Is the profitability of Canadian tiestall farms associated with their performance on an animal welfare assessment?

PubMed

Villettaz Robichaud, M; Rushen, J; de Passillé, A M; Vasseur, E; Haley, D B; Pellerin, D

2018-03-01

In order for dairy producers to comply with animal welfare recommendations, financial investments may be required. In Canada, a new dairy animal care assessment program is currently being implemented under the proAction Initiative to determine the extent to which certain aspects of the Code of Practice are being followed and to assess the care and well-being of dairy cattle on farm. The aim of the current study was to evaluate the association between meeting the proAction animal-based and the electric trainer placement criteria and certain aspects of productivity and profitability on tiestall dairy farms. The results of a previous on-farm cow comfort assessment conducted on 100 Canadian tiestall farms were used to simulate the results of a part of the proAction Animal Care assessment on these farms. Each farm's productivity and profitability data were retrieved from the regional dairy herd improvement associations. Univariable and multivariable linear regressions were used to evaluate the associations between meeting these proAction criteria and the farms' average yearly: corrected milk production, somatic cell count (SCC), calving interval, number of breedings/cow, culling rate, prevalence of cows in third or higher lactation, and margins per cow and per kilogram of quota calculated over replacement costs. The association between milk production and the proAction lameness criterion was moderated through an interaction with the milk production genetic index which resulted in an increase in milk production per year with increasing genetic index that was steeper in farms that met the proAction lameness criterion compared with farms that did not. Meeting the proAction body condition score criterion was associated with reduced SCC and meeting the proAction electric trainer placement criterion was associated with SCC through an interaction with the farms' average SCC genetic index. The increase in SCC with increasing SCC genetic index was milder in farms that met this criterion compared with farms that did not. Farms that met the proAction electric trainer placement criterion had 4.6% more cows in their third or greater lactation. These results suggest that some associations exist between the productivity of Canadian tiestall farms and meeting several parameters of the proAction Animal Care assessment. Meeting these criteria is unlikely to impose any economic burden to the dairy industry as a whole. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Can Pearlite form Outside of the Hultgren Extrapolation of the Ae3 and Acm Phase Boundaries?

NASA Astrophysics Data System (ADS)

Aranda, M. M.; Rementeria, R.; Capdevila, C.; Hackenberg, R. E.

2016-02-01

It is usually assumed that ferrous pearlite can form only when the average austenite carbon concentration C 0 lies between the extrapolated Ae3 ( γ/ α) and Acm ( γ/ θ) phase boundaries (the "Hultgren extrapolation"). This "mutual supersaturation" criterion for cooperative lamellar nucleation and growth is critically examined from a historical perspective and in light of recent experiments on coarse-grained hypoeutectoid steels which show pearlite formation outside the Hultgren extrapolation. This criterion, at least as interpreted in terms of the average austenite composition, is shown to be unnecessarily restrictive. The carbon fluxes evaluated from Brandt's solution are sufficient to allow pearlite growth both inside and outside the Hultgren Extrapolation. As for the feasibility of the nucleation events leading to pearlite, the only criterion is that there are some local regions of austenite inside the Hultgren Extrapolation, even if the average austenite composition is outside.

Occurrence and distribution of fecal indicator bacteria, and physical and chemical indicators of water quality in streams receiving discharge from Dallas/Fort Worth International Airport and vicinity, North-Central Texas, 2008

USGS Publications Warehouse

Harwell, Glenn R.; Mobley, Craig A.

2009-01-01

This report, done by the U.S. Geological Survey in cooperation with Dallas/Fort Worth International (DFW) Airport in 2008, describes the occurrence and distribution of fecal indicator bacteria (fecal coliform and Escherichia [E.] coli), and the physical and chemical indicators of water quality (relative to Texas Surface Water Quality Standards), in streams receiving discharge from DFW Airport and vicinity. At sampling sites in the lower West Fork Trinity River watershed during low-flow conditions, geometric mean E. coli counts for five of the eight West Fork Trinity River watershed sampling sites exceeded the Texas Commission on Environmental Quality E. coli criterion, thus not fully supporting contact recreation. Two of the five sites with geometric means that exceeded the contact recreation criterion are airport discharge sites, which here means that the major fraction of discharge at those sites is from DFW Airport. At sampling sites in the Elm Fork Trinity River watershed during low-flow conditions, geometric mean E. coli counts exceeded the geometric mean contact recreation criterion for seven (four airport, three non-airport) of 13 sampling sites. Under low-flow conditions in the lower West Fork Trinity River watershed, E. coli counts for airport discharge sites were significantly different from (lower than) E. coli counts for non-airport sites. Under low-flow conditions in the Elm Fork Trinity River watershed, there was no significant difference between E. coli counts for airport sites and non-airport sites. During stormflow conditions, fecal indicator bacteria counts at the most downstream (integrator) sites in each watershed were considerably higher than counts at those two sites during low-flow conditions. When stormflow sample counts are included with low-flow sample counts to compute a geometric mean for each site, classification changes from fully supporting to not fully supporting contact recreation on the basis of the geometric mean contact recreation criterion. All water temperature measurements at sampling sites in the lower West Fork Trinity River watershed were less than the maximum criterion for water temperature for the lower West Fork Trinity segment. Of the measurements at sampling sites in the Elm Fork Trinity River watershed, 95 percent were less than the maximum criterion for water temperature for the Elm Fork Trinity River segment. All dissolved oxygen concentrations were greater than the minimum criterion for stream segments classified as exceptional aquatic life use. Nearly all pH measurements were within the pH criterion range for the classified segments in both watersheds, except for those at one airport site. For sampling sites in the lower West Fork Trinity River watershed, all annual average dissolved solids concentrations were less than the maximum criterion for the lower West Fork Trinity segment. For sampling sites in the Elm Fork Trinity River, nine of the 13 sites (six airport, three non-airport) had annual averages that exceeded the maximum criterion for that segment. For ammonia, 23 samples from 12 different sites had concentrations that exceeded the screening level for ammonia. Of these 12 sites, only one non-airport site had more than the required number of exceedances to indicate a screening level concern. Stormflow total suspended solids concentrations were significantly higher than low-flow concentrations at the two integrator sites. For sampling sites in the lower West Fork Trinity River watershed, all annual average chloride concentrations were less than the maximum annual average chloride concentration criterion for that segment. For the 13 sampling sites in the Elm Fork Trinity River watershed, one non-airport site had an annual average concentration that exceeded the maximum annual average chloride concentration criterion for that segment.

Effects of error covariance structure on estimation of model averaging weights and predictive performance

USGS Publications Warehouse

Lu, Dan; Ye, Ming; Meyer, Philip D.; Curtis, Gary P.; Shi, Xiaoqing; Niu, Xu-Feng; Yabusaki, Steve B.

2013-01-01

When conducting model averaging for assessing groundwater conceptual model uncertainty, the averaging weights are often evaluated using model selection criteria such as AIC, AICc, BIC, and KIC (Akaike Information Criterion, Corrected Akaike Information Criterion, Bayesian Information Criterion, and Kashyap Information Criterion, respectively). However, this method often leads to an unrealistic situation in which the best model receives overwhelmingly large averaging weight (close to 100%), which cannot be justified by available data and knowledge. It was found in this study that this problem was caused by using the covariance matrix, CE, of measurement errors for estimating the negative log likelihood function common to all the model selection criteria. This problem can be resolved by using the covariance matrix, Cek, of total errors (including model errors and measurement errors) to account for the correlation between the total errors. An iterative two-stage method was developed in the context of maximum likelihood inverse modeling to iteratively infer the unknown Cek from the residuals during model calibration. The inferred Cek was then used in the evaluation of model selection criteria and model averaging weights. While this method was limited to serial data using time series techniques in this study, it can be extended to spatial data using geostatistical techniques. The method was first evaluated in a synthetic study and then applied to an experimental study, in which alternative surface complexation models were developed to simulate column experiments of uranium reactive transport. It was found that the total errors of the alternative models were temporally correlated due to the model errors. The iterative two-stage method using Cekresolved the problem that the best model receives 100% model averaging weight, and the resulting model averaging weights were supported by the calibration results and physical understanding of the alternative models. Using Cek obtained from the iterative two-stage method also improved predictive performance of the individual models and model averaging in both synthetic and experimental studies.

The role of public and private transfers in the cost-benefit analysis of mental health programs.

PubMed

Brent, Robert J

2004-11-01

This paper revisits the issue of whether to include maintenance costs in an economic evaluation in mental health. The source of these maintenance costs may be public or private transfers. The issue is discussed in terms of a formal cost-benefit criterion. It is shown that, when transfers have productivity effects, income distribution is important, and one recognizes that public transfers have tax implications, transfers can have real resource effects and cannot be ignored. The criterion is then applied to an evaluation of three case management programs in California that sought to reduce the intensive hospitalization of the severely mentally ill. 2004 John Wiley & Sons, Ltd.

Public health impact and cost effectiveness of mass vaccination with live attenuated human rotavirus vaccine (RIX4414) in India: model based analysis.

PubMed

Rose, Johnie; Hawthorn, Rachael L; Watts, Brook; Singer, Mendel E

2009-09-25

To examine the public health impact of mass vaccination with live attenuated human rotavirus vaccine (RIX4414) in a birth cohort in India, and to estimate the cost effectiveness and affordability of such a programme. Decision analytical Markov model encompassing all direct medical costs. Infection risk and severity depended on age, number of previous infections, and vaccination history; probabilities of use of inpatient and outpatient health services depended on symptom severity. Published clinical, epidemiological, and economic data. When possible, parameter estimates were based on data specific for India. Population Simulated Indian birth cohort followed for five years. Decrease in rotavirus gastroenteritis episodes (non-severe and severe), deaths, outpatient visits, and admission to hospital; incremental cost effectiveness ratio of vaccination expressed as net cost in 2007 rupees per life year saved. In the base case, vaccination prevented 28,943 (29.7%) symptomatic episodes, 6981 (38.2%) severe episodes, 164 deaths (41.0%), 7178 (33.3%) outpatient visits, and 812 (34.3%) admissions to hospital per 100,000 children. Vaccination cost 8023 rupees (about pound100, euro113, $165) per life year saved, less than India's per capita gross domestic product, a common criterion for cost effectiveness. The net programme cost would be equivalent to 11.6% of the 2006-7 budget of the Indian Department of Health and Family Welfare. Model results were most sensitive to variations in access to outpatient care for those with severe symptoms. If this parameter was increased to its upper limit, the incremental cost effectiveness ratio for vaccination still fell between one and three times the per capita gross domestic product, meeting the World Health Organization's criterion for "cost effective" interventions. Uncertainty analysis indicated a 94.7% probability that vaccination would be cost effective according to a criterion of one times per capita gross domestic product per life year saved, and a 97.8% probability that it would be cost effective according to a criterion of three times per capita gross domestic product. Across a wide range of assumptions, mass RIX4414 vaccination in India would probably prevent substantial morbidity and mortality at a cost per life year saved below typical thresholds of cost effectiveness. The opportunity costs of such a programme in this or similar settings, however, should be weighed up carefully.

Criterion-Referenced Measurement (CRM) in the Initial Acquisition of a Psychomotor Skill with Exceptional Children

ERIC Educational Resources Information Center

Muhich, Dolores

1976-01-01

Criterion Referenced Measurement (CRM) in the initial acquisition of the psychomotor skill of typewriting demonstrated speed gains from 8 hours of instruction distributed over a 6-week interval for 4 male adolescent underachievers of above- and below-average intelligence. (Author)

Rock Fracture Toughness Under Mode II Loading: A Theoretical Model Based on Local Strain Energy Density

NASA Astrophysics Data System (ADS)

Rashidi Moghaddam, M.; Ayatollahi, M. R.; Berto, F.

2018-01-01

The values of mode II fracture toughness reported in the literature for several rocks are studied theoretically by using a modified criterion based on strain energy density averaged over a control volume around the crack tip. The modified criterion takes into account the effect of T-stress in addition to the singular terms of stresses/strains. The experimental results are related to mode II fracture tests performed on the semicircular bend and Brazilian disk specimens. There are good agreements between theoretical predictions using the generalized averaged strain energy density criterion and the experimental results. The theoretical results reveal that the value of mode II fracture toughness is affected by the size of control volume around the crack tip and also the magnitude and sign of T-stress.

Optimal ventilatory patterns in periodic breathing.

PubMed

Ghazanshahi, S D; Khoo, M C

1993-01-01

The goal of this study was to determine whether periodic breathing (PB), which is highly prevalent during sleep at high altitudes, imposes physiological penalties on the respiratory system in the absence of any accompanying disease. Using a computer model of respiratory gas exchange, we compared the effects of a variety of PB patterns on the chemical and mechanical costs of breathing to those resulting from regular tidal breathing. Although PB produced considerable fluctuation in arterial blood gas tensions, for the same cycle-averaged ventilation, higher arterial oxygen saturation and lower arterial carbon dioxide levels were achieved. This result can be explained by the fact that the combination of large breaths and apnea in PB leads to a substantial reduction in dead space ventilation. At the same time, the savings in mechanical cost achieved by the respiratory muscles during apnea partially offset the increase during the breathing phase. Consequently, the "pressure cost," a criterion based on mean inspiratory pressure, was elevated only slightly, although the average work rate of breathing increased significantly. We found that, at extreme altitudes, PB patterns with clusters of 2 to 4 large breaths that alternate with apnea produce the highest arterial oxygenation levels and lowest pressure costs. The common occurrence of PB patterns with closely similar features has been reported in sleeping healthy sojourners at extreme altitudes. Taken together, these findings suggest that PB favors a reduction in the oxygen demands of the respiratory muscles and therefore may not be as detrimental as it is generally believed to be.

The effect of moonlight on observation of cloud cover at night, and application to cloud climatology

NASA Technical Reports Server (NTRS)

Hahn, Carole J.; Warren, Stephen G.; London, Julius

1995-01-01

Ten years of nighttime weather observations from the Northern Hemisphere in December were classified according to the illuminance of moonlight or twilight on the cloud tops, and a threshold level of illuminance was determined, above which the clouds are apparently detected adequately. This threshold corresponds to light from a full moon at an elevation angle of 6 deg, light from a partial moon at higher elevation, or twilight from the sun less than 9 deg bvelow the horizon. It permits the use of about 38% of the observations made with the sun below the horizon. The computed diurnal cycles of total cloud cover are altered considerably when this moonlight criterion is imposed. Maximum cloud cover over much of the ocean is now found to be at night or in the morning, whereas computations obtained without benefit of the moonlight criterion, as in our published atlases, showed the time of maximum to be noon or early afternoon in many regions. The diurnal cycles of total cloud cover we obtain are compared with those of the International Satellite Cloud Climatology Project (ISCCP) for a few regions; they are generally in better agreement if the moonlight criterion is imposed on the surface observations. Using the moonlight criterion, we have analyzed 10 years (1982-91) of surface weather observations over land and ocean, worldwide, for total cloud cover and for the frequency of occurrence of clear sky, fog, and precipitation. The global average cloud cover (average of day and night) is about 2% higher if the moonlight criterion is imposed than if all observations are used. The difference is greater in winter than in summer, because of the fewer hours of darkness in summer. The amplitude of the annual cycle of total cloud cover over the Arctic Ocean and at the South Pole is diminished by a few percent when the moonlight criterion is imposed. The average cloud cover for 1982-91 is found to be 55% for Northern Hemisphere land, 53% for Southern Hemisphere land, 66% for Northern Hemisphere ocean, and 70% for Southern Hemisphere ocean, giving a global average of 64%. The global average for daytime is 64.6%; for nighttime 63.3%.

What should be the basis for compulsory and optional health insurance premiums? Opinions of Swiss doctors.

PubMed

Jannot, Anne-Sophie; Perneger, Thomas V

2014-02-04

Little is known about doctors' opinions on how to finance health services. In Switzerland, mandatory basic health insurance currently uses regional flat fees that are unrelated to health and ability to pay, and optional complementary insurance uses risk-based premiums. Our objective was to assess Swiss physicians' opinions on what should determine health insurance premiums. We surveyed doctors in the canton of Geneva, Switzerland, about the desirable funding mechanism for mandatory health insurance and complementary health insurance. The proposed determinants of insurance premiums were current health and past medical history, lifestyle, healthcare costs in the previous year, genetic susceptibility to disease, regional average healthcare costs, household income, and wealth and demographic characteristics. Among the 1,516 respondents, only a few (<5%) believed that the mandatory health insurance premium should depend on health risk (health status, previous costs, genetics, and age and sex). More than 30% of respondents supported premiums based on lifestyle (34.6%), regional average health expenditures (31.2%), and household income and wealth (39.6%). For complementary health insurance, most respondents supported premiums based on lifestyle (74.6%) and on health risk (46.4%), but surprisingly also on household income and wealth (44.9%) and regional average health expenditures (39.4%). The characteristic most influencing the answers was the medical specialty. Doctors' opinions about healthcare financing mechanisms varied considerably, for both mandatory and complementary health insurance. Lifestyle was a surprisingly frequent choice, even though this criterion is not currently used in Switzerland. Ability to pay was not supported by the majority.

Use of scan overlap redundancy to enhance multispectral aircraft scanner data

NASA Technical Reports Server (NTRS)

Lindenlaub, J. C.; Keat, J.

1973-01-01

Two criteria were suggested for optimizing the resolution error versus signal-to-noise-ratio tradeoff. The first criterion uses equal weighting coefficients and chooses n, the number of lines averaged, so as to make the average resolution error equal to the noise error. The second criterion adjusts both the number and relative sizes of the weighting coefficients so as to minimize the total error (resolution error plus noise error). The optimum set of coefficients depends upon the geometry of the resolution element, the number of redundant scan lines, the scan line increment, and the original signal-to-noise ratio of the channel. Programs were developed to find the optimum number and relative weights of the averaging coefficients. A working definition of signal-to-noise ratio was given and used to try line averaging on a typical set of data. Line averaging was evaluated only with respect to its effect on classification accuracy.

New Stopping Criteria for Segmenting DNA Sequences

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

Li, Wentian

2001-06-18

We propose a solution on the stopping criterion in segmenting inhomogeneous DNA sequences with complex statistical patterns. This new stopping criterion is based on Bayesian information criterion in the model selection framework. When this criterion is applied to telomere of S.cerevisiae and the complete sequence of E.coli, borders of biologically meaningful units were identified, and a more reasonable number of domains was obtained. We also introduce a measure called segmentation strength which can be used to control the delineation of large domains. The relationship between the average domain size and the threshold of segmentation strength is determined for several genomemore » sequences.« less

The transformation of the tender evaluation process in public procurement in Poland

NASA Astrophysics Data System (ADS)

Plebankiewicz, E.; Kozik, R.

2017-10-01

Procedures regarding the evaluation of tenders have been changed since the public procurement law was enacted (it came into force in January 1, 1995). The contracting authority could apply both the criteria related to the qualities of the contractor and those related to the to the subject - matter of public contract. Two extensive amendments in 2001 and a government project introduced vital regulations and excluded the possibility of applying criteria related to the qualities of the contractor. Act of 29 January 2004 Public Procurement Law allowed to use price as the sole contract award criterion. The changes in the Law in 2014 restricted that possibility to the situation in which the subject matter of a contract is commonly available and has established quality standards. The Act of 22 June 2016 amending the Public Procurement Law Act and some other laws introduced the new criteria list and limited the importance of the price criterion in the certain situations. Instead of price, the cost can also be a criterion for tender evaluation. The cost criterion can be determined using life cycle costing. In the paper, based on contract notices of open tendering published in the Public Procurement Bulletin, the criteria of construction contract selection will be analysed. In particular the effectiveness of changes in the Procurement Law will be researched.

A comparison study of two different control criteria for the real-time management of urban groundwater works.

PubMed

Bauser, G; Hendricks Franssen, Harrie-Jan; Stauffer, Fritz; Kaiser, Hans-Peter; Kuhlmann, U; Kinzelbach, W

2012-08-30

We present the comparison of two control criteria for the real-time management of a water well field. The criteria were used to simulate the operation of the Hardhof well field in the city of Zurich, Switzerland. This well field is threatened by diffuse pollution in the subsurface of the surrounding city area. The risk of attracting pollutants is higher if the pumping rates in four horizontal wells are increased, and can be reduced by increasing artificial recharge in several recharge basins and infiltration wells or by modifying the artificial recharge distribution. A three-dimensional finite elements flow model was built for the Hardhof site. The first control criterion used hydraulic head differences (Δh-criterion) to control the management of the well field and the second criterion used a path line method (%s-criterion) to control the percentage of inflowing water from the city area. Both control methods adapt the allocation of artificial recharge (AR) for given pumping rates in time. The simulation results show that (1) historical management decisions were less effective compared to the optimal control according to the two different criteria and (2) the distribution of artificial recharge calculated with the two control criteria also differ from each other with the %s-criterion giving better results compared to the Δh-criterion. The recharge management with the %s-criterion requires a smaller amount of water to be recharged. The ratio between average artificial recharge and average abstraction is 1.7 for the Δh-criterion and 1.5 for the %s-criterion. Both criteria were tested online. The methodologies were extended to a real-time control method using the Ensemble Kalman Filter method for assimilating 87 online available groundwater head measurements to update the model in real-time. The results of the operational implementation are also satisfying in regard of a reduced risk of well contamination. Copyright © 2012 Elsevier Ltd. All rights reserved.

AMD-stability in the presence of first-order mean motion resonances

NASA Astrophysics Data System (ADS)

Petit, A. C.; Laskar, J.; Boué, G.

2017-11-01

The angular momentum deficit (AMD)-stability criterion allows to discriminate between a priori stable planetary systems and systems for which the stability is not granted and needs further investigations. AMD-stability is based on the conservation of the AMD in the averaged system at all orders of averaging. While the AMD criterion is rigorous, the conservation of the AMD is only granted in absence of mean-motion resonances (MMR). Here we extend the AMD-stability criterion to take into account mean-motion resonances, and more specifically the overlap of first-order MMR. If the MMR islands overlap, the system will experience generalized chaos leading to instability. The Hamiltonian of two massive planets on coplanar quasi-circular orbits can be reduced to an integrable one degree of freedom problem for period ratios close to a first-order MMR. We use the reduced Hamiltonian to derive a new overlap criterion for first-order MMR. This stability criterion unifies the previous criteria proposed in the literature and admits the criteria obtained for initially circular and eccentric orbits as limit cases. We then improve the definition of AMD-stability to take into account the short term chaos generated by MMR overlap. We analyze the outcome of this improved definition of AMD-stability on selected multi-planet systems from the Extrasolar Planets Encyclopædia.

Mercury and methylmercury in reservoirs in Indiana

USGS Publications Warehouse

Risch, Martin R.; Fredericksen, Amanda L.

2015-01-01

Methylmercury (reported as Hg) in fish-tissue samples collected for the State fish consumption advisory program was used to describe MeHg food-web accumulation and magnification in the reservoirs. The highest percentages of fish-tissue samples with Hg concentrations that exceeded the criterion of 0.30 milligram per kilogram for protection of human health were from Monroe Lake (38 percent) and Patoka Lake (33 percent). A review of the number and size of fish species caught from these two reservoirs resulted in two implications for fish consumption by humans. First, the highest numbers of fish harvested for potential human consumption were species more likely to have MeHg concentrations lower than the human-health criterion (crappie, bluegill, and catfish). Second, although largemouth bass were likely to have MeHg concentrations higher than the human-health criterion, they were caught and released more often than they were harvested. However, the average size largemouth bass (in both reservoirs) and above-average size walleye (in Monroe Lake) that were harvested for potential human consumption were likely to have MeHg concentrations higher than the human-health criterion.

A stopping criterion for the iterative solution of partial differential equations

NASA Astrophysics Data System (ADS)

Rao, Kaustubh; Malan, Paul; Perot, J. Blair

2018-01-01

A stopping criterion for iterative solution methods is presented that accurately estimates the solution error using low computational overhead. The proposed criterion uses information from prior solution changes to estimate the error. When the solution changes are noisy or stagnating it reverts to a less accurate but more robust, low-cost singular value estimate to approximate the error given the residual. This estimator can also be applied to iterative linear matrix solvers such as Krylov subspace or multigrid methods. Examples of the stopping criterion's ability to accurately estimate the non-linear and linear solution error are provided for a number of different test cases in incompressible fluid dynamics.

Cost-price: a useful way to evaluate timber growing alternatives.

Treesearch

Allen L. Lundgren

1973-01-01

This paper explains how to calculate and use cost-price as an investment criterion for timber and other forest products. Cost-price is the cost (including a return on invested capital) of producing a unit of output, usually expressed as dollars per cubic foot or other unit of output.

10 CFR 602.12 - Cost sharing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Cost sharing. 602.12 Section 602.12 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.12 Cost sharing. Cost sharing is not required, nor will it be considered, as a criterion in...

Effects of reproductive condition, roost microclimate, and weather patterns on summer torpor use by a vespertilionid bat

PubMed Central

Johnson, Joseph S; Lacki, Michael J

2014-01-01

A growing number of mammal species are recognized as heterothermic, capable of maintaining a high-core body temperature or entering a state of metabolic suppression known as torpor. Small mammals can achieve large energetic savings when torpid, but they are also subject to ecological costs. Studying torpor use in an ecological and physiological context can help elucidate relative costs and benefits of torpor to different groups within a population. We measured skin temperatures of 46 adult Rafinesque's big-eared bats (Corynorhinus rafinesquii) to evaluate thermoregulatory strategies of a heterothermic small mammal during the reproductive season. We compared daily average and minimum skin temperatures as well as the frequency, duration, and depth of torpor bouts of sex and reproductive classes of bats inhabiting day-roosts with different thermal characteristics. We evaluated roosts with microclimates colder (caves) and warmer (buildings) than ambient air temperatures, as well as roosts with intermediate conditions (trees and rock crevices). Using Akaike's information criterion (AIC), we found that different statistical models best predicted various characteristics of torpor bouts. While the type of day-roost best predicted the average number of torpor bouts that bats used each day, current weather variables best predicted daily average and minimum skin temperatures of bats, and reproductive condition best predicted average torpor bout depth and the average amount of time spent torpid each day by bats. Finding that different models best explain varying aspects of heterothermy illustrates the importance of torpor to both reproductive and nonreproductive small mammals and emphasizes the multifaceted nature of heterothermy and the need to collect data on numerous heterothermic response variables within an ecophysiological context. PMID:24558571

Optimization of solar cell contacts by system cost-per-watt minimization

NASA Technical Reports Server (NTRS)

Redfield, D.

1977-01-01

New, and considerably altered, optimum dimensions for solar-cell metallization patterns are found using the recently developed procedure whose optimization criterion is the minimum cost-per-watt effect on the entire photovoltaic system. It is also found that the optimum shadow fraction by the fine grid is independent of metal cost and resistivity as well as cell size. The optimum thickness of the fine grid metal depends on all these factors, and in familiar cases it should be appreciably greater than that found by less complete analyses. The optimum bus bar thickness is much greater than those generally used. The cost-per-watt penalty due to the need for increased amounts of metal per unit area on larger cells is determined quantitatively and thereby provides a criterion for the minimum benefits that must be obtained in other process steps to make larger cells cost effective.

Automated Reconstruction of Neural Trees Using Front Re-initialization

PubMed Central

Mukherjee, Amit; Stepanyants, Armen

2013-01-01

This paper proposes a greedy algorithm for automated reconstruction of neural arbors from light microscopy stacks of images. The algorithm is based on the minimum cost path method. While the minimum cost path, obtained using the Fast Marching Method, results in a trace with the least cumulative cost between the start and the end points, it is not sufficient for the reconstruction of neural trees. This is because sections of the minimum cost path can erroneously travel through the image background with undetectable detriment to the cumulative cost. To circumvent this problem we propose an algorithm that grows a neural tree from a specified root by iteratively re-initializing the Fast Marching fronts. The speed image used in the Fast Marching Method is generated by computing the average outward flux of the gradient vector flow field. Each iteration of the algorithm produces a candidate extension by allowing the front to travel a specified distance and then tracking from the farthest point of the front back to the tree. Robust likelihood ratio test is used to evaluate the quality of the candidate extension by comparing voxel intensities along the extension to those in the foreground and the background. The qualified extensions are appended to the current tree, the front is re-initialized, and Fast Marching is continued until the stopping criterion is met. To evaluate the performance of the algorithm we reconstructed 6 stacks of two-photon microscopy images and compared the results to the ground truth reconstructions by using the DIADEM metric. The average comparison score was 0.82 out of 1.0, which is on par with the performance achieved by expert manual tracers. PMID:24386539

Fidelity criterion for quantum-domain transmission and storage of coherent states beyond the unit-gain constraint.

PubMed

Namiki, Ryo; Koashi, Masato; Imoto, Nobuyuki

2008-09-05

We generalize the experimental success criterion for quantum teleportation (memory) in continuous-variable quantum systems to be suitable for a non-unit-gain condition by considering attenuation (amplification) of the coherent-state amplitude. The new criterion can be used for a nonideal quantum memory and long distance quantum communication as well as quantum devices with amplification process. It is also shown that the framework to measure the average fidelity is capable of detecting all Gaussian channels in the quantum domain.

Health Economic Data in Reimbursement of New Medical Technologies: Importance of the Socio-Economic Burden as a Decision-Making Criterion.

PubMed

Iskrov, Georgi; Dermendzhiev, Svetlan; Miteva-Katrandzhieva, Tsonka; Stefanov, Rumen

2016-01-01

Assessment and appraisal of new medical technologies require a balance between the interests of different stakeholders. Final decision should take into account the societal value of new therapies. This perspective paper discusses the socio-economic burden of disease as a specific reimbursement decision-making criterion and calls for the inclusion of it as a counterbalance to the cost-effectiveness and budget impact criteria. Socio-economic burden is a decision-making criterion, accounting for diseases, for which the assessed medical technology is indicated. This indicator is usually researched through cost-of-illness studies that systematically quantify the socio-economic burden of diseases on the individual and on the society. This is a very important consideration as it illustrates direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. By measuring and comparing the socio-economic burden of different diseases to society, health authorities and payers could benefit in optimizing priority setting and resource allocation. New medical technologies, especially innovative therapies, present an excellent case study for the inclusion of socio-economic burden in reimbursement decision-making. Assessment and appraisal have been greatly concentrated so far on cost-effectiveness and budget impact, marginalizing all other considerations. In this context, data on disease burden and inclusion of explicit criterion of socio-economic burden in reimbursement decision-making may be highly beneficial. Realizing the magnitude of the lost socio-economic contribution resulting from diseases in question could be a reasonable way for policy makers to accept a higher valuation of innovative therapies.

Global surface-based cloud observation for ISCCP

NASA Technical Reports Server (NTRS)

1994-01-01

Visual observations of cloud cover are hindered at night due to inadequate illumination of the clouds. This usually leads to an underestimation of the average cloud cover at night, especially for the amounts of middle and high clouds, in climatologies on surface observations. The diurnal cycles of cloud amounts, if based on all the surface observations, are therefore in error, but they can be obtained more accurately if the nighttime observations are screened to select those made under sufficient moonlight. Ten years of nighttime weather observations from the northern hemisphere in December were classified according to the illuminance of moonlight or twilight on the cloud tops, and a threshold level of illuminance was determined, above which the clouds are apparently detected adequately. This threshold corresponds to light from a full moon at an elevation angle of 6 degrees or from a partial moon at higher elevation, or twilight from the sun less than 9 degrees below the horizon. It permits the use of about 38% of the observations made with the sun below the horizon. The computed diurnal cycles of total cloud cover are altered considerably when this moonlight criterion is imposed. Maximum cloud cover over much of the ocean is now found to be at night or in the morning, whereas computations obtained without benefit of the moonlight criterion, as in our published atlases, showed the time of maximum to be noon or early afternoon in many regions. Cloud cover is greater at night than during the day over the open oceans far from the continents, particularly in summer. However, near noon maxima are still evident in the coastal regions, so that the global annual average oceanic cloud cover is still slightly greater during the day than at night, by 0.3%. Over land, where daytime maxima are still obtained but with reduced amplitude, average cloud cover is 3.3% greater during the daytime. The diurnal cycles of total cloud cover we obtain are compared with those of ISCCP for a few regions; they are generally in better agreement if the moonlight criterion is imposed on the surface observations. Using the moonlight criterion, we have analyzed ten years (1982-1991) of surface weather observations over land and ocean, worldwide, for total cloud cover and for the frequency of occurrence of clear sky, fog and precipitation The global average cloud cover (average of day and night) is about 2% higher if we impose the moonlight criterion than if we use all observations. The difference is greater in winter than in summer, because of the fewer hours of darkness in the summer. The amplitude of the annual cycle of total cloud cover over the Arctic Ocean and at the South Pole is diminished by a few percent when the moonlight criterion is imposed. The average cloud cover for 1982-1991 is found to be 55% for northern hemisphere land, 53% for southern hemisphere land, 66% for northern hemisphere ocean, and 70% for southern hemisphere ocean, giving a global average of 64%. The global average for daytime is 64.6% for nighttime 63.3%.

The System of Objectified Judgement Analysis (SOJA). A tool in rational drug selection for formulary inclusion.

PubMed

Janknegt, R; Steenhoek, A

1997-04-01

Rational drug selection for formulary purposes is important. Besides rational selection criteria, other factors play a role in drug decision making, such as emotional, personal financial and even unconscious criteria. It is agreed that these factors should be excluded as much as possible in the decision making process. A model for drug decision making for formulary purposes is described, the System of Objectified Judgement Analysis (SOJA). In the SOJA method, selection criteria for a given group of drugs are prospectively defined and the extent to which each drug fulfils the requirements for each criterion is determined. Each criterion is given a relative weight, i.e. the more important a given selection criterion is considered, the higher the relative weight. Both the relative scores for each drug per selection criterion and the relative weight of each criterion are determined by a panel of experts in this field. The following selection criteria are applied in all SOJA scores: clinical efficacy, incidence and severity of adverse effects, dosage frequency, drug interactions, acquisition cost, documentation, pharmacokinetics and pharmaceutical aspects. Besides these criteria, group specific criteria are also used, such as development of resistance when a SOJA score was made for antimicrobial agents. The relative weight that is assigned to each criterion will always be a subject of discussion. Therefore, interactive software programs for use on a personal computer have been developed, in which the user of the system may enter their own personal relative weight to each selection criterion and make their own personal SOJA score. The main advantage of the SOJA method is that all nonrational selection criteria are excluded and that drug decision making is based solely on rational criteria. The use of the interactive SOJA discs makes the decision process fully transparent as it becomes clear on which criteria and weighting decisions are based. We have seen that the use of this method for drug decision making greatly aids the discussion in the formulary committee, as discussion becomes much more concrete. The SOJA method is time dependent. Documentation on most products is still increasing and the score for this criterion will therefore change continuously. New products are introduced and prices are also subject to change. To overcome the time-dependence of the SOJA method, regular updates of interactive software programs are being made, in which changes in acquisition cost, documentation or a different weighting of criteria are included, as well as newly introduced products. The possibility of changing the official acquisition cost into the actual purchasing costs for the hospital in question provides a tailor-made interactive program.

Selection criteria of residents for residency programs in Kuwait

PubMed Central

2013-01-01

Background In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. Methods A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Results Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. Conclusions This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training. PMID:23331670

Economics, ethics, and climate policy: framing the debate

NASA Astrophysics Data System (ADS)

Howarth, Richard B.; Monahan, Patricia A.

1996-04-01

This paper examines the economic and ethical dimensions of climate policy in light of existing knowledge of the impacts of global warming and the costs of greenhouse gas emissions abatement. We find that the criterion of economic efficiency, operationalized through cost-benefit analysis, is ill-equipped to cope with the pervasive uncertainties and issues of intergenerational fairness that characterize climate change. In contrast, the concept of sustainable development—that today's policies should ensure that future generations enjoy life opportunities undiminished relative to the present—is a normative criterion that explicitly addresses the uncertainties and distributional aspects of global environmental change. If one interprets the sustainability criterion to imply that it is morally wrong to impose catastrophic risks on unborn generations when reducing those risks would not noticeably diminish the quality of life of existing persons, a case can be made for significant steps to reduce greenhouse gas emissions.

Influences on Academic Achievement Across High and Low Income Countries: A Re-Analysis of IEA Data.

ERIC Educational Resources Information Center

Heyneman, S.; Loxley, W.

Previous international studies of science achievement put the data through a process of winnowing to decide which variables to keep in the final regressions. Variables were allowed to enter the final regressions if they met a minimum beta coefficient criterion of 0.05 averaged across rich and poor countries alike. The criterion was an average…

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain

PubMed Central

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D.; Hirsch, Joshua A.

2017-01-01

Background:Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design:Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives:To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results:The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations:The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion:The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY. PMID:29200944

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

PubMed

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

2017-01-01

Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations: The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion: The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY.

Selection of active spaces for multiconfigurational wavefunctions

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

Keller, Sebastian; Boguslawski, Katharina; Reiher, Markus, E-mail: markus.reiher@phys.chem.ethz.ch

2015-06-28

The efficient and accurate description of the electronic structure of strongly correlated systems is still a largely unsolved problem. The usual procedures start with a multiconfigurational (usually a Complete Active Space, CAS) wavefunction which accounts for static correlation and add dynamical correlation by perturbation theory, configuration interaction, or coupled cluster expansion. This procedure requires the correct selection of the active space. Intuitive methods are unreliable for complex systems. The inexpensive black-box unrestricted natural orbital (UNO) criterion postulates that the Unrestricted Hartree-Fock (UHF) charge natural orbitals with fractional occupancy (e.g., between 0.02 and 1.98) constitute the active space. UNOs generally approximatemore » the CAS orbitals so well that the orbital optimization in CAS Self-Consistent Field (CASSCF) may be omitted, resulting in the inexpensive UNO-CAS method. A rigorous testing of the UNO criterion requires comparison with approximate full configuration interaction wavefunctions. This became feasible with the advent of Density Matrix Renormalization Group (DMRG) methods which can approximate highly correlated wavefunctions at affordable cost. We have compared active orbital occupancies in UNO-CAS and CASSCF calculations with DMRG in a number of strongly correlated molecules: compounds of electronegative atoms (F{sub 2}, ozone, and NO{sub 2}), polyenes, aromatic molecules (naphthalene, azulene, anthracene, and nitrobenzene), radicals (phenoxy and benzyl), diradicals (o-, m-, and p-benzyne), and transition metal compounds (nickel-acetylene and Cr{sub 2}). The UNO criterion works well in these cases. Other symmetry breaking solutions, with the possible exception of spatial symmetry, do not appear to be essential to generate the correct active space. In the case of multiple UHF solutions, the natural orbitals of the average UHF density should be used. The problems of the UNO criterion and their potential solutions are discussed: finding the UHF solutions, discontinuities on potential energy surfaces, and inclusion of dynamical electron correlation and generalization to excited states.« less

Selection of active spaces for multiconfigurational wavefunctions

NASA Astrophysics Data System (ADS)

Keller, Sebastian; Boguslawski, Katharina; Janowski, Tomasz; Reiher, Markus; Pulay, Peter

2015-06-01

The efficient and accurate description of the electronic structure of strongly correlated systems is still a largely unsolved problem. The usual procedures start with a multiconfigurational (usually a Complete Active Space, CAS) wavefunction which accounts for static correlation and add dynamical correlation by perturbation theory, configuration interaction, or coupled cluster expansion. This procedure requires the correct selection of the active space. Intuitive methods are unreliable for complex systems. The inexpensive black-box unrestricted natural orbital (UNO) criterion postulates that the Unrestricted Hartree-Fock (UHF) charge natural orbitals with fractional occupancy (e.g., between 0.02 and 1.98) constitute the active space. UNOs generally approximate the CAS orbitals so well that the orbital optimization in CAS Self-Consistent Field (CASSCF) may be omitted, resulting in the inexpensive UNO-CAS method. A rigorous testing of the UNO criterion requires comparison with approximate full configuration interaction wavefunctions. This became feasible with the advent of Density Matrix Renormalization Group (DMRG) methods which can approximate highly correlated wavefunctions at affordable cost. We have compared active orbital occupancies in UNO-CAS and CASSCF calculations with DMRG in a number of strongly correlated molecules: compounds of electronegative atoms (F2, ozone, and NO2), polyenes, aromatic molecules (naphthalene, azulene, anthracene, and nitrobenzene), radicals (phenoxy and benzyl), diradicals (o-, m-, and p-benzyne), and transition metal compounds (nickel-acetylene and Cr2). The UNO criterion works well in these cases. Other symmetry breaking solutions, with the possible exception of spatial symmetry, do not appear to be essential to generate the correct active space. In the case of multiple UHF solutions, the natural orbitals of the average UHF density should be used. The problems of the UNO criterion and their potential solutions are discussed: finding the UHF solutions, discontinuities on potential energy surfaces, and inclusion of dynamical electron correlation and generalization to excited states.

An Empirical Model Building Criterion Based on Prediction with Applications in Parametric Cost Estimation.

DTIC Science & Technology

1980-08-01

varia- ble is denoted by 7, the total sum of squares of deviations from that mean is defined by n - SSTO - (-Y) (2.6) iul and the regression sum of...squares by SSR - SSTO - SSE (2.7) II 14 A selection criterion is a rule according to which a certain model out of the 2p possible models is labeled "best...dis- cussed next. 1. The R2 Criterion The coefficient of determination is defined by R2 . 1 - SSE/ SSTO . (2.8) It is clear that R is the proportion of

Evaluation of success after second Ahmed glaucoma valve implantation.

PubMed

Nilforushan, Naveed; Yadgari, Maryam; Jazayeri, Anis Alsadat; Karimi, Nasser

2016-03-01

To evaluate the outcome of the second Ahmed glaucoma valve (AGV) surgery in eyes with failed previous AGV surgery. Retrospective case series. Following chart review, 36 eyes of 34 patients with second AGV implantation were enrolled in this study. The primary outcome measure was surgical success defined in terms of intraocular pressure (IOP) control using two criteria: Success was defined as IOP ≤21 mmHg (criterion 1) and IOP ≤16 mmHg (criterion 2), with at least 20% reduction in IOP, either with no medication (complete success) or with no more than two medications (qualified success). Kaplan-Meier survival analysis was used to determine the probability of surgical success. The average age of the patients was 32.7 years (range 4-65), and the mean duration of follow-up was 21.4 months (range 6-96). Preoperatively, the mean IOP was 26.94 mmHg (standard deviation [SD] 7.03), and the patients were using 2.8 glaucoma medications on average (SD 0.9). The mean IOP decreased significantly to 13.28 mmHg (SD 3.59) at the last postoperative visit (P = 0.00) while the patients needed even fewer glaucoma medications on average (1.4 ± 1.1, P = 0.00). Surgical success of second glaucoma drainage devices (Kaplan-Meier analysis), according to criterion 1, at 6, 12, 18, and 42 months was 94%, 85%, 80%, and 53% respectively, and according to criterion 2, was 94%, 85%, 75%, and 45%, respectively. Repeated AGV implantation seems to be a safe modality of treatment with acceptable success rate in cases with failed previous AGV surgery.

Assessing Stress-Related Treatment Needs among Girls at Risk for Poor Functional Outcomes: The Impact of Cumulative Adversity, Criterion Traumas, and Non-Criterion Events

PubMed Central

Lansing, Amy E.; Plante, Wendy Y.; Beck, Audrey N.

2016-01-01

Despite growing recognition that cumulative adversity (total stressor exposure), including complex trauma, increases the risk for psychopathology and impacts development, assessment strategies lag behind: Trauma-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (parental separations) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: 1) an average of 14 adverse Criterion-A and non-Criterion event exposures; 2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; 3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and 4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities. PMID:27745922

Assessing stress-related treatment needs among girls at risk for poor functional outcomes: The impact of cumulative adversity, criterion traumas, and non-criterion events.

PubMed

Lansing, Amy E; Plante, Wendy Y; Beck, Audrey N

2017-05-01

Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: (1) an average of 14 adverse Criterion-A and non-Criterion event exposures; (2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; (3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and (4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Similarity Criterion for Supersonic Flow Past a Cylinder with a Frontal High-Porosity Cellular Insert

NASA Astrophysics Data System (ADS)

Mironov, S. G.; Poplavskaya, T. V.; Kirilovskiy, S. V.; Maslov, A. A.

2018-03-01

We have experimentally and numerically studied the influence of the ratio of the diameter of a cylinder with a frontal gas-permeable porous insert made of nickel sponge to the average pore diameter in the insert on the aerodynamic drag of this model body in supersonic airflow ( M ∞ = 4.85, 7, and 21). The analytical dependence of the normalized drag coefficient on a parameter involving the Mach number and the ratio of cylinder radius to average pore radius in the insert is obtained. It is suggested to use this parameter as a similarity criterion in the problem of supersonic airflow past a cylinder with a frontal high-porosity cellular insert.

A method for economic evaluation of redundancy levels for aerospace systems

NASA Technical Reports Server (NTRS)

Hodge, P. W.; Frumkin, B.

1973-01-01

Principle comprises primary cost impacts, such as operational delays, reflown missions due to aborts, procurement of equipment, and vehicle expansion to accommodate additional equipment. Economics are estimated by criterion which is relatively insensitive to impertinent cost factors.

Learning Hierarchical Feature Extractors for Image Recognition

DTIC Science & Technology

2012-09-01

space as a natural criterion for devising better pools. Finally, we propose ways to make coding faster and more powerful through fast convolutional...parameter is the set of pools over which the summary statistic is computed. We propose locality in feature configuration space as a natural criterion for...pooling (dotted lines) is consistently higher than average pooling (solid lines), but the gap is much less signif - icant with intersection kernel (closed

Validity of a practitioner-administered observational tool to measure physical activity, nutrition, and screen time in school-age programs.

PubMed

Lee, Rebekka M; Emmons, Karen M; Okechukwu, Cassandra A; Barrett, Jessica L; Kenney, Erica L; Cradock, Angie L; Giles, Catherine M; deBlois, Madeleine E; Gortmaker, Steven L

2014-11-28

Nutrition and physical activity interventions have been effective in creating environmental changes in afterschool programs. However, accurate assessment can be time-consuming and expensive as initiatives are scaled up for optimal population impact. This study aims to determine the criterion validity of a simple, low-cost, practitioner-administered observational measure of afterschool physical activity, nutrition, and screen time practices and child behaviors. Directors from 35 programs in three cities completed the Out-of-School Nutrition and Physical Activity Observational Practice Assessment Tool (OSNAP-OPAT) on five days. Trained observers recorded snacks served and obtained accelerometer data each day during the same week. Observations of physical activity participation and snack consumption were conducted on two days. Correlations were calculated to validate weekly average estimates from OSNAP-OPAT compared to criterion measures. Weekly criterion averages are based on 175 meals served, snack consumption of 528 children, and physical activity levels of 356 children. OSNAP-OPAT validly assessed serving water (r = 0.73), fruits and vegetables (r = 0.84), juice >4oz (r = 0.56), and grains (r = 0.60) at snack; sugary drinks (r = 0.70) and foods (r = 0.68) from outside the program; and children's water consumption (r = 0.56) (all p <0.05). Reports of physical activity time offered were correlated with accelerometer estimates (minutes of moderate and vigorous physical activity r = 0.59, p = 0.02; vigorous physical activity r = 0.63, p = 0.01). The reported proportion of children participating in moderate and vigorous physical activity was correlated with observations (r = 0.48, p = 0.03), as were reports of computer (r = 0.85) and TV/movie (r = 0.68) time compared to direct observations (both p < 0.01). OSNAP-OPAT can assist researchers and practitioners in validly assessing nutrition and physical activity environments and behaviors in afterschool settings. Phase 1 of this measure validation was conducted during a study registered at clinicaltrials.gov NCT01396473.

Adaptive Resource Utilization Prediction System for Infrastructure as a Service Cloud.

PubMed

Zia Ullah, Qazi; Hassan, Shahzad; Khan, Gul Muhammad

2017-01-01

Infrastructure as a Service (IaaS) cloud provides resources as a service from a pool of compute, network, and storage resources. Cloud providers can manage their resource usage by knowing future usage demand from the current and past usage patterns of resources. Resource usage prediction is of great importance for dynamic scaling of cloud resources to achieve efficiency in terms of cost and energy consumption while keeping quality of service. The purpose of this paper is to present a real-time resource usage prediction system. The system takes real-time utilization of resources and feeds utilization values into several buffers based on the type of resources and time span size. Buffers are read by R language based statistical system. These buffers' data are checked to determine whether their data follows Gaussian distribution or not. In case of following Gaussian distribution, Autoregressive Integrated Moving Average (ARIMA) is applied; otherwise Autoregressive Neural Network (AR-NN) is applied. In ARIMA process, a model is selected based on minimum Akaike Information Criterion (AIC) values. Similarly, in AR-NN process, a network with the lowest Network Information Criterion (NIC) value is selected. We have evaluated our system with real traces of CPU utilization of an IaaS cloud of one hundred and twenty servers.

Adaptive Resource Utilization Prediction System for Infrastructure as a Service Cloud

PubMed Central

Hassan, Shahzad; Khan, Gul Muhammad

2017-01-01

Infrastructure as a Service (IaaS) cloud provides resources as a service from a pool of compute, network, and storage resources. Cloud providers can manage their resource usage by knowing future usage demand from the current and past usage patterns of resources. Resource usage prediction is of great importance for dynamic scaling of cloud resources to achieve efficiency in terms of cost and energy consumption while keeping quality of service. The purpose of this paper is to present a real-time resource usage prediction system. The system takes real-time utilization of resources and feeds utilization values into several buffers based on the type of resources and time span size. Buffers are read by R language based statistical system. These buffers' data are checked to determine whether their data follows Gaussian distribution or not. In case of following Gaussian distribution, Autoregressive Integrated Moving Average (ARIMA) is applied; otherwise Autoregressive Neural Network (AR-NN) is applied. In ARIMA process, a model is selected based on minimum Akaike Information Criterion (AIC) values. Similarly, in AR-NN process, a network with the lowest Network Information Criterion (NIC) value is selected. We have evaluated our system with real traces of CPU utilization of an IaaS cloud of one hundred and twenty servers. PMID:28811819

The Role of Testing in Affirmative Action.

ERIC Educational Resources Information Center

Manning, Winton H.

Graphs and charts pertaining to testing in affirmative action are presented. Data concern the following: the predictive validity of College Board admissions tests using freshman grade point average as the criterion; validity coefficients of undergraduate grade point average (UGPA) alone, Law School Admission Test (LSAT) scores, and undergraduate…

Frequency of Binge Eating Episodes in Bulimia Nervosa and Binge Eating Disorder: Diagnostic Considerations

PubMed Central

Wilson, G. Terence; Sysko, Robyn

2013-01-01

Objective In DSM-IV, to be diagnosed with Bulimia Nervosa (BN) or the provisional diagnosis of Binge Eating Disorder (BED), an individual must experience episodes of binge eating is “at least twice a week” on average, for three or six months respectively. The purpose of this review was to examine the validity and utility of the frequency criterion for BN and BED. Method Published studies evaluating the frequency criterion were reviewed. Results Our review found little evidence to support the validity or utility of the DSM-IV frequency criterion of twice a week binge eating; however, the number of studies available for our review was limited. Conclusion A number of options are available for the frequency criterion in DSM-V, and the optimal diagnostic threshold for binge eating remains to be determined. PMID:19610014

A comparison of two patient classification instruments in an acute care hospital.

PubMed

Seago, Jean Ann

2002-05-01

Patient classification systems are alternately praised and vilified by staff nurses, nurse managers, and nurse executives. Most nurses agree that substantial resources are used to create or find, implement, manage, and maintain the systems, and that the predictive ability of the instruments is intermittent. The purpose of this study is to compare the predictive validity of two types of patient classification instruments commonly used in acute care hospitals in California. Acute care hospitals in California are required by both the Joint Commission on Accreditation of Healthcare Organizations and California Title 22 to have a reliable and valid patient classification system (PCS). The two general types of systems commonly used are the summative task type PCS and the critical incident or criterion type PCS. There is little to assist nurse executives in deciding which type of PCS to choose. There is modest research demonstrating the validity and reliability of different PCSs but no published data comparing the predictive validity of the different types of systems. The unit of analysis is one patient shift called the study shift. The study shift is defined as the first day shift after the patient has been in the hospital for a full 24 hours. Data were collected using medical record review only. Both types, criterion and summative, of PCS data collection instruments were completed for all patients at both collection points. Each patient had a before and after score for each type of instrument. Three hundred forty-nine medical records for inpatients meeting the inclusion criteria were examined. The average patient age was 76 years, the average length of stay was 6.6 days with an average of 6.7 secondary diagnoses recorded. Fifty-five percent of the sample was female and the most common primary diagnosis was CHF, followed by COPD, CVA, and pneumonia. There was a difference in mean summative predictor score and the mean summative actual score of 1.57 points with the predictor score higher (P =.001; CI =.62--2.5). For the criterion instrument, 68.4% of the predictor criterion scores were in category 2 compared to 65.5% of the actual criterion scores. The criterion predictor agreed with the criterion actual score 45% of the time for category 1 patients, 87.3% of the time for category 2 patients, 77.1% of the time for category 3 patients and 72.7% of the time for category 4 patients, with an overall agreement between predictor and actual criterion scores of 79.9% (Kappa P <.001, indicating agreement is not by chance). The most significant finding of this study is that there are virtually no differences in the predictive ability of summative versus criterion patient classification instruments. Using the same patients, both types of instruments predicted the actual score over 78% of the time.

Reliability Estimates for Undergraduate Grade Point Average

ERIC Educational Resources Information Center

Westrick, Paul A.

2017-01-01

Undergraduate grade point average (GPA) is a commonly employed measure in educational research, serving as a criterion or as a predictor depending on the research question. Over the decades, researchers have used a variety of reliability coefficients to estimate the reliability of undergraduate GPA, which suggests that there has been no consensus…

Evaluation of success after second Ahmed glaucoma valve implantation

PubMed Central

Nilforushan, Naveed; Yadgari, Maryam; Jazayeri, Anis Alsadat; Karimi, Nasser

2016-01-01

Purpose: To evaluate the outcome of the second Ahmed glaucoma valve (AGV) surgery in eyes with failed previous AGV surgery. Design: Retrospective case series. Patients and Methods: Following chart review, 36 eyes of 34 patients with second AGV implantation were enrolled in this study. The primary outcome measure was surgical success defined in terms of intraocular pressure (IOP) control using two criteria: Success was defined as IOP ≤21 mmHg (criterion 1) and IOP ≤16 mmHg (criterion 2), with at least 20% reduction in IOP, either with no medication (complete success) or with no more than two medications (qualified success). Kaplan–Meier survival analysis was used to determine the probability of surgical success. Results: The average age of the patients was 32.7 years (range 4–65), and the mean duration of follow-up was 21.4 months (range 6–96). Preoperatively, the mean IOP was 26.94 mmHg (standard deviation [SD] 7.03), and the patients were using 2.8 glaucoma medications on average (SD 0.9). The mean IOP decreased significantly to 13.28 mmHg (SD 3.59) at the last postoperative visit (P = 0.00) while the patients needed even fewer glaucoma medications on average (1.4 ± 1.1, P = 0.00). Surgical success of second glaucoma drainage devices (Kaplan–Meier analysis), according to criterion 1, at 6, 12, 18, and 42 months was 94%, 85%, 80%, and 53% respectively, and according to criterion 2, was 94%, 85%, 75%, and 45%, respectively. Conclusion: Repeated AGV implantation seems to be a safe modality of treatment with acceptable success rate in cases with failed previous AGV surgery. PMID:27146930

Hierarchical semi-numeric method for pairwise fuzzy group decision making.

PubMed

Marimin, M; Umano, M; Hatono, I; Tamura, H

2002-01-01

Gradual improvements to a single-level semi-numeric method, i.e., linguistic labels preference representation by fuzzy sets computation for pairwise fuzzy group decision making are summarized. The method is extended to solve multiple criteria hierarchical structure pairwise fuzzy group decision-making problems. The problems are hierarchically structured into focus, criteria, and alternatives. Decision makers express their evaluations of criteria and alternatives based on each criterion by using linguistic labels. The labels are converted into and processed in triangular fuzzy numbers (TFNs). Evaluations of criteria yield relative criteria weights. Evaluations of the alternatives, based on each criterion, yield a degree of preference for each alternative or a degree of satisfaction for each preference value. By using a neat ordered weighted average (OWA) or a fuzzy weighted average operator, solutions obtained based on each criterion are aggregated into final solutions. The hierarchical semi-numeric method is suitable for solving a larger and more complex pairwise fuzzy group decision-making problem. The proposed method has been verified and applied to solve some real cases and is compared to Saaty's (1996) analytic hierarchy process (AHP) method.

Development of a Composite Measure of State-Level Malpractice Environment

PubMed Central

Chung, Jeanette W; Sohn, Min-Woong; Merkow, Ryan P; Oh, Elissa H; Minami, Christina; Black, Bernard S; Bilimoria, Karl Y

2014-01-01

Objective To develop a composite measure of state-level malpractice environment. Data Sources Public use data from the National Practitioner Data Bank, Medical Liability Monitor, the National Conference of State Legislatures, and the American Bar Association. Study Design Principal component analysis of state-level indicators (paid claims rate, malpractice premiums, lawyers per capita, average award size, and malpractice laws), with indirect validation of the composite using receiver-operating characteristic curves to determine how accurately the composite could identify states with high-tort activity and costs. Principal Findings A single composite accounted for over 73 percent of total variance in the seven indicators and demonstrated reasonable criterion validity. Conclusion An empirical composite measure of state-level malpractice risk may offer advantages over single indicators in measuring overall risk and may facilitate cross-state comparisons of malpractice environments. PMID:24117397

Uncertainty, imprecision, and the precautionary principle in climate change assessment.

PubMed

Borsuk, M E; Tomassini, L

2005-01-01

Statistical decision theory can provide useful support for climate change decisions made under conditions of uncertainty. However, the probability distributions used to calculate expected costs in decision theory are themselves subject to uncertainty, disagreement, or ambiguity in their specification. This imprecision can be described using sets of probability measures, from which upper and lower bounds on expectations can be calculated. However, many representations, or classes, of probability measures are possible. We describe six of the more useful classes and demonstrate how each may be used to represent climate change uncertainties. When expected costs are specified by bounds, rather than precise values, the conventional decision criterion of minimum expected cost is insufficient to reach a unique decision. Alternative criteria are required, and the criterion of minimum upper expected cost may be desirable because it is consistent with the precautionary principle. Using simple climate and economics models as an example, we determine the carbon dioxide emissions levels that have minimum upper expected cost for each of the selected classes. There can be wide differences in these emissions levels and their associated costs, emphasizing the need for care when selecting an appropriate class.

Model averaging techniques for quantifying conceptual model uncertainty.

PubMed

Singh, Abhishek; Mishra, Srikanta; Ruskauff, Greg

2010-01-01

In recent years a growing understanding has emerged regarding the need to expand the modeling paradigm to include conceptual model uncertainty for groundwater models. Conceptual model uncertainty is typically addressed by formulating alternative model conceptualizations and assessing their relative likelihoods using statistical model averaging approaches. Several model averaging techniques and likelihood measures have been proposed in the recent literature for this purpose with two broad categories--Monte Carlo-based techniques such as Generalized Likelihood Uncertainty Estimation or GLUE (Beven and Binley 1992) and criterion-based techniques that use metrics such as the Bayesian and Kashyap Information Criteria (e.g., the Maximum Likelihood Bayesian Model Averaging or MLBMA approach proposed by Neuman 2003) and Akaike Information Criterion-based model averaging (AICMA) (Poeter and Anderson 2005). These different techniques can often lead to significantly different relative model weights and ranks because of differences in the underlying statistical assumptions about the nature of model uncertainty. This paper provides a comparative assessment of the four model averaging techniques (GLUE, MLBMA with KIC, MLBMA with BIC, and AIC-based model averaging) mentioned above for the purpose of quantifying the impacts of model uncertainty on groundwater model predictions. Pros and cons of each model averaging technique are examined from a practitioner's perspective using two groundwater modeling case studies. Recommendations are provided regarding the use of these techniques in groundwater modeling practice.

Analysis of flow reversal test

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

Cheng, L.Y.; Tichler, P.R.

A series of tests has been conducted to measure the dryout power associated with a flow transient whereby the coolant in a heated channel undergoes a change in flow direction. An analysis of the test was made with the aid of a system code, RELAP5. A dryout criterion was developed in terms of a time-averaged void fraction calculated by RELAP5 for the heated channel. The dryout criterion was also compared with several CHF correlations developed for the channel geometry.

A hedging point strategy--balancing effluent quality, economy and robustness in the control of wastewater treatment plants.

PubMed

Ingildsen, P; Olsson, G; Yuan, Z

2002-01-01

An operational space map is an efficient tool to compare a large number of operational strategies to find an optimal choice of setpoints based on a multicriterion. Typically, such a multicriterion includes a weighted sum of cost of operation and effluent quality. Due to the relative high cost of aeration such a definition of optimality result in a relatively high fraction of the effluent total nitrogen in the form of ammonium. Such a strategy may however introduce a risk into operation because a low degree of ammonium removal leads to a low amount of nitrifiers. This in turn leads to a reduced ability to reject event disturbances, such as large variations in the ammonium load, drop in temperature, the presence of toxic/inhibitory compounds in the influent etc. Hedging is a risk minimisation tool, with the aim to "reduce one's risk of loss on a bet or speculation by compensating transactions on the other side" (The Concise Oxford Dictionary (1995)). In wastewater treatment plant operation hedging can be applied by choosing a higher level of ammonium removal to increase the amount of nitrifiers. This is a sensible way to introduce disturbance rejection ability into the multi criterion. In practice, this is done by deciding upon an internal effluent ammonium criterion. In some countries such as Germany, a separate criterion already applies to the level of ammonium in the effluent. However, in most countries the effluent criterion applies to total nitrogen only. In these cases, an internal effluent ammonium criterion should be selected in order to secure proper disturbance rejection ability.

Structuring Program Analysis for Educational Research.

ERIC Educational Resources Information Center

Levine, Donald M.

Education is too complex, multidimensional, and poorly understood to lend itself to a single cost/effectiveness criterion. Rather, analysts in the educational field seek to rank alternatives by their effectiveness, report separately on the cost implications, and leave the tradeoffs to the decisionmaker's judgment. In this context, a program is any…

Program management aid for redundancy selection and operational guidelines

NASA Technical Reports Server (NTRS)

Hodge, P. W.; Davis, W. L.; Frumkin, B.

1972-01-01

Although this criterion was developed specifically for use on the shuttle program, it has application to many other multi-missions programs (i.e. aircraft or mechanisms). The methodology employed is directly applicable even if the tools (nomographs and equations) are for mission peculiar cases. The redundancy selection criterion was developed to insure that both the design and operational cost impacts (life cycle costs) were considered in the selection of the quantity of operational redundancy. These tools were developed as aids in expediting the decision process and not intended as the automatic decision maker. This approach to redundancy selection is unique in that it enables a pseudo systems analysis to be performed on an equipment basis without waiting for all designs to be hardened.

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

ERIC Educational Resources Information Center

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

2002-01-01

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

'Sportmotorische Bestandesaufnahme': criterion- vs. norm-based reference values of fitness tests for Swiss first grade children.

PubMed

Tomatis, Laura; Krebs, Andreas; Siegenthaler, Jessica; Murer, Kurt; de Bruin, Eling D

2015-01-01

Health is closely linked to physical activity and fitness. It is therefore important to monitor fitness in children. Although many reports on physical tests have been published, data comparison between studies is an issue. This study reports Swiss first grade norm values of fitness tests and compares these with criterion reference data. A total of 10,565 boys (7.18 ± 0.42 years) and 10,204 girls (7.14 ± 0.41 years) were tested for standing long jump, plate tapping, 20-m shuttle run, lateral jump and 20-m sprint. Average values for six-, seven- and eight-year-olds were analysed and reference curves for age were constructed. Z-values were generated for comparisons with criterion references reported in the literature. Results were better for all disciplines in seven-year-old first grade children compared to six-year-old children (p < 0.01). Eight-year-old children did not perform better compared to seven-year-old children in the sprint run (p = 0.11), standing long jump (p > 0.99) and shuttle run (p = 0.43), whereas they were better in all other disciplines compared to their younger peers. The average performance of boys was better than girls except for tapping at the age of 8 (p = 0.06). Differences in performance due to testing protocol and setting must be considered when test values from a first grade setting are compared to criterion-based benchmarks. In a classroom setting, younger children tended to have better results and older children tended to have worse outcomes when compared to their age group criterion reference values. Norm reference data are valid allowing comparison with other data generated by similar test protocols applied in a classroom setting.

Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis

PubMed Central

Bus, Sicco A.; Haspels, Rob; Busch-Westbroek, Tessa E.

2011-01-01

OBJECTIVE Therapeutic footwear for diabetic foot patients aims to reduce the risk of ulceration by relieving mechanical pressure on the foot. However, footwear efficacy is generally not assessed in clinical practice. The purpose of this study was to assess the value of in-shoe plantar pressure analysis to evaluate and optimize the pressure-reducing effects of diabetic therapeutic footwear. RESEARCH DESIGN AND METHODS Dynamic in-shoe plantar pressure distribution was measured in 23 neuropathic diabetic foot patients wearing fully customized footwear. Regions of interest (with peak pressure >200 kPa) were selected and targeted for pressure optimization by modifying the shoe or insole. After each of a maximum of three rounds of modifications, the effect on in-shoe plantar pressure was measured. Successful optimization was achieved with a peak pressure reduction of >25% (criterion A) or below an absolute level of 200 kPa (criterion B). RESULTS In 35 defined regions, mean peak pressure was significantly reduced from 303 (SD 77) to 208 (46) kPa after an average 1.6 rounds of footwear modifications (P < 0.001). This result constitutes a 30.2% pressure relief (range 18–50% across regions). All regions were successfully optimized: 16 according to criterion A, 7 to criterion B, and 12 to criterion A and B. Footwear optimization lasted on average 53 min. CONCLUSIONS These findings suggest that in-shoe plantar pressure analysis is an effective and efficient tool to evaluate and guide footwear modifications that significantly reduce pressure in the neuropathic diabetic foot. This result provides an objective approach to instantly improve footwear quality, which should reduce the risk for pressure-related plantar foot ulcers. PMID:21610125

Simple proof of the quantum benchmark fidelity for continuous-variable quantum devices

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

Namiki, Ryo

2011-04-15

An experimental success criterion for continuous-variable quantum teleportation and memory is to surpass the limit of the average fidelity achieved by classical measure-and-prepare schemes with respect to a Gaussian-distributed set of coherent states. We present an alternative proof of the classical limit based on the familiar notions of state-channel duality and partial transposition. The present method enables us to produce a quantum-domain criterion associated with a given set of measured fidelities.

Criterion 6, indicator 37 : average wage rates, annual average income, and annual injury rates in major forest employment categories

Treesearch

Kenneth Skog; Susan J. Alexander; John Bergstrom; Ken Cordell; Elizabeth Hill; James Howard; Rebecca Westby

2011-01-01

Average annual incomes for forest management and protection includes salaries for full-time permanent employees of the U.S. Department of Agriculture, Forest Service, which have increased from a median of $41,300 in 1992 to $48,200 in 2000, to $50,500 in 2006 (all in 2005$). Salary of full-time permanent employees in state forestry agencies in 1998, for entry level...

Integration of electromagnetic induction sensor data in soil sampling scheme optimization using simulated annealing.

PubMed

Barca, E; Castrignanò, A; Buttafuoco, G; De Benedetto, D; Passarella, G

2015-07-01

Soil survey is generally time-consuming, labor-intensive, and costly. Optimization of sampling scheme allows one to reduce the number of sampling points without decreasing or even increasing the accuracy of investigated attribute. Maps of bulk soil electrical conductivity (EC a ) recorded with electromagnetic induction (EMI) sensors could be effectively used to direct soil sampling design for assessing spatial variability of soil moisture. A protocol, using a field-scale bulk EC a survey, has been applied in an agricultural field in Apulia region (southeastern Italy). Spatial simulated annealing was used as a method to optimize spatial soil sampling scheme taking into account sampling constraints, field boundaries, and preliminary observations. Three optimization criteria were used. the first criterion (minimization of mean of the shortest distances, MMSD) optimizes the spreading of the point observations over the entire field by minimizing the expectation of the distance between an arbitrarily chosen point and its nearest observation; the second criterion (minimization of weighted mean of the shortest distances, MWMSD) is a weighted version of the MMSD, which uses the digital gradient of the grid EC a data as weighting function; and the third criterion (mean of average ordinary kriging variance, MAOKV) minimizes mean kriging estimation variance of the target variable. The last criterion utilizes the variogram model of soil water content estimated in a previous trial. The procedures, or a combination of them, were tested and compared in a real case. Simulated annealing was implemented by the software MSANOS able to define or redesign any sampling scheme by increasing or decreasing the original sampling locations. The output consists of the computed sampling scheme, the convergence time, and the cooling law, which can be an invaluable support to the process of sampling design. The proposed approach has found the optimal solution in a reasonable computation time. The use of bulk EC a gradient as an exhaustive variable, known at any node of an interpolation grid, has allowed the optimization of the sampling scheme, distinguishing among areas with different priority levels.

The distribution over time of costs and social net benefits for pertussis immunization programs.

PubMed

Girard, Dorota Zdanowska

2010-03-01

The cost of a six-dose pertussis immunization programs for children and adolescents is investigated in relation to estimators of the price of acellular vaccine, the value of a child's life, levels of vaccination rate and discount rates. We compare the cost of the program maintained over time at 90% with three alternative strategies, each involving a decrease in vaccination coverage. Data from England and Wales, 1966-2005, is used to formalize a delay in occurrence of pertussis cases as a result of a fall in coverage. We first apply the criterion of minimization of the total social cost of pertussis to identify the best cost saving immunization strategy. The results are also discussed in form of the discounted present value of the total social net benefits. We find that the discounted present value of the total social net benefit is maximized when a stable vaccination program at 90% is compared to a gradual decrease in vaccination coverage leading to the lowest vaccination rate. The benefits to society of providing sustained immunization strategy, vaccinating the highest proportion of children and adolescents, are systematically proved on the basis of the second optimisation criterion, independently of the level of estimators applied during economic evaluation for the cost variables.

Multilevel models for cost-effectiveness analyses that use cluster randomised trial data: An approach to model choice.

PubMed

Ng, Edmond S-W; Diaz-Ordaz, Karla; Grieve, Richard; Nixon, Richard M; Thompson, Simon G; Carpenter, James R

2016-10-01

Multilevel models provide a flexible modelling framework for cost-effectiveness analyses that use cluster randomised trial data. However, there is a lack of guidance on how to choose the most appropriate multilevel models. This paper illustrates an approach for deciding what level of model complexity is warranted; in particular how best to accommodate complex variance-covariance structures, right-skewed costs and missing data. Our proposed models differ according to whether or not they allow individual-level variances and correlations to differ across treatment arms or clusters and by the assumed cost distribution (Normal, Gamma, Inverse Gaussian). The models are fitted by Markov chain Monte Carlo methods. Our approach to model choice is based on four main criteria: the characteristics of the data, model pre-specification informed by the previous literature, diagnostic plots and assessment of model appropriateness. This is illustrated by re-analysing a previous cost-effectiveness analysis that uses data from a cluster randomised trial. We find that the most useful criterion for model choice was the deviance information criterion, which distinguishes amongst models with alternative variance-covariance structures, as well as between those with different cost distributions. This strategy for model choice can help cost-effectiveness analyses provide reliable inferences for policy-making when using cluster trials, including those with missing data. © The Author(s) 2013.

Ranking of predictor variables based on effect size criterion provides an accurate means of automatically classifying opinion column articles

NASA Astrophysics Data System (ADS)

Legara, Erika Fille; Monterola, Christopher; Abundo, Cheryl

2011-01-01

We demonstrate an accurate procedure based on linear discriminant analysis that allows automatic authorship classification of opinion column articles. First, we extract the following stylometric features of 157 column articles from four authors: statistics on high frequency words, number of words per sentence, and number of sentences per paragraph. Then, by systematically ranking these features based on an effect size criterion, we show that we can achieve an average classification accuracy of 93% for the test set. In comparison, frequency size based ranking has an average accuracy of 80%. The highest possible average classification accuracy of our data merely relying on chance is ∼31%. By carrying out sensitivity analysis, we show that the effect size criterion is superior than frequency ranking because there exist low frequency words that significantly contribute to successful author discrimination. Consistent results are seen when the procedure is applied in classifying the undisputed Federalist papers of Alexander Hamilton and James Madison. To the best of our knowledge, the work is the first attempt in classifying opinion column articles, that by virtue of being shorter in length (as compared to novels or short stories), are more prone to over-fitting issues. The near perfect classification for the longer papers supports this claim. Our results provide an important insight on authorship attribution that has been overlooked in previous studies: that ranking discriminant variables based on word frequency counts is not necessarily an optimal procedure.

Racial/Ethnic Differences in the Criterion-Related Validity of Cognitive Ability Tests: A Qualitative and Quantitative Review

ERIC Educational Resources Information Center

Berry, Christopher M.; Clark, Malissa A.; McClure, Tara K.

2011-01-01

The correlation between cognitive ability test scores and performance was separately meta-analyzed for Asian, Black, Hispanic, and White racial/ethnic subgroups. Compared to the average White observed correlation ([image omitted] = 0.33, N = 903,779), average correlations were lower for Black samples ([image omitted] = 0.24, N = 112,194) and…

Study of Multimission Modular Spacecraft (MMS) propulsion requirements

NASA Technical Reports Server (NTRS)

Fischer, N. H.; Tischer, A. E.

1977-01-01

The cost effectiveness of various propulsion technologies for shuttle-launched multimission modular spacecraft (MMS) missions was determined with special attention to the potential role of ion propulsion. The primary criterion chosen for comparison for the different types of propulsion technologies was the total propulsion related cost, including the Shuttle charges, propulsion module costs, upper stage costs, and propulsion module development. In addition to the cost comparison, other criteria such as reliability, risk, and STS compatibility are examined. Topics covered include MMS mission models, propulsion technology definition, trajectory/performance analysis, cost assessment, program evaluation, sensitivity analysis, and conclusions and recommendations.

Information Fusion for High Level Situation Assessment and Prediction

DTIC Science & Technology

2007-03-01

procedure includes deciding a sensor set that achieves the optimal trade -off between its cost and benefit, activating the identified sensors, integrating...and effective decision can be made by dynamic inference based on selecting a subset of sensors with the optimal trade -off between their cost and...first step is achieved by designing a sensor selection criterion that represents the trade -off between the sensor benefit and sensor cost. This is then

a Traffic-Dependent Acoustical Grinding Criterion

NASA Astrophysics Data System (ADS)

DINGS, P.; VERHEIJEN, E.; KOOTWIJK-DAMMAN, C.

2000-03-01

On most lines of the Dutch railway network, where a substantial amount of block-braked trains have rough wheels, the average wheel roughness dominates over the rail roughness. Therefore, reducing wheel roughness is top priority in the Netherlands. However, for the situations where rail roughness exceeds wheel roughness, this roughness can be lowered at acceptable cost. The high rail roughness is often due to rail corrugation which can be removed by grinding. A method has been developed to assess periodically the rail roughness on each railway line of the network, to compare it with the average wheel roughness for that line and to determine whether a noise reduction can be achieved by grinding the rail. Roughness measurements can be carried out with an instrumented coach. The two axle-boxes of a measurement wheelset are equipped with accelerometers. Together with the train speed and the right frequency filter, the accelerometer signal is used to produce a wavelength spectrum of the rail roughness. To determine the average wheel roughness on a given line, the so-called Acoustical Timetable can be used. This database comprises train types, train intensities and train speeds for each track section in the Netherlands. An average wheel roughness spectrum is known for each type of braking system. The number of trains of each type passing by on a certain track section determine the average roughness. Analysis of the data shows on which track sections the rail roughness exceeds the wheel roughness by a specified level difference. If this track section lies in a residential area, the decision can be made to grind this piece of track to reduce the noise production locally. Using this methodology, the noise production can be kept to a minimum, determined by the local average wheel roughness.

Evaluation of entropy and JM-distance criterions as features selection methods using spectral and spatial features derived from LANDSAT images

NASA Technical Reports Server (NTRS)

Parada, N. D. J. (Principal Investigator); Dutra, L. V.; Mascarenhas, N. D. A.; Mitsuo, Fernando Augusta, II

1984-01-01

A study area near Ribeirao Preto in Sao Paulo state was selected, with predominance in sugar cane. Eight features were extracted from the 4 original bands of LANDSAT image, using low-pass and high-pass filtering to obtain spatial features. There were 5 training sites in order to acquire the necessary parameters. Two groups of four channels were selected from 12 channels using JM-distance and entropy criterions. The number of selected channels was defined by physical restrictions of the image analyzer and computacional costs. The evaluation was performed by extracting the confusion matrix for training and tests areas, with a maximum likelihood classifier, and by defining performance indexes based on those matrixes for each group of channels. Results show that in spatial features and supervised classification, the entropy criterion is better in the sense that allows a more accurate and generalized definition of class signature. On the other hand, JM-distance criterion strongly reduces the misclassification within training areas.

Cost-constrained optimal sampling for system identification in pharmacokinetics applications with population priors and nuisance parameters.

PubMed

Sorzano, Carlos Oscars S; Pérez-De-La-Cruz Moreno, Maria Angeles; Burguet-Castell, Jordi; Montejo, Consuelo; Ros, Antonio Aguilar

2015-06-01

Pharmacokinetics (PK) applications can be seen as a special case of nonlinear, causal systems with memory. There are cases in which prior knowledge exists about the distribution of the system parameters in a population. However, for a specific patient in a clinical setting, we need to determine her system parameters so that the therapy can be personalized. This system identification is performed many times by measuring drug concentrations in plasma. The objective of this work is to provide an irregular sampling strategy that minimizes the uncertainty about the system parameters with a fixed amount of samples (cost constrained). We use Monte Carlo simulations to estimate the average Fisher's information matrix associated to the PK problem, and then estimate the sampling points that minimize the maximum uncertainty associated to system parameters (a minimax criterion). The minimization is performed employing a genetic algorithm. We show that such a sampling scheme can be designed in a way that is adapted to a particular patient and that it can accommodate any dosing regimen as well as it allows flexible therapeutic strategies. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

Study of natural radioactivity in Mansehra granite, Pakistan: environmental concerns.

PubMed

Qureshi, Aziz Ahmed; Jadoon, Ishtiaq Ahmed Khan; Wajid, Ali Abbas; Attique, Ahsan; Masood, Adil; Anees, Muhammad; Manzoor, Shahid; Waheed, Abdul; Tubassam, Aneela

2014-03-01

A part of Mansehra Granite was selected for the assessment of radiological hazards. The average activity concentrations of (226)Ra, (232)Th and (40)K were found to be 27.32, 50.07 and 953.10 Bq kg(-1), respectively. These values are in the median range when compared with the granites around the world. Radiological hazard indices and annual effective doses were estimated. All of these indices were found to be within the criterion limits except outdoor external dose (82.38 nGy h(-1)) and indoor external dose (156.04 nGy h(-1)), which are higher than the world's average background levels of 51 and 55 nGy h(-1), respectively. These values correspond to an average annual effective dose of 0.867 mSv y(-1), which is less than the criterion limit of 1 mSv y(-1) (ICRP-103). Some localities in the Mansehra city have annual effective dose higher than the limit of 1 mSv y(-1). Overall, the Mansehra Granite does not pose any significant radiological health hazard in the outdoor or indoor.

Validity and reliability of a simple, low cost measure to quantify children’s dietary intake in afterschool settings

PubMed Central

Davison, Kirsten K.; Austin, S. Bryn; Giles, Catherine; Cradock, Angie L.; Lee, Rebekka M.; Gortmaker, Steven L.

2017-01-01

Interest in evaluating and improving children’s diets in afterschool settings has grown, necessitating the development of feasible yet valid measures for capturing children’s intake in such settings. This study’s purpose was to test the criterion validity and cost of three unobtrusive visual estimation methods compared to a plate-weighing method: direct on-site observation using a 4-category rating scale and off-site rating of digital photographs taken on-site using 4- and 10-category scales. Participants were 111 children in grades 1–6 attending four afterschool programs in Boston, MA in December 2011. Researchers observed and photographed 174 total snack meals consumed across two days at each program. Visual estimates of consumption were compared to weighed estimates (the criterion measure) using intra-class correlations. All three methods were highly correlated with the criterion measure, ranging from 0.92–0.94 for total calories consumed, 0.86–0.94 for consumption of pre-packaged beverages, 0.90–0.93 for consumption of fruits/vegetables, and 0.92–0.96 for consumption of grains. For water, which was not pre-portioned, coefficients ranged from 0.47–0.52. The photographic methods also demonstrated excellent inter-rater reliability: 0.84–0.92 for the 4-point and 0.92–0.95 for the 10-point scale. The costs of the methods for estimating intake ranged from $0.62 per observation for the on-site direct visual method to $0.95 per observation for the criterion measure. This study demonstrates that feasible, inexpensive methods can validly and reliably measure children’s dietary intake in afterschool settings. Improving precision in measures of children’s dietary intake can reduce the likelihood of spurious or null findings in future studies. PMID:25596895

Investigation of detonation velocity in heterogeneous explosive system using the reactive Burgers' analog

NASA Astrophysics Data System (ADS)

Di Labbio, G.; Kiyanda, C. B.; Mi, X.; Higgins, A. J.; Nikiforakis, N.; Ng, H. D.

2016-06-01

In this study, the applicability of the Chapman-Jouguet (CJ) criterion is tested numerically for heterogeneous explosive media using a simple detonation analog. The analog system consists of a reactive Burgers' equation coupled with an Arrhenius type reaction wave, and the heterogeneity of the explosive media is mimicked using a discrete energy source approach. The governing equation is solved using a second order, finite-volume approach and the average propagation velocity of the discrete detonation is determined by tracking the leading shock front. Consistent with previous studies, the averaged velocity of the leading shock front from the unsteady numerical simulations is also found to be in good agreement with the velocity of a CJ detonation in a uniform medium wherein the energy source is spatially homogenized. These simulations have thus implications for whether the CJ criterion is valid to predict the detonation velocity in heterogeneous explosive media.

Comparison of two non-convex mixed-integer nonlinear programming algorithms applied to autoregressive moving average model structure and parameter estimation

NASA Astrophysics Data System (ADS)

Uilhoorn, F. E.

2016-10-01

In this article, the stochastic modelling approach proposed by Box and Jenkins is treated as a mixed-integer nonlinear programming (MINLP) problem solved with a mesh adaptive direct search and a real-coded genetic class of algorithms. The aim is to estimate the real-valued parameters and non-negative integer, correlated structure of stationary autoregressive moving average (ARMA) processes. The maximum likelihood function of the stationary ARMA process is embedded in Akaike's information criterion and the Bayesian information criterion, whereas the estimation procedure is based on Kalman filter recursions. The constraints imposed on the objective function enforce stability and invertibility. The best ARMA model is regarded as the global minimum of the non-convex MINLP problem. The robustness and computational performance of the MINLP solvers are compared with brute-force enumeration. Numerical experiments are done for existing time series and one new data set.

Using the costs of drug therapy to screen patients for a community pharmacy-based medication review program.

PubMed

Krähenbühl, Jean-Marc; Decollogny, Anne; Bugnon, Olivier

2008-12-01

To measure the positive predictive value (PPV) of the cost of drug therapy (threshold = 2000 Swiss francs [CHF], US$1440, 1360) as a screening criterion for identifying patients who may benefit from medication review (MR). To describe identified drug-related problems (DRPs) and expense problems (EPs), and to estimate potential savings if all recommendations were accepted. Five voluntary Swiss community pharmacies. Of 12,680 patients, 592 (4.7%) had drug therapy costs exceeding 2000 CHF over a six-month period from July 1 to December 31, 2002. This threshold limit was set to identify high-risk patients for DRPs and EPs. Three pharmacists consecutively conducted a medication review based on the pharmaceutical charts of 125 sampled patients who met the inclusion criterion. The PPV of a threshold of 2000 CHF for identifying patients who might benefit from a MR: true positives were patients with at least one DRP, while false positives were patients with no DRP. The selection based on this criterion had a PPV of 86% for detecting patients with at least one DRP and 95% if EPs were also considered. There was a mean of 2.64 (SD = 2.20) DRPs per patient and a mean of 2.14 (SD = 1.39) EPs per patient. Of these patients, 90% were over 65 years old or were treated with at least five chronic medications, two common criteria for identifying patients at risk of DRPs. The main types of DRPs were drug-drug interactions, compliance problems and duplicate drugs. Mean daily drug cost per patient was CHF 14.87 (US$10.70, 10.10). A potential savings of CHF 1.67 (US$1.20, 1.14) per day (11%) was estimated if all recommendations to solve DRPs and EPs suggested herein were implemented. Further studies should investigate whether the potential benefit of medication reviews in preventing DRPs and containing costs in this patient group can be confirmed in a real practice environment.

List context effects in languages with opaque and transparent orthographies: a challenge for models of reading.

PubMed

Traficante, Daniela; Burani, Cristina

2014-01-01

This paper offers a review of data which show that reading is a flexible and dynamic process and that readers can exert strategic control over it. Two main hypotheses on the control of reading processes have been suggested: the route de-emphasis hypothesis and the time-criterion hypothesis. According to the former, the presence of irregular words in the list might lead to an attenuation of the non-lexical process, while the presence of non-words could trigger a de-emphasis of the lexical route. An alternative account is proposed by the time-criterion hypothesis whereby the reader sets a flexible deadline to initiate the response. According to the latter view, it is the average pronunciation difficulty of the items in the block that modulates the time-criterion for response. However, it is worth noting that the list composition has been shown to exert different effects in transparent compared to opaque orthographies, as the consistency of spelling-sound correspondences can influence the processing costs of the non-lexical pathway. In transparent orthographies, the non-lexical route is not resource demanding and can successfully contribute to the pronunciation of regular words, thus its de-emphasis could not be as useful/necessary as in opaque orthographies. The complex patterns of results from the literature on list context effects are a challenge for computational models of reading which face the problem of simulating strategic control over reading processes. Different proposals suggest a modification of parameter setting in the non-lexical route or the implementation of a new module aimed at focusing attention on the output of the more convenient pathway. Simulation data and an assessment of the models' fit to the behavioral results are presented and discussed to shed light on the role of the cognitive system when reading aloud.

Suitability of river delta sediment as proppant, Missouri and Niobrara Rivers, Nebraska and South Dakota, 2015

USGS Publications Warehouse

Zelt, Ronald B.; Hobza, Christopher M.; Burton, Bethany L.; Schaepe, Nathaniel J.; Piatak, Nadine

2017-11-16

Sediment management is a challenge faced by reservoir managers who have several potential options, including dredging, for mitigation of storage capacity lost to sedimentation. As sediment is removed from reservoir storage, potential use of the sediment for socioeconomic or ecological benefit could potentially defray some costs of its removal. Rivers that transport a sandy sediment load will deposit the sand load along a reservoir-headwaters reach where the current of the river slackens progressively as its bed approaches and then descends below the reservoir water level. Given a rare combination of factors, a reservoir deposit of alluvial sand has potential to be suitable for use as proppant for hydraulic fracturing in unconventional oil and gas development. In 2015, the U.S. Geological Survey began a program of researching potential sources of proppant sand from reservoirs, with an initial focus on the Missouri River subbasins that receive sand loads from the Nebraska Sand Hills. This report documents the methods and results of assessments of the suitability of river delta sediment as proppant for a pilot study area in the delta headwaters of Lewis and Clark Lake, Nebraska and South Dakota. Results from surface-geophysical surveys of electrical resistivity guided borings to collect 3.7-meter long cores at 25 sites on delta sandbars using the direct-push method to recover duplicate, 3.8-centimeter-diameter cores in April 2015. In addition, the U.S. Geological Survey collected samples of upstream sand sources in the lower Niobrara River valley.At the laboratory, samples were dried, weighed, washed, dried, and weighed again. Exploratory analysis of natural sand for determining its suitability as a proppant involved application of a modified subset of the standard protocols known as American Petroleum Institute (API) Recommended Practice (RP) 19C. The RP19C methods were not intended for exploration-stage evaluation of raw materials. Results for the washed samples are not directly applicable to evaluations of suitability for use as fracture sand because, except for particle-size distribution, the API-recommended practices for assessing proppant properties (sphericity, roundness, bulk density, and crush resistance) require testing of specific proppant size classes. An optical imaging particle-size analyzer was used to make measurements of particle-size distribution and particle shape. Measured samples were sieved to separate the dominant-size fraction, and the separated subsample was further tested for roundness, sphericity, bulk density, and crush resistance.For the bulk washed samples collected from the Missouri River delta, the geometric mean size averaged 0.27 millimeters (mm), 80 percent of the samples were predominantly sand in the API 40/70 size class, and 17 percent were predominantly sand in the API 70/140 size class. Distributions of geometric mean size among the four sandbar complexes were similar, but samples collected from sandbar complex B were slightly coarser sand than those from the other three complexes. The average geometric mean sizes among the four sandbar complexes ranged only from 0.26 to 0.30 mm. For 22 main-stem sampling locations along the lower Niobrara River, geometric mean size averaged 0.26 mm, an average of 61 percent was sand in the API 40/70 size class, and 28 percent was sand in the API 70/140 size class. Average composition for lower Niobrara River samples was 48 percent medium sand, 37 percent fine sand, and about 7 percent each very fine sand and coarse sand fractions. On average, samples were moderately well sorted.Particle shape and strength were assessed for the dominant-size class of each sample. For proppant strength, crush resistance was tested at a predetermined level of stress (34.5 megapascals [MPa], or 5,000 pounds-force per square inch). To meet the API minimum requirement for proppant, after the crush test not more than 10 percent of the tested sample should be finer than the precrush dominant-size class. For particle shape, all samples surpassed the recommended minimum criteria for sphericity and roundness, with most samples being well-rounded. For proppant strength, of 57 crush-resistance tested Missouri River delta samples of 40/70-sized sand, 23 (40 percent) were interpreted as meeting the minimum criterion at 34.5 MPa, or 5,000 pounds-force per square inch. Of 12 tested samples of 70/140-sized sand, 9 (75 percent) of the Missouri River delta samples had less than 10 percent fines by volume following crush testing, achieving the minimum criterion at 34.5 MPa. Crush resistance for delta samples was strongest at sandbar complex A, where 67 percent of tested samples met the 10-percent fines criterion at the 34.5-MPa threshold. This frequency was higher than was indicated by samples from sandbar complexes B, C, and D that had rates of 50, 46, and 42 percent, respectively. The group of sandbar complex A samples also contained the largest percentages of samples dominated by the API 70/140 size class, which overall had a higher percentage of samples meeting the minimum criterion compared to samples dominated by coarser size classes; however, samples from sandbar complex A that had the API 40/70 size class tested also had a higher rate for meeting the minimum criterion (57 percent) than did samples from sandbar complexes B, C, and D (50, 43, and 40 percent, respectively). For samples collected along the lower Niobrara River, of the 25 tested samples of 40/70-sized sand, 9 samples passed the API minimum criterion at 34.5 MPa, but only 3 samples passed the more-stringent criterion of 8 percent postcrush fines. All four tested samples of 70/140 sand passed the minimum criterion at 34.5 MPa, with postcrush fines percentage of at most 4.1 percent.For two reaches of the lower Niobrara River, where hydraulic sorting was energized artificially by the hydraulic head drop at and immediately downstream from Spencer Dam, suitability of channel deposits for potential use as fracture sand was confirmed by test results. All reach A washed samples were well-rounded and had sphericity scores above 0.65, and samples for 80 percent of sampled locations met the crush-resistance criterion at the 34.5-MPa stress level. A conservative lower-bound estimate of sand volume in the reach A deposits was about 86,000 cubic meters. All reach B samples were well-rounded but sphericity averaged 0.63, a little less than the average for upstream reaches A and SP. All four samples tested passed the crush-resistance test at 34.5 MPa. Of three reach B sandbars, two had no more than 3 percent fines after the crush test, surpassing more stringent criteria for crush resistance that accept a maximum of 6 percent fines following the crush test for the API 70/140 size class.Relative to the crush-resistance test results for the API 40/70 size fraction of two samples of mine output from Loup River settling-basin dredge spoils near Genoa, Nebr., four of five reach A sample locations compared favorably. The four samples had increases in fines composition of 1.6–5.9 percentage points, whereas fines in the two mine-output samples increased by an average 6.8 percentage points.

The cost effectiveness of occupational health interventions: preventing occupational back pain.

PubMed

Lahiri, Supriya; Markkanen, Pia; Levenstein, Charles

2005-12-01

Occupational back pain exacts a toll on society with concomitant economic losses; it is imperative to evaluate the cost-effectiveness of interventions to reduce the relevant ergonomic stressors at work. This study estimates and evaluates the average and incremental cost-effectiveness ratios (CERs) of specific interventions for the prevention of occupationally induced back pain for the World Health Organization (WHO) defined subregions of the world. Four back-pain interventions were selected from the literature: training (T), engineering controls (EC), engineering controls and training (EC&T), and a comprehensive full ergonomics program (EP) for evaluation. A simulation model for a 100-year time horizon, developed by the WHO CHOICE initiative project was used to estimate the effectiveness of the interventions in healthy year equivalents. The intervention costs were adjusted for all WHO subregions. In all of the subregions, training was the most cost-effective with CERs varying from 74 dollars per healthy life years gained in the subregion comprising of Egypt, Iraq, Morocco, Yemen (EMROD) to approximately 567 dollars in the subregion covering Canada and the United States (AMROA). Training is considered to be very cost-effective and would be the first choice option where resources are scarce. However, the overall effectiveness of training is low. Although other interventions such as engineering controls and total ergonomic interventions are relatively more expensive, the addition to health outcome through these interventions is much higher. The difference in the CERs for training and other engineering controls and full ergonomic interventions is relatively small for most of the industrialized regions of the world. It is clear from the ranked CERs and incremental CERs over the different subregions that in most of the industrialized regions of the world additional resources, if they become available, should go straight to the full ergonomics program. The model results based on CERs show that worker training is a low cost, feasible first step toward reducing back pain/injury incidence. However, all of the average CERs for the different interventions, for each of the regions, fall well within their GDP per capita estimates [World Bank, 2001]. According to the WHO Commission on Macroeconomics and Health any intervention that costs less than three times GDP per capita for saving a healthy year equivalent should be considered worthwhile and good value for money [WHO, 2002]. Given this criterion, the engineering controls interventions as well as the full ergonomics program look very cost effective for all of the WHO subregions. 2005 Wiley-Liss, Inc.

On the hyperbolic nature of the equations of alluvial river hydraulics and the equivalence of stable and energy dissipating shocks

NASA Astrophysics Data System (ADS)

Zanraea, D. D. L.; Needham, D. J.

The depth-averaged hydraulic equations augmented with a suitable bed-load sediment transport function form a closed system which governs the one-dimensional flow in an alluvial river or channel. In this paper, it is shown that this system is hyperbolic and yields three families of shock-wave solutions. These are determined to be temporally stable in restricted regions of the (H, F0)-plane, via the Lax shock inequalities. Further, it is demonstrated that this criterion is equivalent to the energy dissipation criterion developed by Needham and Hey (1991).

ROI (return on investment): its role in voluntary hospital planning.

PubMed

Cleverley, W

1990-01-01

Return on investment is the primary financial criterion used to evaluate the desirability of capital investment in investor-owned firms. Voluntary health care firms need to examine more carefully their return-on-investment levels. The potential loss of capital cost payment in the Medicare program and the removal of tax-exempt financing would raise the effective cost of capital to voluntary health care firms significantly. Many health care providers might find that they are no longer going concerns if capital costs increase much more.

Cost-effectiveness of hepatitis A vaccination for individuals with chronic hepatitis C.

PubMed

Chapko, Michael K; Yee, Helen S; Monto, Alexander; Dominitz, Jason A

2010-02-17

The incidence of hepatitis A infection in the United States has decreased dramatically in recent years because of childhood immunization programs. A decision analysis of the cost-effectiveness of hepatitis A vaccination for adults with hepatitis C was conducted. No vaccination strategy is cost-effective for adults with hepatitis C using the recent lower anticipated hepatitis A incidence, private sector costs, and a cost-effectiveness criterion of $100,000/QALY. Vaccination is cost-effective only for individuals who have cleared the hepatitis C virus when Department of Veterans Affairs costs are used. The recommendation to vaccinate adults with hepatitis C against hepatitis A should be reconsidered. Published by Elsevier Ltd.

What Can the Diffusion Model Tell Us About Prospective Memory?

PubMed Central

Horn, Sebastian S.; Bayen, Ute J.; Smith, Rebekah E.

2011-01-01

Cognitive process models, such as Ratcliff’s (1978) diffusion model, are useful tools for examining cost- or interference effects in event-based prospective memory (PM). The diffusion model includes several parameters that provide insight into how and why ongoing-task performance may be affected by a PM task and is ideally suited to analyze performance because both reaction time and accuracy are taken into account. Separate analyses of these measures can easily yield misleading interpretations in cases of speed-accuracy tradeoffs. The diffusion model allows us to measure possible criterion shifts and is thus an important methodological improvement over standard analyses. Performance in an ongoing lexical decision task (Smith, 2003) was analyzed with the diffusion model. The results suggest that criterion shifts play an important role when a PM task is added, but do not fully explain the cost effect on RT. PMID:21443332

An investigation of the effects of pitch-roll (de)-coupling on helicopter handling qualities

NASA Technical Reports Server (NTRS)

Ockier, C. J.; Pausder, H. J.; Blanken, C. L.

1995-01-01

An investigation of the effects of pitch-roll coupling on helicopter handling qualities was performed by the US Army and DLR, using a NASA ground-based and a DLR inflight simulator. Over 90 different coupling configurations were evaluated using a roll-axis tracking task. The results show that although the current ADS-33C coupling criterion discriminates against those types of coupling typical of conventionally controlled helicopters, it not always suited for the prediction of handling qualities of helicopters with modern control systems. Based on the observation that high frequency inputs during tracking are used to alleviate coupling, a frequency domain pitch-roll coupling criterion that uses the average coupling ratio between the bandwidth and neutral stability frequency is formulated. This criterion provides a more comprehensive coverage with respect to the different types of coupling and shows excellent consistency.

Comparative analysis of the current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology.

PubMed

Babić, Uroš; Soldatović, Ivan; Vuković, Dejana; Milićević, Milena Šantrić; Stjepanović, Mihailo; Kojić, Dejan; Argirović, Aleksandar; Vukotić, Vinka

2015-03-01

Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR) is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. The data were obtained from the information system used in the Clinical Hospital Center "Dr. Dragiša Mišović"--Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0.001) respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively). Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001) as well as under the projected DRG payment system (β = 0.737, p < 0.001). The same predictor was crucial for the difference in the current payment method and the pro- jected DRG payment methods (β = 0.501, p < 0.001). Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs) per DRG. Given that aggregate costs of treatment under two hospital payment methods compared in the study are not significantly different, the focus on minor surgeries both under the current hospital payment method and under the introduced DRG system would be far more cost-effective for a hospital as great variations in treatment performance (reductions of days of hospitalization and complications), and consequently invoiced amounts would be reduced.

A data driven partial ambiguity resolution: Two step success rate criterion, and its simulation demonstration

NASA Astrophysics Data System (ADS)

Hou, Yanqing; Verhagen, Sandra; Wu, Jie

2016-12-01

Ambiguity Resolution (AR) is a key technique in GNSS precise positioning. In case of weak models (i.e., low precision of data), however, the success rate of AR may be low, which may consequently introduce large errors to the baseline solution in cases of wrong fixing. Partial Ambiguity Resolution (PAR) is therefore proposed such that the baseline precision can be improved by fixing only a subset of ambiguities with high success rate. This contribution proposes a new PAR strategy, allowing to select the subset such that the expected precision gain is maximized among a set of pre-selected subsets, while at the same time the failure rate is controlled. These pre-selected subsets are supposed to obtain the highest success rate among those with the same subset size. The strategy is called Two-step Success Rate Criterion (TSRC) as it will first try to fix a relatively large subset with the fixed failure rate ratio test (FFRT) to decide on acceptance or rejection. In case of rejection, a smaller subset will be fixed and validated by the ratio test so as to fulfill the overall failure rate criterion. It is shown how the method can be practically used, without introducing a large additional computation effort. And more importantly, how it can improve (or at least not deteriorate) the availability in terms of baseline precision comparing to classical Success Rate Criterion (SRC) PAR strategy, based on a simulation validation. In the simulation validation, significant improvements are obtained for single-GNSS on short baselines with dual-frequency observations. For dual-constellation GNSS, the improvement for single-frequency observations on short baselines is very significant, on average 68%. For the medium- to long baselines, with dual-constellation GNSS the average improvement is around 20-30%.

Forecasting mortality of road traffic injuries in China using seasonal autoregressive integrated moving average model.

PubMed

Zhang, Xujun; Pang, Yuanyuan; Cui, Mengjing; Stallones, Lorann; Xiang, Huiyun

2015-02-01

Road traffic injuries have become a major public health problem in China. This study aimed to develop statistical models for predicting road traffic deaths and to analyze seasonality of deaths in China. A seasonal autoregressive integrated moving average (SARIMA) model was used to fit the data from 2000 to 2011. Akaike Information Criterion, Bayesian Information Criterion, and mean absolute percentage error were used to evaluate the constructed models. Autocorrelation function and partial autocorrelation function of residuals and Ljung-Box test were used to compare the goodness-of-fit between the different models. The SARIMA model was used to forecast monthly road traffic deaths in 2012. The seasonal pattern of road traffic mortality data was statistically significant in China. SARIMA (1, 1, 1) (0, 1, 1)12 model was the best fitting model among various candidate models; the Akaike Information Criterion, Bayesian Information Criterion, and mean absolute percentage error were -483.679, -475.053, and 4.937, respectively. Goodness-of-fit testing showed nonautocorrelations in the residuals of the model (Ljung-Box test, Q = 4.86, P = .993). The fitted deaths using the SARIMA (1, 1, 1) (0, 1, 1)12 model for years 2000 to 2011 closely followed the observed number of road traffic deaths for the same years. The predicted and observed deaths were also very close for 2012. This study suggests that accurate forecasting of road traffic death incidence is possible using SARIMA model. The SARIMA model applied to historical road traffic deaths data could provide important evidence of burden of road traffic injuries in China. Copyright © 2015 Elsevier Inc. All rights reserved.

Criterion validity and accuracy of global positioning satellite and data logging devices for wheelchair tennis court movement

PubMed Central

Sindall, Paul; Lenton, John P.; Whytock, Katie; Tolfrey, Keith; Oyster, Michelle L.; Cooper, Rory A.; Goosey-Tolfrey, Victoria L.

2013-01-01

Purpose To compare the criterion validity and accuracy of a 1 Hz non-differential global positioning system (GPS) and data logger device (DL) for the measurement of wheelchair tennis court movement variables. Methods Initial validation of the DL device was performed. GPS and DL were fitted to the wheelchair and used to record distance (m) and speed (m/second) during (a) tennis field (b) linear track, and (c) match-play test scenarios. Fifteen participants were monitored at the Wheelchair British Tennis Open. Results Data logging validation showed underestimations for distance in right (DLR) and left (DLL) logging devices at speeds >2.5 m/second. In tennis-field tests, GPS underestimated distance in five drills. DLL was lower than both (a) criterion and (b) DLR in drills moving forward. Reversing drill direction showed that DLR was lower than (a) criterion and (b) DLL. GPS values for distance and average speed for match play were significantly lower than equivalent values obtained by DL (distance: 2816 (844) vs. 3952 (1109) m, P = 0.0001; average speed: 0.7 (0.2) vs. 1.0 (0.2) m/second, P = 0.0001). Higher peak speeds were observed in DL (3.4 (0.4) vs. 3.1 (0.5) m/second, P = 0.004) during tennis match play. Conclusions Sampling frequencies of 1 Hz are too low to accurately measure distance and speed during wheelchair tennis. GPS units with a higher sampling rate should be advocated in further studies. Modifications to existing DL devices may be required to increase measurement precision. Further research into the validity of movement devices during match play will further inform the demands and movement patterns associated with wheelchair tennis. PMID:23820154

Guaranteed cost control with poles assignment for a flexible air-breathing hypersonic vehicle

NASA Astrophysics Data System (ADS)

Li, Hongyi; Si, Yulin; Wu, Ligang; Hu, Xiaoxiang; Gao, Huijun

2011-05-01

This article investigates the problem of guaranteed cost control for a flexible air-breathing hypersonic vehicle (FAHV). The FAHV includes intricate coupling between the engine and flight dynamics as well as complex interplay between flexible and rigid modes, which results in an intractable system for the control design. A longitudinal model is adopted for control design due to the complexity of the vehicle. First, for a highly nonlinear and coupled FAHV, a linearised model is established around the trim condition, which includes the state of altitude, velocity, angle of attack, pitch angle and pitch rate, etc. Secondly, by using the Lyapunov approach, performance analysis is carried out for the resulting closed-loop FAHV system, whose criterion with respect to guaranteed performance cost and poles assignment is expressed in the framework of linear matrix inequalities (LMIs). The established criterion exhibits a kind of decoupling between the Lyapunov positive-definite matrices to be determined and the FAHV system matrices, which is enabled by the introduction of additional slack matrix variables. Thirdly, a convex optimisation problem with LMI constraints is formulated for designing an admissible controller, which guarantees a prescribed performance cost with the simultaneous consideration of poles assignment for the resulting closed-loop system. Finally, some simulation results are provided to show that the guaranteed cost controller could assign the poles into the desired regional and achieve excellent reference altitude and velocity tracking performance.

Cost decomposition of linear systems with application to model reduction

NASA Technical Reports Server (NTRS)

Skelton, R. E.

1980-01-01

A means is provided to assess the value or 'cst' of each component of a large scale system, when the total cost is a quadratic function. Such a 'cost decomposition' of the system has several important uses. When the components represent physical subsystems which can fail, the 'component cost' is useful in failure mode analysis. When the components represent mathematical equations which may be truncated, the 'component cost' becomes a criterion for model truncation. In this latter event component costs provide a mechanism by which the specific control objectives dictate which components should be retained in the model reduction process. This information can be valuable in model reduction and decentralized control problems.

Arbitrarily small amounts of correlation for arbitrarily varying quantum channels

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

Boche, H., E-mail: boche@tum.de, E-mail: janis.noetzel@tum.de; Nötzel, J., E-mail: boche@tum.de, E-mail: janis.noetzel@tum.de

2013-11-15

As our main result show that in order to achieve the randomness assisted message and entanglement transmission capacities of a finite arbitrarily varying quantum channel it is not necessary that sender and receiver share (asymptotically perfect) common randomness. Rather, it is sufficient that they each have access to an unlimited amount of uses of one part of a correlated bipartite source. This access might be restricted to an arbitrary small (nonzero) fraction per channel use, without changing the main result. We investigate the notion of common randomness. It turns out that this is a very costly resource – generically, itmore » cannot be obtained just by local processing of a bipartite source. This result underlines the importance of our main result. Also, the asymptotic equivalence of the maximal- and average error criterion for classical message transmission over finite arbitrarily varying quantum channels is proven. At last, we prove a simplified symmetrizability condition for finite arbitrarily varying quantum channels.« less

Low degree of satisfactory individual pain relief in post-operative pain trials.

PubMed

Geisler, A; Dahl, J B; Karlsen, A P H; Persson, E; Mathiesen, O

2017-01-01

The majority of clinical trials regarding post-operative pain treatment focuses on the average analgesic efficacy, rather than on efficacy in individual patients. It has been argued, that in acute pain trials, the underlying distributions are often skewed, which makes the average unfit as the only way to measure efficacy. Consequently, dichotomised, individual responder analyses using a predefined 'favourable' response, e.g. Visual Analogue Scale (VAS) pain scores ≤ 30, have recently been suggested as a more clinical relevant outcome. We re-analysed data from 16 randomised controlled trials of post-operative pain treatment and from meta-analyses of a systematic review regarding hip arthroplasty. The predefined success criterion was that at least 80% of patients in active treatment groups should obtain VAS < 30 at 6 and 24 h post-operatively. In the analysis of data from the randomised controlled trials, we found that at 6 h post-operatively, 50% (95% CI: 31-69) of patients allocated to active treatment reached the success criterion for pain at rest and 14% (95% CI: 5-34) for pain during mobilisation. At 24 h post-operatively, 60% (95% CI: 38-78) of patients allocated to active treatment reached the success criterion for pain at rest, and 15% (95% CI: 5-36) for pain during mobilisation. Similar results were found for trials from the meta-analyses. Our results indicate that for conventional, explanatory trials of post-operative pain, individual patient's achievement of a favourable response to analgesic treatment is rather low. Future pragmatic clinical trials should focus on both average pain levels and individual responder analyses in order to promote effective pain treatment at the individually patient level. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Quantitative Criteria to Screen for Cannabis Use Disorder.

PubMed

Casajuana, Cristina; López-Pelayo, Hugo; Miquel, Laia; Balcells-Oliveró, María Mercedes; Colom, Joan; Gual, Antoni

2018-06-27

The Standard Joint Unit (1 SJU = 7 mg of 9-Tetrahydrocannabinol) simplifies the exploration of risky patterns of cannabis use. This study proposes a preliminary quantitative cutoff criterion to screen for cannabis use disorder (CUD). Socio-demographical data and information on cannabis quantities, frequency of use, and risk for CUD (measured with the Cannabis Abuse Screening Test (CAST) of cannabis users recruited in Barcelona (from February 2015 to June 2016) were collected. CAST scores were categorized into low, moderate, and high risk for CUD, based on the SJU consumed and frequency. Receiver operating characteristic (ROC) analysis related daily SJU with CUD. Participants (n = 473) were on average 29 years old (SD = 10), men (77.1%), and single (74.6%). With an average of 4 joints per smoking day, 82.5% consumed cannabis almost every day. Risk for CUD (9.40% low, 23.72% moderate, 66.88% high) increased significantly with more frequency and quantities consumed. The ROC analyses suggest 1.2 SJU per day as a cutoff criterion to screen for at least moderate risk for CUD (sensitivity 69.4%, specificity 63.6%). Frequency and quantity should be considered when exploring cannabis risks. A 1 SJU per day is proposed as a preliminary quantitative-based criterion to screen users with at least a moderate risk for CUD. © 2018 S. Karger AG, Basel.

Biomechanics and running economy.

PubMed

Anderson, T

1996-08-01

Running economy, which has traditionally been measured as the oxygen cost of running at a given velocity, has been accepted as the physiological criterion for 'efficient' performance and has been identified as a critical element of overall distance running performance. There is an intuitive link between running mechanics and energy cost of running, but research to date has not established a clear mechanical profile of an economic runner. It appears that through training, individuals are able to integrate and accommodate their own unique combination of dimensions and mechanical characteristics so that they arrive at a running motion which is most economical for them. Information in the literature suggests that biomechanical factors are likely to contribute to better economy in any runner. A variety of anthropometric dimensions could influence biomechanical effectiveness. These include: average or slightly smaller than average height for men and slightly greater than average height for women; high ponderal index and ectomorphic or ectomesomorphic physique; low percentage body fat; leg morphology which distributes mass closer to the hip joint; narrow pelvis and smaller than average feet. Gait patterns, kinematics and the kinetics of running may also be related to running economy. These factors include: stride length which is freely chosen over considerable running time; low vertical oscillation of body centre of mass; more acute knee angle during swing; less range of motion but greater angular velocity of plantar flexion during toe-off; arm motion of smaller amplitude; low peak ground reaction forces; faster rotation of shoulders in the transverse plane; greater angular excursion of the hips and shoulders about the polar axis in the transverse plane; and effective exploitation of stored elastic energy. Other factors which may improve running economy are: lightweight but well-cushioned shoes; more comprehensive training history; and the running surface of intermediate compliance. At the developmental level, this information might be useful in identifying athletes with favourable characteristics for economical distance running. At higher levels of competition, it is likely that 'natural selection' tends to eliminate athletes who failed to either inherit or develop characteristics which favour economy.

[On the problems of the evolutionary optimization of life history. II. To justification of optimization criterion for nonlinear Leslie model].

PubMed

Pasekov, V P

2013-03-01

The paper considers the problems in the adaptive evolution of life-history traits for individuals in the nonlinear Leslie model of age-structured population. The possibility to predict adaptation results as the values of organism's traits (properties) that provide for the maximum of a certain function of traits (optimization criterion) is studied. An ideal criterion of this type is Darwinian fitness as a characteristic of success of an individual's life history. Criticism of the optimization approach is associated with the fact that it does not take into account the changes in the environmental conditions (in a broad sense) caused by evolution, thereby leading to losses in the adequacy of the criterion. In addition, the justification for this criterion under stationary conditions is not usually rigorous. It has been suggested to overcome these objections in terms of the adaptive dynamics theory using the concept of invasive fitness. The reasons are given that favor the application of the average number of offspring for an individual, R(L), as an optimization criterion in the nonlinear Leslie model. According to the theory of quantitative genetics, the selection for fertility (that is, for a set of correlated quantitative traits determined by both multiple loci and the environment) leads to an increase in R(L). In terms of adaptive dynamics, the maximum R(L) corresponds to the evolutionary stability and, in certain cases, convergent stability of the values for traits. The search for evolutionarily stable values on the background of limited resources for reproduction is a problem of linear programming.

Predictions of Performance in Career Education.

ERIC Educational Resources Information Center

Novick, M. R.; And Others

Prediction weights for educational programs in 22 vocational and technical fields are provided using ability scores from the American College Testing Program (ACT) Career Planning Profile and a Bayesian regression theory. The criterion variable studies was first-semester grade-point average. Each vocational-technical program analyzed was…

Propulsion opportunities for future commuter aircraft

NASA Technical Reports Server (NTRS)

Strack, W. C.

1982-01-01

Circa 1990 propulsion improvement concepts are discussed for 1000 to 5000 SHP conventional turboprop powerplants including engines, gearboxes, and propellers. Cycle selection, power plant configurations and advanced technology elements are defined and evaluated using average stage length DOC for commuter aircraft as the primary merit criterion.

Can we use genetic and genomic approaches to identify candidate animals for targeted selective treatment.

PubMed

Laurenson, Yan C S M; Kyriazakis, Ilias; Bishop, Stephen C

2013-10-18

Estimated breeding values (EBV) for faecal egg count (FEC) and genetic markers for host resistance to nematodes may be used to identify resistant animals for selective breeding programmes. Similarly, targeted selective treatment (TST) requires the ability to identify the animals that will benefit most from anthelmintic treatment. A mathematical model was used to combine the concepts and evaluate the potential of using genetic-based methods to identify animals for a TST regime. EBVs obtained by genomic prediction were predicted to be the best determinant criterion for TST in terms of the impact on average empty body weight and average FEC, whereas pedigree-based EBVs for FEC were predicted to be marginally worse than using phenotypic FEC as a determinant criterion. Whilst each method has financial implications, if the identification of host resistance is incorporated into a wider genomic selection indices or selective breeding programmes, then genetic or genomic information may be plausibly included in TST regimes. Copyright © 2013 Elsevier B.V. All rights reserved.

Costing bias in economic evaluations.

PubMed

Frappier, Julie; Tremblay, Gabriel; Charny, Mark; Cloutier, L Martin

2015-01-01

Determining the cost-effectiveness of healthcare interventions is key to the decision-making process in healthcare. Cost comparisons are used to demonstrate the economic value of treatment options, to evaluate the impact on the insurer budget, and are often used as a key criterion in treatment comparison and comparative effectiveness; however, little guidance is available to researchers for establishing the costing of clinical events and resource utilization. Different costing methods exist, and the choice of underlying assumptions appears to have a significant impact on the results of the costing analysis. This editorial describes the importance of the choice of the costing technique and it's potential impact on the relative cost of treatment options. This editorial also calls for a more efficient approach to healthcare intervention costing in order to ensure the use of consistent costing in the decision-making process.

Fertigation uniformity under sprinkler irrigation: evaluation and analysis

USDA-ARS?s Scientific Manuscript database

n modern farming systems, fertigation is widely practiced as a cost effective and convenient method for applying soluble fertilizers to crops. Along with efficiency and adequacy, uniformity is an important fertigation performance evaluation criterion. Fertigation uniformity is defined here as a comp...

Evaluation of Pump Pulsation in Respirable Size-Selective Sampling: Part III. Investigation of European Standard Methods

PubMed Central

Soo, Jhy-Charm; Lee, Eun Gyung; Lee, Larry A.; Kashon, Michael L.; Harper, Martin

2015-01-01

Lee et al. (Evaluation of pump pulsation in respirable size-selective sampling: part I. Pulsation measurements. Ann Occup Hyg 2014a;58:60–73) introduced an approach to measure pump pulsation (PP) using a real-world sampling train, while the European Standards (EN) (EN 1232-1997 and EN 12919-1999) suggest measuring PP using a resistor in place of the sampler. The goal of this study is to characterize PP according to both EN methods and to determine the relationship of PP between the published method (Lee et al., 2014a) and the EN methods. Additional test parameters were investigated to determine whether the test conditions suggested by the EN methods were appropriate for measuring pulsations. Experiments were conducted using a factorial combination of personal sampling pumps (six medium- and two high-volumetric flow rate pumps), back pressures (six medium- and seven high-flow rate pumps), resistors (two types), tubing lengths between a pump and resistor (60 and 90 cm), and different flow rates (2 and 2.5 l min−1 for the medium- and 4.4, 10, and 11.2 l min−1 for the high-flow rate pumps). The selection of sampling pumps and the ranges of back pressure were based on measurements obtained in the previous study (Lee et al., 2014a). Among six medium-flow rate pumps, only the Gilian5000 and the Apex IS conformed to the 10% criterion specified in EN 1232-1997. Although the AirChek XR5000 exceeded the 10% limit, the average PP (10.9%) was close to the criterion. One high-flow rate pump, the Legacy (PP = 8.1%), conformed to the 10% criterion in EN 12919-1999, while the Elite12 did not (PP = 18.3%). Conducting supplemental tests with additional test parameters beyond those used in the two subject EN standards did not strengthen the characterization of PPs. For the selected test conditions, a linear regression model [PPEN = 0.014 + 0.375 × PPNIOSH (adjusted R2 = 0.871)] was developed to determine the PP relationship between the published method (Lee et al., 2014a) and the EN methods. The 25% PP criterion recommended by Lee et al. (2014a), average value derived from repetitive measurements, corresponds to 11% PPEN. The 10% pass/fail criterion in the EN Standards is not based on extensive laboratory evaluation and would unreasonably exclude at least one pump (i.e. AirChek XR5000 in this study) and, therefore, the more accurate criterion of average 11% from repetitive measurements should be substituted. This study suggests that users can measure PP using either a real-world sampling train or a resistor setup and obtain equivalent findings by applying the model herein derived. The findings of this study will be delivered to the consensus committees to be considered when those standards, including the EN 1232-1997, EN 12919-1999, and ISO 13137-2013, are revised. PMID:25053700

28 CFR 505.2 - Annual determination of average cost of incarceration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MANAGEMENT AND ADMINISTRATION COST OF INCARCERATION FEE § 505.2 Annual determination of average cost of... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Annual determination of average cost of... average cost of incarceration. This calculation is reviewed annually and the revised figure is published...

Identifying Acquisition Framing Assumptions Through Structured Deliberation

DTIC Science & Technology

2014-01-01

and tracking them, the Office of the Secretary of Defense (OSD), and the Services may be able to better manage major risks to and expectations of...programs. An FA is any explicit or implicit assumption that is central in shaping cost, sched- ule, or performance expectations . FAs may change over the... expectations . This criterion means that FAs, when they fail or are incorrect, will have significant cost, schedule and/or per- formance effects on the

Multi-objective experimental design for (13)C-based metabolic flux analysis.

PubMed

Bouvin, Jeroen; Cajot, Simon; D'Huys, Pieter-Jan; Ampofo-Asiama, Jerry; Anné, Jozef; Van Impe, Jan; Geeraerd, Annemie; Bernaerts, Kristel

2015-10-01

(13)C-based metabolic flux analysis is an excellent technique to resolve fluxes in the central carbon metabolism but costs can be significant when using specialized tracers. This work presents a framework for cost-effective design of (13)C-tracer experiments, illustrated on two different networks. Linear and non-linear optimal input mixtures are computed for networks for Streptomyces lividans and a carcinoma cell line. If only glucose tracers are considered as labeled substrate for a carcinoma cell line or S. lividans, the best parameter estimation accuracy is obtained by mixtures containing high amounts of 1,2-(13)C2 glucose combined with uniformly labeled glucose. Experimental designs are evaluated based on a linear (D-criterion) and non-linear approach (S-criterion). Both approaches generate almost the same input mixture, however, the linear approach is favored due to its low computational effort. The high amount of 1,2-(13)C2 glucose in the optimal designs coincides with a high experimental cost, which is further enhanced when labeling is introduced in glutamine and aspartate tracers. Multi-objective optimization gives the possibility to assess experimental quality and cost at the same time and can reveal excellent compromise experiments. For example, the combination of 100% 1,2-(13)C2 glucose with 100% position one labeled glutamine and the combination of 100% 1,2-(13)C2 glucose with 100% uniformly labeled glutamine perform equally well for the carcinoma cell line, but the first mixture offers a decrease in cost of $ 120 per ml-scale cell culture experiment. We demonstrated the validity of a multi-objective linear approach to perform optimal experimental designs for the non-linear problem of (13)C-metabolic flux analysis. Tools and a workflow are provided to perform multi-objective design. The effortless calculation of the D-criterion can be exploited to perform high-throughput screening of possible (13)C-tracers, while the illustrated benefit of multi-objective design should stimulate its application within the field of (13)C-based metabolic flux analysis. Copyright © 2015 Elsevier Inc. All rights reserved.

FFSE Online Membership Form

Science.gov Websites

cover the cost of bus transportation to Fermilab for field trips (average cost $100). Teachers to cover costs of workshops (average cost $200). Families to cover cost of science adventures (average cost $50

Economics of installation of solar heating plants

NASA Astrophysics Data System (ADS)

Popel, O. S.; Frid, S. Y.; Shpiltayn, E. E.

1984-04-01

An engineering-economic analysis of solar heating plants for determination of their cost effectiveness involves calculating the maximum economically feasibile extra capital investment on their installation and calculating the fraction of the total heat demand covered by such a plant which makes replacement of conventional heating plant maximally economical. The annual economic effect of solar heating is calculated in terms of normalized cost differential, as criterion for its competitiveness with conventional heating. Plant performance characteristics, namely dependence of both the percent demand coverage and the annual cost differential on the area of solar radiation collectors is then considered. Analysis of the cost equation, assuming that the extra fixed cost is proportional to the collector area, reveals the necessary and sufficient condition for decrease of annual operating cost.

Changing the definition of impaired fasting glucose: impact on the classification of individuals and risk definition.

PubMed

Vaccaro, Olga; Riccardi, Gabriele

2005-07-01

This study evaluates the impact of lowering the diagnostic threshold for impaired fasting glucose (IFG) from 6.1 to 5.6 mmol/l as proposed by the American Diabetes Association (ADA) on the prevalence of the condition, classification of individuals, and risk definition. A total of 1,285 employees of the Italian Telephone Company aged 35-59 years without known diabetes underwent an oral glucose tolerance test (OGTT). BMI, serum cholesterol, triglycerides, and blood pressure were measured. Medication use was recorded. With the new ADA criterion, the proportion of people diagnosed with IFG increased from 3.2 to 9.7%. The newly proposed IFG category identified 41% of all subjects with impaired glucose tolerance (IGT) compared with 16.2% identified with the use of the World Health Organization criterion for IFG; the improvement in accuracy has been achieved at the cost of classifying more previously "normal" subjects as having IFG (from 2.3 to 7.3%). Both IFG and IGT were associated with an unfavorable risk profile for diabetes and cardiovascular disease, with a higher estimated risk for IGT than IFG. Even with the revised diagnostic criterion, IFG and IGT identify distinct groups that have a different background risk. The cost/benefit of preventive measures tested in people with IGT may not apply to the new IFG category.

A comparative analysis of 9 multi-model averaging approaches in hydrological continuous streamflow simulation

NASA Astrophysics Data System (ADS)

Arsenault, Richard; Gatien, Philippe; Renaud, Benoit; Brissette, François; Martel, Jean-Luc

2015-10-01

This study aims to test whether a weighted combination of several hydrological models can simulate flows more accurately than the models taken individually. In addition, the project attempts to identify the most efficient model averaging method and the optimal number of models to include in the weighting scheme. In order to address the first objective, streamflow was simulated using four lumped hydrological models (HSAMI, HMETS, MOHYSE and GR4J-6), each of which were calibrated with three different objective functions on 429 watersheds. The resulting 12 hydrographs (4 models × 3 metrics) were weighted and combined with the help of 9 averaging methods which are the simple arithmetic mean (SAM), Akaike information criterion (AICA), Bates-Granger (BGA), Bayes information criterion (BICA), Bayesian model averaging (BMA), Granger-Ramanathan average variant A, B and C (GRA, GRB and GRC) and the average by SCE-UA optimization (SCA). The same weights were then applied to the hydrographs in validation mode, and the Nash-Sutcliffe Efficiency metric was measured between the averaged and observed hydrographs. Statistical analyses were performed to compare the accuracy of weighted methods to that of individual models. A Kruskal-Wallis test and a multi-objective optimization algorithm were then used to identify the most efficient weighted method and the optimal number of models to integrate. Results suggest that the GRA, GRB, GRC and SCA weighted methods perform better than the individual members. Model averaging from these four methods were superior to the best of the individual members in 76% of the cases. Optimal combinations on all watersheds included at least one of each of the four hydrological models. None of the optimal combinations included all members of the ensemble of 12 hydrographs. The Granger-Ramanathan average variant C (GRC) is recommended as the best compromise between accuracy, speed of execution, and simplicity.

Building uncertainty into cost-effectiveness rankings: portfolio risk-return tradeoffs and implications for decision rules.

PubMed

O'Brien, B J; Sculpher, M J

2000-05-01

Current principles of cost-effectiveness analysis emphasize the rank ordering of programs by expected economic return (eg, quality-adjusted life-years gained per dollar expended). This criterion ignores the variance associated with the cost-effectiveness of a program, yet variance is a common measure of risk when financial investment options are appraised. Variation in health care program return is likely to be a criterion of program selection for health care managers with fixed budgets and outcome performance targets. Characterizing health care resource allocation as a risky investment problem, we show how concepts of portfolio analysis from financial economics can be adopted as a conceptual framework for presenting cost-effectiveness data from multiple programs as mean-variance data. Two specific propositions emerge: (1) the current convention of ranking programs by expected return is a special case of the portfolio selection problem in which the decision maker is assumed to be indifferent to risk, and (2) for risk-averse decision makers, the degree of joint risk or covariation in cost-effectiveness between programs will create incentives to diversify an investment portfolio. The conventional normative assumption of risk neutrality for social-level public investment decisions does not apply to a large number of health care resource allocation decisions in which health care managers seek to maximize returns subject to budget constraints and performance targets. Portfolio theory offers a useful framework for studying mean-variance tradeoffs in cost-effectiveness and offers some positive predictions (and explanations) of actual decision making in the health care sector.

Protecting public surface transportation against terrorism and serious crime : an executive overview

DOT National Transportation Integrated Search

2001-10-01

Because terrorist threats are not easily quantifiable, it is difficult to determine the "right" level of security. Using cost-benefit analysis as the sole criterion to determine the level of security is inadequate. The risk of death to any individual...

Tuition Discounting without Tears

ERIC Educational Resources Information Center

Martin, Robert E.

2004-01-01

This paper contains a policy model for tuition discounting that avoids the major financial pitfalls encountered in the administration of institutional scholarships. The dual objective of maximizing the funded scholarship discount rate and minimizing the unfunded discount rate is explained. Marginal cost pricing is the accepted criterion for…

Predicting the dynamic fracture of steel via a non-local strain-energy density failure criterion.

DOT National Transportation Integrated Search

2014-06-01

Predicting the onset of fracture in a material subjected to dynamic loading conditions has typically been heavily mesh-dependent, and often must be specifically calibrated for each geometric design. This can lead to costly models and even : costlier ...

A game theoretic approach to a finite-time disturbance attenuation problem

NASA Technical Reports Server (NTRS)

Rhee, Ihnseok; Speyer, Jason L.

1991-01-01

A disturbance attenuation problem over a finite-time interval is considered by a game theoretic approach where the control, restricted to a function of the measurement history, plays against adversaries composed of the process and measurement disturbances, and the initial state. A zero-sum game, formulated as a quadratic cost criterion subject to linear time-varying dynamics and measurements, is solved by a calculus of variation technique. By first maximizing the quadratic cost criterion with respect to the process disturbance and initial state, a full information game between the control and the measurement residual subject to the estimator dynamics results. The resulting solution produces an n-dimensional compensator which expresses the controller as a linear combination of the measurement history. A disturbance attenuation problem is solved based on the results of the game problem. For time-invariant systems it is shown that under certain conditions the time-varying controller becomes time-invariant on the infinite-time interval. The resulting controller satisfies an H(infinity) norm bound.

7 CFR 632.31 - Cost-share payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

7 CFR 632.31 - Cost-share payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

7 CFR 632.31 - Cost-share payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

7 CFR 632.31 - Cost-share payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

7 CFR 632.31 - Cost-share payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... out the contract, the land user is indebted to the United States for the cost of the misused material... contract. The cost-share payment is to be determined by one of the following methods: (1) Average cost. (2) Actual cost but not more than the average cost. (3) Specified maximum cost. If the average cost or the...

Criterion-Focused Approach to Reducing Adverse Impact in College Admissions

ERIC Educational Resources Information Center

Sinha, Ruchi; Oswald, Frederick; Imus, Anna; Schmitt, Neal

2011-01-01

The current study examines how using a multidimensional battery of predictors (high-school grade point average (GPA), SAT/ACT, and biodata), and weighting the predictors based on the different values institutions place on various student performance dimensions (college GPA, organizational citizenship behaviors (OCBs), and behaviorally anchored…

What Is the Minimum Information Needed to Estimate Average Treatment Effects in Education RCTs?

ERIC Educational Resources Information Center

Schochet, Peter Z.

2014-01-01

Randomized controlled trials (RCTs) are considered the "gold standard" for evaluating an intervention's effectiveness. Recently, the federal government has placed increased emphasis on the use of opportunistic experiments. A key criterion for conducting opportunistic experiments, however, is that there is relatively easy access to data…

Predicting Success in Nursing Programs

ERIC Educational Resources Information Center

Crouch, Suzanne J.

2015-01-01

The purpose of this study was to assess the merit of the Watson-Glaser Critical Thinking Appraisal as a pre-admission criterion in conjunction with the frequently utilized admission criteria of the college prerequisite grade point average and the National League of Nursing pre-admission test. Data were collected from 192 first-year nursing…

7 CFR 634.27 - Cost-share payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

7 CFR 634.27 - Cost-share payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

7 CFR 634.27 - Cost-share payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

7 CFR 634.27 - Cost-share payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

7 CFR 634.27 - Cost-share payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.27 Cost-share... essential for meeting the water quality objectives in the project area. (c) Basis for cost-share payment. (1...) Average cost, or (ii) Actual cost not to exceed average cost. (2) If the average cost at the time of...

Diagnostic utility and cost-effectiveness of reflex bacterial culture for the detection of urinary tract infection in dogs with low urine specific gravity.

PubMed

Tivapasi, Musavenga T; Hodges, Joanne; Byrne, Barbara A; Christopher, Mary M

2009-09-01

Urinary tract infections (UTIs) may be subclinical or difficult to detect in dilute urine as sediment abnormalities may not be observed. In our laboratory, bacterial culture is automatically performed (reflex culture) on samples with urine specific gravity (USG)< or =1.013 to increase the likelihood of detecting infection. The value of routine culture of dilute urine, however, has not been fully assessed. The purpose of this retrospective study was to evaluate the frequency of positive bacterial cultures and analyze the diagnostic utility and cost-effectiveness of culture compared with routine sediment examination for detecting UTI in dilute urine specimens from dogs. Urinalysis and concurrent aerobic bacterial culture results were obtained from the electronic medical record system at the University of California-Davis Veterinary Medical Teaching Hospital for samples with USG< or =1.013 analyzed from July 1998 through January 2005. Urine collection method, presence of leukocytes and bacteria, bacterial culture results, and clinical diagnosis were recorded. Cost-effectiveness of reflex culture, based on low USG as the sole criterion, was evaluated. Of 1264 urine specimens, 106 (8.4%) had positive bacterial cultures. Using culture as the gold standard, sediment evaluation had a diagnostic sensitivity of 58.5% and specificity of 98.3% (diagnostic accuracy 94.9%). An additional cost of $60 per patient was incurred, leading to average annual costs of $11,668 for reflex bacterial cultures of all samples with low USG, regardless of collection method. Within our study population, 10 urine samples needed to be cultured for each true positive result. The sensitivity of urine sediment evaluation is low for UTI in dilute urine samples; however, reflex bacterial culture does not appear to be cost-effective in dogs with USG< or =1.013 in the absence of active urine sediment or high clinical suspicion for UTI.

Improvement and Extension of Shape Evaluation Criteria in Multi-Scale Image Segmentation

NASA Astrophysics Data System (ADS)

Sakamoto, M.; Honda, Y.; Kondo, A.

2016-06-01

From the last decade, the multi-scale image segmentation is getting a particular interest and practically being used for object-based image analysis. In this study, we have addressed the issues on multi-scale image segmentation, especially, in improving the performances for validity of merging and variety of derived region's shape. Firstly, we have introduced constraints on the application of spectral criterion which could suppress excessive merging between dissimilar regions. Secondly, we have extended the evaluation for smoothness criterion by modifying the definition on the extent of the object, which was brought for controlling the shape's diversity. Thirdly, we have developed new shape criterion called aspect ratio. This criterion helps to improve the reproducibility on the shape of object to be matched to the actual objectives of interest. This criterion provides constraint on the aspect ratio in the bounding box of object by keeping properties controlled with conventional shape criteria. These improvements and extensions lead to more accurate, flexible, and diverse segmentation results according to the shape characteristics of the target of interest. Furthermore, we also investigated a technique for quantitative and automatic parameterization in multi-scale image segmentation. This approach is achieved by comparing segmentation result with training area specified in advance by considering the maximization of the average area in derived objects or satisfying the evaluation index called F-measure. Thus, it has been possible to automate the parameterization that suited the objectives especially in the view point of shape's reproducibility.

Cost-effectiveness assessment of CO2 reducing measures in shipping

DOT National Transportation Integrated Search

2009-08-01

The results of this study suggest that CATCH550 $/tonne of CO2-eq should be used as a decision criterion for investment in emission reduction measures for shipping. In total, 13 specific measures for reducing CO2 emissions have been analysed for two ...

A Methodology for Project Selection Using Economic Analysis and the Analytic Hierarchy Process

DTIC Science & Technology

1992-09-01

5 L 0.278 G 0.065 Figure 7. Lower Levels for Cost Criterion 58 0 I I i I I 0 BEN’ S #1 0 iL 0. 353 WEIGHT 100% USE DEFF&SAFE MOVE NEW 0 L .333 3 L...and George Foster. Cost Accounting : a Managerial Emphasis (Seventh Edition). Englewood Cliffs NJ: Prentice Hall, 1991. 22. Kankey, Roland D...have cost in terms of manpower and/or dollars if it had been accomplished under contract or if it had been done in-house. Man Years S 4. Often it is not

Model selection and model averaging in phylogenetics: advantages of akaike information criterion and bayesian approaches over likelihood ratio tests.

PubMed

Posada, David; Buckley, Thomas R

2004-10-01

Model selection is a topic of special relevance in molecular phylogenetics that affects many, if not all, stages of phylogenetic inference. Here we discuss some fundamental concepts and techniques of model selection in the context of phylogenetics. We start by reviewing different aspects of the selection of substitution models in phylogenetics from a theoretical, philosophical and practical point of view, and summarize this comparison in table format. We argue that the most commonly implemented model selection approach, the hierarchical likelihood ratio test, is not the optimal strategy for model selection in phylogenetics, and that approaches like the Akaike Information Criterion (AIC) and Bayesian methods offer important advantages. In particular, the latter two methods are able to simultaneously compare multiple nested or nonnested models, assess model selection uncertainty, and allow for the estimation of phylogenies and model parameters using all available models (model-averaged inference or multimodel inference). We also describe how the relative importance of the different parameters included in substitution models can be depicted. To illustrate some of these points, we have applied AIC-based model averaging to 37 mitochondrial DNA sequences from the subgenus Ohomopterus(genus Carabus) ground beetles described by Sota and Vogler (2001).

Differences in prevalence of diastolic arterial hypertension in 1423 young individuals in two different interviews.

PubMed

De Lena, S M; Gende, O A; Almirón, M A; Cingolani, H E

1994-09-01

To determine prevalence of diastolic arterial hypertension (DAH) in young individuals using different criteria. Secondly, to test the possible different blood pressure reactions to mental stress and hand grip in two groups: group A, a 'low blood pressure group', and group B, diastolic blood pressure 90 mmHg or greater in one interview and below these values in a second interview. A total of 1423 volunteer medical students was recruited at La Plata School of Medicine, average age 21 +/- 3 years. Systolic and diastolic blood pressure were measured three times on two different occasions separated by one week. With the values obtained, prevalence of arterial hypertension was determined according to the criteria suggested by The Joint National Committee 4 (JNC-4) and the World Health Organization (WHO), and to statistical bases. Mental stress and hand grip tests were performed by groups A and B. The prevalence of DAH when only the first determination of the first interview was considered was 14.7%, 6.7% (considering the WHO criterion) or 5% (using the statistical criterion). These values are reduced if repeated measurements are averaged. The greatest reduction was obtained when the JNC-4 criterion was used (1.6%). The reactivity of stressors did not show any relationship with the initial blood pressure of the subjects. In epidemiological studies, the differences among the criteria should be considered when analyzing blood pressure of populations. Stress tests (mental stress and hand grip) do not help in identifying differences between the groups studied.

Analysis and Evaluation of Processes and Equipment in Tasks 2 and 4 of the Low-cost Solar Array Project

NASA Technical Reports Server (NTRS)

Wolf, M.

1979-01-01

To facilitate the task of objectively comparing competing process options, a methodology was needed for the quantitative evaluation of their relative cost effectiveness. Such a methodology was developed and is described, together with three examples for its application. The criterion for the evaluation is the cost of the energy produced by the system. The method permits the evaluation of competing design options for subsystems, based on the differences in cost and efficiency of the subsystems, assuming comparable reliability and service life, or of competing manufacturing process options for such subsystems, which include solar cells or modules. This process option analysis is based on differences in cost, yield, and conversion efficiency contribution of the process steps considered.

76 FR 6161 - Annual Determination of Average Cost of Incarceration

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-03

... AGENCY: Bureau of Prisons, Justice. ACTION: Notice. SUMMARY: The fee to cover the average cost of...: 28 CFR part 505 allows for assessment and collection of a fee to cover the average cost of... Prisons determined that, based upon fiscal year 2009 data, the fee to cover the average cost of...

76 FR 57081 - Annual Determination of Average Cost of Incarceration

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

... AGENCY: Bureau of Prisons, Justice. ACTION: Notice. SUMMARY: The fee to cover the average cost of... INFORMATION: 28 CFR part 505 allows for assessment and collection of a fee to cover the average cost of... Prisons determined that, based upon fiscal year 2010 data, the fee to cover the average cost of...

A flexible model for correlated medical costs, with application to medical expenditure panel survey data.

PubMed

Chen, Jinsong; Liu, Lei; Shih, Ya-Chen T; Zhang, Daowen; Severini, Thomas A

2016-03-15

We propose a flexible model for correlated medical cost data with several appealing features. First, the mean function is partially linear. Second, the distributional form for the response is not specified. Third, the covariance structure of correlated medical costs has a semiparametric form. We use extended generalized estimating equations to simultaneously estimate all parameters of interest. B-splines are used to estimate unknown functions, and a modification to Akaike information criterion is proposed for selecting knots in spline bases. We apply the model to correlated medical costs in the Medical Expenditure Panel Survey dataset. Simulation studies are conducted to assess the performance of our method. Copyright © 2015 John Wiley & Sons, Ltd.

Maximum projection designs for computer experiments

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

Joseph, V. Roshan; Gul, Evren; Ba, Shan

Space-filling properties are important in designing computer experiments. The traditional maximin and minimax distance designs only consider space-filling in the full dimensional space. This can result in poor projections onto lower dimensional spaces, which is undesirable when only a few factors are active. Restricting maximin distance design to the class of Latin hypercubes can improve one-dimensional projections, but cannot guarantee good space-filling properties in larger subspaces. We propose designs that maximize space-filling properties on projections to all subsets of factors. We call our designs maximum projection designs. As a result, our design criterion can be computed at a cost nomore » more than a design criterion that ignores projection properties.« less

Maximum projection designs for computer experiments

DOE PAGES

Joseph, V. Roshan; Gul, Evren; Ba, Shan

2015-03-18

Space-filling properties are important in designing computer experiments. The traditional maximin and minimax distance designs only consider space-filling in the full dimensional space. This can result in poor projections onto lower dimensional spaces, which is undesirable when only a few factors are active. Restricting maximin distance design to the class of Latin hypercubes can improve one-dimensional projections, but cannot guarantee good space-filling properties in larger subspaces. We propose designs that maximize space-filling properties on projections to all subsets of factors. We call our designs maximum projection designs. As a result, our design criterion can be computed at a cost nomore » more than a design criterion that ignores projection properties.« less

Cost minimization analysis of a store-and-forward teledermatology consult system.

PubMed

Pak, Hon S; Datta, Santanu K; Triplett, Crystal A; Lindquist, Jennifer H; Grambow, Steven C; Whited, John D

2009-03-01

The aim of this study was to perform a cost minimization analysis of store-and-forward teledermatology compared to a conventional dermatology referral process (usual care). In a Department of Defense (DoD) setting, subjects were randomized to either a teledermatology consult or usual care. Accrued healthcare utilization recorded over a 4-month period included clinic visits, teledermatology visits, laboratories, preparations, procedures, radiological tests, and medications. Direct medical care costs were estimated by combining utilization data with Medicare reimbursement rates and wholesale drug prices. The indirect cost of productivity loss for seeking treatment was also included in the analysis using an average labor rate. Total and average costs were compared between groups. Teledermatology patients incurred $103,043 in total direct costs ($294 average), while usual-care patients incurred $98,365 ($283 average). However, teledermatology patients only incurred $16,359 ($47 average) in lost productivity cost while usual-care patients incurred $30,768 ($89 average). In total, teledermatology patients incurred $119,402 ($340 average) and usual-care patients incurred $129,133 ($372 average) in costs. From the economic perspective of the DoD, store-and-forward teledermatology was a cost-saving strategy for delivering dermatology care compared to conventional consultation methods when productivity loss cost is taken into consideration.

Validation of a PCR-based method for the detection of various rendered materials in feedstuffs using a forensic DNA extraction kit.

PubMed

Myers, Michael J; Yancy, Haile F; Araneta, Michael; Armour, Jennifer; Derr, Janice; Hoostelaere, Lawrence A D; Farmer, Doris; Jackson, Falana; Kiessling, William M; Koch, Henry; Lin, Huahua; Liu, Yan; Mowlds, Gabrielle; Pinero, David; Riter, Ken L; Sedwick, John; Shen, Yuelian; Wetherington, June; Younkins, Ronsha

2006-01-01

A method trial was initiated to validate the use of a commercial DNA forensic kit to extract DNA from animal feed as part of a PCR-based method. Four different PCR primer pairs (one bovine pair, one porcine pair, one ovine primer pair, and one multispecies pair) were also evaluated. Each laboratory was required to analyze a total of 120 dairy feed samples either not fortified (control, true negative) or fortified with bovine meat and bone meal, porcine meat and bone meal (PMBM), or lamb meal. Feeds were fortified with the animal meals at a concentration of 0.1% (wt/wt). Ten laboratories participated in this trial, and each laboratory was required to evaluate two different primer pairs, i.e., each PCR primer pair was evaluated by five different laboratories. The method was considered to be validated for a given animal source when three or more laboratories achieved at least 97% accuracy (29 correct of 30 samples for 96.7% accuracy, rounded up to 97%) in detecting the fortified samples for that source. Using this criterion, the method was validated for the bovine primer because three laboratories met the criterion, with an average accuracy of 98.9%. The average false-positive rate was 3.0% in these laboratories. A fourth laboratory was 80% accurate in identifying the samples fortified with bovine meat and bone meal. A fifth laboratory was not able to consistently extract the DNA from the feed samples and did not achieve the criterion for accuracy for either the bovine or multispecies PCR primers. For the porcine primers, the method was validated, with four laboratories meeting the criterion for accuracy with an average accuracy of 99.2%. The fifth laboratory had a 93.3% accuracy outcome for the porcine primer. Collectively, these five laboratories had a 1.3% false-positive rate for the porcine primer. No laboratory was able to meet the criterion for accuracy with the ovine primers, most likely because of problems with the synthesis of the primer pair; none of the positive control DNA samples could be detected with the ovine primers. The multispecies primer pair was validated in three laboratories for use with bovine meat and bone meal and lamb meal but not with PMBM. The three laboratories had an average accuracy of 98.9% for bovine meat and bone meal, 97.8% for lamb meal, and 63.3% for PMBM. When examined on an individual laboratory basis, one of these four laboratories could not identify a single feed sample containing PMBM by using the multispecies primer, whereas the other laboratory identified only one PMBM-fortified sample, suggesting that the limit of detection for PMBM with this primer pair is around 0.1% (wt/wt). The results of this study demonstrated that the DNA forensic kit can be used to extract DNA from animal feed, which can then be used for PCR analysis to detect animal-derived protein present in the feed sample.

Evaluation of pump pulsation in respirable size-selective sampling: Part III. Investigation of European standard methods.

PubMed

Soo, Jhy-Charm; Lee, Eun Gyung; Lee, Larry A; Kashon, Michael L; Harper, Martin

2014-10-01

Lee et al. (Evaluation of pump pulsation in respirable size-selective sampling: part I. Pulsation measurements. Ann Occup Hyg 2014a;58:60-73) introduced an approach to measure pump pulsation (PP) using a real-world sampling train, while the European Standards (EN) (EN 1232-1997 and EN 12919-1999) suggest measuring PP using a resistor in place of the sampler. The goal of this study is to characterize PP according to both EN methods and to determine the relationship of PP between the published method (Lee et al., 2014a) and the EN methods. Additional test parameters were investigated to determine whether the test conditions suggested by the EN methods were appropriate for measuring pulsations. Experiments were conducted using a factorial combination of personal sampling pumps (six medium- and two high-volumetric flow rate pumps), back pressures (six medium- and seven high-flow rate pumps), resistors (two types), tubing lengths between a pump and resistor (60 and 90 cm), and different flow rates (2 and 2.5 l min(-1) for the medium- and 4.4, 10, and 11.2 l min(-1) for the high-flow rate pumps). The selection of sampling pumps and the ranges of back pressure were based on measurements obtained in the previous study (Lee et al., 2014a). Among six medium-flow rate pumps, only the Gilian5000 and the Apex IS conformed to the 10% criterion specified in EN 1232-1997. Although the AirChek XR5000 exceeded the 10% limit, the average PP (10.9%) was close to the criterion. One high-flow rate pump, the Legacy (PP=8.1%), conformed to the 10% criterion in EN 12919-1999, while the Elite12 did not (PP=18.3%). Conducting supplemental tests with additional test parameters beyond those used in the two subject EN standards did not strengthen the characterization of PPs. For the selected test conditions, a linear regression model [PPEN=0.014+0.375×PPNIOSH (adjusted R2=0.871)] was developed to determine the PP relationship between the published method (Lee et al., 2014a) and the EN methods. The 25% PP criterion recommended by Lee et al. (2014a), average value derived from repetitive measurements, corresponds to 11% PPEN. The 10% pass/fail criterion in the EN Standards is not based on extensive laboratory evaluation and would unreasonably exclude at least one pump (i.e. AirChek XR5000 in this study) and, therefore, the more accurate criterion of average 11% from repetitive measurements should be substituted. This study suggests that users can measure PP using either a real-world sampling train or a resistor setup and obtain equivalent findings by applying the model herein derived. The findings of this study will be delivered to the consensus committees to be considered when those standards, including the EN 1232-1997, EN 12919-1999, and ISO 13137-2013, are revised. Published by Oxford University Press on behalf of the British Occupational Hygiene Society 2014.

Correlates of Black and White University Student Grades Beyond the Freshman Year.

ERIC Educational Resources Information Center

Horowitz, Joseph L; And Others

The freshman, sophomore and junior year grades of 126 black and 178 white freshmen entering the University of Maryland were used as criterion measures in this study on prediction of academic achievement as reflected in grades. Predictors included the Scholastic Aptitude Test (SAT), high school grade point average (HSGPA), the California…

Getting to Know Your Criterion: Examining College Course Grades and GPAs over Time

ERIC Educational Resources Information Center

Marini, Jessica; Shaw, Emily; Young, Linda; Ewing, Maureen

2018-01-01

This study investigated differences in college grading practices (first-year grade point average and course grades) by student and institutional characteristics and by academic discipline to inform and improve our understanding and use as among the most commonly employed criteria in validity and college readiness research. In addition, trends in…

Applications of Simulator Freeze to Carrier Glideslope Tracking Instruction.

DTIC Science & Technology

1982-07-01

Showing Datum Bars and Meatball . .. .. .. ... .. ... .... 19 4 Freezes Per Trial Averaged Across Freeze Conditions and Across 4-Trial Blocks of Training...algorithm linearly increased the criterion in meatball units from 1.0 at 6000 feet from the ramp to 1.5 at the ramp. "Freezes" did not occur beyond 6000

[Treatment of acromion base fractures with double plates internal fixation].

PubMed

Lü, Guo-Qiang; Zhu, Jun-Kun; Lan, Shu-Hua; Wu, Quan-Zhou; Zheng, Rong-Zong; Zheng, Chong-Wu

2013-09-01

To study clinical effects of double plates fixation for the treatment of acromion base fracutres. From January 2010 to May 2012, 7 patients with acromion base fractures were treated with double plates ORIF surgical treatment. There were 5 males and 2 females, with an average age of 36.3 years old (ranged, 24 to 62 years old). All fractures were acuted and closed injuries. The duration from injury to surgery was 4.6 days (ranged, 2 to 10 days). Hardegger functional criterion, Visual Analogue Scale (VAS) and complications of the patients were documented analysis. All the patients were followed up,and the duration ranged from 4 to 13 months (averaged 8.9 months). The healing duration of fractures ranged from 8 to 14 weeks without any infection, shoulder instability, subacromial impingement syndrome, nonunion and failure of internal fixation. At the latest follow-up, the VAS ranged from 0 to 5. According to Hardegger criterion, 2 patients got an excellent result, 4 good and 1 poor. Double plates ORIF plays a positive role in the treatment of acromion base fractures, which reduces complications and maximally restore the function of shoulder.

Effects of task-irrelevant grouping on visual selection in partial report.

PubMed

Lunau, Rasmus; Habekost, Thomas

2017-07-01

Perceptual grouping modulates performance in attention tasks such as partial report and change detection. Specifically, grouping of search items according to a task-relevant feature improves the efficiency of visual selection. However, the role of task-irrelevant feature grouping is not clearly understood. In the present study, we investigated whether grouping of targets by a task-irrelevant feature influences performance in a partial-report task. In this task, participants must report as many target letters as possible from a briefly presented circular display. The crucial manipulation concerned the color of the elements in these trials. In the sorted-color condition, the color of the display elements was arranged according to the selection criterion, and in the unsorted-color condition, colors were randomly assigned. The distractor cost was inferred by subtracting performance in partial-report trials from performance in a control condition that had no distractors in the display. Across five experiments, we manipulated trial order, selection criterion, and exposure duration, and found that attentional selectivity was improved in sorted-color trials when the exposure duration was 200 ms and the selection criterion was luminance. This effect was accompanied by impaired selectivity in unsorted-color trials. Overall, the results suggest that the benefit of task-irrelevant color grouping of targets is contingent on the processing locus of the selection criterion.

FFSE Online Membership Form

Science.gov Websites

: Schools to cover the cost of bus transportation to Fermilab for field trips. The cost averages about $100 . Teachers to cover costs of workshops. The cost averages about $200. Families to cover cost of science adventures. The cost averages about $50. PayPal - The safer, easier way to pay online! Tree of Knowledge Leaf

78 FR 956 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-07

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

75 FR 2551 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

77 FR 801 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-06

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

76 FR 5180 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

Estimating the costs of induced abortion in Uganda: A model-based analysis

PubMed Central

2011-01-01

Background The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. Methods A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. Results The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Conclusion Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical. PMID:22145859

Estimating the costs of induced abortion in Uganda: a model-based analysis.

PubMed

Babigumira, Joseph B; Stergachis, Andy; Veenstra, David L; Gardner, Jacqueline S; Ngonzi, Joseph; Mukasa-Kivunike, Peter; Garrison, Louis P

2011-12-06

The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.

[Allocating resources for cancer control--resolving multicriteria decision-making using the analytic hierarchy process].

PubMed

Gróf, Agnes

2007-01-01

When competing programs ought to be financed simultaneously for the same purpose, an allocation problem occurs due to scarce resources, and different perspectives and preferences. Facing the problem needs determining criteria which the decision might be based on. Those criteria form the objectives (the scope) of the different participants, and are relevant for the achievement of the goal, providing a comprehensive resource allocation that bridges and integrates the different perspectives. In case of cancer control primary prevention, secondary prevention, therapy and tertiary prevention, education, basic sciences, and clinical trials form the alternatives. An analytic hierarchy process (AHP) is used for supporting decision-making in the resource allocation problem. AHP is a method for setting priorities, but can only work out the implications of what was declared through the pairwise-ranking process, namely the relative preferences, weighing the criteria and rating the alternatives two by two. In the first analysis the relative weights to criteria were 0.099 for 'distributive justice'; 0.120 for constitutional and human rights; 0.251 for lay opinion; 0.393 for EBM; 0.137 for cost-effectiveness. Ranking the alternatives using 'judgements' resulted in relative preference of 0.238 for therapy, 0.204 for primary prevention, 0.201 for secondary prevention, 0.135 for clinical trials, 0.111 for tertiary prevention, 0.066 for basic sciences and 0.045 for education. In the second analysis the relative importance of "cost-effectiveness" was doubled, thus resulting in 0.234 for therapy, 0.216 for secondary prevention, 0.183 for primary prevention, 0.145 for clinical trials, 0.113 for tertiary prevention, 0.063 for basic sciences and 0.046 for education. Sensitivity analysis has shown that increasing the relative weight of cost-effectiveness up to approximately 0.4 changes the rank of alternatives, and above 0.4 this criterion gives secondary prevention preferences. According to the relative rates computed in both of the models all criteria vote for therapy, but these preferences change at the high level of weights, in case of EBM, 'rights', and cost-effectiveness. Cost-effectiveness prefers secondary prevention to therapy; the criterion of constitutional and human rights and the criterion of evidence-based medicine vote for primary prevention.

Measurement of the lowest dosage of phenobarbital that can produce drug discrimination in rats

PubMed Central

Overton, Donald A.; Stanwood, Gregg D.; Patel, Bhavesh N.; Pragada, Sreenivasa R.; Gordon, M. Kathleen

2009-01-01

Rationale Accurate measurement of the threshold dosage of phenobarbital that can produce drug discrimination (DD) may improve our understanding of the mechanisms and properties of such discrimination. Objectives Compare three methods for determining the threshold dosage for phenobarbital (D) versus no drug (N) DD. Methods Rats learned a D versus N DD in 2-lever operant training chambers. A titration scheme was employed to increase or decrease dosage at the end of each 18-day block of sessions depending on whether the rat had achieved criterion accuracy during the sessions just completed. Three criterion rules were employed, all based on average percent drug lever responses during initial links of the last 6 D and 6 N sessions of a block. The criteria were: D%>66 and N%<33; D%>50 and N%<50; (D%-N%)>33. Two squads of rats were trained, one immediately after the other. Results All rats discriminated drug versus no drug. In most rats, dosage decreased to low levels and then oscillated near the minimum level required to maintain criterion performance. The lowest discriminated dosage significantly differed under the three criterion rules. The squad that was trained 2nd may have benefited by partially duplicating the lever choices of the previous squad. Conclusions The lowest discriminated dosage is influenced by the criterion of discriminative control that is employed, and is higher than the absolute threshold at which discrimination entirely disappears. Threshold estimations closer to absolute threshold can be obtained when criteria are employed that are permissive, and that allow rats to maintain lever preferences. PMID:19082992

Participant roles of bullying in adolescence: Status characteristics, social behavior, and assignment criteria.

PubMed

Pouwels, J Loes; Lansu, Tessa A M; Cillessen, Antonius H N

2016-01-01

This study had three goals. First, we examined the prevalence of the participant roles of bullying in middle adolescence and possible gender differences therein. Second, we examined the behavioral and status characteristics associated with the participant roles in middle adolescence. Third, we compared two sets of criteria for assigning students to the participant roles of bullying. Participants were 1,638 adolescents (50.9% boys, M(age)  = 16.38 years, SD =.80) who completed the shortened participant role questionnaire and peer nominations for peer status and behavioral characteristics. Adolescents were assigned to the participant roles according to the relative criteria of Salmivalli, Lagerspetz, Björkqvist, Österman, and Kaukiainen (1996). Next, the students in each role were divided in two subgroups based on an additional absolute criterion: the Relative Only Criterion subgroup (nominated by less than 10% of their classmates) and the Absolute & Relative Criterion subgroup (nominated by at least 10% of their classmates). Adolescents who bullied or reinforced or assisted bullies were highly popular and disliked and scored high on peer-valued characteristics. Adolescents who were victimized held the weakest social position in the peer group. Adolescents who defended victims were liked and prosocial, but average in popularity and peer-valued characteristics. Outsiders held a socially weak position in the peer group, but were less disliked, less aggressive, and more prosocial than victims. The behavior and status profiles of adolescents in the participant roles were more extreme for the Absolute & Relative Criterion subgroup than for the Relative Only Criterion subgroup. © 2015 Wiley Periodicals, Inc.

Estimation of economic values for traits of dairy sheep: I. Model development.

PubMed

Wolfová, M; Wolf, J; Krupová, Z; Kica, J

2009-05-01

A bioeconomic model was developed to estimate effects of change in production and functional traits on profit of dairy or dual-purpose milked sheep under alternative management systems. The flock structure was described in terms of animal categories and probabilities of transitions among them, and a Markov chain approach was used to calculate the stationary state of the resultant ewe flock. The model included both deterministic and stochastic components. Performance for most traits was simulated as the population average, but variation in several traits was taken into account. Management options included lambing intervals, mating system, and culling strategy for ewes, weaning and marketing strategy for progeny, and feeding system. The present value of profit computed as the difference between total revenues and total costs per ewe per year, both discounted to the birth date of the animals, was used as the criterion for economic efficiency of the production system in the stationary state. Economic values (change in system profit per unit change in the trait) of up to 35 milk production, growth, carcass, wool, and functional traits may be estimated.

Countermeasures for unintentional and intentional video watermarking attacks

NASA Astrophysics Data System (ADS)

Deguillaume, Frederic; Csurka, Gabriela; Pun, Thierry

2000-05-01

These last years, the rapidly growing digital multimedia market has revealed an urgent need for effective copyright protection mechanisms. Therefore, digital audio, image and video watermarking has recently become a very active area of research, as a solution to this problem. Many important issues have been pointed out, one of them being the robustness to non-intentional and intentional attacks. This paper studies some attacks and proposes countermeasures applied to videos. General attacks are lossy copying/transcoding such as MPEG compression and digital/analog (D/A) conversion, changes of frame-rate, changes of display format, and geometrical distortions. More specific attacks are sequence edition, and statistical attacks such as averaging or collusion. Averaging attack consists of averaging locally consecutive frames to cancel the watermark. This attack works well for schemes which embed random independent marks into frames. In the collusion attack the watermark is estimated from single frames (based on image denoising), and averaged over different scenes for better accuracy. The estimated watermark is then subtracted from each frame. Collusion requires that the same mark is embedded into all frames. The proposed countermeasures first ensures robustness to general attacks by spread spectrum encoding in the frequency domain and by the use of an additional template. Secondly, a Bayesian criterion, evaluating the probability of a correctly decoded watermark, is used for rejection of outliers, and to implement an algorithm against statistical attacks. The idea is to embed randomly chosen marks among a finite set of marks, into subsequences of videos which are long enough to resist averaging attacks, but short enough to avoid collusion attacks. The Bayesian criterion is needed to select the correct mark at the decoding step. Finally, the paper presents experimental results showing the robustness of the proposed method.

7 CFR 1410.41 - Levels and rates for cost-share payments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... shall not pay more than 50 percent of the actual or average cost of establishing eligible practices.... (b) The average cost of performing a practice may be determined by CCC based on recommendations from the State Technical Committee. Such cost may be the average cost in a State, a county, or a part of a...

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.

Crosshole Tomography, Waveform Inversion, and Anisotropy: A Combined Approach Using Simulated Annealing

NASA Astrophysics Data System (ADS)

Afanasiev, M.; Pratt, R. G.; Kamei, R.; McDowell, G.

2012-12-01

Crosshole seismic tomography has been used by Vale to provide geophysical images of mineralized massive sulfides in the Eastern Deeps deposit at Voisey's Bay, Labrador, Canada. To date, these data have been processed using traveltime tomography, and we seek to improve the resolution of these images by applying acoustic Waveform Tomography. Due to the computational cost of acoustic waveform modelling, local descent algorithms are employed in Waveform Tomography; due to non-linearity an initial model is required which predicts first-arrival traveltimes to within a half-cycle of the lowest frequency used. Because seismic velocity anisotropy can be significant in hardrock settings, the initial model must quantify the anisotropy in order to meet the half-cycle criterion. In our case study, significant velocity contrasts between the target massive sulfides and the surrounding country rock led to difficulties in generating an accurate anisotropy model through traveltime tomography, and our starting model for Waveform Tomography failed the half-cycle criterion at large offsets. We formulate a new, semi-global approach for finding the best-fit 1-D elliptical anisotropy model using simulated annealing. Through random perturbations to Thompson's ɛ parameter, we explore the L2 norm of the frequency-domain phase residuals in the space of potential anisotropy models: If a perturbation decreases the residuals, it is always accepted, but if a perturbation increases the residuals, it is accepted with the probability P = exp(-(Ei-E)/T). This is the Metropolis criterion, where Ei is the value of the residuals at the current iteration, E is the value of the residuals for the previously accepted model, and T is a probability control parameter, which is decreased over the course of the simulation via a preselected cooling schedule. Convergence to the global minimum of the residuals is guaranteed only for infinitely slow cooling, but in practice good results are obtained from a variety of finite-time cooling schedules. We present the results of this approach for real and synthetically generated elastic TI data. After traveltime modelling, near offset data satisfied the half-cycle criterion. This gave us confidence that our horizontal velocity model was satisfactory, and we kept it constant while simulated annealing was run to determine the best-fit anisotropy profile. Once a low temperature was reached (so that minimizations to the objective function became rare), we constructed an average anisotropy model using accepted models which possessed a |E| within one standard deviation of the best fit model. This anisotropy model allowed the starting model for Waveform Tomography to satisfy the half-cycle first break criterion at large offsets. We believe that the success of this method is explained by the multipath nature of finite difference wave propagation, which does not suffer from the errors experienced by traveltime ray-tracing along the sharp velocity gradients present in the model.

Interinstitutional Cooperation. Study of Independent Higher Education in Indiana.

ERIC Educational Resources Information Center

Jellema, William W.; Olliver, James

The state of interinstitutional cooperation among private colleges and universities in Indiana was studied in 1974 as part of a larger study, and three recommendations were offered namely, that cooperative arrangements should be encouraged; that such arrangements should involve clear goals using cost-benefit analysis as a criterion; and that the…

Perspectives for Planning.

ERIC Educational Resources Information Center

Miner, Norris

The operations of an institution can be viewed from three perspectives: (1) the "actual operating measurement" such as income and expenditures of a cost center at a point in time; (2) the "criterion" which reflects the established policy for a time period; and (3) the "efficiency level" wherein a balance between input and output is defined.…

Economic efficiency of fire management programs at six National Forests

Treesearch

Dennis L. Schweitzer; Ernest V. Andersen; Thomas J. Mills

1982-01-01

Two components of fire management programs were analyzed at these Forests: Francis Marion (South Carolina), Huron-Manistee (Michigan), San Bernardino (California), Tonto (Arizona), and Deschutes and Willamette (Oregon). Initial attack and aviation operations were evaluated by the criterion of minimizing the program cost plus the net value change of resource outputs and...

Confirmatory factor analysis of different versions of the Body Shape Questionnaire applied to Brazilian university students.

PubMed

da Silva, Wanderson Roberto; Dias, Juliana Chioda Ribeiro; Maroco, João; Campos, Juliana Alvares Duarte Bonini

2014-09-01

This study aimed at evaluating the validity, reliability, and factorial invariance of the complete (34-item) and shortened (8-item and 16-item) versions of the Body Shape Questionnaire (BSQ) when applied to Brazilian university students. A total of 739 female students with a mean age of 20.44 (standard deviation=2.45) years participated. Confirmatory factor analysis was conducted to verify the degree to which the one-factor structure satisfies the proposal for the BSQ's expected structure. Two items of the 34-item version were excluded because they had factor weights (λ)<40. All models had adequate convergent validity (average variance extracted=.43-.58; composite reliability=.85-.97) and internal consistency (α=.85-.97). The 8-item B version was considered the best shortened BSQ version (Akaike information criterion=84.07, Bayes information criterion=157.75, Browne-Cudeck criterion=84.46), with strong invariance for independent samples (Δχ(2)λ(7)=5.06, Δχ(2)Cov(8)=5.11, Δχ(2)Res(16)=19.30). Copyright © 2014 Elsevier Ltd. All rights reserved.

An investigation of the effects of pitch-roll (de)coupling on helicopter handling qualities

NASA Technical Reports Server (NTRS)

Blanken, C. L.; Pausder, H. J.; Ockier, C. J.

1995-01-01

An extensive investigation of the effects of pitch-roll coupling on helicopter handling qualities was performed by the U.S. Army and Deutsche Forschungsanstalt fur Luft- und Raumfahrt (DLR), using a NASA ground-based and a DLR in-flight simulator. Over 90 different coupling configurations were evaluated using a high gain roll-axis tracking task. The results show that although the current ADS-33C coupling criterion discriminates against those types of coupling typical of conventionally controlled helicopters, it is not always suited for the prediction of handling qualities of helicopters with modern control systems. Based on the observation that high frequency inputs during tracking are used to alleviate coupling, a frequency domain pitch-roll coupling criterion that uses the average coupling ratio between the bandwidth and neutral stability frequency is formulated. This criterion provides a more comprehensive coverage with respect to the different types of coupling, shows excellent consistency, and has the additional benefit that compliance testing data are obtained from the bandwidth/phase delay tests, so that no additional flight testing is needed.

Unified Bohm criterion

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

Kos, L.; Tskhakaya, D. D.; Jelić, N.

2015-09-15

Recent decades have seen research into the conditions necessary for the formation of the monotonic potential shape in the sheath, appearing at the plasma boundaries like walls, in fluid, and kinetic approximations separately. Although either of these approaches yields a formulation commonly known as the much-acclaimed Bohm criterion (BC), the respective results involve essentially different physical quantities that describe the ion gas behavior. In the fluid approach, such a quantity is clearly identified as the ion directional velocity. In the kinetic approach, the ion behavior is formulated via a quantity (the squared inverse velocity averaged by the ion distribution function)more » without any clear physical significance, which is, moreover, impractical. In the present paper, we try to explain this difference by deriving a condition called here the Unified Bohm Criterion, which combines an advanced fluid model with an upgraded explicit kinetic formula in a new form of the BC. By introducing a generalized polytropic coefficient function, the unified BC can be interpreted in a form that holds, irrespective of whether the ions are described kinetically or in the fluid approximation.« less

Contract management using cause-effect clues in service worksheets.

PubMed

Chen, J H

1996-01-01

Sophisticated equipment often needs intensive technical resources to maintain its system availability. Service contracts can be an easy channel to outside technical resources. Usually, a service contract purchaser only sees its cost instead of its maintenance quality. A system's needs, however, depend on the trade-off between the cost paid and the quality received. If a clinical engineer can actively interpret and integrate the cause-effect consequences on the compiled service worksheets, those clues can serve as a criterion to justify the quality and the cost-effectiveness of a service contract. Through the analysis of the service labor consumed, the justification of the parts replaced, and the assessment of the "fit" to system availability, this paper provides a cost-effective tool for equipment management.

A General Linear Model Approach to Adjusting the Cumulative GPA.

ERIC Educational Resources Information Center

Young, John W.

A general linear model (GLM), using least-squares techniques, was used to develop a criterion measure to replace freshman year grade point average (GPA) in college admission predictive validity studies. Problems with the use of GPA include those associated with the combination of grades from different courses and disciplines into a single measure,…

Career Performance of Marginally Scholastic Graduates of the Air Force Institute of Technology’s Resident Master’s Degree Programs

DTIC Science & Technology

1984-09-01

between graduate grade point average (GGPA) and various measures of career performance. Most of the research has dealt with graduates of business ... schools and the most frequently measured criterion of career performance is compensation in the form of earnings and salary. Some researchers have found

The Relationship between High School Math Courses, High School GPA, and Retention of Honors Scholarships

ERIC Educational Resources Information Center

Megert, Diann Ackerman

2005-01-01

This research examined the high school transcripts of honors scholarship recipients to identify a better criterion for awarding scholarships than high school grade point average (GPA) alone. Specifically, this study compared the honors scholarship retention rate when the scholarship was awarded based on completed advanced high school math classes…

Factor Retention in Exploratory Factor Analysis: A Comparison of Alternative Methods.

ERIC Educational Resources Information Center

Mumford, Karen R.; Ferron, John M.; Hines, Constance V.; Hogarty, Kristine Y.; Kromrey, Jeffery D.

This study compared the effectiveness of 10 methods of determining the number of factors to retain in exploratory common factor analysis. The 10 methods included the Kaiser rule and a modified Kaiser criterion, 3 variations of parallel analysis, 4 regression-based variations of the scree procedure, and the minimum average partial procedure. The…

Using Performance Data Gathered at Several Stages of Achievement in Predicting Subsequent Performance.

ERIC Educational Resources Information Center

Owen, Steven V.; Feldhusen, John F.

This study compares the effectiveness of three models of multivariate prediction for academic success in identifying the criterion variance of achievement in nursing education. The first model involves the use of an optimum set of predictors and one equation derived from a regression analysis on first semester grade average in predicting the…

A Procedure for Estimating a Criterion-Referenced Standard to Identify Educationally Deprived Children for Title I Services. Final Report.

ERIC Educational Resources Information Center

Ziomek, Robert L.; Wright, Benjamin D.

Techniques such as the norm-referenced and average score techniques, commonly used in the identification of educationally disadvantaged students, are critiqued. This study applied latent trait theory, specifically the Rasch Model, along with teacher judgments relative to the mastery of instructional/test decisions, to derive a standard setting…

Earing Prediction in Cup Drawing using the BBC2008 Yield Criterion

NASA Astrophysics Data System (ADS)

Vrh, Marko; Halilovič, Miroslav; Starman, Bojan; Štok, Boris; Comsa, Dan-Sorin; Banabic, Dorel

2011-08-01

The paper deals with constitutive modelling of highly anisotropic sheet metals. It presents FEM based earing predictions in cup drawing simulation of highly anisotropic aluminium alloys where more than four ears occur. For that purpose the BBC2008 yield criterion, which is a plane-stress yield criterion formulated in the form of a finite series, is used. Thus defined criterion can be expanded to retain more or less terms, depending on the amount of given experimental data. In order to use the model in sheet metal forming simulations we have implemented it in a general purpose finite element code ABAQUS/Explicit via VUMAT subroutine, considering alternatively eight or sixteen parameters (8p and 16p version). For the integration of the constitutive model the explicit NICE (Next Increment Corrects Error) integration scheme has been used. Due to the scheme effectiveness the CPU time consumption for a simulation is comparable to the time consumption of built-in constitutive models. Two aluminium alloys, namely AA5042-H2 and AA2090-T3, have been used for a validation of the model. For both alloys the parameters of the BBC2008 model have been identified with a developed numerical procedure, based on a minimization of the developed cost function. For both materials, the predictions of the BBC2008 model prove to be in very good agreement with the experimental results. The flexibility and the accuracy of the model together with the identification and integration procedure guarantee the applicability of the BBC2008 yield criterion in industrial applications.

Operation costs and pollutant emissions reduction by definition of new collection scheduling and optimization of MSW collection routes using GIS. The case study of Barreiro, Portugal.

PubMed

Zsigraiova, Zdena; Semiao, Viriato; Beijoco, Filipa

2013-04-01

This work proposes an innovative methodology for the reduction of the operation costs and pollutant emissions involved in the waste collection and transportation. Its innovative feature lies in combining vehicle route optimization with that of waste collection scheduling. The latter uses historical data of the filling rate of each container individually to establish the daily circuits of collection points to be visited, which is more realistic than the usual assumption of a single average fill-up rate common to all the system containers. Moreover, this allows for the ahead planning of the collection scheduling, which permits a better system management. The optimization process of the routes to be travelled makes recourse to Geographical Information Systems (GISs) and uses interchangeably two optimization criteria: total spent time and travelled distance. Furthermore, rather than using average values, the relevant parameters influencing fuel consumption and pollutant emissions, such as vehicle speed in different roads and loading weight, are taken into consideration. The established methodology is applied to the glass-waste collection and transportation system of Amarsul S.A., in Barreiro. Moreover, to isolate the influence of the dynamic load on fuel consumption and pollutant emissions a sensitivity analysis of the vehicle loading process is performed. For that, two hypothetical scenarios are tested: one with the collected volume increasing exponentially along the collection path; the other assuming that the collected volume decreases exponentially along the same path. The results evidence unquestionable beneficial impacts of the optimization on both the operation costs (labor and vehicles maintenance and fuel consumption) and pollutant emissions, regardless the optimization criterion used. Nonetheless, such impact is particularly relevant when optimizing for time yielding substantial improvements to the existing system: potential reductions of 62% for the total spent time, 43% for the fuel consumption and 40% for the emitted pollutants. This results in total cost savings of 57%, labor being the greatest contributor, representing over €11,000 per year for the two vehicles collecting glass-waste. Moreover, it is shown herein that the dynamic loading process of the collection vehicle impacts on both the fuel consumption and on pollutant emissions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Validation by simulation of a clinical trial model using the standardized mean and variance criteria.

PubMed

Abbas, Ismail; Rovira, Joan; Casanovas, Josep

2006-12-01

To develop and validate a model of a clinical trial that evaluates the changes in cholesterol level as a surrogate marker for lipodystrophy in HIV subjects under alternative antiretroviral regimes, i.e., treatment with Protease Inhibitors vs. a combination of nevirapine and other antiretroviral drugs. Five simulation models were developed based on different assumptions, on treatment variability and pattern of cholesterol reduction over time. The last recorded cholesterol level, the difference from the baseline, the average difference from the baseline and level evolution, are the considered endpoints. Specific validation criteria based on a 10% minus or plus standardized distance in means and variances were used to compare the real and the simulated data. The validity criterion was met by all models for considered endpoints. However, only two models met the validity criterion when all endpoints were considered. The model based on the assumption that within-subjects variability of cholesterol levels changes over time is the one that minimizes the validity criterion, standardized distance equal to or less than 1% minus or plus. Simulation is a useful technique for calibration, estimation, and evaluation of models, which allows us to relax the often overly restrictive assumptions regarding parameters required by analytical approaches. The validity criterion can also be used to select the preferred model for design optimization, until additional data are obtained allowing an external validation of the model.

Mercury concentrations in water, and mercury and selenium concentrations in fish from Brownlee Reservoir and selected sites in Boise and Snake Rivers, Idaho and Oregon, 2013

USGS Publications Warehouse

MacCoy, Dorene E.

2014-01-01

Mercury (Hg) analyses were conducted on samples of sport fish and water collected from six sampling sites in the Boise and Snake Rivers, and Brownlee Reservoir to meet National Pollution Discharge and Elimination System (NPDES) permit requirements for the City of Boise, Idaho. A water sample was collected from each site during October and November 2013 by the City of Boise personnel and was analyzed by the Boise City Public Works Water Quality Laboratory. Total Hg concentrations in unfiltered water samples ranged from 0.73 to 1.21 nanograms per liter (ng/L) at five river sites; total Hg concentration was highest (8.78 ng/L) in a water sample from Brownlee Reservoir. All Hg concentrations in water samples were less than the EPA Hg chronic aquatic life criterion in Idaho (12 ng/L). The EPA recommended a water-quality criterion of 0.30 milligrams per kilogram (mg/kg) methylmercury (MeHg) expressed as a fish-tissue residue value (wet-weight MeHg in fish tissue). MeHg residue in fish tissue is considered to be equivalent to total Hg in fish muscle tissue and is referred to as Hg in this report. The Idaho Department of Environmental Quality adopted the EPA’s fish-tissue criterion and a reasonable potential to exceed (RPTE) threshold 20 percent lower than the criterion or greater than 0.24 mg/kg based on an average concentration of 10 fish from a receiving waterbody. NPDES permitted discharge to waters with fish having Hg concentrations exceeding 0.24 mg/kg are said to have a reasonable potential to exceed the water-quality criterion and thus are subject to additional permit obligations, such as requirements for increased monitoring and the development of a Hg minimization plan. The Idaho Fish Consumption Advisory Program (IFCAP) issues fish advisories to protect general and sensitive populations of fish consumers and has developed an action level of 0.22 mg/kg wet weight Hg in fish tissue. Fish consumption advisories are water body- and species-specific and are used to advise of allowable fish consumption from specific water bodies. The geometric mean Hg concentration of 10 fish of a single species collected from a single water body (lake or stream) in Idaho is compared to the action level to determine if a fish consumption advisory should be issued. The U.S. Geological Survey collected and analyzed individual fillets of mountain whitefish (Prosopium williamsoni), smallmouth bass (Micropterus dolomieu), and channel catfish (Ictalurus punctatus) for Hg. The median Hg concentration of 0.32 mg/kg exceeded the Idaho water-quality criterion at the site in Brownlee Reservoir. Average Hg concentrations from Brownlee Reservoir (0.32 mg/kg) and the Boise River at mouth (0.33 mg/kg) exceeded the Hg RPTE threshold (>0.24 mg/kg). IFCAP action levels also were exceeded at the sites on Brownlee Reservoir and at the mouth of the Boise River. Median Hg concentrations in fish at the remaining four river sites were less than 0.20 mg/kg with average concentrations ranging from 0.14 to 0.21 mg/kg Hg. Selenium (Se) analysis also was conducted on one composite fish tissue sample per site to screen for general concentrations and to provide information for future risk assessments. Concentrations of Se ranged from 0.07 to 0.49 mg/kg wet weight; average concentrations were highest in smallmouth bass (0.40 mg/kg) and lowest in mountain whitefish (0.12 mg/kg).

Costs along the service cascades for HIV testing and counselling and prevention of mother-to-child transmission

PubMed Central

Bautista-Arredondo, Sergio; Sosa-Rubí, Sandra G.; Opuni, Marjorie; Contreras-Loya, David; Kwan, Ada; Chaumont, Claire; Chompolola, Abson; Condo, Jeanine; Galárraga, Omar; Martinson, Neil; Masiye, Felix; Nsanzimana, Sabin; Ochoa-Moreno, Ivan; Wamai, Richard; Wang’ombe, Joseph

2016-01-01

Objective: We estimate facility-level average annual costs per client along the HIV testing and counselling (HTC) and prevention of mother-to-child transmission (PMTCT) service cascades. Design: Data collected covered the period 2011–2012 in 230 HTC and 212 PMTCT facilities in Kenya, Rwanda, South Africa, and Zambia. Methods: Input quantities and unit prices were collected, as were output data. Annual economic costs were estimated from the service providers’ perspective using micro-costing. Average annual costs per client in 2013 United States dollars (US$) were estimated along the service cascades. Results: For HTC, average cost per client tested ranged from US$5 (SD US$7) in Rwanda to US$31 (SD US$24) in South Africa, whereas average cost per client diagnosed as HIV-positive ranged from US$122 (SD US$119) in Zambia to US$1367 (SD US$2093) in Rwanda. For PMTCT, average cost per client tested ranged from US$18 (SD US$20) in Rwanda to US$89 (SD US$56) in South Africa; average cost per client diagnosed as HIV-positive ranged from US$567 (SD US$417) in Zambia to US$2021 (SD US$3210) in Rwanda; average cost per client on antiretroviral prophylaxis ranged from US$704 (SD US$610) in South Africa to US$2314 (SD US$3204) in Rwanda; and average cost per infant on nevirapine ranged from US$888 (SD US$884) in South Africa to US$2359 (SD US$3257) in Rwanda. Conclusion: We found important differences in unit costs along the HTC and PMTCT service cascades within and between countries suggesting that more efficient delivery of these services is possible. PMID:27753679

Smartphone chloridometer for point-of-care applications

NASA Astrophysics Data System (ADS)

Zhang, Chenji; Kim, Jimin P.; Creer, Michael; Yang, Jian; Liu, Zhiwen

2017-08-01

Chloride level in sweat is a major diagnostic criterion for cystic fibrosis (CF) and many other health conditions. In an effort to develop a low cost, point-of-care sweat diagnostics system for chloride concentration measurement, we demonstrated a smartphone-based chloridometer to measure sweat chloride by using our recently developed fluorescence chloride sensor. We characterized the performance of our device to validate its clinical potential. The study indicates that our smartphone-based chloridometer may potentially advance the point-of-care diagnostic system by reducing cost and improving diagnostic accuracy.

The stressor criterion for posttraumatic stress disorder: Does it matter?

PubMed Central

Roberts, Andrea L.; Dohrenwend, Bruce P.; Aiello, Allison; Wright, Rosalind J.; Maercker, Andreas; Galea, Sandro; Koenen, Karestan C.

2013-01-01

Objective The definition of the stressor criterion for posttraumatic stress disorder (“Criterion A1”) is hotly debated with major revisions being considered for DSM-V. We examine whether symptoms, course, and consequences of PTSD vary predictably with the type of stressful event that precipitates symptoms. Method We used data from the 2009 PTSD diagnostic subsample (N=3,013) of the Nurses Health Study II. We asked respondents about exposure to stressful events qualifying under 1) DSM-III, 2) DSM-IV, or 3) not qualifying under DSM Criterion A1. Respondents selected the event they considered worst and reported subsequent PTSD symptoms. Among participants who met all other DSM-IV PTSD criteria, we compared distress, symptom severity, duration, impairment, receipt of professional help, and nine physical, behavioral, and psychiatric sequelae (e.g. physical functioning, unemployment, depression) by precipitating event group. Various assessment tools were used to determine fulfillment of PTSD Criteria B through F and to assess these 14 outcomes. Results Participants with PTSD from DSM-III events reported on average 1 more symptom (DSM-III mean=11.8 symptoms, DSM-IV=10.7, non-DSM=10.9) and more often reported symptoms lasted one year or longer compared to participants with PTSD from other groups. However, sequelae of PTSD did not vary systematically with precipitating event type. Conclusions Results indicate the stressor criterion as defined by the DSM may not be informative in characterizing PTSD symptoms and sequelae. In the context of ongoing DSM-V revision, these results suggest that Criterion A1 could be expanded in DSM-V without much consequence for our understanding of PTSD phenomenology. Events not considered qualifying stressors under the DSM produced PTSD as consequential as PTSD following DSM-III events, suggesting PTSD may be an aberrantly severe but nonspecific stress response syndrome. PMID:22401487

Building a maintenance policy through a multi-criterion decision-making model

NASA Astrophysics Data System (ADS)

Faghihinia, Elahe; Mollaverdi, Naser

2012-08-01

A major competitive advantage of production and service systems is establishing a proper maintenance policy. Therefore, maintenance managers should make maintenance decisions that best fit their systems. Multi-criterion decision-making methods can take into account a number of aspects associated with the competitiveness factors of a system. This paper presents a multi-criterion decision-aided maintenance model with three criteria that have more influence on decision making: reliability, maintenance cost, and maintenance downtime. The Bayesian approach has been applied to confront maintenance failure data shortage. Therefore, the model seeks to make the best compromise between these three criteria and establish replacement intervals using Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE II), integrating the Bayesian approach with regard to the preference of the decision maker to the problem. Finally, using a numerical application, the model has been illustrated, and for a visual realization and an illustrative sensitivity analysis, PROMETHEE GAIA (the visual interactive module) has been used. Use of PROMETHEE II and PROMETHEE GAIA has been made with Decision Lab software. A sensitivity analysis has been made to verify the robustness of certain parameters of the model.

Active management of labor

PubMed Central

Rogers, Rebecca G; Gardner, Michael O; Tool, Kevin J; Ainsley, Jeanne; Gilson, George

2000-01-01

Objective To compare the costs of a protocol of active management of labor with those of traditional labor management. Design Cost analysis of a randomized controlled trial. Methods From August 1992 to April 1996, we randomly allocated 405 women whose infants were delivered at the University of New Mexico Health Sciences Center, Albuquerque, to an active management of labor protocol that had substantially reduced the duration of labor or a control protocol. We calculated the average cost for each delivery, using both actual costs and charges. Results The average cost for women assigned to the active management protocol was $2,480.79 compared with an average cost of $2,528.61 for women in the control group (P = 0.55). For women whose infant was delivered by cesarean section, the average cost was $4,771.54 for active management of labor and $4,468.89 for the control protocol (P = 0.16). Spontaneous vaginal deliveries cost an average of $27.00 more for actively managed patients compared with the cost for the control protocol. Conclusions The reduced duration of labor by active management did not translate into significant cost savings. Overall, an average cost saving of only $47.91, or 2%, was achieved for labors that were actively managed. This reduction in cost was due to a decrease in the rate of cesarean sections in women whose labor was actively managed and not to a decreased duration of labor. PMID:10778374

A new statistic to express the uncertainty of kriging predictions for purposes of survey planning.

NASA Astrophysics Data System (ADS)

Lark, R. M.; Lapworth, D. J.

2014-05-01

It is well-known that one advantage of kriging for spatial prediction is that, given the random effects model, the prediction error variance can be computed a priori for alternative sampling designs. This allows one to compare sampling schemes, in particular sampling at different densities, and so to decide on one which meets requirements in terms of the uncertainty of the resulting predictions. However, the planning of sampling schemes must account not only for statistical considerations, but also logistics and cost. This requires effective communication between statisticians, soil scientists and data users/sponsors such as managers, regulators or civil servants. In our experience the latter parties are not necessarily able to interpret the prediction error variance as a measure of uncertainty for decision making. In some contexts (particularly the solution of very specific problems at large cartographic scales, e.g. site remediation and precision farming) it is possible to translate uncertainty of predictions into a loss function directly comparable with the cost incurred in increasing precision. Often, however, sampling must be planned for more generic purposes (e.g. baseline or exploratory geochemical surveys). In this latter context the prediction error variance may be of limited value to a non-statistician who has to make a decision on sample intensity and associated cost. We propose an alternative criterion for these circumstances to aid communication between statisticians and data users about the uncertainty of geostatistical surveys based on different sampling intensities. The criterion is the consistency of estimates made from two non-coincident instantiations of a proposed sample design. We consider square sample grids, one instantiation is offset from the second by half the grid spacing along the rows and along the columns. If a sample grid is coarse relative to the important scales of variation in the target property then the consistency of predictions from two instantiations is expected to be small, and can be increased by reducing the grid spacing. The measure of consistency is the correlation between estimates from the two instantiations of the sample grid, averaged over a grid cell. We call this the offset correlation, it can be calculated from the variogram. We propose that this measure is easier to grasp intuitively than the prediction error variance, and has the advantage of having an upper bound (1.0) which will aid its interpretation. This quality measure is illustrated for some hypothetical examples, considering both ordinary kriging and factorial kriging of the variable of interest. It is also illustrated using data on metal concentrations in the soil of north-east England.

Total hospital costs of surgical treatment for adult spinal deformity: an extended follow-up study.

PubMed

McCarthy, Ian M; Hostin, Richard A; Ames, Christopher P; Kim, Han J; Smith, Justin S; Boachie-Adjei, Ohenaba; Schwab, Frank J; Klineberg, Eric O; Shaffrey, Christopher I; Gupta, Munish C; Polly, David W

2014-10-01

Whereas the costs of primary surgery, revisions, and selected complications for adult spinal deformity (ASD) have been individually reported in the literature, the total costs over several years after surgery have not been assessed. The determinants of such costs are also not well understood in the literature. This study analyzes the total hospital costs and operating room (OR) costs of ASD surgery through extended follow-up. Single-center retrospective analysis of consecutive surgical patients. Four hundred eighty-four consecutive patients undergoing surgical treatment for ASD from January 2005 through January 2011 with minimum three levels fused. Costs were collected from hospital administrative data on the total hospital costs incurred for the operation and any related readmissions, expressed in 2010 dollars and discounted at 3.5% per year. Detailed data on OR costs, including implants and biologics, were also collected. We performed a series of paired t tests and Wilcoxon signed-rank tests for differences in total hospital costs over different follow-up periods. The goal of these tests was to identify a time period over which average costs plateau and remain relatively constant over time. Generalized linear model regression was used to estimate the effect of patient and surgical factors on hospital inpatient costs, with different models estimated for different follow-up periods. A similar regression analysis was performed separately for OR costs and all other hospital costs. Patients were predominantly women (n=415 or 86%) with an average age of 48 (18-82) years and an average follow-up of 4.8 (2-8) years. Total hospital costs averaged $120,394, with primary surgery averaging $103,143 and total readmission costs averaging $67,262 per patient with a readmission (n=130 or 27% of all patients). Operating room costs averaged $70,514 per patient, constituting the majority (59%) of total hospital costs. Average total hospital costs across all patients significantly increased (p<.01) after primary surgery, from $111,807 at 1-year follow-up to $126,323 at 4-year follow-up. Regression results also revealed physician preference as the largest determinant of OR costs, accounting for $14,780 of otherwise unexplained OR cost differences across patients, with no significant physician effects on all other non-OR costs (p<.05). The incidence of readmissions increased the average cost of ASD surgery by more than 70%, illustrating the financial burden of revisions/reoperations; however, the cost burden resulting from readmissions appeared to taper off within 5 years after surgery. The estimated impact of physician preference on OR costs also highlights the variation in current practice and the opportunity for large cost reductions via a more standardized approach in the use of implants and biologics. Copyright © 2014 Elsevier Inc. All rights reserved.

Mercury concentrations in water and mercury and selenium concentrations in fish from Brownlee Reservoir and selected sites in the Boise and Snake Rivers, Idaho and Oregon, 2013–15

USGS Publications Warehouse

Williams, Marshall L.; MacCoy, Dorene E.

2016-06-30

Mercury (Hg) analyses were conducted on samples of sport fish and water collected from selected sampling sites in Brownlee Reservoir and the Boise and Snake Rivers to meet National Pollution Discharge and Elimination System (NPDES) permit requirements for the City of Boise, Idaho, between 2013 and 2015. City of Boise personnel collected water samples from six sites between October and November 2013 and 2015, with one site sampled in 2014. Total Hg concentrations in unfiltered water samples ranged from 0.48 to 8.8 nanograms per liter (ng/L), with the highest value in Brownlee Reservoir in 2013. All Hg concentrations in water samples were less than the U.S. Environmental Protection Agency (USEPA) Hg chronic aquatic life criterion of 12 ng/L.The USEPA recommended a water-quality criterion of 0.30 milligrams per kilogram (mg/kg) methylmercury (MeHg) expressed as a fish-tissue residue value (wet-weight MeHg in fish tissue). The Idaho Department of Environmental Quality adopted the USEPA’s fish-tissue criterion and established a reasonable potential to exceed (RPTE) threshold 20 percent lower than the criterion or greater than 0.24 mg/kg Hg based on an average concentration of 10 fish from a receiving waterbody. NPDES permitted discharge to waters with fish having Hg concentrations exceeding 0.24 mg/kg are said to have a reasonable potential to exceed the water-quality criterion and thus are subject to additional permit obligations, such as requirements for increased monitoring and the development of a Hg minimization plan. The Idaho Fish Consumption Advisory Program (IFCAP) issues fish advisories to protect general and sensitive populations of fish consumers and has developed an action level of 0.22 mg/kg Hg in fish tissue. Fish consumption advisories are water body- and species-specific and are used to advise allowable fish consumption from specific water bodies. The geometric mean Hg concentration of 10 fish of a single species collected from a single water body (lake or stream) in Idaho is compared to the action level to determine if a fish consumption advisory should be issued.The U.S. Geological Survey collected and analyzed individual fillets of mountain whitefish (Prosopium williamsoni), rainbow trout (Oncorhynchus mykiss), smallmouth bass (Micropterus dolomieu), and channel catfish (Ictalurus punctatus) for Hg. The 2013 average Hg concentration for small mouth bass (0.32 mg/kg) collected at Brownlee Reservoir and for channel catfish (0.33 mg/kg) collected at the Boise River mouth, exceeded the Idaho water quality criterion (>0.3 mg/kg), the Hg RPTE threshold (>0.24 mg/kg), and the IFCAP action level (>0.22 mg/kg). Average Hg concentrations in fish collected in 2014 or 2015 did not exceed evaluation criteria for any of the species assessed.Selenium (Se) analysis was conducted on one composite fish tissue sample per site to assess general concentrations and to provide information for future risk assessments. Composite concentrations of Se in fish tissue collected between 2013 and 2015 ranged from 0.07 and 0.49 mg/kg wet weight with the highest concentration collected from smallmouth bass from the Snake River near Murphy, and the lowest from mountain whitefish from the Boise River at Eckert Road.

Index of Free and Inexpensive Food and Nutrition Information Materials.

ERIC Educational Resources Information Center

Gordon, Kathleen, Comp.; And Others

This annotated index contains approximately 2,000 free or inexpensive pamphlets or brochures about food and nutrition. The prime criterion for inclusion of materials was that they be easily available and inexpensive; the cut-off cost was set at $3.00. The majority of materials listed were produced in either Canada or the United States. These…

7 CFR 1450.213 - Levels and rates for establishment payments.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (a) CCC will pay not more than 75 percent of the actual or average cost (whichever is lower) of... stewardship plan, or equivalent plan. (b) The average cost of performing a practice may be determined by CCC based on recommendations from the State Technical Committee. Such cost may be the average cost in a...

42 CFR 495.308 - Net average allowable costs as the basis for determining the incentive payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Net average allowable costs as the basis for... Net average allowable costs as the basis for determining the incentive payment. (a) The first year of payment. (1) The incentive is intended to offset the costs associated with the initial adoption...

Criterion-based laparoscopic training reduces total training time.

PubMed

Brinkman, Willem M; Buzink, Sonja N; Alevizos, Leonidas; de Hingh, Ignace H J T; Jakimowicz, Jack J

2012-04-01

The benefits of criterion-based laparoscopic training over time-oriented training are unclear. The purpose of this study is to compare these types of training based on training outcome and time efficiency. During four training sessions within 1 week (one session per day) 34 medical interns (no laparoscopic experience) practiced on two basic tasks on the Simbionix LAP Mentor virtual-reality (VR) simulator: 'clipping and grasping' and 'cutting'. Group C (criterion-based) (N = 17) trained to reach predefined criteria and stopped training in each session when these criteria were met, with a maximum training time of 1 h. Group T (time-based) (N = 17) trained for a fixed time of 1 h each session. Retention of skills was assessed 1 week after training. In addition, transferability of skills was established using the Haptica ProMIS augmented-reality simulator. Both groups improved their performance significantly over the course of the training sessions (Wilcoxon signed ranks, P < 0.05). Both groups showed skill transferability and skill retention. When comparing the performance parameters of group C and group T, their performances in the first, the last and the retention training sessions did not differ significantly (Mann-Whitney U test, P > 0.05). The average number of repetitions needed to meet the criteria also did not differ between the groups. Overall, group C spent less time training on the simulator than did group T (74:48 and 120:10 min, respectively; P < 0.001). Group C performed significantly fewer repetitions of each task, overall and in session 2, 3 and 4. Criterion-based training of basic laparoscopic skills can reduce the overall training time with no impact on training outcome, transferability or retention of skills. Criterion-based should be the training of choice in laparoscopic skills curricula.

Cost-Utility Analysis: Current Methodological Issues and Future Perspectives

PubMed Central

Nuijten, Mark J. C.; Dubois, Dominique J.

2011-01-01

The use of cost–effectiveness as final criterion in the reimbursement process for listing of new pharmaceuticals can be questioned from a scientific and policy point of view. There is a lack of consensus on main methodological issues and consequently we may question the appropriateness of the use of cost–effectiveness data in health care decision-making. Another concern is the appropriateness of the selection and use of an incremental cost–effectiveness threshold (Cost/QALY). In this review, we focus mainly on only some key methodological concerns relating to discounting, the utility concept, cost assessment, and modeling methodologies. Finally we will consider the relevance of some other important decision criteria, like social values and equity. PMID:21713127

One Approach to Formulating and Evaluating Student Work Groups in Legal Environment of Business Courses

ERIC Educational Resources Information Center

Camara, Joan E.; Carr, B. Nathaniel; Grota, Barbara L.

2007-01-01

The principal focus of this study is an investigation of whether students' grade point average (GPA) is a viable criterion for forming student work groups in the undergraduate Legal Environment of Business course. More specifically, the research focuses on the impact of: (1) GPA-homogeneous (HO) and GPA-heterogeneous (HE) groups upon student…

The Perceived Leadership Communication Questionnaire (PLCQ): Development and Validation.

PubMed

Schneider, Frank M; Maier, Michaela; Lovrekovic, Sara; Retzbach, Andrea

2015-01-01

The Perceived Leadership Communication Questionnaire (PLCQ) is a short, reliable, and valid instrument for measuring leadership communication from both perspectives of the leader and the follower. Drawing on a communication-based approach to leadership and following a theoretical framework of interpersonal communication processes in organizations, this article describes the development and validation of a one-dimensional 6-item scale in four studies (total N = 604). Results from Study 1 and 2 provide evidence for the internal consistency and factorial validity of the PLCQ's self-rating version (PLCQ-SR)-a version for measuring how leaders perceive their own communication with their followers. Results from Study 3 and 4 show internal consistency, construct validity, and criterion validity of the PLCQ's other-rating version (PLCQ-OR)-a version for measuring how followers perceive the communication of their leaders. Cronbach's α had an average of.80 over the four studies. All confirmatory factor analyses yielded good to excellent model fit indices. Convergent validity was established by average positive correlations of.69 with subdimensions of transformational leadership and leader-member exchange scales. Furthermore, nonsignificant correlations with socially desirable responding indicated discriminant validity. Last, criterion validity was supported by a moderately positive correlation with job satisfaction (r =.31).

Evaluation of Potential Exposure to Metals in Laundered Shop Towels

PubMed Central

Greenberg, Grace; Beck, Barbara D.

2013-01-01

We reported in 2003 that exposure to metals on laundered shop towels (LSTs) could exceed toxicity criteria. New data from LSTs used by workers in North America document the continued presence of metals in freshly laundered towels. We assessed potential exposure to metals based on concentrations of metals on the LSTs, estimates of LST usage by employees, and the transfer of metals from LST-to-hand, hand-to-mouth, and LST-to-lip, under average- or high-exposure scenarios. Exposure estimates were compared to toxicity criteria. Under an average-exposure scenario (excluding metals' data outliers), exceedances of the California Environmental Protection Agency, U.S. Environmental Protection Agency, and the Agency for Toxic Substances and Disease Registry toxicity criteria may occur for aluminum, cadmium, cobalt, copper, iron, and lead. Calculated intakes for these metals were up to more than 400-fold higher (lead) than their respective toxicity criterion. For the high-exposure scenario, additional exceedances may occur, and high-exposure intakes were up to 1,170-fold higher (lead) than their respective toxicity criterion. A sensitivity analysis indicated that alternate plausible assumptions could increase or decrease the magnitude of exceedances, but were unlikely to eliminate certain exceedances, particularly for lead. PMID:24453472

PERIODIC AUTOREGRESSIVE-MOVING AVERAGE (PARMA) MODELING WITH APPLICATIONS TO WATER RESOURCES.

USGS Publications Warehouse

Vecchia, A.V.

1985-01-01

Results involving correlation properties and parameter estimation for autogressive-moving average models with periodic parameters are presented. A multivariate representation of the PARMA model is used to derive parameter space restrictions and difference equations for the periodic autocorrelations. Close approximation to the likelihood function for Gaussian PARMA processes results in efficient maximum-likelihood estimation procedures. Terms in the Fourier expansion of the parameters are sequentially included, and a selection criterion is given for determining the optimal number of harmonics to be included. Application of the techniques is demonstrated through analysis of a monthly streamflow time series.

Cost of illness among patients with diabetic foot ulcer in Turkey

PubMed Central

Oksuz, Ergun; Malhan, Simten; Sonmez, Bilge; Numanoglu Tekin, Rukiye

2016-01-01

AIM To evaluate the annual cost of patients with Wagner grade 3-4-5 diabetic foot ulcer (DFU) from the public payer’s perspective in Turkey. METHODS This study was conducted focused on a time frame of one year from the public payer’s perspective. Cost-of-illness (COI) methodology, which was developed by the World Health Organization, was used in the generation of cost data. By following a clinical path with the COI method, the main total expenses were reached by multiplying the number of uses of each expense item, the percentage of cases that used them and unit costs. Clinical guidelines and real data specific to Turkey were used in the calculation of the direct costs. Monte Carlo Simulation was used in the study as a sensitivity analysis. RESULTS The following were calculated in DFU treatment from the public payer’s perspective: The annual average per patient outpatient costs $579.5 (4.1%), imaging test costs $283.2 (2.0%), laboratory test costs $284.8 (2.0%), annual average per patient cost of intervention, rehabilitation and trainings $2291.7 (16.0%), annual average per patient cost of drugs used $2545.8 (17.8%) and annual average per patient cost of medical materials used in DFU treatment $735.0 (5.1%). The average annual per patient cost for hospital admission is $7357.4 (51.5%). The average per patient complication cost for DFU is $210.3 (1.5%). The average annual per patient cost of DFU treatment in Turkey is $14287.70. As a result of the sensitivity analysis, the standard deviation of the analysis was $5706.60 (n = 5000, mean = $14146.8, 95%CI: $13988.6-$14304.9). CONCLUSION The health expenses per person are $-PPP 1045 in 2014 in Turkey and the average annual per patient cost for DFU is 14-fold of said amount. The total health expense in 2014 in Turkey is $-PPP 80.3 billion and the total DFU cost has a 3% share in the total annual health expenses for Turkey. Hospital costs are the highest component in DFU disease costs. In order to prevent DFU, training of the patients at risk and raising consciousness in patients with diabetes mellitus (DM) will provide benefits in terms of economy. Appropriate and efficient treatment of DM is a health intervention that can prevent complications. PMID:27795820

Ensemble-Based Parameter Estimation in a Coupled GCM Using the Adaptive Spatial Average Method

DOE PAGES

Liu, Y.; Liu, Z.; Zhang, S.; ...

2014-05-29

Ensemble-based parameter estimation for a climate model is emerging as an important topic in climate research. And for a complex system such as a coupled ocean–atmosphere general circulation model, the sensitivity and response of a model variable to a model parameter could vary spatially and temporally. An adaptive spatial average (ASA) algorithm is proposed to increase the efficiency of parameter estimation. Refined from a previous spatial average method, the ASA uses the ensemble spread as the criterion for selecting “good” values from the spatially varying posterior estimated parameter values; these good values are then averaged to give the final globalmore » uniform posterior parameter. In comparison with existing methods, the ASA parameter estimation has a superior performance: faster convergence and enhanced signal-to-noise ratio.« less

Number and cost of claims linked to minor cervical trauma in Europe: results from the comparative study by CEA, AREDOC and CEREDOC.

PubMed

Chappuis, Guy; Soltermann, Bruno

2008-10-01

Comparative epidemiological study of minor cervical spine trauma (frequently referred to as whiplash injury) based on data from the Comité Européen des Assurances (CEA) gathered in ten European countries. To determine the incidence and expenditure (e.g., for assessment, treatment or claims) for minor cervical spine injury in the participating countries. Controversy still surrounds the basis on which symptoms following minor cervical spine trauma may develop. In particular, there is considerable disagreement with regard to a possible contribution of psychosocial factors in determining outcome. The role of compensation is also a source of constant debate. The method followed here is the comparison of the data from different areas of interest (e.g., incidence of minor cervical spine trauma, percentage of minor cervical spine trauma in relationship to the incidence of bodily trauma, costs for assessment or claims) from ten European countries. Considerable differences exist regarding the incidence of minor cervical spine trauma and related costs in participating countries. France and Finland have the lowest and Great Britain the highest incidence of minor cervical spine trauma. The number of claims following minor cervical spine trauma in Switzerland is around the European average; however, Switzerland has the highest expenditure per claim at an average cost of 35,000.00 euros compared to the European average of 9,000.00 euros. Furthermore, the mandatory accident insurance statistics in Switzerland show very large differences between German-speaking and French- or Italian-speaking parts of the country. In the latter the costs for minor cervical spine trauma expanded more than doubled in the period from 1990 to 2002, whereas in the German-speaking part they rose by a factor of five. All the countries participating in the study have a high standard of medical care. The differences in claims frequency and costs must therefore reflect a social phenomenon based on the different cultural attitudes and medical approach to the problem including diagnosis. In Switzerland, therefore, new ways must be found to try to resolve the problem. The claims treatment model known as "Case Management" represents a new approach in which accelerated social and professional reintegration of the injured party is attempted. The CEA study emphasizes the fundamental role of medicine in that it postulates a clear division between the role of the attending physician and the medical expert. It also draws attention to the need to train medical professionals in the insurance business to the extent that they can interact adequately with insurance professionals. The results of this study indicate that the usefulness of the criterion of so-called typical clinical symptoms, which is at present applied by the courts to determine natural causality and has long been under debate, is inappropriate and should be replaced by objective assessment (e.g. accident and biomechanical analysis). In addition, the legal concept of adequate causality should be interpreted in the same way in both third party liability and social security law, which is currently not the case.

On the density limit in the helicon plasma sources

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

Kotelnikov, Igor A., E-mail: I.A.Kotelnikov@inp.nsk.su

2014-12-15

Existence of the density limit in the helicon plasma sources is revisited. The low- and high-frequency regimes of a helicon plasma source operation are distinguished. In the low-frequency regime with ω<√(ω{sub ci}ω{sub ce}), the density limit is deduced from the Golant-Stix criterion of the accessibility of the lower hybrid resonance. In the high-frequency case, ω>√(ω{sub ci}ω{sub ce}), an appropriate limit is given by the Shamrai-Taranov criterion. Both these criteria are closely related to the phenomenon of the coalescence of the helicon wave with the Trivelpiece-Gould mode. We draw a conclusion that the derived density limits are not currently achieved inmore » existing devices, perhaps, because of high energy cost of gas ionization.« less

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

Sakaguchi, Hidetsugu; Malomed, Boris A.

We study ordinary solitons and gap solitons (GS's) in the framework of the one-dimensional Gross-Pitaevskii equation (GPE) with a combination of both linear and nonlinear lattice potentials. The main points of the analysis are the effects of (in)commensurability between the lattices, the development of analytical methods, viz., the variational approximation (VA) for narrow ordinary solitons and various forms of the averaging method for broad solitons of both types, and also the study of the mobility of the solitons. Under the direct commensurability (equal periods of the lattices, L{sub lin}=L{sub nonlin}), the family of ordinary solitons is similar to its counterpartmore » in the GPE without external potentials. In the case of the subharmonic commensurability with L{sub lin}=(1/2)L{sub nonlin}, or incommensurability, there is an existence threshold for the ordinary solitons and the scaling relation between their amplitude and width is different from that in the absence of the potentials. GS families demonstrate a bistability unless the direct commensurability takes place. Specific scaling relations are found for them as well. Ordinary solitons can be readily set in motion by kicking. GS's are also mobile and feature inelastic collisions. The analytical approximations are shown to be quite accurate, predicting correct scaling relations for the soliton families in different cases. The stability of the ordinary solitons is fully determined by the Vakhitov-Kolokolov (VK) criterion (i.e., a negative slope in the dependence between the solitons's chemical potential mu and norm N). The stability of GS families obeys an inverted ('anti-VK') criterion dmu/dN>0, which is explained by the approximation based on the averaging method. The present system provides for the unique possibility to check the anti-VK criterion, as mu(N) dependencies for GS's feature turning points except in the case of direct commensurability.« less

Measurement of peak impact loads differ between accelerometers - Effects of system operating range and sampling rate.

PubMed

Ziebart, Christina; Giangregorio, Lora M; Gibbs, Jenna C; Levine, Iris C; Tung, James; Laing, Andrew C

2017-06-14

A wide variety of accelerometer systems, with differing sensor characteristics, are used to detect impact loading during physical activities. The study examined the effects of system characteristics on measured peak impact loading during a variety of activities by comparing outputs from three separate accelerometer systems, and by assessing the influence of simulated reductions in operating range and sampling rate. Twelve healthy young adults performed seven tasks (vertical jump, box drop, heel drop, and bilateral single leg and lateral jumps) while simultaneously wearing three tri-axial accelerometers including a criterion standard laboratory-grade unit (Endevco 7267A) and two systems primarily used for activity-monitoring (ActiGraph GT3X+, GCDC X6-2mini). Peak acceleration (gmax) was compared across accelerometers, and errors resulting from down-sampling (from 640 to 100Hz) and range-limiting (to ±6g) the criterion standard output were characterized. The Actigraph activity-monitoring accelerometer underestimated gmax by an average of 30.2%; underestimation by the X6-2mini was not significant. Underestimation error was greater for tasks with greater impact magnitudes. gmax was underestimated when the criterion standard signal was down-sampled (by an average of 11%), range limited (by 11%), and by combined down-sampling and range-limiting (by 18%). These effects explained 89% of the variance in gmax error for the Actigraph system. This study illustrates that both the type and intensity of activity should be considered when selecting an accelerometer for characterizing impact events. In addition, caution may be warranted when comparing impact magnitudes from studies that use different accelerometers, and when comparing accelerometer outputs to osteogenic impact thresholds proposed in literature. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Operative Cost Comparison: Plating Versus Intramedullary Fixation for Clavicle Fractures.

PubMed

Hanselman, Andrew E; Murphy, Timothy R; Bal, George K; McDonough, E Barry

2016-09-01

Although clavicle fractures often heal well with nonoperative management, current literature has shown improved outcomes with operative intervention for specific fracture patterns in specific patient types. The 2 most common methods of midshaft clavicle fracture fixation are intramedullary and plate devices. Through retrospective analysis, this study performed a direct cost comparison of these 2 types of fixation at a single institution over a 5-year period. Outcome measures included operative costs for initial surgery and any hardware removal surgeries. This study reviewed 154 patients (157 fractures), and of these, 99 had intramedullary fixation and 58 had plate fixation. A total of 80% (79 of 99) of intramedullary devices and 3% (2 of 58) of plates were removed. Average cost for initial intramedullary placement was $2955 (US dollars) less than that for initial plate placement (P<.001); average cost for removal was $1874 less than that for plate removal surgery (P=.2). Average total cost for all intramedullary surgeries was $1392 less than the average cost for all plating surgeries (P<.001). Average cost for all intramedullary surgeries requiring plate placement and removal was $653 less than the average cost for all plating surgeries that involved only placement (P=.04). Intramedullary fixation of clavicle fractures resulted in a statistically significant cost reduction compared with plate fixation, despite the incidence of more frequent removal surgeries. [Orthopedics.2016; 39(5):e877-e882.]. Copyright 2016, SLACK Incorporated.

Cost-effectiveness and the socialization of health care.

PubMed

Musgrove, P

1995-01-01

The more health care is socialized, the more cost-effectiveness is an appropriate criterion for expenditure. Utility-maximizing individuals, facing divisibility of health care purchases and declining marginal health gains, and complete information about probable health improvements, should buy health care according to its cost-effectiveness. Absent these features, individual health spending will not be cost-effective; and in any case, differences in personal utilities and risk aversion will not lead to the same ranking of health care interventions for everyone. Private insurance frees consumers from concern for cost, which undermines cost-effectiveness, but lets them emphasize effectiveness, which favors value for money. This is most important for costly and cost-effective interventions, especially for poor people. Cost-effectiveness is more appropriate and easier to achieve under second-party insurance. More complete socialization of health care, via public finance, can yield greater efficiency by making insurance compulsory. Cost-effectiveness is also more attractive when taxpayers subsidize others' care: needs (effectiveness) take precedence over wants (utility). The gain in effectiveness may be greater, and the welfare loss from Pareto non-optimality smaller, in poor countries than in rich ones.

A cost analysis of a smoke alarm installation and fire safety education program.

PubMed

Parmer, John E; Corso, Phaedra S; Ballesteros, Michael F

2006-01-01

While smoke alarm installation programs can help prevent residential fire injuries, the costs of running these programs are not well understood. We conducted a retrospective cost analysis of a smoke alarm installation program in 12 funded communities across four states. Costs included financial and economic resources needed for training, canvassing, installing, and following-up, within four cost categories: (a) personnel, (b) transportation, (c) facility, and (d) supplies. Local cost per completed home visit averaged 214.54 dollars, with an average local cost per alarm installed of 115.02 dollars. Combined state and local cost per alarm installed across all four states averaged 132.15 dollars. For every 1% increase in alarm installation, costs per alarm decrease by 1.32 dollars. As more smoke alarms are installed, the average installation cost per alarm decreases. By demonstrating effective economies of scale, this study suggests that smoke alarm programs can be implemented efficiently and receive positive economic returns on investment.

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Average System Cost methodology functionalization. 301.7 Section 301.7 Conservation of Power and Water Resources FEDERAL ENERGY... ACT § 301.7 Average System Cost methodology functionalization. (a) Functionalization of each Account...

16 CFR 305.20 - Paper catalogs and websites.

Code of Federal Regulations, 2012 CFR

2012-01-01

...] national average electricity cost of [ ___ cents per kWh]. For more information, visit www.ftc.gov... estimated operating cost is based on a [Year] national average [electricity, natural gas, propane, or oil... washers] and a [Year] national average cost of ___ cents per kWh for electricity and $ ___ per therm for...

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Average System Cost methodology functionalization. 301.7 Section 301.7 Conservation of Power and Water Resources FEDERAL ENERGY... ACT § 301.7 Average System Cost methodology functionalization. (a) Functionalization of each Account...

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Average System Cost methodology functionalization. 301.7 Section 301.7 Conservation of Power and Water Resources FEDERAL ENERGY... ACT § 301.7 Average System Cost methodology functionalization. (a) Functionalization of each Account...

16 CFR 305.20 - Paper catalogs and websites.

Code of Federal Regulations, 2013 CFR

2013-01-01

...] national average electricity cost of [ ___ cents per kWh]. For more information, visit www.ftc.gov... estimated operating cost is based on a [Year] national average [electricity, natural gas, propane, or oil... washers] and a [Year] national average cost of ___ cents per kWh for electricity and $ ___ per therm for...

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Average System Cost methodology functionalization. 301.7 Section 301.7 Conservation of Power and Water Resources FEDERAL ENERGY... ACT § 301.7 Average System Cost methodology functionalization. (a) Functionalization of each Account...

Gravitational instability and star formation in NGC 628

NASA Astrophysics Data System (ADS)

Marchuk, A. A.

2018-05-01

The gas-stars instability criterion for infinitesimally thin disc was applied to the galaxy NGC 628. Instead of using the azimuthally averaged profiles of data, the maps of the gas surface densities (THINGS, HERACLES), of the velocity dispersions of stars (VENGA) and gas (THINGS), and of the surface brightness of the galaxy (S4G) were analysed. All these maps were collected for the same region with a noticeable star formation rate and were superimposed on each other. Using the data on the rotation, curve values of Qeff were calculated for each pixel in the image. The areas within the contours Qeff < 3 were compared with the ongoing star formation regions (ΣSFR > 0.007 M⊙ yr-1 kpc-2) and showed a good coincidence between them. The Romeo-Falstad disc instability diagnostics taking into account the thickness of the stellar and gas layers does not change the result. If the one-fluid instability criterion is used, the coincidence is worse. The analysis was carried out for the area r < 0.5r25. Leroy et al. using azimuthally averaged data obtained Qeff ≈ 3-4 for this area of the disc, which makes it stable against non-axisymmetric perturbations and gas dissipation, and does not predict the location of star-forming regions. Since, in the galaxies, the distribution of hydrogen and the regions of star formation is often patchy, the relationship between gravitational instability and star formation should be sought using data maps rather than azimuthally averaged data.

Association between costs and quality of acute myocardial infarction care hospitals under the Korea National Health Insurance program.

PubMed

Kang, Hee-Chung; Hong, Jae-Seok

2017-08-01

If cost reductions produce a cost-quality trade-off, healthcare policy makers need to be more circumspect about the use of cost-effective initiatives. Additional empirical evidence about the relationship between cost and quality is needed to design a value-based payment system. We examined the association between cost and quality performances for acute myocardial infarction (AMI) care at the hospital level.In 2008, this cross-sectional study examined 69 hospitals with 6599 patients hospitalized under the Korea National Health Insurance (KNHI) program. We separately estimated hospital-specific effects on cost and quality using the fixed effect models adjusting for average patient risk. The analysis examined the association between the estimated hospital effects against the treatment cost and quality. All hospitals were distributed over the 4 cost × quality quadrants rather than concentrated in only the trade-off quadrants (i.e., above-average cost and above-average quality, below-average cost and below-average quality). We found no significant trade-off between cost and quality among hospitals providing AMI care in Korea.Our results further contribute to formulating a rationale for value-based hospital-level incentive programs by supporting the necessity of different approaches depending on the quality location of a hospital in these 4 quadrants.

Years of potential life lost amongst heroin users in the Australian Treatment Outcome Study cohort, 2001-2015.

PubMed

Darke, Shane; Marel, Christina; Mills, Katherine L; Ross, Joanne; Slade, Tim; Tessson, Maree

2016-05-01

Heroin use carries the highest burden of disease of any drug of dependence. The study aimed to determine mortality rates of the Australian Treatment Outcome Study cohort over the period 2001-2015, and the years of potential life lost (YPLL). The cohort consisted of 615 heroin users. Crude mortality rates per 1000 person years (PY) and Standardised Mortality Ratios (SMR) were calculated. YPLL were calculated using two criteria: years lost prior to age 65, and years lost prior to average life expectancy. The cohort was followed for 7,790.9 PY. At 2015, 72 (11.7%) of the cohort were deceased, with a crude mortality rate of 9.2 per 1000 PYs. Neither age nor gender associated with mortality. The SMR was 10.2 (males 7.3, females 17.2), matched for age, gender and year of death. The most common mortality cause was opioid overdose (52.8%). Using the<65 years criterion, there were 1988.3 YPLL, with a mean of 27.6 (males 27.6, females 27.7). Using the average life expectancy criterion, there were 3135.1 YPLL, with a mean of 43.5 (males 41.9, females 46.3). Accidental overdose (<65 yr 63.0%, average life expectancy 63.7%) and suicide (<65 yr 12.8%, average life expectancy 13.3%) accounted for three quarters of YPLL where cause of death was known. YPLL associated with heroin use was a quarter of a century, or close to half a century, depending on the criteria used. Given the prominent role of overdose and suicide, the majority of these fatalities, and the associated YPLL, appear preventable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Analysing the accuracy of machine learning techniques to develop an integrated influent time series model: case study of a sewage treatment plant, Malaysia.

PubMed

Ansari, Mozafar; Othman, Faridah; Abunama, Taher; El-Shafie, Ahmed

2018-04-01

The function of a sewage treatment plant is to treat the sewage to acceptable standards before being discharged into the receiving waters. To design and operate such plants, it is necessary to measure and predict the influent flow rate. In this research, the influent flow rate of a sewage treatment plant (STP) was modelled and predicted by autoregressive integrated moving average (ARIMA), nonlinear autoregressive network (NAR) and support vector machine (SVM) regression time series algorithms. To evaluate the models' accuracy, the root mean square error (RMSE) and coefficient of determination (R 2 ) were calculated as initial assessment measures, while relative error (RE), peak flow criterion (PFC) and low flow criterion (LFC) were calculated as final evaluation measures to demonstrate the detailed accuracy of the selected models. An integrated model was developed based on the individual models' prediction ability for low, average and peak flow. An initial assessment of the results showed that the ARIMA model was the least accurate and the NAR model was the most accurate. The RE results also prove that the SVM model's frequency of errors above 10% or below - 10% was greater than the NAR model's. The influent was also forecasted up to 44 weeks ahead by both models. The graphical results indicate that the NAR model made better predictions than the SVM model. The final evaluation of NAR and SVM demonstrated that SVM made better predictions at peak flow and NAR fit well for low and average inflow ranges. The integrated model developed includes the NAR model for low and average influent and the SVM model for peak inflow.

Prevalence and effects of life event exposure among undergraduate and community college students.

PubMed

Anders, Samantha L; Frazier, Patricia A; Shallcross, Sandra L

2012-07-01

The purposes of this study were to assess lifetime and recent exposure to various life events among undergraduate and community college students and to assess the relation between event exposure and a broad range of outcomes (i.e., mental and physical health, life satisfaction, grade point average). Undergraduate students from a midwestern university (N = 842) and a community college (N = 242) completed online measures of lifetime event exposure and outcomes at Time 1 and recent event exposure at Time 2 two months later. Life events assessed included events that did and did not meet the definition of a traumatic event (i.e., posttraumatic stress disorder Criterion A1) in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) as well as directly (e.g., own life-threatening illness) and indirectly (e.g., others' illness) experienced events. Students reported experiencing many lifetime and recent Criterion A1 and non-A1 events, and community college students reported more events than did university students. Generally, individuals who reported more lifetime events also reported poorer outcomes (e.g., poorer health). The number of non-Criterion A1 and directly experienced events tended to be more strongly correlated with negative outcomes than were the number of Criterion A1 and indirectly experienced events reported. These findings suggest that non-A1 events are important to assess and can be significantly related to outcomes for students.

A Classroom Exercise to Examine the Trade-off between Mission Capacity and Life Cycle Cost

ERIC Educational Resources Information Center

Kang, Keebom; Doerr, Kenneth H.

2015-01-01

This article presents a classroom exercise, centered on a simulation that has been used for 4 years in an MBA program to help students develop an understanding of the trade-offs involved in managing capital assets in the public sector. Though often ignored in business schools, "mission" is a key criterion that must be considered when…

Decision analysis applied to the purchase of frozen premixed intravenous admixtures.

PubMed

Witte, K W; Eck, T A; Vogel, D P

1985-04-01

A structured decision-analysis model was used to evaluate frozen premixed cefazolin admixtures. Decision analysis is a process of stating the desired outcome, establishing and weighting evaluation criteria, identifying options for reaching the outcome, evaluating and numerically ranking each option for each criterion, multiplying the ranking by the weight for each criterion, and calculating total points for each option. It was used to compare objectively frozen premixed cefazolin admixtures with batch reconstitution from vials and reconstitution of lyophilized, ready-to-mix containers. In this institution the model numerically demonstrated a distinct preference for the premixed frozen admixture over these other alternatives. A comparison of these results with the total cost impact of each option resulted in a decision to purchase the frozen premixed solution. The advantages of the frozen premixed solution that contributed most to this decision were decreased waste and personnel time. The latter was especially important since it allowed for the reallocation of personnel resources to other potentially cost-reducing clinical functions. Decision analysis proved to be an effective tool for formalizing the process of selecting among various alternatives to reach a desired outcome in this hospital pharmacy.

[Spatial and temporal patterns of the ecological compensation criterion in Jiangxi Province, China based on carbon footprint.

PubMed

Hu, Xiao Fei; Zou, Yan; Fu, Chun

2017-02-01

Carbon footprint is a new method to measure carbon emissions, and the ecological compensation criterion can be determined according to the regional carbon footprint and carbon carrying capacity. The spatial and temporal patterns of ecological compensation criterion were studied among 11 cities in Jiangxi Province using carbon footprint, carbon capacity and carbon surplus/deficit models. Our results found that carbon footprint in Jiangxi Province showed a rapid growth trend from 2000 to 2013, with an average annual growth rate of 8.7%. The carbon carrying capacity always remained surplus, but the net carbon surplus amount decreased from 2000 to 2013. Among the 11 cities, Nanchang and Jiujiang made the biggest contribution to total carbon emission, and Ganzhou, Ji'an and Shangrao had provided the largest contribution to carbon total absorption. In 2013, the total carbon surplus amount was 2.273 billion yuan in Jiangxi Province. Ganzhou, Ji'an, Fuzhou and Shangrao should be given priority to ecological compensation money. These results could provide a scientific basis for the establishment of ecological compensation mechanism in Jiangxi Province and the transfer of CO 2 emission rights.

Fracture mechanics in fiber reinforced composite materials, taking as examples B/A1 and CRFP

NASA Technical Reports Server (NTRS)

Peters, P. W. M.

1982-01-01

The validity of linear elastic fracture mechanics and other fracture criteria was investigated with laminates of boron fiber reinforced aluminum (R/A1) and of carbon fiber reinforced epoxide (CFRP). Cracks are assessed by fracture strength Kc or Kmax (critical or maximum value of the stress intensity factor). The Whitney and Nuismer point stress criterion and average stress criterion often show that Kmax of fiber composite materials increases with increasing crack length; however, for R/A1 and CFRP the curve showing fracture strength as a function of crack length is only applicable in a small domain. For R/A1, the reason is clearly the extension of the plastic zone (or the damage zone n the case of CFRP) which cannot be described with a stress intensity factor.

The MusIC method: a fast and quasi-optimal solution to the muscle forces estimation problem.

PubMed

Muller, A; Pontonnier, C; Dumont, G

2018-02-01

The present paper aims at presenting a fast and quasi-optimal method of muscle forces estimation: the MusIC method. It consists in interpolating a first estimation in a database generated offline thanks to a classical optimization problem, and then correcting it to respect the motion dynamics. Three different cost functions - two polynomial criteria and a min/max criterion - were tested on a planar musculoskeletal model. The MusIC method provides a computation frequency approximately 10 times higher compared to a classical optimization problem with a relative mean error of 4% on cost function evaluation.

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

PubMed

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

2017-10-06

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

Closed-loop carrier phase synchronization techniques motivated by likelihood functions

NASA Technical Reports Server (NTRS)

Tsou, H.; Hinedi, S.; Simon, M.

1994-01-01

This article reexamines the notion of closed-loop carrier phase synchronization motivated by the theory of maximum a posteriori phase estimation with emphasis on the development of new structures based on both maximum-likelihood and average-likelihood functions. The criterion of performance used for comparison of all the closed-loop structures discussed is the mean-squared phase error for a fixed-loop bandwidth.

THE G.P.A. CRITERION AND SELECTIVE RETENTION IN TEACHER EDUCATION.

ERIC Educational Resources Information Center

PIERSON, ROBERT A.

TO DETERMINE WHETHER ARBITRARY GRADE-POINT AVERAGE CUT-OFF POINTS (E.G. 2.25) FOR ENTRANCE INTO TEACHER EDUCATION PROGRAMS ARE UNFAIR TO PRESENT-DAY STUDENTS, NINETY 1966 COLLEGE SOPHOMORES WITH FRESHMAN-YEAR GPA'S BETWEEN 2.00 AND 2.09 WERE COMPARED TO THE SAME NUMBER OF 1961 SOPHOMORES WITH FRESHMAN-YEAR GPA'S BETWEEN 2.25 AND 2.34 USING (1)…

The Unobtrusive Measurement of Racial Bias Among Recruit Classification Specialists

DTIC Science & Technology

1974-10-01

Sattler, J. M. Racial "experimenter effects" in experimentation, testing , interviewing, and psychotherapy. Psychological Bulletin, 1970, 73...16 5 Analyses of Variance of Mean Test Scores (GCT + ARI) of Black and White Recruits Seen by Each Classifier 17 6 Average Criterion Scores... test scores and experiences equivalent to those interviewed by black classifiers. If these assumptions can be verified, several interesting

The economic burden of HIV/AIDS on individuals and households in Nepal: a quantitative study.

PubMed

Poudel, Ak Narayan; Newlands, David; Simkhada, Padam

2017-01-24

There have been only limited studies assessing the economic burden of HIV/AIDS in terms of direct costs, and there has been no published study related to productivity costs in Nepal. Therefore, this study explores in detail the economic burden of HIV/AIDS, including direct costs and productivity costs. This paper focuses on the direct costs of seeking treatment, productivity costs, and related factors affecting direct costs, and productivity costs. This study was a cross-sectional, quantitative study. The primary data were collected through a structured face-to-face survey from 415 people living with HIV/AIDS (PLHIV). The study was conducted in six representative treatment centres of six districts of Nepal. The data analysis regarding the economic burden (direct costs and productivity costs) was performed from the household's perspective. Descriptive statistics have been used, and regression analyses were applied to examine the extent, nature and determinants of the burden of the disease, and its correlations. Average total costs due to HIV/AIDS (the sum of average total direct and average productivity costs before adjustment for coping strategies) were Nepalese Rupees (NRs) 2233 per month (US$ 30.2/month), which was 28.5% of the sample households' average monthly income. The average total direct costs for seeking HIV/AIDS treatment were NRs 1512 (US$ 20.4), and average productivity costs (before adjustment for coping strategies) were NRs 721 (US$ 9.7). The average monthly productivity losses (before adjustment for coping strategies) were 5.05 days per person. The major determinants for the direct costs were household income, occupation, health status of respondents, respondents accompanied or not, and study district. Health status of respondents, ethnicity, sexual orientation and study district were important determinants for productivity costs. The study concluded that HIV/AIDS has caused a significant economic burden for PLHIV and their families in Nepal. The study has a number of policy implications for different stakeholders. Provision of social support and income generating programmes to HIV-affected individuals and their families, and decentralising treatment services in each district seem to be viable solutions to reduce the economic burden of HIV-affected individuals and households.

An Approach for Assessing Development and Deployment Risks in the DOE Fuel Cycle Options Evaluation and Screening Study

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

Gehin, Jess C; Oakley, Brian; Worrall, Andrew

2015-01-01

Abstract One of the key objectives of the U.S. Department of Energy (DOE) Nuclear Energy R&D Roadmap is the development of sustainable nuclear fuel cycles that can improve natural resource utilization and provide solutions to the management of nuclear wastes. Recently, an evaluation and screening (E&S) of fuel cycle systems has been conducted to identify those options that provide the best opportunities for obtaining such improvements and also to identify the required research and development activities that can support the development of advanced fuel cycle options. In order to evaluate and screen the E&S study included nine criteria including Developmentmore » and Deployment Risk (D&DR). More specifically, this criterion was represented by the following metrics: Development time, development cost, deployment cost from prototypic validation to first-of-a-kind commercial, compatibility with the existing infrastructure, existence of regulations for the fuel cycle and familiarity with licensing, and existence of market incentives and/or barriers to commercial implementation of fuel cycle processes. Given the comprehensive nature of the study, a systematic approach was needed to determine metric data for the D&DR criterion, and is presented here. As would be expected, the Evaluation Group representing the once-through use of uranium in thermal reactors is always the highest ranked fuel cycle Evaluation Group for this D&DR criterion. Evaluation Groups that consist of once-through fuel cycles that use existing reactor types are consistently ranked very high. The highest ranked limited and continuous recycle fuel cycle Evaluation Groups are those that recycle Pu in thermal reactors. The lowest ranked fuel cycles are predominately continuous recycle single stage and multi-stage fuel cycles that involve TRU and/or U-233 recycle.« less

Development of a Framework Based on Reflective MCDA to Support Patient-Clinician Shared Decision-Making: The Case of the Management of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NET) in the United States.

PubMed

Wagner, Monika; Samaha, Dima; Khoury, Hanane; O'Neil, William M; Lavoie, Louis; Bennetts, Liga; Badgley, Danielle; Gabriel, Sylvie; Berthon, Anthony; Dolan, James; Kulke, Matthew H; Goetghebeur, Mireille

2018-01-01

Well- or moderately differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are often slow-growing, and some patients with unresectable, asymptomatic, non-functioning tumors may face the choice between watchful waiting (WW), or somatostatin analogues (SSA) to delay progression. We developed a comprehensive multi-criteria decision analysis (MCDA) framework to help patients and physicians clarify their values and preferences, consider each decision criterion, and support communication and shared decision-making. The framework was adapted from a generic MCDA framework (EVIDEM) with patient and clinician input. During a workshop, patients and clinicians expressed their individual values and preferences (criteria weights) and, on the basis of two scenarios (treatment vs WW; SSA-1 [lanreotide] vs SSA-2 [octreotide]) with evidence from a literature review, expressed how consideration of each criterion would impact their decision in favor of either option (score), and shared their knowledge and insights verbally and in writing. The framework included benefit-risk criteria and modulating factors, such as disease severity, quality of evidence, costs, and constraints. Overall and progression-free survival being most important, criteria weights ranged widely, highlighting variations in individual values and the need to share them. Scoring and considering each criterion prompted a rich exchange of perspectives and uncovered individual assumptions and interpretations. At the group level, type of benefit, disease severity, effectiveness, and quality of evidence favored treatment; cost aspects favored WW (scenario 1). For scenario 2, most criteria did not favor either option. Patients and clinicians consider many aspects in decision-making. The MCDA framework provided a common interpretive frame to structure this complexity, support individual reflection, and share perspectives. Ipsen Pharma.

42 CFR 100.2 - Average cost of a health insurance policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Average cost of a health insurance policy. 100.2 Section 100.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of determining...

10 CFR 170.20 - Average cost per professional staff-hour.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Average cost per professional staff-hour. 170.20 Section... Provisions § 170.20 Average cost per professional staff-hour. Fees for permits, licenses, amendments... professional staff-hour rate of $274 per hour. [77 FR 35826, June 15, 2012] Schedule of Fees ...

10 CFR 170.20 - Average cost per professional staff-hour.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Average cost per professional staff-hour. 170.20 Section... Provisions § 170.20 Average cost per professional staff-hour. Fees for permits, licenses, amendments... professional staff-hour rate of $257 per hour. [74 FR 27660, June 10, 2009] Schedule of Fees ...

10 CFR 170.20 - Average cost per professional staff-hour.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Average cost per professional staff-hour. 170.20 Section... Provisions § 170.20 Average cost per professional staff-hour. Fees for permits, licenses, amendments... professional staff-hour rate of $272 per hour. [78 FR 39481, July 1, 2013] Schedule of Fees ...

10 CFR 170.20 - Average cost per professional staff-hour.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Average cost per professional staff-hour. 170.20 Section... Provisions § 170.20 Average cost per professional staff-hour. Fees for permits, licenses, amendments... professional staff-hour rate of $259 per hour. [75 FR 34235, June 16, 2010] Schedule of Fees ...

18 CFR 301.5 - Changes in Average System Cost methodology.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Changes in Average System Cost methodology. 301.5 Section 301.5 Conservation of Power and Water Resources FEDERAL ENERGY... ACT § 301.5 Changes in Average System Cost methodology. (a) The Administrator, at his or her...

16 CFR 305.10 - Ranges of comparability on the required labels.

Code of Federal Regulations, 2013 CFR

2013-01-01

... modification under this section need not be relabeled. (b) Representative average unit energy cost. The Representative Average Unit Energy Cost to be used on labels as required by § 305.11 and disclosures as required... Representative Average Unit Energy Cost figures every five years beginning in 2012 in the Federal Register. When...

7 CFR 993.159 - Payments for services performed with respect to reserve tonnage prunes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... overhead costs, which include those for supervision, indirect labor, fuel, power and water, taxes and... tonnage prunes. The Committee will compute the average industry cost for holding reserve pool prunes by... choose to exclude the high and low data in computing an industry average. The industry average costs may...

18 CFR 301.5 - Changes in Average System Cost methodology.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Changes in Average System Cost methodology. 301.5 Section 301.5 Conservation of Power and Water Resources FEDERAL ENERGY... ACT § 301.5 Changes in Average System Cost methodology. (a) The Administrator, at his or her...

16 CFR 305.10 - Ranges of comparability on the required labels.

Code of Federal Regulations, 2010 CFR

2010-01-01

... modification under this section need not be relabeled. (b) Representative average unit energy cost. The Representative Average Unit Energy Cost to be used on labels as required by § 305.11 and disclosures as required... Representative Average Unit Energy Cost figures every five years beginning in 2012 in the Federal Register. When...

7 CFR 993.159 - Payments for services performed with respect to reserve tonnage prunes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... overhead costs, which include those for supervision, indirect labor, fuel, power and water, taxes and... tonnage prunes. The Committee will compute the average industry cost for holding reserve pool prunes by... choose to exclude the high and low data in computing an industry average. The industry average costs may...

16 CFR 305.10 - Ranges of comparability on the required labels.

Code of Federal Regulations, 2012 CFR

2012-01-01

... modification under this section need not be relabeled. (b) Representative average unit energy cost. The Representative Average Unit Energy Cost to be used on labels as required by § 305.11 and disclosures as required... Representative Average Unit Energy Cost figures every five years beginning in 2012 in the Federal Register. When...

16 CFR 305.20 - Paper catalogs and Web sites.

Code of Federal Regulations, 2014 CFR

2014-01-01

... based on a [Year] national average electricity cost of [ ___ cents per kWh]. For more information, visit... estimated operating cost is based on a [Year] national average [electricity, natural gas, propane, or oil... washers] and a [Year] national average cost of ___ cents per kWh for electricity and $ ___ per therm for...

18 CFR 301.5 - Changes in Average System Cost methodology.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Changes in Average System Cost methodology. 301.5 Section 301.5 Conservation of Power and Water Resources FEDERAL ENERGY... ACT § 301.5 Changes in Average System Cost methodology. (a) The Administrator, at his or her...

18 CFR 301.5 - Changes in Average System Cost methodology.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Changes in Average System Cost methodology. 301.5 Section 301.5 Conservation of Power and Water Resources FEDERAL ENERGY... ACT § 301.5 Changes in Average System Cost methodology. (a) The Administrator, at his or her...

7 CFR 993.159 - Payments for services performed with respect to reserve tonnage prunes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... overhead costs, which include those for supervision, indirect labor, fuel, power and water, taxes and... tonnage prunes. The Committee will compute the average industry cost for holding reserve pool prunes by... choose to exclude the high and low data in computing an industry average. The industry average costs may...

16 CFR 305.10 - Ranges of comparability on the required labels.

Code of Federal Regulations, 2011 CFR

2011-01-01

... modification under this section need not be relabeled. (b) Representative average unit energy cost. The Representative Average Unit Energy Cost to be used on labels as required by § 305.11 and disclosures as required... Representative Average Unit Energy Cost figures every five years beginning in 2012 in the Federal Register. When...

Yelp for Prescribers: A Quasi-Experimental Study of Providing Antibiotic Cost Data and Prescription of High-Cost Antibiotics in an Academic and Tertiary Care Hospital.

PubMed

Newman, Kira L; Varkey, Jay; Rykowski, Justin; Mohan, Arun V

2015-08-01

Physicians frequently prescribe antibiotics to inpatients without knowledge of medication cost. It is not well understood whether providing cost data would change prescribing behavior. To evaluate the association between providing cost data alongside culture and antibiotic susceptibility results and prescribing of high-cost antibiotics. Quasi-experimental pre-post analysis. Inpatients diagnosed with bacteremia or urinary tract infection in two tertiary care hospitals. Cost category data for each antibiotic ($, $$, $$$, or $$) were added to culture and susceptibility testing results available to physicians. Average cost category of antibiotics prescribed to patients after the receipt of susceptibility testing results. There was a significant decrease in the average cost category of antibiotics per patient after the intervention (pre-intervention = 1.9 $ vs. post-intervention = 1.7 $, where 1.5 $ would mean that the average number of dollar signs for antibiotics prescribed was between $ and $$, p = 0.002). After adjusting for age, insurance type, and prior length of stay, the odds ratio (OR) of a patient's average antibiotic being higher cost vs. lower cost after the intervention compared to before the intervention was 0.74 [95% confidence interval (CI) 0.56, 0.98]. The intervention was associated with a 31.3% reduction in the average cost per unit of antibiotics prescribed (p < 0.001). Providing physicians with cost feedback alongside susceptibility testing data was associated with a significant decrease in prescription of high-cost antibiotics. This intervention is intuitive, low cost, and may shift providers toward lower cost medications when equally acceptable options are available.

[A possibility of using increased oxygen consumption as a criterion for mechanical respiration weaning in pediatric practice].

PubMed

Grigoliia, G N; Chokhonelidze, I K; Gvelesiani, L G; Sulakvelidze, K R; Tutberidze, K N

2007-01-01

The body oxygen consumption and the oxygen cost of breathing (which is the difference in oxygen consumption measured during controlled ventilation and again during spontaneous ventilation) were measured in 46 children with congenital heart diseases after open-heart surgery. There was a significant exponential correlation between the body oxygen consumption (ml/m(2)/min) and the oxygen cost of breathing as a percentage of total oxygen consumption during spontaneous ventilation and the duration of weaning in minutes (r=+0,882, p<0,02). Therefore, as the oxygen cost of breathing was correlated with the total weaning time, this may be a useful index on the weaning process (sensitivity 92%, specificity 85%).

The research of Raman spectra measurement system based on tiled-grating monochromator

NASA Astrophysics Data System (ADS)

Liu, Li-na; Zhang, Yin-chao; Chen, Si-ying; Chen, He; Guo, Pan; Wang, Yuan

2013-09-01

A set of Raman spectrum measurement system, essentially a Raman spectrometer, has been independently designed and accomplished by our research group. This system adopts tiled-grating structure, namely two 50mm × 50mm holographic gratings are tiled to form a big spectral grating. It not only improves the resolution but also reduces the cost. This article outlines the Raman spectroscopy system's composition structure and performance parameters. Then corresponding resolutions of the instrument under different criterions are deduced through experiments and data fitting. The result shows that the system's minimum resolution is up to 0.02nm, equivalent to 0.5cm-1 wavenumber under Rayleigh criterion; and it will be up to 0.007nm, equivalent to 0.19cm-1 wavenumber under Sparrow criterion. Then Raman spectra of CCl4 and alcohol have been obtained by the spectrometer, which agreed with the standard spectrum respectively very well. Finally, we measured the spectra of the alcohol solutions with different concentrations and extracted the intensity of characteristic peaks from smoothed spectra. Linear fitting between intensity of characteristic peaks and alcohol solution concentrations has been made. And the linear correlation coefficient is 0.96.

Color filter array design based on a human visual model

NASA Astrophysics Data System (ADS)

Parmar, Manu; Reeves, Stanley J.

2004-05-01

To reduce cost and complexity associated with registering multiple color sensors, most consumer digital color cameras employ a single sensor. A mosaic of color filters is overlaid on a sensor array such that only one color channel is sampled per pixel location. The missing color values must be reconstructed from available data before the image is displayed. The quality of the reconstructed image depends fundamentally on the array pattern and the reconstruction technique. We present a design method for color filter array patterns that use red, green, and blue color channels in an RGB array. A model of the human visual response for luminance and opponent chrominance channels is used to characterize the perceptual error between a fully sampled and a reconstructed sparsely-sampled image. Demosaicking is accomplished using Wiener reconstruction. To ensure that the error criterion reflects perceptual effects, reconstruction is done in a perceptually uniform color space. A sequential backward selection algorithm is used to optimize the error criterion to obtain the sampling arrangement. Two different types of array patterns are designed: non-periodic and periodic arrays. The resulting array patterns outperform commonly used color filter arrays in terms of the error criterion.

Effect of Crystal Orientation on Analysis of Single-Crystal, Nickel-Based Turbine Blade Superalloys

NASA Technical Reports Server (NTRS)

Swanson, G. R.; Arakere, N. K.

2000-01-01

High-cycle fatigue-induced failures in turbine and turbopump blades is a pervasive problem. Single-crystal nickel turbine blades are used because of their superior creep, stress rupture, melt resistance, and thermomechanical fatigue capabilities. Single-crystal materials have highly orthotropic properties making the position of the crystal lattice relative to the part geometry a significant and complicating factor. A fatigue failure criterion based on the maximum shear stress amplitude on the 24 octahedral and 6 cube slip systems is presented for single-crystal nickel superalloys (FCC crystal). This criterion greatly reduces the scatter in uniaxial fatigue data for PWA 1493 at 1,200 F in air. Additionally, single-crystal turbine blades used in the Space Shuttle main engine high pressure fuel turbopump/alternate turbopump are modeled using a three-dimensional finite element (FE) model. This model accounts for material orthotrophy and crystal orientation. Fatigue life of the blade tip is computed using FE stress results and the failure criterion that was developed. Stress analysis results in the blade attachment region are also presented. Results demonstrate that control of crystallographic orientation has the potential to significantly increase a component's resistance to fatigue crack growth without adding additional weight or cost.

Application of color mixing for safety and quality inspection of agricultural products

NASA Astrophysics Data System (ADS)

Ding, Fujian; Chen, Yud-Ren; Chao, Kuanglin

2005-11-01

In this paper, color-mixing applications for food safety and quality was studied, including two-color mixing and three-color mixing. It was shown that the chromaticness of the visual signal resulting from two- or three-color mixing is directly related to the band ratio of light intensity at the two or three selected wavebands. An optical visual device using color mixing to implement the band ratio criterion was presented. Inspection through human vision assisted by an optical device that implements the band ratio criterion would offer flexibility and significant cost savings as compared to inspection with a multispectral machine vision system that implements the same criterion. Example applications of this optical color mixing technique were given for the inspection of chicken carcasses with various diseases and for the detection of chilling injury in cucumbers. Simulation results showed that discrimination by chromaticness that has a direct relation with band ratio can work very well with proper selection of the two or three narrow wavebands. This novel color mixing technique for visual inspection can be implemented on visual devices for a variety of applications, ranging from target detection to food safety inspection.

Sitnikov problem in the cyclic kite configuration

NASA Astrophysics Data System (ADS)

Shahbaz Ullah, M.; Bhatnagar, K. B.; Hassan, M. R.

2014-12-01

This manuscript deals with the development of the series solutions of the Sitnikov kite configuration by the methods given of Lindstedt-Poincarė, using Green's function and MacMillan. Next we have developed averaged equation of motion by applying the Van der Pol transformation and averaging technique of Guckenheimer and Holmes (Nonlinear oscillations, dynamical system bifurcations of vector fields. Springer, Berlin, 1983). In addition to the resonance criterion at the 3/2 commensurability we have chosen ω=2 n/3, n=2, ω is the angular velocity of the coordinate system. Lastly the periodicity of the solutions has been examined by the Poincarė section.

Optimal firing rate estimation

NASA Technical Reports Server (NTRS)

Paulin, M. G.; Hoffman, L. F.

2001-01-01

We define a measure for evaluating the quality of a predictive model of the behavior of a spiking neuron. This measure, information gain per spike (Is), indicates how much more information is provided by the model than if the prediction were made by specifying the neuron's average firing rate over the same time period. We apply a maximum Is criterion to optimize the performance of Gaussian smoothing filters for estimating neural firing rates. With data from bullfrog vestibular semicircular canal neurons and data from simulated integrate-and-fire neurons, the optimal bandwidth for firing rate estimation is typically similar to the average firing rate. Precise timing and average rate models are limiting cases that perform poorly. We estimate that bullfrog semicircular canal sensory neurons transmit in the order of 1 bit of stimulus-related information per spike.

Predicting sun protection behaviors using protection motivation variables.

PubMed

Ch'ng, Joanne W M; Glendon, A Ian

2014-04-01

Protection motivation theory components were used to predict sun protection behaviors (SPBs) using four outcome measures: typical reported behaviors, previous reported behaviors, current sunscreen use as determined by interview, and current observed behaviors (clothing worn) to control for common method bias. Sampled from two SE Queensland public beaches during summer, 199 participants aged 18-29 years completed a questionnaire measuring perceived severity, perceived vulnerability, response efficacy, response costs, and protection motivation (PM). Personal perceived risk (similar to threat appraisal) and response likelihood (similar to coping appraisal) were derived from their respective PM components. Protection motivation predicted all four SPB criterion variables. Personal perceived risk and response likelihood predicted protection motivation. Protection motivation completely mediated the effect of response likelihood on all four criterion variables. Alternative models are considered. Strengths and limitations of the study are outlined and suggestions made for future research.

Accounting for the relationship between per diem cost and LOS when estimating hospitalization costs.

PubMed

Ishak, K Jack; Stolar, Marilyn; Hu, Ming-yi; Alvarez, Piedad; Wang, Yamei; Getsios, Denis; Williams, Gregory C

2012-12-01

Hospitalization costs in clinical trials are typically derived by multiplying the length of stay (LOS) by an average per-diem (PD) cost from external sources. This assumes that PD costs are independent of LOS. Resource utilization in early days of the stay is usually more intense, however, and thus, the PD cost for a short hospitalization may be higher than for longer stays. The shape of this relationship is unlikely to be linear, as PD costs would be expected to gradually plateau. This paper describes how to model the relationship between PD cost and LOS using flexible statistical modelling techniques. An example based on a clinical study of clevidipine for the treatment of peri-operative hypertension during hospitalizations for cardiac surgery is used to illustrate how inferences about cost-savings associated with good blood pressure (BP) control during the stay can be affected by the approach used to derive hospitalization costs.Data on the cost and LOS of hospitalizations for coronary artery bypass grafting (CABG) from the Massachusetts Acute Hospital Case Mix Database (the MA Case Mix Database) were analyzed to link LOS to PD cost, factoring in complications that may have occurred during the hospitalization or post-discharge. The shape of the relationship between LOS and PD costs in the MA Case Mix was explored graphically in a regression framework. A series of statistical models including those based on simple logarithmic transformation of LOS to more flexible models using LOcally wEighted Scatterplot Smoothing (LOESS) techniques were considered. A final model was selected, using simplicity and parsimony as guiding principles in addition traditional fit statistics (like Akaike's Information Criterion, or AIC). This mapping was applied in ECLIPSE to predict an LOS-specific PD cost, and then a total cost of hospitalization. These were then compared for patients who had good vs. poor peri-operative blood-pressure control. The MA Case Mix dataset included data from over 10,000 patients. Visual inspection of PD vs. LOS revealed a non-linear relationship. A logarithmic model and a series of LOESS and piecewise-linear models with varying connection points were tested. The logarithmic model was ultimately favoured for its fit and simplicity. Using this mapping in the ECLIPSE trials, we found that good peri-operative BP control was associated with a cost savings of $5,366 when costs were derived using the mapping, compared with savings of $7,666 obtained using the traditional approach of calculating the cost. PD costs vary systematically with LOS, with short stays being associated with high PD costs that drop gradually and level off. The shape of the relationship may differ in other settings. It is important to assess this and model the observed pattern, as this may have an impact on conclusions based on derived hospitalization costs.

Accounting for the relationship between per diem cost and LOS when estimating hospitalization costs

PubMed Central

2012-01-01

Background Hospitalization costs in clinical trials are typically derived by multiplying the length of stay (LOS) by an average per-diem (PD) cost from external sources. This assumes that PD costs are independent of LOS. Resource utilization in early days of the stay is usually more intense, however, and thus, the PD cost for a short hospitalization may be higher than for longer stays. The shape of this relationship is unlikely to be linear, as PD costs would be expected to gradually plateau. This paper describes how to model the relationship between PD cost and LOS using flexible statistical modelling techniques. Methods An example based on a clinical study of clevidipine for the treatment of peri-operative hypertension during hospitalizations for cardiac surgery is used to illustrate how inferences about cost-savings associated with good blood pressure (BP) control during the stay can be affected by the approach used to derive hospitalization costs. Data on the cost and LOS of hospitalizations for coronary artery bypass grafting (CABG) from the Massachusetts Acute Hospital Case Mix Database (the MA Case Mix Database) were analyzed to link LOS to PD cost, factoring in complications that may have occurred during the hospitalization or post-discharge. The shape of the relationship between LOS and PD costs in the MA Case Mix was explored graphically in a regression framework. A series of statistical models including those based on simple logarithmic transformation of LOS to more flexible models using LOcally wEighted Scatterplot Smoothing (LOESS) techniques were considered. A final model was selected, using simplicity and parsimony as guiding principles in addition traditional fit statistics (like Akaike’s Information Criterion, or AIC). This mapping was applied in ECLIPSE to predict an LOS-specific PD cost, and then a total cost of hospitalization. These were then compared for patients who had good vs. poor peri-operative blood-pressure control. Results The MA Case Mix dataset included data from over 10,000 patients. Visual inspection of PD vs. LOS revealed a non-linear relationship. A logarithmic model and a series of LOESS and piecewise-linear models with varying connection points were tested. The logarithmic model was ultimately favoured for its fit and simplicity. Using this mapping in the ECLIPSE trials, we found that good peri-operative BP control was associated with a cost savings of $5,366 when costs were derived using the mapping, compared with savings of $7,666 obtained using the traditional approach of calculating the cost. Conclusions PD costs vary systematically with LOS, with short stays being associated with high PD costs that drop gradually and level off. The shape of the relationship may differ in other settings. It is important to assess this and model the observed pattern, as this may have an impact on conclusions based on derived hospitalization costs. PMID:23198908

Validation of dynamic contrast-enhanced ultrasound in predicting outcomes of antiangiogenic therapy for solid tumors: the French multicenter support for innovative and expensive techniques study.

PubMed

Lassau, Nathalie; Bonastre, Julia; Kind, Michèle; Vilgrain, Valérie; Lacroix, Joëlle; Cuinet, Marie; Taieb, Sophie; Aziza, Richard; Sarran, Antony; Labbe-Devilliers, Catherine; Gallix, Benoit; Lucidarme, Olivier; Ptak, Yvette; Rocher, Laurence; Caquot, Louis-Michel; Chagnon, Sophie; Marion, Denis; Luciani, Alain; Feutray, Sylvaine; Uzan-Augui, Joëlle; Coiffier, Benedicte; Benastou, Baya; Koscielny, Serge

2014-12-01

Dynamic contrast-enhanced ultrasound (DCE-US) has been used in single-center studies to evaluate tumor response to antiangiogenic treatments: the change of area under the perfusion curve (AUC), a criterion linked to blood volume, was consistently correlated with the Response Evaluation Criteria in Solid Tumors response. The main objective here was to do a multicentric validation of the use of DCE-US to evaluate tumor response in different solid tumor types treated by several antiangiogenic agents. A secondary objective was to evaluate the costs of the procedure. This prospective study included patients from 2007 to 2010 in 19 centers (8 teaching hospitals and 11 comprehensive cancer centers). All patients treated with antiangiogenic therapy were eligible. Dynamic contrast-enhanced ultrasound examinations were performed at baseline as well as on days 7, 15, 30, and 60. For each examination, a perfusion curve was recorded during 3 minutes after injection of a contrast agent. Change from baseline at each time point was estimated for each of 7 fitted criteria. The main end point was freedom from progression (FFP). Criterion/time-point combinations with the strongest correlation with FFP were analyzed further to estimate an optimal cutoff point. A total of 1968 DCE-US examinations in 539 patients were analyzed. The median follow-up was 1.65 years. Variations from baseline were significant at day 30 for several criteria, with AUC having the most significant association with FFP (P = 0.00002). Patients with a greater than 40% decrease in AUC at day 30 had better FFP (P = 0.005) and overall survival (P = 0.05). The mean cost of each DCE-US was 180&OV0556;, which corresponds to $250 using the current exchange rate. Dynamic contrast-enhanced ultrasound is a new functional imaging technique that provides a validated criterion, namely, the change of AUC from baseline to day 30, which is predictive of tumor progression in a large multicenter cohort. Because of its low cost, it should be considered in the routine evaluation of solid tumors treated with antiangiogenic therapy.

The complications of trauma and their associated costs in a level I trauma center.

PubMed

O'Keefe, G E; Maier, R V; Diehr, P; Grossman, D; Jurkovich, G J; Conrad, D

1997-08-01

To estimate the expected costs for acute trauma care, to quantify the costs associated with the development of complications in injury victims, and to determine the deficit incurred by patients in whom complications develop. A retrospective, cohort design. A referral trauma center. A total of 12,088 patients admitted to a single regional trauma center during a period of 5 years. This is an observational study, and no interventions specific to this study are included in the design. (1) The expected costs for injury victims based on readily available clinical data. (2) The costs associated with the most important complications of trauma. (3) The effect of complications on inadequate reimbursement for trauma care. The expected costs were estimated using a linear model incorporating demographic variables and measures of injury severity. The expected costs averaged $14,567, and the observed costs averaged $15,032. Six complications were important predictors of cost. These included adult respiratory distress syndrome, acute kidney failure, sepsis, pneumonia, decubitus ulceration, and wound infections. For 1201 individuals with these complications, the predicted costs averaged $23,266 and the observed costs averaged $47,457. The mean excess costs for a single complication ranged from $6669 to $18,052. Multiple complications led to greater increases in excess cost, averaging $110,007 for the 62 patients with 3 or more complications. Costs exceeded reimbursement to a much greater degree in those in whom any of the 6 complications developed. Expected hospital costs can be estimated using admission clinical data. Each of 6 complications was associated with enormous increases in costs, indicating their importance as a cause of avoidable expenditures in injury victims and identifying situations in which reimbursement may not be adequate.

Orthognathic cases: what are the surgical costs?

PubMed

Kumar, Sanjay; Williams, Alison C; Ireland, Anthony J; Sandy, Jonathan R

2008-02-01

This multicentre, retrospective, study assessed the cost, and factors influencing the cost, of combined orthodontic and surgical treatment for dentofacial deformity. The sample, from a single region in England, comprised 352 subjects treated in 11 hospital orthodontic units who underwent orthognathic surgery between 1 January 1995 and 31 March 2000. Statistical analysis of the data was undertaken using non-parametric tests (Spearman and Wilcoxon signed rank). The average total treatment cost for the tax year from 6 April 2000 to 5 April 2001 was euro6360.19, with costs ranging from euro3835.90 to euro12 150.55. The average operating theatre cost was euro2189.54 and the average inpatient care (including the cost of the intensive care unit and ward stay) was euro1455.20. Joint clinic costs comprised, on average, 10 per cent of the total cost, whereas appointments in other specialities, apart from orthodontics, comprised 2 per cent of the total costs. Differences in the observed costings between the units were unexplained but may reflect surgical difficulties, differences in clinical practice, or efficiency of patient care. These indicators need to be considered in future outcome studies for orthognathic patients.

Combining Risk Analysis and Slicing for Test Reduction in Open Architecture

DTIC Science & Technology

2014-04-30

collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources...full-system testing, whose purpose is to check that all the parts work harmoniously together. This part of the effort cannot be reduced unless it is...that eliminates program statements irrelevant to a given slicing criterion. Slicing algorithms detect and follow dependencies of the kinds described

Mesoscale Modeling of Dynamic Compression of Boron Carbide Polycrystals

DTIC Science & Technology

2013-05-01

reported later. Recrystallization has not been reported in the literature and is precluded by the model, meaning : 0 →1 is irreversible. Following...average HEL, above which a measurable strength loss is evident (Vogler et al., 2004), though amorphization has not been definitively proven to cause... definition (A.7) is exact when ı2 E→ 0 (Clayton, 2012). This criterion agrees exactly with that for classical stability under hydrostatic loading

Model weights and the foundations of multimodel inference

USGS Publications Warehouse

Link, W.A.; Barker, R.J.

2006-01-01

Statistical thinking in wildlife biology and ecology has been profoundly influenced by the introduction of AIC (Akaike?s information criterion) as a tool for model selection and as a basis for model averaging. In this paper, we advocate the Bayesian paradigm as a broader framework for multimodel inference, one in which model averaging and model selection are naturally linked, and in which the performance of AIC-based tools is naturally evaluated. Prior model weights implicitly associated with the use of AIC are seen to highly favor complex models: in some cases, all but the most highly parameterized models in the model set are virtually ignored a priori. We suggest the usefulness of the weighted BIC (Bayesian information criterion) as a computationally simple alternative to AIC, based on explicit selection of prior model probabilities rather than acceptance of default priors associated with AIC. We note, however, that both procedures are only approximate to the use of exact Bayes factors. We discuss and illustrate technical difficulties associated with Bayes factors, and suggest approaches to avoiding these difficulties in the context of model selection for a logistic regression. Our example highlights the predisposition of AIC weighting to favor complex models and suggests a need for caution in using the BIC for computing approximate posterior model weights.

Variations in county-level costs between traditional medicare and medicare advantage have implications for premium support.

PubMed

Biles, Brian; Casillas, Giselle; Guterman, Stuart

2015-01-01

Concern about the future growth of Medicare spending has led some in Congress and elsewhere to promote converting Medicare to a "premium support" system. Under premium support, Medicare would provide a "defined contribution" to each Medicare beneficiary to purchase either a Medicare Advantage (MA)-type private health plan or the traditional Medicare public plan. To better understand the implications of such a shift, we compared the average costs per beneficiary of providing Medicare benefits at the county level for traditional Medicare and four types of MA plans. We found that the relative costs of Medicare Advantage and traditional Medicare varied greatly by MA plan type and by geographic location. The costs of health maintenance organization-type plans averaged 7 percent less than those of traditional Medicare, but the costs of the more loosely structured preferred provider organization and private fee-for-service plans averaged 12-18 percent more than those of traditional Medicare. In some counties MA plan costs averaged 28 percent less than costs in traditional Medicare, while in other counties MA plan costs averaged 26 percent more than traditional Medicare costs. Enactment of a Medicare premium-support proposal could trigger cost increases for beneficiaries participating in Medicare Advantage as well as those in traditional Medicare. Project HOPE—The People-to-People Health Foundation, Inc.

Regularised extreme learning machine with misclassification cost and rejection cost for gene expression data classification.

PubMed

Lu, Huijuan; Wei, Shasha; Zhou, Zili; Miao, Yanzi; Lu, Yi

2015-01-01

The main purpose of traditional classification algorithms on bioinformatics application is to acquire better classification accuracy. However, these algorithms cannot meet the requirement that minimises the average misclassification cost. In this paper, a new algorithm of cost-sensitive regularised extreme learning machine (CS-RELM) was proposed by using probability estimation and misclassification cost to reconstruct the classification results. By improving the classification accuracy of a group of small sample which higher misclassification cost, the new CS-RELM can minimise the classification cost. The 'rejection cost' was integrated into CS-RELM algorithm to further reduce the average misclassification cost. By using Colon Tumour dataset and SRBCT (Small Round Blue Cells Tumour) dataset, CS-RELM was compared with other cost-sensitive algorithms such as extreme learning machine (ELM), cost-sensitive extreme learning machine, regularised extreme learning machine, cost-sensitive support vector machine (SVM). The results of experiments show that CS-RELM with embedded rejection cost could reduce the average cost of misclassification and made more credible classification decision than others.

Lifetime cost of stroke subtypes in Australia: findings from the North East Melbourne Stroke Incidence Study (NEMESIS).

PubMed

Dewey, Helen M; Thrift, Amanda G; Mihalopoulos, Cathy; Carter, Robert; Macdonell, Richard A L; McNeil, John J; Donnan, Geoffrey A

2003-10-01

Little is known about any variations in resource use and costs of care between stroke subtypes, especially nonhospital costs. The purpose of this study was to describe the patterns of resource use and to estimate the first-year and lifetime costs for stroke subtypes. A cost-of-illness model was used to estimate the total first-year costs and lifetime costs of stroke subtypes for all strokes (subarachnoid hemorrhages excluded) that occurred in Australia during 1997. For each subtype, average cost per case during the first year and the present value of average cost per case over a lifetime were calculated. Resource use data obtained in the North East Melbourne Stroke Incidence Study (NEMESIS) were used. The present value of total lifetime costs for all strokes was Aus 1.3 billion dollars (US 985 million dollars). Total lifetime costs were greatest for ischemic stroke (72%; Aus 936.8 million dollars; US 709.7 million dollars), followed by intracerebral hemorrhage (26%; Aus 334.5 million dollars; US 253.4 million dollars) and unclassified stroke (2%; Aus 30 million dollars; US 22.7 million dollars). The average cost per case during the first year was greatest for total anterior circulation infarction (Aus 28 266 dollars). Over a lifetime, the present value of average costs was greatest for intracerebral hemorrhage (Aus 73 542 dollars), followed by total anterior circulation infarction (Aus 53 020 dollars), partial anterior circulation infarction (Aus 50 692 dollars), posterior circulation infarction (Aus 37 270 dollars), lacunar infarction (Aus 34 470 dollars), and unclassified stroke (Aus 12 031 dollars). First-year and lifetime costs vary considerably between stroke subtypes. Variation in average length of total hospital stay is the main explanation for differences in first-year costs.

The Inclusion of In-Plane Stresses in Delamination Criteria

NASA Technical Reports Server (NTRS)

Fenske, Matthew T.

1999-01-01

A study of delamination failure was conducted with emphasis on delamination criteria. Evidence is presented which supports the inclusion of the in-plane stresses in addition to the interlaminar stress terms in delamination criteria. The delamination is characterized as the failure of a resin rich region in between ply sets. The entire six component stress state in this resin layer is calculated through a finite element analysis, averaged over a dimension of 1.75 ply thicknesses, and used in a Modified von Mises Delamination Criterion. This criterion builds onto previous criteria by including all six stress components in the interply resin layer. The MVMDC shows good correlation to experimental data. The results show that the treatment of delamination as the failure of a finite interply resin layer is a valid method and that the MVMDC, considering the full stress state, accurately indicates delamination for different laminate families.

Dynamic injury tolerances for long bones of the female upper extremity

PubMed Central

DUMA, STEFAN M.; SCHREIBER, PHIL H.; McMASTER, JOHN D.; CRANDALL, JEFF R.; BASS, CAMERON R.; PILKEY, WALTER D.

1999-01-01

This paper presents the dynamic injury tolerances for the female humerus and forearm derived from dynamic 3-point bending tests using 22 female cadaver upper extremities. Twelve female humeri were tested at an average strain rate of 3.7±1.3%/s. The strain rates were chosen to be representative of those observed during upper extremity interaction with frontal and side airbags. The average moment to failure when mass scaled for the 5th centile female was 128±19 Nm. Using data from the in situ strain gauges during the drop tests and geometric properties obtained from pretest CT scans, an average dynamic elastic modulus for the female humerus was found to be 24.4±3.9 GPa. The injury tolerance for the forearm was determined from 10 female forearms tested at an average strain rate of 3.94±2.0%/s. Using 3 matched forearm pairs, it was determined that the forearm is 21% stronger in the supinated position (92±5 Nm) versus the pronated position (75±7 Nm). Two distinct fracture patterns were seen for the pronated and supinated groups. In the supinated position the average difference in fracture time between the radius and ulna was a negligible 0.4±0.3 ms. However, the pronated tests yielded an average difference in fracture time of 3.6±1.2 ms, with the ulna breaking before the radius in every test. This trend implies that in the pronated position, the ulna and radius are loaded independently, while in the supinated position the ulna and radius are loaded together as a combined structure. To produce a conservative injury criterion, a total of 7 female forearms were tested in the pronated position, which resulted in the forearm injury criterion of 58±12 Nm when scaled for the 5th centile female. It is anticipated that these data will provide injury reference values for the female forearm during driver air bag loading, and the female humerus during side air bag loading. PMID:10386782

Trends in health care resource utilization and pharmacological management of COPD in Taiwan from 2004 to 2010.

PubMed

Tsai, Ying-Huang; Yang, Tsung-Ming; Lin, Chieh-Mo; Huang, Shu-Yi; Wen, Yu-Wen

2017-01-01

COPD has attracted widespread attention worldwide. The prevalence of COPD in Taiwan has been reported, but little is known about trends in health care resource utilization and pharmacologic management in COPD treatment. The objective of this article was to study trends in health care resource utilization, pharmacologic management, and medical costs of COPD treatment in Taiwan. Reimbursement claims in the Taiwan National Health Insurance System from 2004 to 2010 were collected. The disease burden of COPD, including health care resource utilization and medical costs, was evaluated. The pharmacy cost of COPD increased from 2004 to 2010 due to the increased utilization of long-acting muscarinic antagonist (LAMA) and fixed-dose combination of long-acting β2-agonist and inhaled corticosteroid (LABA/ICS), whereas the cost of all other COPD-related medications decreased. The average outpatient department (OPD) cost per patient increased 29.3% from 1,070 USD in 2004 to 1,383 USD in 2010. The highest average total medical cost per patient was 3,434 USD in 2005, and it decreased 12.4% to 3,008 USD in 2010. There was no significant difference in the average number of OPD visits and emergency department visits per patient. The highest average number of hospital admissions was 0.81 in 2005, and it decreased to 0.65 in 2010. The average number of intensive care unit (ICU) admissions decreased from 0.52 in 2005 to 0.31 in 2010. From 2004 to 2010, the average total medical cost per patient of COPD was slightly decreased because of the decreased average number of hospital admissions and ICU admissions. The costs of both LAMA and LABA/ICS increased, while the cost for all other COPD-related medications decreased. These findings suggest that the increased utilization of LAMA and LABA/ICS may have contributed to the decreased average number of hospital admissions and ICU admissions in COPD patients from 2004 to 2010.

Management of leg and pressure ulcer in hospitalized patients: direct costs are lower than expected.

PubMed

Assadian, Ojan; Oswald, Joseph S; Leisten, Rainer; Hinz, Peter; Daeschlein, Georg; Kramer, Axel

2011-01-01

In Germany, cost calculations on the financial burden of wound treatment are scarce. Studies for attributable costs in hospitalized patients estimate for pressure ulcer additional costs of € 6,135.50 per patient, a calculation based on the assumption that pressure ulcers will lead to prolonged hospitalization averaging 2 months. The scant data available in this field prompted us to conduct a prospective economical study assessing the direct costs of treatment of chronic ulcers in hospitalized patients. The study was designed and conducted as an observational, prospective, multi-centre economical study over a period of 8 months in three community hospitals in Germany. Direct treatment costs for leg ulcer (n=77) and pressure ulcer (n=35) were determined observing 67 patients (average age: 75±12 years). 109 treatments representing 111 in-ward admissions and 62 outpatient visits were observed. During a total of 3,331 hospitalized and 867 outpatient wound therapies, 4,198 wound dressing changes were documented. Costs of material were calculated on a per item base. Direct costs of care and treatment, including materials used, surgical interventions, and personnel costs were determined. An average of € 1,342 per patient (€ 48/d) was spent for treatment of leg ulcer (staff costs € 581, consumables € 458, surgical procedures € 189, and diagnostic procedures € 114). On average, each wound dressing change caused additional costs of € 15. For pressure ulcer, € 991 per patient (€ 52/d) was spent on average (staff costs € 313, consumables € 618, and for surgical procedures € 60). Each wound dressing change resulted in additional costs of € 20 on average. When direct costs of chronic wounds are calculated on a prospective case-by-case basis for a treatment period over 3 months, these costs are lower than estimated to date. While reduction in prevalence of chronic wounds along with optimised patient care will result in substantial cost saving, this saving might be lower than expected. Our results, however, do not serve as basis for making any conclusions on cost-benefit analysis for both, the affected individual, as well as for the society.

Market power and state costs of HIV/AIDS drugs.

PubMed

Leibowitz, Arleen A; Sood, Neeraj

2007-03-01

We examine whether U.S. states can use their market power to reduce the costs of supplying prescription drugs to uninsured and underinsured persons with HIV through a public program, the AIDS Drug Assistance Program (ADAP). Among states that purchase drugs from manufacturers and distribute them directly to clients, those that purchase a greater volume pay lower average costs per prescription. Among states depending on retail pharmacies to distribute drugs and then claiming rebates from manufacturers, those that contract with smaller numbers of pharmacy networks have lower average costs. Average costs per prescription do not differ between the two purchase methods.

A cost assessment of reliability requirements for shuttle-recoverable experiments

NASA Technical Reports Server (NTRS)

Campbell, J. W.

1975-01-01

The relaunching of unsuccessful experiments or satellites will become a real option with the advent of the space shuttle. An examination was made of the cost effectiveness of relaxing reliability requirements for experiment hardware by allowing more than one flight of an experiment in the event of its failure. Any desired overall reliability or probability of mission success can be acquired by launching an experiment with less reliability two or more times if necessary. Although this procedure leads to uncertainty in total cost projections, because the number of flights is not known in advance, a considerable cost reduction can sometimes be achieved. In cases where reflight costs are low relative to the experiment's cost, three flights with overall reliability 0.9 can be made for less than half the cost of one flight with a reliability of 0.9. An example typical of shuttle payload cost projections is cited where three low reliability flights would cost less than $50 million and a single high reliability flight would cost over $100 million. The ratio of reflight cost to experiment cost is varied and its effect on the range in total cost is observed. An optimum design reliability selection criterion to minimize expected cost is proposed, and a simple graphical method of determining this reliability is demonstrated.

Trends in Harvest Cost in New Hampshire: 1964 to 1983

Treesearch

Donald F. Dennis; Susan B. Remington; Susan B. Remington

1987-01-01

Timber harvesting costs for New Hampshire from 1964 to 1983 were examined. During this period, real harvesting costs for sawtimber decreased at an average annual rate of 1.2 percent, while stumpage prices increased. Real harvesting costs for pulpwood declined at a 0.8 percent average annual rate. Harvest cost data for fuelwood were available only for 1973 to 1983....

Visual judgements of steadiness in one-legged stance: reliability and validity.

PubMed

Haupstein, T; Goldie, P

2000-01-01

There is a paucity of information about the validity and reliability of clinicians' visual judgements of steadiness in one-legged stance. Such judgements are used frequently in clinical practice to support decisions about treatment in the fields of neurology, sports medicine, paediatrics and orthopaedics. The aim of the present study was to address the validity and reliability of visual judgements of steadiness in one-legged stance in a group of physiotherapists. A videotape of 20 five-second performances was shown to 14 physiotherapists with median clinical experience of 6.75 years. Validity of visual judgement was established by correlating scores obtained from an 11-point rating scale with criterion scores obtained from a force platform. In addition, partial correlations were used to control for the potential influence of body weight on the relationship between the visual judgements and criterion scores. Inter-observer reliability was quantified between the physiotherapists; intra-observer reliability was quantified between two tests four weeks apart. Mean criterion-related validity was high, regardless of whether body weight was controlled for statistically (Pearson's r = 0.84, 0.83, respectively). The standard error of estimating the criterion score was 3.3 newtons. Inter-observer reliability was high (ICC (2,1) = 0.81 at Test 1 and 0.82 at Test 2). Intra-observer reliability was high (on average ICC (2,1) = 0.88; Pearson's r = 0.90). The standard error of measurement for the 11-point scale was one unit. The finding of higher accuracy of making visual judgements than previously reported may be due to several aspects of design: use of a criterion score derived from the variability of the force signal which is more discriminating than variability of centre of pressure; use of a discriminating visual rating scale; specificity and clear definition of the phenomenon to be rated.

Potential economic benefits of adapting agricultural production systems to future climate change

USGS Publications Warehouse

Fagre, Daniel B.; Pederson, Gregory; Bengtson, Lindsey E.; Prato, Tony; Qui, Zeyuan; Williams, Jimmie R.

2010-01-01

Potential economic impacts of future climate change on crop enterprise net returns and annual net farm income (NFI) are evaluated for small and large representative farms in Flathead Valley in Northwest Montana. Crop enterprise net returns and NFI in an historical climate period (1960–2005) and future climate period (2006–2050) are compared when agricultural production systems (APSs) are adapted to future climate change. Climate conditions in the future climate period are based on the A1B, B1, and A2 CO2 emission scenarios from the Intergovernmental Panel on Climate Change Fourth Assessment Report. Steps in the evaluation include: (1) specifying crop enterprises and APSs (i.e., combinations of crop enterprises) in consultation with locals producers; (2) simulating crop yields for two soils, crop prices, crop enterprises costs, and NFIs for APSs; (3) determining the dominant APS in the historical and future climate periods in terms of NFI; and (4) determining whether NFI for the dominant APS in the historical climate period is superior to NFI for the dominant APS in the future climate period. Crop yields are simulated using the Environmental/Policy Integrated Climate (EPIC) model and dominance comparisons for NFI are based on the stochastic efficiency with respect to a function (SERF) criterion. Probability distributions that best fit the EPIC-simulated crop yields are used to simulate 100 values for crop yields for the two soils in the historical and future climate periods. Best-fitting probability distributions for historical inflation-adjusted crop prices and specified triangular probability distributions for crop enterprise costs are used to simulate 100 values for crop prices and crop enterprise costs. Averaged over all crop enterprises, farm sizes, and soil types, simulated net return per ha averaged over all crop enterprises decreased 24% and simulated mean NFI for APSs decreased 57% between the historical and future climate periods. Although adapting APSs to future climate change is advantageous (i.e., NFI with adaptation is superior to NFI without adaptation based on SERF), in six of the nine cases in which adaptation is advantageous, NFI with adaptation in the future climate period is inferior to NFI in the historical climate period. Therefore, adaptation of APSs to future climate change in Flathead Valley is insufficient to offset the adverse impacts on NFI of such change.

Potential economic benefits of adapting agricultural production systems to future climate change.

PubMed

Prato, Tony; Zeyuan, Qiu; Pederson, Gregory; Fagre, Dan; Bengtson, Lindsey E; Williams, Jimmy R

2010-03-01

Potential economic impacts of future climate change on crop enterprise net returns and annual net farm income (NFI) are evaluated for small and large representative farms in Flathead Valley in Northwest Montana. Crop enterprise net returns and NFI in an historical climate period (1960-2005) and future climate period (2006-2050) are compared when agricultural production systems (APSs) are adapted to future climate change. Climate conditions in the future climate period are based on the A1B, B1, and A2 CO(2) emission scenarios from the Intergovernmental Panel on Climate Change Fourth Assessment Report. Steps in the evaluation include: (1) specifying crop enterprises and APSs (i.e., combinations of crop enterprises) in consultation with locals producers; (2) simulating crop yields for two soils, crop prices, crop enterprises costs, and NFIs for APSs; (3) determining the dominant APS in the historical and future climate periods in terms of NFI; and (4) determining whether NFI for the dominant APS in the historical climate period is superior to NFI for the dominant APS in the future climate period. Crop yields are simulated using the Environmental/Policy Integrated Climate (EPIC) model and dominance comparisons for NFI are based on the stochastic efficiency with respect to a function (SERF) criterion. Probability distributions that best fit the EPIC-simulated crop yields are used to simulate 100 values for crop yields for the two soils in the historical and future climate periods. Best-fitting probability distributions for historical inflation-adjusted crop prices and specified triangular probability distributions for crop enterprise costs are used to simulate 100 values for crop prices and crop enterprise costs. Averaged over all crop enterprises, farm sizes, and soil types, simulated net return per ha averaged over all crop enterprises decreased 24% and simulated mean NFI for APSs decreased 57% between the historical and future climate periods. Although adapting APSs to future climate change is advantageous (i.e., NFI with adaptation is superior to NFI without adaptation based on SERF), in six of the nine cases in which adaptation is advantageous, NFI with adaptation in the future climate period is inferior to NFI in the historical climate period. Therefore, adaptation of APSs to future climate change in Flathead Valley is insufficient to offset the adverse impacts on NFI of such change.

Efficient methods for implementation of multi-level nonrigid mass-preserving image registration on GPUs and multi-threaded CPUs.

PubMed

Ellingwood, Nathan D; Yin, Youbing; Smith, Matthew; Lin, Ching-Long

2016-04-01

Faster and more accurate methods for registration of images are important for research involved in conducting population-based studies that utilize medical imaging, as well as improvements for use in clinical applications. We present a novel computation- and memory-efficient multi-level method on graphics processing units (GPU) for performing registration of two computed tomography (CT) volumetric lung images. We developed a computation- and memory-efficient Diffeomorphic Multi-level B-Spline Transform Composite (DMTC) method to implement nonrigid mass-preserving registration of two CT lung images on GPU. The framework consists of a hierarchy of B-Spline control grids of increasing resolution. A similarity criterion known as the sum of squared tissue volume difference (SSTVD) was adopted to preserve lung tissue mass. The use of SSTVD consists of the calculation of the tissue volume, the Jacobian, and their derivatives, which makes its implementation on GPU challenging due to memory constraints. The use of the DMTC method enabled reduced computation and memory storage of variables with minimal communication between GPU and Central Processing Unit (CPU) due to ability to pre-compute values. The method was assessed on six healthy human subjects. Resultant GPU-generated displacement fields were compared against the previously validated CPU counterpart fields, showing good agreement with an average normalized root mean square error (nRMS) of 0.044±0.015. Runtime and performance speedup are compared between single-threaded CPU, multi-threaded CPU, and GPU algorithms. Best performance speedup occurs at the highest resolution in the GPU implementation for the SSTVD cost and cost gradient computations, with a speedup of 112 times that of the single-threaded CPU version and 11 times over the twelve-threaded version when considering average time per iteration using a Nvidia Tesla K20X GPU. The proposed GPU-based DMTC method outperforms its multi-threaded CPU version in terms of runtime. Total registration time reduced runtime to 2.9min on the GPU version, compared to 12.8min on twelve-threaded CPU version and 112.5min on a single-threaded CPU. Furthermore, the GPU implementation discussed in this work can be adapted for use of other cost functions that require calculation of the first derivatives. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The financial cost of hamstring strain injuries in the Australian Football League.

PubMed

Hickey, Jack; Shield, Anthony J; Williams, Morgan D; Opar, David A

2014-04-01

Hamstring strain injuries (HSIs) have remained the most prevalent injury in the Australian Football League (AFL) over the past 21 regular seasons. The effect of HSIs in sports is often expressed as regular season games missed due to injury. However, the financial cost of athletes missing games due to injury has not been investigated. The aim of this report is to estimate the financial cost of games missed due to HSIs in the AFL. Data were collected using publicly available information from the AFL's injury report and the official AFL annual report for the past 10 competitive AFL seasons. Average athlete salary and injury epidemiology data were used to determine the average yearly financial cost of HSIs for AFL clubs and the average financial cost of a single HSI over this time period. Across the observed period, average yearly financial cost of HSIs per club increased by 71% compared with a 43% increase in average yearly athlete salary. Over the same time period the average financial cost of a single HSI increased by 56% from $A25,603 in 2003 to $A40,021 in 2012, despite little change in the HSI rates during the period. The observed increased financial cost of HSIs was ultimately explained by the failure of teams to decrease HSI rates, but coupled with increases in athlete salaries over the past 10 season. The information presented in this report highlights the financial cost of HSIs and other sporting injuries, raising greater awareness and the need for further funding for research into injury prevention strategies to maximise economical return for investment in athletes.

Methodology for reducing energy and resource costs in construction of trenchless crossover of pipelines

NASA Astrophysics Data System (ADS)

Toropov, V. S.

2018-05-01

The paper suggests a set of measures to select the equipment and its components in order to reduce energy costs in the process of pulling the pipeline into the well in the constructing the trenchless pipeline crossings of various materials using horizontal directional drilling technology. A methodology for reducing energy costs has been developed by regulating the operation modes of equipment during the process of pulling the working pipeline into a drilled and pre-expanded well. Since the power of the drilling rig is the most important criterion in the selection of equipment for the construction of a trenchless crossover, an algorithm is proposed for calculating the required capacity of the rig when operating in different modes in the process of pulling the pipeline into the well.

Cost-utility analysis of a telehealth programme for patients with severe chronic obstructive pulmonary disease treated with long-term oxygen therapy.

PubMed

Jódar-Sánchez, Francisco; Ortega, Francisco; Parra, Carlos; Gómez-Suárez, Cristina; Bonachela, Patricia; Leal, Sandra; Pérez, Pablo; Jordán, Ana; Barrot, Emilia

2014-09-01

We conducted a cost-utility analysis of a telehealth programme for patients with severe chronic obstructive pulmonary disease (COPD) compared with usual care. A randomized controlled trial was carried out over four months with 45 patients treated with long-term oxygen therapy, 24 in the telehealth group (TG) and 21 in the control group (CG). The analysis took into account whether the severity of comorbidity (defined as the presence of additional chronic diseases co-occurring with COPD) was associated with differences in costs and/or quality-adjusted life years (QALYs). Results of cost-utility analysis were expressed in terms of the incremental cost-effectiveness ratio (ICER). The average total cost was €2300 for the TG and €1103 for the CG, and the average QALY gain was 0.0059 for the TG and 0.0006 for the CG (resulting an ICER of 223,726 €/QALY). For patients without comorbidity, the average total cost was €855 for the TG and €1354 for the CG, and the average QALY gain was 0.0288 for the TG and 0.0082 for the CG (resulting in the telehealth programme being the dominant strategy). For patients with comorbidity, the average total cost was €2782 for the TG and €949 for the CG, and the average QALY gain was -0.0017 for the TG and -0.0041 for the CG (resulting an ICER of 754,592 €/QALY). The telehealth programme may not have been cost-effective compared to usual care, although it could be considered cost-effective for patients without comorbidity. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Productivity and cost implications of implementing electronic medical records into an ambulatory surgical subspecialty clinic.

PubMed

Patil, Mukul; Puri, Lalit; Gonzalez, Chris M

2008-02-01

Electronic medical records (EMRs) have been proposed as technology through which the quality of healthcare could be improved. We present an analysis of the cost and productivity implications associated with the transition from transcription to an EMR system in an ambulatory setting. Data were collected from eight consecutive fiscal years from 1998 to 2005. Transcription was used in the first 4-year period, and EMR was implemented and used in the later 4-year period. Productivity was defined as ambulatory revenue and the number of patient encounters. All costs related to transcription and EMR implementation were calculated. All data were adjusted for inflation. Within the transcription era, the transcription costs were $395,404, total revenue was $18,137,945, and patient encounters numbered 52,027. The average transcription cost per encounter was $7.60, average revenue per encounter was $348.63, and average revenue per provider was $505,615. Within the EMR era, the EMR-related costs were $293,406, total revenue was $30,370,647 and patient encounters numbered 65,102. The average documentation cost per encounter was $4.51, average revenue per encounter was $466.51, and average revenue per provider was $690,242. The startup costs of initial EMR implementation were $10,329 per physician provider. The results of our study have shown that the implementation of an EMR system when an economy of scale exists coincides with an increase in the revenue per encounter and per provider compared with transcription. The advantage of the fixed costs of an EMR system compared with the variable costs of a transcription-based system is the allowance of cash savings in an ambulatory surgical subspecialty practice.

Measuring the direct costs of graduate medical education training in Minnesota.

PubMed

Blewett, L A; Smith, M A; Caldis, T G

2001-05-01

To demonstrate the usefulness of self-reported cost-accounting data from the sponsors of training programs for estimating the direct costs of graduate medical education (GME). The study also assesses the relative contributions of resident, faculty, and administrative costs to primary care, surgery, and the combined programs of radiology, emergency medicine, anesthesiology, and pathology (REAP). The data were the FY97 direct costs of clinical education reported to Minnesota's Department of Health by eight sponsors of 117 accredited medical education programs, representing 394 sites of training (both hospital- and community-based) and 2,084 full-time-equivalent trainees (both residents and fellows). Average costs of clinical training were calculated as residency, faculty, and administrative costs. Preliminary analysis showed average costs by type of training programs, comparing the cost components for surgery, primary care, and REAP. The average direct cost of clinical training in FY97 was $130,843. Faculty costs were 52%, resident costs were 26%, and administrative costs were 20% of the total. Primary care programs' average costs were lower than were those of either surgery or REAP programs, but proportionally they included more administrative costs. As policymakers assess government subsidies for GME, more detailed cost information will be required. Self-reported data are more cost-effective and efficient than are the more detailed and costly time-and-motion studies. This data-collection study also revealed that faculty costs, driven by faculty hours and base salaries, represent a higher proportion of direct costs of GME than studies have shown in the past.

Maximum number of live births per donor in artificial insemination.

PubMed

Wang, Charlotte; Tsai, Miao-Yu; Lee, Mei-Hsien; Huang, Su-Yun; Kao, Chen-Hung; Ho, Hong-Nerng; Hsiao, Chuhsing Kate

2007-05-01

The maximal number of live births (k) per donor was usually determined by cultural and social perspective. It was rarely decided on the basis of scientific evidence or discussed from mathematical or probabilistic viewpoint. To recommend a value for k, we propose three criteria to evaluate its impact on consanguinity and disease incidence due to artificial insemination by donor (AID). The first approach considers the optimization of k under the criterion of fixed tolerable number of consanguineous mating due to AID. The second approach optimizes k under fixed allowable average coefficient of inbreeding. This approach is particularly helpful when assessing the impact on the public, is of interest. The third criterion considers specific inheritance diseases. This approach is useful when evaluating the individual's risk of genetic diseases. When different diseases are considered, this criterion can be easily adopted. All these derivations are based on the assumption of shortage of gamete donors due to great demand and insufficient supply. Our results indicate that strong degree of assortative mating, small population size and insufficient supply in gamete donors will lead to greater risk of consanguinity. Recommendations under other settings are also tabulated for reference. A web site for calculating the limit for live births per donor is available.

Costs and outcomes associated with IVF using recombinant FSH.

PubMed

Ledger, W; Wiebinga, C; Anderson, P; Irwin, D; Holman, A; Lloyd, A

2009-09-01

Cost and outcome estimates based on clinical trial data may not reflect usual clinical practice, yet they are often used to inform service provision and budget decisions. To expand understanding of assisted reproduction treatment in clinical practice, an economic evaluation of IVF/intracytoplasmic sperm injection (ICSI) data from a single assisted conception unit (ACU) in England was performed. A total of 1418 IVF/ICSI cycles undertaken there between October 2001 and January 2006 in 1001 women were analysed. The overall live birth rate was 22% (95% CI: 19.7-24.2), with the 30- to 34-year age group achieving the highest rate (28%). The average recombinant FSH (rFSH) dose/cycle prescribed was 1855 IU. Average cost of rFSH/cycle was 646 pound(SD: 219 pound), and average total cost/cycle was 2932 pound (SD: 422 pound). Economic data based on clinical trials informing current UK guidance assumes higher doses of rFSH dose/cycle (1750-2625 IU), higher average cost of drugs/cycle (1179 pound), and higher average total cost/cycle (3266 pound). While the outcomes in this study matched UK averages, total cost/cycle was lower than those cited in UK guidelines. Utilizing the protocols and (lower) rFSH dosages reported in this study may enable other ACU to provide a greater number of IVF/ICSI cycles to patients within given budgets.

The Justice of Preventive War

DTIC Science & Technology

2004-09-01

deontological criteria, these criteria are teleological and thereby introduce a utilitarian element to just war thinking. They are also inherently...become the “last resort” has its own costs and risks that should be considered under the teleology of the proportionality criterion, but the last...intention raise in preventive wars are not so much ethical as they are practical. On the other side of the deontological/ teleological divide, the just war

An Evaluation of Economists’ Influence on Electric Utility Rate Reforms,

DTIC Science & Technology

1982-01-01

PURPA ) of 1978 required all 50 state utility commissions and more than 150 other jurisdictions regulating electric utility rates to con- sider the...complex rate structure). The "cost effectiveness" language of PURPA suggests such an evaluation criterion based on long term considerations without...detailing the components of benefit; see Joskow. Individual hearings under PURPA have generally employed three standards: fuel or energy savings (if a TOU

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

PubMed

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

2017-12-01

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

The average cost of pressure ulcer management in a community dwelling spinal cord injury population.

PubMed

Chan, Brian C; Nanwa, Natasha; Mittmann, Nicole; Bryant, Dianne; Coyte, Peter C; Houghton, Pamela E

2013-08-01

Pressure ulcers (PUs) are a common secondary complication experienced by community dwelling individuals with spinal cord injury (SCI). There is a paucity of literature on the health economic impact of PU in SCI population from a societal perspective. The objective of this study was to determine the resource use and costs in 2010 Canadian dollars of a community dwelling SCI individual experiencing a PU from a societal perspective. A non-comparative cost analysis was conducted on a cohort of community dwelling SCI individuals from Ontario, Canada. Medical resource use was recorded over the study period. Unit costs associated with these resources were collected from publicly available sources and published literature. Average monthly cost was calculated based on 7-month follow-up. Costs were stratified by age, PU history, severity level, location of SCI, duration of current PU and PU surface area. Sensitivity analyses were also carried out. Among the 12 study participants, total average monthly cost per community dwelling SCI individual with a PU was $4745. Hospital admission costs represented the greatest percentage of the total cost (62%). Sensitivity analysis showed that the total average monthly costs were most sensitive to variations in hospitalisation costs. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Costs of polio immunization days in China: implications for mass immunization campaign strategies.

PubMed

Zhang, J; Yu, J J; Zhang, R Z; Zhang, X L; Zhou, J; Wing, J S; Schnur, A; Wang, K A

1998-01-01

Ten provinces of China were selected to estimate the cost per immunization of the 1994-95 national immunization days (NIDs) at five levels (e.g. province, prefecture, county, township and village). Personnel costs accounted for the largest overall share of costs (39 per cent), followed by publicity and promotion costs (27 per cent), and logistic costs (15 per cent). Without consideration of vaccine costs, the major part of NID expenses were shouldered at the township level, which paid for 47 per cent of all incremental costs, while county and village level covered 28 per cent and 18 per cent respectively. Estimation of average costs per immunization was 2.86 RMB yuan, or $0.34, including vaccine costs, buildings and equipment amortization and salaries at all levels. The factors affecting average cost of NID included the output volume, socio-economic development and geographic features. Various approaches were recommended: to intensify the productivity of time and staff, to employ alternative inexpensive manpower resources, to make the best use of publicity and social promotion, the expansion of the age groups and utilization of multi-intervention strategies. Good planning at township level was a decisive factor to ensure an effective NID conducted in an efficient manner. The average cost of China's NID was the lowest among all mass immunization campaigns ever documented. Much of the reduced average cost was attributable to economies of scale.

Criteria for determining a basic health services package. Recent developments in The Netherlands.

PubMed

Stolk, E A; Poley, M J

2005-03-01

The criterion of medical need figures prominently in the Dutch model for reimbursement decisions as well as in many international models for health care priority setting. Nevertheless the conception of need remains too vague and general to be applied successfully in priority decisions. This contribution explores what is wrong with the proposed definitions of medical need and identifies features in the decision-making process that inhibit implementation and usefulness of this criterion. In contrast to what is commonly assumed, the problem is not so much a failure to understand the nature of the medical need criterion and the value judgments involved. Instead the problem seems to be a mismatch between the information regarding medical need and the way in which these concerns are incorporated into policy models. Criteria--medical need, as well as other criteria such as effectiveness and cost-effectiveness--are usually perceived as "hurdles," and each intervention can pass or fail assessment on the basis of each criterion and therefore be included or excluded from public funding. These models fail to understand that choices are not so much between effective and ineffective treatments, or necessary and unnecessary ones. Rather, choices are often between interventions that are somewhat effective and/or needed. Evaluation of such services requires a holistic approach and not a sequence of fail or pass judgments. To improve applicability of criteria that pertain to medical need we therefore suggest further development of these criteria beyond their original binary meaning and propose meaningful ways in which these criteria can be integrated into policy decisions.

Evaluation of the NASA Ames no. 1 7 by 10 foot wind tunnel as an acoustic test facility

NASA Technical Reports Server (NTRS)

Wilby, J. F.; Scharton, T. D.

1975-01-01

Measurements were made in the no. 1 7'x10' wind tunnel at NASA Ames Research Center, with the objectives of defining the acoustic characteristics and recommending minimum cost treatments so that the tunnel can be converted into an acoustic research facility. The results indicate that the noise levels in the test section are due to (a) noise generation in the test section, associated with the presence of solid bodies such as the pitot tube, and (b) propagation of acoustic energy from the fan. A criterion for noise levels in the test section is recommended, based on low-noise microphone support systems. Noise control methods required to meet the criterion include removal of hardware items for the test section and diffuser, improved design of microphone supports, and installation of acoustic treatment in the settling chamber and diffuser.

GPS baseline configuration design based on robustness analysis

NASA Astrophysics Data System (ADS)

Yetkin, M.; Berber, M.

2012-11-01

The robustness analysis results obtained from a Global Positioning System (GPS) network are dramatically influenced by the configurationof the observed baselines. The selection of optimal GPS baselines may allow for a cost effective survey campaign and a sufficiently robustnetwork. Furthermore, using the approach described in this paper, the required number of sessions, the baselines to be observed, and thesignificance levels for statistical testing and robustness analysis can be determined even before the GPS campaign starts. In this study, wepropose a robustness criterion for the optimal design of geodetic networks, and present a very simple and efficient algorithm based on thiscriterion for the selection of optimal GPS baselines. We also show the relationship between the number of sessions and the non-centralityparameter. Finally, a numerical example is given to verify the efficacy of the proposed approach.

Entanglement-enhanced Neyman-Pearson target detection using quantum illumination

NASA Astrophysics Data System (ADS)

Zhuang, Quntao; Zhang, Zheshen; Shapiro, Jeffrey H.

2017-08-01

Quantum illumination (QI) provides entanglement-based target detection---in an entanglement-breaking environment---whose performance is significantly better than that of optimum classical-illumination target detection. QI's performance advantage was established in a Bayesian setting with the target presumed equally likely to be absent or present and error probability employed as the performance metric. Radar theory, however, eschews that Bayesian approach, preferring the Neyman-Pearson performance criterion to avoid the difficulties of accurately assigning prior probabilities to target absence and presence and appropriate costs to false-alarm and miss errors. We have recently reported an architecture---based on sum-frequency generation (SFG) and feedforward (FF) processing---for minimum error-probability QI target detection with arbitrary prior probabilities for target absence and presence. In this paper, we use our results for FF-SFG reception to determine the receiver operating characteristic---detection probability versus false-alarm probability---for optimum QI target detection under the Neyman-Pearson criterion.

Average cost per person victimized by an intimate partner of the opposite gender: a comparison of men and women.

PubMed

Arias, Ileana; Corso, Phaedra

2005-08-01

Differences in prevalence, injury, and utilization of services between female and male victims of intimate partner violence (IPV) have been noted. However, there are no studies indicating approximate costs of men's IPV victimization. This study explored gender differences in service utilization for physical IPV injuries and average cost per person victimized by an intimate partner of the opposite gender. Significantly more women than men reported physical IPV victimization and related injuries. A greater proportion of women than men reported seeking mental health services and reported more visits on average in response to physical IPV victimization. Women were more likely than men to report using emergency department, inpatient hospital, and physician services, and were more likely than men to take time off from work and from childcare or household duties because of their injuries. The total average per person cost for women experiencing at least one physical IPV victimization was more than twice the average per person cost for men.

The accuracy of the SenseWear Pro3 and the activPAL3 Micro devices for measurement of energy expenditure.

PubMed

Powell, Cormac; Carson, Brian P; Dowd, Kieran P; Donnelly, Alan E

2016-09-21

Activity monitors such as the SenseWear Pro3 (SWP3) and the activPAL3 Micro (aP 3 M) are regularly used by researchers and practitioners to provide estimates of the metabolic cost (METs) of activities in free-living settings. The purpose of this study is to examine the accuracy of the MET predictions from the SWP3 and the aP 3 M compared to the criterion standard MET values from indirect calorimetry. Fifty-six participants (mean age: 39.9 (±11.5), 25M/31F) performed eight activities (four daily living, three ambulatory and one cycling), while simultaneously wearing a SWP3, aP 3 M and the Cosmed K4B 2 (K4B 2 ) mobile metabolic unit. Paired samples T-tests were used to examine differences between device predicted METs and criterion METs. Bland-Altman plots were constructed to examine the mean bias and limits of agreement for predicted METs compared to criterion METs. SWP3 predicted MET values were significantly different from the K4B 2 for each activity (p  ⩽  0.004), excluding sweeping (p  =  0.122). aP 3 M predicted MET values were significantly different (p  <  0.001) from the K4B 2 for each activity. When examining the activities collectively, both devices underestimated activity intensity (0.20 METs (SWP3), 0.95 METs (aP 3 M)). The greatest mean bias for the SWP3 was for cycling (-3.25 METs), with jogging (-5.16 METs) producing the greatest mean bias for the aP 3 M. All of the activities (excluding SWP3 sweeping) were significantly different from the criterion measure. Although the SWP3 predicted METs are more accurate than their aP 3 M equivalent, the predicted MET values from both devices are significantly different from the criterion measure for the majority of activities.

Latin American Clinical Epidemiology Network Series - Paper 6: The influence of alcohol in traffic accidents and health care costs of it in Bogotá-Colombia.

PubMed

Gómez-Restrepo, Carlos; Naranjo-Lujan, Salomé; Rondón, Martín; Acosta, Andrés; Maldonado, Patricia; Arango Villegas, Carlos; Hurtado, Jaime; Hernández, Juan Carlos; Angarita, María Del Pilar; Peña, Marcela; Saavedra, Miguel Ángel; Quitian, Hoover

2017-06-01

In Colombia, some studies have estimated medical costs associated to traffic accidents. It is required to assess results by city or region and determine the influence of variables such as alcohol consumption. The main objective of this study was to identify health care costs associated to traffic accidents in Bogota and determine whether alcohol consumption can increase them. Cross-sectional costs study conducted in patients over 18 years treated in the emergency rooms of six different hospitals in Bogota, Colombia. The average total cost of medical care per patient was 628 USD, in Bogota-Colombia. The average cost per accident was estimated at 1,349 USD. On average, the total cost for health care for patients with positive blood alcohol level was 1.8 times higher than those who did not consume alcohol. The indirect costs were on average 115.3 USD per injured person. Numbers are expressed in 2011 U.S. dollars. Alcohol consumption increases the risk of traffic accidents and direct medical health costs. Copyright © 2016 Elsevier Inc. All rights reserved.

Total energy expenditure estimated using foot-ground contact pedometry.

PubMed

Hoyt, Reed W; Buller, Mark J; Santee, William R; Yokota, Miyo; Weyand, Peter G; Delany, James P

2004-02-01

Routine walking and running, by increasing daily total energy expenditure (TEE), can play a significant role in reducing the likelihood of obesity. The objective of this field study was to compare TEE estimated using foot-ground contact time (Tc)-pedometry (TEE(PEDO)) with that measured by the criterion doubly labeled water (DLW) method. Eight male U.S. Marine test volunteers [27 +/- 4 years of age (mean +/- SD); weight = 83.2 +/- 10.7 kg; height = 182.2 +/- 4.5 cm; body fat = 17.0 +/- 2.9%] engaged in a field training exercise were studied over 2 days. TEE(PEDO) was defined as (calculated resting energy expenditure + estimated thermic effect of food + metabolic cost of physical activity), where physical activity was estimated by Tc-pedometry. Tc-pedometry was used to differentiate inactivity, activity other than exercise (i.e., non-exercise activity thermogenesis, or NEAT), and the metabolic cost of locomotion (M(LOCO)), where M(LOCO) was derived from total weight (body weight + load weight) and accelerometric measurements of Tc. TEE(PEDO) data were compared with TEEs measured by the DLW (2H2(18)O) method (TEE(DLW)): TEE(DLW) = 15.27 +/- 1.65 MJ/day and TEE(PEDO) = 15.29 +/- 0.83 MJ/day. Mean bias (i.e., TEE(PEDO) - TEE(DLW)) was 0.02 MJ, and mean error (SD of individual differences between TEE(PEDO) and TEE(DLW)) was 1.83 MJ. The Tc-pedometry method provided a valid estimate of the average TEE of a small group of physically active subjects where walking was the dominant activity.

Characteristics and treatability of oil-bearing wastes from aluminum alloy machining operations.

PubMed

Chen, Luke; Hsieh, Chueh-Chen; Wetherbee, John; Yang, Chen-Lu

2008-04-15

Enomoto Industry Co., exclusively uses water-based cutting fluids in its aluminum alloy machining operations. Since the cost of disposal can be much greater than the cost of purchase, the treatability of spent cutting fluids is becoming a major criterion for cutting fluid selection. Samples were collected from the machining lines at Enomoto's facility to determine their characteristics and evaluate their treatability with centrifugation, chemical coagulation and electrochemical coagulation. As expected, oil and grease (O&G) and total suspended solids (TSS) are the main reasons that spent cutting fluids are prohibited from being discharged into local swage systems. The average O&G found in the spent cutting fluids is 87,354 mg/L with TSS of more than 70,000 mg/L. Both O&G and TSS are the major contributors to the high turbidity of these waste effluents. A centrifuge with a relative centrifugal force of 1318 x g, was able to reduce 60% of the turbidity. By adding the coagulant aluminum chloride, the oil-water emulsion was destabilized, and the turbidity was reduced from 3249 Formazin Attenuation Units (FAU) to around 314 FAU. With freshly generated aluminum ions in the spent cutting fluid, the electrochemical process destabilized the oil-water emulsion system. The coalesced oil droplets were adsorbed onto the highly dispersed aluminum coagulant. The oil-rich sludge that was generated in the operation was then floated to the surface, forming a blanket that was removed by skimming. The electrochemical treatment was able to reduce the turbidity to less than 14 FAU, which is the detection limit of the Hach DR/4000 UV-vis spectrophotometer.

SCOUSE: Semi-automated multi-COmponent Universal Spectral-line fitting Engine

NASA Astrophysics Data System (ADS)

Henshaw, J. D.; Longmore, S. N.; Kruijssen, J. M. D.; Davies, B.; Bally, J.; Barnes, A.; Battersby, C.; Burton, M.; Cunningham, M. R.; Dale, J. E.; Ginsburg, A.; Immer, K.; Jones, P. A.; Kendrew, S.; Mills, E. A. C.; Molinari, S.; Moore, T. J. T.; Ott, J.; Pillai, T.; Rathborne, J.; Schilke, P.; Schmiedeke, A.; Testi, L.; Walker, D.; Walsh, A.; Zhang, Q.

2016-01-01

The Semi-automated multi-COmponent Universal Spectral-line fitting Engine (SCOUSE) is a spectral line fitting algorithm that fits Gaussian files to spectral line emission. It identifies the spatial area over which to fit the data and generates a grid of spectral averaging areas (SAAs). The spatially averaged spectra are fitted according to user-provided tolerance levels, and the best fit is selected using the Akaike Information Criterion, which weights the chisq of a best-fitting solution according to the number of free-parameters. A more detailed inspection of the spectra can be performed to improve the fit through an iterative process, after which SCOUSE integrates the new solutions into the solution file.

The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa.

PubMed

Lince-Deroche, Naomi; Fetters, Tamara; Sinanovic, Edina; Devjee, Jaymala; Moodley, Jack; Blanchard, Kelly

2017-01-01

Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars. A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5%) were eligible to choose their abortion procedure; 94.1% (n = 834) chose medication abortion. The total average cost per medication abortion was $63.91 (52.32-75.51). The total average cost per MVA was higher at $69.60 (52.62-86.57); though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4%) medication abortion women being hospitalized and two (0.3%) having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods. This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back-up, without increasing costs.

Trends in southern forest harvesting equipment and logging costs

Treesearch

Frederick W. Cubbage; Bryce J. Stokes; James E. Granskog

1988-01-01

Southern timber harvesting equipment and on-road vehicle costs were obtained for the years from 1967 to 1984. Average cost trends for equipment and vehicles were determined for the period. Average logging contract rates and price trends were also estimated. Comparisons indicated that equipment costs increased more than the general inflation rate and less than the...

Anatomy of backcountry management costs

Treesearch

Herbert E Echelberger; Harriet J. Plumley; Harriet J. Plumley

1986-01-01

Operation and management costs for several dispersed overnight site locations and backcountry trails in the White Mountain National Forest were studied. Average annual costs ranged from $200 to $1,500 per mile for trails and from $0.35 to $4.29 per visitor for overnight sites. Average annual costs for trails and overnight sites increased with elevation and use levels,...

77 FR 7237 - Railroad Cost Recovery Procedures-Productivity Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-10

... Cost Recovery Procedures--Productivity Adjustment AGENCY: Surface Transportation Board. ACTION: Proposed railroad cost recovery procedures productivity adjustment. SUMMARY: In a decision served on... productivity for the 2006-2010 (5-year) averaging period. This represents a 0.6% decrease over the average for...

Direct cost of pars plana vitrectomy for the treatment of macular hole, epiretinal membrane and vitreomacular traction: a bottom-up approach.

PubMed

Nicod, Elena; Jackson, Timothy L; Grimaccia, Federico; Angelis, Aris; Costen, Marc; Haynes, Richard; Hughes, Edward; Pringle, Edward; Zambarakji, Hadi; Kanavos, Panos

2016-11-01

The direct cost to the National Health Service (NHS) in England of pars plana vitrectomy (PPV) is unknown since a bottom-up costing exercise has not been undertaken. Healthcare resource group (HRG) costing relies on a top-down approach. We aimed to quantify the direct cost of intermediate complexity PPV. Five NHS vitreoretinal units prospectively recorded all consumables, equipment and staff salaries during PPV undertaken for vitreomacular traction, epiretinal membrane and macular hole. Out-of-surgery costs between admission and discharge were estimated using a representative accounting method. The average patient time in theatre for 57 PPVs was 72 min. The average in-surgery cost for staff was £297, consumables £619, and equipment £82 (total £997). The average out-of-surgery costs were £260, including nursing and medical staff, other consumables, eye drops and hospitalisation. The total cost was therefore £1634, including 30 % overheads. This cost estimate was an under-estimate because it did not include out-of-theatre consumables or equipment. The average reimbursed HRG tariff was £1701. The cost of undertaking PPV of intermediate complexity is likely to be higher than the reimbursed tariff, except for hospitals with high throughput, where amortisation costs benefit from economies of scale. Although this research was set in England, the methodology may provide a useful template for other countries.

ASSESSING THE COST BURDEN OF DENGUE INFECTION TO HOUSEHOLDS IN SEREMBAN, MALAYSIA.

PubMed

Mia, Md Shahin; Begum, Rawshan Ara; Er, A C; Pereira, Joy Jacqueline

2016-11-01

Dengue is endemic in all parts of Malaysia. However, there is limited data regarding the cost burden of this disease at household level. We aimed to examine the cost of dengue infection at the household level in Seremban District, Malaysia. This cost assessment can provide an insight to policy-makers about economic impact of dengue infection in order to guide and prioritize control strategies. The data were collected via interview. We evaluated120 previous dengue infection patients registered at the Tuanku Ja’afar Hospital, Seremban District, Malaysia. The average duration of dengue illness was 9.69 days. The average household days lost was 18.7; students lost an average of 6.3 days of school and patients and caregivers lost an average of 12.5 days of work. The mean total cost per case of dengue infection was estimated to be USD365.16 with the indirect cost being USD327.90 (89.8% of the total cost) and the direct cost being USD37.26 (10.2% of the total cost). Our findings suggest each episode of dengue infection imposes a significant financial burden at the household level in Seremban District, Malaysia; most of the burden being indirect cost. This cost needs to be factored into the overall cost to society of dengue infection. This data can inform policy makers when allocating resources to manage public health problems in Malaysia.

Workplace smoking related absenteeism and productivity costs in Taiwan

PubMed Central

Tsai, S; Wen, C; Hu, S; Cheng, T; Huang, S

2005-01-01

Objective: To estimate productivity losses and financial costs to employers caused by cigarette smoking in the Taiwan workplace. Methods: The human capital approach was used to calculate lost productivity. Assuming the value of lost productivity was equal to the wage/salary rate and basing the calculations on smoking rate in the workforce, average days of absenteeism, average wage/salary rate, and increased risk and absenteeism among smokers obtained from earlier research, costs due to smoker absenteeism were estimated. Financial losses caused by passive smoking, smoking breaks, and occupational injuries were calculated. Results: Using a conservative estimate of excess absenteeism from work, male smokers took off an average of 4.36 sick days and male non-smokers took off an average of 3.30 sick days. Female smokers took off an average of 4.96 sick days and non-smoking females took off an average of 3.75 sick days. Excess absenteeism caused by employee smoking was estimated to cost US$178 million per annum for males and US$6 million for females at a total cost of US$184 million per annum. The time men and women spent taking smoking breaks amounted to nine days per year and six days per year, respectively, resulting in reduced output productivity losses of US$733 million. Increased sick leave costs due to passive smoking were approximately US$81 million. Potential costs incurred from occupational injuries among smoking employees were estimated to be US$34 million. Conclusions: Financial costs caused by increased absenteeism and reduced productivity from employees who smoke are significant in Taiwan. Based on conservative estimates, total costs attributed to smoking in the workforce were approximately US$1032 million. PMID:15923446

Workplace smoking related absenteeism and productivity costs in Taiwan.

PubMed

Tsai, S P; Wen, C P; Hu, S C; Cheng, T Y; Huang, S J

2005-06-01

To estimate productivity losses and financial costs to employers caused by cigarette smoking in the Taiwan workplace. The human capital approach was used to calculate lost productivity. Assuming the value of lost productivity was equal to the wage/salary rate and basing the calculations on smoking rate in the workforce, average days of absenteeism, average wage/salary rate, and increased risk and absenteeism among smokers obtained from earlier research, costs due to smoker absenteeism were estimated. Financial losses caused by passive smoking, smoking breaks, and occupational injuries were calculated. Using a conservative estimate of excess absenteeism from work, male smokers took off an average of 4.36 sick days and male non-smokers took off an average of 3.30 sick days. Female smokers took off an average of 4.96 sick days and non-smoking females took off an average of 3.75 sick days. Excess absenteeism caused by employee smoking was estimated to cost USD 178 million per annum for males and USD 6 million for females at a total cost of USD 184 million per annum. The time men and women spent taking smoking breaks amounted to nine days per year and six days per year, respectively, resulting in reduced output productivity losses of USD 733 million. Increased sick leave costs due to passive smoking were approximately USD 81 million. Potential costs incurred from occupational injuries among smoking employees were estimated to be USD 34 million. Financial costs caused by increased absenteeism and reduced productivity from employees who smoke are significant in Taiwan. Based on conservative estimates, total costs attributed to smoking in the workforce were approximately USD 1032 million.

Profitable capitation requires accurate costing.

PubMed

West, D A; Hicks, L L; Balas, E A; West, T D

1996-01-01

In the name of costing accuracy, nurses are asked to track inventory use on per treatment basis when more significant costs, such as general overhead and nursing salaries, are usually allocated to patients or treatments on an average cost basis. Accurate treatment costing and financial viability require analysis of all resources actually consumed in treatment delivery, including nursing services and inventory. More precise costing information enables more profitable decisions as is demonstrated by comparing the ratio-of-cost-to-treatment method (aggregate costing) with alternative activity-based costing methods (ABC). Nurses must participate in this costing process to assure that capitation bids are based upon accurate costs rather than simple averages.

Cue quality and criterion setting in recognition memory.

PubMed

Kent, Christopher; Lamberts, Koen; Patton, Richard

2018-02-02

Previous studies on how people set and modify decision criteria in old-new recognition tasks (in which they have to decide whether or not a stimulus was seen in a study phase) have almost exclusively focused on properties of the study items, such as presentation frequency or study list length. In contrast, in the three studies reported here, we manipulated the quality of the test cues in a scene-recognition task, either by degrading through Gaussian blurring (Experiment 1) or by limiting presentation duration (Experiment 2 and 3). In Experiments 1 and 2, degradation of the test cue led to worse old-new discrimination. Most importantly, however, participants were more liberal in their responses to degraded cues (i.e., more likely to call the cue "old"), demonstrating strong within-list, item-by-item, criterion shifts. This liberal response bias toward degraded stimuli came at the cost of increasing the false alarm rate while maintaining a constant hit rate. Experiment 3 replicated Experiment 2 with additional stimulus types (words and faces) but did not provide accuracy feedback to participants. The criterion shifts in Experiment 3 were smaller in magnitude than Experiments 1 and 2 and varied in consistency across stimulus type, suggesting, in line with previous studies, that feedback is important for participants to shift their criteria.

Three-color mixing for classifying agricultural products for safety and quality

NASA Astrophysics Data System (ADS)

Ding, Fujian; Chen, Yud-Ren; Chao, Kuanglin; Kim, Moon S.

2006-05-01

A three-color mixing application for food safety inspection is presented. It is shown that the chromaticness of the visual signal resulting from the three-color mixing achieved through our device is directly related to the three-band ratio of light intensity at three selected wavebands. An optical visual device using three-color mixing to implement the three-band ratio criterion is presented. Inspection through human vision assisted by an optical device that implements the three-band ratio criterion would offer flexibility and significant cost savings as compared to inspection with a multispectral machine vision system that implements the same criterion. Example applications of this optical three-color mixing technique are given for the inspection of chicken carcasses with various diseases and for apples with fecal contamination. With proper selection of the three narrow wavebands, discrimination by chromaticness that has a direct relation with the three-band ratio can work very well. In particular, compared with the previously presented two-color mixing application, the conditions of chicken carcasses were more easily identified using the three-color mixing application. The novel three-color mixing technique for visual inspection can be implemented on visual devices for a variety of applications, ranging from target detection to food safety inspection.

Two-phase strategy of controlling motor coordination determined by task performance optimality.

PubMed

Shimansky, Yury P; Rand, Miya K

2013-02-01

A quantitative model of optimal coordination between hand transport and grip aperture has been derived in our previous studies of reach-to-grasp movements without utilizing explicit knowledge of the optimality criterion or motor plant dynamics. The model's utility for experimental data analysis has been demonstrated. Here we show how to generalize this model for a broad class of reaching-type, goal-directed movements. The model allows for measuring the variability of motor coordination and studying its dependence on movement phase. The experimentally found characteristics of that dependence imply that execution noise is low and does not affect motor coordination significantly. From those characteristics it is inferred that the cost of neural computations required for information acquisition and processing is included in the criterion of task performance optimality as a function of precision demand for state estimation and decision making. The precision demand is an additional optimized control variable that regulates the amount of neurocomputational resources activated dynamically. It is shown that an optimal control strategy in this case comprises two different phases. During the initial phase, the cost of neural computations is significantly reduced at the expense of reducing the demand for their precision, which results in speed-accuracy tradeoff violation and significant inter-trial variability of motor coordination. During the final phase, neural computations and thus motor coordination are considerably more precise to reduce the cost of errors in making a contact with the target object. The generality of the optimal coordination model and the two-phase control strategy is illustrated on several diverse examples.

New benchmarks for costs and cost-efficiency of school-based feeding programs in food-insecure areas.

PubMed

Gelli, Aulo; Cavallero, Andrea; Minervini, Licia; Mirabile, Mariana; Molinas, Luca; de la Mothe, Marc Regnault

2011-12-01

School feeding is a popular intervention that has been used to support the education, health and nutrition of school children. Although the benefits of school feeding are well documented, the evidence on the costs of such programs is remarkably thin. Address the need for systematic estimates of the cost of different school feeding modalities, and of the determinants of the considerable cost variation among countries. WFP project data, including expenditures and number of schoolchildren covered, were collected for 78 projects in 62 countries through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The standardized yearly average school feeding cost per child, not including school-level costs, was US$48. The yearly costs per child were lowest at US$23 for biscuit programs reaching school-going children and highest at US$75 for take-home rations programs reaching families of schoolgoing children. The average cost of programs combining on-site meals with extra take-home rations for children from vulnerable households was US$61. Commodity costs were on average 58% of total costs and were highest for biscuit and take-home rations programs (71% and 68%, respectively). Fortified biscuits provided the most cost-efficient option in terms of micronutrient delivery, whereas take-home rations were more cost-efficient in terms of food quantities delivered. Both costs and effects should be considered carefully when designing school feeding interventions. The average costs of school feeding estimated here are higher than those found in earlier studies but fall within the range of costs previously reported. Because this analysis does not include school-level costs, these findings highlight the higher nontransfer costs for programs delivering cooked meals in schools than for other school feeding modalities. The benchmarks presented here reflect the centralized WFP implementation model, which is not always relevant in terms of government school feeding programs, particularly those procuring within national boundaries using "home-grown" approaches.

Validation of GPU based TomoTherapy dose calculation engine.

PubMed

Chen, Quan; Lu, Weiguo; Chen, Yu; Chen, Mingli; Henderson, Douglas; Sterpin, Edmond

2012-04-01

The graphic processing unit (GPU) based TomoTherapy convolution/superposition(C/S) dose engine (GPU dose engine) achieves a dramatic performance improvement over the traditional CPU-cluster based TomoTherapy dose engine (CPU dose engine). Besides the architecture difference between the GPU and CPU, there are several algorithm changes from the CPU dose engine to the GPU dose engine. These changes made the GPU dose slightly different from the CPU-cluster dose. In order for the commercial release of the GPU dose engine, its accuracy has to be validated. Thirty eight TomoTherapy phantom plans and 19 patient plans were calculated with both dose engines to evaluate the equivalency between the two dose engines. Gamma indices (Γ) were used for the equivalency evaluation. The GPU dose was further verified with the absolute point dose measurement with ion chamber and film measurements for phantom plans. Monte Carlo calculation was used as a reference for both dose engines in the accuracy evaluation in heterogeneous phantom and actual patients. The GPU dose engine showed excellent agreement with the current CPU dose engine. The majority of cases had over 99.99% of voxels with Γ(1%, 1 mm) < 1. The worst case observed in the phantom had 0.22% voxels violating the criterion. In patient cases, the worst percentage of voxels violating the criterion was 0.57%. For absolute point dose verification, all cases agreed with measurement to within ±3% with average error magnitude within 1%. All cases passed the acceptance criterion that more than 95% of the pixels have Γ(3%, 3 mm) < 1 in film measurement, and the average passing pixel percentage is 98.5%-99%. The GPU dose engine also showed similar degree of accuracy in heterogeneous media as the current TomoTherapy dose engine. It is verified and validated that the ultrafast TomoTherapy GPU dose engine can safely replace the existing TomoTherapy cluster based dose engine without degradation in dose accuracy.

Development of a Monte Carlo multiple source model for inclusion in a dose calculation auditing tool.

PubMed

Faught, Austin M; Davidson, Scott E; Fontenot, Jonas; Kry, Stephen F; Etzel, Carol; Ibbott, Geoffrey S; Followill, David S

2017-09-01

The Imaging and Radiation Oncology Core Houston (IROC-H) (formerly the Radiological Physics Center) has reported varying levels of agreement in their anthropomorphic phantom audits. There is reason to believe one source of error in this observed disagreement is the accuracy of the dose calculation algorithms and heterogeneity corrections used. To audit this component of the radiotherapy treatment process, an independent dose calculation tool is needed. Monte Carlo multiple source models for Elekta 6 MV and 10 MV therapeutic x-ray beams were commissioned based on measurement of central axis depth dose data for a 10 × 10 cm 2 field size and dose profiles for a 40 × 40 cm 2 field size. The models were validated against open field measurements consisting of depth dose data and dose profiles for field sizes ranging from 3 × 3 cm 2 to 30 × 30 cm 2 . The models were then benchmarked against measurements in IROC-H's anthropomorphic head and neck and lung phantoms. Validation results showed 97.9% and 96.8% of depth dose data passed a ±2% Van Dyk criterion for 6 MV and 10 MV models respectively. Dose profile comparisons showed an average agreement using a ±2%/2 mm criterion of 98.0% and 99.0% for 6 MV and 10 MV models respectively. Phantom plan comparisons were evaluated using ±3%/2 mm gamma criterion, and averaged passing rates between Monte Carlo and measurements were 87.4% and 89.9% for 6 MV and 10 MV models respectively. Accurate multiple source models for Elekta 6 MV and 10 MV x-ray beams have been developed for inclusion in an independent dose calculation tool for use in clinical trial audits. © 2017 American Association of Physicists in Medicine.

78 FR 10262 - Railroad Cost Recovery Procedures-Productivity Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... Cost Recovery Procedures--Productivity Adjustment AGENCY: Surface Transportation Board, DOT. ACTION: Proposed railroad cost recovery procedures productivity adjustment. SUMMARY: In a decision served on... productivity for the 2007-2011 (5-year) averaging period. This represents a 0.1% increase over the average for...

Cost of individual peer counselling for the promotion of exclusive breastfeeding in Uganda

PubMed Central

2011-01-01

Background Exclusive breastfeeding (EBF) for 6 months is the recommended form of infant feeding. Support of mothers through individual peer counselling has been proved to be effective in increasing exclusive breastfeeding prevalence. We present a costing study of an individual peer support intervention in Uganda, whose objective was to raise exclusive breastfeeding rates at 3 months of age. Methods We costed the peer support intervention, which was offered to 406 breastfeeding mothers in Uganda. The average number of counselling visits was about 6 per woman. Annual financial and economic costs were collected in 2005-2008. Estimates were made of total project costs, average costs per mother counselled and average costs per peer counselling visit. Alternative intervention packages were explored in the sensitivity analysis. We also estimated the resources required to fund the scale up to district level, of a breastfeeding intervention programme within a public health sector model. Results Annual project costs were estimated to be US$56,308. The largest cost component was peer supporter supervision, which accounted for over 50% of total project costs. The cost per mother counselled was US$139 and the cost per visit was US$26. The cost per week of EBF was estimated to be US$15 at 12 weeks post partum. We estimated that implementing an alternative package modelled on routine public health sector programmes can potentially reduce costs by over 60%. Based on the calculated average costs and annual births, scaling up modelled costs to district level would cost the public sector an additional US$1,813,000. Conclusion Exclusive breastfeeding promotion in sub-Saharan Africa is feasible and can be implemented at a sustainable cost. The results of this study can be incorporated in cost effectiveness analyses of exclusive breastfeeding promotion programmes in sub-Saharan Africa. PMID:21714877

Cost-Benefit Analysis of Green Infrastructures on Community Stormwater Reduction and Utilization: A Case of Beijing, China.

PubMed

Liu, Wen; Chen, Weiping; Feng, Qi; Peng, Chi; Kang, Peng

2016-12-01

Cost-benefit analysis is demanded for guiding the plan, design and construction of green infrastructure practices in rapidly urbanized regions. We developed a framework to calculate the costs and benefits of different green infrastructures on stormwater reduction and utilization. A typical community of 54,783 m 2 in Beijing was selected for case study. For the four designed green infrastructure scenarios (green space depression, porous brick pavement, storage pond, and their combination), the average annual costs of green infrastructure facilities are ranged from 40.54 to 110.31 thousand yuan, and the average of the cost per m 3 stormwater reduction and utilization is 4.61 yuan. The total average annual benefits of stormwater reduction and utilization by green infrastructures of the community are ranged from 63.24 to 250.15 thousand yuan, and the benefit per m 3 stormwater reduction and utilization is ranged from 5.78 to 11.14 yuan. The average ratio of average annual benefit to cost of four green infrastructure facilities is 1.91. The integrated facilities had the highest economic feasibility with a benefit to cost ratio of 2.27, and followed by the storage pond construction with a benefit to cost ratio of 2.14. The results suggested that while the stormwater reduction and utilization by green infrastructures had higher construction and maintenance costs, their comprehensive benefits including source water replacements benefits, environmental benefits and avoided cost benefits are potentially interesting. The green infrastructure practices should be promoted for sustainable management of urban stormwater.

Cost associated with stroke: outpatient rehabilitative services and medication.

PubMed

Godwin, Kyler M; Wasserman, Joan; Ostwald, Sharon K

2011-10-01

This study aimed to capture direct costs of outpatient rehabilitative stroke care and medications for a 1-year period after discharge from inpatient rehabilitation. Outpatient rehabilitative services and medication costs for 1 year, during the time period of 2001 to 2005, were calculated for 54 first-time stroke survivors. Costs for services were based on Medicare reimbursement rates. Medicaid reimbursement rates and average wholesale price were used to estimate medication costs. Of the 54 stroke survivors, 40 (74.1%) were categorized as independent, 12 (22.2%) had modified dependence, and 2 (3.7%) were dependent at the time of discharge from inpatient rehabilitation. Average cost for outpatient stroke rehabilitation services and medications the first year post inpatient rehabilitation discharge was $17,081. The corresponding average yearly cost of medication was $5,392, while the average cost of yearly rehabilitation service utilization was $11,689. Cost attributed to medication remained relatively constant throughout the groups. Outpatient rehabilitation service utilization constituted a large portion of cost within each group: 69.7% (dependent), 72.5% (modified dependence), and 66.7% (independent). Stroke survivors continue to incur significant costs associated with their stroke for the first 12 months following discharge from an inpatient rehabilitation setting. Changing public policies affect the cost and availability of care. This study provides a snapshot of outpatient medication and therapy costs prior to the enactment of major changes in federal legislation and serves as a baseline for future studies.

Cost and efficacy comparison of integrated pest management strategies with monthly spray insecticide applications for German cockroach (Dictyoptera: Blattellidae) control in public housing.

PubMed

Miller, D M; Meek, F

2004-04-01

The long-term costs and efficacy of two treatment methodologies for German cockroach, Blattella germanica (L.), control were compared in the public housing environment. The "traditional" treatment for German cockroaches consisted of monthly baseboard and crack and crevice treatment (TBCC) by using spray and dust formulation insecticides. The integrated pest management treatment (IPM) involved initial vacuuming of apartments followed by monthly or quarterly applications of baits and insect growth regulator (IGR) devices. Cockroach populations in the IPM treatment were also monitored with sticky traps. Technician time and the amount of product applied were used to measure cost in both treatments. Twenty-four hour sticky trap catch was used as an indicator of treatment efficacy. The cost of the IPM treatment was found to be significantly greater than the traditional treatment, particularly at the initiation of the test. In the first month (clean-out), the average cost per apartment unit was dollar 14.60, whereas the average cost of a TBCC unit was dollar 2.75. In the second month of treatment, the average cost of IPM was still significantly greater than the TBCC cost. However, after month 4 the cost of the two treatments was no longer significantly different because many of the IPM apartments were moved to a quarterly treatment schedule. To evaluate the long-term costs of the two treatments over the entire year, technician time and product quantities were averaged over all units treated within the 12-mo test period (total 600 U per treatment). The average per unit cost of the IPM treatment was (dollar 4.06). The average IPM cost was significantly greater than that of the TBCC treatment at dollar 1.50 per unit. Although the TBCC was significantly less expensive than the IPM treatment, it was also less effective. Trap catch data indicated that the TBCC treatment had little, if any, effect on the cockroach populations over the course of the year. Cockroach populations in the TBCC treatment remained steady for the first 5 mo of the test and then had a threefold increase during the summer. Cockroach populations in the IPM treatment were significantly reduced from an average of 24.7 cockroaches per unit before treatment to an average 3.9 cockroaches per unit in month 4. The suppressed cockroach populations (< 5 per unit) in the IPM treatment remained constant for the remaining 8 mo of the test.

[Experience of a Break-Even Point Analysis for Make-or-Buy Decision.].

PubMed

Kim, Yunhee

2006-12-01

Cost containment through continuous quality improvement of medical service is required in an age of a keen competition of the medical market. Laboratory managers should examine the matters on make-or-buy decision periodically. On this occasion, a break-even point analysis can be useful as an analyzing tool. In this study, cost accounting and break-even point (BEP) analysis were performed in case that the immunoassay items showing a recent increase in order volume were to be in-house made. Fixed and variable costs were calculated in case that alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), prostate-specific antigen (PSA), ferritin, free thyroxine (fT4), triiodothyronine (T3), thyroid-stimulating hormone (TSH), CA 125, CA 19-9, and hepatitis B envelope antibody (HBeAb) were to be tested with Abbott AxSYM instrument. Break-even volume was calculated as fixed cost per year divided by purchasing cost per test minus variable cost per test and BEP ratio as total purchasing costs at break-even volume divided by total purchasing costs at actual annual volume. The average fixed cost per year of AFP, CEA, PSA, ferritin, fT4, T3, TSH, CA 125, CA 19-9, and HBeAb was 8,279,187 won and average variable cost per test, 3,786 won. Average break-even volume was 1,599 and average BEP ratio was 852%. Average BEP ratio without including quality costs such as calibration and quality control was 74%. Because the quality assurance of clinical tests cannot be waived, outsourcing all of 10 items was more adequate than in-house make at the present volume in financial aspect. BEP analysis was useful as a financial tool for make-or-buy decision, the common matter which laboratory managers meet with.

Data processing 1: Advancements in machine analysis of multispectral data

NASA Technical Reports Server (NTRS)

Swain, P. H.

1972-01-01

Multispectral data processing procedures are outlined beginning with the data display process used to accomplish data editing and proceeding through clustering, feature selection criterion for error probability estimation, and sample clustering and sample classification. The effective utilization of large quantities of remote sensing data by formulating a three stage sampling model for evaluation of crop acreage estimates represents an improvement in determining the cost benefit relationship associated with remote sensing technology.

AUTOMATIC RECOGNITION OF FALLS IN GAIT-SLIP: A HARNESS LOAD CELL BASED CRITERION

PubMed Central

Yang, Feng; Pai, Yi-Chung

2012-01-01

Over-head-harness systems, equipped with load cell sensors, are essential to the participants’ safety and to the outcome assessment in perturbation training. The purpose of this study was to first develop an automatic outcome recognition criterion among young adults for gait-slip training and then verify such criterion among older adults. Each of 39 young and 71 older subjects, all protected by safety harness, experienced 8 unannounced, repeated slips, while walking on a 7-m walkway. Each trial was monitored with a motion capture system, bilateral ground reaction force (GRF), harness force and video recording. The fall trials were first unambiguously indentified with careful visual inspection of all video records. The recoveries without balance loss (in which subjects’ trailing foot landed anteriorly to the slipping foot) were also first fully recognized from motion and GRF analyses. These analyses then set the gold standard for the outcome recognition with load cell measurements. Logistic regression analyses based on young subjects’ data revealed that peak load cell force was the best predictor of falls (with 100% accuracy) at the threshold of 30% body weight. On the other hand, the peak moving average force of load cell across 1-s period, was the best predictor (with 100% accuracy) separating recoveries with backward balance loss (in which the recovery step landed posterior to slipping foot) from harness assistance at the threshold of 4.5% body weight. These threshold values were fully verified using the data from older adults (100% accuracy in recognizing falls). Because of the increasing popularity in the perturbation training coupling with the protective over-head-harness system, this new criterion could have far reaching implications in automatic outcome recognition during the movement therapy. PMID:21696744

Estimation of a Stopping Criterion for Geophysical Granular Flows Based on Numerical Experimentation

NASA Astrophysics Data System (ADS)

Yu, B.; Dalbey, K.; Bursik, M.; Patra, A.; Pitman, E. B.

2004-12-01

Inundation area may be the most important factor for mitigation of natural hazards related to avalanches, debris flows, landslides and pyroclastic flows. Run-out distance is the key parameter for inundation because the front deposits define the leading edge of inundation. To define the run-out distance, it is necessary to know when a flow stops. Numerical experiments are presented for determining a stopping criterion and exploring the suitability of a Savage-Hutter granular model for computing inundation areas of granular flows. The TITAN2D model was employed to run numerical experiments based on the Savage-Hutter theory. A potentially reasonable stopping criterion was found as a function of dimensionless average velocity, aspect ratio of pile, internal friction angle, bed friction angle and bed slope in the flow direction. Slumping piles on a horizontal surface and geophysical flows over complex topography were simulated. Several mountainous areas, including Colima volcano (MX), Casita (Nic.), Little Tahoma Peak (WA, USA) and the San Bernardino Mountains (CA, USA) were used to simulate geophysical flows. Volcanic block and ash flows, debris avalanches and debris flows occurred in these areas and caused varying degrees of damage. The areas have complex topography, including locally steep open slopes, sinuous channels, and combinations of these. With different topography and physical scaling, slumping piles and geophysical flows have a somewhat different dependence of dimensionless stopping velocity on power-law constants associated with aspect ratio of pile, internal friction angle, bed friction angle and bed slope in the flow direction. Visual comparison of the details of the inundation area obtained from the TITAN2D model with models that contain some form of viscous dissipation point out weaknesses in the model that are not evident by investigation of the stopping criterion alone.

Rupture model based on non-associated plasticity

NASA Astrophysics Data System (ADS)

Pradeau, Adrien; Yoon, Jeong Whan; Thuillier, Sandrine; Lou, Yanshan; Zhang, Shunying

2018-05-01

This research work is about modeling the mechanical behavior of metallic sheets of AA6016 up to rupture using non-associated flow rule. Experiments were performed at room temperature in uniaxial tension and simple shear in different directions according to the rolling direction and an additional hydraulic bulge test. The anisotropy of the material is described by a Yld2000-2d yield surface [1], calibrated by stress ratios, and a plastic potential represented by Hill1948 [2], calibrated using Lankford coefficients. That way, the former is able to reproduce the yield stresses in different directions and the latter is able to reproduce the deformations in different directions as well [3], [4]. Indeed, the non-associated flow rule allows for the direction of the plastic flow not to be necessarily normal to the yield surface. Concerning the rupture, the macroscopic ductile fracture criterion DF2014 was used [5]. It indirectly uses the three invariants of the stress tensor by using the three following parameters: the stress triaxiality η, the Lode parameter L and the equivalent plastic strain to fracture ∈f-p . In order to be consistent with the plastic model and to add more flexibility to the p criterion, the equivalent stress σ ¯ and the equivalent strain to fracture ∈f-p have been substituted respectively as Yld2000-2d and Hill1948 in the DF2014 fracture criterion. The parameters for the fracture criterion were obtained by optimization and the fracture locus can be plotted in the (η ,L ,∈-p) space. The damage indicator D is then numerically predicted with respect of average strain values. A good correlation with the experimental results is obtained.

Consumer Cost-Sharing in Marketplace vs. Employer Health Insurance Plans, 2015.

PubMed

Gabel, Jon; Whitmore, Heidi; Green, Matthew; Stromberg, Sam; Oran, Rebecca

2015-12-01

Using data from 49 states and Washington, D.C., we analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. We examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance. We found cost-sharing under marketplace plans remained essentially unchanged from 2014 to 2015. Stable premiums during that period do not reflect greater costs borne by enrollees. Further, 56 percent of enrollees in marketplace plans attained cost-sharing reductions in 2015. However, for people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average, while cost-sharing under gold plans is similar employer-based plans on average. Marketplace plans are far more likely than employer-based plans to require enrollees to meet deductibles before they receive coverage for prescription drugs.

How much is the cost of multiple sclerosis--systematic literature review.

PubMed

Kolasa, Katarzyna

2013-01-01

In Poland, a data on MS costs is lacking. The systematic review of cost of illness studies was conducted to estimate the average annual cost of MS patient and its breakdown. The PubMed database was searched for relevant literature. Following search criteria were used: "multiple sclerosis", "costs", "cost of illness" and "disease burden". Articles written in English including total costs published 2002-2012 were included. In total 17 studies were classified. The costs were re-calculated into USD Purchasing Power Parity (PPP). The available approach from the literature was used for the cost breakdown presentation. The average patient was 47 years old with EDSS equals 4 and 13 years from the date of diagnosis. The average annual cost was 41 133 US$ PPP. The direct costs did not exceed 70% of total costs in any study. The pharmaceutical expenses were one of the most important contributors to the direct costs. Only 40% of patients were active on the labor market what translated into the loss of productivity and consequently an increase in total costs. The preformed systematic review revealed that multiple sclerosis imposes a huge economic burden on the healthcare system and society. It happens due to productivity loss and caregiver burden.

Protection of Electrical Systems from EM Hazards - Design Guide.

DTIC Science & Technology

1981-09-01

cm) Surface flashover Voltage (KV/cm) This criterion should be met for lighting voltage stresses of either polarity applied at up to 1000 KV/v sec rate...suppressor devices can be predicted. The part failure rate models in the handbook include the effects of part electrical stress , thermal stress , operating... stress . This test series contained over one million device hours of operation at temperatures uF to 145°C. The average duration of testing ranges from

The Predictive Validity of the GRE and TOEFL Exams with GGPA as the Criterion of Graduate Success for International Graduate Students in Science and Engineering.

ERIC Educational Resources Information Center

Neal, Menka E.

This study investigated the relationship between graduate grade-point-average (GGPA) and the total score, as well as the scores on each part, of the Graduate Record Examination (GRE). It also investigated the relationship between GGPA and the total score, as well as the scores on each part, of the Test of English as a Foreign Language (TOEFL). The…

Nutrient enrichment and fish nutrient tolerance: Assessing biologically relevant nutrient criteria

USGS Publications Warehouse

Meador, Michael R.

2013-01-01

Relationships between nutrient concentrations and fish nutrient tolerance were assessed relative to established nutrient criteria. Fish community, nitrate plus nitrite (nitrate), and total phosphorus (TP) data were collected during summer low-flow periods in 2003 and 2004 at stream sites along a nutrient-enrichment gradient in an agricultural basin in Indiana and Ohio and an urban basin in the Atlanta, Georgia, area. Tolerance indicator values for nitrate and TP were assigned for each species and averaged separately for fish communities at each site (TIVo). Models were used to predict fish species expected to occur at a site under minimally disturbed conditions and average tolerance indicator values were determined for nitrate and TP separately for expected communities (TIVe). In both areas, tolerance scores (TIVo/TIVe) for nitrate increased significantly with increased nitrate concentrations whereas no significant relationships were detected between TP tolerance scores and TP concentrations. A 0% increase in the tolerance score (TIVo/TIVe = 1) for nitrate corresponded to a nitrate concentration of 0.19 mg/l (compared with a USEPA summer nitrate criterion of 0.17 mg/l) in the urban area and 0.31 mg/l (compared with a USEPA summer nitrate criterion of 0.86 mg/l) in the agricultural area. Fish nutrient tolerance values offer the ability to evaluate nutrient enrichment based on a quantitative approach that can provide insights into biologically relevant nutrient criteria.

[Character accentuations as a criterion for psychological risks in the professional activity of the builders of main gas pipelines in the conditions of arctic].

PubMed

Korneeva, Ia A; Simonova, N N

2015-01-01

The article is devoted to the study of character accentuations as a criterion for psychological risks in the professional activity of builders of main gas pipelines in the conditions of Arctic. to study the severity of character accentuations in rotation-employed builders of main gas pipelines, stipulated by their professional activities, as well as personal resources to overcome these destructions. The study involved 70 rotation-employed builders of trunk pipelines, working in the Tyumen Region (duration of the shift-in--52 days), aged from 23 to 59 (mean age 34,9 ± 8.1) years, with the experience of work from 0.5 years to 14 years (the average length of 4.42 ± 3.1). Methods of the study: questionnaires, psychological testing, participant observation. One-Sample t-test of Student, multiple regression analysis, incremental analysis. In the work there were revealed differences of expression of character accentuations in builders of trunk pipelines with experience in work on rotation less and more than five years. There was determined that builders of the main gas pipelines, working on the rotation in Arctic, with more pronounced accentuation ofthe character use mainly psychological defenses of compensation, substitution and denial, and have an average level of expression of flexibility as the regulatory process.

Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia.

PubMed

Curtis, Kate; Lam, Mary; Mitchell, Rebecca; Black, Deborah; Taylor, Colman; Dickson, Cara; Jan, Stephen; Palmer, Cameron S; Langcake, Mary; Myburgh, John

2014-01-01

Accurate economic data are fundamental for improving current funding models and ultimately in promoting the efficient delivery of services. The financial burden of a high trauma casemix to designated trauma centres in Australia has not been previously determined, and there is some evidence that the episode funding model used in Australia results in the underfunding of trauma. To describe the costs of acute trauma admissions in trauma centres, identify predictors of higher treatment costs and cost variance in New South Wales (NSW), Australia. Data linkage of admitted trauma patient and financial data provided by 12 Level 1 NSW trauma centres for the 08/09 financial year was performed. Demographic, injury details and injury scores were obtained from trauma registries. Individual patient general ledger costs (actual trauma patient costs), Australian Refined Diagnostic Related Groups (AR-DRG) and state-wide average costs (which form the basis of funding) were obtained. The actual costs incurred by the hospital were then compared with the state-wide AR-DRG average costs. Multivariable multiple linear regression was used for identifying predictors of costs. There were 17,522 patients, the average per patient cost was $10,603 and the median was $4628 (interquartile range: $2179-10,148). The actual costs incurred by trauma centres were on average $134 per bed day above AR-DRG costs-determined costs. Falls, road trauma and violence were the highest causes of total cost. Motor cyclists and pedestrians had higher median costs than motor vehicle occupants. As a result of greater numbers, patients with minor injury had comparable total costs with those generated by patients with severe injury. However the median cost of severely injured patients was nearly four times greater. The count of body regions injured, sex, length of stay, serious traumatic brain injury and admission to the Intensive Care Unit were significantly associated with increased costs (p<0.001). This multicentre trauma costing study demonstrated the feasibility of trauma registry and financial data linkage. Discrepancies between the observed costs of care in these 12 trauma centres and the NSW average AR-DRG costs suggest that trauma care is currently underfunded in NSW. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Sampling Molecular Conformers in Solution with Quantum Mechanical Accuracy at a Nearly Molecular-Mechanics Cost.

PubMed

Rosa, Marta; Micciarelli, Marco; Laio, Alessandro; Baroni, Stefano

2016-09-13

We introduce a method to evaluate the relative populations of different conformers of molecular species in solution, aiming at quantum mechanical accuracy, while keeping the computational cost at a nearly molecular-mechanics level. This goal is achieved by combining long classical molecular-dynamics simulations to sample the free-energy landscape of the system, advanced clustering techniques to identify the most relevant conformers, and thermodynamic perturbation theory to correct the resulting populations, using quantum-mechanical energies from density functional theory. A quantitative criterion for assessing the accuracy thus achieved is proposed. The resulting methodology is demonstrated in the specific case of cyanin (cyanidin-3-glucoside) in water solution.

Defense Sector Consolidation: Will Consolidation Within the Defense Sector Improve the Financial Performance of Defense Contractors While, Simultaneously Yielding Cost Savings to Taxpayers

DTIC Science & Technology

2005-12-01

Treaty USSR Union of Soviet Socialist Republics WACC Weighted Average Cost of Capital...a present value using the company’s weighted average cost of capital ( WACC ). Synergy: The Premium for Potential Success For the most part

Cost of practice in a tertiary/quaternary referral center: is it sustainable?

PubMed

Cologne, K G; Hwang, G S; Senagore, A J

2014-11-01

Third-party payers are moving toward a bundled care payment system. This means that there will need to be a warranty cost of care-where the cost of complexity and complication rates is built into the bundled payment. The theoretical benefit of this system is that providers with lower complication rates will be able to provide care with lower warranty costs and lower overall costs. This may also result in referring riskier patients to tertiary or quaternary referral centers. Unless the payment model truly covers the higher cost of managing such referred cases, the economic risk may be unsustainable for these centers. We took the last seven patients that were referred by other surgeons as "too high risk" for colectomy at other centers. A contribution margin was calculated using standard Medicare reimbursement rates at our institution and cost of care based on our administrative database. We then recalculated a contribution margin assuming a 3 % reduction in payment for a higher than average readmission rate, like that which will take effect in 2014. Finally, we took into account the cost of any readmissions. Seven patients with diagnosis related group (DRG) 330 were reviewed with an average age of 66.8 ± 16 years, American Society of Anesthesiologists score 2.3 ± 1.0, body mass index 31.6 ± 9.8 kg/m(2) (range 22-51 kg/m(2)). There was a 57 % readmission rate, 29 % reoperation rate, 10.8 ± 7.7 day average initial length of stay with 14 ± 8.6 day average readmission length of stay. Forty-two percent were discharged to a location other than home. Seventy-one percent of these patients had Medicare insurance. The case mix index was 2.45. Average reimbursement for DRG 330 was $17,084 (based on Medicare data) for our facility in 2012, with the national average being $12,520. The total contribution margin among all cases collectively was -$19,122 ± 13,285 (average per patient -$2,731, range -$21,905-$12,029). Assuming a 3 % reimbursement reduction made the overall contribution margin -$22,122 ± 13,285 (average -$3,244). Including the cost of readmission in the variable cost made the contribution margin -$115,741 ± 16,023 (average -$16,534). Care of high-risk patients at tertiary and quaternary referral centers is a very expensive proposition and can lead to financial ruin under the current reimbursement system.

Does scale matter? The costs of HIV-prevention interventions for commercial sex workers in India.

PubMed Central

Guinness, Lorna; Kumaranayake, Lilani; Rajaraman, Bhuvaneswari; Sankaranarayanan, Girija; Vannela, Gangadhar; Raghupathi, P.; George, Alex

2005-01-01

OBJECTIVE: To explore how the scale of a project affects both the total costs and average costs of HIV prevention in India. METHODS: Economic cost data and measures of scale (coverage and service volume indicators for number of cases of sexually transmitted infections (STIs) referred, number of STIs treated, condoms distributed and contacts made with target groups) were collected from 17 interventions run by nongovernmental organizations aimed at commercial sex workers in southern India. Nonparametric methods and regression analyses were used to look at the relationship between total costs, unit costs and scale. FINDINGS: Coverage varied from 250 to 2008 sex workers. Annual costs ranged from US$ 11 274 to US$ 52 793. The median cost per sex worker reached was US$ 19.21 (range = US$ 10.00-51.00). The scale variables explain more than 50% of the variation in unit costs for all of the unit cost measures except cost per contact. Total costs and unit costs have non-linear relationships to scale. CONCLUSION: Average costs vary with the scale of the project. Estimates of resource requirements based on a constant average cost could underestimate or overestimate total costs. The results highlight the importance of improving scale-specific cost information for planning. PMID:16283051

Volatilization of organic compounds from streams

USGS Publications Warehouse

Rathburn, R.E.; Tai, D.Y.

1982-01-01

Mass-transfer coefficients for the volatilization of ethylene and propane were correlated with the hydraulic and geometric properties of seven streams, and predictive equations were developed. The equations were evaluated using a normalized root-mean-square error as the criterion of comparison. The two best equations were a two-variable equation containing the energy dissipated per unit mass per unit time and the average depth of flow and a three-variable equation containing the average velocity, the average depth of flow, and the slope of the stream. Procedures for adjusting the ethylene and propane coefficients for other organic compounds were evaluated. These procedures are based on molecular diffusivity, molecular diameter, or molecular weight. Because of limited data, none of these procedures have been extensively verified. Therefore, until additional data become available, it is suggested that the mass-transfer coefficient be assumed to be inversely proportional to the square root of the molecular weight.

Tractor-logging costs and production in old-growth redwood forests

Treesearch

Kenneth N. Boe

1963-01-01

A cost accounting analysis of full-scale logging operations in old-growth redwood during 2 years revealed that it cost $12.24 per M bd. ft. (gross Scribner log scale) to get logs on trucks. Road development costs averaged another $5.19 per M bd. ft. Felling-bucking production was calculated by average tree d.b.h. Both skidding and loading outputs per hour were...

Stationary Fuel Cell System Composite Data Products | Hydrogen and Fuel

Science.gov Websites

Capacity by Equipment Type CDP STAT 14, 10/21/15 Average Eligible Cost by Equipment Type, including Other Distributed Generation CDP STAT 15, 10/21/15 Average Eligible Cost for Biogas Sources CDP STAT 16, 10/21/15 Capacity and Eligible Cost (CHP Fuel Cells) CDP STAT 22, 10/21/15 Distribution of Eligible Cost with and

Physician Education on Controllable Costs Significantly Reduces Cost of Laparoscopic Hysterectomy.

PubMed

Croft, Katherine; Mattingly, Patricia J; Bosse, Patrick; Naumann, R Wendel

2017-01-01

To determine whether educating surgeons about their controllable instrumentation costs by providing cost data on total laparoscopic hysterectomy (LH) would reduce the cost of this procedure. Prospective cohort study (Canadian Task Force classification III). Academic-affiliated community hospital. Patients who underwent LH between April 2014 and March 2015 with surgeons who performed at least 10 LHs during that time period, along with a second group who underwent LH with the same cohort of surgeons between July 2015 and September 2015. The cost of LH was calculated for all surgeons who performed more than 10 LHs between April 2014 and March 2015. Itemized cost data were collected. The individual costs, as well as a summary of the data, were shared with all of the physicians to highlight areas of potential cost savings. The costs were then measured for 3 months after the educational intervention (July-September 2015) to gauge the impact of physician cost education. Thirteen surgeons met the criteria for inclusion in this analysis. Together, they performed 271 hysterectomies, with an average instrumentation cost of $1539.47 ± $294.16 and an average operating room time of 178 ± 26 minutes. Bipolar instrument choice represented 37% of the baseline costs, followed by 10% for trocar, 9% for cuff closure, and 8% for uterine manipulator. This same group of surgeons performed a total of 69 hysterectomies in the 3-month follow-up period of July-September 2015, with an average instrumentation cost of $1282.62 ± $235.03 and an average operating room time of 163 ± 50 minutes. There was statistically significant cost reduction of $256.85 ± $190.69 (p = .022), with no significant change in operating room time. Bipolar instrument cost decreased significantly, by $130.02 ± $125.02 (p = .021), representing 51% of the total cost savings. Trocar, cuff closure, and uterine manipulator costs were not significant sources of cost savings on average, but did represent sources of cost savings for some surgeons individually. Given adequate education about the products available for use in their institution, surgeons make informed decisions regarding the choice of instrumentation, allowing them to directly impact the cost of total LH, resulting in cost savings. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Novel Measure of Opioid Dose and Costs of Care for Diabetes Mellitus: Opioid Dose and Health Care Costs.

PubMed

Gautam, Santosh; Franzini, Luisa; Mikhail, Osama I; Chan, Wenyaw; Turner, Barbara J

2016-03-01

Diabetes mellitus (DM) has well known costly complications but we hypothesized that costs of care for chronic pain treated with opioid analgesic (OA) medications would also be substantial. In a statewide, privately insured cohort of 29,033 adults aged 18 to 64 years with DM and noncancer pain who filled OA prescription(s) from 2008 to 2012, our outcomes were costs for specific health care services and total costs per 6-month intervals after the first filled OA prescription. Average daily OA dose (4 categories) and total dose (quartiles) in morphine-equivalent milligrams were calculated per 6-month interval after the first OA prescription and combined into a novel OA dose measure. Associations of OA measures with costs of care (n = 126,854 6-month intervals) were examined using generalized estimating equations adjusted for clinical conditions, psychotherapeutic drugs, and DM treatment. Incremental costs for each type of health care service and total cost of care increased progressively with average daily and total OA dose versus no OAs. The combined OA measure identified the highest incremental total costs per 6-month interval that were increased by $8,389 for 50- to 99-mg average daily dose plus >900 mg total dose and, by $9,181 and $9,958 respectively, for ≥100 mg average daily dose plus 301- to 900-mg or >900 mg total dose. In this statewide DM cohort, total health care costs per 6-month interval increased progressively with higher average daily OA dose and with total OA dose but the greatest increases of >$8,000 were distinguished by combinations of higher average daily and total OA doses. The higher costs of care for opioid-treated patients appeared for all types of services and likely reflects multiple factors including morbidity from the underlying cause of pain, care and complications related to opioid use, and poorer control of diabetes as found in other studies. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Comprehensive investigation into historical pipeline construction costs and engineering economic analysis of Alaska in-state gas pipeline

NASA Astrophysics Data System (ADS)

Rui, Zhenhua

This study analyzes historical cost data of 412 pipelines and 220 compressor stations. On the basis of this analysis, the study also evaluates the feasibility of an Alaska in-state gas pipeline using Monte Carlo simulation techniques. Analysis of pipeline construction costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary by diameter, length, volume, year, and location. Overall average learning rates for pipeline material and labor costs are 6.1% and 12.4%, respectively. Overall average cost shares for pipeline material, labor, miscellaneous, and right of way (ROW) are 31%, 40%, 23%, and 7%, respectively. Regression models are developed to estimate pipeline component costs for different lengths, cross-sectional areas, and locations. An analysis of inaccuracy in pipeline cost estimation demonstrates that the cost estimation of pipeline cost components is biased except for in the case of total costs. Overall overrun rates for pipeline material, labor, miscellaneous, ROW, and total costs are 4.9%, 22.4%, -0.9%, 9.1%, and 6.5%, respectively, and project size, capacity, diameter, location, and year of completion have different degrees of impacts on cost overruns of pipeline cost components. Analysis of compressor station costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary in terms of capacity, year, and location. Average learning rates for compressor station material and labor costs are 12.1% and 7.48%, respectively. Overall average cost shares of material, labor, miscellaneous, and ROW are 50.6%, 27.2%, 21.5%, and 0.8%, respectively. Regression models are developed to estimate compressor station component costs in different capacities and locations. An investigation into inaccuracies in compressor station cost estimation demonstrates that the cost estimation for compressor stations is biased except for in the case of material costs. Overall average overrun rates for compressor station material, labor, miscellaneous, land, and total costs are 3%, 60%, 2%, -14%, and 11%, respectively, and cost overruns for cost components are influenced by location and year of completion to different degrees. Monte Carlo models are developed and simulated to evaluate the feasibility of an Alaska in-state gas pipeline by assigning triangular distribution of the values of economic parameters. Simulated results show that the construction of an Alaska in-state natural gas pipeline is feasible at three scenarios: 500 million cubic feet per day (mmcfd), 750 mmcfd, and 1000 mmcfd.

Monitoring of unstable slopes by MEMS tilting sensors and its application to early warning

NASA Astrophysics Data System (ADS)

Towhata, I.; Uchimura, T.; Seko, I.; Wang, L.

2015-09-01

The present paper addresses the newly developed early warning technology that can help mitigate the slope failure disasters during heavy rains. Many studies have been carried out in the recent times on early warning that is based on rainfall records. Although those rainfall criteria of slope failure tells the probability of disaster on a regional scale, it is difficult for them to judge the risk of particular slopes. This is because the rainfall intensity is spatially too variable to forecast and the early warning based on rainfall alone cannot take into account the effects of local geology, hydrology and topography that vary spatially as well. In this regard, the authors developed an alternative technology in which the slope displacement/deformation is monitored and early warning is issued when a new criterion is satisfied. The new MEMS-based sensor monitors the tilting angle of an instrument that is embedded at a very shallow depth and the record of the tilting angle corresponds to the lateral displacement at the slope surface. Thus, the rate of tilting angle that exceeds a new criterion value implies an imminent slope failure. This technology has been validated against several events of slope failures as well as against a field rainfall test. Those validations have made it possible to determine the criterion value of the rate of tilting angle to be 0.1 degree/hour. The advantage of the MEMS tilting sensor lies in its low cost. Hence, it is possible to install many low-cost sensors over a suspected slope in which the precise range of what is going to fall down during the next rainfall is unknown. In addition to the past validations, this paper also introduces a recent application to a failed slope in the Izu Oshima Island where a heavy rainfall-induced slope failure occurred in October, 2013.

Criteria for prioritization of HIV programs in Viet Nam: a discrete choice experiment.

PubMed

Safarnejad, Ali; Pavlova, Milena; Son, Vo Hai; Phuong, Huynh Lan; Groot, Wim

2017-11-13

With the decline in funding for Viet Nam's response to the HIV epidemic, there is a need for evidence on the criteria to guide the prioritization of HIV programs. There is a gap in the research on the relative importance of multiple criteria for prioritizing a package of interventions. This study elicits preferences and the trade-offs made between different HIV programs by relevant stakeholders and decision-makers in Viet Nam. It also pays attention to how differences in social and professional characteristics of stakeholders and their agency affiliations shape preferences for HIV program criteria in Viet Nam. This study uses self-explicated ranking and discrete choice experiments to determine the relative importance of five criteria - effectiveness, feasibility, cost-effectiveness, rate of investment and prevention/treatment investment ratio - to stakeholders when they evaluate and select hypothetical HIV programs. The study includes 69 participants from government, civil society, and international development partners. Results of the discrete choice experiment show that overall the feasibility criterion is ranked highest in importance to the participants when choosing a hypothetical HIV program, followed by sustainability, treatment to prevention spending ratio, and effectiveness. The participant's work in management, programming, or decision-making has a significant effect on the importance of some criteria to the participant. In the self-explicated ranking effectiveness is the most important criterion and the cost-effectiveness criterion ranks low in importance across all groups. This study has shown that the preferred HIV program in Viet Nam is feasible, front-loaded for sustainability, has a higher proportion of investment on prevention, saves more lives and prevents more infections. Similarities in government and civil society rankings of criteria can create common grounds for future policy dialogues between stakeholders. Innovative models of planning should be utilized to allow inputs of informed stakeholders at relevant stages of the HIV program planning process.

Effects of housing system on the costs of commercial egg production1

PubMed Central

Matthews, W. A.; Sumner, D. A.

2014-01-01

This article reports the first publicly available egg production costs compared across 3 hen-housing systems. We collected detailed data from 2 flock cycles from a commercial egg farm operating a conventional barn, an aviary, and an enriched colony system at the same location. The farm employed the same operational and accounting procedures for each housing system. Results provide clear evidence that egg production costs are much higher for the aviary system than the other 2 housing systems. Feed costs per dozen eggs are somewhat higher for the aviary and lower for the enriched house compared with the conventional house. Labor costs are much lower for the conventional house than the other 2, and pullet costs are much higher for the aviary. Energy and miscellaneous costs are a minimal part of total operating costs and do not differ by housing system. Total capital investments per hen-capacity are much higher for the aviary and the enriched house. Capital costs per dozen eggs depend on assumptions about appropriate interest and depreciation rates. Using the same 10% rate for each housing system shows capital costs per dozen for the aviary and the enriched housing system are much higher than capital costs per dozen for the conventional house. The aviary has average operating costs (feed, labor, pullet, energy, and miscellaneous costs that recur for each flock and vary with egg production) about 23% higher and average total costs about 36% higher compared with the conventional house. The enriched housing system has average operating costs only about 4% higher compared with the conventional house, but average total costs are 13% higher than for the conventional house. PMID:25480736

Effects of housing system on the costs of commercial egg production.

PubMed

Matthews, W A; Sumner, D A

2015-03-01

This article reports the first publicly available egg production costs compared across 3 hen-housing systems. We collected detailed data from 2 flock cycles from a commercial egg farm operating a conventional barn, an aviary, and an enriched colony system at the same location. The farm employed the same operational and accounting procedures for each housing system. Results provide clear evidence that egg production costs are much higher for the aviary system than the other 2 housing systems. Feed costs per dozen eggs are somewhat higher for the aviary and lower for the enriched house compared with the conventional house. Labor costs are much lower for the conventional house than the other 2, and pullet costs are much higher for the aviary. Energy and miscellaneous costs are a minimal part of total operating costs and do not differ by housing system. Total capital investments per hen-capacity are much higher for the aviary and the enriched house. Capital costs per dozen eggs depend on assumptions about appropriate interest and depreciation rates. Using the same 10% rate for each housing system shows capital costs per dozen for the aviary and the enriched housing system are much higher than capital costs per dozen for the conventional house. The aviary has average operating costs (feed, labor, pullet, energy, and miscellaneous costs that recur for each flock and vary with egg production) about 23% higher and average total costs about 36% higher compared with the conventional house. The enriched housing system has average operating costs only about 4% higher compared with the conventional house, but average total costs are 13% higher than for the conventional house. © The Author 2015. Published by Oxford University Press on behalf of Poultry Science Association.

Cost of illness of oral lichen planus in a U.K. population--a pilot study.

PubMed

Ni Riordain, Richeal; Christou, Joanna; Pinder, Denise; Squires, Vanessa; Hodgson, Tim

2016-05-01

To assess the economic burden of oral lichen planus (OLP) from the perspective of the healthcare provider in a U.K. population. This prevalence-based cost-of-illness analysis was carried out via a cross-sectional study conducted in the Oral Medicine Unit of the Eastman Dental Hospital. This study was conducted in three phases - phase 1 involved framing of the cost-of-illness analysis, development of the cost inventory and design of the patient questionnaire for ease of data collection. Data collected from patients were inputted during phase 2, and costings were determined. The final phase consisted of the calculation of the cost of illness of OLP. One hundred patients were enrolled in the study, 30 males and 70 females, with an average age of 59.9 years (±13.4 years). The average OLP patient, based on our cohort, attends the oral medicine unit 2.64 times per year, their general medical practitioner 1.13 times annually, their general dental practitioner 0.82 times in a year and fills on average 3.37 prescriptions annually. This leads to an average annual cost of £398.58 (€541.16) per patient per year from the perspective of the healthcare provider. The annual average cost of OLP to the healthcare provider in the U.K. is substantial. The prevalence-based cost-of-illness data generated in this study will facilitate comparison with other chronic oral mucosal diseases and with chronic diseases managed in allied medical specialties. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cost analytic model to determine the least costly inpatient erythropoiesis stimulating therapy regimen.

PubMed

Sikand, Harminder; Decter, Adam; Greco, Tina; Watson, Sue H; Kang, Yoon Jun; Mody, Samir H; Piech, Catherine Tak; Duh, Mei Sheng; Naeem, Ayesha

2008-01-01

Unlike in outpatient settings, the comparative costs of epoetin alpha (EPO) and darbepoetin alpha (DARB) have not been evaluated broadly from the inpatient hospital perspective. To develop a cost analytic model comparing hospital inpatient costs for erythropoiesis stimulating therapies within the nephrology and oncology settings. A cost analytic model incorporating erythropoietic drug, pharmacy, and nursing costs was developed from the inpatient hospital perspective to evaluate comparative costs of EPO and DARB. Erythropoietic drug costs were calculated using unit wholesale acquisition cost multiplied by the number of units or micrograms while comparing the following dosing regimens: EPO 3 times weekly, EPO once weekly, and DARB once weekly. Pharmacy costs included dispensing and delivery costs, while nursing costs incorporated administration time costs; all were calculated by estimated fractional hours per activity multiplied by hourly wages. The total frequency of erythropoiesis stimulating therapy administrations was determined based on the average hospital length of stay. The first erythropoiesis stimulating therapy dose was assumed to occur on day 3 of hospitalization. For total inpatient costs, a weighted average was calculated across disease states. One-way sensitivity analyses were conducted by varying length of stay, day of initial erythropoiesis stimulating therapy dose, pharmacy and nursing costs, and once-weekly DARB dose. EPO 3 times weekly was the least costly regimen across all disease states evaluated. Threshold analysis indicated that the cost of once-weekly DARB regimens would have to be reduced by 37% to equal the cost of EPO 3 times weekly for an average length of stay. Sensitivity analyses did not considerably affect the results. EPO 3 times weekly was found to be the least costly erythropoiesis stimulating therapy regimen for nephrology and oncology inpatients for the average length of stay as well as most other lengths of stay considered. Once-weekly EPO was the least costly erythropoiesis stimulating therapy regimen for several other lengths of stay, while once-weekly DARB was never found to be the least costly regimen.

Releasing young hardwood crop trees-use of a chain saw costs less than herbicides

Treesearch

Gary W. Miller; Gary W. Miller

1984-01-01

A crown-touching release of 12-year-old black cherry and yellow-poplar crop trees on a good site required removing an average of 14 trees for every crop tree. An average of 80 crop trees per acre was left free-to-grow with an average growing space of 4.7 feet on all sides of the crown. Basal spraying cost $0.80 per crop tree, stem injecting cost $0.61 per crop tree,...

A comparison between detailed and configuration-averaged collisional-radiative codes applied to nonlocal thermal equilibrium plasmas

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

Poirier, M.; Gaufridy de Dortan, F. de

A collisional-radiative model describing nonlocal-thermodynamic-equilibrium plasmas is developed. It is based on the HULLAC (Hebrew University Lawrence Livermore Atomic Code) suite for the transitions rates, in the zero-temperature radiation field hypothesis. Two variants of the model are presented: the first one is configuration averaged, while the second one is a detailed level version. Comparisons are made between them in the case of a carbon plasma; they show that the configuration-averaged code gives correct results for an electronic temperature T{sub e}=10 eV (or higher) but fails at lower temperatures such as T{sub e}=1 eV. The validity of the configuration-averaged approximation ismore » discussed: the intuitive criterion requiring that the average configuration-energy dispersion must be less than the electron thermal energy turns out to be a necessary but far from sufficient condition. Another condition based on the resolution of a modified rate-equation system is proposed. Its efficiency is emphasized in the case of low-temperature plasmas. Finally, it is shown that near-threshold autoionization cascade processes may induce a severe failure of the configuration-average formalism.« less

Decohesion models informed by first-principles calculations: The ab initio tensile test

NASA Astrophysics Data System (ADS)

Enrique, Raúl A.; Van der Ven, Anton

2017-10-01

Extreme deformation and homogeneous fracture can be readily studied via ab initio methods by subjecting crystals to numerical "tensile tests", where the energy of locally stable crystal configurations corresponding to elongated and fractured states are evaluated by means of density functional method calculations. The information obtained can then be used to construct traction curves of cohesive zone models in order to address fracture at the macroscopic scale. In this work, we perform an in depth analysis of traction curves and how ab initio calculations must be interpreted to rigorously parameterize an atomic scale cohesive zone model, using crystalline Ag as an example. Our analysis of traction curves reveal the existence of two qualitatively distinct decohesion criteria: (i) an energy criterion whereby the released elastic energy equals the energy cost of creating two new surfaces and (ii) an instability criterion that occurs at a higher and size independent stress than that of the energy criterion. We find that increasing the size of the simulation cell renders parts of the traction curve inaccessible to ab initio calculations involving the uniform decohesion of the crystal. We also find that the separation distance below which a crack heals is not a material parameter as has been proposed in the past. Finally, we show that a large energy barrier separates the uniformly stressed crystal from the decohered crystal, resolving a paradox predicted by a scaling law based on the energy criterion that implies that large crystals will decohere under vanishingly small stresses. This work clarifies confusion in the literature as to how a cohesive zone model is to be parameterized with ab initio "tensile tests" in the presence of internal relaxations.

Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia.

PubMed

Ali Jadoo, Saad Ahmed; Aljunid, Syed Mohamed; Nur, Amrizal Muhammad; Ahmed, Zafar; Van Dort, Dexter

2015-02-10

The service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital. All patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components' cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs). Drugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83. A mixed approach which is based partly on top-down and partly on bottom up costing methodology has been recruited to develop MY-DRG case-mix pharmacy service weight for 450 groups utilized by the UKMMC in 2011.

The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa

PubMed Central

Devjee, Jaymala; Moodley, Jack

2017-01-01

Background Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. Methods We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars. Results A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5%) were eligible to choose their abortion procedure; 94.1% (n = 834) chose medication abortion. The total average cost per medication abortion was $63.91 (52.32–75.51). The total average cost per MVA was higher at $69.60 (52.62–86.57); though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4%) medication abortion women being hospitalized and two (0.3%) having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods. Conclusion This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back-up, without increasing costs. PMID:28369061

Health resource utilization and the economic burden of patients with wet age-related macular degeneration in Thailand

PubMed Central

Dilokthornsakul, Piyameth; Chaiyakunapruk, Nathorn; Ruamviboonsuk, Paisan; Ratanasukon, Mansing; Ausayakhun, Somsanguan; Tungsomeroengwong, Akrapope; Pokawattana, Nattapol; Chanatittarat, Chalakorn

2014-01-01

AIM To determine healthcare resource utilization and the economic burden associated with wet age-related macular degeneration (AMD) in Thailand METHODS This study included patients diagnosed with wet AMD that were 60 years old or older, and had best corrected visual acuity (BCVA) measured at least two times during the follow-up period. We excluded patients having other eye diseases. Two separate sub-studies were conducted. The first sub-study was a retrospective cohort study; electronic medical charts were reviewed to estimate the direct medical costs. The second sub-study was a cross-sectional survey estimating the direct non-medical costs based on face-to-face interviews using a structured questionnaire. For the first sub-study, direct medical costs, including the cost of drugs, laboratory, procedures, and other treatments were obtained. For the second sub-study, direct non-medical costs, e.g. transportation, food, accessories, home renovation, and caregiver costs, were obtained from face-to-face interviews with patients and/or caregivers. RESULTS For the first sub-study, sixty-four medical records were reviewed. The annual average number of medical visits was 11.1±6.0. The average direct medical costs were $3 604±4 530 per year. No statistically-significant differences of the average direct medical costs among the BCVA groups were detected (P=0.98). Drug costs accounted for 77% of total direct medical costs. For direct non-medical costs, 67 patients were included. Forty-eight patients (71.6%) required the accompaniment of a person during the out-patient visit. Seventeen patients (25.4%) required a caregiver at home. The average direct non-medical cost was $2 927±6 560 per year. There were no statistically-significant differences in the average costs among the BCVA groups (P=0.74). Care-giver cost accounted for 87% of direct non-medical costs. CONCLUSION Our study indicates that wet AMD is associated with a substantial economic burden, especially concerning drug and care-giver costs. PMID:24634881

Costs of examinations performed in a hospital laboratory in Chile.

PubMed

Andrade, Germán Lobos; Palma, Carolina Salas

2018-01-01

To determine the total average costs related to laboratory examinations performed in a hospital laboratory in Chile. Retrospective study with data from July 2014 to June 2015. 92 examinations classified in ten groups were selected according to the analysis methodology. The costs were estimated as the sum of direct and indirect laboratory costs and indirect institutional factors. The average values obtained for the costs according to examination group (in USD) were: 1.79 (clinical chemistry), 10.21 (immunoassay techniques), 13.27 (coagulation), 26.06 (high-performance liquid chromatography), 21.2 (immunological), 3.85 (gases and electrolytes), 156.48 (cytogenetic), 1.38 (urine), 4.02 (automated hematological), 4.93 (manual hematological). The value, or service fee, returned to public institutions who perform laboratory services does not adequately reflect the true total average production costs of examinations.

Virginia ridesharing statistics : methodologies for determining carpooler and vanpool average life bases and the average fuel economy of commuter vehicles.

DOT National Transportation Integrated Search

1985-01-01

The objective of this research was to investigate methods of computing average life values for carpoolers and vanpools in Virginia. These statistics are to be used by the Rail and Public Transportation Division in evaluating the efficiency and cost-e...

47 CFR 36.622 - National and study area average unseparated loop costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2011-10-01 2011-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

47 CFR 36.622 - National and study area average unseparated loop costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... companies which did not make an update filing by the most recent filing date. (b) Study Area Average... 47 Telecommunication 2 2010-10-01 2010-10-01 false National and study area average unseparated... Universal Service Fund Calculation of Loop Costs for Expense Adjustment § 36.622 National and study area...

16 CFR Appendix K to Part 305 - Representative Average Unit Energy Costs

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Representative Average Unit Energy Costs K... CONGRESS ENERGY AND WATER USE LABELING FOR CONSUMER PRODUCTS UNDER THE ENERGY POLICY AND CONSERVATION ACT (âENERGY LABELING RULEâ) Pt. 305, App. K Appendix K to Part 305—Representative Average Unit Energy...

The cost of feeding bred dairy heifers on native warm-season grasses and harvested feedstuffs.

PubMed

Lowe, J K; Boyer, C N; Griffith, A P; Waller, J C; Bates, G E; Keyser, P D; Larson, J A; Holcomb, E

2016-01-01

Heifer rearing is one of the largest production expenses for dairy cattle operations, which is one reason milking operations outsource heifer rearing to custom developers. The cost of harvested feedstuffs is a major expense in heifer rearing. A possible way to lower feed costs is to graze dairy heifers, but little research exists on this topic in the mid-south United States. The objectives of this research were to determine the cost of feeding bred dairy heifers grazing native warm-season grasses (NWSG), with and without legumes, and compare the cost of grazing with the cost of rearing heifers using 3 traditional rations. The 3 rations were corn silage with soybean meal, corn silage with dry distillers grain, and a wet distillers grain-based ration. Bred Holstein heifers between 15- and 20-mo-old continuously grazed switchgrass (SG), SG with red clover (SG+RC), a big bluestem and Indiangrass mixture (BBIG), and BBIG with red clover (BBIG+RC) in Tennessee during the summer months. Total grazing days were calculated for each NWSG to determine the average cost/animal per grazing day. The average daily gain (ADG) was calculated for each NWSG to develop 3 harvested feed rations that would result in the same ADG over the same number of grazing day as each NWSG treatment. The average cost/animal per grazing day was lowest for SG ($0.48/animal/grazing d) and highest for BBIG+RC ($1.10/animal/grazing d). For both BBIG and SG, legumes increased the average cost/animal per grazing day because grazing days did not increase enough to account for the additional cost of the legumes. No difference was observed in ADG for heifers grazing BBIG (0.85 kg/d) and BBIG+RC (0.94 kg/d), and no difference was observed in ADG for heifers grazing SG (0.71 kg/d) and SG+RC (0.70 kg/d). However, the ADG for heifers grazing SG and SG+RC was lower than the ADG for heifers grazing either BBIG or BBIG+RC. The average cost/animal per grazing day was lower for all NWSG treatments than the average cost/animal per day for all comparable feed rations at a low, average, and high yardage fee. Results of this study suggest that SG was the most cost-effective NWSG alternative to harvested feeds for bred dairy heifer rearing. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

V/V(max) test applied to SMM gamma-ray bursts

NASA Technical Reports Server (NTRS)

Matz, S. M.; Higdon, J. C.; Share, G. H.; Messina, D. C.; Iadicicco, A.

1992-01-01

We have applied the V/V(max) test to candidate gamma-ray bursts detected by the Gamma-Ray Spectrometer (GRS) aboard the SMM satellite to examine quantitatively the uniformity of the burst source population. For a sample of 132 candidate bursts identified in the GRS data by an automated search using a single uniform trigger criterion we find average V/V(max) = 0.40 +/- 0.025. This value is significantly different from 0.5, the average for a uniform distribution in space of the parent population of burst sources; however, the shape of the observed distribution of V/V(max) is unusual and our result conflicts with previous measurements. For these reasons we can currently draw no firm conclusion about the distribution of burst sources.

Potential costs of breast augmentation mammaplasty.

PubMed

Schmitt, William P; Eichhorn, Mitchell G; Ford, Ronald D

2016-01-01

Augmentation mammaplasty is one of the most common surgical procedures performed by plastic surgeons. The aim of this study was to estimate the cost of the initial procedure and its subsequent complications, as well as project the cost of Food and Drug Administration (FDA)-recommended surveillance imaging. The potential costs to the individual patient and society were calculated. Local plastic surgeons provided billing data for the initial primary silicone augmentation and reoperative procedures. Complication rates used for the cost analysis were obtained from the Allergen Core study on silicone implants. Imaging surveillance costs were considered in the estimations. The average baseline initial cost of silicone augmentation mammaplasty was calculated at $6335. The average total cost of primary breast augmentation over the first decade for an individual patient, including complications requiring reoperation and other ancillary costs, was calculated at $8226. Each decade thereafter cost an additional $1891. Costs may exceed $15,000 over an averaged lifetime, and the recommended implant surveillance could cost an additional $33,750. The potential cost of a breast augmentation, which includes the costs of complications and imaging, is significantly higher than the initial cost of the procedure. Level III, economic and decision analysis study. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A cubic map chaos criterion theorem with applications in generalized synchronization based pseudorandom number generator and image encryption.

PubMed

Yang, Xiuping; Min, Lequan; Wang, Xue

2015-05-01

This paper sets up a chaos criterion theorem on a kind of cubic polynomial discrete maps. Using this theorem, Zhou-Song's chaos criterion theorem on quadratic polynomial discrete maps and generalized synchronization (GS) theorem construct an eight-dimensional chaotic GS system. Numerical simulations have been carried out to verify the effectiveness of theoretical results. The chaotic GS system is used to design a chaos-based pseudorandom number generator (CPRNG). Using FIPS 140-2 test suit/Generalized FIPS 140-2, test suit tests the randomness of two 1000 key streams consisting of 20 000 bits generated by the CPRNG, respectively. The results show that there are 99.9%/98.5% key streams to have passed the FIPS 140-2 test suit/Generalized FIPS 140-2 test. Numerical simulations show that the different keystreams have an average 50.001% same codes. The key space of the CPRNG is larger than 2(1345). As an application of the CPRNG, this study gives an image encryption example. Experimental results show that the linear coefficients between the plaintext and the ciphertext and the decrypted ciphertexts via the 100 key streams with perturbed keys are less than 0.00428. The result suggests that the decrypted texts via the keystreams generated via perturbed keys of the CPRNG are almost completely independent on the original image text, and brute attacks are needed to break the cryptographic system.

A cubic map chaos criterion theorem with applications in generalized synchronization based pseudorandom number generator and image encryption

NASA Astrophysics Data System (ADS)

Yang, Xiuping; Min, Lequan; Wang, Xue

2015-05-01

This paper sets up a chaos criterion theorem on a kind of cubic polynomial discrete maps. Using this theorem, Zhou-Song's chaos criterion theorem on quadratic polynomial discrete maps and generalized synchronization (GS) theorem construct an eight-dimensional chaotic GS system. Numerical simulations have been carried out to verify the effectiveness of theoretical results. The chaotic GS system is used to design a chaos-based pseudorandom number generator (CPRNG). Using FIPS 140-2 test suit/Generalized FIPS 140-2, test suit tests the randomness of two 1000 key streams consisting of 20 000 bits generated by the CPRNG, respectively. The results show that there are 99.9%/98.5% key streams to have passed the FIPS 140-2 test suit/Generalized FIPS 140-2 test. Numerical simulations show that the different keystreams have an average 50.001% same codes. The key space of the CPRNG is larger than 21345. As an application of the CPRNG, this study gives an image encryption example. Experimental results show that the linear coefficients between the plaintext and the ciphertext and the decrypted ciphertexts via the 100 key streams with perturbed keys are less than 0.00428. The result suggests that the decrypted texts via the keystreams generated via perturbed keys of the CPRNG are almost completely independent on the original image text, and brute attacks are needed to break the cryptographic system.

Experimental Investigation of the Peak Shear Strength Criterion Based on Three-Dimensional Surface Description

NASA Astrophysics Data System (ADS)

Liu, Quansheng; Tian, Yongchao; Ji, Peiqi; Ma, Hao

2018-04-01

The three-dimensional (3D) morphology of joints is enormously important for the shear mechanical properties of rock. In this study, three-dimensional morphology scanning tests and direct shear tests are conducted to establish a new peak shear strength criterion. The test results show that (1) surface morphology and normal stress exert significant effects on peak shear strength and distribution of the damage area. (2) The damage area is located at the steepest zone facing the shear direction; as the normal stress increases, it extends from the steepest zone toward a less steep zone. Via mechanical analysis, a new formula for the apparent dip angle is developed. The influence of the apparent dip angle and the average joint height on the potential contact area is discussed, respectively. A new peak shear strength criterion, mainly applicable to specimens under compression, is established by using new roughness parameters and taking the effects of normal stress and the rock mechanical properties into account. A comparison of this newly established model with the JRC-JCS model and the Grasselli's model shows that the new one could apparently improve the fitting effect. Compared with earlier models, the new model is simpler and more precise. All the parameters in the new model have clear physical meanings and can be directly determined from the scanned data. In addition, the indexes used in the new model are more rational.

An experimental study on the noise correlation properties of CBCT projection data

NASA Astrophysics Data System (ADS)

Zhang, Hua; Ouyang, Luo; Ma, Jianhua; Huang, Jing; Chen, Wufan; Wang, Jing

2014-03-01

In this study, we systematically investigated the noise correlation properties among detector bins of CBCT projection data by analyzing repeated projection measurements. The measurements were performed on a TrueBeam on-board CBCT imaging system with a 4030CB flat panel detector. An anthropomorphic male pelvis phantom was used to acquire 500 repeated projection data at six different dose levels from 0.1 mAs to 1.6 mAs per projection at three fixed angles. To minimize the influence of the lag effect, lag correction was performed on the consecutively acquired projection data. The noise correlation coefficient between detector bin pairs was calculated from the corrected projection data. The noise correlation among CBCT projection data was then incorporated into the covariance matrix of the penalized weighted least-squares (PWLS) criterion for noise reduction of low-dose CBCT. The analyses of the repeated measurements show that noise correlation coefficients are non-zero between the nearest neighboring bins of CBCT projection data. The average noise correlation coefficients for the first- and second- order neighbors are 0.20 and 0.06, respectively. The noise correlation coefficients are independent of the dose level. Reconstruction of the pelvis phantom shows that the PWLS criterion with consideration of noise correlation results in a lower noise level as compared to the PWLS criterion without considering the noise correlation at the matched resolution.

Triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) index as a reference criterion of risk for metabolic syndrome (MetS) and low insulin sensitivity in apparently healthy subjects.

PubMed

Baez-Duarte, Blanca Guadalupe; Zamora-Gínez, Irma; González-Duarte, Ramiro; Torres-Rasgado, Enrique; Ruiz-Vivanco, Guadalupe; Pérez-Fuentes, Ricardo; Celis, The Multidisciplinary Research Group Of Diabetes

To evaluate if the TG/HDL-C index can be considered as a reference criterion of MetS and low insulin sensitivity in apparently healthy subjects. The subjects were Mexican mestizos who resided in Puebla City, Mexico, who were anthropometrically, biochemically, and clinically characterized. The TG/HDL-C index was calculated by dividing triglyceride (TG) levels by HDL-C levels. MetS was diagnosed by the Third Report from the Adult Treatment Panel-National Cholesterol Education Program (ATP-III NCEP) criteria, while insulin sensitivity was evaluated by the Quantitative Insulin sensitivity Check Index (QUICKI). The study included 813 subjects, with an average age of 38.6 ± 12.1 years, of which 564 were women and 249 men. An association was found between high TG/HDL-C index and low insulin sensitivity (Odds ratio [OR]: 4.09; p < 0.01) and with MetS (OR: 15.29; p < 0.01). A correlation was found between the TG/HDL-C index and QUICKI (rho: -0.4989; p < 0.01) and with MetS (rho: 0.6581; p < 0.01). The results indicate that the TG/HDL-C index is associated with low insulin sensitivity and MetS in apparently healthy subjects, suggesting this index as a reference criterion of risk for low insulin sensitivity and MetS.

College Costs: Recent Trends, Likely Future. Policy Brief.

ERIC Educational Resources Information Center

Henderson, Cathy

Recent trends in college costs and reasons why college costs have been increasing are considered. Comparative data are presented on recent rates of growth among average college charges, faculty salaries, the Higher Education Price Index (HEPI), and the Consumer Price Index (CPI). It is shown that from 1977 through 1982, average total tuition,…

16 CFR 305.10 - Ranges of comparability on the required labels.

Code of Federal Regulations, 2014 CFR

2014-01-01

... cost. The Representative Average Unit Energy Cost figures to be used on labels as required by § 305.11... Commission shall publish revised Representative Average Unit Energy Cost figures in the Federal Register in... ACTS OF CONGRESS ENERGY AND WATER USE LABELING FOR CONSUMER PRODUCTS UNDER THE ENERGY POLICY AND...

Real Options as a Strategic Management Framework: A Case Study of the Operationally Responsive Space Initiative

DTIC Science & Technology

2007-03-01

of the project, and the Weighted Average Cost of Capital ( WACC ). WACC is defined as the after-tax marginal cost of capital (Copeland & Antikarov...Initial Investment t = Life Expectancy of Project (Start =1, to Finish=N) E(FCF) = Expected Free-Cash Flow WACC = Weighted Average Cost of

Values of decentralized systems that avoid investments in idle capacity within the wastewater sector: a theoretical justification.

PubMed

Wang, Sheng

2014-04-01

In this work, the values of decentralized (onsite) systems that avoid investments in idle capacity within wastewater plans are quantitatively justified using the specific net present value (SNPV) approach. SNPV is a currently proposed criterion in environmental engineering economics that is defined as the net present value of the cost per unit of service or per population equivalent (PE). The SNPV approach was reintroduced with bugs fixed and then applied to the economic analysis of the capital and operating costs of one-stage completed central plants, stage-expanded central plants, and decentralized treatment facilities. The results show that under a demand growth scenario, the central plant will inevitably reach idle capacity, which can be reduced by a staged expansion. However, the staged expansion plan will lose the economies of scale and, hence, is only viable under projections of a low or moderate price inflation rate or high demand growth rate. Onsite treatment systems can theoretically achieve 100% utilization. Assuming that the capital costs per PE of the onsite and central systems are equal, the former is economically favorable in most cases of price inflation as a result of its cost saving on idle capacity. Onsite treatment systems can be viable even though their capital expenditures per PE are higher than that of a comparable centralized option as to a capital investment. This finding suggests wide opening of onsite technology choices. Use of the SNPV showed that average operating expenses of centralized plants decrease as demand growth rates increase as a benefit of economies of scale, whereas those of onsite treatment systems depend only on price inflation. Semi-decentralized systems feature both the financial advantage of the onsite system (capital investment) and the superiority of centralized systems (operation and maintenance); thus, it is worth consideration. The results of this study illustrate not only the value of decentralized systems but also the value of the SNPV approach in the planning of wastewater services, especially in areas undergoing high demand growth. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reliability, Factor Structure, and Associations With Measures of Problem Relationship and Behavior of the Personality Inventory for DSM-5 in a Sample of Italian Community-Dwelling Adolescents.

PubMed

Somma, Antonella; Borroni, Serena; Maffei, Cesare; Giarolli, Laura E; Markon, Kristian E; Krueger, Robert F; Fossati, Andrea

2017-10-01

In order to assess the reliability, factorial validity, and criterion validity of the Personality Inventory for DSM-5 (PID-5) among adolescents, 1,264 Italian high school students were administered the PID-5. Participants were also administered the Questionnaire on Relationships and Substance Use as a criterion measure. In the full sample, McDonald's ω values were adequate for the PID-5 scales (median ω = .85, SD = .06), except for Suspiciousness. However, all PID-5 scales showed average inter-item correlation values in the .20-.55 range. Exploratory structural equation modeling analyses provided moderate support for the a priori model of PID-5 trait scales. Ordinal logistic regression analyses showed that selected PID-5 trait scales predicted a significant, albeit moderate (Cox & Snell R 2 values ranged from .08 to .15, all ps < .001) amount of variance in Questionnaire on Relationships and Substance Use variables.

Dynamical freeze-out criterion in a hydrodynamical description of Au + Au collisions at √{sNN}=200 GeV and Pb + Pb collisions at √{sNN}=2760 GeV

NASA Astrophysics Data System (ADS)

Ahmad, Saeed; Holopainen, Hannu; Huovinen, Pasi

2017-05-01

In hydrodynamical modeling of ultrarelativistic heavy-ion collisions, the freeze-out is typically assumed to take place at a surface of constant temperature or energy density. A more physical approach is to assume that freeze-out takes place at a surface of constant Knudsen number. We evaluate the Knudsen number as a ratio of the expansion rate of the system to the pion-scattering rate and apply the constant Knudsen number freeze-out criterion to the ideal hydrodynamical description of heavy-ion collisions at the Relativistic Heavy Ion Collider at BNL (√{sNN}=200 GeV) and the Large Hadron Collider (√{sNN}=2760 GeV) energies. We see that once the numerical values of freeze-out temperature and freeze-out Knudsen number are chosen to produce similar pT distributions, the elliptic and triangular anisotropies are similar too, in both event-by-event and averaged initial state calculations.

A method to achieve comparable thermal states of car brakes during braking on the road and on a high-speed roll-stand

NASA Astrophysics Data System (ADS)

Wolff, Andrzej

2010-01-01

The temperature of a brake friction surface influences significantly the braking effectiveness. The paper describes a heat transfer process in car brakes. Using a developed program of finite element method, the temperature distributions in brake rotors (disc and drum brake) of a light truck have been calculated. As a preliminary consistency criterion of the brake thermal state in road and roll-stand braking conditions, a balance of the energy cumulated in the brake rotor has been taken into account. As the most reliable consistency criterion an equality of average temperatures of the friction surface has been assumed. The presented method allows to achieve on a roll-stand the analogical thermal states of automotive brakes, which are observed during braking in road conditions. Basing on this method, it is possible to calculate the braking time and force for a high-speed roll-stand. In contrast to the previous papers of the author, new calculation results have been presented.

Survey of Foods to Improve Logistic Support and Extend Mission Endurance of Submarines

DTIC Science & Technology

1981-12-01

lower priority. For example, in the computer run, Chicken , Frozen, Broiler -Fryer, Whole (National Stock Number (NSN) 8905-00-126-3416) is specified...Increase ration density 1 (Decrease Logistical costs 2 Reduce number of line items 3 Conserve onboard refrigeration space 4 i Reduce food service labor...selection priority is based primarily on the ability of the substitute item to achieve increased ration density , and each subsequent I criterion has a

Variable-Reluctance Motor For Electric Vehicles

NASA Technical Reports Server (NTRS)

Lang, Jeffrey H.

1987-01-01

Report describes research on variable-reluctance electric-motor drive for eventual use in electric-vehicle propulsion. Primary design and performance criteria were torque and power output per unit mass of motor, cost, and drive efficiency. For each criterion, optimized drive design developed, and designs unified to yield single electric-vehicle drive. Scaled-down motor performed as expected. Prototype of paraplegic lift operated by toggle switch and joystick. Lift plugs into household electrical outlet for recharging when not in use.

Effort and Accuracy in Choice.

DTIC Science & Technology

1984-01-01

AUTOMIS . CONTPRACT OR GANT MUNGICAfO) Eric J. Johnson John W. Payne . NOOO-14-80-C-a 114 UPCOVRIMIS ORGANIZATION NDE1 AND AGOREM If- =AtI9ET PR 1T...concerning human rationality in the absence of a detailed analysis of the sensitivity of the criterion and the cost involved in evaluating the alternatives (p...can be thought of as being part of long-term memory. Arguments for the value of production systems as a representation of human cognitive processes

Selection of infectious medical waste disposal firms by using the analytic hierarchy process and sensitivity analysis.

PubMed

Hsu, Pi-Fang; Wu, Cheng-Ru; Li, Ya-Ting

2008-01-01

While Taiwanese hospitals dispose of large amounts of medical waste to ensure sanitation and personal hygiene, doing so inefficiently creates potential environmental hazards and increases operational expenses. However, hospitals lack objective criteria to select the most appropriate waste disposal firm and evaluate its performance, instead relying on their own subjective judgment and previous experiences. Therefore, this work presents an analytic hierarchy process (AHP) method to objectively select medical waste disposal firms based on the results of interviews with experts in the field, thus reducing overhead costs and enhancing medical waste management. An appropriate weight criterion based on AHP is derived to assess the effectiveness of medical waste disposal firms. The proposed AHP-based method offers a more efficient and precise means of selecting medical waste firms than subjective assessment methods do, thus reducing the potential risks for hospitals. Analysis results indicate that the medical sector selects the most appropriate infectious medical waste disposal firm based on the following rank: matching degree, contractor's qualifications, contractor's service capability, contractor's equipment and economic factors. By providing hospitals with an effective means of evaluating medical waste disposal firms, the proposed AHP method can reduce overhead costs and enable medical waste management to understand the market demand in the health sector. Moreover, performed through use of Expert Choice software, sensitivity analysis can survey the criterion weight of the degree of influence with an alternative hierarchy.

Conceptual basis for an integrated system for the management of a protected area. Examples from its application in a mediterranean area.

PubMed

Cornejo, E; Fungairiño, S G; Barandica, J M; Serrano, J M; Zorrilla, J M; Gómez, T; Zapata, F J; Acosta, F J

2016-01-15

Improving the efficiency of management in protected areas is imperative in a generalized context of limited conservation budgets. However, this is overlooked due to flaws in problem definition, general disregard for cost information, and a lack of suitable tools for measuring costs and management quality. This study describes an innovative methodological framework, implemented in the web application SIGEIN, focused on maximizing the quality of management against its costs, establishing an explicit justification for any decision. The tool integrates, with this aim, a procedure for prioritizing management objects according to a conservation value, modified by a functional criterion; a project management module; and a module for management of continuous assessment. This appraisal associates the relevance of the conservation targets, the efficacy of the methods employed, both resource and personnel investments, and the resulting costs. Preliminary results of a prototypical SIGEIN application on the Site of Community Importance Chafarinas Islands are included. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Pay for performance explained by transaction costs theory].

PubMed

Gorbaneff, Yuri; Cortes, Ariel; Torres, Sergio; Yepes, Francisco

2011-01-01

To evaluate the ability of transaction costs theory to explain incentives in the health care chain. We performed a case study of CPS, a health insurance company in Bogota (Colombia), which preferred not to publish its name. CPS moves in the environment of high transaction costs and uses the hybrid form of governance at the outpatient level. Incentive intensity, administrative control and the contract all agree with the theory. At the hospital level, the market is used, despite greater uncertainty. Because of the discrete form (1.0) of the incentives and the absence of administrative control, it is difficult for CPS to relate payment to hospital performance. Transaction costs theory explains the configuration of incentives. Another contribution made by this theory to the literature is the criterion to differentiate between the market and the hybrid. We propose that the market uses discrete-type (1.0) incentives, while the hybrid uses continuous, commission-like incentives. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

The effects of scale on the costs of targeted HIV prevention interventions among female and male sex workers, men who have sex with men and transgenders in India

PubMed Central

Guinness, L; Kumaranayake, L; Reddy, Bhaskar; Govindraj, Y; Vickerman, P; Alary, M

2010-01-01

Background The India AIDS Initiative (Avahan) project is involved in rapid scale-up of HIV-prevention interventions in high-risk populations. This study examines the cost variation of 107 non-governmental organisations (NGOs) implementing targeted interventions, over the start up (defined as period from project inception until services to the key population commenced) and first 2 years of intervention. Methods The Avahan interventions for female and male sex workers and their clients, in 62 districts of four southern states were costed for the financial years 2004/2005 and 2005/2006 using standard costing techniques. Data sources include financial and economic costs from the lead implementing partners (LPs) and subcontracted local implementing NGOs retrospectively and prospectively collected from a provider perspective. Ingredients and step-down allocation processes were used. Outcomes were measured using routinely collected project data. The average costs were estimated and a regression analysis carried out to explore causes of cost variation. Costs were calculated in US$ 2006. Results The total number of registered people was 134 391 at the end of 2 years, and 124 669 had used STI services during that period. The median average cost of Avahan programme for this period was $76 per person registered with the project. Sixty-one per cent of the cost variation could be explained by scale (positive association), number of NGOs per district (negative), number of LPs in the state (negative) and project maturity (positive) (p<0.0001). Conclusions During rapid scale-up in the initial phase of the Avahan programme, a significant reduction in average costs was observed. As full scale-up had not yet been achieved, the average cost at scale is yet to be realised and the extent of the impact of scale on costs yet to be captured. Scale effects are important to quantify for planning resource requirements of large-scale interventions. The average cost after 2 years is within the range of global scale-up costs estimates and other studies in India. PMID:20167740

The effects of scale on the costs of targeted HIV prevention interventions among female and male sex workers, men who have sex with men and transgenders in India.

PubMed

Chandrashekar, S; Guinness, L; Kumaranayake, L; Reddy, Bhaskar; Govindraj, Y; Vickerman, P; Alary, M

2010-02-01

The India AIDS Initiative (Avahan) project is involved in rapid scale-up of HIV-prevention interventions in high-risk populations. This study examines the cost variation of 107 non-governmental organisations (NGOs) implementing targeted interventions, over the start up (defined as period from project inception until services to the key population commenced) and first 2 years of intervention. The Avahan interventions for female and male sex workers and their clients, in 62 districts of four southern states were costed for the financial years 2004/2005 and 2005/2006 using standard costing techniques. Data sources include financial and economic costs from the lead implementing partners (LPs) and subcontracted local implementing NGOs retrospectively and prospectively collected from a provider perspective. Ingredients and step-down allocation processes were used. Outcomes were measured using routinely collected project data. The average costs were estimated and a regression analysis carried out to explore causes of cost variation. Costs were calculated in US$ 2006. The total number of registered people was 134,391 at the end of 2 years, and 124,669 had used STI services during that period. The median average cost of Avahan programme for this period was $76 per person registered with the project. Sixty-one per cent of the cost variation could be explained by scale (positive association), number of NGOs per district (negative), number of LPs in the state (negative) and project maturity (positive) (p<0.0001). During rapid scale-up in the initial phase of the Avahan programme, a significant reduction in average costs was observed. As full scale-up had not yet been achieved, the average cost at scale is yet to be realised and the extent of the impact of scale on costs yet to be captured. Scale effects are important to quantify for planning resource requirements of large-scale interventions. The average cost after 2 years is within the range of global scale-up costs estimates and other studies in India.

The Hidden Cost of Regulation: The Administrative Cost of Reporting Serious Reportable Events.

PubMed

Blanchfield, Bonnie B; Acharya, Bijay; Mort, Elizabeth

2018-04-01

More than half of the 50 states (27) and the District of Columbia require reporting of Serous Reportable Events (SREs). The goal is to hold providers accountable and improve patient safety, but there is little information about the administrative cost of this reporting requirement. This study was conducted to identify costs associated with investigating and reporting SREs. This qualitative study used case study methods that included interviewing staff and review of data and documents to investigate each SRE occurring at one academic medical center during fiscal year 2013. A framework of tasks and a model to categorize costs was created. Time was summarized and costs were estimated for each SRE. The administrative cost to process 44 SREs was estimated at $353,291, an average cost of $8,029 per SRE, ranging $6,653 for an environmental-related SRE to $21,276 for a device-related SRE. Care management SREs occurred most frequently, costing an average $7,201 per SRE. Surgical SREs, the most expensive on average, cost $9,123 per SRE. Investigation of events accounted for 64.5% of total cost; public reporting, 17.2%; internal reporting, 10.2%; finance and administration, 6.0%; and 2.1%, other. Even with 26 states mandating reporting, the 17.2% incremental cost of public reporting is substantial. Policy makers should consider the opportunity costs of these resources, averaging $8,029 per SRE, when mandating reporting. The benefits of public reporting should be collectively reviewed to ensure that the incremental costs in this resource-constrained environment continue to improve patient safety and that trade-offs are acknowledged. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Economic impact of switching from an open to a closed enteral nutrition feeding system in an acute care setting.

PubMed

Phillips, Wendy; Roman, Brandis; Glassman, Kendra

2013-08-01

This study compared an open-system (OS) enteral nutrition (EN) delivery system with a closed system (CS). Factors evaluated included nursing time for administration, patient safety factors, and cost of formula and supplies. This study analyzed the cost of formula and supplies in 1 major academic medical center. Data were collected on patients requiring EN in acute care settings. Information collected included formula type and amount of formula ordered and delivered. The average daily cost to feed each adult patient using delivered volume with the OS was $3.84 compared with $4.31 if the patient had been receiving EN from a CS. Considering waste costs, the average cost to feed increased to $4.21 compared with $4.80, respectively. After factoring in increased nursing time with the OS, the cost increased to $9.83. For pediatric patients, formula delivery reached 1 L in only 2% of patient days. The average cost to feed each patient each day using actual delivered volume was $1.89 in the OS and $1.94 in the CS. When factoring in the cost of waste, those costs increased to $2.12 and $3.30, respectively. After factoring in increased nursing time with the OS, the cost increased to $8.92. Due to the higher contract price and increased waste of the CS formulas compared with the OS formulas, a higher daily average cost for formula delivered may be incurred by switching to a CS. However, the CS is more cost-effective when factoring in nursing time.

Strategies to Prevent MRSA Transmission in Community-Based Nursing Homes: A Cost Analysis.

PubMed

Roghmann, Mary-Claire; Lydecker, Alison; Mody, Lona; Mullins, C Daniel; Onukwugha, Eberechukwu

2016-08-01

OBJECTIVE To estimate the costs of 3 MRSA transmission prevention scenarios compared with standard precautions in community-based nursing homes. DESIGN Cost analysis of data collected from a prospective, observational study. SETTING AND PARTICIPANTS Care activity data from 401 residents from 13 nursing homes in 2 states. METHODS Cost components included the quantities of gowns and gloves, time to don and doff gown and gloves, and unit costs. Unit costs were combined with information regarding the type and frequency of care provided over a 28-day observation period. For each scenario, the estimated costs associated with each type of care were summed across all residents to calculate an average cost and standard deviation for the full sample and for subgroups. RESULTS The average cost for standard precautions was $100 (standard deviation [SD], $77) per resident over a 28-day period. If gown and glove use for high-risk care was restricted to those with MRSA colonization or chronic skin breakdown, average costs increased to $137 (SD, $120) and $125 (SD, $109), respectively. If gowns and gloves were used for high-risk care for all residents in addition to standard precautions, the average cost per resident increased substantially to $223 (SD, $127). CONCLUSIONS The use of gowns and gloves for high-risk activities with all residents increased the estimated cost by 123% compared with standard precautions. This increase was ameliorated if specific subsets (eg, those with MRSA colonization or chronic skin breakdown) were targeted for gown and glove use for high-risk activities. Infect Control Hosp Epidemiol 2016;37:962-966.

What difference a decade? The costs of psychosis in Australia in 2000 and 2010: comparative results from the first and second Australian national surveys of psychosis.

PubMed

Neil, Amanda L; Carr, Vaughan J; Mihalopoulos, Cathrine; Mackinnon, Andrew; Lewin, Terry J; Morgan, Vera A

2014-03-01

To assess differences in costs of psychosis between the first and second Australian national surveys of psychosis and examine them in light of policy developments. Cost differences due to changes in resource use and/or real price rises were assessed by minimizing differences in recruitment and costing methodologies between the two surveys. For each survey, average annual societal costs of persons recruited through public specialized mental health services in the census month were assessed through prevalence-based, bottom-up cost-of-illness analyses. The first survey costing methodology was employed as the reference approach. Unit costs were specific to each time period (2000, 2010) and expressed in 2010 Australian dollars. There was minimal change in the average annual costs of psychosis between the surveys, although newly included resources in the second survey's analysis cost AUD$3183 per person. Among resources common to each analysis were significant increases in the average annual cost per person for ambulatory care of AUD$7380, non-government services AUD$2488 and pharmaceuticals AUD$1892, and an upward trend in supported accommodation costs. These increases were offset by over a halving of mental health inpatient costs of AUD$11,790 per person and a 84.6% (AUD$604) decrease in crisis accommodation costs. Productivity losses, the greatest component cost, changed minimally, reflecting the magnitude and constancy of reduced employment levels of individuals with psychosis across the surveys. Between 2000 and 2010 there was little change in total average annual costs of psychosis for individuals receiving treatment at public specialized mental health services. However, there was a significant redistribution of costs within and away from the health sector in line with government initiatives arising from the Second and Third National Mental Health Plans. Non-health sector costs are now a critical component of cost-of-illness analyses of mental illnesses reflecting, at least in part, a whole-of-government approach to care.

A fuzzy call admission control scheme in wireless networks

NASA Astrophysics Data System (ADS)

Ma, Yufeng; Gong, Shenguang; Hu, Xiulin; Zhang, Yunyu

2007-11-01

Scarcity of the spectrum resource and mobility of users make quality of service (QoS) provision a critical issue in wireless networks. This paper presents a fuzzy call admission control scheme to meet the requirement of the QoS. A performance measure is formed as a weighted linear function of new call and handoff call blocking probabilities. Simulation compares the proposed fuzzy scheme with an adaptive channel reservation scheme. Simulation results show that fuzzy scheme has a better robust performance in terms of average blocking criterion.

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

Xi, P. W.; Lawrence Livermore National Laboratory, Livermore, California 94550; Xu, X. Q.

We demonstrate that the occurrence of Edge-Localized-Modes (ELM) crashes does not depend only on the linear peeling-ballooning threshold, but also relies on nonlinear processes. Wave-wave interaction constrains the growth time of a mode, thus inducing a shift in the criterion for triggering an ELM crash. An ELM crash requires the P-B growth rate to exceed a critical value γ>γ{sub c}, where γ{sub c} is set by 1/τ{sup ¯}{sub c}, and τ{sup ¯}{sub c} is the averaged mode phase coherence time. For 0

Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

PubMed

Lääperi, A L

1996-01-01

The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and nonmonetary variables was developed. In it the radiologist, radiographer and examination-specific equipment costs were allocated to the examinations applying estimated cost equivalents. Some minor cost items were replaced by a general cost factor (GCF). The program is suitable for internal cost accounting of radiological departments as well as regional planning. If more accurate cost information is required, cost assignment employing the actual consumption of the resources and applying the principles of activity-based cost accounting is recommended. As an application of the cost accounting formula the average costs of the radiological examinations were calculated. In conventional radiography the average proportion of the cost factors in the total material was: personnel costs 43%, equipment costs 26%, material costs 7%, real estate costs 11%, administration and overheads 14%. The average total costs including radiologist costs in the hospitals were (FIM): conventional roentgen examinations 188, contrast medium examinations 695, ultrasound 296, mammography 315, roentgen examinations with mobile equipment 1578. The average total costs without radiologist costs in the public health centres were (FIM): conventional roentgen examinations 107, contrast medium examinations 988, ultrasound 203, mammography 557. The average currency rate of exchange in 1991 was USD 1 = FIM 4.046. The following formula is proposed for calculating the cost of a radiological examination (or a group of examinations) performed with a certain piece of equipment during a period of time (e.g. 1 year): a2/ sigma ax*ax+ b2/ sigma bx*bx+ d1/d5*dx+ e1 + [(c1+ c2) + d4 + (e2 - e3) + f5 + g1+ g2+ i]/n.

Comparison of beverage consumption in adult populations from three different countries: do the international reference values allow establishing the adequacy of water and beverage intakes?

PubMed

Nissensohn, Mariela; Fuentes Lugo, Daniel; Serra-Majem, Lluis

2016-07-13

Recommendations of adequate total water intake (aTWI) have been proposed by the European Food Safety Agency (EFSA) and the Institute of Medicine (IOM)of the United States of America. However, there are differences in the approach used to support them: IOM recommendation is based on average intakes observed in NHANES III (Third National Health and Nutrition Examination Survey) and EFSA recommendation on a combination of observed intakes from 13 different European countries. Despite these recommendations of aTWI, the currently available scientifi c evidence is not sufficient to establish a cut-off value that would prevent disease, reduce the risk for chronic diseases or improve health status. To compare the average daily consumption of fluids (water and other beverages) in selective samples of population from Mexico, US and Spain, evaluating the quantity of fluid intake and understanding the contribution of each fluid type to the total fl uid intake. We also aim to determine if they reached adequate intake (AI) values, as defi ned by three different criteria: IOM, EFSA and water density. Three studies were compared: from Mexico, the National Health and Nutrition Survey conducted in 2012 (NHNS 2012); from US, the NHANES III 2005-2010 and from Spain the ANIBES study leaded in 2013. Different categories of beverages were used to establish the pattern of energy intake for each country. Only adult population was selected. TWI of each study was compared with EFSA and IOM AI recommendations, as well as applying the criterion of water density (mL/kcal). The American study obtained the higher value of total kcal/day from food and beverages (2,437 ± 13). Furthermore, the percentage of daily energy intake coming from beverages was, for American adults, 21%. Mexico was slightly behind with 19% and Spain ANIBES study registered only 12%. ANIBES showed signifi cantly low AI values for the overall population, but even more alarming in the case of males. Only 12% of men, in contrast with 21% of women, do satisfy the EFSA criterion. The IOM criterion reaches even less with higher recommended values for daily intake. In contrast, 60% of the American population reached the recommended intake of the IOM criterion. However, available data did not allow calculating the percentage reached by the EFSA criterion. Data from the Mexican study did not permit conducting comparisons with IOM or with EFSA. However, the water density criteria (mL/kcal) was higher than 1. There is a notable difference between all three populations in terms of TWI. Furthermore, within the same population, values of adequacy of TWI changed signifi cantly when they were assessed using different criteria. More scientifi c evidence is required for the production of better defined water intake recommendations in the future as well as more studies focusing on beverage consumption patterns in different settings.

Low-flow analysis and selected flow statistics representative of 1930-2002 for streamflow-gaging stations in or near West Virginia

USGS Publications Warehouse

Wiley, Jeffrey B.

2006-01-01

Five time periods between 1930 and 2002 are identified as having distinct patterns of annual minimum daily mean flows (minimum flows). Average minimum flows increased around 1970 at many streamflow-gaging stations in West Virginia. Before 1930, however, there might have been a period of minimum flows greater than any period identified between 1930 and 2002. The effects of climate variability are probably the principal causes of the differences among the five time periods. Comparisons of selected streamflow statistics are made between values computed for the five identified time periods and values computed for the 1930-2002 interval for 15 streamflow-gaging stations. The average difference between statistics computed for the five time periods and the 1930-2002 interval decreases with increasing magnitude of the low-flow statistic. The greatest individual-station absolute difference was 582.5 percent greater for the 7-day 10-year low flow computed for 1970-1979 compared to the value computed for 1930-2002. The hydrologically based low flows indicate approximately equal or smaller absolute differences than biologically based low flows. The average 1-day 3-year biologically based low flow (1B3) and 4-day 3-year biologically based low flow (4B3) are less than the average 1-day 10-year hydrologically based low flow (1Q10) and 7-day 10-year hydrologic-based low flow (7Q10) respectively, and range between 28.5 percent less and 13.6 percent greater. Seasonally, the average difference between low-flow statistics computed for the five time periods and 1930-2002 is not consistent between magnitudes of low-flow statistics, and the greatest difference is for the summer (July 1-September 30) and fall (October 1-December 31) for the same time period as the greatest difference determined in the annual analysis. The greatest average difference between 1B3 and 4B3 compared to 1Q10 and 7Q10, respectively, is in the spring (April 1-June 30), ranging between 11.6 and 102.3 percent greater. Statistics computed for the individual station's record period may not represent the statistics computed for the period 1930 to 2002 because (1) station records are available predominantly after about 1970 when minimum flows were greater than the average between 1930 and 2002 and (2) some short-term station records are mostly during dry periods, whereas others are mostly during wet periods. A criterion-based sampling of the individual station's record periods at stations was taken to reduce the effects of statistics computed for the entire record periods not representing the statistics computed for 1930-2002. The criterion used to sample the entire record periods is based on a comparison between the regional minimum flows and the minimum flows at the stations. Criterion-based sampling of the available record periods was superior to record-extension techniques for this study because more stations were selected and areal distribution of stations was more widespread. Principal component and correlation analyses of the minimum flows at 20 stations in or near West Virginia identify three regions of the State encompassing stations with similar patterns of minimum flows: the Lower Appalachian Plateaus, the Upper Appalachian Plateaus, and the Eastern Panhandle. All record periods of 10 years or greater between 1930 and 2002 where the average of the regional minimum flows are nearly equal to the average for 1930-2002 are determined as representative of 1930-2002. Selected statistics are presented for the longest representative record period that matches the record period for 77 stations in West Virginia and 40 stations near West Virginia. These statistics can be used to develop equations for estimating flow in ungaged stream locations.

SU-E-T-20: A Correlation Study of 2D and 3D Gamma Passing Rates for Prostate IMRT Plans

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

Zhang, D; Sun Yat-sen University Cancer Center, Guangzhou, Guangdong; Wang, B

2015-06-15

Purpose: To investigate the correlation between the two-dimensional gamma passing rate (2D %GP) and three-dimensional gamma passing rate (3D %GP) in prostate IMRT quality assurance. Methods: Eleven prostate IMRT plans were randomly selected from the clinical database and were used to obtain dose distributions in the phantom and patient. Three types of delivery errors (MLC bank sag errors, central MLC errors and monitor unit errors) were intentionally introduced to modify the clinical plans through an in-house Matlab program. This resulted in 187 modified plans. The 2D %GP and 3D %GP were analyzed using different dose-difference and distance-toagreement (1%-1mm, 2%-2mm andmore » 3%-3mm) and 20% dose threshold. The 2D %GP and 3D %GP were then compared not only for the whole region, but also for the PTVs and critical structures using the statistical Pearson’s correlation coefficient (γ). Results: For different delivery errors, the average comparison of 2D %GP and 3D %GP showed different conclusions. The statistical correlation coefficients between 2D %GP and 3D %GP for the whole dose distribution showed that except for 3%/3mm criterion, 2D %GP and 3D %GP of 1%/1mm criterion and 2%/2mm criterion had strong correlations (Pearson’s γ value >0.8). Compared with the whole region, the correlations of 2D %GP and 3D %GP for PTV were better (the γ value for 1%/1mm, 2%/2mm and 3%/3mm criterion was 0.959, 0.931 and 0.855, respectively). However for the rectum, there was no correlation between 2D %GP and 3D %GP. Conclusion: For prostate IMRT, the correlation between 2D %GP and 3D %GP for the PTV is better than that for normal structures. The lower dose-difference and DTA criterion shows less difference between 2D %GP and 3D %GP. Other factors such as the dosimeter characteristics and TPS algorithm bias may also influence the correlation between 2D %GP and 3D %GP.« less

Health-service Use in Women with Binge Eating Disorders

PubMed Central

Dickerson, John; DeBar, Lynn; Perrin, Nancy A.; Lynch, Frances; Wilson, G. Terence; Rosselli, Francine; Kraemer, Helena C.; Striegel-Moore, Ruth H.

2014-01-01

Objective To compare health-care utilization between participants who met DSM-IV criteria for Binge Eating Disorder (BED) and those engaged in Recurrent Binge Eating (RBE) and to evaluate whether objective binge eating (OBE) days, a key measurement for diagnosing BED, predicted health-care costs. Method We obtained utilization and cost data from electronic medical records to augment patient reported data for 100 adult female members of a large health maintenance organization (HMO) who were enrolled in a randomized clinical trial to treat binge eating. Results Total costs did not differ between the BED and RBE groups (β=−0.117, z=−0.48, p=0.629), nor did the number of OBE days predictor total costs (β= −0.017, z=−1.01, p=0.313). Conclusions Findings suggest that the medical impairment, as assessed through health care costs, caused by BED may not be greater than impairment caused by RBE. The current threshold number of two OBE days/week as a criterion for BED may need to be reconsidered PMID:21823138

Postintroduction Study of Cost Effectiveness of Pneumococcal Vaccine PCV10 from Public Sector Payer's Perspective in the State of Santa Catarina, Brazil.

PubMed

Kupek, Emil; Viertel, Ilse

2018-05-14

To evaluate cost effectiveness of 10-valent pneumococcal conjugate vaccine in the routine immunization program for children younger than 5 years in Brazil by a postintroduction study. Ecological study of prevaccine (2006-2009) versus postvaccine (2011-2014) period related the changes in mortality rate and hospitalization rate to direct cost of pneumonia treatment from the payer's perspective to estimate the cost effectiveness regarding lives saved, life-years gained, and disability-adjusted life-year for children younger than 5 years in the southern Brazilian state of Santa Catarina. All-cause pneumonia (ICD-10 J12-J18) deaths, hospital admissions, and associated costs were retrieved from the Brazilian Ministry of Health official Web site. Life expectancy at birth, population, ambulatory costs, cost savings, and plausible range of these parameters were used from published sources. Computer simulations with sensitivity analysis were performed to obtain the cost-effectiveness estimates. About 27 lives were saved and 2573 hospitalizations averted by the 10-valent pneumococcal conjugate vaccine vaccination in the 2011 to 2014 period at the cost of US $24,348 per life-year gained and US $27,748 per disability-adjusted life-year. The latter cost is 81% of Brazilian gross domestic product per capita over the same period. The vaccine was very cost-effective according to the World Health Organization criterion. Copyright © 2018. Published by Elsevier Inc.

A benefit-cost analysis of ten tree species in Modesto, California, U.S.A

Treesearch

E.G. McPherson

2003-01-01

Tree work records for ten species were analyzed to estimate average annual management costs by dbh class for six activity areas. Average annual benefits were calculated by dbh class for each species with computer modeling. Average annual net benefits per tree were greatest for London plane (Platanus acerifolia) ($178.57), hackberry (...

An evaluation system for financial compensation in traditional Chinese medicine services.

PubMed

Dou, Lei; Yin, Ai-Tian; Hao, Mo; Lu, Jun

2015-10-01

To describe the major factors influencing financial compensation in traditional Chinese medicine (TCM) and prioritize what TCM services should be compensated for. Two structured questionnaires-a TCM service baseline questionnaire and a service cost questionnaire-were used to collect information from TCM public hospitals on TCM services provided in certain situations and service cost accounting. The cross-sectional study examined 110 TCM services provided in four county TCM public hospitals in Shandong province. From the questionnaire data, a screening index system was established via expert consultation and brainstorming. Comprehensive evaluation of TCM services was performed using the analytic hierarchy process method. Weighted coefficients were used to measure the importance of each criterion, after which comprehensive evaluation scores for each service were ranked to indicate what services should receive priority for financial compensation. Economy value, social value, and efficacy value were the three main criteria for screening for what TCM services should be compensated for. The economy value local weight had the highest value (0.588), of which the profit sub-criterion (0.278) was the most important for TCM financial compensation. Moxibustion was tied for the highest comprehensive evaluation scores, at 0.65 while Acupuncture and Massage Therapy were tied for the second and third highest, with 0.63 and 0.58, respectively. Government and policymakers should consider offer financial compensation to Moxibustion, Acupuncture, Massage Therapy, and TCM Orthopedics as priority services. In the meanwhile, it is essential to correct the unreasonable pricing, explore compensation methods, objects and payment, and revise and improve the accounting system for the costs of TCM services. Copyright © 2015 Elsevier Ltd. All rights reserved.

The cost of hospitalization in Crohn's disease.

PubMed

Cohen, R D; Larson, L R; Roth, J M; Becker, R V; Mummert, L L

2000-02-01

The aim of this study was to evaluate the demographics, resource use, and costs associated with hospitalization of Crohn's disease patients. All patients hospitalized at our institution from 7/1/96 to 6/30/97 with a primary diagnosis of "Crohn's Disease" were analyzed using a computerized database. Data are presented "per hospitalization." A total of 175 hospitalizations (147 patients) were identified. Mean patient age was 36.5 yr; 61% were female; 82% Caucasian. Payer mix was most commonly contracted (57%), commercial (21%), or Medicare (13%). 57% of hospitalizations had a primary surgical procedure; the remainder were medical. Average length of stay was 8.7 days (surgical, 9.6 days; medical, 7.5 days). The average cost of hospitalization, excluding physician fees, was $12,528 (surgical, $14,409; medical, $10,020), whereas average charges were $35,378 (surgical, $46,354; medical, $20,744), including physician fees, which averaged $7,249 (surgical, $11,217; medical, $1,959). Mean reimbursements were $21,968 (surgical, $28,946; medical, $12,666) with average weighted reimbursement rates of 60.17% of hospital charges, 69.57% of physician fees. The distribution of costs across subcategories was: Surgery (39.6%), Pharmacy (18.6%), Laboratory (3.8%), Radiology (2.1%), Pathology (0.8%), Endoscopy (0.3%), and Other Hospital Costs (34.9%). Of the hospitalizations, 87% included treatment with steroids, 23% with immunomodulators, and 14% with aminosalicylates; 27% included the administration of total parenteral nutrition, which accounted for 63% of the total pharmacy costs. Surgery accounts for the majority of hospitalizations, nearly 40% of their total costs, and 75% of overall charges and reimbursements. Therapy that decreases the number of surgical hospitalizations should substantially reduce inpatient Crohn's disease costs, as well as overall costs.

Estimating the effect of hospital closure on areawide inpatient hospital costs: a preliminary model and application.

PubMed Central

Shepard, D S

1983-01-01

A preliminary model is developed for estimating the extent of savings, if any, likely to result from discontinuing a specific inpatient service. By examining the sources of referral to the discontinued service, the model estimates potential demand and how cases will be redistributed among remaining hospitals. This redistribution determines average cost per day in hospitals that receive these cases, relative to average cost per day of the discontinued service. The outflow rate, which measures the proportion of cases not absorbed in other acute care hospitals, is estimated as 30 percent for the average discontinuation. The marginal cost ratio, which relates marginal costs of cases absorbed in surrounding hospitals to the average costs in those hospitals, is estimated as 87 percent in the base case. The model was applied to the discontinuation of all inpatient services in the 75-bed Chelsea Memorial Hospital, near Boston, Massachusetts, using 1976 data. As the precise value of key parameters is uncertain, sensitivity analysis was used to explore a range of values. The most likely result is a small increase ($120,000) in the area's annual inpatient hospital costs, because many patients are referred to more costly teaching hospitals. A similar situation may arise with other urban closures. For service discontinuations to generate savings, recipient hospitals must be low in costs, the outflow rate must be large, and the marginal cost ratio must be low. PMID:6668181

Clinical Costs of Colorectal Cancer Screening in 5 Federally Funded Demonstration Programs

PubMed Central

Tangka, Florence K. L.; Subramanian, Sujha; Beebe, Maggie C.; Hoover, Sonja; Royalty, Janet; Seeff, Laura C.

2016-01-01

BACKGROUND The Centers for Disease Control and Prevention initiated the Colorectal Cancer Screening Demonstration Program (CRCSDP) to explore the feasibility of establishing a large-scale colorectal cancer (CRC) screening program for underserved populations in the United States. The authors of this report assessed the clinical costs incurred at each of the 5 participating sites during the demonstration period. METHODS By using data on payments to providers by each of the 5 CRCSDP sites, the authors estimated costs for specific clinical services and overall clinical costs for each of the 2 CRC screening methods used by the sites: colonoscopy and fecal occult blood test (FOBT). RESULTS Among CRCSDP clients who were at average risk for CRC and for whom complete cost data were available, 2131 were screened by FOBT, and 1888 were screened by colonoscopy. The total average clinical cost per individual screened by FOBT (including costs for screening, diagnosis, initial surveillance, office visits, and associated clinical services averaged across all individuals who received screening FOBT) ranged from $48 in Nebraska to $149 in Greater Seattle. This compared with an average clinical cost per individual for all services related to the colonoscopy screening ranging from $654 in St. Louis to $1600 in Baltimore City. CONCLUSIONS Variations in how sites contracted with providers and in the services provided through CRCSDP affected the cost of clinical services and the complexity of collecting cost data. Health officials may find these data useful in program planning and budgeting. PMID:23868481

Cost-effectiveness of a brief video-based HIV intervention for African American and Latino sexually transmitted disease clinic clients.

PubMed

Sweat, M; O'Donnell, C; O'Donnell, L

2001-04-13

Decisions about the dissemination of HIV interventions need to be informed by evidence of their cost-effectiveness in reducing negative health outcomes. Having previously shown the effectiveness of a single-session video-based group intervention (VOICES/VOCES) in reducing incidence of sexually transmitted diseases (STD) among male African American and Latino clients attending an urban STD clinic, this study estimates its cost-effectiveness in terms of disease averted. Cost-effectiveness was calculated using data on effectiveness from a randomized clinical trial of the VOICES/VOCES intervention along with updated data on the costs of intervention from four replication sites. STD incidence and self-reported behavioral data were used to make estimates of reduction in HIV incidence among study participants. The average annual cost to provide the intervention to 10 000 STD clinic clients was estimated to be US$447 005, with a cost per client of US$43.30. This expenditure would result in an average of 27.69 HIV infections averted, with an average savings from averted medical costs of US$5 544 408. The number of quality adjusted life years saved averaged 387.61, with a cost per HIV infection averted of US$21 486. This brief behavioral intervention was found to be feasible and cost-saving when targeted to male STD clinic clients at high risk of contracting and transmitting infections, indicating that this strategy should be considered for inclusion in HIV prevention programming.

The economic consequences of irritable bowel syndrome: a US employer perspective.

PubMed

Leong, Stephanie A; Barghout, Victoria; Birnbaum, Howard G; Thibeault, Crystal E; Ben-Hamadi, Rym; Frech, Feride; Ofman, Joshua J

2003-04-28

The objective of this study was to measure the direct costs of treating irritable bowel syndrome (IBS) and the indirect costs in the workplace. This was accomplished through retrospective analysis of administrative claims data from a national Fortune 100 manufacturer, which includes all medical, pharmaceutical, and disability claims for the company's employees, spouses/dependents, and retirees. Patients with IBS were identified as individuals, aged 18 to 64 years, who received a primary code for IBS or a secondary code for IBS and a primary code for constipation or abdominal pain between January 1, 1996, and December 31, 1998. Of these patients with IBS, 93.7% were matched based on age, sex, employment status, and ZIP code to a control population of beneficiaries. Direct and indirect costs for patients with IBS were compared with those of matched controls. The average total cost (direct plus indirect) per patient with IBS was 4527 dollars in 1998 compared with 3276 dollars for a control beneficiary (P<.001). The average physician visit costs were 524 dollars and 345 dollars for patients with IBS and controls, respectively (P<.001). The average outpatient care costs to the employer were 1258 dollars and 742 dollars for patients with IBS and controls, respectively (P<.001). Medically related work absenteeism cost the employer 901 dollars on average per employee treated for IBS compared with 528 dollars on average per employee without IBS (P<.001). Irritable bowel syndrome is a significant financial burden on the employer that arises from an increase in direct and indirect costs compared with the control group.

Parents and the High Cost of Child Care: 2012 Report

ERIC Educational Resources Information Center

Child Care Aware of America, 2012

2012-01-01

"Parents and the High Cost of Child Care: 2012 Report" presents 2011 data reflecting what parents pay for full-time child care in America. It includes average fees for both child care centers and family child care homes. Information was collected through a survey conducted in January 2012 that asked for the average costs charged for…

STOL propulsion systems

NASA Technical Reports Server (NTRS)

Denington, R. J.; Koenig, R. W.; Vanco, M. R.; Sagerser, D. A.

1972-01-01

The selection and the characteristics of quiet, clean propulsion systems for STOL aircraft are discussed. Engines are evaluated for augmentor wing and externally blown flap STOL aircraft with the engines located both under and over the wings. Some supporting test data are presented. Optimum engines are selected based on achieving the performance, economic, acoustic, and pollution goals presently being considered for future STOL aircraft. The data and results presented were obtained from a number of contracted studies and some supporting NASA inhouse programs, most of which began in early 1972. The contracts include: (1) two aircraft and mission studies, (2) two propulsion system studies, (3) the experimental and analytic work on the augmentor wing, and (4) the experimental programs on Q-Fan. Engines are selected and discussed based on aircraft economics using the direct operating cost as the primary criterion. This cost includes the cost of the crew, fuel, aircraft, and engine maintenance and depreciation.

Resource utilization pattern and cost of tuberculosis treatment from the provider and patient perspectives in the state of Penang, Malaysia.

PubMed

Atif, Muhammad; Sulaiman, Syed Azhar Syed; Shafie, Asrul Akmal; Asif, Muhammad; Babar, Zaheer-Ud-Din

2014-08-19

Studies from both developed and developing countries have demonstrated a considerable fluctuation in the average cost of TB treatment. The objective of this study was to analyze the medical resource utilization among new smear positive pulmonary tuberculosis patients. We also estimated the cost of tuberculosis treatment from the provider and patient perspectives, and identified the significant cost driving factors. All new smear positive pulmonary tuberculosis patients who were registered at the chest clinic of the Penang General Hospital, between March 2010 and February 2011, were invited to participate in the study. Provider sector costs were estimated using bottom-up, micro-costing technique. For the calculation of costs from the patients' perspective, all eligible patients who agreed to participate in the study were interviewed after the intensive phase and subsequently at the end of the treatment by a trained nurse. PASW was used to analyze the data (Predictive Analysis SoftWare, version 19.0, Armonk, NY: IBM Corp.). During the study period, 226 patients completed the treatment. However, complete costing data were available for 212 patients. The most highly utilized resources were chest X-ray followed by sputum smear examination. Only a smaller proportion of the patients were hospitalized. The average provider sector cost was MYR 992.34 (i.e., USD 325.35 per patient) whereby the average patient sector cost was MYR 1225.80 (i.e., USD 401.90 per patient). The average patient sector cost of our study population accounted for 5.7% of their annual family income. In multiple linear regression analysis, prolonged treatment duration (i.e., > 6 months) was the only predictor of higher provider sector costs whereby higher patient sector costs were determined by greater household income and persistent cough at the end of the intensive phase of the treatment. In relation to average provider sector cost, our estimates are substantially higher than the budget allocated by the Ministry of Health for the treatment of a tuberculosis case in Malaysia. The expenses borne by the patients and their families on the treatment of the current episode of tuberculosis were not catastrophic for them.

Generic script share and the price of brand-name drugs: the role of consumer choice.

PubMed

Rizzo, John A; Zeckhauser, Richard

2009-09-01

Pharmaceutical expenditures have grown rapidly in recent decades, and now total nearly 10% of health care costs. Generic drug utilization has risen substantially alongside, from 19% of scripts in 1984 to 47% in 2001, thus tempering expenditure growth through significant direct dollar savings. However, generic drugs may lead to indirect savings as well if their use reduces the average price of those brand-name drugs that are still purchased. Prior work indicates that brand-name producers do not lower their prices in the face of generic competition, and our study confirms that finding. However, prior work is silent on how the mix of consumer choices between generic and brand-name drugs might affect the average price of those brand-name drugs that are purchased. We use a nationally representative panel of data on drug utilization and costs for the years 1996-2001 to examine how the share of an individual's prescriptions filled by generics (generic script share) affects his average out-of-pocket cost for brand-name drugs, and the net cost paid by the insurer. Our principal finding is that a higher generic script share lowers average brand-name prices to consumers, presumably because consumers are more likely to substitute generics when brand-name drugs would cost them more. This effect is substantial: a 10% increase in the consumer's generic script share is associated with a 15.6% decline in the average price paid for brand-name drugs by consumers. This implies that the potential cost savings to consumers from generic substitution are far greater than prior work suggests. In contrast, the percentage reduction in average brand costs to health plans is far smaller, and statistically insignificant.

A risk-based prospective payment system that integrates patient, hospital and national costs.

PubMed

Siegel, C; Jones, K; Laska, E; Meisner, M; Lin, S

1992-05-01

We suggest that a desirable form for prospective payment for inpatient care is hospital average cost plus a linear combination of individual patient and national average cost. When the coefficients are chosen to minimize mean squared error loss between payment and costs, the payment has efficiency and access incentives. The coefficient multiplying patient costs is a hospital specific measure of financial risk of the patient. Access is promoted since providers receive higher reimbursements for risky, high cost patients. Historical cost data can be used to obtain estimates of payment parameters. The method is applied to Medicare data on psychiatric inpatients.

The Cost and Burden of the Residency Match in Emergency Medicine.

PubMed

Blackshaw, Aaron M; Watson, Simon C; Bush, Jeffrey S

2017-01-01

To obtain a residency match, medical students entering emergency medicine (EM) must complete away rotations, submit a number of lengthy applications, and travel to multiple programs to interview. The expenses incurred acquiring this residency position are burdensome, but there is little specialty-specific data estimating it. We sought to quantify the actual cost spent by medical students applying to EM residency programs by surveying students as they attended a residency interview. Researchers created a 16-item survey, which asked about the time and monetary costs associated with the entire EM residency application process. Applicants chosen to interview for an EM residency position at our institution were invited to complete the survey during their interview day. In total, 66 out of a possible 81 residency applicants (an 81% response rate) completed our survey. The "average applicant" who interviewed at our residency program for the 2015-16 cycle completed 1.6 away, or "audition," rotations, each costing an average of $1,065 to complete. This "average applicant" applied to 42.8 programs, and then attended 13.7 interviews. The cost of interviewing at our program averaged $342 and in total , an average of $8,312 would be spent in the pursuit of an EM residency. Due to multiple factors, the costs of securing an EM residency spot can be expensive. By understanding the components that are driving this trend, we hope that the academic EM community can explore avenues to help curtail these costs.

HIV prevention costs and their predictors: evidence from the ORPHEA Project in Kenya

PubMed Central

Galárraga, Omar; Wamai, Richard G; Sosa-Rubí, Sandra G; Mugo, Mercy G; Contreras-Loya, David; Bautista-Arredondo, Sergio; Nyakundi, Helen; Wang’ombe, Joseph K

2017-01-01

Abstract We estimate costs and their predictors for three HIV prevention interventions in Kenya: HIV testing and counselling (HTC), prevention of mother-to-child transmission (PMTCT) and voluntary medical male circumcision (VMMC). As part of the ‘Optimizing the Response of Prevention: HIV Efficiency in Africa’ (ORPHEA) project, we collected retrospective data from government and non-governmental health facilities for 2011–12. We used multi-stage sampling to determine a sample of health facilities by type, ownership, size and interventions offered totalling 144 sites in 78 health facilities in 33 districts across Kenya. Data sources included key informants, registers and time-motion observation methods. Total costs of production were computed using both quantity and unit price of each input. Average cost was estimated by dividing total cost per intervention by number of clients accessing the intervention. Multivariate regression methods were used to analyse predictors of log-transformed average costs. Average costs were $7 and $79 per HTC and PMTCT client tested, respectively; and $66 per VMMC procedure. Results show evidence of economies of scale for PMTCT and VMMC: increasing the number of clients per year by 100% was associated with cost reductions of 50% for PMTCT, and 45% for VMMC. Task shifting was associated with reduced costs for both PMTCT (59%) and VMMC (54%). Costs in hospitals were higher for PMTCT (56%) in comparison to non-hospitals. Facilities that performed testing based on risk factors as opposed to universal screening had higher HTC average costs (79%). Lower VMMC costs were associated with availability of male reproductive health services (59%) and presence of community advisory board (52%). Aside from increasing production scale, HIV prevention costs may be contained by using task shifting, non-hospital sites, service integration and community supervision. PMID:29029086

The Annual Economic Burden of Syphilis: An Estimation of Direct, Productivity, and Intangible Costs for Syphilis in Guangdong Initiative for Comprehensive Control of Syphilis Sites.

PubMed

Zou, Yaming; Liao, Yu; Liu, Fengying; Chen, Lei; Shen, Hongcheng; Huang, Shujie; Zheng, Heping; Yang, Bin; Hao, Yuantao

2017-11-01

Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective. Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method. Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54. Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis.

The cost of long-term follow-up of high-risk infants for research studies.

PubMed

Doyle, Lex W; Clucas, Luisa; Roberts, Gehan; Davis, Noni; Duff, Julianne; Callanan, Catherine; McDonald, Marion; Anderson, Peter J; Cheong, Jeanie L Y

2015-10-01

Neonatal intensive care is expensive, and thus it is essential that its long-term outcomes are measured. The costs of follow-up studies for high-risk children who survive are unknown. This study aims to determine current costs for the assessment of health and development of children followed up in our research programme. Costs were determined for children involved in the research follow-up programme at the Royal Women's Hospital, Melbourne, over the 6-month period between 1st January 2012 and 30th June 2012. The time required for health professionals involved in assessments in early and later childhood was estimated, and converted into dollar costs. Costs for equipment and data management were added. Estimated costs were compared with actual costs of running the research follow-up programme. A total of 134 children were assessed over the 6-month period. The estimated average cost per child assessed was $1184, much higher than was expected. The estimated cost to assess a toddler was $1149, whereas for an 11-year-old it was $1443, the difference attributable to the longer psychological and paediatric assessments. The actual average cost per child assessed was $1623. The shortfall of $439 between the actual and estimated average costs per child arose chiefly because of the need to pay staff even when participants were late or failed to attend. The average costs of assessing children at each age for research studies are much higher than expected. These data are useful for planning similar long-term follow-up assessments for high-risk children. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Environmental service payments: evaluating biodiversity conservation trade-offs and cost-efficiency in the Osa Conservation Area, Costa Rica.

PubMed

Barton, D N; Faith, D P; Rusch, G M; Acevedo, H; Paniagua, L; Castro, M

2009-02-01

The cost-efficiency of payments for environmental services (PES) to private landowners in the Osa Conservation Area, Costa Rica, is evaluated in terms of the trade-off between biodiversity representation and opportunity costs of conservation to agricultural and forestry land-use. Using available GIS data and an 'off-the-shelf' software application called TARGET, we find that the PES allocation criteria applied by authorities in 2002-2003 were more than twice as cost-efficient as criteria applied during 1999-2001. Results show that a policy relevant assessment of the cost-effectiveness of PES relative to other conservation policies can be carried out at regional level using available studies and GIS data. However, there are a number of data and conceptual limitations to using heuristic optimisation algorithms in the analysis of the cost-efficiency of PES. Site specific data on probabilities of land-use change, and a detailed specification of opportunity costs of farm land, labour and capital are required to use algorithms such as TARGET for ranking individual sites based on cost-efficiency. Despite its conceptual soundness for regional conservation analysis, biodiversity complementarity presents a practical challenge as a criterion for PES eligibility at farm level because it varies depending on the set of areas under PES contracts at any one time.

Home health care cost-function analysis

PubMed Central

Hay, Joel W.; Mandes, George

1984-01-01

An exploratory home health care (HHC) cost-function model is estimated using State rate-setting data for the 74 traditional (nonprofit) Connecticut agencies. The analysis demonstrates U-shaped average costs curves for agencies' provision of skilled nursing visits, with substantial diseconomies of scale in the observable range. It is determined from the estimated cost function that the sample representative agency is providing fewer visits than optimal, and its marginal cost is significantly below average cost. The finding that an agency's costs are predominantly related to output levels, with little systematic variation due to other agency or patient characteristics, suggests that the economic inefficiency in a cost-based HHC reimbursement policy may be substantial. PMID:10310596

Away Rotations and Matching in Integrated Plastic Surgery Residency: Applicant and Program Director Perspectives.

PubMed

Drolet, Brian C; Brower, Jonathan P; Lifchez, Scott D; Janis, Jeffrey E; Liu, Paul Y

2016-04-01

Although nearly all medical students pursuing integrated plastic surgery residency participate in elective rotations away from their home medical school, the value and costs of these "away" rotations have not been well studied. The authors surveyed all integrated plastic surgery program directors and all applicants in the 2015 National Residency Matching Program. Forty-two program directors and 149 applicants (64 percent and 70 percent response rate, respectively) completed the survey. Applicants reported 13.7 weeks spent on plastic surgery rotations during medical school, including a mean of 9.2 weeks on away rotations. Average reported cost for away rotations was $3591 per applicant. Both applicants and program directors most commonly reported "making a good impression" (44.6 percent and 36.6 percent, respectively) or finding a "good-fit" program (27.7 percent and 48.8 percent, respectively) as the primary goal for away rotations. Almost all applicants (91.1 percent) believed an away rotation made them more competitive for matching to a program at which they rotated. Program directors ranked a strong away rotation performance as the most important residency selection criterion. Twenty-seven percent of postgraduate year-1 positions were filled by an away rotatorm and an additional 17 percent were filled by a home medical student. Away rotations appear to be mutually beneficial for applicants and programs in helping to establish a good fit between students and training programs through an extended interaction with the students, residents, and faculty. In addition, making a good impression on a senior elective rotation (home or away) may improve an applicant's chance of matching to a residency program.

A low-cost experiment to visualise the Fourier series: video analysis of a real plucked coiled spring

NASA Astrophysics Data System (ADS)

de Jesus, V. L. B.; Haubrichs, C.; de Oliveira, A. L.; Sasaki, D. G. G.

2018-03-01

In the present work, we develop a low-cost and simple experiment to visualise Fourier’s synthesis using a short, soft, and light plastic coiled spring oscillating in a horizontal plane, and a basic camera (120 fps). It is shown that the spring obeys a linear wave differential equation, as gravitational influence is neglected. A nonlinear criterion is evaluated to determine if magnitudes of the parameters in the initial conditions satisfy the linear wave equation. Our setup promotes some desirable characteristics that make Fourier’s synthesis experiments feasible, visual, and enlightening: (i) it requires few, common, and cheap resources, and the experiment can be carried out even in a high-school laboratory; (ii) since the spring’s tension is small (∼1 N, on average), the frequencies of normal modes are low (close to 2 Hz), and therefore, it is possible to record the oscillations just with the camera and extract a considerable number of position and time data in just one cycle; (iii) when the video is loaded in the Tracker free software, it can be reproduced in slow motion. Since the frequencies involved are low, an interesting and instructive temporal sequence of images of the spring displaying the typical trapezoidal shape appears clearly; (iv) the tools associated with the Tracker software tools can yield the relevant oscillation parameters, such as the damping constant, amplitudes, frequencies, and phases; and (v) it is possible to carry out superposition of a snapshot of the spring in Tracker at any time, and to draw the related Fourier synthesis graphs. The visual match between the shape of the spring and the theoretical graph is remarkable, and can be enhanced by adding the damping term.

Comparison of EHR-based diagnosis documentation locations to a gold standard for risk stratification in patients with multiple chronic conditions.

PubMed

Martin, Shelby; Wagner, Jesse; Lupulescu-Mann, Nicoleta; Ramsey, Katrina; Cohen, Aaron; Graven, Peter; Weiskopf, Nicole G; Dorr, David A

2017-08-02

To measure variation among four different Electronic Health Record (EHR) system documentation locations versus 'gold standard' manual chart review for risk stratification in patients with multiple chronic illnesses. Adults seen in primary care with EHR evidence of at least one of 13 conditions were included. EHRs were manually reviewed to determine presence of active diagnoses, and risk scores were calculated using three different methodologies and five EHR documentation locations. Claims data were used to assess cost and utilization for the following year. Descriptive and diagnostic statistics were calculated for each EHR location. Criterion validity testing compared the gold standard verified diagnoses versus other EHR locations and risk scores in predicting future cost and utilization. Nine hundred patients had 2,179 probable diagnoses. About 70% of the diagnoses from the EHR were verified by gold standard. For a subset of patients having baseline and prediction year data (n=750), modeling showed that the gold standard was the best predictor of outcomes on average for a subset of patients that had these data. However, combining all data sources together had nearly equivalent performance for prediction as the gold standard. EHR data locations were inaccurate 30% of the time, leading to improvement in overall modeling from a gold standard from chart review for individual diagnoses. However, the impact on identification of the highest risk patients was minor, and combining data from different EHR locations was equivalent to gold standard performance. The reviewer's ability to identify a diagnosis as correct was influenced by a variety of factors, including completeness, temporality, and perceived accuracy of chart data.

A Sparse Bayesian Approach for Forward-Looking Superresolution Radar Imaging

PubMed Central

Zhang, Yin; Zhang, Yongchao; Huang, Yulin; Yang, Jianyu

2017-01-01

This paper presents a sparse superresolution approach for high cross-range resolution imaging of forward-looking scanning radar based on the Bayesian criterion. First, a novel forward-looking signal model is established as the product of the measurement matrix and the cross-range target distribution, which is more accurate than the conventional convolution model. Then, based on the Bayesian criterion, the widely-used sparse regularization is considered as the penalty term to recover the target distribution. The derivation of the cost function is described, and finally, an iterative expression for minimizing this function is presented. Alternatively, this paper discusses how to estimate the single parameter of Gaussian noise. With the advantage of a more accurate model, the proposed sparse Bayesian approach enjoys a lower model error. Meanwhile, when compared with the conventional superresolution methods, the proposed approach shows high cross-range resolution and small location error. The superresolution results for the simulated point target, scene data, and real measured data are presented to demonstrate the superior performance of the proposed approach. PMID:28604583

Evaluation of wheelchair seating system crashworthiness: "drop hook"-type seat attachment hardware.

PubMed

Bertocci, G; Ha, D; Deemer, E; Karg, P

2001-04-01

To evaluate the crashworthiness of commercially available hardware that attaches seat surfaces to the wheelchair frame. A low cost static crashworthiness test procedure that simulates a frontal impact motor vehicle crash. Safety testing laboratory. Eleven unique sets of drop-hook hardware made of carbon steel (4), stainless steel (4), and aluminum (3). Replicated seat-loading conditions associated with a 20g/48 kph frontal impact. Test criterion for seat loading was 16,680 N (3750 lb). Failure load and deflection of seat surface. None of the hardware sets tested met the crashworthiness test criterion. All failed at less than 50% of the load that seating hardware could be exposed to in a 20g/48 kph frontal impact. The primary failure mode was excessive deformation, leading to an unstable seat support surface. Results suggest that commercially available seating drop hooks may be unable to withstand loading associated with a frontal crash and may not be the best option for use with transport wheelchairs.

Analysis of light emitting diode array lighting system based on human vision: normal and abnormal uniformity condition.

PubMed

Qin, Zong; Ji, Chuangang; Wang, Kai; Liu, Sheng

2012-10-08

In this paper, condition for uniform lighting generated by light emitting diode (LED) array was systematically studied. To take human vision effect into consideration, contrast sensitivity function (CSF) was novelly adopted as critical criterion for uniform lighting instead of conventionally used Sparrow's Criterion (SC). Through CSF method, design parameters including system thickness, LED pitch, LED's spatial radiation distribution and viewing condition can be analytically combined. In a specific LED array lighting system (LALS) with foursquare LED arrangement, different types of LEDs (Lambertian and Batwing type) and given viewing condition, optimum system thicknesses and LED pitches were calculated and compared with those got through SC method. Results show that CSF method can achieve more appropriate optimum parameters than SC method. Additionally, an abnormal phenomenon that uniformity varies with structural parameters non-monotonically in LALS with non-Lambertian LEDs was found and analyzed. Based on the analysis, a design method of LALS that can bring about better practicability, lower cost and more attractive appearance was summarized.

Analysis of tractable distortion metrics for EEG compression applications.

PubMed

Bazán-Prieto, Carlos; Blanco-Velasco, Manuel; Cárdenas-Barrera, Julián; Cruz-Roldán, Fernando

2012-07-01

Coding distortion in lossy electroencephalographic (EEG) signal compression methods is evaluated through tractable objective criteria. The percentage root-mean-square difference, which is a global and relative indicator of the quality held by reconstructed waveforms, is the most widely used criterion. However, this parameter does not ensure compliance with clinical standard guidelines that specify limits to allowable noise in EEG recordings. As a result, expert clinicians may have difficulties interpreting the resulting distortion of the EEG for a given value of this parameter. Conversely, the root-mean-square error is an alternative criterion that quantifies distortion in understandable units. In this paper, we demonstrate that the root-mean-square error is better suited to control and to assess the distortion introduced by compression methods. The experiments conducted in this paper show that the use of the root-mean-square error as target parameter in EEG compression allows both clinicians and scientists to infer whether coding error is clinically acceptable or not at no cost for the compression ratio.

Costs of major intracranial, gastrointestinal and other bleeding events in patients with atrial fibrillation - a nationwide cohort study.

PubMed

Jakobsen, Marie; Kolodziejczyk, Christophe; Klausen Fredslund, Eskild; Poulsen, Peter Bo; Dybro, Lars; Paaske Johnsen, Søren

2017-06-12

Use of oral anticoagulation therapy in patients with atrial fibrillation (AF) involves a trade-off between a reduced risk of ischemic stroke and an increased risk of bleeding events. Different anticoagulation therapies have different safety profiles and data on the societal costs of both ischemic stroke and bleeding events are necessary for assessing the cost-effectiveness and budgetary impact of different treatment options. To our knowledge, no previous studies have estimated the societal costs of bleeding events in patients with AF. The objective of this study was to estimate the 3-years societal costs of first-incident intracranial, gastrointestinal and other major bleeding events in Danish patients with AF. The study was an incidence-based cost-of-illness study carried out from a societal perspective and based on data from national Danish registries covering the period 2002-2012. Costs were estimated using a propensity score matching and multivariable regression analysis (first difference OLS) in a cohort design. Average 3-years societal costs attributable to intracranial, gastrointestinal and other major bleeding events were 27,627, 17,868, and 12,384 EUR per patient, respectively (2015 prices). Existing evidence shows that the corresponding costs of ischemic stroke were 24,084 EUR per patient (2012 prices). The average costs of bleeding events did not differ between patients with AF who were on oral anticoagulation therapy prior to the event and patients who were not. The societal costs attributable to major bleeding events in patients with AF are significant. Intracranial haemorrhages are most costly to society with average costs of similar magnitude as the costs of ischemic stroke. The average costs of gastrointestinal and other major bleeding events are lower than the costs of intracranial haemorrhages, but still substantial. Knowledge about the relative size of the costs of bleeding events compared to ischemic stroke in patients with AF constitutes valuable evidence for decisions-makers in Denmark as well as in other countries.

Value-based neurosurgery: measuring and reducing the cost of microvascular decompression surgery.

PubMed

McLaughlin, Nancy; Upadhyaya, Pooja; Buxey, Farzad; Martin, Neil A

2014-09-01

Care providers have put significant effort into optimizing patient safety and quality of care. Value, defined as meaningful outcomes achieved per dollar spent, is emerging as a promising framework to redesign health care. Scarce data exist regarding cost measurement and containment for episodes of neurosurgical care. The authors assessed how cost measurement and strategic containment could be used to optimize the value of delivered care after the implementation and maturation of quality improvement initiatives. A retrospective study of consecutive patients undergoing microvascular decompression was performed. Group 1 comprised patients treated prior to the implementation of quality improvement interventions, and Group 2 consisted of those treated after the implementation and maturation of quality improvement processes. A third group, Group 3, represented a contemporary group studied after the implementation of cost containment interventions targeting the three most expensive activities: pre-incision time in the operating room (OR) and total OR time, intraoperative neuromonitoring (IOM), and bed assignment (and overall length of stay [LOS]). The value of care was assessed for all three groups. Forty-four patients were included in the study. Average preparation time pre-incision decreased from 73 to 65 to 45 minutes in Groups 1, 2, and 3, respectively. The average total OR time and OR cost were 434 minutes and $8513 in Group 1; 348 minutes and $7592 in Group 2; and 407 minutes and $8333 in Group 3. The average cost for IOM, excluding electrode needles, was $1557, $1585, and $1263, respectively, in Groups 1, 2, and 3. Average total cost for bed assignment was $5747, $5198, and $4535, respectively, in Groups 1, 2, and 3. The average total LOS decreased from 3.16 days in Group 1 to 2.14 days in Group 3. Complete relief of or a significant decrease in preoperative symptomatology was achieved in 42 of the 44 patients, respectively. Overall, the average cost of a surgical care episode (index hospitalization + readmission/reoperation) decreased 25% from Group 1 to 3. Linking cost-containment and cost-reduction strategies to ongoing outcome improvement measures is an important step toward the optimization of value-based delivery of care.

Direct Medical Costs of Dengue Fever in Vietnam: A Retrospective Study in a Tertiary Hospital

PubMed Central

VO, Nhung Thi Tuyet; PHAN, Trang Ngo Diem; VO, Trung Quang

2017-01-01

Background In Vietnam, dengue fever is a major health concern, yet comprehensive information on its economic costs is lacking. The present study investigated treatment costs associated with dengue fever from the perspective of health care provision. Methods This retrospective study was conducted between January 2013 and December 2015 in Cu Chi General Hospital. The following dengue-related treatment costs were calculated: hospitalisation, diagnosis, specialised services, drug usage and medical supplies. Average cost per case and treatment cost across different age was calculated. Results In the study period, 1672 patients with dengue fever were hospitalised. The average age was 24.98 (SD = 14.10) years, and 47.5% were males (795 patients). Across age groups, the average cost per episode was USD 48.10 (SD = 3.22). The highest costs (USD 56.61, SD = 48.84) were incurred in the adult age group (> 15 years), and the lowest costs (USD 30.10, SD = 17.27) were incurred in the paediatric age group (< 15 years). Conclusion The direct medical costs of dengue-related hospitalisation place a severe economic burden on patients and their families. The probable economic value of dengue management in Vietnam is significant. PMID:28814934

Impulsive Control for Continuous-Time Markov Decision Processes: A Linear Programming Approach

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

Dufour, F., E-mail: dufour@math.u-bordeaux1.fr; Piunovskiy, A. B., E-mail: piunov@liv.ac.uk

2016-08-15

In this paper, we investigate an optimization problem for continuous-time Markov decision processes with both impulsive and continuous controls. We consider the so-called constrained problem where the objective of the controller is to minimize a total expected discounted optimality criterion associated with a cost rate function while keeping other performance criteria of the same form, but associated with different cost rate functions, below some given bounds. Our model allows multiple impulses at the same time moment. The main objective of this work is to study the associated linear program defined on a space of measures including the occupation measures ofmore » the controlled process and to provide sufficient conditions to ensure the existence of an optimal control.« less

Noise Considerations for V/STOL Transports

NASA Technical Reports Server (NTRS)

Kenyon, George C.

1968-01-01

Noise consideration may well be as important a factor in future aircraft concept selection as such economic factors as operating cost and profitability. The impact of noise on some of the design and operational aspects of future V/STOL transports is examined in detail, including consideration of configuration, attitude-control system, lift system, and terminal flight pattern. Extended vertical rise of VTOL aircraft as a method of limiting the intense noise exposure to the terminal area is shown to be only partially effective as well as costly. Comparisons are made of noise contours for conceptual V/STOL transports for several PNdB criteria. The variation in extent of affected area with configuration and criterion emphasizes the importance of establishing an "acceptable" noise level for "city-center" operation.

Total Lifetime and Cancer-related Costs for Elderly Patients Diagnosed With Anal Cancer in the United States.

PubMed

Deshmukh, Ashish A; Zhao, Hui; Franzini, Luisa; Lairson, David R; Chiao, Elizabeth Y; Das, Prajnan; Swartz, Michael D; Giordano, Sharon H; Cantor, Scott B

2018-02-01

To determine the lifetime and phase-specific cost of anal cancer management and the economic burden of anal cancer care in elderly (66 y and older) patients in the United States. For this study, we used Surveillance Epidemiology and End Results-Medicare linked database (1992 to 2009). We matched newly diagnosed anal cancer patients (by age and sex) to noncancer controls. We estimated survival time from the date of diagnosis until death. Lifetime and average annual cost by stage and age at diagnosis were estimated by combining survival data with Medicare claims. The average lifetime cost, proportion of patients who were elderly, and the number of incident cases were used to estimate the economic burden. The average lifetime cost for patients with anal cancer was US$50,150 (N=2227) (2014 US dollars). The average annual cost in men and women was US$8025 and US$5124, respectively. The overall survival after the diagnosis of cancer was 8.42 years. As the age and stage at diagnosis increased, so did the cost of cancer-related care. The anal cancer-related lifetime economic burden in Medicare patients in the United States was US$112 million. Although the prevalence of anal cancer among the elderly in the United States is small, its economic burden is considerable.

A comparative study of orphan drug prices in Europe

PubMed Central

Young, Katherine Eve; Soussi, Imen; Hemels, Michiel; Toumi, Mondher

2017-01-01

ABSTRACT Background and Objective: This study assessed price differences by comparing annual treatment costs of similarly available orphan drugs in France, Germany, Italy, Norway, Spain, Sweden, and UK. Methods: Annual treatment costs per drug were calculated using ex-factory prices from IHS POLI and country price databases. The treatment cost in the comparator country was compared to the UK and ratios were analysed. Subanalyses were done on disease areas and UK cost quartiles. Results: 120 orphan drugs were included. Compared to the UK, the average costs were more expensive in France (1.13), Germany (1.11), Italy (1.08), Spain (1.07), and were cheaper in Sweden (0.99) and Norway (0.88). The average ratios offered a restrictive view as ratios were greatly heterogeneous (0.26 to 1.92) which was also seen in the different disease areas. The averaged ratios varied minimally among the cost quartiles which shows that cost differences were similar for the most expensive and least expensive orphan drugs in the UK. Conclusions: Individual orphan drug prices can vary widely across European countries, although on average these differences are relatively minor. This study suggests that in Europe, we may not be able predict which country may have higher or lower prices for orphan drugs. PMID:28473887

Economic Impact of Revision Surgery for Proximal Junctional Failure After Adult Spinal Deformity Surgery: A Cost Analysis of 57 Operations in a 10-year Experience at a Major Deformity Center.

PubMed

Theologis, Alexander A; Miller, Liane; Callahan, Matt; Lau, Darryl; Zygourakis, Corinna; Scheer, Justin K; Burch, Shane; Pekmezci, Murat; Chou, Dean; Tay, Bobby; Mummaneni, Praveen; Berven, Sigurd; Deviren, Vedat; Ames, Christopher P

2016-08-15

Retrospective cohort analysis. To evaluate the economic impact of revision surgery for proximal junctional failures (PJF) after thoracolumbar fusions for adult spinal deformity (ASD). PJF after fusions for ASD is a major cause of disability. Although clinical sequelae are described, PJF-revision operation costs are incompletely defined. Consecutive adults who underwent thoracolumbar fusions for ASD (August, 2003 to January, 2013) were evaluated. Inclusion criteria include construct from pelvis to L2 or above and minimum 6 months follow-up after the index ASD operation. Direct costs (surgical supplies/implants, room/care, pharmacy, services) were identified from medical billing data and calculated for index ASD operations and subsequent surgeries for PJF. Not included in direct cost data were indirect costs, charges, surgeon fees, or revision operations for indications other than PJF (i.e., pseudarthrosis). Patients were compared based on the construct's upper-instrumented vertebra: upper thoracic (UT: T1-6) versus thoracolumbar junction (TLjxn: T9-L2). Of 501 patients, 382 met inclusion criteria. Fifty-one patients [UT:14; TLjxn: 40 at index; average follow-up 32.6 months (6-92 months)] had revisions for PJF, which summed to $3.2 million total direct cost. Average direct cost of index operations for the cohort ($68,294) was significantly greater than PJF-revisions ($55,547). Compared with TLjxn, UT had a significantly higher average cost for index operations ($79,860 vs. $65,868). However, PJF-revision cases were similar in average cost (UT:$60,103; TLjxn:$53,920; P = 0.09). Costs of PJF amounted to an additional 12.1% of the total index surgical cost in 382 patients. Revision operations for PJF after long thoracolumbar fusions for ASD are associated with an average direct cost of $55,547 per case. Revision costs for PJF are similar based on the index procedure's upper-instrumented vertebra level. At a major tertiary center over a 10-year period, PJF came at a very significant economic expense amounting to $3.2 million for 57 cases. 3.

An economic evaluation of the healthcare cost of tinnitus management in the UK.

PubMed

Stockdale, David; McFerran, Don; Brazier, Peter; Pritchard, Clive; Kay, Tony; Dowrick, Christopher; Hoare, Derek J

2017-08-22

There is no standard treatment pathway for tinnitus patients in the UK. Possible therapies include education and reassurance, cognitive behavioural therapies, modified tinnitus retraining therapy (education and sound enrichment), or amplification of external sound using hearing aids. However, the effectiveness of most therapies is somewhat controversial. As health services come under economic pressure to deploy resources more effectively there is an increasing need to demonstrate the value of tinnitus therapies, and how value may be continuously enhanced. The objective of this project was to map out existing clinical practice, estimate the NHS costs associated with the management approaches used, and obtain initial indicative estimates of cost-effectiveness. Current treatment pathways, costs and health outcomes were determined from the tinnitus literature, national statistics, a patient survey, and expert opinion. These were used to create an Excel-based economic model of therapy options for tinnitus patients. The probabilities associated with the likelihood of an individual patient receiving a particular combination of therapies was used to calculate the average cost of treatment per patient, average health outcome per patient measured in QALYs gained, and cost-effectiveness, measured by the average cost per QALY gained. The average cost of tinnitus treatment per patient per year is GB£717, equating to an NHS healthcare bill of GB£750 million per year. Across all pathways, tinnitus therapy costs £10,600 per QALY gained. Results were relatively insensitive to restrictions on access to cognitive behaviour therapy, and a subsequent reliance on other therapies. NHS provisions for tinnitus are cost-effective against the National Institute for Health and Care Excellence cost-effective threshold. Most interventions help, but education alone offers very small QALY gains. The most cost-effective therapies in the model were delivered within audiology.

Human-centered design for neonatal apnea monitoring: application of the UFuRT process to analyze a monitor display layout.

PubMed

Brannon, Timothy S

2008-11-06

Resolution of apnea of prematurity is a criterion for hospital discharge of the preterm infant. False alarms recorded as true events can prolong hospitalization and increase cost of care. The UFuRT process was used to analyze neonatal apnea monitoring, using a typical monitor display. The goals were to determine 1) the data needed to recognize true events and reject false alarms, and 2) how the display layout could be modified to better support these tasks.

A study of geothermal prospects in the western United States

NASA Technical Reports Server (NTRS)

1975-01-01

The commercial development potential of 13 underdeveloped geothermal prospects in the Western United States was examined, and the prospects were ranked in order of relative potential for development on the basis of investment considerations. The following were considered in the ranking: geotechnical and engineering data, energy market accessibility, administrative constraints, and environmental and socio-economic factors. The primary ranking criterion is the unit cost of energy production expected from each prospect. Secondary criteria are administrative constraints, environmental factors and the quality of the geotechnical data.

Montana geothermal commercialization planning. Semi-annual progress report, January 1, 1979-June 30, 1979

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

Birkby, J.; Brown, K.; Chapman, M.

1979-06-01

Area development plans were prepared which describe geothermal resources and their potential use on a county or multicounty basis. Development plans for two areas are presented. Cost analyses show that the proximity of the geothermal resource to the end user is the most important criterion in geothermal energy development. Thirteen tentative site-specific plans are being revised. The analysis of institutional factors affecting geothermal development, the outreach, and the state geothermal are discussed briefly. (MHR)

Criteria for software modularization

NASA Technical Reports Server (NTRS)

Card, David N.; Page, Gerald T.; Mcgarry, Frank E.

1985-01-01

A central issue in programming practice involves determining the appropriate size and information content of a software module. This study attempted to determine the effectiveness of two widely used criteria for software modularization, strength and size, in reducing fault rate and development cost. Data from 453 FORTRAN modules developed by professional programmers were analyzed. The results indicated that module strength is a good criterion with respect to fault rate, whereas arbitrary module size limitations inhibit programmer productivity. This analysis is a first step toward defining empirically based standards for software modularization.

Solution for a bipartite Euclidean traveling-salesman problem in one dimension

NASA Astrophysics Data System (ADS)

Caracciolo, Sergio; Di Gioacchino, Andrea; Gherardi, Marco; Malatesta, Enrico M.

2018-05-01

The traveling-salesman problem is one of the most studied combinatorial optimization problems, because of the simplicity in its statement and the difficulty in its solution. We characterize the optimal cycle for every convex and increasing cost function when the points are thrown independently and with an identical probability distribution in a compact interval. We compute the average optimal cost for every number of points when the distance function is the square of the Euclidean distance. We also show that the average optimal cost is not a self-averaging quantity by explicitly computing the variance of its distribution in the thermodynamic limit. Moreover, we prove that the cost of the optimal cycle is not smaller than twice the cost of the optimal assignment of the same set of points. Interestingly, this bound is saturated in the thermodynamic limit.

Solution for a bipartite Euclidean traveling-salesman problem in one dimension.

PubMed

Caracciolo, Sergio; Di Gioacchino, Andrea; Gherardi, Marco; Malatesta, Enrico M

2018-05-01

The traveling-salesman problem is one of the most studied combinatorial optimization problems, because of the simplicity in its statement and the difficulty in its solution. We characterize the optimal cycle for every convex and increasing cost function when the points are thrown independently and with an identical probability distribution in a compact interval. We compute the average optimal cost for every number of points when the distance function is the square of the Euclidean distance. We also show that the average optimal cost is not a self-averaging quantity by explicitly computing the variance of its distribution in the thermodynamic limit. Moreover, we prove that the cost of the optimal cycle is not smaller than twice the cost of the optimal assignment of the same set of points. Interestingly, this bound is saturated in the thermodynamic limit.

Improving data analysis in herpetology: Using Akaike's information criterion (AIC) to assess the strength of biological hypotheses

USGS Publications Warehouse

Mazerolle, M.J.

2006-01-01

In ecology, researchers frequently use observational studies to explain a given pattern, such as the number of individuals in a habitat patch, with a large number of explanatory (i.e., independent) variables. To elucidate such relationships, ecologists have long relied on hypothesis testing to include or exclude variables in regression models, although the conclusions often depend on the approach used (e.g., forward, backward, stepwise selection). Though better tools have surfaced in the mid 1970's, they are still underutilized in certain fields, particularly in herpetology. This is the case of the Akaike information criterion (AIC) which is remarkably superior in model selection (i.e., variable selection) than hypothesis-based approaches. It is simple to compute and easy to understand, but more importantly, for a given data set, it provides a measure of the strength of evidence for each model that represents a plausible biological hypothesis relative to the entire set of models considered. Using this approach, one can then compute a weighted average of the estimate and standard error for any given variable of interest across all the models considered. This procedure, termed model-averaging or multimodel inference, yields precise and robust estimates. In this paper, I illustrate the use of the AIC in model selection and inference, as well as the interpretation of results analysed in this framework with two real herpetological data sets. The AIC and measures derived from it is should be routinely adopted by herpetologists. ?? Koninklijke Brill NV 2006.

Healthcare utilization and cost of Stevens-Johnson syndrome and toxic epidermal necrolysis management in Thailand.

PubMed

Dilokthornsakul, P; Sawangjit, R; Inprasong, C; Chunhasewee, S; Rattanapan, P; Thoopputra, T; Chaiyakunapruk, N

2016-01-01

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening dermatologic conditions. Although, the incidence of SJS/TEN in Thailand is high, information on cost of care for SJS/TEN is limited. This study aims to estimate healthcare resource utilization and cost of SJS/TEN in Thailand, using hospital perspective. A retrospective study using an electronic health database from a university-affiliated hospital in Thailand was undertaken. Patients admitted with SJS/TEN from 2002 to 2007 were included. Direct medical cost was estimated by the cost-to-charge ratio. Cost was converted to 2013 value by consumer price index, and converted to $US using 31 Baht/ 1 $US. The healthcare resource utilization was also estimated. A total of 157 patients were included with average age of 45.3±23.0 years. About 146 patients (93.0%) were diagnosed as SJS and the remaining (7.0%) were diagnosed as TEN. Most of the patients (83.4%) were treated with systemic corticosteroids. Overall, mortality rate was 8.3%, while the average length of stay (LOS) was 10.1±13.2 days. The average cost of managing SJS/TEN for all patients was $1,064±$2,558. The average cost for SJS patients was $1,019±$2,601 while that for TEN patients was $1,660±$1,887. Healthcare resource utilization and cost of care for SJS/TEN in Thailand were tremendous. The findings are important for policy makers to allocate healthcare resources and develop strategies to prevent SJS/TEN which could decrease length of stay and cost of care.

Multi-faceted case management: reducing compensation costs of musculoskeletal work injuries in Australia.

PubMed

Iles, Ross Anthony; Wyatt, M; Pransky, G

2012-12-01

This study aimed to determine whether a multi-faceted model of management of work related musculoskeletal disorders reduced compensation claim costs and days of compensation for injured workers. An intervention including early reporting, employee centred case management and removal of barriers to return to work was instituted in 16 selected companies with a combined remuneration over $337 million. Outcomes were evaluated by an administrative dataset from the Victorian WorkCover Authority database. A 'quasi experimental' pre-post design was employed with 492 matched companies without the intervention used as a control group and an average of 21 months of post-intervention follow-up. Primary outcomes were average number of days of compensation and average cost of claims. Secondary outcomes were total medical costs and weekly benefits paid. Information on 3,312 claims was analysed. In companies where the intervention was introduced the average cost of claims was reduced from $6,019 to $3,913 (estimated difference $2,329, 95 % CI $1,318-$3,340) and the number of days of compensation decreased from 33.5 to 14.1 (HR 0.77, 95 % CI 0.67-0.88). Medical costs and weekly benefits costs were also lower after the intervention (p < 0.05). Reduction in claims costs were noted across industry types, injury location and most employer sizes. The model of claims management investigated was effective in reducing the number of days of compensation, total claim costs, total medical costs and the amount paid in weekly benefits. Further research should investigate whether the intervention improves non-financial outcomes in the return to work process.

The impact of hospital market structure on patient volume, average length of stay, and the cost of care.

PubMed

Robinson, J C; Luft, H S

1985-12-01

A variety of recent proposals rely heavily on market forces as a means of controlling hospital cost inflation. Sceptics argue, however, that increased competition might lead to cost-increasing acquisitions of specialized clinical services and other forms of non-price competition as means of attracting physicians and patients. Using data from hospitals in 1972 we analyzed the impact of market structure on average hospital costs, measured in terms of both cost per patient and cost per patient day. Under the retrospective reimbursement system in place at the time, hospitals in more competitive environments exhibited significantly higher costs of production than did those in less competitive environments.

The economic burden of pneumonia and meningitis among children less than five years old in Hanoi, Vietnam.

PubMed

Le, Phuc; Griffiths, Ulla K; Anh, Dang D; Franzini, Luisa; Chan, Wenyaw; Pham, Ha; Swint, John M

2014-11-01

To estimate the average treatment costs of pneumonia and meningitis among children under five years of age in a tertiary hospital in Hanoi, Vietnam from societal, health sector and household perspectives. We used a cost-of-illness approach to identify cost categories to be included for different perspectives. A prospective survey was conducted among eligible patients to get detailed personal costing items. From the perspective of the health sector, the mean costs for treating a case of pneumonia and meningitis were USD 180 and USD 300, respectively. From the household's perspective, the average treatment costs were USD 272 for pneumonia and USD 534 for meningitis. When also including indirect costs, the average total treatment costs from the societal perspective were USD 318 for pneumonia and USD 727 for meningitis. The study contributed to limited evidence on the high treatment costs of pneumonia and meningitis to the Vietnamese society, which is useful for a cost-effectiveness analysis of Haemophilus influenzae type b vaccine or other relevant disease preventions. It also indicated a need to re-evaluate the health insurance policy for children under 6 years old, so that the unnecessarily high out-of-pocket costs of these diseases are reduced. © 2014 John Wiley & Sons Ltd.

The lifetime cost of hepatocellular carcinoma : a claims data analysis from a medical centre in Taiwan.

PubMed

Lang, Hui-Chu; Wu, Jaw-Ching; Yen, Sang-Hue; Lan, Chung-Fu; Wu, Shi-Liang

2008-01-01

Hepatocellular carcinoma (HCC) is the second most common cancer in Taiwan. For males in Taiwan, it is the most dangerous cancer, with both the highest incidence and mortality rate. To determine cancer-related medical care costs for long-term survivors of HCC. The estimation of the lifetime cost was based on the insurer perspective and adopted an incidence-based approach. Data was sourced from the 1999-2002 cancer registry statistics of patients with HCC and the claims data of Taipei Veterans General Hospital (TVGH). In total there were 2873 HCC patients at TVGH. In addition to this data, the research used population National Health Insurance claims data from the National Health Research Institutes (1996-2002) as the comparison group. The probabilities of survival, dying of cancer or dying of other causes were estimated using cancer registry statistics. To estimate lifetime (10-year) cost, we divided the disease process into three phases: initial, continuing and terminal. The cost of HCC was calculated as the sum of the average cost of each phase. The expected lifetime cost for treatment of an HCC patient was estimated by incorporating the phase-specific costs with the survival and mortality rates. The results showed that 895 patients survived <1 year, and treatment for each of these patients cost on average New Taiwan dollars ($NT) 206 573 ($US 1 = $NT 33, year 2002 value) over this period. For those who survived > or =1 year, the terminal phase of treatment resulted in the highest costs, $NT 237 032. On average, for each patient, the initial phase cost was $NT 140 403 and the monthly cost for the continuing phase was $NT 8687. For the average HCC patient, the 10-year lifetime cost was $NT 418 554 (in nominal $NT). Our study showed that the terminal phase cost the most out of the three treatment phases. The aggregate lifetime cost of HCC is useful for health policy making and clinical decision making.

Size and emotion averaging: costs of dividing attention after all.

PubMed

Brand, John; Oriet, Chris; Tottenham, Laurie Sykes

2012-03-01

Perceptual averaging is a process by which sets of similar items are represented by summary statistics such as their average size, luminance, or orientation. Researchers have argued that this process is automatic, able to be carried out without interference from concurrent processing. Here, we challenge this conclusion and demonstrate a reliable cost of computing the mean size of circles distinguished by colour (Experiments 1 and 2) and the mean emotionality of faces distinguished by sex (Experiment 3). We also test the viability of two strategies that could have allowed observers to guess the correct response without computing the average size or emotionality of both sets concurrently. We conclude that although two means can be computed concurrently, doing so incurs a cost of dividing attention.

The costs of the soviet empire.

PubMed

Wolf, C

1985-11-29

A comprehensive framework is developed and applied to estimate the economic costs incurred by the Soviet Union in acquiring, maintaining, and expanding its empire. The terms "empire" and "costs" are explicitly defined. Between 1971 and 1980, the average ratio between empire costs and Soviet gross national product was about 3.5 percent; as a ratio to Soviet military spending, empire costs averaged about 28 percent. The burden imposed on Soviet economic growth by empire costs is also considered, as well as rates of change in these costs, and the important political, military, and strategic benefits associated by the Soviet leadership with maintenance and expansion of the empire. Prospective empire costs and changes in Soviet economic constraints resulting from the declining performance of the domestic economy are also considered.

Costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin

PubMed Central

Kramer, Michael H.; Blair, Kathleen A.; Addiss, David G.; Davis, Jeffrey P.; Haddix, Anne C.

2003-01-01

To assess the total medical costs and productivity losses associated with the 1993 waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, including the average cost per person with mild, moderate, and severe illness, we conducted a retrospective cost-of-illness analysis using data from 11 hospitals in the greater Milwaukee area and epidemiologic data collected during the outbreak. The total cost of outbreak-associated illness was $96.2 million: $31.7 million in medical costs and $64.6 million in productivity losses. The average total costs for persons with mild, moderate, and severe illness were $116, $475, and $7,808, respectively. The potentially high cost of waterborne disease outbreaks should be considered in economic decisions regarding the safety of public drinking water supplies. PMID:12702221

Using benefit-cost ratio to select Universal Newborn Hearing Screening test criteria.

PubMed

Porter, Heather L; Neely, Stephen T; Gorga, Michael P

2009-08-01

Current protocols presumably use criteria that are chosen on the basis of the sensitivity and specificity rates they produce. Such an approach emphasizes test performance but does not include societal implications of the benefit of early identification. The purpose of the present analysis was to evaluate an approach to selecting criteria for use in Universal Newborn Hearing Screening (UNHS) programs that uses benefit-cost ratio (BCR) to demonstrate an alternative method to audiologists, administrators, and others involved in UNHS protocol decisions. Existing data from more than 1200 ears were used to analyze BCR as a function of Distortion Product Otoacoustic Emission (DPOAE) level. These data were selected because both audiometric and DPOAE data were available on every ear. Although these data were not obtained in newborns, this compromise was necessary because audiometric outcomes (especially in infants with congenital hearing loss) in neonates are either lacking or limited in number. As such, it is important to note that the characteristics of responses from the group of subjects that formed the bases of the present analyses are different from those for neonates. This limits the extent to which actual criterion levels can be selected but should not affect the general approach of using BCR as a framework for considering UNHS criteria. Estimates of the prevalence of congenital hearing loss identified through UNHS in 37 states and U.S. territories in 2004 were used to calculate BCR. A range of estimates for the lifetime monetary benefits and yearly costs for UNHS were used, based on data available in the literature. Still, exact benefits and costs are difficult to know. Both one-step (DPOAE alone) and two-step (DPOAE followed by automated auditory brainstem response, AABR) screening paradigms were considered in the calculation of BCR. The influence of middle ear effusion was simulated by incorporating a range of expected DPOAE level reductions into an additional BCR analyses Our calculations indicate that for a range of proposed benefit and cost estimates, the monetary benefits of both one-step (DPOAE alone) and two-step (DPOAE followed by AABR) NHS programs outweigh programmatic costs. Our calculations indicate that BCR is robust in that it can be applied regardless of the values that are assigned to benefit and cost. Maximum BCR was identified and remained stable regardless of these values; however, it was recognized that the use of maximum BCR could result in reduced test sensitivity and may not be optimal for use in UNHS programs. The inclusion of secondary AABR screening increases BCR but does not alter the DPOAE criterion level at which maximum BCR occurs. The model of middle ear effusion reduces overall DPOAE level, subsequently lowering the DPOAE criterion level at which maximum BCR was obtained BCR is one of several alternative methods for choosing UNHS criteria, in which the evaluation of costs and benefits allows clinical and societal considerations to be incorporated into the pass/refer decision in a meaningful way. Although some of the benefits of early identification of hearing impairment cannot be estimated through a monetary analysis, such as improved psychosocial development and quality of life, this article provides an alternative to audiologists and administrators for selecting UNHS protocols that includes consideration of societal implications of UNHS screening criteria. BCR suggests that UNHS is a worthwhile investment for society as benefits always outweigh costs, at least for the estimations included in this article. Although the use of screening criteria that maximize BCR results in lower test sensitivity compared with other criteria, BCR may be used to select criteria that result in increased test sensitivity and still provide a high, although not maximal, BCR. Using BCR analysis provides a framework in which the societal implications of NHS protocols are considered and emphasizes the value of UNHS.

Medicare long-term CPAP coverage policy: a cost-utility analysis.

PubMed

Billings, Martha E; Kapur, Vishesh K

2013-10-15

CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Cost-utility and cost-effectiveness analysis. U.S. Medicare Population. N/A. N/A. We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change.

Energy System and Thermoeconomic Analysis of Combined Heat and Power High Temperature Proton Exchange Membrane Fuel Cell Systems for Light Commercial Buildings

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

Colella, Whitney G.; Pilli, Siva Prasad

2015-06-01

The United States (U.S.) Department of Energy (DOE)’s Pacific Northwest National Laboratory (PNNL) is spearheading a program with industry to deploy and independently monitor five kilowatt-electric (kWe) combined heat and power (CHP) fuel cell systems (FCSs) in light commercial buildings. This publication discusses results from PNNL’s research efforts to independently evaluate manufacturer-stated engineering, economic, and environmental performance of these CHP FCSs at installation sites. The analysis was done by developing parameters for economic comparison of CHP installations. Key thermodynamic terms are first defined, followed by an economic analysis using both a standard accounting approach and a management accounting approach. Keymore » economic and environmental performance parameters are evaluated, including (1) the average per unit cost of the CHP FCSs per unit of power, (2) the average per unit cost of the CHP FCSs per unit of energy, (3) the change in greenhouse gas (GHG) and air pollution emissions with a switch from conventional power plants and furnaces to CHP FCSs; (4) the change in GHG mitigation costs from the switch; and (5) the change in human health costs related to air pollution. From the power perspective, the average per unit cost per unit of electrical power is estimated to span a range from $15–19,000/ kilowatt-electric (kWe) (depending on site-specific changes in installation, fuel, and other costs), while the average per unit cost of electrical and heat recovery power varies between $7,000 and $9,000/kW. From the energy perspective, the average per unit cost per unit of electrical energy ranges from $0.38 to $0.46/kilowatt-hour-electric (kWhe), while the average per unit cost per unit of electrical and heat recovery energy varies from $0.18 to $0.23/kWh. These values are calculated from engineering and economic performance data provided by the manufacturer (not independently measured data). The GHG emissions were estimated to decrease by one-third by shifting from a conventional energy system to a CHP FCS system. The GHG mitigation costs were also proportional to the changes in the GHG gas emissions. Human health costs were estimated to decrease significantly with a switch from a conventional system to a CHP FCS system.« less

Spine surgery cost reduction at a specialized treatment center

PubMed Central

Viola, Dan Carai Maia; Lenza, Mario; de Almeida, Suze Luize Ferraz; dos Santos, Oscar Fernando Pavão; Cendoroglo, Miguel; Lottenberg, Claudio Luiz; Ferretti, Mario

2013-01-01

ABSTRACT Objective To compare the estimated cost of treatment of spinal disorders to those of this treatment in a specialized center. Methods An evaluation of average treatment costs of 399 patients referred by a Health Insurance Company for evaluation and treatment at the Spine Treatment Reference Center of Hospital Israelita Albert Einstein. All patients presented with an indication for surgical treatment before being referred for assessment. Of the total number of patients referred, only 54 underwent surgical treatment and 112 received a conservative treatment with motor physical therapy and acupuncture. The costs of both treatments were calculated based on a previously agreed table of values for reimbursement for each phase of treatment. Results Patients treated non-surgically had an average treatment cost of US$ 1,650.00, while patients treated surgically had an average cost of US$ 18,520.00. The total estimated cost of the cohort of patients treated was US$ 1,184,810.00, which represents a 158.5% decrease relative to the total cost projected for these same patients if the initial type of treatment indicated were performed. Conclusion Treatment carried out within a center specialized in treating spine pathologies has global costs lower than those regularly observed. PMID:23579752

Integration of Fixed and Flexible Route Public Transportation Systems, Phase II

DOT National Transportation Integrated Search

2012-01-01

Conventional bus service (with fixed routes and schedules) has lower average cost than flexible bus service (with : demand-responsive routes) at high demand densities. At low demand densities flexible bus service has lower : average costs and provide...

Impact of childhood obesity on employers.

PubMed

Sepulveda, Martin-J; Tait, Fan; Zimmerman, Edward; Edington, Dee

2010-01-01

The impact of childhood obesity on the workplace is not well understood. A study conducted for one large employer indicated that average per capita health insurance claims costs were as high as $2,907 in 2008 for an obese child and $10,789 for a child with type II diabetes. The average claims cost for children with type II diabetes actually exceeded the level of the average claims cost for adults with type II diabetes ($8,844). This paper reviews the evidence on the impact of childhood obesity on employers and discusses opportunities for business engagement-including two current examples of activities involving employers.

Does the average cost of home health care vary with case mix?

PubMed

Nyman, J A; Svetlik, M A

1989-01-01

The relationship between the average cost of home health care and the case mix of patients served by the home health agency is investigated using 1983 data from Wisconsin's home health care agencies. In contrast to previous work, case mix is shown to have a significant effect on the home health agency's average costs. The methods used in the previous work are evaluated, and differences between the earlier study and the present study are discussed to explain the divergent results. Also, average costs are shown to decrease with output, to increase with the proportion of private patients served by the agency, and to be higher if the home health agency is located in an urban area or if it has a proprietary charter. The implications of this research for the design of an appropriate home health reimbursement policy are discussed. Primarily, it is argued that, although future research might confirm the relationship between average costs and case mix for home health agencies, we cannot necessarily conclude that reimbursement rates must be adjusted to account for differences in case mix as many States are now doing for nursing home reimbursement. Policies must take into account the fundamental differences between home health agencies and nursing homes, and their respective markets, in order to be effective.

Does the average cost of home health care vary with case mix?

PubMed Central

Nyman, J A; Svetlik, M A

1989-01-01

The relationship between the average cost of home health care and the case mix of patients served by the home health agency is investigated using 1983 data from Wisconsin's home health care agencies. In contrast to previous work, case mix is shown to have a significant effect on the home health agency's average costs. The methods used in the previous work are evaluated, and differences between the earlier study and the present study are discussed to explain the divergent results. Also, average costs are shown to decrease with output, to increase with the proportion of private patients served by the agency, and to be higher if the home health agency is located in an urban area or if it has a proprietary charter. The implications of this research for the design of an appropriate home health reimbursement policy are discussed. Primarily, it is argued that, although future research might confirm the relationship between average costs and case mix for home health agencies, we cannot necessarily conclude that reimbursement rates must be adjusted to account for differences in case mix as many States are now doing for nursing home reimbursement. Policies must take into account the fundamental differences between home health agencies and nursing homes, and their respective markets, in order to be effective. PMID:2502804

The Cost and Burden of the Residency Match in Emergency Medicine

PubMed Central

Blackshaw, Aaron M.; Watson, Simon C.; Bush, Jeffrey S.

2017-01-01

Introduction To obtain a residency match, medical students entering emergency medicine (EM) must complete away rotations, submit a number of lengthy applications, and travel to multiple programs to interview. The expenses incurred acquiring this residency position are burdensome, but there is little specialty-specific data estimating it. We sought to quantify the actual cost spent by medical students applying to EM residency programs by surveying students as they attended a residency interview. Methods Researchers created a 16-item survey, which asked about the time and monetary costs associated with the entire EM residency application process. Applicants chosen to interview for an EM residency position at our institution were invited to complete the survey during their interview day. Results In total, 66 out of a possible 81 residency applicants (an 81% response rate) completed our survey. The “average applicant” who interviewed at our residency program for the 2015–16 cycle completed 1.6 away, or “audition,” rotations, each costing an average of $1,065 to complete. This “average applicant” applied to 42.8 programs, and then attended 13.7 interviews. The cost of interviewing at our program averaged $342 and in total, an average of $8,312 would be spent in the pursuit of an EM residency. Conclusion Due to multiple factors, the costs of securing an EM residency spot can be expensive. By understanding the components that are driving this trend, we hope that the academic EM community can explore avenues to help curtail these costs. PMID:28116032

Current and projected patient and insurer costs for the care of patients with non-small cell lung cancer in the United States through 2040.

PubMed

Hess, Lisa M; Cui, Zhanglin Lin; Wu, Yixun; Fang, Yun; Gaynor, Paula J; Oton, Ana B

2017-08-01

The objective of this study was to quantify the current and to project future patient and insurer costs for the care of patients with non-small cell lung cancer in the US. An analysis of administrative claims data among patients diagnosed with non-small cell lung cancer from 2007-2015 was conducted. Future costs were projected through 2040 based on these data using autoregressive models. Analysis of claims data found the average total cost of care during first- and second-line therapy was $1,161.70 and $561.80 for patients, and $45,175.70 and $26,201.40 for insurers, respectively. By 2040, the average total patient out-of-pocket costs are projected to reach $3,047.67 for first-line and $2,211.33 for second-line therapy, and insurance will pay an average of $131,262.39 for first-line and $75,062.23 for second-line therapy. Claims data are not collected for research purposes; therefore, there may be errors in entry and coding. Additionally, claims data do not contain important clinical factors, such as stage of disease at diagnosis, tumor histology, or data on disease progression, which may have important implications on the cost of care. The trajectory of the cost of lung cancer care is growing. This study estimates that the cost of care may double by 2040, with the greatest proportion of increase in patient out-of-pocket costs. Despite the average cost projections, these results suggest that a small sub-set of patients with very high costs could be at even greater risk in the future.

Cost-Effectiveness analysis of Recovery Management Checkups (RMC) for adults with chronic substance use disorders: evidence from a four-year randomized trial

PubMed Central

McCollister, Kathryn E.; French, Michael T.; Freitas, Derek M.; Dennis, Michael L.; Scott, Christy K.; Funk, Rodney R.

2013-01-01

Aims This study performs the first cost-effectiveness analysis (CEA) of Recovery Management Checkups (RMC) for adults with chronic substance use disorders. Design Cost-effectiveness analysis of a randomized clinical trial of RMC. Participants were randomly assigned to a control condition of outcome monitoring (OM-only) or the experimental condition OM-plus-RMC, with quarterly follow-up for four years. Setting Participants were recruited from the largest central intake unit for substance abuse treatment in Chicago, Illinois, USA. Participants 446 participants who were 38 years old on average, 54 percent male, and predominantly African American (85%). Measurements Data on the quarterly cost per participant come from a previous study of OM and RMC intervention costs. Effectiveness is measured as the number of days of abstinence and number of substance-use-related problems. Findings Over the four-year trial, OM-plus-RMC cost on average $2,184 more than OM-only (p<0.01). Participants in OM-plus-RMC averaged 1,026 days abstinent and had 89 substance-use-related problems. OM-only averaged 932 days abstinent and reported 126 substance-use-related problems. Mean differences for both effectiveness measures were statistically significant (p<0.01). The incremental cost-effectiveness ratio for OM-plus-RMC was $23.38 per day abstinent and $59.51 per reduced substance-related problem. When additional costs to society were factored into the analysis, OM-plus-RMC was less costly and more effective than OM-only. Conclusions Recovery Management Checkups are a cost-effective and potentially cost-saving strategy for promoting abstinence and reducing substance-use-related problems among chronic substance users. PMID:23961833

Cost-effectiveness analysis of Recovery Management Checkups (RMC) for adults with chronic substance use disorders: evidence from a 4-year randomized trial.

PubMed

McCollister, Kathryn E; French, Michael T; Freitas, Derek M; Dennis, Michael L; Scott, Christy K; Funk, Rodney R

2013-12-01

This study performs the first cost-effectiveness analysis (CEA) of Recovery Management Checkups (RMC) for adults with chronic substance use disorders. Cost-effectiveness analysis of a randomized clinical trial of RMC. Participants were assigned randomly to a control condition of outcome monitoring (OM-only) or the experimental condition OM-plus-RMC, with quarterly follow-up for 4 years. Participants were recruited from the largest central intake unit for substance abuse treatment in Chicago, Illinois, USA. A total of 446 participants who were 38 years old on average, 54% male, and predominantly African American (85%). Data on the quarterly cost per participant come from a previous study of OM and RMC intervention costs. Effectiveness is measured as the number of days of abstinence and number of substance use-related problems. Over the 4-year trial, OM-plus-RMC cost on average $2184 more than OM-only (P < 0.01). Participants in OM-plus-RMC averaged 1026 days abstinent and had 89 substance use-related problems. OM-only averaged 932 days abstinent and reported 126 substance use-related problems. Mean differences for both effectiveness measures were statistically significant (P < 0.01). The incremental cost-effectiveness ratio for OM-plus-RMC was $23.38 per day abstinent and $59.51 per reduced substance-related problem. When additional costs to society were factored into the analysis, OM-plus-RMC was less costly and more effective than OM-only. Recovery Management Checkups are a cost-effective and potentially cost-saving strategy for promoting abstinence and reducing substance use-related problems among chronic substance users. © 2013 Society for the Study of Addiction.

Clearcut harvesting costs and production rates for young-growth mixed-conifer stands

Treesearch

William A. Atkinson; Dale O. Hall

1966-01-01

In clearcutting 90-year-old stands at the Challenge Experimental Forest, all merchantable trees greater than 12 inches d.b.h. were removed. Felling costs averaged $3.86 and required 0.55 man-hours per M bd. ft. in cut volumes averaging 19,700 bd. ft. per acre. Yarding, at a rate of 0.54 hours per M bd. ft., cost $4.42.

The cost of fall related presentations to the ED: a prospective, in-person, patient-tracking analysis of health resource utilization.

PubMed

Woolcott, J C; Khan, K M; Mitrovic, S; Anis, A H; Marra, C A

2012-05-01

We prospectively collected data on elderly fallers to estimate the total cost of a fall requiring an Emergency Department presentation. Using data collected on 102 falls, we found the average cost per fall causing an Emergency Department presentation of $11,408. When hospitalization was required, the average cost per fall was $29,363. For elderly persons, falls are a major source of mortality, morbidity, and disability. Previous Canadian cost estimates of seniors' falls were based upon administrative data that has been shown to underestimate the incidence of falls. Our objective was to use a labor-intensive, direct observation patient-tracking method to accurately estimate the total cost of falls among seniors who presented to a major urban Emergency Department (ED) in Canada. We prospectively collected data from seniors (>70 years) presenting to the Vancouver General Hospital ED after a fall. We excluded individuals who where cognitively impaired or unable to read/write English. Data were collected on the care provided including physician assessments/consultations, radiology and laboratory tests, ED/hospital time, rehabilitation facility time, and in-hospital procedures. Unit costs of health resources were taken from a fully allocated hospital cost model. Data were collected on 101 fall-related ED presentations. The most common diagnoses were fractures (n = 33) and lacerations (n = 11). The mean cost of a fall causing ED presentation was $11,408 (SD: $19,655). Thirty-eight fallers had injuries requiring hospital admission with an average total cost of $29,363 (SD: $22,661). Hip fractures cost $39,507 (SD: $17,932). Among the 62 individuals not admitted to the hospital, the average cost of their ED visit was $674 (SD: $429). Among the growing population of Canadian seniors, falls have substantial costs. With the cost of a fall-related hospitalization approaching $30,000, there is an increased need for fall prevention programs.

Docetaxel chemotherapy in metastatic castration-resistant prostate cancer: cost of care in Medicare and commercial populations.

PubMed

Armstrong, A; Bui, C; Fitch, K; Sawhney, T Goss; Brown, B; Flanders, S; Balk, M; Deangelis, J; Chambers, J

2017-06-01

To estimate the healthcare costs and characteristics of docetaxel chemotherapy episodes of care for men with metastatic castration-resistant prostate cancer (mCRPC). This study used the Medicare 5% sample and MarketScan Commercial (2010-2013) claims data sets to identify men with mCRPC and initial episodes of docetaxel treatment. Docetaxel episodes included docetaxel claim costs from the first claim until 30 days after the last claim, with earlier termination for death, insurance disenrollment, or the end of a 24-month look-forward period from initial docetaxel index date. Docetaxel drug claim costs were adjusted for 2011 generic docetaxel introduction, while other costs were adjusted to 2015 values using the national average annual unit cost increase. This study identified 281 Medicare-insured and 155 commercially insured men, with 325 and 172 docetaxel episodes, respectively. The average number of cycles (unique docetaxel infusion days) per episode was 6.9 for Medicare and 6.3 for commercial cohorts. The average cost per episode was $28,792 for Medicare and $67,958 for commercial cohorts, with docetaxel drug costs contributing $2,588 and $13,169 per episode, respectively. The average cost per episode on docetaxel infusion days was $8,577 (30%) for Medicare and $28,412 (42%) for commercial. Non-docetaxel infusion day costs included $7,074 (25%) for infused or injected drugs for Medicare, $10,838 (16%) for commercial cohorts, and $6,875 (24%) and $9,324 (14%) for inpatient admissions, respectively. The applicability is only to the metastatic castration-resistance clinical setting, rather than the metastatic hormone-sensitive setting, and the lack of data on the cost effectiveness of different sequencing strategies of a range of systemic therapies including enzalutamide, abiraterone, radium-223, and taxane chemotherapy. The majority of docetaxel episode costs in Medicare and commercial mCRPC populations were non-docetaxel drug costs. Future research should evaluate the total cost of care in mCPRC.

The Norwegian General Practice--Nursing Home criteria (NORGEP-NH) for potentially inappropriate medication use: A web-based Delphi study.

PubMed

Nyborg, Gunhild; Straand, Jørund; Klovning, Atle; Brekke, Mette

2015-06-01

To develop a set of explicit criteria for pharmacologically inappropriate medication use in nursing homes. In an expert panel, a three-round Delphi consensus process was conducted via survey software. Norway. Altogether 80 participants - specialists in geriatrics or clinical pharmacology, physicians in nursing homes and experienced pharmacists - agreed to participate in the survey. Of these, 62 completed the first round, and 49 panellists completed all three rounds (75.4% of those ultimately entering the survey). The authors developed a list of 27 criteria based on the Norwegian General Practice (NORGEP) criteria, literature, and clinical experience. The main outcome measure was the panellists' evaluation of the clinical relevance of each suggested criterion on a digital Likert scale from 1 (no clinical relevance) to 10. In the first round panellists could also suggest new criteria to be included in the process. For each criterion, degree of consensus was based on the average Likert score and corresponding standard deviation (SD). A list of 34 explicit criteria for potentially inappropriate medication use in nursing homes was developed through a three-round web-based Delphi consensus process. Degree of consensus increased with each round. No criterion was voted out. Suggestions from the panel led to the inclusion of seven additional criteria in round two. The NORGEP-NH list may serve as a tool in the prescribing process and in medication list reviews and may also be used in quality assessment and for research purposes.

Communicating Conservation Status: How Different Statistical Assessment Criteria Affect Perceptions of Extinction Risk.

PubMed

Song, Hwanseok; Schuldt, Jonathon P

2017-09-01

Although alternative forms of statistical and verbal information are routinely used to convey species' extinction risk to policymakers and the public, little is known about their effects on audience information processing and risk perceptions. To address this gap in literature, we report on an experiment that was designed to explore how perceptions of extinction risk differ as a function of five different assessment benchmarks (Criteria A-E) used by scientists to classify species within IUCN Red List risk levels (e.g., Critically Endangered, Vulnerable), as well as the role of key individual differences in these effects (e.g., rational and experiential thinking styles, environmental concern). Despite their normative equivalence within the IUCN classification system, results revealed divergent effects of specific assessment criteria: on average, describing extinction risk in terms of proportional population decline over time (Criterion A) and number of remaining individuals (Criterion D) evoked the highest level of perceived risk, whereas the single-event probability of a species becoming extinct (Criterion E) engendered the least perceived risk. Furthermore, participants scoring high in rationality (analytic thinking) were less prone to exhibit these biases compared to those low in rationality. Our findings suggest that despite their equivalence in the eyes of scientific experts, IUCN criteria are indeed capable of engendering different levels of risk perception among lay audiences, effects that carry direct and important implications for those tasked with communicating about conservation status to diverse publics. © 2016 Society for Risk Analysis.

Criterion-related validity of perceived exertion scales in healthy children: a systematic review and meta-analysis.

PubMed

Rodríguez, Iván; Zambrano, Lysien; Manterola, Carlos

2016-04-01

Physiological parameters used to measure exercise intensity are oxygen uptake and heart rate. However, perceived exertion (PE) is a scale that has also been frequently applied. The objective of this study is to establish the criterion-related validity of PE scales in children during an incremental exercise test. Seven electronic databases were used. Studies aimed at assessing criterion-related validity of PE scales in healthy children during an incremental exercise test were included. Correlation coefficients were transformed into z-values and assessed in a meta-analysis by means of a fixed effects model if I2 was below 50% or a random effects model, if it was above 50%. wenty-five articles that studied 1418 children (boys: 49.2%) met the inclusion criteria. Children's average age was 10.5 years old. Exercise modalities included bike, running and stepping exercises. The weighted correlation coefficient was 0.835 (95% confidence interval: 0.762-0.887) and 0.874 (95% confidence interval: 0.794-0.924) for heart rate and oxygen uptake as reference criteria. The production paradigm and scales that had not been adapted to children showed the lowest measurement performance (p < 0.05). Measuring PE could be valid in healthy children during an incremental exercise test. Child-specific rating scales showed a better performance than those that had not been adapted to this population. Further studies with better methodological quality should be conducted in order to confirm these results. Sociedad Argentina de Pediatría.

A measurable Lawson criterion and hydro-equivalent curves for inertial confinement fusion

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

Zhou, C. D.; Betti, R.; Departments of Mechanical Engineering and Physics and Astronomy, University of Rochester, Rochester, New York 14623

2008-10-15

It is shown that the ignition condition (Lawson criterion) for inertial confinement fusion (ICF) can be cast in a form dependent on the only two parameters of the compressed fuel assembly that can be measured with existing techniques: the hot spot ion temperature (T{sub i}{sup h}) and the total areal density ({rho}R{sub tot}), which includes the cold shell contribution. A marginal ignition curve is derived in the {rho}R{sub tot}, T{sub i}{sup h} plane and current implosion experiments are compared with the ignition curve. On this plane, hydrodynamic equivalent curves show how a given implosion would perform with respect to themore » ignition condition when scaled up in the laser-driver energy. For 3<{sub n}<6 keV, an approximate form of the ignition condition (typical of laser-driven ICF) is {sub n}{sup 2.6}{center_dot}<{rho}R{sub tot}>{sub n}>50 keV{sup 2.6}{center_dot} g/cm{sup 2}, where <{rho}R{sub tot}>{sub n} and {sub n} are the burn-averaged total areal density and hot spot ion temperature, respectively. Both quantities are calculated without accounting for the alpha-particle energy deposition. Such a criterion can be used to determine how surrogate D{sub 2} and subignited DT target implosions perform with respect to the one-dimensional ignition threshold.« less

Mental health care in Italy: organisational structure, routine clinical activity and costs of a community psychiatric service in Lombardy region.

PubMed

Fattore, G; Percudani, M; Pugnoli, C; Contini, A; Beecham, J

2000-01-01

The Magenta Community Mental Health Centre (CMHC) is the public agency responsible for providing adult psychiatric care to about 85,000 adult residents. In 1995, it had 1,145 clients and incurred costs of Euro 1.9 millions. Average cost per patient and per adult resident were Euro 1,661 and Euro 22.2, respectively. These values mask large variation across diagnosis: while patients with schizophrenia and related disorders had an average cost of Euro 3,771, those with neurotic and related disorders had an average cost of Euro 439. Patients with schizophrenia and related disorders (28% of the patients) absorbed about 60% of total costs and made extensive use of several types of services (hospital, outpatient, domiciliary, social and rehabilitative care). Since integrating different types of services is the key element of Italian psychiatric care, the new fee-for-service system adopted by the NHS to fund providers does not appear appropriate, particularly for schizophrenic patients.

[Definition of a "domestic-setting corpse"--a retrospective study of 211 discoveries].

PubMed

Merz, Marius; Heidorn, Frank; Birngruber, Christoph G; Ramsthaler, Frank; Risse, Manfred; Kreutz, Kerstin; Krähahn, Jonathan; Verhoff, Marcel A

2012-01-01

In Germany, the term "domestic-setting corpse" is regularly used both in the medicolegal field (daily work, specialist literature) and by the general public (press, novels). The only formal definition of the term is in the German-language textbook "Basiswissen Rechtsmedizin" (Madea and Dettmeyer 2007). In this retrospective study, we compared the criteria for this definition with our findings. Autopsy reports from the Institute of Forensic Medicine at the Justus Liebig University in Giessen, Germany, for the period between 2005 and 2011 (including February), were reviewed retropectively to see if the criteria for this formal definition could be found. We chose a postmortem interval of more than 24 hours and discovery of the corpse in a private home as inclusion criteria for our study (n = 211). We could verify four of the criteria for the definition ("advanced signs of decomposition", "reclusiveness", "unclear cause of death", "difficult to identify") in our study. One criterion ("frequently a long postmortem interval") was too vague to be of use, and two further criteria ("discovery circumstances" and "high frequency of active alcohol dependence") could only be partially confirmed. In almost half of our cases there were, however, signs of general substance abuse. The proportion of male "domestic-setting corpses" was distinctly higher than that of females (approx. 3:1). The average age-at-death was 50.1 years for men, and 57.8 years for women, and thus clearly below the average life expectancies. In over half of the cases - even those with explicitly mentioned advanced facial decay--the identification method had not been noted. In the formal definition, the criteria "discovery circumstances" and "alcoholism" thus need to be more precisely defined. Also, due to the inexplicit time range, the criterion "frequently a long postmortem interval" was too vague to be applied to, or compared with, our cases as a classic criterion. We suggest specifying a minimum postmortem interval of 24 hours for "domestic-setting corpses". In addition, more attention should be paid to the identification of "domestic-setting corpses". To date, investigation authorities frequently seem to assume that a corpse discovered in a private residence is that of the home owner or occupant.

Value of the Signal-Averaged Electrocardiogram in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia

PubMed Central

Kamath, Ganesh S.; Zareba, Wojciech; Delaney, Jessica; Koneru, Jayanthi N.; McKenna, William; Gear, Kathleen; Polonsky, Slava; Sherrill, Duane; Bluemke, David; Marcus, Frank; Steinberg, Jonathan S.

2011-01-01

Background Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is an inherited disease causing structural and functional abnormalities of the right ventricle (RV). The presence of late potentials as assessed by the signal averaged electrocardiogram (SAECG) is a minor Task Force criterion. Objective The purpose of this study was to examine the diagnostic and clinical value of the SAECG in a large population of genotyped ARVC/D probands. Methods We compared the SAECGs of 87 ARVC/D probands (age 37 ± 13 years, 47 males) diagnosed as affected or borderline by Task Force criteria without using the SAECG criterion with 103 control subjects. The association of SAECG abnormalities was also correlated with clinical presentation; surface ECG; VT inducibility at electrophysiologic testing; ICD therapy for VT; and RV abnormalities as assessed by cardiac magnetic resonance imaging (cMRI). Results When compared with controls, all 3 components of the SAECG were highly associated with the diagnosis of ARVC/D (p<0.001). These include the filtered QRS duration (fQRSD) (97.8 ± 8.7 msec vs. 119.6 ± 23.8 msec), low amplitude signal (LAS) (24.4 ± 9.2 msec vs. 46.2 ± 23.7 msec) and root mean square amplitude of the last 40 msec of late potentials (RMS-40) (50.4 ± 26.9 µV vs. 27.9 ± 36.3 µV). The sensitivity of using SAECG for diagnosis of ARVC/D was increased from 47% using the established 2 of 3 criteria (i.e. late potentials) to 69% by using a modified criterion of any 1 of the 3 criteria, while maintaining a high specificity of 95%. Abnormal SAECG as defined by this modified criteria was associated with a dilated RV volume and decreased RV ejection fraction detected by cMRI (p<0.05). SAECG abnormalities did not vary with clinical presentation or reliably predict spontaneous or inducible VT, and had limited correlation with ECG findings. Conclusion Using 1 of 3 SAECG criteria contributed to increased sensitivity and specificity for the diagnosis of ARVC/D. This finding is incorporated in the recent modification of the Task Force criteria. PMID:20933608

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

PubMed

Bhattacharya, Anasua; Leigh, J Paul

2011-01-01

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

The burden of gunshot injuries on orthopaedic healthcare resources in South Africa.

PubMed

Martin, Case; Thiart, Gerhard; McCollum, Graham; Roche, Stephen; Maqungo, Sithombo

2017-06-30

Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective. To estimate the burden and average cost of treating GSW victims requiring orthopaedic interventions in an SA tertiary level hospital. This retrospective study surveyed more than 1 500 orthopaedic admissions over a 12-month period (2012) at Groote Schuur Hospital, Cape Town, SA. Chart review subsequently yielded data that allowed analysis of cost, theatre time, number and type of implants, duration of admission, diagnostic imaging studies performed, blood products used, laboratory studies ordered and medications administered. A total of 111 patients with an average age of 28 years (range 13 - 74) were identified. Each patient was hit by an average of 1.69 bullets (range 1 - 7). These patients sustained a total of 147 fractures, the majority in the lower extremities. Ninety-five patients received surgical treatment for a total of 135 procedures, with a cumulative surgical theatre time of >306 hours. Theatre costs, excluding implants, were in excess of USD94 490. Eighty of the patients received a total of 99 implants during surgery, which raised theatre costs an additional USD53 381 cumulatively, or USD667 per patient. Patients remained hospitalised for an average of 9.75 days, and total ward costs exceeded USD130 400. Individual patient costs averaged about USD2 940 (ZAR24 945) per patient. This study assessed the burden of orthopaedic firearm injuries in SA. It was estimated that on average, treating an orthopaedic GSW patient cost USD2 940, used just over 3 hours of theatre time per operation, and necessitated a hospital bed for an average period of 9.75 days. Improved understanding of the high incidence of orthopaedic GSWs treated in an SA tertiary care trauma centre and the costs incurred will help the state healthcare system better prioritise orthopaedic trauma funding and training opportunities, while also supporting cost-saving measures, including redirection of financial resources to primary prevention initiatives.

Australian quad bike fatalities: what is the economic cost?

PubMed

Lower, Tony; Pollock, Kirrily; Herde, Emily

2013-04-01

To determine the economic costs associated with all quad bike-related fatalities in Australia, 2001 to 2010. A human capital approach to establish the economic costs of quad bike related fatalities to the Australian economy. The model included estimates on loss of earnings due to premature death and direct costs based on coronial records for ambulance, police, hospital, premature funeral, coronial and work safety authority investigation, and death compensation costs. All costs were calculated to 2010 dollars. The estimated total economic cost associated with quad bike fatalities over this period was $288.1 million, with an average cost for each fatality of $2.3 million. When assessing the average cost of incidents between age cohorts, those aged 25-34 years had the lowest number of fatalities but had the highest average cost ($4.2 million). Quad bike fatalities have a significant economic impact on Australian society that is increasing. Implications : Given the high cost to society, interventions to address quad bike fatalities have the potential to be highly cost-effective. Such interventions should focus on design approaches to improve the safety of quad bikes in terms of stability and protection in the event of a rollover. Additionally, relevant policy (e.g. no children under 16 years riding quads, no passengers) and intervention approaches (e.g. training and use of helmets) must also support the design modifications. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

A comparison of the 'cost per child treated' at a primary care-based sedation referral service, compared to a general anaesthetic in hospital.

PubMed

Jameson, K; Averley, P A; Shackley, P; Steele, J

2007-09-22

To compare the cost-effectiveness of dental sedation techniques used in the treatment of children, focusing on hospital-based dental general anaesthetic (DGA) and advanced conscious sedation in a controlled primary care environment. Data on fees, costs and treatment pathways were obtained from a primary care clinic specialising in advanced sedation techniques. For the hospital-based DGA cohort, data were gathered from hospital trusts in the same area. Comparison was via an average cost per child treated and subsequent sensitivity analysis. Analysing records spanning one year, the average cost per child treated via advanced conscious sedation was pound245.47. As some treatments fail (3.5% of cases attempted), and the technique is not deemed suitable for all patients (4-5%), DGA is still required and has been factored into this cost. DGA has an average cost per case treated of pound359.91, 46.6% more expensive than advanced conscious sedation. These cost savings were robust to plausible variation in all parameters. The costs of advanced conscious sedation techniques, applied in a controlled primary care environment, are substantially lower than the equivalent costs of hospital-based DGA, informing the debate about the optimum way of managing this patient group.

Operations and support cost modeling using Markov chains

NASA Technical Reports Server (NTRS)

Unal, Resit

1989-01-01

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

Out-of-pocket cost of drug abuse consequences: results from Iranian National Mental Health Survey.

PubMed

Amin-Esmaeili, Masoumeh; Hefazi, Mitra; Radgoodarzi, Reza; Motevalian, Abbas; Sharifi, Vandad; Hajebi, Ahmad; Rahimi-Movaghar, Afarin

2017-05-01

Drug abuse has significant cost to the individual, the family and the society. This study aimed to assess out of-pocket costs of consequences of drug use disorder. Data were drawn from the Iranian Mental Health Survey (IranMHS) through face-to-face interviews with 7841 respondents aged 15-64 years. We used a bottom-up cost-ofillness method for economic analysis. Out-of-pocket costs for treatment of mental and drug problems, treatment of medical illnesses, as well as costs of crimes were assessed. The average of total annual expense was US$ 2120.6 for those with drug use disorder, which was 23.5% of annual income of an average Iranian family in the year 2011. The average of total out-of-pocket cost was US$ 674.6 for those with other mental disorder and US$ 421.9 for those with no mental disorder. Catastrophic payment was reported in 47.6% of the patients with drug use disorder and 14.4% of those with other mental disorder. Thus, considerable amount of family resources are spent on the consequences of drug use.

Costs of Dengue to the Health System and Individuals in Colombia from 2010 to 2012

PubMed Central

Rodriguez, Raul Castro; Galera-Gelvez, Katia; Yescas, Juan Guillermo López; Rueda-Gallardo, Jorge A.

2015-01-01

Dengue fever (DF) is an important health issue in Colombia, but detailed information on economic costs to the healthcare system is lacking. Using information from official databases (2010–2012) and a face-to-face survey of 1,483 households with DF and dengue hemorrhagic fever (DHF) patients, we estimated the average cost per case. In 2010, the mean direct medical costs to the healthcare system per case of ambulatory DF, hospitalized DF, and DHF (in Colombian pesos converted to US dollars using the average exchange rate for 2012) were $52.8, $235.8, and $1,512.2, respectively. The mean direct non-medical costs to patients were greater ($29.7, $46.7, and $62.6, respectively) than the mean household direct medical costs ($13.3, $34.8, and $57.3, respectively). The average direct medical cost to the healthcare system of a case of ambulatory DF in 2010 was 57% of that in 2011. Our results highlight the high economic burden of the disease and could be useful for assigning limited health resources. PMID:25667054

Grey water characteristics and treatment options for rural areas in Jordan.

PubMed

Halalsheh, M; Dalahmeh, S; Sayed, M; Suleiman, W; Shareef, M; Mansour, M; Safi, M

2008-09-01

Low water consumption in rural areas in Jordan had resulted in the production of concentrated grey water. Average COD, BOD and TSS values were 2568mg/l, 1056mg/l and 845mg/l, respectively. The average grey water generation was measured to be 14L/c.d. Three different treatment options were selected based on certain criterions, and discussed in this article. The examined treatment systems are septic tank followed by intermittent sand filter; septic tank followed by wetlands; and UASB-hybrid reactor. Advantages and disadvantages of each system are presented. It was concluded that UASB-hybrid reactor would be the most suitable treatment option in terms of compactness and simplicity in operation. The volume of UASB-hybrid reactor was calculated to be 0.268m(3) with a surface area of 0.138m(2) for each house having 10 inhabitants on average. Produced effluent is expected to meet Jordanian standards set for reclaimed water reuse in irrigating fruit trees.

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

PubMed

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

2016-09-01

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

Estimating the cost of informal caregiving for elderly patients with cancer.

PubMed

Hayman, J A; Langa, K M; Kabeto, M U; Katz, S J; DeMonner, S M; Chernew, M E; Slavin, M B; Fendrick, A M

2001-07-01

As the United States population ages, the increasing prevalence of cancer is likely to result in higher direct medical and nonmedical costs. Although estimates of the associated direct medical costs exist, very little information is available regarding the prevalence, time, and cost associated with informal caregiving for elderly cancer patients. To estimate these costs, we used data from the first wave (1993) of the Asset and Health Dynamics (AHEAD) Study, a nationally representative longitudinal survey of people aged 70 or older. Using a multivariable, two-part regression model to control for differences in health and functional status, social support, and sociodemographics, we estimated the probability of receiving informal care, the average weekly number of caregiving hours, and the average annual caregiving cost per case (assuming an average hourly wage of $8.17) for subjects who reported no history of cancer (NC), having a diagnosis of cancer but not receiving treatment for their cancer in the last year (CNT), and having a diagnosis of cancer and receiving treatment in the last year (CT). Of the 7,443 subjects surveyed, 6,422 (86%) reported NC, 718 (10%) reported CNT, and 303 (4%) reported CT. Whereas the adjusted probability of informal caregiving for those respondents reporting NC and CNT was 26%, it was 34% for those reporting CT (P <.05). Those subjects reporting CT received an average of 10.0 hours of informal caregiving per week, as compared with 6.9 and 6.8 hours for those who reported NC and CNT, respectively (P <.05). Accordingly, cancer treatment was associated with an incremental increase of 3.1 hours per week, which translates into an additional average yearly cost of $1,200 per patient and just over $1 billion nationally. Informal caregiving costs are substantial and should be considered when estimating the cost of cancer treatment in the elderly.

Computational studies of horizontal axis wind turbines

NASA Astrophysics Data System (ADS)

Xu, Guanpeng

A numerical technique has been developed for efficiently simulating fully three-dimensional viscous fluid flow around horizontal axis wind turbines (HAWT) using a zonal approach. The flow field is viewed as a combination of viscous regions, inviscid regions and vortices. The method solves the costly unsteady Reynolds averaged Navier-Stokes (RANS) equations only in the viscous region around the turbine blades. It solves the full potential equation in the inviscid region where flow is irrotational and isentropic. The tip vortices are simulated using a Lagrangean approach, thus removing the need to accurately resolve them on a fine grid. The hybrid method is shown to provide good results with modest CPU resources. A full Navier-Stokes based methodology has also been developed for modeling wind turbines at high wind conditions where extensive stall may occur. An overset grid based version that can model rotor-tower interactions has been developed. Finally, a blade element theory based methodology has been developed for the purpose of developing improved tip loss models and stall delay models. The effects of turbulence are simulated using a zero equation eddy viscosity model, or a one equation Spalart-Allmaras model. Two transition models, one based on the Eppler's criterion, and the other based on Michel's criterion, have been developed and tested. The hybrid method has been extensively validated for axial wind conditions for three rotors---NREL Phase II, Phase III, and Phase VI configurations. A limited set of calculations has been done for rotors operating under yaw conditions. Preliminary simulations have also been carried out to assess the effects of the tower wake on the rotor. In most of these cases, satisfactory agreement has been obtained with measurements. Using the numerical results from present methodologies as a guide, Prandtl's tip loss model and Corrigan's stall delay model were correlated with present calculations. An improved tip loss model has been obtained. A correction to the Corrigan's stall delay model has also been developed. Incorporation of these corrections is shown to considerably improve power predictions, even when a very simple aerodynamic theory---blade element method with annular inflow---is used.

A Topological Criterion for Filtering Information in Complex Brain Networks

PubMed Central

Latora, Vito; Chavez, Mario

2017-01-01

In many biological systems, the network of interactions between the elements can only be inferred from experimental measurements. In neuroscience, non-invasive imaging tools are extensively used to derive either structural or functional brain networks in-vivo. As a result of the inference process, we obtain a matrix of values corresponding to a fully connected and weighted network. To turn this into a useful sparse network, thresholding is typically adopted to cancel a percentage of the weakest connections. The structural properties of the resulting network depend on how much of the inferred connectivity is eventually retained. However, how to objectively fix this threshold is still an open issue. We introduce a criterion, the efficiency cost optimization (ECO), to select a threshold based on the optimization of the trade-off between the efficiency of a network and its wiring cost. We prove analytically and we confirm through numerical simulations that the connection density maximizing this trade-off emphasizes the intrinsic properties of a given network, while preserving its sparsity. Moreover, this density threshold can be determined a-priori, since the number of connections to filter only depends on the network size according to a power-law. We validate this result on several brain networks, from micro- to macro-scales, obtained with different imaging modalities. Finally, we test the potential of ECO in discriminating brain states with respect to alternative filtering methods. ECO advances our ability to analyze and compare biological networks, inferred from experimental data, in a fast and principled way. PMID:28076353

Selection of infectious medical waste disposal firms by using the analytic hierarchy process and sensitivity analysis

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

Hsu, P.-F.; Wu, C.-R.; Li, Y.-T.

2008-07-01

While Taiwanese hospitals dispose of large amounts of medical waste to ensure sanitation and personal hygiene, doing so inefficiently creates potential environmental hazards and increases operational expenses. However, hospitals lack objective criteria to select the most appropriate waste disposal firm and evaluate its performance, instead relying on their own subjective judgment and previous experiences. Therefore, this work presents an analytic hierarchy process (AHP) method to objectively select medical waste disposal firms based on the results of interviews with experts in the field, thus reducing overhead costs and enhancing medical waste management. An appropriate weight criterion based on AHP is derivedmore » to assess the effectiveness of medical waste disposal firms. The proposed AHP-based method offers a more efficient and precise means of selecting medical waste firms than subjective assessment methods do, thus reducing the potential risks for hospitals. Analysis results indicate that the medical sector selects the most appropriate infectious medical waste disposal firm based on the following rank: matching degree, contractor's qualifications, contractor's service capability, contractor's equipment and economic factors. By providing hospitals with an effective means of evaluating medical waste disposal firms, the proposed AHP method can reduce overhead costs and enable medical waste management to understand the market demand in the health sector. Moreover, performed through use of Expert Choice software, sensitivity analysis can survey the criterion weight of the degree of influence with an alternative hierarchy.« less

Cluster analysis and its application to healthcare claims data: a study of end-stage renal disease patients who initiated hemodialysis.

PubMed

Liao, Minlei; Li, Yunfeng; Kianifard, Farid; Obi, Engels; Arcona, Stephen

2016-03-02

Cluster analysis (CA) is a frequently used applied statistical technique that helps to reveal hidden structures and "clusters" found in large data sets. However, this method has not been widely used in large healthcare claims databases where the distribution of expenditure data is commonly severely skewed. The purpose of this study was to identify cost change patterns of patients with end-stage renal disease (ESRD) who initiated hemodialysis (HD) by applying different clustering methods. A retrospective, cross-sectional, observational study was conducted using the Truven Health MarketScan® Research Databases. Patients aged ≥18 years with ≥2 ESRD diagnoses who initiated HD between 2008 and 2010 were included. The K-means CA method and hierarchical CA with various linkage methods were applied to all-cause costs within baseline (12-months pre-HD) and follow-up periods (12-months post-HD) to identify clusters. Demographic, clinical, and cost information was extracted from both periods, and then examined by cluster. A total of 18,380 patients were identified. Meaningful all-cause cost clusters were generated using K-means CA and hierarchical CA with either flexible beta or Ward's methods. Based on cluster sample sizes and change of cost patterns, the K-means CA method and 4 clusters were selected: Cluster 1: Average to High (n = 113); Cluster 2: Very High to High (n = 89); Cluster 3: Average to Average (n = 16,624); or Cluster 4: Increasing Costs, High at Both Points (n = 1554). Median cost changes in the 12-month pre-HD and post-HD periods increased from $185,070 to $884,605 for Cluster 1 (Average to High), decreased from $910,930 to $157,997 for Cluster 2 (Very High to High), were relatively stable and remained low from $15,168 to $13,026 for Cluster 3 (Average to Average), and increased from $57,909 to $193,140 for Cluster 4 (Increasing Costs, High at Both Points). Relatively stable costs after starting HD were associated with more stable scores on comorbidity index scores from the pre-and post-HD periods, while increasing costs were associated with more sharply increasing comorbidity scores. The K-means CA method appeared to be the most appropriate in healthcare claims data with highly skewed cost information when taking into account both change of cost patterns and sample size in the smallest cluster.

Nursing Home Cost Studies and Reimbursement Issues

PubMed Central

Bishop, Christine E.

1980-01-01

This review of nursing home cost function research shows that certain provider and service characteristics are systematically associated with differences in the average cost of care. This information can be used to group providers for reasonable cost related rate-setting or to adjust their rates or rate ceilings. However, relationships between average cost and such service characteristics as patient mix, service intensity, and quality of care have not been fully delineated. Therefore, econometric cost functions cannot yet provide rate-setters with predictions about the cost of the efficient provision of nursing home care appropriate to patient needs. In any case, the design of reimbursement systems must be founded not only on technical information but also on public policy goals for long-term care. PMID:10309223

Nursing home cost studies and reimbursement issues.

PubMed

Bishop, C E

1980-01-01

This review of nursing home cost function research shows that certain provider and service characteristics are systematically associated with differences in the average cost of care. This information can be used to group providers for reasonable cost related rate-setting or to adjust their rates or rate ceilings. However, relationships between average cost and such service characteristics as patient mix, service intensity, and quality of care have not been fully delineated. Therefore, econometric cost functions cannot yet provide rate-setters with predictions about the cost of the efficient provision of nursing home care appropriate to patient needs. In any case, the design of reimbursement systems must be founded not only on technical information but also on public policy goals for long-term care.

SU-F-T-301: Planar Dose Pass Rate Inflation Due to the MapCHECK Measurement Uncertainty Function

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

Bailey, D; Spaans, J; Kumaraswamy, L

Purpose: To quantify the effect of the Measurement Uncertainty function on planar dosimetry pass rates, as analyzed with Sun Nuclear Corporation analytic software (“MapCHECK” or “SNC Patient”). This optional function is toggled on by default upon software installation, and automatically increases the user-defined dose percent difference (%Diff) tolerance for each planar dose comparison. Methods: Dose planes from 109 IMRT fields and 40 VMAT arcs were measured with the MapCHECK 2 diode array, and compared to calculated planes from a commercial treatment planning system. Pass rates were calculated within the SNC analytic software using varying calculation parameters, including Measurement Uncertainty onmore » and off. By varying the %Diff criterion for each dose comparison performed with Measurement Uncertainty turned off, an effective %Diff criterion was defined for each field/arc corresponding to the pass rate achieved with MapCHECK Uncertainty turned on. Results: For 3%/3mm analysis, the Measurement Uncertainty function increases the user-defined %Diff by 0.8–1.1% average, depending on plan type and calculation technique, for an average pass rate increase of 1.0–3.5% (maximum +8.7%). For 2%, 2 mm analysis, the Measurement Uncertainty function increases the user-defined %Diff by 0.7–1.2% average, for an average pass rate increase of 3.5–8.1% (maximum +14.2%). The largest increases in pass rate are generally seen with poorly-matched planar dose comparisons; the MapCHECK Uncertainty effect is markedly smaller as pass rates approach 100%. Conclusion: The Measurement Uncertainty function may substantially inflate planar dose comparison pass rates for typical IMRT and VMAT planes. The types of uncertainties incorporated into the function (and their associated quantitative estimates) as described in the software user’s manual may not accurately estimate realistic measurement uncertainty for the user’s measurement conditions. Pass rates listed in published reports or otherwise compared to the results of other users or vendors should clearly indicate whether the Measurement Uncertainty function is used.« less