasian, less well educated (M = 15.2 years, SEM = 0.2; P < 0.05), more equally divided by family history of alcoholism (43% FH- and 57% FH+), and lower in SES (M = 42.8, SEM = 1.3; P < 0.05)] and was more cost effective (72 dollars vs 2272 dollars per participant) than random digit dialling. Findings are relevant to alcohol researchers trying to determine the recruitment strategy that will yield the most representative sample at the lowest cost.

The costs and cost-effectiveness of an integrated sepsis treatment protocol.

PubMed

Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

2008-04-01

Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial

PubMed Central

McBain, Ryan K; Salhi, Carmel; Hann, Katrina; Salomon, Joshua A; Kim, Jane J; Betancourt, Theresa S

2016-01-01

Background: One billion children live in war-affected regions of the world. We conducted the first cost-effectiveness analysis of an intervention for war-affected youth in sub-Saharan Africa, as well as a broader cost analysis. Methods: The Youth Readiness Intervention (YRI) is a behavioural treatment for reducing functional impairment associated with psychological distress among war-affected young persons. A randomized controlled trial was conducted in Freetown, Sierra Leone, from July 2012 to July 2013. Participants (n = 436, aged 15–24) were randomized to YRI (n = 222) or care as usual (n = 214). Functional impairment was indexed by the World Health Organization Disability Assessment Scale; scores were converted to quality-adjusted life years (QALYs). An ‘ingredients approach’ estimated financial and economic costs, assuming a societal perspective. Incremental cost-effectiveness ratios (ICERs) were also expressed in terms of gains across dimensions of mental health and schooling. Secondary analyses explored whether intervention effects were largest among those worst-off (upper quartile) at baseline. Results: Retention at 6-month follow-up was 85% (n = 371). The estimated economic cost of the intervention was $104 per participant. Functional impairment was lower among YRI recipients, compared with controls, following the intervention but not at 6-month follow-up, and yielded an ICER of $7260 per QALY gained. At 8-month follow-up, teachers’ interviews indicated that YRI recipients observed higher school enrolment [P < 0.001, odds ratio (OR) 8.9], denoting a cost of $431 per additional school year gained, as well as better school attendance (P = 0.007, OR 34.9) and performance (P = 0.03, effect size = −1.31). Secondary analyses indicated that the intervention was cost-effective among those worst-off at baseline, yielding an ICER of $3564 per QALY gained. Conclusions: The YRI is not cost-effective at a willingness

Cost effectiveness of a mail-delivered individually tailored physical activity intervention for Latinas vs. a mailed contact control.

PubMed

Larsen, Britta; Gilmer, Todd; Pekmezi, Dori; Napolitano, Melissa A; Marcus, Bess H

2015-11-11

Physical inactivity is high in Latinas, as are chronic health conditions. There is a need for physical activity (PA) interventions that are not only effective but have potential for cost-effective widespread dissemination. The purpose of this paper was to assess the costs and cost effectiveness of a Spanish-language print-based mail-delivered PA intervention that was linguistically and culturally adapted for Latinas. Adult Latinas (N = 266) were randomly assigned to receive mail-delivered individually tailored intervention materials or wellness information mailed on the same schedule (control). PA was assessed at baseline, six months (post-intervention) and 12 months (maintenance phase) using the 7-Day Physical Activity Recall Interview. Costs were calculated from a payer perspective, and included personnel time (wage, fringe, and overhead), materials, equipment, software, and postage costs. At six months, the PA intervention cost $29/person/month, compared to $15/person/month for wellness control. These costs fell to $17 and $9 at 12 months, respectively. Intervention participants increased their PA by an average of 72 min/week at six months and 94 min/week at 12 months, while wellness control participants increased their PA by an average of 30 min/week and 40 min/week, respectively. At six months, each minute increase in PA cost $0.18 in the intervention group compared to $0.23 in wellness control, which fell to $0.07 and $0.08 at 12 months, respectively. The incremental cost per increase in physical activity associated with the intervention was $0.15 at 6 months and $0.05 at 12 months. While the intervention was more costly than the wellness control, costs per minute of increase in PA were lower in the intervention. The print-based mail-delivered format has potential for broad, cost-effective dissemination, which could help address disparities in this at-risk population. NCT01583140; Date of Registration: 03/06/2012; Funding Source of Trial: National

ATCA digital controller hardware for vertical stabilization of plasmas in tokamaks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Batista, A. J. N.; Sousa, J.; Varandas, C. A. F.

2006-10-15

The efficient vertical stabilization (VS) of plasmas in tokamaks requires a fast reaction of the VS controller, for example, after detection of edge localized modes (ELM). For controlling the effects of very large ELMs a new digital control hardware, based on the Advanced Telecommunications Computing Architecture trade mark sign (ATCA), is being developed aiming to reduce the VS digital control loop cycle (down to an optimal value of 10 {mu}s) and improve the algorithm performance. The system has 1 ATCA trade mark sign processor module and up to 12 ATCA trade mark sign control modules, each one with 32 analogmore » input channels (12 bit resolution), 4 analog output channels (12 bit resolution), and 8 digital input/output channels. The Aurora trade mark sign and PCI Express trade mark sign communication protocols will be used for data transport, between modules, with expected latencies below 2 {mu}s. Control algorithms are implemented on a ix86 based processor with 6 Gflops and on field programmable gate arrays with 80 GMACS, interconnected by serial gigabit links in a full mesh topology.« less

Digital control algorithms for microgravity isolation systems

NASA Technical Reports Server (NTRS)

Sinha, Alok; Wang, Yung-Peng

1992-01-01

New digital control algorithms were developed to achieve the desired acceleration transmissibility function. The attractive electromagnets have been taken as actuators. The relative displacement and the acceleration of the mass were used as feedback signals. Two approaches were developed to find that controller transfer function in Z-domain, which yields the desired transmissibility at each frequency. In the first approach, the controller transfer function is obtained by assuming that the desired transmissibility is known in Z-domain. Since the desired transmissibility H sub d(S) = 1/(tauS+1)(exp 2) is given in S-domain, the first task is to obtain the desired transmissibility in Z-domain. There are three methods to perform this task: bilinear transformation, and backward and forward rectangular rules. The bilinear transformation and backward rectangular rule lead to improper controller transfer functions, which are physically not realizable. The forward rectangular rule does lead to a physically realizable controller. However, this controller is found to be marginally stable because of a pole at Z=1. In order to eliminate this pole, a hybrid control structure is proposed. Here the control input is composed of two parts: analog and digital. The analog input simply represents the velocity (or the integral of acceleration) feedback; and the digital controller which uses only relative displacement signal, is then obtained to achieve the desired closed-loop transfer function. The stability analysis indicates that the controller transfer function is stable for typical values of sampling period. In the second approach, the aforementioned hybrid control structure is again used. First, an analog controller transfer function corresponding to relative displacement feedback is obtained to achieve the transmissibility as 1/(tauS+1)(exp 2). Then the transfer function for the digital control input is obtained by discretizing this analog controller transfer function via bilinear

Is cost effectiveness sustained after weekend inpatient rehabilitation? 12 month follow up from a randomized controlled trial.

PubMed

Brusco, Natasha Kareem; Watts, Jennifer J; Shields, Nora; Taylor, Nicholas F

2015-04-18

Our previous work showed that providing additional rehabilitation on a Saturday was cost effective in the short term from the perspective of the health service provider. This study aimed to evaluate if providing additional rehabilitation on a Saturday was cost effective at 12 months, from a health system perspective inclusive of private costs. Cost effectiveness analyses alongside a single-blinded randomized controlled trial with 12 months follow up inclusive of informal care. Participants were adults admitted to two publicly funded inpatient rehabilitation facilities. The control group received usual care rehabilitation services from Monday to Friday and the intervention group received usual care plus additional Saturday rehabilitation. Incremental cost effectiveness ratios were reported as cost per quality adjusted life year (QALY) gained and for a minimal clinical important difference (MCID) in functional independence. A total of 996 patients [mean age 74 years (SD 13)] were randomly assigned to the intervention (n = 496) or control group (n = 500). The intervention was associated with improvements in QALY and MCID in function, as well as a non-significant reduction in cost from admission to 12 months (mean difference (MD) AUD$6,325; 95% CI -4,081 to 16,730; t test p = 0.23 and MWU p = 0.06), and a significant reduction in cost from admission to 6 months (MD AUD$6,445; 95% CI 3,368 to 9,522; t test p = 0.04 and MWU p = 0.01). There is a high degree of certainty that providing additional rehabilitation services on Saturday is cost effective. Sensitivity analyses varying the cost of informal carers and self-reported health service utilization, favored the intervention. From a health system perspective inclusive of private costs the provision of additional Saturday rehabilitation for inpatients is likely to have sustained cost savings per QALY gained and for a MCID in functional independence, for the inpatient stay and 12 months following

Effectiveness and cost-effectiveness of a universal parenting skills programme in deprived communities: multicentre randomised controlled trial

PubMed Central

Simkiss, D E; Snooks, H A; Stallard, N; Kimani, P K; Sewell, B; Fitzsimmons, D; Anthony, R; Winstanley, S; Wilson, L; Phillips, C J; Stewart-Brown, S

2013-01-01

Objective To evaluate the effectiveness and cost utility of a universally provided early years parenting programme. Design Multicentre randomised controlled trial with cost-effectiveness analysis. Setting Early years centres in four deprived areas of South Wales. Participants Families with children aged between 2 and 4 years. 286 families were recruited and randomly allocated to the intervention or waiting list control. Intervention The Family Links Nurturing Programme (FLNP), a 10-week course with weekly 2 h facilitated group sessions. Main outcome measures Negative and supportive parenting, child and parental well-being and costs assessed before the intervention, following the course (3 months) and at 9 months using standardised measures. Results There were no significant differences in primary or secondary outcomes between trial arms at 3 or 9 months. With ‘+’ indicating improvement, difference in change in negative parenting score at 9 months was +0.90 (95%CI −1.90 to 3.69); in supportive parenting, +0.17 (95%CI −0.61 to 0.94); and 12 of the 17 secondary outcomes showed a non-significant positive effect in the FLNP arm. Based on changes in parental well-being (SF-12), the cost per quality-adjusted life year (QALY) gained was estimated to be £34 913 (range 21 485–46 578) over 5 years and £18 954 (range 11 664–25 287) over 10 years. Probability of cost per QALY gained below £30 000 was 47% at 5 years and 57% at 10 years. Attendance was low: 34% of intervention families attended no sessions (n=48); only 47% completed the course (n=68). Also, 19% of control families attended a parenting programme before 9-month follow-up. Conclusions Our trial has not found evidence of clinical or cost utility for the FLNP in a universal setting. However, low levels of exposure and contamination mean that uncertainty remains. Trial registration The trial is registered with Current Controlled Trials ISRCTN13919732. PMID:23906953

Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba.

PubMed

Baly, Alberto; Toledo, Maria E; Rodriguez, Karina; Benitez, Juan R; Rodriguez, Maritza; Boelaert, Marleen; Vanlerberghe, Veerle; Van der Stuyft, Patrick

2012-01-01

To assess the economic cost of routine Aedes aegypti control in an at-risk environment without dengue endemicity and the incremental costs incurred during a sporadic outbreak. The study was conducted in 2006 in the city of Guantanamo, Cuba. We took a societal perspective to calculate costs in months without dengue transmission (January-July) and during an outbreak (August-December). Data sources were bookkeeping records, direct observations and interviews. The total economic cost per inhabitant (p.i.) per month. (p.m.) increased from 2.76 USD in months without dengue transmission to 6.05 USD during an outbreak. In months without transmission, the routine Aedes control programme cost 1.67 USD p.i. p.m. Incremental costs during the outbreak were mainly incurred by the population and the primary/secondary level of the healthcare system, hardly by the vector control programme (1.64, 1.44 and 0.21 UDS increment p.i. p.m., respectively). The total cost for managing a hospitalized suspected dengue case was 296.60 USD (62.0% direct medical, 9.0% direct non-medical and 29.0% indirect costs). In both periods, the main cost drivers for the Aedes control programme, the healthcare system and the community were the value of personnel and volunteer time or productivity losses. Intensive efforts to keep A. aegypti infestation low entail important economic costs for society. When a dengue outbreak does occur eventually, costs increase sharply. In-depth studies should assess which mix of activities and actors could maximize the effectiveness and cost-effectiveness of routine Aedes control and dengue prevention. © 2011 Blackwell Publishing Ltd.

Implementation of Adaptive Digital Controllers on Programmable Logic Devices

NASA Technical Reports Server (NTRS)

Gwaltney, David A.; King, Kenneth D.; Smith, Keary J.; Ormsby, John (Technical Monitor)

2002-01-01

Much has been made of the capabilities of FPGA's (Field Programmable Gate Arrays) in the hardware implementation of fast digital signal processing (DSP) functions. Such capability also makes and FPGA a suitable platform for the digital implementation of closed loop controllers. There are myriad advantages to utilizing an FPGA for discrete-time control functions which include the capability for reconfiguration when SRAM- based FPGA's are employed, fast parallel implementation of multiple control loops and implementations that can meet space level radiation tolerance in a compact form-factor. Other researchers have presented the notion that a second order digital filter with proportional-integral-derivative (PID) control functionality can be implemented in an FPGA. At Marshall Space Flight Center, the Control Electronics Group has been studying adaptive discrete-time control of motor driven actuator systems using digital signal processor (DSF) devices. Our goal is to create a fully digital, flight ready controller design that utilizes an FPGA for implementation of signal conditioning for control feedback signals, generation of commands to the controlled system, and hardware insertion of adaptive control algorithm approaches. While small form factor, commercial DSP devices are now available with event capture, data conversion, pulse width modulated outputs and communication peripherals, these devices are not currently available in designs and packages which meet space level radiation requirements. Meeting our goals requires alternative compact implementation of such functionality to withstand the harsh environment encountered on spacecraft. Radiation tolerant FPGA's are a feasible option for reaching these goals.

Cost-effectiveness of tobacco control policies and programmes targeting adolescents: a systematic review.

PubMed

Leão, Teresa; Kunst, Anton E; Perelman, Julian

2018-02-01

Consistent evidence shows the importance of preventing smoking at young ages, when health behaviours are formed, with long-term consequences on health and survival. Although tobacco control policies and programmes targeting adolescents are widely promoted, the cost-effectiveness of such interventions has not been systematically documented. We performed a systematic review on the cost-effectiveness of policies and programmes preventing tobacco consumption targeting adolescents. We systematically reviewed literature on the (i) cost and effectiveness of (ii) prevention policies targeting (iii) smoking by (iv) adolescents. PubMed, Web of Science, Cochrane, CEA-TUFTS, Health Economic Evaluations, Wiley Online Library, Centre for Reviews and Dissemination Database, the National Institute for Health and Care Excellence and Google Scholar databases were used, and Google search engine was used for other grey literature review. We obtained 793 full-text papers and 19 grey literature documents, from which 16 studies fulfilled the inclusion criteria. Of these, only one was published in the last 5 years, and 15 were performed in high-income countries. Eight analyzed the cost-effectiveness of school-based programmes, five focused on media campaigns and three on legal bans. Policies and programmes were found to be cost-effective in all studies, and both effective and cost-saving in about half of the studies. Evidence is scarce and relatively obsolete, and rarely focused on the evaluation of legal bans. Moreover, no comparisons have been made between different interventions or across different contexts and implementation levels. However, all studies conclude that smoking prevention policies and programmes amongst adolescents are greatly worth their costs. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

Telemonitoring-based service redesign for the management of uncontrolled hypertension (HITS): cost and cost-effectiveness analysis of a randomised controlled trial

PubMed Central

Stoddart, Andrew; Hanley, Janet; Wild, Sarah; Pagliari, Claudia; Paterson, Mary; Lewis, Steff; Sheikh, Aziz; Krishan, Ashma; Padfield, Paul; McKinstry, Brian

2013-01-01

Objectives To compare the costs and cost-effectiveness of managing patients with uncontrolled blood pressure (BP) using telemonitoring versus usual care from the perspective of the National Health Service (NHS). Design Within trial post hoc economic evaluation of data from a pragmatic randomised controlled trial using an intention-to-treat approach. Setting 20 socioeconomically diverse general practices in Lothian, Scotland. Participants 401 primary care patients aged 29–95 with uncontrolled daytime ambulatory blood pressure (ABP) (≥135/85, but <210/135 mm Hg). Intervention Participants were centrally randomised to 6 months of a telemonitoring service comprising of self-monitoring of BP transmitted to a secure website for review by the attending nurse/doctor and patient, with optional automated patient decision-support by text/email (n=200) or usual care (n-201). Randomisation was undertaken with minimisation for age, sex, family practice, use of three or more hypertension drugs and self-monitoring history. Main outcome measures Mean difference in total NHS costs between trial arms and blinded assessment of mean cost per 1 mm Hg systolic BP point reduced. Results Home telemonitoring of BP costs significantly more than usual care (mean difference per patient £115.32 (95% CI £83.49 to £146.63; p<0.001)). Increased costs were due to telemonitoring service costs, patient training and additional general practitioner and nurse consultations. The mean cost of systolic BP reduction was £25.56/mm Hg (95% CI £16.06 to £46.89) per patient. Conclusions Over the 6-month trial period, supported telemonitoring was more effective at reducing BP than usual care but also more expensive. If clinical gains are maintained, these additional costs would be very likely to be compensated for by reductions in the cost of future cardiovascular events. Longer-term modelling of costs and outcomes is required to fully examine the cost-effectiveness implications. Trial

Costs and cost-effectiveness of vector control in Eritrea using insecticide-treated bed nets.

PubMed

Yukich, Joshua O; Zerom, Mehari; Ghebremeskel, Tewolde; Tediosi, Fabrizio; Lengeler, Christian

2009-03-30

While insecticide-treated nets (ITNs) are a recognized effective method for preventing malaria, there has been an extensive debate in recent years about the best large-scale implementation strategy. Implementation costs and cost-effectiveness are important elements to consider when planning ITN programmes, but so far little information on these aspects is available from national programmes. This study uses a standardized methodology, as part of a larger comparative study, to collect cost data and cost-effectiveness estimates from a large programme providing ITNs at the community level and ante-natal care facilities in Eritrea. This is a unique model of ITN implementation fully integrated into the public health system. Base case analysis results indicated that the average annual cost of ITN delivery (2005 USD 3.98) was very attractive when compared with past ITN delivery studies at different scales. Financing was largely from donor sources though the Eritrean government and net users also contributed funding. The intervention's cost-effectiveness was in a highly attractive range for sub-Saharan Africa. The cost per DALY averted was USD 13 - 44. The cost per death averted was USD 438-1449. Distribution of nets coincided with significant increases in coverage and usage of nets nationwide, approaching or exceeding international targets in some areas. ITNs can be cost-effectively delivered at a large scale in sub-Saharan Africa through a distribution system that is highly integrated into the health system. Operating and sustaining such a system still requires strong donor funding and support as well as a functional and extensive system of health facilities and community health workers already in place.

Cost-effectiveness of environmental management for vector control in resource development projects.

PubMed

Bos, R

1991-01-01

Vector control methods are traditionally divided in chemical, biological and environmental management approaches, and this distinction also reflected in certain financial and economic aspects. This is particularly true for environmental modification, usually engineering or other structural works. It is highly capital intensive, as opposed to chemical and biological control which require recurrent expenditures, and discount rates are therefore a prominent consideration in deciding for one or the other approach. Environmental manipulation requires recurrent action, but can often be carried out with the community participation, which raises the issue of opportunity costs. The incorporation of environmental management in resource projects is generally impeded by economic considerations. The Internal Rate of Return continues to be a crucial criterion for funding agencies and development banks to support new projects; at the same time Governments of debt-riden countries in the Third World will do their best to avoid additional loans on such frills as environmental and health safeguards. Two approaches can be recommended to nevertheless ensure the incorporation of environmental management measures in resource projects in an affordable way. First, there are several examples of cases where environmental management measures either have a dual benefit (increasing both agricultural production and reducing vector-borne disease transmission) or can be implemented at zero costs. Second, the additional costs involved in structural modifications can be separated from the project development costs considered in the calculations of the Internal Rate of Return, and financial support can be sought from bilateral technical cooperation agencies particularly interested in environmental and health issues. There is a dearth of information in the cost-effectiveness of alternative vector control strategies in the developing country context. The process of integrating vector control in the

Real Time Digital Control of a Magnetostrictive Actuator

NASA Technical Reports Server (NTRS)

Zrostlik, Rick L.; Hall, David L.; Flatau, Alison B.

1996-01-01

The use of the magnetostrictive material Terfenol-D as a motion source in active vibration control (AVC) systems are being studied. Currently it is of limited use due to the nonlinear nature of the strain versus magnetization curve and the magnetic hysteresis in the Terfenol-D. One manifestation of these nonlinearities is waveform distortion in the output velocity of the transducer. For Terfenol-D to be used in ever greater numbers of AVC systems, these nonlinearities must be addressed. In this study the nonlinearities are treated as disturbances to a linear system. The acceleration output is used in simple analog and digital feedback control schemes to improve linearity of the transducer. In addition, the use of a Terfenol-D actuator in an AVC system is verified. Both analog and digital controllers are implemented and results compared. A cantilever beam system is considered for AVC applications. The second thrust of this presentation is the reduction of harmonic distortions. Two conclusions can be reached from this work. One, the linearization of Terfenol-D transducers is possible with the use of feedback controllers, both digital and analog. Second, Terfenol-D is a viable motion source in active vibration control systems utilizing either analog or digital controllers.

Digital Signal Processing and Control for the Study of Gene Networks

PubMed Central

Shin, Yong-Jun

2016-01-01

Thanks to the digital revolution, digital signal processing and control has been widely used in many areas of science and engineering today. It provides practical and powerful tools to model, simulate, analyze, design, measure, and control complex and dynamic systems such as robots and aircrafts. Gene networks are also complex dynamic systems which can be studied via digital signal processing and control. Unlike conventional computational methods, this approach is capable of not only modeling but also controlling gene networks since the experimental environment is mostly digital today. The overall aim of this article is to introduce digital signal processing and control as a useful tool for the study of gene networks. PMID:27102828

Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial

PubMed Central

Edwards, Rhiannon T; Neal, Richard D; Linck, Pat; Bruce, Nigel; Mullock, Linda; Nelhans, Nick; Pasterfield, Diana; Russell, Daphne; Russell, Ian; Woodfine, Louise

2011-01-01

Background There has been little rigorous economic analysis of the relationship between asthma and improved housing. Aim To evaluate the cost-effectiveness of installing ventilation systems, and central heating if necessary, in homes of children with ‘moderate’ or ‘severe’ asthma. Design and setting An incremental cost-effectiveness analysis alongside a pragmatic randomised controlled trial of a tailored package of housing modifications designed to improve ventilation and household heating in homes within Wrexham County Borough, Wales, UK. Method A total of 177 children aged between 5 and 14 years, identified from general practice registers, were studied. Parents reported on the quality of life of their children over a 12-month period. General practices reported on health-service resources used by those children, and their asthma-related prescriptions, over the same period. Results The tailored package shifted 17% of children in the intervention group from ‘severe’ to ‘moderate’ asthma, compared with a 3% shift in the control group. The mean cost of these modifications was £1718 per child treated or £12300 per child shifted from ‘severe’ to ‘moderate’. Healthcare costs over 12 months following randomisation did not differ significantly between intervention and control groups. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of £234 per point improvement on the 100-point PedsQL™ asthma-specific scale, with 95% confidence interval (CI) = £140 to £590. The ICER fell to £165 (95% CI = £84 to £424) for children with ‘severe’ asthma. Conclusion This novel and pragmatic trial, with integrated economic evaluation, reported that tailored improvement of the housing of children with moderate to severe asthma is likely to be a cost-effective use of public resources. This is a rare example of evidence for collaboration between local government and the NHS. PMID:22054337

The x-ray light valve: a low-cost, digital radiographic imaging system-spatial resolution

NASA Astrophysics Data System (ADS)

MacDougall, Robert D.; Koprinarov, Ivaylo; Webster, Christie A.; Rowlands, J. A.

2007-03-01

In recent years, new x-ray radiographic systems based on large area flat panel technology have revolutionized our capability to produce digital x-ray radiographic images. However, these active matrix flat panel imagers (AMFPIs) are extraordinarily expensive compared to the systems they are replacing. Thus there is a need for a low cost digital imaging system for general applications in radiology. Different approaches have been considered to make lower cost, integrated x-ray imaging devices for digital radiography, including: scanned projection x-ray, an integrated approach based on computed radiography technology and optically demagnified x-ray screen/CCD systems. These approaches suffer from either high cost or high mechanical complexity and do not have the image quality of AMFPIs. We have identified a new approach - the X-ray Light Valve (XLV). The XLV has the potential to achieve the immediate readout in an integrated system with image quality comparable to AMFPIs. The XLV concept combines three well-established and hence lowcost technologies: an amorphous selenium (a-Se) layer to convert x-rays to image charge, a liquid crystal (LC) cell as an analog display, and an optical scanner for image digitization. Here we investigate the spatial resolution possible with XLV systems. Both a-Se and LC cells have both been shown separately to have inherently very high spatial resolution. Due to the close electrostatic coupling in the XLV, it can be expected that the spatial resolution of this system will also be very high. A prototype XLV was made and a typical office scanner was used for image digitization. The Modulation Transfer Function was measured and the limiting factor was seen to be the optical scanner. However, even with this limitation the XLV system is able to meet or exceed the resolution requirements for chest radiography.

An Economic Evaluation of a Video- and Text-Based Computer-Tailored Intervention for Smoking Cessation: A Cost-Effectiveness and Cost-Utility Analysis of a Randomized Controlled Trial

PubMed Central

Stanczyk, Nicola E.; Smit, Eline S.; Schulz, Daniela N.; de Vries, Hein; Bolman, Catherine; Muris, Jean W. M.; Evers, Silvia M. A. A.

2014-01-01

Background Although evidence exists for the effectiveness of web-based smoking cessation interventions, information about the cost-effectiveness of these interventions is limited. Objective The study investigated the cost-effectiveness and cost-utility of two web-based computer-tailored (CT) smoking cessation interventions (video- vs. text-based CT) compared to a control condition that received general text-based advice. Methods In a randomized controlled trial, respondents were allocated to the video-based condition (N = 670), the text-based condition (N = 708) or the control condition (N = 721). Societal costs, smoking status, and quality-adjusted life years (QALYs; EQ-5D-3L) were assessed at baseline, six-and twelve-month follow-up. The incremental costs per abstinent respondent and per QALYs gained were calculated. To account for uncertainty, bootstrapping techniques and sensitivity analyses were carried out. Results No significant differences were found in the three conditions regarding demographics, baseline values of outcomes and societal costs over the three months prior to baseline. Analyses using prolonged abstinence as outcome measure indicated that from a willingness to pay of €1,500, the video-based intervention was likely to be the most cost-effective treatment, whereas from a willingness to pay of €50,400, the text-based intervention was likely to be the most cost-effective. With regard to cost-utilities, when quality of life was used as outcome measure, the control condition had the highest probability of being the most preferable treatment. Sensitivity analyses yielded comparable results. Conclusion The video-based CT smoking cessation intervention was the most cost-effective treatment for smoking abstinence after twelve months, varying the willingness to pay per abstinent respondent from €0 up to €80,000. With regard to cost-utility, the control condition seemed to be the most preferable treatment. Probably, more time will be

Cost-effectiveness of Occupational Therapy in Older People: Systematic Review of Randomized Controlled Trials.

PubMed

Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Yamauchi, Keita

2016-06-01

A systematic review of the cost-effectiveness of occupational therapy for older people was conducted. MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library, OT seeker and unpublished trials registers were searched. Reference lists of all potentially eligible studies were searched with no language restrictions. We included trial-based full economic evaluations that considered both costs and outcomes in occupational therapy for older people compared with standard care (i.e. other therapy) or no intervention. We reviewed each trial for methodological quality using the Cochrane risk of bias tool and assessed the quality of economic evaluations using a Drummond checklist. In the results of this review, we included five eligible studies (1-5) that were randomized controlled trials with high-quality economic evaluation. Two studies were full economic evaluations of interventions for fall prevention (1 and 2); two studies were full economic evaluations of preventive occupational therapy interventions (3 and 4; one was a comparison of an occupational therapy group with a social work group); one study was a full economic evaluation of occupational therapy for individuals with dementia (5). Two of the studies (one was preventive occupational therapy [3] and the other was occupational therapy for dementia [5]) found a significant effect and confirmed the cost-effectiveness of occupational therapy for older people compared with the control group. These studies found that occupational therapy for older people was clinically effective and cost-effective in comparison with standard care or other therapies. With reference to their clinical implication, these intervention studies (using a client-centred approach) suggested potentially cost-effective means to motivate clients to maintain their own health. However, this review has limitations because of the high heterogeneity of the reviewed studies on full economic evaluations of occupational therapy for older people. Future

Comparison of flight results with digital simulation for a digital electronic engine control in an F-15 airplane

NASA Technical Reports Server (NTRS)

Myers, L. P.; Burcham, F. W., Jr.

1983-01-01

Substantial benefits of a full authority digital electronic engine control on an air breathing engine were demonstrated repeatedly in simulation studies, ground engine tests, and engine altitude test facilities. A digital engine electronic control system showed improvements in efficiency, performance, and operation. An additional benefit of full authority digital controls is the capability of detecting and correcting failures and providing engine health diagnostics.

Cost-effectiveness of rehabilitation after an acute coronary event: a randomised controlled trial.

PubMed

Briffa, Tom G; Eckermann, Simon D; Griffiths, Alison D; Harris, Phillip J; Heath, M Rose; Freedman, Saul B; Donaldson, Lana T; Briffa, N Kathryn; Keech, Anthony C

2005-11-07

To estimate the incremental effects on cost and quality of life of cardiac rehabilitation after an acute coronary syndrome. Open randomised controlled trial with 1 year's follow-up. Analysis was on an intention-to-treat basis. Two tertiary hospitals in Sydney. 18 sessions of comprehensive exercise-based outpatient cardiac rehabilitation or conventional care as provided by the treating doctor. 113 patients aged 41-75 years who were self-caring and literate in English. Patients with uncompensated heart failure, uncontrolled arrhythmias, severe and symptomatic aortic stenosis or physical impairment were excluded. Costs (hospitalisations, medication use, outpatient visits, investigations, and personal expenses); and measures of quality of life. Incremental cost per quality-adjusted life year (QALY) saved at 1 year (this estimate combines within-study utility effects with reported 1-year risk of survival and treatment effects of rehabilitation on mortality). Sensitivity analyses around a base case estimate included alternative assumptions of no treatment effect on survival, 3 years of treatment effect on survival and variations in utility. The estimated incremental cost per QALY saved for rehabilitation relative to standard care was 42,535 US dollars when modelling included the reported treatment effect on survival. This increased to 70,580 US dollars per QALY saved if treatment effect on survival was not included. The results were sensitive to variations in utility and ranged from 19,685 US dollars per QALY saved to rehabilitation not being cost-effective. The effects on quality of life tend to reinforce treatment advantages on survival for patients having postdischarge rehabilitation after an acute coronary syndrome. The estimated base case incremental cost per QALY saved is consistent with those historically accepted by decision making authorities such as the Pharmaceutical Benefits Advisory Committee.

Digital telephony analysis model and issues

NASA Astrophysics Data System (ADS)

Keuthan, Lynn M.

1995-09-01

Experts in the fields of digital telephony and communications security have stated the need for an analytical tool for evaluating complex issues. Some important policy issues discussed by experts recently include implementing digital wire-taps, implementation of the 'Clipper Chip', required registration of encryption/decryption keys, and export control of cryptographic equipment. Associated with the implementation of these policies are direct costs resulting from implementation, indirect cost benefits from implementation, and indirect costs resulting from the risks of implementation or factors reducing cost benefits. Presented herein is a model for analyzing digital telephony policies and systems and their associated direct costs and indirect benefit and risk factors. In order to present the structure of the model, issues of national importance and business-related issues are discussed. The various factors impacting the implementation of the associated communications systems and communications security are summarized, and various implementation tradeoffs are compared based on economic benefits/impact. The importance of the issues addressed herein, as well as other digital telephony issues, has greatly increased with the enormous increases in communication system connectivity due to the advance of the National Information Infrastructure.

Determining the cost effectiveness of a smoke alarm give-away program using data from a randomized controlled trial.

PubMed

Ginnelly, Laura; Sculpher, Mark; Bojke, Chris; Roberts, Ian; Wade, Angie; Diguiseppi, Carolyn

2005-10-01

In 2001, 486 deaths and 17,300 injuries occurred in domestic fires in the UK. Domestic fires represent a significant cost to the UK economy, with the value of property loss alone estimated at pounds 375 million in 1999. In 2001 in the US, there were 383 500 home fires, resulting in 3110 deaths, 15,200 injuries and dollar 5.5 billion in direct property damage. A cluster RCT was conducted to determine whether a smoke alarm give-away program, directed to an inner-city UK population, is effective and cost-effective in reducing the risk of fire-related deaths/injuries. Forty areas were randomized to the give-away or control group. The number of injuries/deaths and the number of fires in each ward were collected prospectively. Cost-effectiveness analysis was undertaken to relate the number of deaths/injuries to resource use (damage, fire service, healthcare and give-away costs). Analytical methods were used which reflected the characteristics of the trial data including the cluster design of the trial and a large number of zero costs and effects. The mean cost for a household in a give-away ward, including the cost of the program, was pounds 12.76, compared to pounds 10.74 for the control ward. The total mean number of deaths and injuries was greater in the intervention wards then the control wards, 6.45 and 5.17. When an injury/death avoided is valued at pounds 1000, a smoke alarm give-away has a probability of being cost effective of 0.15. A smoke alarm give-away program, as administered in the trial, is unlikely to represent a cost-effective use of resources.

Controlled-Root Approach To Digital Phase-Locked Loops

NASA Technical Reports Server (NTRS)

Stephens, Scott A.; Thomas, J. Brooks

1995-01-01

Performance tailored more flexibly and directly to satisfy design requirements. Controlled-root approach improved method for analysis and design of digital phase-locked loops (DPLLs). Developed rigorously from first principles for fully digital loops, making DPLL theory and design simpler and more straightforward (particularly for third- or fourth-order DPLL) and controlling performance more accurately in case of high gain.

YADCLAN: yet another digitally-controlled linear artificial neuron.

PubMed

Frenger, Paul

2003-01-01

This paper updates the author's 1999 RMBS presentation on digitally controlled linear artificial neuron design. Each neuron is based on a standard operational amplifier having excitatory and inhibitory inputs, variable gain, an amplified linear analog output and an adjustable threshold comparator for digital output. This design employs a 1-wire serial network of digitally controlled potentiometers and resistors whose resistance values are set and read back under microprocessor supervision. This system embodies several unique and useful features, including: enhanced neuronal stability, dynamic reconfigurability and network extensibility. This artificial neuronal is being employed for feature extraction and pattern recognition in an advanced robotic application.

Floating-point system quantization errors in digital control systems

NASA Technical Reports Server (NTRS)

Phillips, C. L.; Vallely, D. P.

1978-01-01

This paper considers digital controllers (filters) operating in floating-point arithmetic in either open-loop or closed-loop systems. A quantization error analysis technique is developed, and is implemented by a digital computer program that is based on a digital simulation of the system. The program can be integrated into existing digital simulations of a system.

The Effectiveness of Prompts to Promote Engagement With Digital Interventions: A Systematic Review.

PubMed

Alkhaldi, Ghadah; Hamilton, Fiona L; Lau, Rosa; Webster, Rosie; Michie, Susan; Murray, Elizabeth

2016-01-08

Digital interventions have been effective in improving numerous health outcomes and health behaviors; furthermore, they are increasingly being used in different health care areas, including self-management of long-term conditions, mental health, and health promotion. The full potential of digital interventions is hindered by a lack of user engagement. There is an urgent need to develop effective strategies that can promote users' engagement with digital interventions. One potential method is the use of technology-based reminders or prompts. To evaluate the effectiveness of technology-based strategies for promoting engagement with digital interventions. Cochrane Collaboration guidelines on systematic review methodology were followed. The search strategy was executed across 7 electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, the Education Resources Information Center (ERIC), PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Databases were searched from inception to September 13, 2013, with no language or publication type restrictions, using three concepts: randomized controlled trials, digital interventions, and engagement. Gray literature and reference lists of included studies were also searched. Titles and abstracts were independently screened by 2 authors, then the full texts of potentially eligible papers were obtained and double-screened. Data from eligible papers were extracted by one author and checked for accuracy by another author. Bias was assessed using the Cochrane risk of bias assessment tool. Narrative synthesis was performed on all included studies and, where appropriate, data were pooled using meta-analysis. All findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 14 studies were included in the review with 8774 participants. Of the 14 studies, 9 had sufficient data

Digitally controlled analog proportional-integral-derivative (PID) controller for high-speed scanning probe microscopy

NASA Astrophysics Data System (ADS)

Dukic, Maja; Todorov, Vencislav; Andany, Santiago; Nievergelt, Adrian P.; Yang, Chen; Hosseini, Nahid; Fantner, Georg E.

2017-12-01

Nearly all scanning probe microscopes (SPMs) contain a feedback controller, which is used to move the scanner in the direction of the z-axis in order to maintain a constant setpoint based on the tip-sample interaction. The most frequently used feedback controller in SPMs is the proportional-integral (PI) controller. The bandwidth of the PI controller presents one of the speed limiting factors in high-speed SPMs, where higher bandwidths enable faster scanning speeds and higher imaging resolution. Most SPM systems use digital signal processor-based PI feedback controllers, which require analog-to-digital and digital-to-analog converters. These converters introduce additional feedback delays which limit the achievable imaging speed and resolution. In this paper, we present a digitally controlled analog proportional-integral-derivative (PID) controller. The controller implementation allows tunability of the PID gains over a large amplification and frequency range, while also providing precise control of the system and reproducibility of the gain parameters. By using the analog PID controller, we were able to perform successful atomic force microscopy imaging of a standard silicon calibration grating at line rates up to several kHz.

Digitally controlled analog proportional-integral-derivative (PID) controller for high-speed scanning probe microscopy.

PubMed

Dukic, Maja; Todorov, Vencislav; Andany, Santiago; Nievergelt, Adrian P; Yang, Chen; Hosseini, Nahid; Fantner, Georg E

2017-12-01

Nearly all scanning probe microscopes (SPMs) contain a feedback controller, which is used to move the scanner in the direction of the z-axis in order to maintain a constant setpoint based on the tip-sample interaction. The most frequently used feedback controller in SPMs is the proportional-integral (PI) controller. The bandwidth of the PI controller presents one of the speed limiting factors in high-speed SPMs, where higher bandwidths enable faster scanning speeds and higher imaging resolution. Most SPM systems use digital signal processor-based PI feedback controllers, which require analog-to-digital and digital-to-analog converters. These converters introduce additional feedback delays which limit the achievable imaging speed and resolution. In this paper, we present a digitally controlled analog proportional-integral-derivative (PID) controller. The controller implementation allows tunability of the PID gains over a large amplification and frequency range, while also providing precise control of the system and reproducibility of the gain parameters. By using the analog PID controller, we were able to perform successful atomic force microscopy imaging of a standard silicon calibration grating at line rates up to several kHz.

Digital Plasma Control System for Alcator C-Mod

NASA Astrophysics Data System (ADS)

Ferrara, M.; Wolfe, S.; Stillerman, J.; Fredian, T.; Hutchinson, I.

2004-11-01

A digital plasma control system (DPCS) has been designed to replace the present C-Mod system, which is based on hybrid analog-digital computer. The initial implementation of DPCS comprises two 64 channel, 16 bit, low-latency cPCI digitizers, each with 16 analog outputs, controlled by a rack-mounted single-processor Linux server, which also serves as the compute engine. A prototype system employing three older 32 channel digitizers was tested during the 2003-04 campaign. The hybrid's linear PID feedback system was emulated by IDL code executing a synchronous loop, using the same target waveforms and control parameters. Reliable real-time operation was accomplished under a standard Linux OS (RH9) by locking memory and disabling interrupts during the plasma pulse. The DPCS-computed outputs agreed to within a few percent with those produced by the hybrid system, except for discrepancies due to offsets and non-ideal behavior of the hybrid circuitry. The system operated reliably, with no sample loss, at more than twice the 10kHz design specification, providing extra time for implementing more advanced control algorithms. The code is fault-tolerant and produces consistent output waveforms even with 10% sample loss.

Cost-effectiveness prospects of picture archiving and communication systems.

PubMed

Hindel, R; Preger, W

1988-01-01

PAC (picture archiving and communication) systems are widely discussed and promoted as the organizational solution to digital image management in a radiology department. For approximately two decades digital imaging has increasingly been used for such diagnostic modalities as CT, DSA, MRI, DR (Digital Radiography) and others. PACS are seen as a step toward high technology integration and more efficient management. Although the acquisition of such technology is investment intensive, there are well-founded projections that prolonged operation will prove cost justified. Such justification can only partly be derived from cost reduction through PAC with respect to present department management--the major justification is preparation for future economic pressures which could make survival of a department without modern technology difficult. Especially in the United States the political climate favors 'competitive medicine' and reduced government support. Seen in this context PACS promises to speed the transition of Health Care Services into a business with tight resource management, cost accounting and marketing. The following paper analyzes cost and revenue in a typical larger Radiology Department, projects various scenarios of cost reduction by means of digital technology and concludes with cautious optimism that the investment expenses for a PACS will be justified in the near future by prudent utilization of high technology.

Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial.

PubMed

McBain, Ryan K; Salhi, Carmel; Hann, Katrina; Salomon, Joshua A; Kim, Jane J; Betancourt, Theresa S

2016-05-01

One billion children live in war-affected regions of the world. We conducted the first cost-effectiveness analysis of an intervention for war-affected youth in sub-Saharan Africa, as well as a broader cost analysis. The Youth Readiness Intervention (YRI) is a behavioural treatment for reducing functional impairment associated with psychological distress among war-affected young persons. A randomized controlled trial was conducted in Freetown, Sierra Leone, from July 2012 to July 2013. Participants (n = 436, aged 15-24) were randomized to YRI (n = 222) or care as usual (n = 214). Functional impairment was indexed by the World Health Organization Disability Assessment Scale; scores were converted to quality-adjusted life years (QALYs). An 'ingredients approach' estimated financial and economic costs, assuming a societal perspective. Incremental cost-effectiveness ratios (ICERs) were also expressed in terms of gains across dimensions of mental health and schooling. Secondary analyses explored whether intervention effects were largest among those worst-off (upper quartile) at baseline. Retention at 6-month follow-up was 85% (n = 371). The estimated economic cost of the intervention was $104 per participant. Functional impairment was lower among YRI recipients, compared with controls, following the intervention but not at 6-month follow-up, and yielded an ICER of $7260 per QALY gained. At 8-month follow-up, teachers' interviews indicated that YRI recipients observed higher school enrolment [P < 0.001, odds ratio (OR) 8.9], denoting a cost of $431 per additional school year gained, as well as better school attendance (P = 0.007, OR 34.9) and performance (P = 0.03, effect size = -1.31). Secondary analyses indicated that the intervention was cost-effective among those worst-off at baseline, yielding an ICER of $3564 per QALY gained. The YRI is not cost-effective at a willingness-to-pay threshold of three times average gross domestic product

An extensible, low-cost drifter control unit

NASA Astrophysics Data System (ADS)

Giudici, Andrea; Torsvik, Tomas; Soomere, Tarmo

2017-04-01

We introduce an extensible, low-cost drifter control unit, which is developed for use with surface drifters that are deployed in inland water bodies or near-coast regions. The control unit is custom-built on top of a small footprint micro controller. It makes use of a GPS receiver for position tracking, a GSM radio for data transmission, and two sensor buses to handle analog and digital data measured by an array of external sensors. A cloud-based data collection platform receives and stores the data transmitted over GPRS from the drifter. The control unit was found to perform satisfactorily in operational testing, providing data at sub-Hz frequency for position and temperature during extended time. Test deployments revealed some issues related to power consumption spikes. Even though the unit is fully functional in the present form and shows, on average, low energy consumption , battery packs with relatively large maximum output power are required to ensure its operation within prolonged periods of time. We expect that a further development of the power supply unit together with a careful de-synchronization scheme of sensors' operation would smooth those peaks without any loss of the quality of recorded information.

Economic evaluation of a web-based tailored lifestyle intervention for adults: findings regarding cost-effectiveness and cost-utility from a randomized controlled trial.

PubMed

Schulz, Daniela N; Smit, Eline S; Stanczyk, Nicola E; Kremers, Stef P J; de Vries, Hein; Evers, Silvia M A A

2014-03-20

Different studies have reported the effectiveness of Web-based computer-tailored lifestyle interventions, but economic evaluations of these interventions are scarce. The objective was to assess the cost-effectiveness and cost-utility of a sequential and a simultaneous Web-based computer-tailored lifestyle intervention for adults compared to a control group. The economic evaluation, conducted from a societal perspective, was part of a 2-year randomized controlled trial including 3 study groups. All groups received personalized health risk appraisals based on the guidelines for physical activity, fruit intake, vegetable intake, alcohol consumption, and smoking. Additionally, respondents in the sequential condition received personal advice about one lifestyle behavior in the first year and a second behavior in the second year; respondents in the simultaneous condition received personal advice about all unhealthy behaviors in both years. During a period of 24 months, health care use, medication use, absenteeism from work, and quality of life (EQ-5D-3L) were assessed every 3 months using Web-based questionnaires. Demographics were assessed at baseline, and lifestyle behaviors were assessed at both baseline and after 24 months. Cost-effectiveness and cost-utility analyses were performed based on the outcome measures lifestyle factor (the number of guidelines respondents adhered to) and quality of life, respectively. We accounted for uncertainty by using bootstrapping techniques and sensitivity analyses. A total of 1733 respondents were included in the analyses. From a willingness to pay of €4594 per additional guideline met, the sequential intervention (n=552) was likely to be the most cost-effective, whereas from a willingness to pay of €10,850, the simultaneous intervention (n=517) was likely to be most cost-effective. The control condition (n=664) appeared to be preferred with regard to quality of life. Both the sequential and the simultaneous lifestyle

Stand-alone digital data storage control system including user control interface

NASA Technical Reports Server (NTRS)

Wright, Kenneth D. (Inventor); Gray, David L. (Inventor)

1994-01-01

A storage control system includes an apparatus and method for user control of a storage interface to operate a storage medium to store data obtained by a real-time data acquisition system. Digital data received in serial format from the data acquisition system is first converted to a parallel format and then provided to the storage interface. The operation of the storage interface is controlled in accordance with instructions based on user control input from a user. Also, a user status output is displayed in accordance with storage data obtained from the storage interface. By allowing the user to control and monitor the operation of the storage interface, a stand-alone, user-controllable data storage system is provided for storing the digital data obtained by a real-time data acquisition system.

Preventing diabetes blindness: cost effectiveness of a screening programme using digital non-mydriatic fundus photography for diabetic retinopathy in a primary health care setting in South Africa.

PubMed

Khan, Taskeen; Bertram, Melanie Y; Jina, Ruxana; Mash, Bob; Levitt, Naomi; Hofman, Karen

2013-08-01

South Africa like many other developing countries is experiencing an epidemiologic transition with a marked increase in the non-communicable disease (NCD) burden. Diabetic retinopathy is the most common cause of incidental blindness in adults. A screening programme using a mobile fundal camera in a primary care setting has been shown to be effective in the country. Information on affordability and cost is essential for policymakers to consider its adoption. Economic evaluation is the comparative analysis of competing alternative interventions in terms of costs and consequences. A cost effectiveness analysis was done using actual costs from the primary care screening programme. A total of 14,541 patients were screened in three primary healthcare facilities in the Western Cape. Photographs were taken by a trained technician with supervision by an ophthalmic nurse. The photographs were then read by a medical officer with ophthalmic experience. A cost effective ratio of $1206 per blindness case averted was obtained. This included costs for screening and treating an individual. The cost just to screen a patient for retinopathy was $22. The costs of screening and treating all incident cases of blindness due to diabetes in South Africa would be 168,000,000 ZAR ($19,310,344) per annum. Non mydriatic digital fundoscopy is a cost effective measure in the screening and diagnosis of diabetic retinopathy in a primary care setting in South Africa. The major savings in the long term are a result of avoiding government disability grant for people who suffer loss of vision. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Telemonitoring and self-management in the control of hypertension (TASMINH2): a cost-effectiveness analysis.

PubMed

Kaambwa, Billingsley; Bryan, Stirling; Jowett, Sue; Mant, Jonathan; Bray, Emma P; Hobbs, F D Richard; Holder, Roger; Jones, Miren I; Little, Paul; Williams, Bryan; McManus, Richard J

2014-12-01

Self-monitoring and self-titration of antihypertensives (self-management) is a novel intervention which improves blood pressure control. However, little evidence exists regarding the cost-effectiveness of self-monitoring of blood pressure in general and self-management in particular. This study aimed to evaluate whether self-management of hypertension was cost-effective. A cohort Markov model-based probabilistic cost-effectiveness analysis was undertaken extrapolating to up to 35 years from cost and outcome data collected from the telemonitoring and self-management in hypertension trial (TASMINH2). Self-management of hypertension was compared with usual care in terms of lifetime costs, quality adjusted life years and cost-effectiveness using a UK Health Service perspective. Sensitivity analyses examined the effect of different time horizons and reduced effectiveness over time from self-management. In the long-term, when compared with usual care, self-management was more effective by 0.24 and 0.12 quality adjusted life years (QALYs) gained per patient for men and women, respectively. The resultant incremental cost-effectiveness ratio for self-management was £1624 per QALY for men and £4923 per QALY for women. There was at least a 99% chance of the intervention being cost-effective for both sexes at a willingness to pay threshold of £20,000 per QALY gained. These results were robust to sensitivity analyses around the assumptions made, provided that the effects of self-management lasted at least two years for men and five years for women. Self-monitoring with self-titration of antihypertensives and telemonitoring of blood pressure measurements not only reduces blood pressure, compared with usual care, but also represents a cost-effective use of health care resources. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Cost-effectiveness of novel vaccines for tuberculosis control: a decision analysis study

PubMed Central

2011-01-01

Background The development of a successful new tuberculosis (TB) vaccine would circumvent many limitations of current diagnostic and treatment practices. However, vaccine development is complex and costly. We aimed to assess the potential cost effectiveness of novel vaccines for TB control in a sub-Saharan African country - Zambia - relative to the existing strategy of directly observed treatment, short course (DOTS) and current level of bacille Calmette-Guérin (BCG) vaccination coverage. Methods We conducted a decision analysis model-based simulation from the societal perspective, with a 3% discount rate and all costs expressed in 2007 US dollars. Health outcomes and costs were projected over a 30-year period, for persons born in Zambia (population 11,478,000 in 2005) in year 1. Initial development costs for single vaccination and prime-boost strategies were prorated to the Zambian share (0.398%) of global BCG vaccine coverage for newborns. Main outcome measures were TB-related morbidity, mortality, and costs over a range of potential scenarios for vaccine efficacy. Results Relative to the status quo strategy, a BCG replacement vaccine administered at birth, with 70% efficacy in preventing rapid progression to TB disease after initial infection, is estimated to avert 932 TB cases and 422 TB-related deaths (prevention of 199 cases/100,000 vaccinated, and 90 deaths/100,000 vaccinated). This would result in estimated net savings of $3.6 million over 30 years for 468,073 Zambians born in year 1 of the simulation. The addition of a booster at age 10 results in estimated savings of $5.6 million compared to the status quo, averting 1,863 TB cases and 1,011 TB-related deaths (prevention of 398 cases/100,000 vaccinated, and of 216 deaths/100,000 vaccinated). With vaccination at birth alone, net savings would be realized within 1 year, whereas the prime-boost strategy would require an additional 5 years to realize savings, reflecting a greater initial development cost

MAS2-8 radar and digital control unit

NASA Technical Reports Server (NTRS)

Oberg, J. M.; Ulaby, F. T.

1974-01-01

The design of the MAS 2-8 (2 to 8 GHz microwave-active spectrometer), a ground-based sensor system, is presented. A major modification in 1974 to the MAS 2-8, that of a control subsystem to automate the data-taking operation, is the prime focus. The digital control unit automatically changes all system parameters except FM rate and records the return signal on paper tape. The overall system operation and a detailed discussion of the design and operation of the digital control unit are presented.

Cost and cost-effectiveness of newborn home visits: findings from the Newhints cluster-randomised controlled trial in rural Ghana.

PubMed

Pitt, Catherine; Tawiah, Theresa; Soremekun, Seyi; ten Asbroek, Augustinus H A; Manu, Alexander; Tawiah-Agyemang, Charlotte; Hill, Zelee; Owusu-Agyei, Seth; Kirkwood, Betty R; Hanson, Kara

2016-01-01

Every year, 2·9 million newborn babies die worldwide. A meta-analysis of four cluster-randomised controlled trials estimated that home visits by trained community members in programme settings in Ghana and south Asia reduced neonatal mortality by 12% (95% CI 5-18). We aimed to estimate the costs and cost-effectiveness of newborn home visits in a programme setting. We prospectively collected detailed cost data alongside the Newhints trial, which tested the effect of a home-visits intervention in seven districts in rural Ghana and showed a reduction of 8% (95% CI -12 to 25%) in neonatal mortality. The intervention consisted of a package of home visits to pregnant women and their babies in the first week of life by community-based surveillance volunteers. We calculated incremental cost-effectiveness ratios (ICERs) with Monte Carlo simulation and one-way sensitivity analyses and characterised uncertainty with cost-effectiveness planes and cost-effectiveness acceptability curves. We then modelled the potential cost-effectiveness for baseline neonatal mortality rates of 20-60 deaths per 1000 livebirths with use of a meta-analysis of effectiveness estimates. In the 49 zones randomly allocated to receive the Newhints intervention, a mean of 407 (SD 18) community-based surveillance volunteers undertook home visits for 7848 pregnant women who gave birth to 7786 live babies in 2009. Annual economic cost of implementation was US$203 998, or $0·53 per person. In the base-case analysis, the Newhints intervention cost a mean of $10 343 (95% CI 2963 to -7674) per newborn life saved, or $352 (95% CI 104 to -268) per discounted life-year saved, and had a 72% chance of being highly cost effective with respect to Ghana's 2009 gross domestic product per person. Key determinants of cost-effectiveness were the discount rate, protective effectiveness, baseline neonatal mortality rate, and implementation costs. In the scenarios modelled with the meta-analysis results, the ICER

COSTS OF URBAN STORMWATER CONTROL

EPA Science Inventory

This report presents information on the cost of stormwater pollution control facilities in urban areas, including collection, control, and treatment systems. Information on prior cost studies of control technologies and cost estimating models used in these studies was collected,...

COSTS OF URBAN STORMWATER CONTROL

EPA Science Inventory

This paper presents information on the cost of stormwater pollution control facilities in urban areas, including collection, control, and treatment systems. Information on prior cost studies of control technologies and cost estimating models used in these studies was collected, r...

Improving Hypertension Control and Patient Engagement Using Digital Tools.

PubMed

Milani, Richard V; Lavie, Carl J; Bober, Robert M; Milani, Alexander R; Ventura, Hector O

2017-01-01

Hypertension is present in 30% of the adult US population and is a major contributor to cardiovascular disease. The established office-based approach yields only 50% blood pressure control rates and low levels of patient engagement. Available home technology now provides accurate, reliable data that can be transmitted directly to the electronic medical record. We evaluated blood pressure control in 156 patients with uncontrolled hypertension enrolled into a home-based digital-medicine blood pressure program and compared them with 400 patients (matched to age, sex, body mass index, and blood pressure) in a usual-care group after 90 days. Digital-medicine patients completed questionnaires online, were asked to submit at least one blood pressure reading/week, and received medication management and lifestyle recommendations via a clinical pharmacist and a health coach. Blood pressure units were commercially available that transmitted data directly to the electronic medical record. Digital-medicine patients averaged 4.2 blood pressure readings per week. At 90 days, 71% of digital-medicine vs 31% of usual-care patients had achieved target blood pressure control. Mean decrease in systolic/diastolic blood pressure was 14/5 mm Hg in digital medicine, vs 4/2 mm Hg in usual care (P < .001). Excess sodium consumption decreased from 32% to 8% in the digital-medicine group (P = .004). Mean patient activation increased from 41.9 to 44.1 (P = .008), and the percentage of patients with low patient activation decreased from 15% to 6% (P = .03) in the digital-medicine group. A digital hypertension program is feasible and associated with significant improvement in blood pressure control rates and lifestyle change. Utilization of a virtual health intervention using connected devices improves patient activation and is well accepted by patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Development and testing of controller performance evaluation methodology for multi-input/multi-output digital control systems

NASA Technical Reports Server (NTRS)

Pototzky, Anthony; Wieseman, Carol; Hoadley, Sherwood Tiffany; Mukhopadhyay, Vivek

1991-01-01

Described here is the development and implementation of on-line, near real time controller performance evaluation (CPE) methods capability. Briefly discussed are the structure of data flow, the signal processing methods used to process the data, and the software developed to generate the transfer functions. This methodology is generic in nature and can be used in any type of multi-input/multi-output (MIMO) digital controller application, including digital flight control systems, digitally controlled spacecraft structures, and actively controlled wind tunnel models. Results of applying the CPE methodology to evaluate (in near real time) MIMO digital flutter suppression systems being tested on the Rockwell Active Flexible Wing (AFW) wind tunnel model are presented to demonstrate the CPE capability.

IDSAC-IUCAA digital sampler array controller

NASA Astrophysics Data System (ADS)

Chattopadhyay, Sabyasachi; Chordia, Pravin; Ramaprakash, A. N.; Burse, Mahesh P.; Joshi, Bhushan; Chillal, Kalpesh

2016-07-01

In order to run the large format detector arrays and mosaics that are required by most astronomical instruments, readout electronic controllers are required which can process multiple CCD outputs simultaneously at high speeds and low noise levels. These CCD controllers need to be modular and configurable, should be able to run multiple detector types to cater to a wide variety of requirements. IUCAA Digital Sampler Array Controller (IDSAC), is a generic CCD Controller based on a fully scalable architecture which is adequately flexible and powerful enough to control a wide variety of detectors used in ground based astronomy. The controller has a modular backplane architecture that consists of Single Board Controller Cards (SBCs) and can control up to 5 CCDs (mosaic or independent). Each Single Board Controller (SBC) has all the resources to a run Single large format CCD having up to four outputs. All SBCs are identical and are easily interchangeable without needing any reconfiguration. A four channel video processor on each SBC can process up to four output CCDs with or without dummy outputs at 0.5 Megapixels/Sec/Channel with 16 bit resolution. Each SBC has a USB 2.0 interface which can be connected to a host computer via optional USB to Fibre converters. The SBC uses a reconfigurable hardware (FPGA) as a Master Controller. IDSAC offers Digital Correlated Double Sampling (DCDS) to eliminate thermal kTC noise. CDS performed in Digital domain (DCDS) has several advantages over its analog counterpart, such as - less electronics, faster readout and easier post processing. It is also flexible with sampling rate and pixel throughput while maintaining the core circuit topology intact. Noise characterization of the IDSAC CDS signal chain has been performed by analytical modelling and practical measurements. Various types of noise such as white, pink, power supply, bias etc. has been considered while creating an analytical noise model tool to predict noise of a controller

Reducing disability in community-dwelling frail older people: cost-effectiveness study alongside a cluster randomised controlled trial.

PubMed

Metzelthin, Silke F; van Rossum, Erik; Hendriks, Marike R C; De Witte, Luc P; Hobma, Sjoerd O; Sipers, Walther; Kempen, Gertrudis I J M

2015-05-01

although proactive primary care, including early detection and treatment of community-dwelling frail older people, is a part of the national healthcare policy in several countries, little is known about its cost-effectiveness. to evaluate the cost-effectiveness of a proactive primary care approach in community-dwelling frail older people. embedded in a cluster randomised trial among 12 Dutch general practitioner practices, an economic evaluation was performed from a societal perspective with a time horizon of 24 months. frail older people in the intervention group received an in-home assessment and interdisciplinary care based on a tailor-made treatment plan and regular evaluation and follow-up. Practices in the control group delivered usual care. The primary outcome for the cost-effectiveness and cost-utility analysis was disability and health-related quality of life, respectively. multilevel analyses among 346 frail older people showed no significant differences between the groups regarding disability and health-related quality of life at 24 months. People in the intervention group used, as expected, more primary care services, but there was no decline in more expensive hospital and long-term care. Total costs over 24 months tended to be higher in the intervention group than in the control group (€26,503 versus €20,550, P = 0.08). the intervention under study led to an increase in healthcare utilisation and related costs without providing any beneficial effects. This study adds to the scarce amount of evidence of the cost-effectiveness of proactive primary care in community-dwelling frail older people. Current Controlled Trials, ISRCTN 31954692. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Challenges in Measuring Outcomes Following Digital Replantation

PubMed Central

Sebastin, Sandeep J.; Chung, Kevin C.

2013-01-01

In the early period of replantation surgery, the emphasis was on digit survival. Subsequently, with better microsurgical techniques and instrumentation, the focus has shifted to function and in recent years to consideration of cost-effectiveness. Despite over 40 years of effort in refining digital replantation surgery, a rigorous evaluation of the outcomes of digital replantation has not been performed. This is because of the many confounding variables that influence outcome comparisons. These variables include the mechanism of injury (guillotine, crush, avulsion), the injury itself (total, near total, subtotal, partial amputation), and the surgical procedure (replantation, revascularization). In addition, the traditional outcome measures (two-point discrimination, range of motion, grip strength, or the ability to return to work) are reported inconsistently and vary widely among publications. All these factors make meaningful comparison of outcomes difficult. The recent emphasis on outcome research and cost-effectiveness necessitates a rethinking in the way we report outcomes of digital replantation. In this article, the authors summarize the challenges in assessing outcomes of digital replantation and explain the need to measure outcomes using rigorous clinical research designs that incorporate cost-effectiveness studies in the research protocol. PMID:24872766

E-learning: controlling costs and increasing value.

PubMed

Walsh, Kieran

2015-04-01

E-learning now accounts for a substantial proportion of medical education provision. This progress has required significant investment and this investment has in turn come under increasing scrutiny so that the costs of e-learning may be controlled and its returns maximised. There are multiple methods by which the costs of e-learning can be controlled and its returns maximised. This short paper reviews some of those methods that are likely to be most effective and that are likely to save costs without compromising quality. Methods might include accessing free or low-cost resources from elsewhere; create short learning resources that will work on multiple devices; using open source platforms to host content; using in-house faculty to create content; sharing resources between institutions; and promoting resources to ensure high usage. Whatever methods are used to control costs or increase value, it is most important to evaluate the impact of these methods.

Computer aided design of digital controller for radial active magnetic bearings

NASA Technical Reports Server (NTRS)

Cai, Zhong; Shen, Zupei; Zhang, Zuming; Zhao, Hongbin

1992-01-01

A five degree of freedom Active Magnetic Bearing (AMB) system is developed which is controlled by digital controllers. The model of the radial AMB system is linearized and the state equation is derived. Based on the state variables feedback theory, digital controllers are designed. The performance of the controllers are evaluated according to experimental results. The Computer Aided Design (CAD) method is used to design controllers for magnetic bearings. The controllers are implemented with a digital signal processing (DSP) system. The control algorithms are realized with real-time programs. It is very easy to change the controller by changing or modifying the programs. In order to identify the dynamic parameters of the controlled magnetic system, a special experiment was carried out. Also, the online Recursive Least Squares (RLS) parameter identification method is studied. It can be realized with the digital controllers. Online parameter identification is essential for the realization of an adaptive controller.

Quadruplex digital flight control system assessment

NASA Technical Reports Server (NTRS)

Mulcare, D. B.; Downing, L. E.; Smith, M. K.

1988-01-01

Described are the development and validation of a double fail-operational digital flight control system architecture for critical pitch axis functions. Architectural tradeoffs are assessed, system simulator modifications are described, and demonstration testing results are critiqued. Assessment tools and their application are also illustrated. Ultimately, the vital role of system simulation, tailored to digital mechanization attributes, is shown to be essential to validating the airworthiness of full-time critical functions such as augmented fly-by-wire systems for relaxed static stability airplanes.

Community-based youth tobacco control interventions: cost effectiveness of the Full Court Press project.

PubMed

Ross, Hana; Powell, Lisa M; Bauer, Joseph E; Levy, David T; Peck, Richard M; Lee, Hye-Ryeon

2006-01-01

We evaluated the impact of a community-based tobacco control project that was implemented in the city of Tucson, Arizona, USA, between 1996 and 2001. The project's goal was to reduce the prevalence of youth smoking through change in social norms at schools and in communities and workplaces. As is often the case, these community-based health promotion interventions were implemented in conjunction with other broader programmes, in this case implemented on the state level. Taking into account state level interventions as well as changes in sociodemographic and economic environment over the course of the project (e.g. increases in cigarette prices), we measure the net effect of the intervention in terms of the number of people who quit or did not initiate smoking and by the discounted life-years gained. To establish the value of investing into community-based intervention, we calculated the real discounted cost per quit and per life-year gained of 3789 US dollars and 3942 US dollars, respectively. These compare favourably with the real cost per quit of 4270 US dollars when implementing the 1996 US Clinical Practice Guideline for smoking cessation but exceed the real cost of 2923 US dollars per discounted life-year gained when following the guideline. A sensitivity analysis that assumed 5% programme persistence (i.e. 5% of the programme's impact would last forever in the absence of future funding for the programme), one-third would relapse and that one-third of those who quit may have quit smoking even without the programme, suggested a lower cost per discounted life-year saved of 3476 US dollars. The cost effectiveness of this project compares favourably with other tobacco control interventions. Despite its relatively small target group, this community-based intervention was cost effective.

Cost-effectiveness of a distance lifestyle counselling programme among overweight employees from a company perspective, ALIFE@Work: a randomized controlled trial.

PubMed

Gussenhoven, A H M; van Wier, M F; Bosmans, J E; Dekkers, J C; van Mechelen, W

2013-01-01

The objective of this study was to determine whether a lifestyle intervention with individual counselling was cost-effective for reducing body weight compared with usual care from a company perspective. Overweight employees were recruited and randomly assigned to the intervention groups, either phone or Internet, or the control group. The intervention was based on a cognitive behavioural approach and addressed physical activity and diet. Self-reported body weight was collected at baseline and 12 months follow-up. Intervention costs and costs of sick leave days based on gross and net lost productivity days (GLPDs/NLPDs) obtained from the participating companies were calculated. Missing data were imputed using multiple imputation techniques. Uncertainty surrounding the differences in costs and the incremental cost-effectiveness ratios (ICER) was estimated by bootstrapping techniques, and presented on cost-effectiveness planes and cost-effectiveness acceptability curves. No statistically significant differences in total costs were found between the intervention groups and control group, though mean total costs in both intervention groups tended to be higher than those in the control group. The ICER of the Internet group compared with the control group was €59 per kilogram of weight loss based on GLPD costs. The probability of cost effectiveness of the Internet intervention was 45% at a willingness-to-pay of €0 per extra kilogram weight loss and 75% at a willingness-to-pay of €1500 per extra kilogram body weight loss. Comparable results were found for the phone intervention. The intervention was not cost effective in comparison with usual care from the company perspective. Due to the large amount of missing data, it is not possible to draw firm conclusions.

Digital Optical Control System

NASA Astrophysics Data System (ADS)

Jordan, David H.; Tipton, Charles A.; Christmann, Charles E.; Hochhausler, Nils P.

1988-09-01

We describe the digital optical control system (DOGS), a state-of-the-art controller for electrical feedback in an optical system. The need for a versatile optical controller arose from a number of unique experiments being performed by the Air Force Weapons Laboratory. These experiments use similar detectors and actuator-controlled mirrors, but the control requirements vary greatly. The experiments have in common a requirement for parallel control systems. The DOGS satisfies these needs by allowing several control systems to occupy a single chassis with one master controller. The architecture was designed to allow upward compatibility with future configurations. Combinations of off-the-shelf and custom boards are configured to meet the requirements of each experiment. The configuration described here was used to control piston error to X/80 at a wavelength of 0.51 Am. A peak sample rate of 8 kHz, yielding a closed loop bandwidth of 800 Hz, was achieved.

The cost and cost-effectiveness of opportunistic screening for Chlamydia trachomatis in Ireland.

PubMed

Gillespie, Paddy; O'Neill, Ciaran; Adams, Elisabeth; Turner, Katherine; O'Donovan, Diarmuid; Brugha, Ruairi; Vaughan, Deirdre; O'Connell, Emer; Cormican, Martin; Balfe, Myles; Coleman, Claire; Fitzgerald, Margaret; Fleming, Catherine

2012-04-01

The objective of this study was to estimate the cost and cost-effectiveness of opportunistic screening for Chlamydia trachomatis in Ireland. Prospective cost analysis of an opportunistic screening programme delivered jointly in three types of healthcare facility in Ireland. Incremental cost-effectiveness analysis was performed using an existing dynamic modelling framework to compare screening to a control of no organised screening. A healthcare provider perspective was adopted with respect to costs and included the costs of screening and the costs of complications arising from untreated infection. Two outcome measures were examined: major outcomes averted, comprising cases of pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility in women, neonatal conjunctivitis and pneumonia, and epididymitis in men; and quality-adjusted life-years (QALY) gained. Uncertainty was explored using sensitivity analyses and cost-effectiveness acceptability curves. The average cost per component of screening was estimated at €26 per offer, €66 per negative case, €152 per positive case and €74 per partner notified and treated. The modelled screening scenario was projected to be more effective and more costly than the control strategy. The incremental cost per major outcomes averted was €6093, and the incremental cost per QALY gained was €94,717. For cost-effectiveness threshold values of €45,000 per QALY gained and lower, the probability of the screening being cost effective was estimated at <1%. An opportunistic chlamydia screening programme, as modelled in this study, would be expensive to implement nationally and is unlikely to be judged cost effective by policy makers in Ireland.

Flight testing the Digital Electronic Engine Control (DEEC) A unique management experience

NASA Technical Reports Server (NTRS)

Putnam, T. W.; Burcham, F. W., Jr.; Kock, B. M.

1983-01-01

The concept for the DEEC had its origin in the early 1970s. At that time it was recognized that the F100 engine performance, operability, reliability, and cost could be substantially improved by replacing the original mechanical/supervisory electronic control system with a full-authority digital control system. By 1978, the engine manufacturer had designed and initiated the procurement of flight-qualified control system hardware. As a precursor to an integrated controls program, a flight evaluation of the DEEC system on the F-15 aircraft was proposed. Questions regarding the management of the DEEC flight evaluation program are discussed along with the program elements, the technical results of the F-15 evaluation, and the impact of the flight evaluation on after-burning turbofan controls technology and its use in and application to military aircraft. The lessons learned through the conduct of the program are discussed.

Searching for the most cost-effective strategy for controlling epidemics spreading on regular and small-world networks

PubMed Central

Kleczkowski, Adam; Oleś, Katarzyna; Gudowska-Nowak, Ewa; Gilligan, Christopher A.

2012-01-01

We present a combined epidemiological and economic model for control of diseases spreading on local and small-world networks. The disease is characterized by a pre-symptomatic infectious stage that makes detection and control of cases more difficult. The effectiveness of local (ring-vaccination or culling) and global control strategies is analysed by comparing the net present values of the combined cost of preventive treatment and illness. The optimal strategy is then selected by minimizing the total cost of the epidemic. We show that three main strategies emerge, with treating a large number of individuals (global strategy, GS), treating a small number of individuals in a well-defined neighbourhood of a detected case (local strategy) and allowing the disease to spread unchecked (null strategy, NS). The choice of the optimal strategy is governed mainly by a relative cost of palliative and preventive treatments. If the disease spreads within the well-defined neighbourhood, the local strategy is optimal unless the cost of a single vaccine is much higher than the cost associated with hospitalization. In the latter case, it is most cost-effective to refrain from prevention. Destruction of local correlations, either by long-range (small-world) links or by inclusion of many initial foci, expands the range of costs for which the NS is most cost-effective. The GS emerges for the case when the cost of prevention is much lower than the cost of treatment and there is a substantial non-local component in the disease spread. We also show that local treatment is only desirable if the disease spreads on a small-world network with sufficiently few long-range links; otherwise it is optimal to treat globally. In the mean-field case, there are only two optimal solutions, to treat all if the cost of the vaccine is low and to treat nobody if it is high. The basic reproduction ratio, R0, does not depend on the rate of responsive treatment in this case and the disease always invades (but

Searching for the most cost-effective strategy for controlling epidemics spreading on regular and small-world networks.

PubMed

Kleczkowski, Adam; Oleś, Katarzyna; Gudowska-Nowak, Ewa; Gilligan, Christopher A

2012-01-07

We present a combined epidemiological and economic model for control of diseases spreading on local and small-world networks. The disease is characterized by a pre-symptomatic infectious stage that makes detection and control of cases more difficult. The effectiveness of local (ring-vaccination or culling) and global control strategies is analysed by comparing the net present values of the combined cost of preventive treatment and illness. The optimal strategy is then selected by minimizing the total cost of the epidemic. We show that three main strategies emerge, with treating a large number of individuals (global strategy, GS), treating a small number of individuals in a well-defined neighbourhood of a detected case (local strategy) and allowing the disease to spread unchecked (null strategy, NS). The choice of the optimal strategy is governed mainly by a relative cost of palliative and preventive treatments. If the disease spreads within the well-defined neighbourhood, the local strategy is optimal unless the cost of a single vaccine is much higher than the cost associated with hospitalization. In the latter case, it is most cost-effective to refrain from prevention. Destruction of local correlations, either by long-range (small-world) links or by inclusion of many initial foci, expands the range of costs for which the NS is most cost-effective. The GS emerges for the case when the cost of prevention is much lower than the cost of treatment and there is a substantial non-local component in the disease spread. We also show that local treatment is only desirable if the disease spreads on a small-world network with sufficiently few long-range links; otherwise it is optimal to treat globally. In the mean-field case, there are only two optimal solutions, to treat all if the cost of the vaccine is low and to treat nobody if it is high. The basic reproduction ratio, R(0), does not depend on the rate of responsive treatment in this case and the disease always invades

Are digital interventions for smoking cessation in pregnancy effective? A systematic review protocol.

PubMed

Griffiths, Sarah Ellen; Brown, Katherine E; Fulton, Emily Anne; Tombor, Ildiko; Naughton, Felix

2016-12-01

Behavioural support for smoking cessation in pregnancy can be effective; however, many pregnant women face barriers to seeking support to stop smoking. Some digital interventions have been found to be effective for smoking cessation in the general population and may be effective for supporting cessation in pregnancy due to their flexibility and the potential for personalisation. To date, there is limited evidence of the effectiveness of digital interventions for smoking cessation in pregnancy. This review aims to assess the following: (1) whether digital interventions are effective at promoting smoking cessation among pregnant women; (2) which behaviour change techniques (BCTs) or combinations of BCTs are associated with the effectiveness of digital interventions for smoking cessation in pregnancy; and (3) whether the number of BCTs used is associated with the effectiveness of digital interventions for smoking cessation in pregnancy. This review will include digital interventions delivered largely through computer (PC or laptop), video/DVD, mobile phone (including smartphones) or portable handheld device (e.g. tablet, iPad) and include websites, mobile or tablet applications and SMS text messages. Interventions must be randomised or quasi-randomised controlled trials aimed at women who smoke in pregnancy, with smoking cessation as a measured outcome (preferably the latest available point prevalence smoking status measure taken during pregnancy, biochemically verified if available). Electronic bibliographic databases will be searched to identify suitable studies indexed in the following: Academic Search Complete, ASSIA, CINAHL, The Cochrane Library, EMBASE, Medline, PsycINFO, Scopus, and Web of Science. The search strategy will include key words and database-specific subject headings relating to 'pregnancy' and 'smoking' and synonyms for the terms 'digital' and 'randomised controlled trial'. Where required and where possible, the first and second authors will

Cost effectiveness analysis of Year 2 of an elementary school-located influenza vaccination program-Results from a randomized controlled trial.

PubMed

Yoo, Byung-Kwang; Humiston, Sharon G; Szilagyi, Peter G; Schaffer, Stanley J; Long, Christine; Kolasa, Maureen

2015-11-16

School-located vaccination against influenza (SLV-I) has the potential to improve current suboptimal influenza immunization coverage for U.S. school-aged children. However, little is known about SLV-I's cost-effectiveness. The objective of this study is to establish the cost-effectiveness of SLV-I based on a two-year community-based randomized controlled trial (Year 1: 2009-2010 vaccination season, an unusual H1N1 pandemic influenza season, and Year 2: 2010-2011, a more typical influenza season). We performed a cost-effectiveness analysis on a two-year randomized controlled trial of a Western New York SLV-I program. SLV-I clinics were offered in 21 intervention elementary schools (Year 1 n = 9,027; Year 2 n = 9,145 children) with standard-of-care (no SLV-I) in control schools (Year 1 n = 4,534 (10 schools); Year 2 n = 4,796 children (11 schools)). We estimated the cost-per-vaccinated child, by dividing the incremental cost of the intervention by the incremental effectiveness (i.e., the number of additionally vaccinated students in intervention schools compared to control schools). In Years 1 and 2, respectively, the effectiveness measure (proportion of children vaccinated) was 11.2 and 12.0 percentage points higher in intervention (40.7 % and 40.4 %) than control schools. In year 2, the cost-per-vaccinated child excluding vaccine purchase ($59.88 in 2010 US $) consisted of three component costs: (A) the school costs ($8.25); (B) the project coordination costs ($32.33); and (C) the vendor costs excluding vaccine purchase ($16.68), summed through Monte Carlo simulation. Compared to Year 1, the two component costs (A) and (C) decreased, while the component cost (B) increased in Year 2. The cost-per-vaccinated child, excluding vaccine purchase, was $59.73 (Year 1) and $59.88 (Year 2, statistically indistinguishable from Year 1), higher than the published cost of providing influenza vaccination in medical practices ($39.54). However, taking indirect costs (e.g., averted

Digital control analysis and design of a field-sensed magnetic suspension system.

PubMed

Li, Jen-Hsing; Chiou, Juing-Shian

2015-03-13

Magnetic suspension systems are mechatronic systems and crucial in several engineering applications, such as the levitation of high-speed trains, frictionless bearings, and wind tunnels. Magnetic suspension systems are nonlinear and unstable systems; therefore, they are suitable educational benchmarks for testing various modeling and control methods. This paper presents the digital modeling and control of magnetic suspension systems. First, the magnetic suspension system is stabilized using a digital proportional-derivative controller. Subsequently, the digital model is identified using recursive algorithms. Finally, a digital mixed linear quadratic regulator (LQR)/H∞ control is adopted to stabilize the magnetic suspension system robustly. Simulation examples and a real-world example are provided to demonstrate the practicality of the study results. In this study, a digital magnetic suspension system model was developed and reviewed. In addition, equivalent state and output feedback controls for magnetic suspension systems were developed. Using this method, the controller design for magnetic suspension systems was simplified, which is the novel contribution of this study. In addition, this paper proposes a complete digital controller design procedure for magnetic suspension systems.

Cost-utility analysis of case management for frail older people: effects of a randomised controlled trial.

PubMed

Sandberg, Magnus; Jakobsson, Ulf; Midlöv, Patrik; Kristensson, Jimmie

2015-12-01

To evaluate the effects of a case management intervention for frail older people (aged 65+ years) by cost and utility. One hundred and fifty-three frail older people living at home were randomly assigned to either an intervention (n = 80) or a control group (n = 73). The 1-year intervention was carried out by nurses and physiotherapists working as case managers, who undertook home visits at least once a month. Differences in costs and quality-adjusted life years (QALYs) based on the health-related quality-of-life instruments EQ-5D and EQ-VAS, and also the incremental cost-effectiveness ratio were investigated. All analyses used the intention-to-treat principle. There were no significant differences between the intervention group and control group for total cost, EQ-5D-based QALY or EQ-VAS-based QALY for the 1-year study. Incremental cost-effectiveness ratio was not conducted because no significant differences were found for either EQ-5D- or EQ-VAS-based QALY, or costs. However, the intervention group had significantly lower levels of informal care and help with instrumental activities of daily living both as costs (3,927 vs. 6,550, p = 0.037) and provided hours (200 vs. 333 hours per year, p = 0.037). The intervention was cost neutral and does not seem to have affected health-related quality of life for the 1-year study, which may be because the follow-up period was too short. The intervention seems to have reduced hours and cost of informal care and help required with instrumental activities of daily living. This suggests that the intervention provides relief to informal caregivers.

Cost-effectiveness of FENO-based and web-based monitoring in paediatric asthma management: a randomised controlled trial.

PubMed

Beerthuizen, Thijs; Voorend-van Bergen, Sandra; van den Hout, Wilbert B; Vaessen-Verberne, Anja A; Brackel, Hein J; Landstra, Anneke M; van den Berg, Norbert J; de Jongste, Johan C; Merkus, Peter J; Pijnenburg, Mariëlle W; Sont, Jacob K

2016-07-01

In children with asthma, web-based monitoring and inflammation-driven therapy may lead to improved asthma control and reduction in medications. However, the cost-effectiveness of these monitoring strategies is yet unknown. We assessed the cost-effectiveness of web-based monthly monitoring and of 4-monthly monitoring of FENO as compared with standard care. An economic evaluation was performed alongside a randomised controlled multicentre trial with a 1-year follow-up. Two hundred and seventy-two children with asthma, aged 4-18 years, were randomised to one of three strategies. In standard care, treatment was adapted according to Asthma Control Test (ACT) at 4-monthly visits, in the web-based strategy also according to web-ACT at 1 month intervals, and in the FENO-based strategy according to ACT and FENO at 4-monthly visits. Outcome measures were patient utilities, healthcare costs, societal costs and incremental cost per quality-adjusted life year (QALY) gained. No statistically significant differences were found in QALYs and costs between the three strategies. The web-based strategy had 77% chance of being most cost-effective from a healthcare perspective at a willingness to pay a generally accepted €40 000/QALY. The FENO-based strategy had 83% chance of being most cost-effective at €40 000/QALY from a societal perspective. Economically, web-based monitoring was preferred from a healthcare perspective, while the FENO-based strategy was preferred from a societal perspective, although in QALYs and costs no statistically significant changes were found as compared with standard care. As clinical outcomes also favoured the web-based and FENO-based strategies, these strategies may be useful additions to standard care. Netherlands Trial Register (NTR1995). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Estimating costs of sea lice control strategy in Norway.

PubMed

Liu, Yajie; Bjelland, Hans Vanhauwaer

2014-12-01

This paper explores the costs of sea lice control strategies associated with salmon aquaculture at a farm level in Norway. Diseases can cause reduction in growth, low feed efficiency and market prices, increasing mortality rates, and expenditures on prevention and treatment measures. Aquaculture farms suffer the most direct and immediate economic losses from diseases. The goal of a control strategy is to minimize the total disease costs, including biological losses, and treatment costs while to maximize overall profit. Prevention and control strategies are required to eliminate or minimize the disease, while cost-effective disease control strategies at the fish farm level are designed to reduce the losses, and to enhance productivity and profitability. Thus, the goal can be achieved by integrating models of fish growth, sea lice dynamics and economic factors. A production function is first constructed to incorporate the effects of sea lice on production at a farm level, followed by a detailed cost analysis of several prevention and treatment strategies associated with sea lice in Norway. The results reveal that treatments are costly and treatment costs are very sensitive to treatment types used and timing of the treatment conducted. Applying treatment at an early growth stage is more economical than at a later stage. Copyright © 2014 Elsevier B.V. All rights reserved.

Costs and cost-effectiveness analysis of treatment in children with eczema by nurse practitioner vs. dermatologist: results of a randomized, controlled trial and a review of international costs.

PubMed

Schuttelaar, M L A; Vermeulen, K M; Coenraads, P J

2011-09-01

In a randomized, controlled trial (RCT) on childhood eczema we reported that substituting nurse practitioners (NPs) for dermatologists resulted in similar outcomes of eczema severity and in the quality of life, and higher patient satisfaction. To determine costs and cost-effectiveness of care provided by NPs vs. dermatologists and to compare our results with those in studies from other countries. We estimated the healthcare costs, family costs and the costs in other sectors alongside the RCT. All the costs were linked to quality of life [Infants' Dermatitis Quality of Life Index (IDQOL), Children's Dermatology Life Quality Index (CDLQI)] and to patient satisfaction (Client Satisfaction Questionnaire-8) to determine the incremental cost-effectiveness ratio (ICER). We also examined all the reported studies on the costs of childhood eczema. The mean annual healthcare costs, family costs and costs in other sectors were €658, €302 and €21, respectively, in the NP group and €801, €608 and €0·93, respectively, in the dermatologist group. The ICER in the NP group compared with the dermatologist group indicated €925 and €751 savings per one point less improvement in IDQOL and CDLQI, respectively, and €251 savings per one point more satisfaction in the NP group at 12 months. The mean annual healthcare costs and family costs varied considerably in the six identified studies. Substituting NPs for dermatologists is both cost-saving and cost-effective. The treatment of choice is that provided by the NPs as it is similarly effective to treatment provided by a dermatologist with a higher parent satisfaction. International comparisons are difficult because the types of costs determined, the units and unit prices, and eczema severity all differ between studies. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

Cost-effectiveness and budget impact analyses of a long-term hypertension detection and control program for stroke prevention.

PubMed

Yamagishi, Kazumasa; Sato, Shinichi; Kitamura, Akihiko; Kiyama, Masahiko; Okada, Takeo; Tanigawa, Takeshi; Ohira, Tetsuya; Imano, Hironori; Kondo, Masahide; Okubo, Ichiro; Ishikawa, Yoshinori; Shimamoto, Takashi; Iso, Hiroyasu

2012-09-01

The nation-wide, community-based intensive hypertension detection and control program, as well as universal health insurance coverage, may well be contributing factors for helping Japan rank near the top among countries with the longest life expectancy. We sought to examine the cost-effectiveness of such a community-based intervention program, as no evidence has been available for this issue. The hypertension detection and control program was initiated in 1963 in full intervention and minimal intervention communities in Akita, Japan. We performed comparative cost-effectiveness and budget-impact analyses for the period 1964-1987 of the costs of public health services and treatment of patients with hypertension and stroke on the one hand, and incidence of stroke on the other in the full intervention and minimal intervention communities. The program provided in the full intervention community was found to be cost saving 13 years after the beginning of program in addition to the fact of effectiveness that; the prevalence and incidence of stroke were consistently lower in the full intervention community than in the minimal intervention community throughout the same period. The incremental cost was minus 28,358 yen per capita over 24 years. The community-based intensive hypertension detection and control program was found to be both effective and cost saving. The national government's policy to support this program may have contributed in part to the substantial decline in stroke incidence and mortality, which was largely responsible for the increase in Japanese life expectancy.

Digital Baseband Architecture For Transponder

NASA Technical Reports Server (NTRS)

Nguyen, Tien M.; Yeh, Hen-Geul

1995-01-01

Proposed advanced transponder for long-distance radio communication system with turnaround ranging contains carrier-signal-tracking loop including baseband digital "front end." For reduced cost, transponder includes analog intermediate-frequency (IF) section and analog automatic gain control (AGC) loop at first of two IF mixers. However, second IF mixer redesigned to ease digitization of baseband functions. To conserve power and provide for simpler and smaller transponder hardware, baseband digital signal-processing circuits designed to implement undersampling scheme. Furthermore, sampling scheme and sampling frequency chosen so redesign involves minimum modification of command-detector unit (CDU).

Cost effectiveness of the occupation-based approach for subacute stroke patients: result of a randomized controlled trial.

PubMed

Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Nagatani, Ryutaro; Izumi, Ryota; Moriwaki, Kensuke; Yamauchi, Keita

2017-07-01

The cost effectiveness of occupational therapy for subacute stroke patients is unclear in the extant literature. Consequently, this study determined the cost effectiveness of the occupation-based approach using Aid for Decision-Making in Occupation Choice (ADOC) for subacute stroke patients compared with an impairment-based approach. We conducted an economic evaluation from a societal perspective alongside a pilot randomized controlled trial, with a single blind assessor for participants in 10 subacute rehabilitation units in Japan. The intervention group received occupation-based goal setting using ADOC, with interventions focused on meaningful occupations. The control group received an impairment-based approach focused on restoring capacities. For both groups, occupational-therapy intervention was administered more than five times per week, for over 40 min each time, and they received physical and speech therapy prior to discharge. The main outcomes were quality-adjusted life years (QALYs) and total costs. Further, sensitivity analyses were performed to examine the influence of parameter uncertainty on the base case results. The final number of participants was 24 in each of the two groups. In terms of QALYs, the intervention group is significantly higher than the control group (p = 0.001, difference 95% CI: 0.002-0.008) and total costs are not statistically significant. Applying a willingness-to-pay threshold of JPY 5 million/QALY, the probability of the occupation-based approach using ADOC being cost effective was estimated to be 65.3%. The results show that the occupation-based approach is associated with significantly improved QALYs and has potential cost effectiveness, compared with the impairment-based approach.

Cost-Effectiveness Analysis of Trauma-Focused Cognitive Behavioral Therapy: A Randomized Control Trial among Norwegian Youth.

PubMed

Aas, Eline; Iversen, Tor; Holt, Tonje; Ormhaug, Silje M; Jensen, Tine K

2018-06-07

Traumatic events by young people can adversely affect their psychological and social well-being when left untreated. This can result in high costs for society. In this study, we aimed to evaluate whether trauma-focused cognitive behavioral therapy (TF-CBT) is a cost-effective alternative to therapy as usual (TAU). Individual-level data were collected from 2008 to 2013, as part of a randomized control trial in Norwegian youth, 10-18 years of age, presenting with symptoms of posttraumatic stress (N = 156). Health outcomes, costs, and patient and family characteristics were recorded. Health-related quality of life (HRQoL) was measured with the 16D instrument, and quality-adjusted life-years (QALYs) were derived; total costs included the costs of therapy, and last we calculated the incremental cost-effectiveness ratio (ratio of differences in costs and QALYs gained). We performed nonparametric bootstrapping and used the results to draw a cost-effectiveness acceptability curve depicting the probability that TF-CBT is cost-effective. HRQoL increased in both treatment groups, whereas no significant differences in QALYs were observed. Resource use measured in minutes per session was significantly higher in the TF-CBT group; however, total minutes of therapy and costs were not significantly different between the two groups. In addition, use of resources, such as psychological counseling services, welfare services, and medication, was lower in the TF-CBT group posttreatment. The likelihood of TF-CBT being cost-effective varied from 91% to 96%. TF-CBT is likely to be a cost-effective alternative to standard treatment and should be recommended as the guideline treatment for youth with posttraumatic stress disorder.

Improving the delivery of care and reducing healthcare costs with the digitization of information.

PubMed

Noffsinger, R; Chin, S

2000-01-01

In the coming years, the digitization of information and the Internet will be extremely powerful in reducing healthcare costs while assisting providers in the delivery of care. One example of healthcare inefficiency that can be managed through information digitization is the process of prescription writing. Due to the handwritten and verbal communication surrounding prescription writing, as well as the multiple tiers of authorizations, the prescription drug process causes extensive financial waste as well as medical errors, lost time, and even fatal accidents. Electronic prescription management systems are being designed to address these inefficiencies. By utilizing new electronic prescription systems, physicians not only prescribe more accurately, but also improve formulary compliance thereby reducing pharmacy utilization. These systems expand patient care by presenting proactive alternatives at the point of prescription while reducing costs and providing additional benefits for consumers and healthcare providers.

a Review of Digital Watermarking and Copyright Control Technology for Cultural Relics

NASA Astrophysics Data System (ADS)

Liu, H.; Hou, M.; Hu, Y.

2018-04-01

With the rapid growth of the application and sharing of the 3-D model data in the protection of cultural relics, the problem of Shared security and copyright control of the three-dimensional model of cultural relics is becoming increasingly prominent. Followed by a digital watermarking copyright control has become the frontier technology of 3-D model security protection of cultural relics and effective means, related technology research and application in recent years also got further development. 3-D model based on cultural relics digital watermarking and copyright control technology, introduces the research background and demand, its unique characteristics were described, and its development and application of the algorithm are discussed, and the prospects of the future development trend and some problems and the solution.

A cost-effectiveness analysis of online, radio and print tobacco control advertisements targeting 25-39 year-old males.

PubMed

Clayforth, Cassandra; Pettigrew, Simone; Mooney, Katie; Lansdorp-Vogelaar, Iris; Rosenberg, Michael; Slevin, Terry

2014-06-01

To assess the relative cost-effectiveness of various non-television advertising media in encouraging 25-39 year-old male smokers to respond to a cessation-related call to action. Information about how new electronic media compare in effectiveness is important to inform the implementation of future tobacco control media campaigns. Two testimonial advertisements featuring members of the target group were developed for radio, press and online media. Multiple waves of media activity were scheduled over a period of seven weeks, including an initial integrated period that included all three media and subsequent single media phases that were interspersed with a week of no media activity. The resulting Quit website hits, Quitline telephone calls, and registrations to online and telephone counselling services were compared to advertising costs to determine the relative cost-effectiveness of each media in isolation and the integrated approach. The online-only campaign phase was substantially more cost-effective than the other phases, including the integrated approach. This finding is contrary to the current assumption that the use of a consistent message across multiple media simultaneously is the most cost-effective way of reaching and affecting target audiences. Online advertising may be a highly cost-effective channel for low-budget tobacco control media campaigns. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

Low-cost conversion of the Polaroid MD-4 land camera to a digital gel documentation system.

PubMed

Porch, Timothy G; Erpelding, John E

2006-04-30

A simple, inexpensive design is presented for the rapid conversion of the popular MD-4 Polaroid land camera to a high quality digital gel documentation system. Images of ethidium bromide stained DNA gels captured using the digital system were compared to images captured on Polaroid instant film. Resolution and sensitivity were enhanced using the digital system. In addition to the low cost and superior image quality of the digital system, there is also the added convenience of real-time image viewing through the swivel LCD of the digital camera, wide flexibility of gel sizes, accurate automatic focusing, variable image resolution, and consistent ease of use and quality. Images can be directly imported to a computer by using the USB port on the digital camera, further enhancing the potential of the digital system for documentation, analysis, and archiving. The system is appropriate for use as a start-up gel documentation system and for routine gel analysis.

F-8C digital CCV flight control laws

NASA Technical Reports Server (NTRS)

Hartmann, G. L.; Hauge, J. A.; Hendrick, R. C.

1976-01-01

A set of digital flight control laws were designed for the NASA F-8C digital fly-by-wire aircraft. The control laws emphasize Control Configured Vehicle (CCV) benefits. Specific pitch axis objectives were improved handling qualities, angle-of-attack limiting, gust alleviation, drag reduction in steady and maneuvering flight, and a capability to fly with reduced static stability. The lateral-directional design objectives were improved Dutch roll damping and turn coordination over a wide range in angle-of-attack. An overall program objective was to explore the use of modern control design methodilogy to achieve these specific CCV benefits. Tests for verifying system integrity, an experimental design for handling qualities evaluation, and recommended flight test investigations were specified.

The design of digital-adaptive controllers for VTOL aircraft

NASA Technical Reports Server (NTRS)

Stengel, R. F.; Broussard, J. R.; Berry, P. W.

1976-01-01

Design procedures for VTOL automatic control systems have been developed and are presented. Using linear-optimal estimation and control techniques as a starting point, digital-adaptive control laws have been designed for the VALT Research Aircraft, a tandem-rotor helicopter which is equipped for fully automatic flight in terminal area operations. These control laws are designed to interface with velocity-command and attitude-command guidance logic, which could be used in short-haul VTOL operations. Developments reported here include new algorithms for designing non-zero-set-point digital regulators, design procedures for rate-limited systems, and algorithms for dynamic control trim setting.

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

PubMed

Janzic, Andrej; Kos, Mitja

2015-04-01

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

Digital Avionics Information System (DAIS): Impact of DAIS Concept on Life Cycle Cost--Supplement. Final Report.

ERIC Educational Resources Information Center

Goclowski, John C.; And Others

This supplement to a technical report providing the results of a preliminary investigation of the potential impact of the Digital Avionics Information System (DAIS) concept on system support personnel requirements and life cycle cost (LCC) includes: (1) additional details of the cost comparison of a hypothetical application of a conceptual…

A digital control system for high level acoustic noise generation

NASA Technical Reports Server (NTRS)

Lee, John P.; Bosco, Jerry H.

1986-01-01

As part of the modernization of the Acoustic Test Facility at Lockheed Missiles and Space Company, Sunnyvale, a digital acoustic control system was designed and built. The requirements imposed by Lockheed on the control system and the degree to which those requirements were met are discussed. Acceptance test results as well as some of the features of the digital control system not found in traditional manual control systems are discussed.

Psycho-educational CBT-Insomnia workshops in the community. A cost-effectiveness analysis alongside a randomised controlled trial.

PubMed

Bonin, Eva-Maria; Beecham, Jennifer; Swift, Naomi; Raikundalia, Shriti; Brown, June S L

2014-04-01

Around one in three of the UK population suffer from sleep problems, resulting in high costs to society. Cognitive behaviour therapy for insomnia (CBT-I) has been shown to be effective. Community-based workshops may be a cost-effective way to provide CBT-I to groups that are usually hard to reach or reluctant to seek treatment. A sample of 151 participants aged 18 or over from five London boroughs who self-referred were randomised into a group receiving workshops and a waiting list control group. 111 provided complete data on service use and outcome measures. Results from the cost-effectiveness and cost-utility analyses are presented using cost-effectiveness acceptability curves. At a maximum willingness to pay per quality-adjusted life-year (QALY) of £30,000, the probability of the intervention being cost-effective is 80%. If commissioners are willing to pay £150 per point improvement on the Insomnia Severity Index, which is approximately the cost of the intervention, there is a 97% probability of cost-effectiveness. Community-based CBT-I workshops are likely to be a cost-effective intervention to improve insomnia symptoms and are a promising low-level option to include within the panoply of interventions that are encouraged within the UK policy of increasing access to psychological therapies. Copyright © 2014 Elsevier Ltd. All rights reserved.

47 CFR 76.1909 - Redistribution control of unencrypted digital terrestrial broadcast content.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Redistribution control of unencrypted digital... Redistribution control of unencrypted digital terrestrial broadcast content. (a) For the purposes of this section, the terms unencrypted digital terrestrial broadcast content, EIT, PMT, broadcast flag, covered...

Parallel Digital Phase-Locked Loops

NASA Technical Reports Server (NTRS)

Sadr, Ramin; Shah, Biren N.; Hinedi, Sami M.

1995-01-01

Wide-band microwave receivers of proposed type include digital phase-locked loops in which band-pass filtering and down-conversion of input signals implemented by banks of multirate digital filters operating in parallel. Called "parallel digital phase-locked loops" to distinguish them from other digital phase-locked loops. Systems conceived as cost-effective solution to problem of filtering signals at high sampling rates needed to accommodate wide input frequency bands. Each of M filters process 1/M of spectrum of signal.

Cost Effective Prototyping

NASA Technical Reports Server (NTRS)

Wickman, Jerry L.; Kundu, Nikhil K.

1996-01-01

This laboratory exercise seeks to develop a cost effective prototype development. The exercise has the potential of linking part design, CAD, mold development, quality control, metrology, mold flow, materials testing, fixture design, automation, limited parts production and other issues as related to plastics manufacturing.

Textured digital elevation model formation from low-cost UAV LADAR/digital image data

NASA Astrophysics Data System (ADS)

Bybee, Taylor C.; Budge, Scott E.

2015-05-01

Textured digital elevation models (TDEMs) have valuable use in precision agriculture, situational awareness, and disaster response. However, scientific-quality models are expensive to obtain using conventional aircraft-based methods. The cost of creating an accurate textured terrain model can be reduced by using a low-cost (<$20k) UAV system fitted with ladar and electro-optical (EO) sensors. A texel camera fuses calibrated ladar and EO data upon simultaneous capture, creating a texel image. This eliminates the problem of fusing the data in a post-processing step and enables both 2D- and 3D-image registration techniques to be used. This paper describes formation of TDEMs using simulated data from a small UAV gathering swaths of texel images of the terrain below. Being a low-cost UAV, only a coarse knowledge of position and attitude is known, and thus both 2D- and 3D-image registration techniques must be used to register adjacent swaths of texel imagery to create a TDEM. The process of creating an aggregate texel image (a TDEM) from many smaller texel image swaths is described. The algorithm is seeded with the rough estimate of position and attitude of each capture. Details such as the required amount of texel image overlap, registration models, simulated flight patterns (level and turbulent), and texture image formation are presented. In addition, examples of such TDEMs are shown and analyzed for accuracy.

Digital controls for gas turbine engines

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robinson, K.

1987-01-01

This paper begins by first describing the simplistic requirements of a gas turbine engine; how these requirements are best satisfied, frequently with the aid of electronic control systems; what the trade-off between integrity and reliability means; and finally, but forming a major section, this paper describes in qualitative detail a few of the current programmes for Full Authority Digital Engine Controls (FADEC).

A picture speaks a thousand words: the use of digital photography and the Internet as a cost-effective tool in monitoring free flaps.

PubMed

Varkey, Prashanth; Tan, Ngian Chye; Girotto, Riccardo; Tang, Wen-Ruay; Liu, Yi-Tein; Chen, Hung-Chi

2008-01-01

Microsurgical free tissue transfer is progressing rapidly and is being used more frequently the world over. Monitoring these cases is crucial for a satisfactory outcome. More sophisticated methods are available for monitoring, though they are often expensive. We propose a novel technique using digital photography and the Internet to offer a reliable and cost-effective method to monitor free-tissue transfers. During an 8-month period, 163 microvascular procedures were monitored using this technique. Serial photographs taken were stored in a separate case folder and sent to the surgeon as deemed necessary. Analysis of the 67 cases is presented. Five reexplorations were done. The early diagnosis of venous congestion was possible using this technique. Timely intervention contributed to the success of the reexplorations, and these flaps could be salvaged. The file size of images was in the range of 1 MB to 6 MB. The file size of a set of photographs was usually around 7 MB to 9 MB. These were sent across the asymmetric digital subscriber line Internet lines. The use of the digital images and the Internet allows reconstructive surgeons to have a reliable picture of the state of their free-tissue transfers. This allows decreasing observer error and saves valuable time which otherwise needs to be spent to verify situations of doubt.

Migration of Older to New Digital Control Systems in Nuclear Power Plant Main Control Rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kovesdi, Casey Robert; Joe, Jeffrey Clark

The United States (U.S.) Department of Energy (DOE) Office of Nuclear Energy (NE) has the primary mission to advance nuclear power by resolving socio-technical issues through research and development (R&D). One DOE-NE activity supporting this mission is the Light Water Reactor Sustainability (LWRS) program. LWRS has the overall objective to sustain the operation of existing commercial nuclear power plants (NPPs) through conducting R&D across multiple “pathways,” or R&D focus areas. The Advanced Instrumentation, Information, and Control (II&C) Systems Technologies pathway conducts targeted R&D to address aging and reliability concerns with the legacy instrumentation and control (I&C) and related information systemsmore » in operating U.S. NPPs. This work involves (1) ensuring that legacy analog II&C systems are not life-limiting issues for the LWR fleet, and (2) implementing digital II&C technology in a manner that enables broad innovation and business improvement in the NPP operating model. Under the LWRS Advanced II&C pathway, Human Factors experts at Idaho National Laboratory (INL) have been conducting R&D in support of NPP main control room (MCR) modernization activities. Work in prior years has focused on migrating analog I&C systems to new digital I&C systems (). In fiscal year 2016 (FY16), one new focus area for this research is migrating older digital I&C systems to new and advanced digital I&C systems. This report summarizes a plan for conducting a digital-to-digital migration of a legacy digital I&C system to a new digital I&C system in support of control room modernization activities.« less

The effectiveness of insurer-supported safety and health engineering controls in reducing workers' compensation claims and costs.

PubMed

Wurzelbacher, Steven J; Bertke, Stephen J; Lampl, Michael P; Bushnell, P Timothy; Meyers, Alysha R; Robins, David C; Al-Tarawneh, Ibraheem S

2014-12-01

This study evaluated the effectiveness of a program in which a workers' compensation (WC) insurer provided matching funds to insured employers to implement safety/health engineering controls. Pre- and post-intervention WC metrics were compiled for the employees designated as affected by the interventions within 468 employers for interventions occurring from 2003 to 2009. Poisson, two-part, and linear regression models with repeated measures were used to evaluate differences in pre- and post-data, controlling for time trends independent of the interventions. For affected employees, total WC claim frequency rates (both medical-only and lost-time claims) decreased 66%, lost-time WC claim frequency rates decreased 78%, WC paid cost per employee decreased 81%, and WC geometric mean paid claim cost decreased 30% post-intervention. Reductions varied by employer size, specific industry, and intervention type. The insurer-supported safety/health engineering control program was effective in reducing WC claims and costs for affected employees. © 2014 Wiley Periodicals, Inc.

The Effectiveness of Insurer-Supported Safety and Health Engineering Controls in Reducing Workers’ Compensation Claims and Costs

PubMed Central

Wurzelbacher, Steven J.; Bertke, Stephen J.; Lampl, Michael P.; Bushnell, P. Timothy; Meyers, Alysha R.; Robins, David C.; Al-Tarawneh, Ibraheem S.

2015-01-01

Background This study evaluated the effectiveness of a program in which a workers’ compensation (WC) insurer provided matching funds to insured employers to implement safety/health engineering controls. Methods Pre- and post-intervention WC metrics were compiled for the employees designated as affected by the interventions within 468 employers for interventions occurring from 2003 to 2009. Poisson, two-part, and linear regression models with repeated measures were used to evaluate differences in pre- and post-data, controlling for time trends independent of the interventions. Results For affected employees, total WC claim frequency rates (both medical-only and lost-time claims) decreased 66%, lost-time WC claim frequency rates decreased 78%, WC paid cost per employee decreased 81%, and WC geometric mean paid claim cost decreased 30% post-intervention. Reductions varied by employer size, specific industry, and intervention type. Conclusions The insurer-supported safety/health engineering control program was effective in reducing WC claims and costs for affected employees. PMID:25223846

Cost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trial.

PubMed

Gillespie, Paddy; O'Shea, Eamon; O'Hara, Mary Clare; Dinneen, Sean F

2014-06-14

This study examines the cost effectiveness of group follow-up after participation in the Dose Adjustment for Normal Eating (DAFNE) structured education programme for type 1 diabetes. Economic evaluation conducted alongside a cluster randomised controlled trial involving 437 adults with type 1 diabetes in Ireland. Group follow-up involved two group education 'booster' sessions post-DAFNE. Individual follow-up involved two standard one-to-one hospital clinic visits. Incremental costs, quality-adjusted life years (QALYs) gained and cost effectiveness were estimated at 18 months. Uncertainty was explored using sensitivity analysis and by estimating cost effectiveness acceptability curves. Group follow-up was associated with a mean reduction in QALYs gained of 0.04 per patient (P value, 0.052; 95% CI, -0.08 to 0.01, intra-class correlation (ICC), 0.033) and a mean reduction in total healthcare costs of €772 (P value, 0.020; 95% CI, -1,415 to -128: ICC, 0.016) per patient. At alternative threshold values of €5,000, €15,000, €25,000, €35,000, and €45,000, the probability of group follow-up being cost effective was estimated to be 1.000, 0.762, 0.204, 0.078, and 0.033 respectively. The results do not support implementation of group follow-up as the sole means of follow-up post-DAFNE. Given the reported cost savings, future studies should explore the cost effectiveness of alternative models of group care for diabetes. Current Controlled Trials ISRCTN79759174 (assigned: 9 February 2007).

Cost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trial

PubMed Central

2014-01-01

Background This study examines the cost effectiveness of group follow-up after participation in the Dose Adjustment for Normal Eating (DAFNE) structured education programme for type 1 diabetes. Methods Economic evaluation conducted alongside a cluster randomised controlled trial involving 437 adults with type 1 diabetes in Ireland. Group follow-up involved two group education ‘booster’ sessions post-DAFNE. Individual follow-up involved two standard one-to-one hospital clinic visits. Incremental costs, quality-adjusted life years (QALYs) gained and cost effectiveness were estimated at 18 months. Uncertainty was explored using sensitivity analysis and by estimating cost effectiveness acceptability curves. Results Group follow-up was associated with a mean reduction in QALYs gained of 0.04 per patient (P value, 0.052; 95% CI, −0.08 to 0.01, intra-class correlation (ICC), 0.033) and a mean reduction in total healthcare costs of €772 (P value, 0.020; 95% CI, −1,415 to −128: ICC, 0.016) per patient. At alternative threshold values of €5,000, €15,000, €25,000, €35,000, and €45,000, the probability of group follow-up being cost effective was estimated to be 1.000, 0.762, 0.204, 0.078, and 0.033 respectively. Conclusions The results do not support implementation of group follow-up as the sole means of follow-up post-DAFNE. Given the reported cost savings, future studies should explore the cost effectiveness of alternative models of group care for diabetes. Trial registration Current Controlled Trials ISRCTN79759174 (assigned: 9 February 2007). PMID:24927851

Time-efficiency analysis of the treatment with monolithic implant crowns in a digital workflow: a randomized controlled trial.

PubMed

Joda, Tim; Brägger, Urs

2016-11-01

The aim of the randomized controlled trial was to analyze time-efficiency of a treatment with implant crowns made of monolithic lithium disilicate (LS2) plus titanium base vs. porcelain fuse to zirconium dioxide (ZrO 2 ) in a digital workflow. Twenty study participants were included for single-tooth replacement in premolar and molar sites. Baseline was the start of the prosthetic treatment. All patients received transocclusal screw-retained implant reconstructions on a soft tissue level-type implant. The 3D implant position was captured with intraoral optical scanning (IOS). After randomization, ten patients were restored with CAD-/CAM-produced monolithic LS2-crowns bonded to prefabricated titanium abutments without any physical models (test), and ten patients with CAD-/CAM-fabricated ZrO 2 -suprastructures and hand-layered ceramic veneering with milled master models (control). Every single clinical and laboratory work step was timed in minutes and then analyzed for time-efficiency with Wilcoxon Rank Sum Tests. Direct costs were assessed for laboratory fees for first line production in Swiss Francs (CHF). Two clinical appointments were necessary for IOS and seating of all implant crowns. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different, resulting in 75.3 min (SD ± 2.1) for test and 156.6 min (SD ± 4.6) for control [P = 0.0001]. Analysis for clinical treatment sessions showed a significantly shorter mean chair time for the complete digital workflow of 20.8 min (SD ± 0.3) compared to 24.1 min (SD ± 1.1) [P = 0.001]. Even more obvious were the results for the mean laboratory work time with a significant reduction of 54.5 min (SD ± 4.9) vs. 132.5 min (SD ± 8.7), respectively [P = 0.0001]. The test workflow was more time-efficient than the controls for implant-supported crowns; notably, laboratory fabrication steps could be effectively shortened with the digital process of

A Nonlinear Digital Control Solution for a DC/DC Power Converter

NASA Technical Reports Server (NTRS)

Zhu, Minshao

2002-01-01

A digital Nonlinear Proportional-Integral-Derivative (NPID) control algorithm was proposed to control a 1-kW, PWM, DC/DC, switching power converter. The NPID methodology is introduced and a practical hardware control solution is obtained. The design of the controller was completed using Matlab (trademark) Simulink, while the hardware-in-the-loop testing was performed using both the dSPACE (trademark) rapid prototyping system, and a stand-alone Texas Instruments (trademark) Digital Signal Processor (DSP)-based system. The final Nonlinear digital control algorithm was implemented and tested using the ED408043-1 Westinghouse DC-DC switching power converter. The NPID test results are discussed and compared to the results of a standard Proportional-Integral (PI) controller.

Exercise, Manual Therapy, and Booster Sessions in Knee Osteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial.

PubMed

Bove, Allyn M; Smith, Kenneth J; Bise, Christopher G; Fritz, Julie M; Childs, John; Brennan, Gerard P; Abbott, J Haxby; Fitzgerald, G Kelley

2018-01-01

Limited information exists regarding the cost-effectiveness of rehabilitation strategies for individuals with knee osteoarthritis (OA). The study objective was to compare the cost-effectiveness of 4 different combinations of exercise, manual therapy, and booster sessions for individuals with knee OA. This economic evaluation involved a cost-effectiveness analysis performed alongside a multicenter randomized controlled trial. The study took place in Pittsburgh, Pennsylvania; Salt Lake City, Utah; and San Antonio, Texas. The study participants were 300 individuals taking part in a randomized controlled trial investigating various physical therapy strategies for knee OA. Participants were randomized into 4 treatment groups: exercise only (EX), exercise plus booster sessions (EX+B), exercise plus manual therapy (EX+MT), and exercise plus manual therapy and booster sessions (EX+MT+B). For the 2-year base case scenario, a Markov model was constructed using the United States societal perspective and a 3% discount rate for costs and quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios were calculated to compare differences in cost per QALY gained among the 4 treatment strategies. In the 2-year analysis, booster strategies (EX+MT+B and EX+B) dominated no-booster strategies, with both lower health care costs and greater effectiveness. EX+MT+B had the lowest total health care costs. EX+B cost ${\\$}$1061 more and gained 0.082 more QALYs than EX+MT+B, for an incremental cost-effectiveness ratio of ${\\$}$12,900/QALY gained. The small number of total knee arthroplasty surgeries received by individuals in this study made the assessment of whether any particular strategy was more successful at delaying or preventing surgery in individuals with knee OA difficult. Spacing exercise-based physical therapy sessions over 12 months using periodic booster sessions was less costly and more effective over 2 years than strategies not containing booster sessions for

Digital control of wind tunnel magnetic suspension and balance systems

NASA Technical Reports Server (NTRS)

Britcher, Colin P.; Goodyer, Michael J.; Eskins, Jonathan; Parker, David; Halford, Robert J.

1987-01-01

Digital controllers are being developed for wind tunnel magnetic suspension and balance systems, which in turn permit wind tunnel testing of aircraft models free from support interference. Hardware and software features of two existing digital control systems are reviewed. Some aspects of model position sensing and system calibration are also discussed.

Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial

PubMed Central

Prah Ruger, Jennifer; Abdallah, Arbi Ben; Luekens, Craig; Cottler, Linda

2012-01-01

Aims To determine whether the additional interventions to standard care are cost-effective in addressing cocaine and alcohol abuse at 4 months (4 M) and 12 months (12 M) from baseline. Method We conducted a cost-effectiveness analysis of a randomized controlled trial with three arms: (1) NIDA's Standard intervention (SI); (2) SI plus a Well Woman Exam (WWE); and, (3) SI, WWE, plus four Educational Sessions (4ES). Results To obtain an additional cocaine abstainer, WWE compared to SI cost $7,223 at 4 M and $3,611 at 12 M. Per additional alcohol abstainer, WWE compared to SI cost $3,611 and $7,223 at 4 M and 12 M, respectively. At 12 M, 4ES was dominated (more costly and less effective) by WWE for abstinence outcomes. Conclusions To our knowledge, this is the first cost-effectiveness analysis simultaneously examining cocaine and alcohol abuse in women. Depending on primary outcomes sought and priorities of policy makers, peer-delivered interventions can be a cost-effective way to address the needs of this growing, underserved population. Trial Registration ClinicalTrials.gov NCT01235091 PMID:22448255

Cost-effectiveness of adherence therapy versus health education for people with schizophrenia: randomised controlled trial in four European countries

PubMed Central

2013-01-01

Background Non-adherence to anti-psychotics is common, expensive and affects recovery. We therefore examine the cost-effectiveness of adherence therapy for people with schizophrenia by multi-centre randomised trial in Amsterdam, London, Leipzig and Verona. Methods Participants received 8 sessions of adherence therapy or health education. We measured lost productivity and use of health/social care, criminal justice system and informal care at baseline and one year to estimate and compare mean total costs from health/social care and societal perspectives. Outcomes were the Short Form 36 (SF-36) mental component score (MCS) and quality-adjusted life years (QALYs) gained (SF-36 and EuroQoL 5 dimension (EQ5D)). Cost-effectiveness was examined for all cost and outcome combinations using cost-effectiveness acceptability curves (CEACs). Results 409 participants were recruited. There were no cost or outcome differences between adherence therapy and health education. The probability of adherence therapy being cost-effective compared to health education was between 0.3 and 0.6 for the six cost-outcome combinations at the willingness to pay thresholds we examined. Conclusions Adherence therapy appears equivalent to health education. It is unclear whether it would have performed differently against a treatment as usual control, whether such an intervention can impact on quality of life in the short-term, or whether it is likely to be cost-effective in some sites but not others. Trial registration Trial registration: Current Controlled Trials ISRCTN01816159 PMID:23705862

Research on cost control and management in high voltage transmission line construction

NASA Astrophysics Data System (ADS)

Xu, Xiaobin

2017-05-01

Enterprises. The cost control is of vital importance to the construction enterprises. It is the key to the profitability of the transmission line project, which is related to the survival and development of the electric power construction enterprises. Due to the long construction line, complex and changeable construction terrain as well as large construction costs of transmission line, it is difficult for us to take accurate and effective cost control on the project implementation of entire transmission line. Therefore, the cost control of transmission line project is a complicated and arduous task. It is of great theoretical and practical significance to study the cost control scheme of transmission line project by a more scientific and efficient way. Based on the characteristics of the construction project of the transmission line project, this paper analyzes the construction cost structure of the transmission line project and the current cost control problem of the transmission line project, and demonstrates the necessity and feasibility of studying the cost control scheme of the transmission line project more accurately. In this way, the dynamic cycle cost control process including plan, implementation, feedback, correction, modification and re-implement is achieved to realize the accurate and effective cost control of entire electric power transmission line project.

Estimating mean QALYs in trial-based cost-effectiveness analysis: the importance of controlling for baseline utility.

PubMed

Manca, Andrea; Hawkins, Neil; Sculpher, Mark J

2005-05-01

In trial-based cost-effectiveness analysis baseline mean utility values are invariably imbalanced between treatment arms. A patient's baseline utility is likely to be highly correlated with their quality-adjusted life-years (QALYs) over the follow-up period, not least because it typically contributes to the QALY calculation. Therefore, imbalance in baseline utility needs to be accounted for in the estimation of mean differential QALYs, and failure to control for this imbalance can result in a misleading incremental cost-effectiveness ratio. This paper discusses the approaches that have been used in the cost-effectiveness literature to estimate absolute and differential mean QALYs alongside randomised trials, and illustrates the implications of baseline mean utility imbalance for QALY calculation. Using data from a recently conducted trial-based cost-effectiveness study and a micro-simulation exercise, the relative performance of alternative estimators is compared, showing that widely used methods to calculate differential QALYs provide incorrect results in the presence of baseline mean utility imbalance regardless of whether these differences are formally statistically significant. It is demonstrated that multiple regression methods can be usefully applied to generate appropriate estimates of differential mean QALYs and an associated measure of sampling variability, while controlling for differences in baseline mean utility between treatment arms in the trial. Copyright 2004 John Wiley & Sons, Ltd

Modern digital flight control system design for VTOL aircraft

NASA Technical Reports Server (NTRS)

Broussard, J. R.; Berry, P. W.; Stengel, R. F.

1979-01-01

Methods for and results from the design and evaluation of a digital flight control system (DFCS) for a CH-47B helicopter are presented. The DFCS employed proportional-integral control logic to provide rapid, precise response to automatic or manual guidance commands while following conventional or spiral-descent approach paths. It contained altitude- and velocity-command modes, and it adapted to varying flight conditions through gain scheduling. Extensive use was made of linear systems analysis techniques. The DFCS was designed, using linear-optimal estimation and control theory, and the effects of gain scheduling are assessed by examination of closed-loop eigenvalues and time responses.

Cost-Effectiveness of Nicotine Patches for Smoking Cessation in Pregnancy: A Placebo Randomized Controlled Trial (SNAP).

PubMed

Essex, Holly N; Parrott, Steve; Wu, Qi; Li, Jinshuo; Cooper, Sue; Coleman, Tim

2015-06-01

Smoking during pregnancy is the most important, preventable cause of adverse pregnancy outcomes including miscarriage, premature birth, and low birth weight with huge financial costs to the National Health Service. However, there are very few published economic evaluations of smoking cessation interventions in pregnancy and previous studies are predominantly U.S.-based and do not present incremental cost-effectiveness ratios (ICER). A number of studies have demonstrated cost-effectiveness of nicotine replacement therapy (NRT) in the general population, but this has yet to be tested among pregnant smokers. A cost-effectiveness analysis was undertaken alongside the smoking, nicotine, and pregnancy trial to compare NRT patches plus behavioral support to behavioral support alone, for pregnant women who smoked. At delivery, biochemically verified quit rates were slightly higher at 9.4% in the NRT group compared to 7.6% in the control group (odds ratio = 1.26, 95% CI = 0.82-1.96), at an increased cost of around £90 per participant. Higher costs in the NRT group were mainly attributable to the cost of NRT patches (mean = £46.07). The incremental cost-effectiveness ratio associated with NRT was £4,926 per quitter and a sensitivity analysis including only singleton births yielded an ICER of £4,156 per quitter. However, wide confidence intervals indicated a high level of uncertainty. Without a specific willingness to pay threshold, and due to high levels of statistical uncertainty, it is hard to determine the cost-effectiveness of NRT in this population. Furthermore, future research should address compliance issues, as these may dilute any potential effects of NRT, thus reducing the cost-effectiveness. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Fabrication and test of digital output interface devices for gas turbine electronic controls

NASA Technical Reports Server (NTRS)

Newirth, D. M.; Koenig, E. W.

1978-01-01

A program was conducted to develop an innovative digital output interface device, a digital effector with optical feedback of the fuel metering valve position, for future electronic controls for gas turbine engines. A digital effector (on-off solenoids driven directly by on-off signals from a digital electronic controller) with optical position feedback was fabricated, coupled with the fuel metering valve, and tested under simulated engine operating conditions. The testing indicated that a digital effector with optical position feedback is a suitable candidate, with proper development for future digital electronic gas turbine controls. The testing also identified several problem areas which would have to be overcome in a final production configuration.

Converting the Active Digital Controller for Use in Two Tests

NASA Technical Reports Server (NTRS)

Wright, Robert G.

1995-01-01

The Active Digital Controller is a system used to control the various functions of wind tunnel models. It has the capability of digitizing and saving of up to sixty-four channels of analog data. It can output up to 16 channels of analog command signals. In addition to its use as a general controller, it can run up to two distinct control laws. All of this is done at a regulated speed of two hundred hertz. The Active Digital Controller (ADC) was modified for use in the Actively Controlled Response of Buffet Affected Tails (ACROBAT) tests and for side-wall pressure data acquisition. The changes included general maintenance and updating of the controller as well as setting up special modes of operation. The ACROBAT tests required that two sets of output signals be available. The pressure data acquisition needed a sampling rate of four hundred hertz, twice the standard ADC rate. These modifications were carried out and the ADC was used during the ACROBAT wind tunnel entry.

A low-cost, scalable, current-sensing digital headstage for high channel count μECoG.

PubMed

Trumpis, Michael; Insanally, Michele; Zou, Jialin; Elsharif, Ashraf; Ghomashchi, Ali; Sertac Artan, N; Froemke, Robert C; Viventi, Jonathan

2017-04-01

High channel count electrode arrays allow for the monitoring of large-scale neural activity at high spatial resolution. Implantable arrays featuring many recording sites require compact, high bandwidth front-end electronics. In the present study, we investigated the use of a small, light weight, and low cost digital current-sensing integrated circuit for acquiring cortical surface signals from a 61-channel micro-electrocorticographic (μECoG) array. We recorded both acute and chronic μECoG signal from rat auditory cortex using our novel digital current-sensing headstage. For direct comparison, separate recordings were made in the same anesthetized preparations using an analog voltage headstage. A model of electrode impedance explained the transformation between current- and voltage-sensed signals, and was used to reconstruct cortical potential. We evaluated the digital headstage using several metrics of the baseline and response signals. The digital current headstage recorded neural signal with similar spatiotemporal statistics and auditory frequency tuning compared to the voltage signal. The signal-to-noise ratio of auditory evoked responses (AERs) was significantly stronger in the current signal. Stimulus decoding based on true and reconstructed voltage signals were not significantly different. Recordings from an implanted system showed AERs that were detectable and decodable for 52 d. The reconstruction filter mitigated the thermal current noise of the electrode impedance and enhanced overall SNR. We developed and validated a novel approach to headstage acquisition that used current-input circuits to independently digitize 61 channels of μECoG measurements of the cortical field. These low-cost circuits, intended to measure photo-currents in digital imaging, not only provided a signal representing the local cortical field with virtually the same sensitivity and specificity as a traditional voltage headstage but also resulted in a small, light headstage that can

A low-cost, scalable, current-sensing digital headstage for high channel count μECoG

NASA Astrophysics Data System (ADS)

Trumpis, Michael; Insanally, Michele; Zou, Jialin; Elsharif, Ashraf; Ghomashchi, Ali; Sertac Artan, N.; Froemke, Robert C.; Viventi, Jonathan

2017-04-01

Objective. High channel count electrode arrays allow for the monitoring of large-scale neural activity at high spatial resolution. Implantable arrays featuring many recording sites require compact, high bandwidth front-end electronics. In the present study, we investigated the use of a small, light weight, and low cost digital current-sensing integrated circuit for acquiring cortical surface signals from a 61-channel micro-electrocorticographic (μECoG) array. Approach. We recorded both acute and chronic μECoG signal from rat auditory cortex using our novel digital current-sensing headstage. For direct comparison, separate recordings were made in the same anesthetized preparations using an analog voltage headstage. A model of electrode impedance explained the transformation between current- and voltage-sensed signals, and was used to reconstruct cortical potential. We evaluated the digital headstage using several metrics of the baseline and response signals. Main results. The digital current headstage recorded neural signal with similar spatiotemporal statistics and auditory frequency tuning compared to the voltage signal. The signal-to-noise ratio of auditory evoked responses (AERs) was significantly stronger in the current signal. Stimulus decoding based on true and reconstructed voltage signals were not significantly different. Recordings from an implanted system showed AERs that were detectable and decodable for 52 d. The reconstruction filter mitigated the thermal current noise of the electrode impedance and enhanced overall SNR. Significance. We developed and validated a novel approach to headstage acquisition that used current-input circuits to independently digitize 61 channels of μECoG measurements of the cortical field. These low-cost circuits, intended to measure photo-currents in digital imaging, not only provided a signal representing the local cortical field with virtually the same sensitivity and specificity as a traditional voltage headstage but

A low-cost, scalable, current-sensing digital headstage for high channel count μECoG

PubMed Central

Trumpis, Michael; Insanally, Michele; Zou, Jialin; Elsharif, Ashraf; Ghomashchi, Ali; Artan, N. Sertac; Froemke, Robert C.; Viventi, Jonathan

2017-01-01

Objective High channel count electrode arrays allow for the monitoring of large-scale neural activity at high spatial resolution. Implantable arrays featuring many recording sites require compact, high bandwidth front-end electronics. In the present study, we investigated the use of a small, light weight, and low cost digital current-sensing integrated circuit for acquiring cortical surface signals from a 61-channel micro-electrocorticographic (μECoG) array. Approach We recorded both acute and chronic μECoG signal from rat auditory cortex using our novel digital current-sensing headstage. For direct comparison, separate recordings were made in the same anesthetized preparations using an analog voltage headstage. A model of electrode impedance explained the transformation between current- and voltage-sensed signals, and was used to reconstruct cortical potential. We evaluated the digital headstage using several metrics of the baseline and response signals. Main results The digital current headstage recorded neural signal with similar spatiotemporal statistics and auditory frequency tuning compared to the voltage signal. The signal-to-noise ratio of auditory evoked responses (AERs) was significantly stronger in the current signal. Stimulus decoding based on true and reconstructed voltage signals were not significantly different. Recordings from an implanted system showed AERs that were detectable and decodable for 52 days. The reconstruction filter mitigated the thermal current noise of the electrode impedance and enhanced overall SNR. Significance We developed and validated a novel approach to headstage acquisition that used current-input circuits to independently digitize 61 channels of μECoG measurements of the cortical field. These low-cost circuits, intended to measure photo-currents in digital imaging, not only provided a signal representing the local cortical field with virtually the same sensitivity and specificity as a traditional voltage headstage but

Results and Insights on the Impact of Smoke on Digital Instrumentation and Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanaka, T. J.; Nowlen, S. P.

2001-01-31

Smoke can cause interruptions and upsets in active electronics. Because nuclear power plants are replacing analog with digital instrumentation and control systems, qualification guidelines for new systems are being reviewed for severe environments such as smoke and electromagnetic interference. Active digital systems, individual components, and active circuits have been exposed to smoke in a program sponsored by the U.S. Nuclear Regulatory Commission. The circuits and systems were all monitored during the smoke exposure, indicating any immediate effects of the smoke. The major effect of smoke has been to increase leakage currents (through circuit bridging across contacts and leads) and tomore » cause momentary upsets and failures in digital systems. This report summarizes two previous reports and presents new results from conformal coating, memory chip, and hard drive tests. The report describes practices for mitigation of smoke damage through digital system design, fire barriers, ventilation, fire suppressants, and post fire procedures.« less

Quantum Cascade Laser Tuning by Digital Micromirror Array-controlled External Cavity

DTIC Science & Technology

2014-01-01

P. Vujkovic-Cvijin, B. Gregor, A. C. Samuels, E. S. Roese, Quantum cascade laser tuning by digital micromirror array-controlled external cavity...REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Quantum cascade laser tuning by digital micromirror array-controlled...dimensional digital micromirror array (DMA) is described. The laser is tuned by modulating the reflectivity of DMA micromirror pixels under computer

The Design, Implementation, and Evaluation of a Digital Interactive Globe System Integrated into an Earth Science Course

ERIC Educational Resources Information Center

Liou, Wei-Kai; Bhagat, Kaushal Kumar; Chang, Chun-Yen

2018-01-01

The aim of this study is to design and implement a digital interactive globe system (DIGS), by integrating low-cost equipment to make DIGS cost-effective. DIGS includes a data processing unit, a wireless control unit, an image-capturing unit, a laser emission unit, and a three-dimensional hemispheric body-imaging screen. A quasi-experimental study…

The cost-effectiveness of life-saving interventions in Japan. Do chemical regulations cost too much?

PubMed

Kishimoto, Atsuo; Oka, Tosihiro; Nakanishi, Junko

2003-10-01

This paper compares the cost-effectiveness of life-saving interventions in Japan, based on information collected from the health, safety and environmental literature. More than 50 life-saving interventions are analyzed. Cost-effectiveness is defined as the cost per life-year saved or as the cost per quality-adjusted life-year saved. Finding a large cost-effectiveness disparity between chemical controls and health care intervention, we raise the question of whether chemical regulations cost society too much. We point out the limitations of this study and propose a way to improve the incorporation of morbidity effects in cost-effectiveness analysis.

Clinical and cost-effectiveness of non-medical prescribing: A systematic review of randomised controlled trials

PubMed Central

Marriott, John; Graham-Clarke, Emma; Shirley, Debra; Rushton, Alison

2018-01-01

Objective To evaluate the clinical and cost-effectiveness of non-medical prescribing (NMP). Design Systematic review. Two reviewers independently completed searches, eligibility assessment and assessment of risk of bias. Data sources Pre-defined search terms/combinations were utilised to search electronic databases. In addition, hand searches of reference lists, key journals and grey literature were employed alongside consultation with authors/experts. Eligibility criteria for included studies Randomised controlled trials (RCTs) evaluating clinical or cost-effectiveness of NMP. Measurements reported on one or more outcome(s) of: pain, function, disability, health, social impact, patient-safety, costs-analysis, quality adjusted life years (QALYs), patient satisfaction, clinician perception of clinical and functional outcomes. Results Three RCTs from two countries were included (n = 932 participants) across primary and tertiary care settings. One RCT was assessed as low risk of bias, one as high risk of bias and one as unclear risk of bias. All RCTs evaluated clinical effectiveness with one also evaluating cost-effectiveness. Clinical effectiveness was evaluated using a range of safety and patient-reported outcome measures. Participants demonstrated significant improvement in outcomes when receiving NMP compared to treatment as usual (TAU) in all RCTs. An associated cost analysis showed NMP to be more expensive than TAU (regression coefficient p = 0.0000), however experimental groups generated increased QALYs compared to TAU. Conclusion Limited evidence with overall unclear risk of bias exists evaluating clinical and cost-effectiveness of NMP across all professions and clinical settings. GRADE assessment revealed moderate quality evidence. Evidence suggests that NMP is safe and can provide beneficial clinical outcomes. Benefits to the health economy remain unclear, with the cost-effectiveness of NMP assessed by a single pilot RCT of low risk of bias. Adequately

Use of prior mammograms in the transition to digital mammography: a performance and cost analysis.

PubMed

Taylor-Phillips, S; Wallis, M G; Duncan, A; Gale, A G

2012-01-01

Breast screening in Europe is gradually changing from film to digital imaging and reporting of cases. In the transition period prior mammograms (from the preceding screening round) are films thereby potentially causing difficulties in comparison to current digital mammograms. To examine this breast screening performance was measured at a digital mammography workstation with prior mammograms displayed in different formats, and the associated costs calculated. 160 selected difficult cases (41% malignant) were read by eight UK qualified mammography readers in three conditions: with film prior mammograms; with digitised prior mammograms; or without prior mammograms. Lesion location and probability of malignancy were recorded, alongside a decision of whether to recall each case for further tests. JAFROC analysis showed a difference between conditions (p=.006); performance with prior mammograms in either film or digitised formats was superior to that without prior mammograms (p<.05). There was no difference in the performance when the prior mammograms were presented in film or digitised form. The number of benign or normal cases recalled was 26% higher without prior mammograms than with digitised or film prior mammograms (p<.05). This would correspond to an increase in recall rate at the study hospital from 4.3% to 5.5% with no associated increase in cancer detection rate. The cost of this increase was estimated to be £11,581 (€13,666) per 10,000 women screened, which is higher than the cost of digitised (£11,114/€13,115), or film display (£6451/€7612) of the prior mammograms. It is recommended that, where available, prior mammograms are used in the transition to digital breast screening. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Cost-Effectiveness of a Model Infection Control Program for Preventing Multi-Drug-Resistant Organism Infections in Critically Ill Surgical Patients.

PubMed

Jayaraman, Sudha P; Jiang, Yushan; Resch, Stephen; Askari, Reza; Klompas, Michael

2016-10-01

Interventions to contain two multi-drug-resistant Acinetobacter (MDRA) outbreaks reduced the incidence of multi-drug-resistant (MDR) organisms, specifically methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile in the general surgery intensive care unit (ICU) of our hospital. We therefore conducted a cost-effective analysis of a proactive model infection-control program to reduce transmission of MDR organisms based on the practices used to control the MDRA outbreak. We created a model of a proactive infection control program based on the 2011 MDRA outbreak response. We built a decision analysis model and performed univariable and probabilistic sensitivity analyses to evaluate the cost-effectiveness of the proposed program compared with standard infection control practices to reduce transmission of these MDR organisms. The cost of a proactive infection control program would be $68,509 per year. The incremental cost-effectiveness ratio (ICER) was calculated to be $3,804 per aversion of transmission of MDR organisms in a one-year period compared with standard infection control. On the basis of probabilistic sensitivity analysis, a willingness-to-pay (WTP) threshold of $14,000 per transmission averted would have a 42% probability of being cost-effective, rising to 100% at $22,000 per transmission averted. This analysis gives an estimated ICER for implementing a proactive program to prevent transmission of MDR organisms in the general surgery ICU. To better understand the causal relations between the critical steps in the program and the rate reductions, a randomized study of a package of interventions to prevent healthcare-associated infections should be considered.

High Rate Digital Demodulator ASIC

NASA Technical Reports Server (NTRS)

Ghuman, Parminder; Sheikh, Salman; Koubek, Steve; Hoy, Scott; Gray, Andrew

1998-01-01

The architecture of High Rate (600 Mega-bits per second) Digital Demodulator (HRDD) ASIC capable of demodulating BPSK and QPSK modulated data is presented in this paper. The advantages of all-digital processing include increased flexibility and reliability with reduced reproduction costs. Conventional serial digital processing would require high processing rates necessitating a hardware implementation in other than CMOS technology such as Gallium Arsenide (GaAs) which has high cost and power requirements. It is more desirable to use CMOS technology with its lower power requirements and higher gate density. However, digital demodulation of high data rates in CMOS requires parallel algorithms to process the sampled data at a rate lower than the data rate. The parallel processing algorithms described here were developed jointly by NASA's Goddard Space Flight Center (GSFC) and the Jet Propulsion Laboratory (JPL). The resulting all-digital receiver has the capability to demodulate BPSK, QPSK, OQPSK, and DQPSK at data rates in excess of 300 Mega-bits per second (Mbps) per channel. This paper will provide an overview of the parallel architecture and features of the HRDR ASIC. In addition, this paper will provide an over-view of the implementation of the hardware architectures used to create flexibility over conventional high rate analog or hybrid receivers. This flexibility includes a wide range of data rates, modulation schemes, and operating environments. In conclusion it will be shown how this high rate digital demodulator can be used with an off-the-shelf A/D and a flexible analog front end, both of which are numerically computer controlled, to produce a very flexible, low cost high rate digital receiver.

EPA Air Pollution Control Cost Manual

EPA Science Inventory

EPA's Air Pollution Control Cost Manual provides guidance for the development of accurate and consistent costs for air pollution control devices. A long-standing document prepared by EPA, the Control Cost Manual focuses on point source and stationary area source air pollution con...

Impact of Smoke Exposure on Digital Instrumentation and Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanaka, Tina J.; Nowlen, Steven P.; Korsah, Kofi

2003-08-15

Smoke can cause interruptions and upsets in active electronics. Because nuclear power plants are replacing analog with digital instrumentation and control systems, qualification guidelines for new systems are being reviewed for severe environments such as smoke and electromagnetic interference. Active digital systems, individual components, and active circuits have been exposed to smoke in a program sponsored by the U.S. Nuclear Regulatory Commission. The circuits and systems were all monitored during the smoke exposure, indicating any immediate effects of the smoke. The results of previous smoke exposure studies have been reported in various publications. The major immediate effect of smoke hasmore » been to increase leakage currents and to cause momentary upsets and failures in digital systems. This paper presents new results from conformal coatings, memory chips, and hard drive tests.The best conformal coatings were found to be polyurethane, parylene, and acrylic (when applied by dipping). Conformal coatings can reduce smoke-induced leakage currents and protect against metal loss through corrosion. However conformal coatings are typically flammable, so they do increase material flammability. Some of the low-voltage biased memory chips failed during a combination of high smoke and high humidity. Typically, smoke along with heat and humidity is expected during fire, rather than smoke alone. Thus, due to high sensitivity of digital circuits to heat and humidity, it is hypothesized that the impact of smoke may be secondary.Low-voltage (3.3-V) static random-access memory (SRAMs) were found to be the most vulnerable to smoke. Higher bias voltages decrease the likelihood of failure. Erasable programmable read-only memory (EPROMs) and nonvolatile SRAMs were very smoke tolerant. Failures of the SRAMs occurred when two conditions were present: high density of smoke and high humidity. As the high humidity was present for only part of the test, the failures were

[Intra-oral digital photography with the non professional camera--simplicity and effectiveness at a low price].

PubMed

Sackstein, M

2006-10-01

Over the last five years digital photography has become ubiquitous. For the family photo album, a 4 or 5 megapixel camera costing about 2000 NIS will produce satisfactory results for most people. However, for intra-oral photography the common wisdom holds that only professional photographic equipment is up to the task. Such equipment typically costs around 12,000 NIS and includes the camera body, an attachable macro lens and a ringflash. The following article challenges this conception. Although professional equipment does produce the most exemplary results, a highly effective database of clinical pictures can be compiled even with a "non-professional" digital camera. Since the year 2002, my clinical work has been routinely documented with digital cameras of the Nikon CoolPix series. The advantages are that these digicams are economical both in price and in size and allow easy transport and operation when compared to their expensive and bulky professional counterparts. The details of how to use a non-professional digicam to produce and maintain an effective clinical picture database, for documentation, monitoring, demonstration and professional fulfillment, are described below.

A self-adaptive metamaterial beam with digitally controlled resonators for subwavelength broadband flexural wave attenuation

NASA Astrophysics Data System (ADS)

Li, Xiaopeng; Chen, Yangyang; Hu, Gengkai; Huang, Guoliang

2018-04-01

Designing lightweight materials and/or structures for broadband low-frequency noise/vibration mitigation is an issue of fundamental importance both practically and theoretically. In this paper, by leveraging the concept of frequency-dependent effective stiffness control, we numerically and experimentally demonstrate, for the first time, a self-adaptive metamaterial beam with digital circuit controlled mechanical resonators for strong and broadband flexural wave attenuation at subwavelength scales. The digital controllers that are capable of feedback control of piezoelectric shunts are integrated into mechanical resonators in the metamaterial, and the transfer function is semi-analytically determined to realize an effective bending stiffness in a quadratic function of the wave frequency for adaptive band gaps. The digital as well as analog control circuits as the backbone of the system are experimentally realized with the guarantee stability of the whole electromechanical system in whole frequency regions, which is the most challenging problem so far. Our experimental results are in good agreement with numerical predictions and demonstrate the strong wave attenuation in almost a three times larger frequency region over the bandwidth of a passive metamaterial. The proposed metamaterial could be applied in a range of applications in the design of elastic wave control devices.

Randomised controlled trial of the cost-effectiveness of water-based therapy for lower limb osteoarthritis.

PubMed

Cochrane, T; Davey, R C; Matthes Edwards, S M

2005-08-01

To determine the efficacy of community water-based therapy for the management of lower limb osteoarthritis (OA) in older patients. A pre-experimental matched-control study was used to estimate efficacy of water-based exercise treatment, to check design assumptions and delivery processes. The main study was a randomised controlled trial of the effectiveness of water-based exercise (treatment) compared with usual care (control) in older patients with hip and/or knee OA. The latter was accompanied by an economic evaluation comparing societal costs and consequences of the two treatments. Water exercise was delivered in public swimming pools in the UK. Physical function assessments were carried out in established laboratory settings. 106 patients (93 women, 13 men) over the age of 60 years with confirmed hip and/or knee OA took part in the preliminary study. A similar, but larger, group of 312 patients (196 women, 116 men) took part in the main study, randomised into control (159) and water exercise (153) groups. Control group patients received usual care with quarterly semi-structured telephone interview follow-up only. The intervention in the main study lasted for 1 year, with a further follow-up period of 6 months. Pain score on the Western Ontario and McMaster Universities OA index (WOMAC). Additional outcome measures were included to evaluate effects on quality of life, cost-effectiveness and physical function measurements. Short-term efficacy of water exercise in the management of lower limb OA was confirmed, with effect sizes ranging from 0.44 [95% confidence interval (CI) 0.03 to 0.85] on WOMAC pain to 0.76 (95% CI 0.33 to 1.17) on WOMAC physical function. Of 153 patients randomised to treatment, 82 (53.5%) were estimated to have complied satisfactorily with their treatment at the 1-year point. This had declined to 28 (18%) by the end of the 6-month follow-up period, during which support for the intervention had been removed and those wishing to continue

Digital frequency control of satellite frequency standards. [Defense Navigation Satellites

NASA Technical Reports Server (NTRS)

Nichols, S. A.

1973-01-01

In the Frequency and Time Standard Development Program of the TIMATION System, a new miniaturized rubidium vapor frequency standard has been tested and analyzed for possible use on the TIMATION 3A launch, as part of the Defense Navigation Satellite Development Program. The design and construction of a digital frequency control was required to remotely control this rubidium vapor frequency standard as well as the quartz oscillator in current use. This control must be capable of accepting commands from a satellite telemetry system, verify that the correct commands have been sent and control the frequency to the requirements of the system. Several modifications must be performed to the rubidium vapor frequency standard to allow it to be compatible with the digital frequency control. These include the addition of a varactor to voltage tune the coarse range of the flywheel oscillator, and a modification to supply the C field current externally. The digital frequency control for the rubidium vapor frequency standard has been successfully tested in prototype form.

Effectiveness and Cost-Effectiveness of Antidepressants in Primary Care: A Multiple Treatment Comparison Meta-Analysis and Cost-Effectiveness Model

PubMed Central

Ramsberg, Joakim; Asseburg, Christian; Henriksson, Martin

2012-01-01

Objective To determine effectiveness and cost-effectiveness over a one-year time horizon of pharmacological first line treatment in primary care for patients with moderate to severe depression. Design A multiple treatment comparison meta-analysis was employed to determine the relative efficacy in terms of remission of 10 antidepressants (citalopram, duloxetine escitalopram, fluoxetine, fluvoxamine mirtazapine, paroxetine, reboxetine, sertraline and venlafaxine). The estimated remission rates were then applied in a decision-analytic model in order to estimate costs and quality of life with different treatments at one year. Data Sources Meta-analyses of remission rates from randomised controlled trials, and cost and quality-of-life data from published sources. Results The most favourable pharmacological treatment in terms of remission was escitalopram with an 8- to 12-week probability of remission of 0.47. Despite a high acquisition cost, this clinical effectiveness translated into escitalopram being both more effective and having a lower total cost than all other comparators from a societal perspective. From a healthcare perspective, the cost per QALY of escitalopram was €3732 compared with venlafaxine. Conclusion Of the investigated antidepressants, escitalopram has the highest probability of remission and is the most effective and cost-effective pharmacological treatment in a primary care setting, when evaluated over a one year time-horizon. Small differences in remission rates may be important when assessing costs and cost-effectiveness of antidepressants. PMID:22876296

Digital Controller For Emergency Beacon

NASA Technical Reports Server (NTRS)

Ivancic, William D.

1990-01-01

Prototype digital controller intended for use in 406-MHz emergency beacon. Undergoing development according to international specifications, 406-MHz emergency beacon system includes satellites providing worldwide monitoring of beacons, with Doppler tracking to locate each beacon within 5 km. Controller turns beacon on and off and generates binary codes identifying source (e.g., ship, aircraft, person, or vehicle on land). Codes transmitted by phase modulation. Knowing code, monitor attempts to communicate with user, monitor uses code information to dispatch rescue team appropriate to type and locations of carrier.

Digital adaptive flight controller development

NASA Technical Reports Server (NTRS)

Kaufman, H.; Alag, G.; Berry, P.; Kotob, S.

1974-01-01

A design study of adaptive control logic suitable for implementation in modern airborne digital flight computers was conducted. Two designs are described for an example aircraft. Each of these designs uses a weighted least squares procedure to identify parameters defining the dynamics of the aircraft. The two designs differ in the way in which control law parameters are determined. One uses the solution of an optimal linear regulator problem to determine these parameters while the other uses a procedure called single stage optimization. Extensive simulation results and analysis leading to the designs are presented.

Effectiveness and cost-effectiveness of unsupervised buprenorphine-naloxone for the treatment of heroin dependence in a randomized waitlist controlled trial.

PubMed

Dunlop, Adrian J; Brown, Amanda L; Oldmeadow, Christopher; Harris, Anthony; Gill, Anthony; Sadler, Craig; Ribbons, Karen; Attia, John; Barker, Daniel; Ghijben, Peter; Hinman, Jennifer; Jackson, Melissa; Bell, James; Lintzeris, Nicholas

2017-05-01

Access to opioid agonist treatment can be associated with extensive waiting periods with significant health and financial burdens. This study aimed to determine whether patients with heroin dependence dispensed buprenorphine-naloxone weekly have greater reductions in heroin use and related adverse health effects 12-weeks after commencing treatment, compared to waitlist controls and to examine the cost-effectiveness of this strategy. An open-label waitlist RCT was conducted in an opioid treatment clinic in Newcastle, Australia. Fifty patients with DSM-IV-TR heroin dependence (and no other substance dependence) were recruited. The intervention group (n=25) received take-home self-administered sublingual buprenorphine-naloxone weekly (mean dose, 22.7±5.7mg) and weekly clinical review. Waitlist controls (n=25) received no clinical intervention. The primary outcome was heroin use (self-report, urine toxicology verified) at weeks four, eight and 12. The primary cost-effectiveness outcome was incremental cost per additional heroin-free-day. Outcome data were available for 80% of all randomized participants. Across the 12-weeks, treatment group heroin use was on average 19.02days less/month (95% CI -22.98, -15.06, p<0.0001). A total 12-week reduction in adjusted costs including crime of $A5,722 (95% CI 3299, 8154) in favor of treatment was observed. Excluding crime, incremental cost per heroin-free-day gained from treatment was $A18.24 (95% CI 4.50, 28.49). When compared to remaining on a waitlist, take-home self-administered buprenorphine-naloxone treatment is associated with significant reductions in heroin use for people with DSM-IV-TR heroin dependence. This cost-effective approach may be an efficient strategy to enhance treatment capacity. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial.

PubMed

Ryan, Dermot; Price, David; Musgrave, Stan D; Malhotra, Shweta; Lee, Amanda J; Ayansina, Dolapo; Sheikh, Aziz; Tarassenko, Lionel; Pagliari, Claudia; Pinnock, Hilary

2012-03-23

To determine whether mobile phone based monitoring improves asthma control compared with standard paper based monitoring strategies. Multicentre randomised controlled trial with cost effectiveness analysis. UK primary care. 288 adolescents and adults with poorly controlled asthma (asthma control questionnaire (ACQ) score ≥ 1.5) from 32 practices. Participants were centrally randomised to twice daily recording and mobile phone based transmission of symptoms, drug use, and peak flow with immediate feedback prompting action according to an agreed plan or paper based monitoring. Changes in scores on asthma control questionnaire and self efficacy (knowledge, attitude, and self efficacy asthma questionnaire (KASE-AQ)) at six months after randomisation. Assessment of outcomes was blinded. Analysis was on an intention to treat basis. There was no significant difference in the change in asthma control or self efficacy between the two groups (ACQ: mean change 0.75 in mobile group v 0.73 in paper group, mean difference in change -0.02 (95% confidence interval -0.23 to 0.19); KASE-AQ score: mean change -4.4 v -2.4, mean difference 2.0 (-0.3 to 4.2)). The numbers of patients who had acute exacerbations, steroid courses, and unscheduled consultations were similar in both groups, with similar healthcare costs. Overall, the mobile phone service was more expensive because of the expenses of telemonitoring. Mobile technology does not improve asthma control or increase self efficacy compared with paper based monitoring when both groups received clinical care to guidelines standards. The mobile technology was not cost effective. Clinical Trials NCT00512837.

Custom LSI plus hybrid equals cost effectiveness

NASA Astrophysics Data System (ADS)

Friedman, S. N.

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

The effectiveness and cost-effectiveness of a mindfulness training programme in schools compared with normal school provision (MYRIAD): study protocol for a randomised controlled trial.

PubMed

Kuyken, Willem; Nuthall, Elizabeth; Byford, Sarah; Crane, Catherine; Dalgleish, Tim; Ford, Tamsin; Greenberg, Mark T; Ukoumunne, Obioha C; Viner, Russell M; Williams, J Mark G

2017-04-26

Mindfulness-based approaches for adults are effective at enhancing mental health, but few controlled trials have evaluated their effectiveness or cost-effectiveness for young people. The primary aim of this trial is to evaluate the effectiveness and cost-effectiveness of a mindfulness training (MT) programme to enhance mental health, wellbeing and social-emotional behavioural functioning in adolescence. To address this aim, the design will be a superiority, cluster randomised controlled, parallel-group trial in which schools offering social and emotional provision in line with good practice (Formby et al., Personal, Social, Health and Economic (PSHE) Education: A mapping study of the prevalent models of delivery and their effectiveness, 2010; OFSTED, Not Yet Good Enough: Personal, Social, Health and Economic Education in schools, 2013) will be randomised to either continue this provision (control) or include MT in this provision (intervention). The study will recruit and randomise 76 schools (clusters) and 5700 school students aged 12 to 14 years, followed up for 2 years. The study will contribute to establishing if MT is an effective and cost-effective approach to promoting mental health in adolescence. International Standard Randomised Controlled Trials, identifier: ISRCTN86619085 . Registered on 3 June 2016.

Cost and Cost-effectiveness of Students for Nutrition and Exercise (SNaX)

PubMed Central

Ladapo, Joseph A.; Bogart, Laura M.; Klein, David J.; Cowgill, Burton O.; Uyeda, Kimberly; Binkle, David G.; Stevens, Elizabeth R.; Schuster, Mark A.

2015-01-01

Objective To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Methods Five intervention and five control middle schools (mean enrollment = 1,520 students) from the Los Angeles Unified School District participated in a randomized controlled trial of SNaX. Acquisition costs for materials and time and wage data for employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined using the ratio of variable costs to program efficacy outcomes. Results The costs of implementing the program over 5 weeks were $5,433.26 per school in fixed costs and $2.11 per student in variable costs, equaling a total cost of $8,637.17 per school, or $0.23 per student per day. This investment yielded significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks. The cost-effectiveness of the program, per student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per additional full-priced lunch served, $2.11 per additional reduced-price/free lunch served, and $1.69 per reduction in snacks sold. Conclusions SNaX demonstrated the feasibility and cost-effectiveness of a middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost is modest and unlikely to be a significant barrier to adoption for many schools considering its implementation. PMID:26427719

The cost-effectiveness analysis of JinQi Jiangtang tablets for the treatment on prediabetes: a randomized, double-blind, placebo-controlled, multicenter design.

PubMed

Sun, Xiao; Guo, Liping; Shang, Hongcai; Ren, Ming; Wang, Yue; Huo, Da; Lei, Xiang; Wang, Hui; Zhai, Jingbo

2015-11-03

At present, diabetes is a chronic disease of great cost and heavy burdens. The International Diabetes Federation has repeatedly warned that by 2025, the global number of diabetics would rise to 333 million from 194 million in 2003. Although the occurrence of diabetes in developing countries is lower, China has a large population, so that the number of cases is increased. At the same time, more people have prediabetes, a growing health concern where a large percentage of the patients develop full type 2 diabetes. In addition, the patients of diabetes easily incur complications such as blindness, kidney failure, and cardiovascular diseases that can seriously affect the patients' quality of life and cause great economic burdens to family and society. Therefore, effective interventions for prediabetes are needed to prevent or delay the occurrence and development of diabetes. A randomized controlled trial that was assessed with pharmacoeconomic methods was undertaken in this study. The study term was 24 months (12 months for the intervention and 12 months for follow up). Four hundred participants, recruited from four cities in China: Beijing, Tianjin, Xian, and Naning, were randomized to the treatment group (JQJT tablets) and the control group (placebo). Participants included in this study had been diagnosed with prediabetes according to the criteria for western medicine and Traditional Chinese Medicine (TCM). The end-point effectiveness indexes included the incidence of diabetes and the reversion rate. The drug costs and lifestyle intervention costs were included in the total costs. The study used the cost-effectiveness analysis to discuss the economic advantage of the JQJT tablets. The outcomes of the study contained 2 sections,namely clinical outcomes and cost-effectiveness analysis outcomes. The clinical outcomes: the treatment group and control group had no significant statistical difference P> 0.05) on the baseline of situation; Jinqi Jiangtang tablet effectively

Epidemiology and economic impact of health care-associated infections and cost-effectiveness of infection control measures at a Thai university hospital.

PubMed

Rattanaumpawan, Pinyo; Thamlikitkul, Visanu

2017-02-01

Data on clinical and economic impact of health care-associated infections (HAIs) from resource limited countries are limited. We aimed to determine epidemiology and economic impact of HAIs and cost-effectiveness of infection prevention and control measures in a resource-limited setting. A retrospective cohort study was conducted among hospitalized patients at Siriraj Hospital, Thailand. Results from the cohort were subsequently used to conduct cost-effective analysis (CEA) to compare the comprehensive implementation of individualized bundling infection control measures (IBICMs) with regular infection control care. From February-May 2013, there were 515 hospitalizations (497 patients) with 7,848 hospitalization days. Cumulative incidence of HAIs was 23.30%, and the incidence rate of HAIs was 18.66 ± 44.19 per 1,000 hospitalization days. Hospital mortality among those with and without HAIs was 33.33% and 20.00%, respectively (P < .001). The adjusted cost attributable to HAIs was $704.72 ± $226.73 (P < .001). CEA identified IBICMs as a non-dominated strategy, with an incremental cost-effectiveness ratio of -$20,444.62 per life saved. HAI is significantly related with higher hospital mortality, longer length of stay, and higher hospitalization costs. IBICMs were confirmed to be cost-effective at Siriraj Hospital. Implementing this intervention could improve care quality and save costs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Cost Estimation and Control for Flight Systems

NASA Technical Reports Server (NTRS)

Hammond, Walter E.; Vanhook, Michael E. (Technical Monitor)

2002-01-01

Good program management practices, cost analysis, cost estimation, and cost control for aerospace flight systems are interrelated and depend upon each other. The best cost control process cannot overcome poor design or poor systems trades that lead to the wrong approach. The project needs robust Technical, Schedule, Cost, Risk, and Cost Risk practices before it can incorporate adequate Cost Control. Cost analysis both precedes and follows cost estimation -- the two are closely coupled with each other and with Risk analysis. Parametric cost estimating relationships and computerized models are most often used. NASA has learned some valuable lessons in controlling cost problems, and recommends use of a summary Project Manager's checklist as shown here.

Is AF Ablation Cost Effective?

PubMed Central

Martin-Doyle, William; Reynolds, Matthew R.

2010-01-01

The use of catheter ablation to treat AF is increasing rapidly, but there is presently an incomplete understanding of its cost-effectiveness. AF ablation procedures involve significant up-front expenditures, but multiple randomized trials have demonstrated that ablation is more effective than antiarrhythmic drugs at maintaining sinus rhythm in a second-line and possibly first-line rhythm control setting. Although truly long-term data are limited, ablation, as compared with antiarrrhythmic drugs, also appears associated with improved symptoms and quality of life and a reduction in downstream hospitalization and other health care resource utilization. Several groups have developed cost effectiveness models comparing AF ablation primarily to antiarrhythmic drugs and the model results suggest that ablation likely falls within the range generally accepted as cost-effective in developed nations. This paper will review available information on the cost-effectiveness of catheter ablation for the treatment of atrial fibrillation, and discuss continued areas of uncertainty where further research is required. PMID:20936083

Effect of comprehensive cardiac telerehabilitation on one-year cardiovascular rehospitalization rate, medical costs and quality of life: A cost-effectiveness analysis.

PubMed

Frederix, Ines; Hansen, Dominique; Coninx, Karin; Vandervoort, Pieter; Vandijck, Dominique; Hens, Niel; Van Craenenbroeck, Emeline; Van Driessche, Niels; Dendale, Paul

2016-05-01

Notwithstanding the cardiovascular disease epidemic, current budgetary constraints do not allow for budget expansion of conventional cardiac rehabilitation programmes. Consequently, there is an increasing need for cost-effectiveness studies of alternative strategies such as telerehabilitation. The present study evaluated the cost-effectiveness of a comprehensive cardiac telerehabilitation programme. This multi-centre randomized controlled trial comprised 140 cardiac rehabilitation patients, randomized (1:1) to a 24-week telerehabilitation programme in addition to conventional cardiac rehabilitation (intervention group) or to conventional cardiac rehabilitation alone (control group). The incremental cost-effectiveness ratio was calculated based on intervention and health care costs (incremental cost), and the differential incremental quality adjusted life years (QALYs) gained. The total average cost per patient was significantly lower in the intervention group (€2156 ± €126) than in the control group (€2720 ± €276) (p = 0.01) with an overall incremental cost of €-564.40. Dividing this incremental cost by the baseline adjusted differential incremental QALYs (0.026 QALYs) yielded an incremental cost-effectiveness ratio of €-21,707/QALY. The number of days lost due to cardiovascular rehospitalizations in the intervention group (0.33 ± 0.15) was significantly lower than in the control group (0.79 ± 0.20) (p = 0.037). This paper shows the addition of cardiac telerehabilitation to conventional centre-based cardiac rehabilitation to be more effective and efficient than centre-based cardiac rehabilitation alone. These results are useful for policy makers charged with deciding how limited health care resources should best be allocated in the era of exploding need. © The European Society of Cardiology 2015.

Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme

PubMed Central

Posso, Margarita; Carles, Misericòrdia; Rué, Montserrat; Puig, Teresa; Bonfill, Xavier

2016-01-01

Objectives The usual practice in breast cancer screening programmes for mammogram interpretation is to perform double reading. However, little is known about its cost-effectiveness in the context of digital mammography. Our purpose was to evaluate the cost-effectiveness of double reading versus single reading of digital mammograms in a population-based breast cancer screening programme. Methods Data from 28,636 screened women was used to establish a decision-tree model and to compare three strategies: 1) double reading; 2) double reading for women in their first participation and single reading for women in their subsequent participations; and 3) single reading. We calculated the incremental cost-effectiveness ratio (ICER), which was defined as the expected cost per one additionally detected cancer. We performed a deterministic sensitivity analysis to test the robustness of the ICER. Results The detection rate of double reading (5.17‰) was similar to that of single reading (4.78‰; P = .768). The mean cost of each detected cancer was €8,912 for double reading and €8,287 for single reading. The ICER of double reading versus single reading was €16,684. The sensitivity analysis showed variations in the ICER according to the sensitivity of reading strategies. The strategy that combines double reading in first participation with single reading in subsequent participations was ruled out due to extended dominance. Conclusions From our results, double reading appears not to be a cost-effective strategy in the context of digital mammography. Double reading would eventually be challenged in screening programmes, as single reading might entail important net savings without significantly changing the cancer detection rate. These results are not conclusive and should be confirmed in prospective studies that investigate long-term outcomes like quality adjusted life years (QALYs). PMID:27459663

Cost-Effectiveness of Financial Incentives to Promote Adherence to Depot Antipsychotic Medication: Economic Evaluation of a Cluster-Randomised Controlled Trial

PubMed Central

Henderson, Catherine; Knapp, Martin; Yeeles, Ksenija; Bremner, Stephen; Eldridge, Sandra; David, Anthony S.; O’Connell, Nicola; Burns, Tom; Priebe, Stefan

2015-01-01

Background Offering a modest financial incentive to people with psychosis can promote adherence to depot antipsychotic medication, but the cost-effectiveness of this approach has not been examined. Methods Economic evaluation within a pragmatic cluster-randomised controlled trial. 141 patients under the care of 73 teams (clusters) were randomised to intervention or control; 138 patients with diagnoses of schizophrenia, schizo-affective disorder or bipolar disorder participated. Intervention participants received £15 per depot injection over 12 months, additional to usual acute, mental and community primary health services. The control group received usual health services. Main outcome measures: incremental cost per 20% increase in adherence to depot antipsychotic medication; incremental cost of ‘good’ adherence (defined as taking at least 95% of the prescribed number of depot medications over the intervention period). Findings Economic and outcome data for baseline and 12-month follow-up were available for 117 participants. The adjusted difference in adherence between groups was 12.2% (73.4% control vs. 85.6% intervention); the adjusted costs difference was £598 (95% CI -£4 533, £5 730). The extra cost per patient to increase adherence to depot medications by 20% was £982 (95% CI -£8 020, £14 000). The extra cost per patient of achieving 'good' adherence was £2 950 (CI -£19 400, £27 800). Probability of cost-effectiveness exceeded 97.5% at willingness-to-pay values of £14 000 for a 20% increase in adherence and £27 800 for good adherence. Interpretation Offering a modest financial incentive to people with psychosis is cost-effective in promoting adherence to depot antipsychotic medication. Direct healthcare costs (including costs of the financial incentive) are unlikely to be increased by this intervention. Trial Registration ISRCTN.com 77769281 PMID:26448540

Digital PI-PD controller design for arbitrary order systems: Dominant pole placement approach.

PubMed

Dincel, Emre; Söylemez, Mehmet Turan

2018-05-02

In this paper, a digital PI-PD controller design method is proposed for arbitrary order systems with or without time-delay to achieve desired transient response in the closed-loop via dominant pole placement approach. The digital PI-PD controller design problem is solved by converting the original problem to the digital PID controller design problem. Firstly, parametrization of the digital PID controllers which assign dominant poles to desired location is done. After that the subset of digital PID controller parameters in which the remaining poles are located away from the dominant pole pair is found via Chebyshev polynomials. The obtained PID controller parameters are then transformed into the PI-PD controller parameters by considering the closed-loop controller zero and the design is completed. Success of the proposed design method is firstly demonstrated on an example transfer function and compared with the well-known PID controller methods from the literature through simulations. After that the design method is implemented on the fan and plate laboratory system in a real environment. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

Digital rights management for digital cinema

NASA Astrophysics Data System (ADS)

Kirovski, Darko; Peinado, Marcus; Petitcolas, Fabien A. P.

2001-12-01

There is a wide consensus among the feature film production studios that the Internet era brings a new paradigm for film distribution to cinemas worldwide. The benefits of digital cinema to both producers and cinemas are numerous: significantly lower distribution and maintenance costs, immediate access to film libraries, higher presentation quality, and strong potential for developing new business models. Despite these advantages, the studios are still reluctant to jump into the digital age. The main showstopper for digital cinema is the danger of widespread piracy. Piracy already costs Hollywood an estimated two billion dollars annually and digital cinema without proper copyright enforcement could increase this number. In this paper, we present a copyright management system that aims at providing the set of necessary security tools: standard cryptographic primitives and copyright protection mechanisms that enable a reliable and secure feature film delivery system.

Digital controllers for VTOL aircraft

NASA Technical Reports Server (NTRS)

Stengel, R. F.; Broussard, J. R.; Berry, P. W.

1976-01-01

Using linear-optimal estimation and control techniques, digital-adaptive control laws have been designed for a tandem-rotor helicopter which is equipped for fully automatic flight in terminal area operations. Two distinct discrete-time control laws are designed to interface with velocity-command and attitude-command guidance logic, and each incorporates proportional-integral compensation for non-zero-set-point regulation, as well as reduced-order Kalman filters for sensor blending and noise rejection. Adaptation to flight condition is achieved with a novel gain-scheduling method based on correlation and regression analysis. The linear-optimal design approach is found to be a valuable tool in the development of practical multivariable control laws for vehicles which evidence significant coupling and insufficient natural stability.

Development of Low-Cost Microcontroller-Based Interface for Data Acquisition and Control of Microbioreactor Operation.

PubMed

Husain, Abdul Rashid; Hadad, Yaser; Zainal Alam, Muhd Nazrul Hisham

2016-10-01

This article presents the development of a low-cost microcontroller-based interface for a microbioreactor operation. An Arduino MEGA 2560 board with 54 digital input/outputs, including 15 pulse-width-modulation outputs, has been chosen to perform the acquisition and control of the microbioreactor. The microbioreactor (volume = 800 µL) was made of poly(dimethylsiloxane) and poly(methylmethacrylate) polymers. The reactor was built to be equipped with sensors and actuators for the control of reactor temperature and the mixing speed. The article discusses the circuit of the microcontroller-based platform, describes the signal conditioning steps, and evaluates the capacity of the proposed low-cost microcontroller-based interface in terms of control accuracy and system responses. It is demonstrated that the proposed microcontroller-based platform is able to operate parallel microbioreactor operation with satisfactory performances. Control accuracy at a deviation less than 5% of the set-point values and responses in the range of few seconds have been recorded. © 2015 Society for Laboratory Automation and Screening.

Digital implementation of the TF30-P-3 turbofan engine control

NASA Technical Reports Server (NTRS)

Cwynar, D. S.; Batterton, P. G.

1975-01-01

The standard hydromechanical control modes for TF30-P-3 engine were implemented on a digital process control computer. Programming methods are described, and a method is presented to solve stability problems associated with fast response dynamic loops contained within the exhaust nozzle control. A modification of the exhaust nozzle control to provide for either velocity or position servoactuation systems is discussed. Transient response of the digital control was evaluated by tests on a real time hybrid simulation of the TF30-P-3 engine. It is shown that the deadtime produced by the calculation time delay between sampling and final output is more significant to transient response than the effects associated with sampling rate alone. For the main fuel control, extended update and calculation times resulted in a lengthened transient response to throttle bursts from idle to intermediate with an increase in high pressure compressor stall margin. Extremely long update intervals of 250 msec could be achieved without instability. Update extension for the exhaust nozzle control resulted in a delayed response of the afterburner light-off detector and exhaust nozzle overshoot with resulting fan oversuppression. Long update times of 150 msec caused failure of the control due to a false indication by the blowout detector.

The Cost Effectiveness of Docetaxel and Active Symptom Control versus Active Symptom Control Alone for Refractory Oesophagogastric Adenocarcinoma: Economic Analysis of the COUGAR-02 Trial.

PubMed

Meads, David M; Marshall, Andrea; Hulme, Claire T; Dunn, Janet A; Ford, Hugo E R

2016-01-01

The COUGAR-02 trial recently showed survival and quality-of-life benefits of docetaxel and active symptom control (DXL + ASC) over active symptom control (ASC) alone in patients with refractory oesophagogastric adenocarcinoma. The aim of this study was to conduct an economic evaluation conforming to National Institute for Health and Care Excellence (NICE) technology appraisal guidance to evaluate the cost effectiveness of DXL + ASC versus ASC from the perspective of the English National Health Service (NHS). Cost-utility analyses were conducted using trial data. Utility values were captured using the EQ-5D completed by patients at 3- and 6-weekly intervals, while resource use was captured using nurse-completed report forms and patient reports. Incremental cost-effectiveness ratios (ICERs) were calculated and the main outcome was cost per incremental quality-adjusted life-year (QALY). Nonparametric bootstrapping was conducted to capture sampling uncertainty and to generate a cost-effectiveness acceptability curve (CEAC). The analysis horizon was the trial period (median follow-up 12 months) and no modelling or discounting of future costs and benefits was conducted. Average costs were £9352 and £6218 for DXL + ASC and ASC, respectively, and average QALYs were 0.302 and 0.186, respectively. This yielded an ICER of £27,180 for DXL + ASC. DXL + ASC had a 24 % chance of being cost effective at a £20,000 QALY threshold (lambda) and a mean net monetary benefit of -£821; this rose to 59 % and £332 when the threshold was raised to £30,000. If NICE end-of-life criteria are applied, the probability of cost effectiveness increases to 90 % (at lambda = £50,000). Results were robust to sensitivity analyses. DXL + ASC is likely to be cost effective if an end-of-life premium is applied. Further research should determine the impact of different utility measurement strategies and different chemotherapy delivery modes on estimates of cost effectiveness.

Integrated digital/electric aircraft concepts study

NASA Technical Reports Server (NTRS)

Cronin, M. J.; Hays, A. P.; Green, F. B.; Radovcich, N. A.; Helsley, C. W.; Rutchik, W. L.

1985-01-01

The integrated digital/electrical aircraft (IDEA) is an aircraft concept which employs all electric secondary power systems and advanced digital flight control systems. After trade analysis, preferred systems were applied to the baseline configuration. An additional configuration, the alternate IDEA, was also considered. For this concept the design ground rules were relaxed in order to quantify additional synergistic benefits. It was proposed that an IDEA configuration and technical risks associated with the IDEA systems concepts be defined and the research and development required activities to reduce these risks be identified. The selected subsystems include: power generation, power distribution, actuators, environmental control system and flight controls systems. When the aircraft was resized, block fuel was predicted to decrease by 11.3 percent, with 7.9 percent decrease in direct operating cost. The alternate IDEA shows a further 3.4 percent reduction in block fuel and 3.1 percent reduction in direct operating cost.

A professional and cost effective digital video editing and image storage system for the operating room.

PubMed

Scollato, A; Perrini, P; Benedetto, N; Di Lorenzo, N

2007-06-01

We propose an easy-to-construct digital video editing system ideal to produce video documentation and still images. A digital video editing system applicable to many video sources in the operating room is described in detail. The proposed system has proved easy to use and permits one to obtain videography quickly and easily. Mixing different streams of video input from all the devices in use in the operating room, the application of filters and effects produces a final, professional end-product. Recording on a DVD provides an inexpensive, portable and easy-to-use medium to store or re-edit or tape at a later time. From stored videography it is easy to extract high-quality, still images useful for teaching, presentations and publications. In conclusion digital videography and still photography can easily be recorded by the proposed system, producing high-quality video recording. The use of firewire ports provides good compatibility with next-generation hardware and software. The high standard of quality makes the proposed system one of the lowest priced products available today.

Cost Effectiveness and Cost Containment in the Era of Interferon-Free Therapies to Treat Hepatitis C Virus Genotype 1

PubMed Central

Morgan, Jake R.; Pho, Mai T.; Leff, Jared A.; Schackman, Bruce R.; Horsburgh, C. Robert; Assoumou, Sabrina A.; Salomon, Joshua A.; Weinstein, Milton C.; Freedberg, Kenneth A.; Kim, Arthur Y.

2017-01-01

Abstract Background. Interferon-free regimens to treat hepatitis C virus (HCV) genotype 1 are effective but costly. At this time, payers in the United States use strategies to control costs including (1) limiting treatment to those with advanced disease and (2) negotiating price discounts in exchange for exclusivity. Methods. We used Monte Carlo simulation to investigate budgetary impact and cost effectiveness of these treatment policies and to identify strategies that balance access with cost control. Outcomes included nondiscounted 5-year payer cost per 10000 HCV-infected patients and incremental cost-effectiveness ratios. Results. We found that the budgetary impact of HCV treatment is high, with 5-year undiscounted costs of $1.0 billion to 2.3 billion per 10000 HCV-infected patients depending on regimen choices. Among noncirrhotic patients, using the least costly interferon-free regimen leads to the lowest payer costs with negligible difference in clinical outcomes, even when the lower cost regimen is less convenient and/or effective. Among cirrhotic patients, more effective but costly regimens remain cost effective. Controlling costs by restricting treatment to those with fibrosis stage 2 or greater disease was cost ineffective for any patient type compared with treating all patients. Conclusions. Treatment strategies using interferon-free therapies to treat all HCV-infected persons are cost effective, but short-term cost is high. Among noncirrhotic patients, using the least costly interferon-free regimen, even if it is not single tablet or once daily, is the cost-control strategy that results in best outcomes. Restricting treatment to patients with more advanced disease often results in worse outcomes than treating all patients, and it is not preferred. PMID:28480259

Reducing Suicidal Ideation: Cost-Effectiveness Analysis of a Randomized Controlled Trial of Unguided Web-Based Self-help

PubMed Central

Majo, M. Cristina; Smit, Filip; van Straten, Annemieke; Kerkhof, Ad J.F.M

2012-01-01

Background Suicidal ideation is highly prevalent, but often remains untreated. The Internet can be used to provide accessible interventions. Objective To evaluate the cost-effectiveness of an online, unguided, self-help intervention for reducing suicidal ideation. Methods A total of 236 adults with mild to moderate suicidal thoughts, defined as scores between 1-26 on the Beck Scale for Suicide Ideation (BSS), were recruited in the general population and randomized to the intervention (n = 116) or to a waitlist, information-only, control group (n = 120). The intervention aimed to decrease the frequency and intensity of suicidal ideation and consisted of 6 modules based on cognitive behavioral techniques. Participants in both groups had unrestricted access to care as usual. Assessments took place at baseline and 6 weeks later (post-test). All questionnaires were self-report and administered via the Internet. Treatment response was defined as a clinically significant decrease in suicidal ideation on the BSS. Total per-participant costs encompassed costs of health service uptake, participants’ out-of-pocket expenses, costs stemming from production losses, and intervention costs. These were expressed in Euros (€) for the reference year 2009. Results At post-test, treatment response was 35.3% and 20.8% in the experimental and control conditions, respectively. The incremental effectiveness was 0.35 − 0.21 = 0.15 (SE 0.06, P = .01). The annualized incremental costs were −€5039 per participant. Therefore, the mean incremental cost-effectiveness ratio (ICER) was estimated to be −€5039/0.15 = −€34,727 after rounding (US −$41,325) for an additional treatment response, indicating annual cost savings per treatment responder. Conclusions This is the first trial to indicate that online self-help to reduce suicidal ideation is feasible, effective, and cost saving. Limitations included reliance on self-report and a short timeframe (6 weeks). Therefore

Optimal combinations of control strategies and cost-effective analysis for visceral leishmaniasis disease transmission.

PubMed

Biswas, Santanu; Subramanian, Abhishek; ELMojtaba, Ibrahim M; Chattopadhyay, Joydev; Sarkar, Ram Rup

2017-01-01

Visceral leishmaniasis (VL) is a deadly neglected tropical disease that poses a serious problem in various countries all over the world. Implementation of various intervention strategies fail in controlling the spread of this disease due to issues of parasite drug resistance and resistance of sandfly vectors to insecticide sprays. Due to this, policy makers need to develop novel strategies or resort to a combination of multiple intervention strategies to control the spread of the disease. To address this issue, we propose an extensive SIR-type model for anthroponotic visceral leishmaniasis transmission with seasonal fluctuations modeled in the form of periodic sandfly biting rate. Fitting the model for real data reported in South Sudan, we estimate the model parameters and compare the model predictions with known VL cases. Using optimal control theory, we study the effects of popular control strategies namely, drug-based treatment of symptomatic and PKDL-infected individuals, insecticide treated bednets and spray of insecticides on the dynamics of infected human and vector populations. We propose that the strategies remain ineffective in curbing the disease individually, as opposed to the use of optimal combinations of the mentioned strategies. Testing the model for different optimal combinations while considering periodic seasonal fluctuations, we find that the optimal combination of treatment of individuals and insecticide sprays perform well in controlling the disease for the time period of intervention introduced. Performing a cost-effective analysis we identify that the same strategy also proves to be efficacious and cost-effective. Finally, we suggest that our model would be helpful for policy makers to predict the best intervention strategies for specific time periods and their appropriate implementation for elimination of visceral leishmaniasis.

Digital gate pulse generator for cycloconverter control

DOEpatents

Klein, Frederick F.; Mutone, Gioacchino A.

1989-01-01

The present invention provides a digital gate pulse generator which controls the output of a cycloconverter used for electrical power conversion applications by determining the timing and delivery of the firing pulses to the switching devices in the cycloconverter. Previous gate pulse generators have been built with largely analog or discrete digital circuitry which require many precision components and periodic adjustment. The gate pulse generator of the present invention utilizes digital techniques and a predetermined series of values to develop the necessary timing signals for firing the switching device. Each timing signal is compared with a reference signal to determine the exact firing time. The present invention is significantly more compact than previous gate pulse generators, responds quickly to changes in the output demand and requires only one precision component and no adjustments.

The effectiveness and cost effectiveness of the PAtient-Centred Team (PACT) model: study protocol of a prospective matched control before-and-after study.

PubMed

Bergmo, Trine S; Berntsen, Gro K; Dalbakk, Monika; Rumpsfeld, Markus

2015-10-23

The present study protocol describes the evaluation of a comprehensive integrated care model implemented at two hospital sites at the University Hospital of North Norway (UNN). The PAtient Centred Team (PACT) model includes proactive, patient-centred interdisciplinary teams that aim to improve the continuum and quality of care of frail elderly patients and reduce health care costs. The main objectives of the evaluation are to analyse the effectiveness and cost effectiveness of using patient-centred teams as part of routine service provision for this patient group. The evaluation will analyse the effect on patient health and functional status, patient experiences and hospital utilisation, and it will conduct an economic evaluation. This paper describes the PACT model and the rationale for and design of the planned effectiveness and cost-effectiveness study. This is a prospective, non-randomised matched control before-and-after intervention study. Patients in the intervention group will be recruited from the hospital sites that have implemented the PACT model. The controls will be recruited from two hospitals without the model. The control patients and the index patients will be matched according to sex, age and number of long-term conditions. The study aims to include 600 patients in each group, which will provide sufficient power to detect a clinical change in the primary outcome. The primary outcome is the physical dimension of the Short Form Health Survey (SF-36). Secondary outcomes are the Patient Generated Index (PGI), the Patient Activation Measure (PAM), the Patient Assessment of Chronic Illness Care (PACIC), hospitalisation and length of stay. The cost-effectiveness study takes a health provider perspective and calculates the cost per quality-adjusted life-years (QALYs) gained. The data will be collected at baseline, 6 and 12 months. The data will be analysed using techniques and models that recognise the lack of randomisation and the correlation of cost

Cost Effectiveness of Community Based Strategies for Blood Pressure Control in a Low income Developing Country: Findings from A Cluster Randomized Factorial Controlled Trial

PubMed Central

Jafar, Tazeen H; Islam, Muhammad; Bux, Rasool; Poulter, Neil; Hatcher, Juanita; Chaturvedi, Nish; Ebrahim, Shah; Cosgrove, Peter

2011-01-01

Background Evidence on economically efficient strategies to lower blood pressure (BP) from low- and middle-income countries remains scarce. The Control of Blood Pressure and Risk Attenuation (COBRA) trial randomized 1341 hypertensive subjects in 12 randomly selected communities in Karachi, Pakistan, to three intervention programs: combined home health education (HHE) plus trained general practitioner (GP); 2) HHE only; 3) trained GP only. The comparator was no intervention (or usual care). The reduction in BP was most pronounced in the combined group. The present study examined the cost-effectiveness of these strategies. Methods and Results Total costs were assessed at baseline and 2 years to estimate incremental cost effectiveness ratios (ICER) based on (a) intervention cost; b) cost of physician consultation, medications and diagnostics, changes in lifestyle, and productivity loss and (c) change in systolic BP. Precision of the ICER estimates was assessed by 1000 bootstrapping replications. Bayesian probabilistic sensitivity analysis was also performed. The annual per participant cost associated with the combined HHE plus trained GP, HHE alone, and trained GP alone were $3.99, $3.34, and $0.65, respectively. HHE plus trained GP was the most cost effective intervention with an ICER of $ 23 (6 to 99) per mm Hg reduction in systolic BP compared to usual care and remained so in 97.7% of 1000 bootstrapped replications. Conclusions The combined intervention of HHE plus trained GP is potentially affordable and more cost effective for BP control than usual care or either strategy alone in some communities in Pakistan, and possibly other countries in Indo-China with similar healthcare infrastructure. PMID:21931077

Cost of malaria control in Sri Lanka.

PubMed

Konradsen, F; Steele, P; Perera, D; van der Hoek, W; Amerasinghe, P H; Amerasinghe, F P

1999-01-01

The study provides estimates of the cost of various malaria control measures in an area of North-Central Province of Sri Lanka where the disease is endemic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated to cost Rs 48 (US(40.87) per individual protected per year, less than half the cost of spraying houses with residual insecticides. Larviciding of vector breeding sites and especially the elimination of breeding habitats by flushing streams through seasonal release of water from upstream reservoirs was estimated to be cheaper than other preventive measures (Rs 27 (US$ 0.49) and Rs 13 (US$ 0.24) per individual protected, respectively). Inclusion of both operational and capital costs of treatment indicates that the most cost-effective intervention for the government was a centrally located hospital with a relatively large catchment area (Rs 71 (US$ 1.29) per malaria case treated). Mobile clinics (Rs 153 (US$ 2.78) per malaria case treated) and a village treatment centre (Rs 112 (US$ 2.04)) per malaria case treated) were more expensive options for the government, but were considerably cheaper for households than the traditional hospital facilities. This information can guide health planners and government decision-makers in choosing the most appropriate combination of curative and preventive measures to control malaria. However, the option that is cheapest for the government may not be so for the householders, and further studies are needed to estimate the effectiveness of the various preventive measures.

Cost of malaria control in Sri Lanka.

PubMed Central

Konradsen, F.; Steele, P.; Perera, D.; van der Hoek, W.; Amerasinghe, P. H.; Amerasinghe, F. P.

1999-01-01

The study provides estimates of the cost of various malaria control measures in an area of North-Central Province of Sri Lanka where the disease is endemic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated to cost Rs 48 (US(40.87) per individual protected per year, less than half the cost of spraying houses with residual insecticides. Larviciding of vector breeding sites and especially the elimination of breeding habitats by flushing streams through seasonal release of water from upstream reservoirs was estimated to be cheaper than other preventive measures (Rs 27 (US$ 0.49) and Rs 13 (US$ 0.24) per individual protected, respectively). Inclusion of both operational and capital costs of treatment indicates that the most cost-effective intervention for the government was a centrally located hospital with a relatively large catchment area (Rs 71 (US$ 1.29) per malaria case treated). Mobile clinics (Rs 153 (US$ 2.78) per malaria case treated) and a village treatment centre (Rs 112 (US$ 2.04)) per malaria case treated) were more expensive options for the government, but were considerably cheaper for households than the traditional hospital facilities. This information can guide health planners and government decision-makers in choosing the most appropriate combination of curative and preventive measures to control malaria. However, the option that is cheapest for the government may not be so for the householders, and further studies are needed to estimate the effectiveness of the various preventive measures. PMID:10327708