New technology based on clamping for high gradient radio frequency photogun

NASA Astrophysics Data System (ADS)

Alesini, David; Battisti, Antonio; Ferrario, Massimo; Foggetta, Luca; Lollo, Valerio; Ficcadenti, Luca; Pettinacci, Valerio; Custodio, Sean; Pirez, Eylene; Musumeci, Pietro; Palumbo, Luigi

2015-09-01

High gradient rf photoguns have been a key development to enable several applications of high quality electron beams. They allow the generation of beams with very high peak current and low transverse emittance, satisfying the tight demands for free-electron lasers, energy recovery linacs, Compton/Thomson sources and high-energy linear colliders. In the present paper we present the design of a new rf photogun recently developed in the framework of the SPARC_LAB photoinjector activities at the laboratories of the National Institute of Nuclear Physics in Frascati (LNF-INFN, Italy). This design implements several new features from the electromagnetic point of view and, more important, a novel technology for its realization that does not involve any brazing process. From the electromagnetic point of view the gun presents high mode separation, low peak surface electric field at the iris and minimized pulsed heating on the coupler. For the realization, we have implemented a novel fabrication design that, avoiding brazing, strongly reduces the cost, the realization time and the risk of failure. Details on the electromagnetic design, low power rf measurements and high power radiofrequency and beam tests performed at the University of California in Los Angeles (UCLA) are discussed in the paper.

Nutrition therapy cost analysis in the US: pre-mixed multi-chamber bag vs compounded parenteral nutrition.

PubMed

Turpin, Robin S; Canada, Todd; Liu, Frank Xiaoqing; Mercaldi, Catherine J; Pontes-Arruda, Alessandro; Wischmeyer, Paul

2011-09-01

Bloodstream infections (BSI) occur in up to 350 000 inpatient admissions each year in the US, with BSI rates among patients receiving parenteral nutrition (PN) varying from 1.3% to 39%. BSI-attributable costs were estimated to approximate $US12 000 per episode in 2000. While previous studies have compared the cost of different PN preparation methods, this analysis evaluates both the direct costs of PN and the treatment costs for BSI associated with different PN delivery methods to determine whether compounded or manufactured pre-mixed PN has lower overall costs. The purpose of this study was to compare costs in the US associated with compounded PN versus pre-mixed multi-chamber bag (MCB) PN based on underlying infection risk. Using claims information from the Premier Perspective™ database, multivariate logistic regression was used to estimate the risk of infection. A total of 44 358 hospitalized patients aged ≥18 years who received PN between 1 January 2005 and 31 December 2007 were included in the analyses. A total of 3256 patients received MCB PN and 41 102 received compounded PN. The PN-associated costs and length of stay were analysed using multivariate ordinary least squares regression models constructed to measure the impact of infectious events on total hospital costs after controlling for baseline and clinical patient characteristics. There were 7.3 additional hospital days attributable to BSI. After adjustment for baseline variables, the probability of developing a BSI was 30% higher in patients receiving compounded PN than in those receiving MCB PN (16.1% vs 11.3%; odds ratio = 1.56; 95% CI 1.37, 1.79; p < 0.0001), demonstrating 2172 potentially avoidable infections. The observed daily mean PN acquisition cost for patients receiving MCB PN was $US164 (including all additives and fees) compared with $US239 for patients receiving compounded PN (all differences p < 0.001). With a mean cost attributable to BSI of $US16 141, the total per-patient savings (including avoided BSI and PN costs) was $US1545. In this analysis of real-world PN use, MCB PN is associated with lower costs than compounded PN with regards to both PN acquisition and potential avoidance of BSI. Our base case indicates that $US1545 per PN patient may be saved; even if as few as 50% of PN patients are candidates for standardized pre-mix formulations, a potential savings of $US773 per patient may be realized.

Heritage and Advanced Technology Systems Engineering Lessons Learned from NASA Space Missions

NASA Technical Reports Server (NTRS)

Barley, Bryan; Newhouse, Marilyn; Bacskay, Allen

2010-01-01

Use of heritage and new technology is necessary/enabling to implementing small, low cost missions, yet overruns decrease the ability to sustain future mission flight rates The majority of the cost growth drivers seen in the D&NF study were embedded early during formulation phase and later realized during the development and I&T phases Cost drivers can be avoided or significantly decreased by project management and SE emphasis on early identification of risks and realistic analyses SE processes that emphasize an assessment of technology within the mission system to identify technical issues in the design or operational use of the technology. Realistic assessment of new and heritage spacecraft technology assumptions , identification of risks and mitigation strategies. Realistic estimates of effort required to inherit existing or qualify new technology, identification of risks to estimates and develop mitigation strategies. Allocation of project reserves for risk-based mitigation strategies of each individual area of heritage or new technology. Careful tailoring of inheritance processes to ensure due diligence.

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

Safety and compliance-related hazards in the medical practice: Part one.

PubMed

Calway, R C

2001-01-01

Safety and risk management hazards are a fact of life for the medical practice, and the costs of these incidents can place the group at significant risk of liability. Good compliance and risk management programs help minimize these incidents, improve staff morale, increase a practice's visibility in the community, and positively affect the practice's financial and operational bottom line performance. Medical practices that implement effective safety and risk management programs can realize savings in staffing costs, operational efficiency, morale, insurance premiums, and improved third-party relationships while at the same time avoiding embarrassing risks, fines, and liability. This article outlines some of the most common safety and risk management-related deficiencies seen in medical practices today. The author explains how to remedy these deficiencies and provides a self-test tool to enable the reader to assess areas within his or her own practice in need of attention.

Analyses on Cost Reduction and CO2 Mitigation by Penetration of Fuel Cells to Residential Houses

NASA Astrophysics Data System (ADS)

Aki, Hirohisa; Yamamoto, Shigeo; Kondoh, Junji; Murata, Akinobu; Ishii, Itaru; Maeda, Tetsuhiko

This paper presents analyses on the penetration of polymer electrolyte fuel cells (PEFC) into a group of 10 residential houses and its effects of CO2 emission mitigation and consumers’ cost reduction in next 30 years. The price is considered to be reduced as the penetration progress which is expected to begin in near future. An experimental curve is assumed to express the decrease of the price. Installation of energy interchange systems which involve electricity, gas and hydrogen between a house which has a FC and contiguous houses is assumed to utilize both electricity and heat more efficiently, and to avoid start-stop operation of fuel processor (reformer) as much as possible. A multi-objective model which considers CO2 mitigation and consumers’ cost reduction is constructed and provided a Pareto optimum solution. A solution which simultaneously realizes both CO2 mitigation and consumers’ cost reduction appeared in the Pareto optimum solution. Strategies to reduce CO2 emission and consumers’ cost are suggested from the results of the analyses. The analyses also revealed that the energy interchange systems are effective especially in the early stage of the penetration.

Higher threat avoidance costs reduce avoidance behaviour which in turn promotes fear extinction in humans.

PubMed

Rattel, Julina A; Miedl, Stephan F; Blechert, Jens; Wilhelm, Frank H

2017-09-01

Theoretical models specifying the underlying mechanisms of the development and maintenance of anxiety and related disorders state that fear responses acquired through classical Pavlovian conditioning are maintained by repeated avoidance behaviour; thus, it is assumed that avoidance prevents fear extinction. The present study investigated behavioural avoidance decisions as a function of avoidance costs in a naturalistic fear conditioning paradigm. Ecologically valid avoidance costs - manipulated between participant groups - were represented via time-delays during a detour in a gamified computer task. After differential acquisitions of shock-expectancy to a predictive conditioned stimulus (CS+), participants underwent extinction where they could either take a risky shortcut, while anticipating shock signaled by the CS+, or choose a costly avoidance option (lengthy detour); thus, they were faced with an approach-avoidance conflict. Groups with higher avoidance costs (longer detours) showed lower proportions of avoiders. Avoiders gave heightened shock-expectancy ratings post-extinction, demonstrating 'protecting from extinction', i.e. failure to extinguish. Moreover, there was an indirect effect of avoidance costs on protection from extinction through avoidance behaviour. No moderating role of trait-anxiety was found. Theoretical implications of avoidance behaviour are discussed, considering the involvement of instrumental learning in the maintenance of fear responses. Copyright © 2016 Elsevier Ltd. All rights reserved.

Economic benefits of sponsored clinical trials on pharmaceutical expenditures at a medical center in Taiwan.

PubMed

Shen, Li-Jiuan; Chou, Hua; Huang, Chih-Fen; Chou, Guann-Miaw; Chan, Wing Kai; Wu, Fe-Lin Lin

2011-07-01

Concerns exist regarding the additional cost of patient care when patients are enrolled in clinical trials at hospitals. To assess the avoidance of drug costs by conducting sponsored clinical trials, a retrospective analysis evaluating drug cost avoidance in all sponsored clinical trials was conducted in 2008 at the most prominent medical center in Taiwan. The National Health Insurance (NHI) reimbursement prices of either the investigated drugs or the standardized drug therapy for each specific disease were used to calculate the cost avoidance. Drug cost avoidance from sponsored clinical trials per year, per trial, per patient, in different therapeutic areas, and in different phases was analyzed. Three quarters of the cost avoidance in drug expenditures from 194 sponsored clinical trials were estimated. All cost values are in US Dollars. Around $11.2 million was avoided at the center in 2008. The average value of cost avoidance was $58,000/trial-year or $3,900/participant-year. The early-phase trials and phase III trials accounted for 25% and 56% of all trials, respectively, while they constituted 32% and 49% of the total costs avoided, respectively. The most frequently conducted and highest cost-avoiding trials were those for antineoplastic agents, especially targeted therapy which accounted for 85% of the total cost avoidance of anti-cancer trials. This study demonstrates the profoundly positive economic impact on the healthcare system in Taiwan by sponsored clinical trials. To understand the trend of economic benefits of the trials on pharmaceutical expenditure, it would be important to analyze the cost avoidance of trials regularly in an institution. Copyright © 2011 Elsevier Inc. All rights reserved.

Preliminary In-Situ Evaluation of an Innovative, Semi-Flexible Pavement Wearing Course Mixture Using Fast Falling Weight Deflectometer

PubMed Central

Pratelli, Chiara; Betti, Giacomo; Marradi, Alessandro

2018-01-01

In the last forty, years semi-flexible pavements have been successfully employed, especially in those areas subjected to heavy and slow-moving loads. They usually comprise a wearing course of Grouted Macadam, a composite pavement material that provides significant advantages in comparison to both concrete and asphalt pavements. On the other hand, the laying process of this material is a two-stage operation, and the realization complexity leads to long realization times and high initial costs. Therefore, the use of semi-flexible pavements has been limited to some fields of application and areas. Recently, an innovative material has been developed to be used as an alternative to Grouted Macadam for semi-flexible pavement wearing course realization. This material should provide similar or even superior characteristics compared to traditional Grouted Macadam. This will reduce semi-flexible pavement construction time and avoid the need for dividing the laying process. This paper presents an experimental program involving the use of FastFWD, as an APT device, to evaluate in-situ properties and performance of this material. The achieved results regarding the validation of this new material by means of FastFWD appear promising both in terms of the material’s properties and resistance to dynamic load repetitions. PMID:29659543

Preliminary In-Situ Evaluation of an Innovative, Semi-Flexible Pavement Wearing Course Mixture Using Fast Falling Weight Deflectometer.

PubMed

Pratelli, Chiara; Betti, Giacomo; Giuffrè, Tullio; Marradi, Alessandro

2018-04-16

In the last forty, years semi-flexible pavements have been successfully employed, especially in those areas subjected to heavy and slow-moving loads. They usually comprise a wearing course of Grouted Macadam, a composite pavement material that provides significant advantages in comparison to both concrete and asphalt pavements. On the other hand, the laying process of this material is a two-stage operation, and the realization complexity leads to long realization times and high initial costs. Therefore, the use of semi-flexible pavements has been limited to some fields of application and areas. Recently, an innovative material has been developed to be used as an alternative to Grouted Macadam for semi-flexible pavement wearing course realization. This material should provide similar or even superior characteristics compared to traditional Grouted Macadam. This will reduce semi-flexible pavement construction time and avoid the need for dividing the laying process. This paper presents an experimental program involving the use of FastFWD, as an APT device, to evaluate in-situ properties and performance of this material. The achieved results regarding the validation of this new material by means of FastFWD appear promising both in terms of the material's properties and resistance to dynamic load repetitions.

Evolution of precopulatory and post-copulatory strategies of inbreeding avoidance and associated polyandry.

PubMed

Duthie, A B; Bocedi, G; Germain, R R; Reid, J M

2018-01-01

Inbreeding depression is widely hypothesized to drive adaptive evolution of precopulatory and post-copulatory mechanisms of inbreeding avoidance, which in turn are hypothesized to affect evolution of polyandry (i.e. female multiple mating). However, surprisingly little theory or modelling critically examines selection for precopulatory or post-copulatory inbreeding avoidance, or both strategies, given evolutionary constraints and direct costs, or examines how evolution of inbreeding avoidance strategies might feed back to affect evolution of polyandry. Selection for post-copulatory inbreeding avoidance, but not for precopulatory inbreeding avoidance, requires polyandry, whereas interactions between precopulatory and post-copulatory inbreeding avoidance might cause functional redundancy (i.e. 'degeneracy') potentially generating complex evolutionary dynamics among inbreeding strategies and polyandry. We used individual-based modelling to quantify evolution of interacting precopulatory and post-copulatory inbreeding avoidance and associated polyandry given strong inbreeding depression and different evolutionary constraints and direct costs. We found that evolution of post-copulatory inbreeding avoidance increased selection for initially rare polyandry and that evolution of a costly inbreeding avoidance strategy became negligible over time given a lower-cost alternative strategy. Further, fixed precopulatory inbreeding avoidance often completely precluded evolution of polyandry and hence post-copulatory inbreeding avoidance, but fixed post-copulatory inbreeding avoidance did not preclude evolution of precopulatory inbreeding avoidance. Evolution of inbreeding avoidance phenotypes and associated polyandry is therefore affected by evolutionary feedbacks and degeneracy. All else being equal, evolution of precopulatory inbreeding avoidance and resulting low polyandry is more likely when post-copulatory inbreeding avoidance is precluded or costly, and evolution of post-copulatory inbreeding avoidance greatly facilitates evolution of costly polyandry. © The Authors. Journal of Evolutionary Biology published by John Wiley & Sons Ltd on behalf of European Society for Evolutionary Biology.

Communication Avoiding and Overlapping for Numerical Linear Algebra

DTIC Science & Technology

2012-05-08

future exascale systems, communication cost must be avoided or overlapped. Communication-avoiding 2.5D algorithms improve scalability by reducing...linear algebra problems to future exascale systems, communication cost must be avoided or overlapped. Communication-avoiding 2.5D algorithms improve...will continue to grow relative to the cost of computation. With exascale computing as the long-term goal, the community needs to develop techniques

Methodology for Determining the Avoidable and Fully Allocated Costs of Amtrak Routes : Volume II, Appendix A

DOT National Transportation Integrated Search

2009-08-01

The Federal Railroad Administration tasked the Volpe Center with developing a methodology for determining the avoidable and fully allocated costs of Amtrak routes. Avoidable costs are costs that would not be incurred if an Amtrak route were discontin...

Methodology for Determining the Avoidable and Fully Allocated Costs of Amtrak Routes : Volume III, Appendix B-H

DOT National Transportation Integrated Search

2009-08-01

The Federal Railroad Administration tasked the Volpe Center with developing a methodology for determining the avoidable and fully allocated costs of Amtrak routes. Avoidable costs are costs that would not be incurred if an Amtrak route were discontin...

Methodology for determining the avoidable and fully allocated costs of Amtrak routes, volume 1 : main report

DOT National Transportation Integrated Search

2009-08-01

The Federal Railroad Administration tasked the Volpe Center with developing a methodology for determining the avoidable and fully allocated costs of Amtrak routes. Avoidable costs are costs that would not be incurred if an Amtrak route were discontin...

Everything you need to know to understand the current controversies you learned from psychological research. A comment on the Rind and Lilienfeld controversies.

PubMed

Sternberg, Robert J

2002-03-01

Psychological theory and research can help explain some of the aspects of the controversies that arose over articles written by B. Rind, P. Tromovitch, and R. Bauserman (1998) and by S. O. Lilienfeld (2002). In particular, one needs to distinguish between rational and intuitive thinking, to recognize the power of context, to be reflective in one's own thinking, and to realize the costs of defying the crowd. There are steps one can take to be wiser and more balanced in one's own thinking than one may have been in the past. One such step is to resolve conflicts among psychologists by attempting to defuse rather than to exacerbate or avoid them.

Selective transformations of complex molecules are enabled by aptameric protective groups

NASA Astrophysics Data System (ADS)

Bastian, Andreas A.; Marcozzi, Alessio; Herrmann, Andreas

2012-10-01

Emerging trends in drug discovery are prompting a renewed interest in natural products as a source of chemical diversity and lead structures. However, owing to the structural complexity of many natural compounds, the synthesis of derivatives is not easily realized. Here, we demonstrate a conceptually new approach using oligonucleotides as aptameric protective groups. These block several functionalities by non-covalent interactions in a complex molecule and enable the highly chemo- and regioselective derivatization (>99%) of natural antibiotics in a single synthetic step with excellent conversions of up to 83%. This technique reveals an important structure-activity relationship in neamine-based antibiotics and should help both to accelerate the discovery of new biologically active structures and to avoid potentially costly and cumbersome synthetic routes.

Interferometric architectures based All-Optical logic design methods and their implementations

NASA Astrophysics Data System (ADS)

Singh, Karamdeep; Kaur, Gurmeet

2015-06-01

All-Optical Signal Processing is an emerging technology which can avoid costly Optical-electronic-optical (O-E-O) conversions which are usually compulsory in traditional Electronic Signal Processing systems, thus greatly enhancing operating bit rate with some added advantages such as electro-magnetic interference immunity and low power consumption etc. In order to implement complex signal processing tasks All-Optical logic gates are required as backbone elements. This review describes the advances in the field of All-Optical logic design methods based on interferometric architectures such as Mach-Zehnder Interferometer (MZI), Sagnac Interferometers and Ultrafast Non-Linear Interferometer (UNI). All-Optical logic implementations for realization of arithmetic and signal processing applications based on each interferometric arrangement are also presented in a categorized manner.

Febuxostat in the management of gout: a cost-effectiveness analysis.

PubMed

Smolen, Lee J; Gahn, James C; Mitri, Ghaith; Shiozawa, Aki

2016-01-01

To determine the cost-effectiveness of febuxostat vs allopurinol for the management of gout. A stochastic microsimulation cost-effectiveness model with a US private-payer perspective and 5-year time horizon was developed. Model flow based on guideline and real-world treatment paradigms incorporated gout flare, serum uric acid (sUA) testing, treatment titration, discontinuation, and adverse events, chronic kidney disease (CKD) incidence and progression, and type 2 diabetes mellitus (T2DM) incidence. Outcomes were estimated for the general gout population and for gout patients with CKD stages 3/4. Modeled treatment interventions were daily oral febuxostat 40-80 mg and allopurinol 100-300 mg. Baseline patient characteristics were taken from epidemiologic studies, efficacy data from randomized controlled trials, adverse event rates from package inserts, and costs from the literature, government sources, and expert opinion. Eight clinically-relevant incremental cost-effectiveness ratios were estimated: per patient reaching target sUA, per flare avoided, per CKD incidence, progression, stages 3/4 progression, and stage 5 progression avoided, per incident T2DM avoided, and per death avoided. Five-year incremental cost-effectiveness ratios for the general gout population were $5377 per patient reaching target sUA, $1773 per flare avoided, $221,795 per incident CKD avoided, $29,063 per CKD progression avoided, $36,018 per progression to CKD 3/4 avoided, $71,426 per progression to CKD 5 avoided, $214,277 per incident T2DM avoided, and $217,971 per death avoided. In patients with CKD 3/4, febuxostat dominated allopurinol for all cost-effectiveness outcome measures. Febuxostat may be a cost-effective alternative to allopurinol, especially for patients with CKD stages 3 or 4.

Solar Avoided Cost Solution SunShot 6 Final Report

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

Tucker, John; Danziger, Eric

2014-01-29

The core objectives of this project were two separate but integrated products, collectively providing game-changing Avoided Cost capabilities. The first was a kit of avoided cost tools and data that any solar provider can use a-lacarte or as a whole. It’s open and easily accessible nature allows the rapid and accurate calculation of avoided cost in whatever context and software that make sense (“Typical and Avoided Cost Tools”). This kit includes a dataset of typical energy rates, costs and usage that can be used for solar prospecting, lead generation and any situation where data about an opportunity is missing ormore » imperfect. The second is a web application and related APIs specifically built for solar providers to radically streamline their lead-to-sale process (“Solar Provider Module”). The typical and Avoided Cost tools are built directly into this, and allow for solar providers to track their opportunities, collaborate with their installers and financiers, and close more sales faster.« less

Incorporation of Tropical Cyclone Avoidance Into Automated Ship Scheduling

DTIC Science & Technology

2014-06-01

damage and even sink ships. Avoiding TCs adds to fuel costs and causes delays. In the private sector, commercial shipping uses automated routing...improvements in forecasting have enabled ships to avoid TC-impacted areas altogether. Avoiding TCs does not come without a cost . Delaying departure or...steaming around a TC results in more fuel being burned at a high cost , plus the cost due to the delay in arrival at the destination, and the associated

Platform Architecture for Decentralized Positioning Systems.

PubMed

Kasmi, Zakaria; Norrdine, Abdelmoumen; Blankenbach, Jörg

2017-04-26

A platform architecture for positioning systems is essential for the realization of a flexible localization system, which interacts with other systems and supports various positioning technologies and algorithms. The decentralized processing of a position enables pushing the application-level knowledge into a mobile station and avoids the communication with a central unit such as a server or a base station. In addition, the calculation of the position on low-cost and resource-constrained devices presents a challenge due to the limited computing, storage capacity, as well as power supply. Therefore, we propose a platform architecture that enables the design of a system with the reusability of the components, extensibility (e.g., with other positioning technologies) and interoperability. Furthermore, the position is computed on a low-cost device such as a microcontroller, which simultaneously performs additional tasks such as data collecting or preprocessing based on an operating system. The platform architecture is designed, implemented and evaluated on the basis of two positioning systems: a field strength system and a time of arrival-based positioning system.

Research and design of smart grid monitoring control via terminal based on iOS system

NASA Astrophysics Data System (ADS)

Fu, Wei; Gong, Li; Chen, Heli; Pan, Guangji

2017-06-01

Aiming at a series of problems existing in current smart grid monitoring Control Terminal, such as high costs, poor portability, simple monitoring system, poor software extensions, low system reliability when transmitting information, single man-machine interface, poor security, etc., smart grid remote monitoring system based on the iOS system has been designed. The system interacts with smart grid server so that it can acquire grid data through WiFi/3G/4G networks, and monitor each grid line running status, as well as power plant equipment operating conditions. When it occurs an exception in the power plant, incident information can be sent to the user iOS terminal equipment timely, which will provide troubleshooting information to help the grid staff to make the right decisions in a timely manner, to avoid further accidents. Field tests have shown the system realizes the integrated grid monitoring functions, low maintenance cost, friendly interface, high security and reliability, and it possesses certain applicable value.

Platform Architecture for Decentralized Positioning Systems

PubMed Central

Kasmi, Zakaria; Norrdine, Abdelmoumen; Blankenbach, Jörg

2017-01-01

A platform architecture for positioning systems is essential for the realization of a flexible localization system, which interacts with other systems and supports various positioning technologies and algorithms. The decentralized processing of a position enables pushing the application-level knowledge into a mobile station and avoids the communication with a central unit such as a server or a base station. In addition, the calculation of the position on low-cost and resource-constrained devices presents a challenge due to the limited computing, storage capacity, as well as power supply. Therefore, we propose a platform architecture that enables the design of a system with the reusability of the components, extensibility (e.g., with other positioning technologies) and interoperability. Furthermore, the position is computed on a low-cost device such as a microcontroller, which simultaneously performs additional tasks such as data collecting or preprocessing based on an operating system. The platform architecture is designed, implemented and evaluated on the basis of two positioning systems: a field strength system and a time of arrival-based positioning system. PMID:28445414

Agricultural costs of the Chesapeake Bay total maximum daily load.

PubMed

Kaufman, Zach; Abler, David; Shortle, James; Harper, Jayson; Hamlett, James; Feather, Peter

2014-12-16

This study estimates costs to agricultural producers of the Watershed Implementation Plans (WIPs) developed by states in the Chesapeake Bay Watershed to comply with the Chesapeake Bay total maximum daily load (TMDL) and potential cost savings that could be realized by a more efficient selection of agricultural Best Management Practices (BMPs) and spatial targeting of BMP implementation. The cost of implementing the WIPs between 2011 and 2025 is estimated to be about $3.6 billion (in 2010 dollars). The annual cost associated with full implementation of all WIP BMPs from 2025 onward is about $900 million. Significant cost savings can be realized through careful and efficient BMP selection and spatial targeting. If retiring up to 25% of current agricultural land is included as an option, Bay-wide cost savings of about 60% could be realized compared to the WIPs.

Faith community nursing demonstrates good stewardship of community benefit dollars through cost savings and cost avoidance.

PubMed

Brown, Ameldia R; Coppola, Patricia; Giacona, Marian; Petriches, Anne; Stockwell, Mary Ann

2009-01-01

Health systems seeking responsible stewardship of community benefit dollars supporting Faith Community Nursing Networks require demonstration of positive measurable health outcomes. Faith Community Nurses (FCNs) answer the call for measurable outcomes by documenting cost savings and cost avoidances to families, communities, and health systems associated with their interventions. Using a spreadsheet tool based on Medicare reimbursements and diagnostic-related groupings, 3 networks of FCNs have together shown more than 600 000 (for calendar year 2008) healthcare dollars saved by avoidance of unnecessary acute care visits and extended care placements. The cost-benefit ratio of support dollars to cost savings and cost avoidance demonstrates that support of FCNs is good stewardship of community benefit dollars.

Analysis of Realized Volatility in Two Trading Sessionsof the Japanese Stock Market

NASA Astrophysics Data System (ADS)

Takaishi, T.; Chen, T. T.; Zheng, Z.

We analyze realized volatilities constructedusing high-frequency stock data on the Tokyo Stock Exchange. In order to avoid non-trading hours issue in volatility calculations we define two realized volatilities calculated separately in the two trading sessions of the Tokyo Stock Exchange, i.e. morning and afternoon sessions. After calculating the realized volatilities at various sampling frequencies we evaluate the bias from the microstructure noise as a function of sampling frequency. Taking account of the bias to realized volatility we examine returns standardized by realized volatilities and confirm that price returns on the Tokyo Stock Exchange are described approximately by Gaussian time series with time-varying volatility, i.e. consistent with a mixture of distributions hypothesis.

Projected Impact of Salt Restriction on Prevention of Cardiovascular Disease in China: A Modeling Study

PubMed Central

Liu, Jing; Coxson, Pamela G.; Penko, Joanne; Goldman, Lee; Bibbins-Domingo, Kirsten; Zhao, Dong

2016-01-01

Objectives To estimate the effects of achieving China’s national goals for dietary salt (NaCl) reduction or implementing culturally-tailored dietary salt restriction strategies on cardiovascular disease (CVD) prevention. Methods The CVD Policy Model was used to project blood pressure lowering and subsequent downstream prevented CVD that could be achieved by population-wide salt restriction in China. Outcomes were annual CVD events prevented, relative reductions in rates of CVD incidence and mortality, quality-adjusted life-years (QALYs) gained, and CVD treatment costs saved. Results Reducing mean dietary salt intake to 9.0 g/day gradually over 10 years could prevent approximately 197 000 incident annual CVD events [95% uncertainty interval (UI): 173 000–219 000], reduce annual CVD mortality by approximately 2.5% (2.2–2.8%), gain 303 000 annual QALYs (278 000–329 000), and save approximately 1.4 billion international dollars (Int$) in annual CVD costs (Int$; 1.2–1.6 billion). Reducing mean salt intake to 6.0 g/day could approximately double these benefits. Implementing cooking salt-restriction spoons could prevent 183 000 fewer incident CVD cases (153 000–215 000) and avoid Int$1.4 billion in CVD treatment costs annually (1.2–1.7 billion). Implementing a cooking salt substitute strategy could lead to approximately three times the health benefits of the salt-restriction spoon program. More than three-quarters of benefits from any dietary salt reduction strategy would be realized in hypertensive adults. Conclusion China could derive substantial health gains from implementation of population-wide dietary salt reduction policies. Most health benefits from any dietary salt reduction program would be realized in adults with hypertension. PMID:26840409

Low-cost distributed solar-thermal-electric power generation

NASA Astrophysics Data System (ADS)

Der Minassians, Artin; Aschenbach, Konrad H.; Sanders, Seth R.

2004-01-01

Due to their high relative cost, solar electric energy systems have yet to be exploited on a widespread basis. It is believed in the energy community that a technology similar to photovoltaic (PV), but offered at about $1/W would lead to widespread deployment at residential and commercial sites. This paper addresses the investigation and feasibility study of a low-cost solar thermal electricity generation technology, suitable for distributed deployment. Specifically, we discuss a system based on nonimaging solar concentrators, integrated with free-piston Stirling engine devices incorporating integrated electric generation. We target concentrator-collector operation at moderate temperatures, in the range of 125°C to 150°C. This temperature is consistent with use of optical concentrators with concentration ratios on the order of 1-2. These low ratio concentrators admit wide angles of radiation acceptance and are thus compatible with no diurnal tracking, and no or only a few seasonal adjustments. Thus, costs and reliability hazards associated with tracking hardware systems are avoided. Further, we note that in the intended application, there is no shortage of incident solar energy, but rather it is the capital cost of the solar-electric system that is most precious. Thus, we outline a strategy for exploiting solar resources in a cost constrained manner. The paper outlines design issues, and a specific design for an appropriately dimensioned free-piston Stirling engine. Only standard low-cost materials and manufacturing methods are required to realize such a machine.

Feasibility study of current pulse induced 2-bit/4-state multilevel programming in phase-change memory

NASA Astrophysics Data System (ADS)

Liu, Yan; Fan, Xi; Chen, Houpeng; Wang, Yueqing; Liu, Bo; Song, Zhitang; Feng, Songlin

2017-08-01

In this brief, multilevel data storage for phase-change memory (PCM) has attracted more attention in the memory market to implement high capacity memory system and reduce cost-per-bit. In this work, we present a universal programing method of SET stair-case current pulse in PCM cells, which can exploit the optimum programing scheme to achieve 2-bit/ 4state resistance-level with equal logarithm interval. SET stair-case waveform can be optimized by TCAD real time simulation to realize multilevel data storage efficiently in an arbitrary phase change material. Experimental results from 1 k-bit PCM test-chip have validated the proposed multilevel programing scheme. This multilevel programming scheme has improved the information storage density, robustness of resistance-level, energy efficient and avoiding process complexity.

Communicating Risk to Program Managers

NASA Technical Reports Server (NTRS)

Shivers, C. Herbert

2005-01-01

Program Managers (PM) can protect program resources and improve chances of success by anticipating, understanding and managing risks. Understanding the range of potential risks helps one to avoid or manage the risks. A PM must choose which risks to accept to reduce fire fighting, must meet the expectations of stakeholders consistently, and avoid falling into costly "black holes" that may open. A good risk management process provides the PM more confidence to seize opportunities save money, meet schedule, even improve relationships with people important to the program. Evidence of managing risk and sound internal controls can mean better support from superiors for the program by building a trust and reputation from being on top of issues. Risk managers have an obligation to provide the PM with the best information possible to allow the benefits to be realized (Small Business Consortium, 2004). The Institute for Chartered Accountants in England and Wales sees very important benefits for companies in providing better information about what they do to assess and manage key business risks. Such information will: a) provide practical forward-looking information; b) reduce the cost of capital; c) encourage better risk management; and d) improve accountability for stewardship, investor protection and the usefulness of financial reporting. We are particularly convinced that enhanced risk reporting will help listed companies obtain capital at the lowest possible cost (The Institute of Chartered Accountants in England &Wales, June 2002). Risk managers can take a significant role in quantifying the success of their department and communicating those figures to executive (program) management levels while pushing for a broader risk management role. Overall, risk managers must show that risk management work matters in the most crucial place-the bottom line- as they prove risk management can be a profit center (Sullivan, 2004).

Highly efficient luminescent solar concentrators based on earth-abundant indirect-bandgap silicon quantum dots

NASA Astrophysics Data System (ADS)

Meinardi, Francesco; Ehrenberg, Samantha; Dhamo, Lorena; Carulli, Francesco; Mauri, Michele; Bruni, Francesco; Simonutti, Roberto; Kortshagen, Uwe; Brovelli, Sergio

2017-02-01

Building-integrated photovoltaics is gaining consensus as a renewable energy technology for producing electricity at the point of use. Luminescent solar concentrators (LSCs) could extend architectural integration to the urban environment by realizing electrode-less photovoltaic windows. Crucial for large-area LSCs is the suppression of reabsorption losses, which requires emitters with negligible overlap between their absorption and emission spectra. Here, we demonstrate the use of indirect-bandgap semiconductor nanostructures such as highly emissive silicon quantum dots. Silicon is non-toxic, low-cost and ultra-earth-abundant, which avoids the limitations to the industrial scaling of quantum dots composed of low-abundance elements. Suppressed reabsorption and scattering losses lead to nearly ideal LSCs with an optical efficiency of η = 2.85%, matching state-of-the-art semi-transparent LSCs. Monte Carlo simulations indicate that optimized silicon quantum dot LSCs have a clear path to η > 5% for 1 m2 devices. We are finally able to realize flexible LSCs with performances comparable to those of flat concentrators, which opens the way to a new design freedom for building-integrated photovoltaics elements.

Computer-generated holograms (CGH) realization: the integration of dedicated software tool with digital slides printer

NASA Astrophysics Data System (ADS)

Guarnieri, Vittorio; Francini, Franco

1997-12-01

Last generation of digital printer is usually characterized by a spatial resolution enough high to allow the designer to realize a binary CGH directly on a transparent film avoiding photographic reduction techniques. These devices are able to produce slides or offset prints. Furthermore, services supplied by commercial printing company provide an inexpensive method to rapidly verify the validity of the design by means of a test-and-trial process. Notably, this low-cost approach appears to be suitable for a didactical environment. On the basis of these considerations, a set of software tools able to design CGH's has been developed. The guidelines inspiring the work have been the following ones: (1) ray-tracing approach, considering the object to be reproduced as source of spherical waves; (2) Optimization and speed-up of the algorithms used, in order to produce a portable code, runnable on several hardware platforms. In this paper calculation methods to obtain some fundamental geometric functions (points, lines, curves) are described. Furthermore, by the juxtaposition of these primitives functions it is possible to produce the holograms of more complex objects. Many examples of generated CGHs are presented.

Cost-effectiveness of natalizumab vs fingolimod for the treatment of relapsing-remitting multiple sclerosis: analyses in Sweden.

PubMed

O'Day, Ken; Meyer, Kellie; Stafkey-Mailey, Dana; Watson, Crystal

2015-04-01

To assess the cost-effectiveness of natalizumab vs fingolimod over 2 years in relapsing-remitting multiple sclerosis (RRMS) patients and patients with rapidly evolving severe disease in Sweden. A decision analytic model was developed to estimate the incremental cost per relapse avoided of natalizumab and fingolimod from the perspective of the Swedish healthcare system. Modeled 2-year costs in Swedish kronor of treating RRMS patients included drug acquisition costs, administration and monitoring costs, and costs of treating MS relapses. Effectiveness was measured in terms of MS relapses avoided using data from the AFFIRM and FREEDOMS trials for all patients with RRMS and from post-hoc sub-group analyses for patients with rapidly evolving severe disease. Probabilistic sensitivity analyses were conducted to assess uncertainty. The analysis showed that, in all patients with MS, treatment with fingolimod costs less (440,463 Kr vs 444,324 Kr), but treatment with natalizumab results in more relapses avoided (0.74 vs 0.59), resulting in an incremental cost-effectiveness ratio (ICER) of 25,448 Kr per relapse avoided. In patients with rapidly evolving severe disease, natalizumab dominated fingolimod. Results of the sensitivity analysis demonstrate the robustness of the model results. At a willingness-to-pay (WTP) threshold of 500,000 Kr per relapse avoided, natalizumab is cost-effective in >80% of simulations in both patient populations. Limitations include absence of data from direct head-to-head studies comparing natalizumab and fingolimod, use of relapse rate reduction rather than sustained disability progression as the primary model outcome, assumption of 100% adherence to MS treatment, and exclusion of adverse event costs in the model. Natalizumab remains a cost-effective treatment option for patients with MS in Sweden. In the RRMS patient population, the incremental cost per relapse avoided is well below a 500,000 Kr WTP threshold per relapse avoided. In the rapidly evolving severe disease patient population, natalizumab dominates fingolimod.

Obstacle avoidance handling and mixed integer predictive control for space robots

NASA Astrophysics Data System (ADS)

Zong, Lijun; Luo, Jianjun; Wang, Mingming; Yuan, Jianping

2018-04-01

This paper presents a novel obstacle avoidance constraint and a mixed integer predictive control (MIPC) method for space robots avoiding obstacles and satisfying physical limits during performing tasks. Firstly, a novel kind of obstacle avoidance constraint of space robots, which needs the assumption that the manipulator links and the obstacles can be represented by convex bodies, is proposed by limiting the relative velocity between two closest points which are on the manipulator and the obstacle, respectively. Furthermore, the logical variables are introduced into the obstacle avoidance constraint, which have realized the constraint form is automatically changed to satisfy different obstacle avoidance requirements in different distance intervals between the space robot and the obstacle. Afterwards, the obstacle avoidance constraint and other system physical limits, such as joint angle ranges, the amplitude boundaries of joint velocities and joint torques, are described as inequality constraints of a quadratic programming (QP) problem by using the model predictive control (MPC) method. To guarantee the feasibility of the obtained multi-constraint QP problem, the constraints are treated as soft constraints and assigned levels of priority based on the propositional logic theory, which can realize that the constraints with lower priorities are always firstly violated to recover the feasibility of the QP problem. Since the logical variables have been introduced, the optimization problem including obstacle avoidance and system physical limits as prioritized inequality constraints is termed as MIPC method of space robots, and its computational complexity as well as possible strategies for reducing calculation amount are analyzed. Simulations of the space robot unfolding its manipulator and tracking the end-effector's desired trajectories with the existence of obstacles and physical limits are presented to demonstrate the effectiveness of the proposed obstacle avoidance strategy and MIPC control method of space robots.

The social benefits of private infectious disease-risk mitigation.

PubMed

Morin, Benjamin R; Perrings, Charles; Kinzig, Ann; Levin, Simon

2015-11-01

Does society benefit from private measures to mitigate infectious disease risks? Since mitigation reduces both peak prevalence and the number of people who fall ill, the answer might appear to be yes. But mitigation also prolongs epidemics and therefore the time susceptible people engage in activities to avoid infection. These avoidance activities come at a cost-in lost production or consumption, for example. Whether private mitigation yields net social benefits depends on the social weight given to the costs of illness and illness avoidance, now and into the future. We show that, for a large class of infectious diseases, private risk mitigation is socially beneficial. However, in cases where society discounts the future at either very low or very high rates relative to private individuals, or where it places a low weight on the private cost of illness, the social cost of illness under proportionate mixing (doing nothing) may be lower than the social cost of illness under preferential mixing (avoiding infectious individuals). That is, under some circumstances, society would prefer shorter, more intense epidemics without avoidance costs over longer, less intense epidemics with avoidance costs. A sobering (although not surprising) implication of this is that poorer societies should be expected to promote less private disease-risk mitigation than richer societies.

The computer coordination method and research of inland river traffic based on ship database

NASA Astrophysics Data System (ADS)

Liu, Shanshan; Li, Gen

2018-04-01

A computer coordinated management method for inland river ship traffic is proposed in this paper, Get the inland ship's position, speed and other navigation information by VTS, building ship's statics and dynamic data bases, writing a program of computer coordinated management of inland river traffic by VB software, Automatic simulation and calculation of the meeting states of ships, Providing ship's long-distance collision avoidance information. The long-distance collision avoidance of ships will be realized. The results show that, Ships avoid or reduce meetings, this method can effectively control the macro collision avoidance of ships.

Where do the Field Plots Belong? A Multiple-Constraint Sampling Design for the BigFoot Project

NASA Astrophysics Data System (ADS)

Kennedy, R. E.; Cohen, W. B.; Kirschbaum, A. A.; Gower, S. T.

2002-12-01

A key component of a MODIS validation project is effective characterization of biophysical measures on the ground. Fine-grain ecological field measurements must be placed strategically to capture variability at the scale of the MODIS imagery. Here we describe the BigFoot project's revised sampling scheme, designed to simultaneously meet three important goals: capture landscape variability, avoid spatial autocorrelation between field plots, and minimize time and expense of field sampling. A stochastic process places plots in clumped constellations to reduce field sampling costs, while minimizing spatial autocorrelation. This stochastic process is repeated, creating several hundred realizations of plot constellations. Each constellation is scored and ranked according to its ability to match landscape variability in several Landsat-based spectral indices, and its ability to minimize field sampling costs. We show how this approach has recently been used to place sample plots at the BigFoot project's two newest study areas, one in a desert system and one in a tundra system. We also contrast this sampling approach to that already used at the four prior BigFoot project sites.

A unique patterned diamond stamp for a periodically hierarchical nanoarray structure.

PubMed

Wang, Yi; Shen, Yanting; Xu, Weiqing; Xu, Shuping; Li, Hongdong

2016-09-23

A diamond stamp with a hierarchical pattern was designed for the direct preparation of a periodic nanoarray structure, which was prepared by the reactive ion etching technique with a hierarchical ultrathin alumina membrane (HUTAM) as a mask. The optimal etching conditions for fabricating the diamond stamp were discussed in order to realize a vertical nanopore structure, avoiding structural damage from lateral etching. By using this diamond stamp, a polymer film with the desired hierarchical nanorod array structure can be obtained easily via the simple stamping process, which greatly simplifies the processing procedure. More importantly, the stamp is reusable because of its super-hardness, which ensures the reproducibility of the nanorod array pattern. Another merit is that the smooth surface of the etched diamond can avoid the use of a release agent. Our results prove that this hard stamp can be used for quick preparation of an elaborate periodic nanoarray structure. This study is significant in that it solves the problems of high cost and easy damage of stamps in nanoimprint lithography, and it might inspire more sophisticated applications of such an ordered structure in nanoplasmonics, biochemical sensing and nanophotonic devices.

Submersible Spectrofluorometer for Real-Time Sensing of Water Quality

PubMed Central

Puiu, Adriana; Fiorani, Luca; Menicucci, Ivano; Pistilli, Marco; Lai, Antonia

2015-01-01

In this work, we present a newly developed submersible spectrofluorometer (patent pending) applied to real-time sensing of water quality, suitable for monitoring some important indicators of the ecological status of natural waters such as chlorophyll-a, oil and protein-like material. For the optomechanical realization of the apparatus, a novel conceptual design has been adopted in order to avoid filters and pumps while maintaining a high signal-to-noise ratio. The elimination of filters and pumps has the advantage of greater system simplicity and especially of avoiding the risk of sample degradation. The use of light-emitting diodes as an excitation source instead of Xe lamps or laser diodes helped save on size, weight, power consumption and costs. For sensor calibration we performed measurements on water samples with added chlorophyll prepared in the laboratory. The sensor functionality was tested during field campaigns conducted at Albano Lake in Latium Region of Italy as well as in the Herzliya Harbor, a few kilometers North East of Tel Aviv in Israel. The obtained results are reported in the paper. The sensitivity achieved for chlorophyll-a detection was found to be at least 0.2 µg/L. PMID:26094628

The Six Cs of Managing Federal Projects: How to Avoid Cost Disallowances.

ERIC Educational Resources Information Center

Goeres, Ernest R.; Mancini, Cesidio G.

1995-01-01

To avoid embarrassment and financial cost of incurring cost disallowances on federally-sponsored projects, college and university administrators must pay particular attention to these management areas: compensation (release time, overload, and others); costs (allowable, attributable, transfers, and others); consulting; certification of time and…

Improving patient care in cardiac surgery using Toyota production system based methodology.

PubMed

Culig, Michael H; Kunkle, Richard F; Frndak, Diane C; Grunden, Naida; Maher, Thomas D; Magovern, George J

2011-02-01

A new cardiac surgery program was developed in a community hospital setting using the operational excellence (OE) method, which is based on the principles of the Toyota production system. The initial results of the first 409 heart operations, performed over the 28 months between March 1, 2008, and June 30, 2010, are presented. Operational excellence methodology was taught to the cardiac surgery team. Coaching started 2 months before the opening of the program and continued for 24 months. Of the 409 cases presented, 253 were isolated coronary artery bypass graft operations. One operative death occurred. According to the database maintained by The Society of Thoracic Surgeons, the risk-adjusted operative mortality rate was 61% lower than the regional rate. Likewise, the risk-adjusted rate of major complications was 57% lower than The Society of Thoracic Surgeons regional rate. Daily solution to determine cause was attempted on 923 distinct perioperative problems by all team members. Using the cost of complications as described by Speir and coworkers, avoiding predicted complications resulted in a savings of at least $884,900 as compared with the regional average. By the systematic use of a real time, highly formatted problem-solving methodology, processes of care improved daily. Using carefully disciplined teamwork, reliable implementation of evidence-based protocols was realized by empowering the front line to make improvements. Low rates of complications were observed, and a cost savings of $3,497 per each case of isolated coronary artery bypass graft was realized. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The social benefits of private infectious disease-risk mitigation

PubMed Central

Perrings, Charles; Kinzig, Ann; Levin, Simon

2015-01-01

Does society benefit from private measures to mitigate infectious disease risks? Since mitigation reduces both peak prevalence and the number of people who fall ill, the answer might appear to be yes. But mitigation also prolongs epidemics and therefore the time susceptible people engage in activities to avoid infection. These avoidance activities come at a cost—in lost production or consumption, for example. Whether private mitigation yields net social benefits depends on the social weight given to the costs of illness and illness avoidance, now and into the future. We show that, for a large class of infectious diseases, private risk mitigation is socially beneficial. However, in cases where society discounts the future at either very low or very high rates relative to private individuals, or where it places a low weight on the private cost of illness, the social cost of illness under proportionate mixing (doing nothing) may be lower than the social cost of illness under preferential mixing (avoiding infectious individuals). That is, under some circumstances, society would prefer shorter, more intense epidemics without avoidance costs over longer, less intense epidemics with avoidance costs. A sobering (although not surprising) implication of this is that poorer societies should be expected to promote less private disease-risk mitigation than richer societies. PMID:26858777

Analysis of Realized Volatility for Nikkei Stock Average on the Tokyo Stock Exchange

NASA Astrophysics Data System (ADS)

Takaishi, Tetsuya; Watanabe, Toshiaki

2016-04-01

We calculate realized volatility of the Nikkei Stock Average (Nikkei225) Index on the Tokyo Stock Exchange and investigate the return dynamics. To avoid the bias on the realized volatility from the non-trading hours issue we calculate realized volatility separately in the two trading sessions, i.e. morning and afternoon, of the Tokyo Stock Exchange and find that the microstructure noise decreases the realized volatility at small sampling frequency. Using realized volatility as a proxy of the integrated volatility we standardize returns in the morning and afternoon sessions and investigate the normality of the standardized returns by calculating variance, kurtosis and 6th moment. We find that variance, kurtosis and 6th moment are consistent with those of the standard normal distribution, which indicates that the return dynamics of the Nikkei Stock Average are well described by a Gaussian random process with time-varying volatility.

Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting.

PubMed

Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Early decision-analytic modeling - a case study on vascular closure devices.

PubMed

Brandes, Alina; Sinner, Moritz F; Kääb, Stefan; Rogowski, Wolf H

2015-10-27

As economic considerations become more important in healthcare reimbursement, decisions about the further development of medical innovations need to take into account not only medical need and potential clinical effectiveness, but also cost-effectiveness. Already early in the innovation process economic evaluations can support decisions on development in specific indications or patient groups by anticipating future reimbursement and implementation decisions. One potential concept for early assessment is value-based pricing. The objective is to assess the feasibility of value-based pricing and product design for a hypothetical vascular closure device in the pre-clinical stage which aims at decreasing bleeding events. A deterministic decision-analytic model was developed to estimate the cost-effectiveness of established vascular closure devices from the perspective of the Statutory Health Insurance system. To identify early benchmarks for pricing and product design, three strategies of determining the product's value are explored: 1) savings from complications avoided by the new device; 2) valuation of the avoided complications based on an assumed willingness-to-pay-threshold (the efficiency frontier approach); 3) value associated with modifying the care pathways within which the device would be applied. Use of established vascular closure devices is dominated by manual compression. The hypothetical vascular closure device reduces overall complication rates at higher costs than manual compression. Maximum cost savings of only about €4 per catheterization could be realized by applying the hypothetical device. Extrapolation of an efficiency frontier is only possible for one subgroup where vascular closure devices are not a dominated strategy. Modifying care in terms of same-day discharge of patients treated with vascular closure devices could result in cost savings of €400-600 per catheterization. It was partially feasible to calculate value-based prices for the novel closure device which can be used to inform product design. However, modifying the care pathway may generate much more value from the payers' perspective than modifying the device per se. Manufacturers should thus explore the feasibility of combining reimbursement of their product with arrangements that make same-day discharge attractive also for hospitals. Due to the early nature of the product, the results are afflicted with substantial uncertainty.

Ensuring food security with lower environmental costs under intensive agricultural land use patterns: A case study from China.

PubMed

Qi, Xiaoxing; Wang, Raymond Yu; Li, Jianchun; Zhang, Tao; Liu, Liming; He, Yanling

2018-05-01

Rapid population growth and environmental deterioration make ensuring food security with lower environmental costs fundamental to realizing sustainable development in China and other developing countries. The conceptual framework used in this paper integrates the major consequences of intensive agricultural land use and the diverse objectives of policymakers and farmers. It also offers an operational approach, based on farmers' diverse performance in grain production and farmland productivity, to assess food production and environmental impacts under foci-differentiated scenarios. Using data from farmer household surveys, soil surveys, land use images, and statistical yearbooks, this approach was tested using a regional case in China. The results indicate that, among all farmer types, the medium-scale farmers had a better comprehensive performance for grain production for yield, fertilizer and pesticide inputs, labor productivity, and sustainability. Therefore, grain yields can be increased and environmental costs reduced simultaneously through the use of policy instruments that encourage the transformation of trapped farmers into medium-scale farmers and balancing the proportion of single and double cropped rice. In addition, and in order to reduce grain losses caused by natural disasters and to prevent environmental degradation, robust policy measures should be developed to avoid the currently predominant cropping patterns that erode biodiversity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Traffic Alert and Collision Avoidance System (TCAS): Cockpit Display of Traffic Information (CDTI) investigation. Phase 1: Feasibility study

NASA Technical Reports Server (NTRS)

Burgess, Malcolm; Davis, Dean; Hollister, Walter; Sorensen, John A.

1991-01-01

The possibility of the Threat Alert and Collision Avoidance System (TCAS) traffic sensor and display being used for meaningful Cockpit Display of Traffic Information (CDTI) applications has resulted in the Federal Aviation Administration initiating a project to establish the technical and operational requirements to realize this potential. Phase 1 of the project is presented here. Phase 1 was organized to define specific CDTI applications for the terminal area, to determine what has already been learned about CDTI technology relevant to these applications, and to define the engineering required to supply the remaining TCAS-CDTI technology for capacity benefit realization. The CDTI applications examined have been limited to those appropriate to the final approach and departure phases of flight.

The Necessity of Functional Analysis for Space Exploration Programs

NASA Technical Reports Server (NTRS)

Morris, A. Terry; Breidenthal, Julian C.

2011-01-01

As NASA moves toward expanded commercial spaceflight within its human exploration capability, there is increased emphasis on how to allocate responsibilities between government and commercial organizations to achieve coordinated program objectives. The practice of program-level functional analysis offers an opportunity for improved understanding of collaborative functions among heterogeneous partners. Functional analysis is contrasted with the physical analysis more commonly done at the program level, and is shown to provide theoretical performance, risk, and safety advantages beneficial to a government-commercial partnership. Performance advantages include faster convergence to acceptable system solutions; discovery of superior solutions with higher commonality, greater simplicity and greater parallelism by substituting functional for physical redundancy to achieve robustness and safety goals; and greater organizational cohesion around program objectives. Risk advantages include avoidance of rework by revelation of some kinds of architectural and contractual mismatches before systems are specified, designed, constructed, or integrated; avoidance of cost and schedule growth by more complete and precise specifications of cost and schedule estimates; and higher likelihood of successful integration on the first try. Safety advantages include effective delineation of must-work and must-not-work functions for integrated hazard analysis, the ability to formally demonstrate completeness of safety analyses, and provably correct logic for certification of flight readiness. The key mechanism for realizing these benefits is the development of an inter-functional architecture at the program level, which reveals relationships between top-level system requirements that would otherwise be invisible using only a physical architecture. This paper describes the advantages and pitfalls of functional analysis as a means of coordinating the actions of large heterogeneous organizations for space exploration programs.

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

PubMed

Chiao, Evelyn; Meyer, Kellie

2009-06-01

Disease-modifying therapy (DMT) is the largest single-cost item that contributes to the total per-patient cost of multiple sclerosis (MS), a disabling disorder of the central nervous system. Natalizumab is the most recent DMT to be approved for the treatment of relapsing MS and may be an attractive alternative to interferon beta and glatiramer acetate (GA). To determine from the perspective of a United States payer (1) the incremental cost effectiveness of natalizumab compared with other DMTs and (2) the budgetary impact of utilization of natalizumab for the treatment of relapsing MS. A combined cost effectiveness and budget impact model was developed. Model inputs were drug acquisition costs (wholesale acquisition cost), costs of drug administration and monitoring, costs of treating relapses, anticipated reduction in relapse rates after 2 years of therapy, and estimated market utilization of natalizumab. Outcomes included total 2-year costs of therapy per patient, costs per relapse avoided for each treatment, and overall 2-year costs to the health plan and per member per month (PMPM) costs. Drug acquisition costs are in 2008 US dollars, and all other costs were inflated to 2008 US dollars when necessary. Univariate sensitivity analyses were performed to determine the model inputs with the greatest influence on the cost per relapse avoided for natalizumab. The overall 2-year cost of therapy per patient was $72,120 for natalizumab, $56,790 for intramuscular (IM) interferon beta-1a (IFNbeta-1a), $56,773 for IFNbeta-1b, $57,180 for GA, and $58,538 for subcutaneous (SC) IFNbeta-1a. The cost per relapse avoided was lowest for natalizumab at $56,594, followed by $87,791 for IFNbeta-1b, $93,306 for IM IFNbeta-1a, $96,178 for SC IFNbeta-1a, and $103,665 for GA. The incremental cost-effectiveness ratios of natalizumab relative to IM IFNbeta-1a, IFNbeta-1b, GA, and SC IFNbeta-1a were $23,029, $24,452, $20,671, and $20,403 per additional relapse avoided, respectively. An increase in natalizumab utilization to 9% resulted in an increase of approximately $61 760 in total 2-year costs to a hypothetical health plan of 1 million members, or a $0.003 PMPM incremental cost. Univariate sensitivity analyses indicated that the model inputs with the most influence on cost per relapse avoided for natalizumab were the weighted average number of relapses before treatment and the anticipated relative relapse rate reduction. Natalizumab was the most cost-effective therapy as measured by total cost per relapse avoided, not withstanding a higher drug acquisition cost versus other DMTs. Entry of natalizumab to the market is likely to result in a minimal increase in health-plan costs on a PMPM basis. Limitations of the study include the use of a surrogate measure, relapse avoided, as an outcome measure; also, adverse events were not included in the model.

Neural Mechanisms for Adaptive Learned Avoidance of Mental Effort.

PubMed

Mitsuto Nagase, Asako; Onoda, Keiichi; Clifford Foo, Jerome; Haji, Tomoki; Akaishi, Rei; Yamaguchi, Shuhei; Sakai, Katsuyuki; Morita, Kenji

2018-02-05

Humans tend to avoid mental effort. Previous studies have demonstrated this tendency using various demand-selection tasks; participants generally avoid options associated with higher cognitive demand. However, it remains unclear whether humans avoid mental effort adaptively in uncertain and non-stationary environments, and if so, what neural mechanisms underlie this learned avoidance and whether they remain the same irrespective of cognitive-demand types. We addressed these issues by developing novel demand-selection tasks where associations between choice options and cognitive-demand levels change over time, with two variations using mental arithmetic and spatial reasoning problems (29:4 and 18:2 males:females). Most participants showed avoidance, and their choices depended on the demand experienced on multiple preceding trials. We assumed that participants updated the expected cost of mental effort through experience, and fitted their choices by reinforcement learning models, comparing several possibilities. Model-based fMRI analyses revealed that activity in the dorsomedial and lateral frontal cortices was positively correlated with the trial-by-trial expected cost for the chosen option commonly across the different types of cognitive demand, and also revealed a trend of negative correlation in the ventromedial prefrontal cortex. We further identified correlates of cost-prediction-error at time of problem-presentation or answering the problem, the latter of which partially overlapped with or were proximal to the correlates of expected cost at time of choice-cue in the dorsomedial frontal cortex. These results suggest that humans adaptively learn to avoid mental effort, having neural mechanisms to represent expected cost and cost-prediction-error, and the same mechanisms operate for various types of cognitive demand. SIGNIFICANCE STATEMENT In daily life, humans encounter various cognitive demands, and tend to avoid high-demand options. However, it remains unclear whether humans avoid mental effort adaptively under dynamically changing environments, and if so, what are the underlying neural mechanisms and whether they operate irrespective of cognitive-demand types. To address these issues, we developed novel tasks, where participants could learn to avoid high-demand options under uncertain and non-stationary environments. Through model-based fMRI analyses, we found regions whose activity was correlated with the expected mental effort cost, or cost-prediction-error, regardless of demand-type, with overlap or adjacence in the dorsomedial frontal cortex. This finding contributes to clarifying the mechanisms for cognitive-demand avoidance, and provides empirical building blocks for the emerging computational theory of mental effort. Copyright © 2018 the authors.

Prospective multi-center study for quantification of chemotherapies and CTX-related direct medication costs avoided by use of biomarkers uPA and PAI-1 in primary breast cancer.

PubMed

Jacobs, Volker R; Augustin, Doris; Wischnik, Arthur; Kiechle, Marion; Höss, Cornelia; Steinkohl, Oliver; Rack, Brigitte; Kapitza, Thomas; Krase, Peter

2013-08-01

Biomarkers uPA/PAI-1 as recommended by ASCO and AGO are used in primary breast cancer to avoid unnecessary CTX in medium risk-recurrence patients. This study verified how many CTX cycles and CTX-related direct medication costs can be avoided by uPA/PAI-1 testing. A prospective, non-interventional, multi-center study was performed among six Certified Breast Centers to analyze application of uPA/PAI-1 and consecutive decision-making. CTX avoided were identified and direct costs for CTX, CTX-related concomitant medication and febrile neutropenia (FN) prophylaxis with G-CSF calculated. In n = 93 breast cancers n = 35 CTX (37.6%) with 210 CTX cycles were avoided according to uPA/PAI-1 test result. uPA/PAI-1 testing saved direct medication costs for CTX of 177,453 €, CTX-related concomitant medication of 27,482 € and FN prophylaxis of 20,599 €, overall 225,534 €. At test costs at 287.50 € uPA/PAI-1 testing resulted in additional costs of 26,737.50 €. uPA/PAI-1 has proven to be cost-effective at a return-on-investment ratio of 8.4:1. Indirect cost savings further increase this ROI. These results support decision-making for cost-effective diagnostics and therapy in breast cancer. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cost-outcome description of clinical pharmacist interventions in a university teaching hospital.

PubMed

Gallagher, James; Byrne, Stephen; Woods, Noel; Lynch, Deirdre; McCarthy, Suzanne

2014-04-17

Pharmacist interventions are one of the pivotal parts of a clinical pharmacy service within a hospital. This study estimates the cost avoidance generated by pharmacist interventions due to the prevention of adverse drug events (ADE). The types of interventions identified are also analysed. Interventions recorded by a team of hospital pharmacists over a one year time period were included in the study. Interventions were assigned a rating score, determined by the probability that an ADE would have occurred in the absence of an intervention. These scores were then used to calculate cost avoidance. Net cost benefit and cost benefit ratio were the primary outcomes. Categories of interventions were also analysed. A total cost avoidance of €708,221 was generated. Input costs were calculated at €81,942. This resulted in a net cost benefit of €626,279 and a cost benefit ratio of 8.64: 1. The most common type of intervention was the identification of medication omissions, followed by dosage adjustments and requests to review therapies. This study provides further evidence that pharmacist interventions provide substantial cost avoidance to the healthcare payer. There is a serious issue of patient's regular medication being omitted on transfer to an inpatient setting in Irish hospitals.

Selected inversion as key to a stable Langevin evolution across the QCD phase boundary

NASA Astrophysics Data System (ADS)

Bloch, Jacques; Schenk, Olaf

2018-03-01

We present new results of full QCD at nonzero chemical potential. In PRD 92, 094516 (2015) the complex Langevin method was shown to break down when the inverse coupling decreases and enters the transition region from the deconfined to the confined phase. We found that the stochastic technique used to estimate the drift term can be very unstable for indefinite matrices. This may be avoided by using the full inverse of the Dirac operator, which is, however, too costly for four-dimensional lattices. The major breakthrough in this work was achieved by realizing that the inverse elements necessary for the drift term can be computed efficiently using the selected inversion technique provided by the parallel sparse direct solver package PARDISO. In our new study we show that no breakdown of the complex Langevin method is encountered and that simulations can be performed across the phase boundary.

Appropriate uses and considerations for online surveying in human dimensions research

USGS Publications Warehouse

Sexton, Natalie R.; Miller, Holly M.; Dietsch, Alia M.

2011-01-01

Online surveying has gained attention in recent years for its applicability to human dimensions research as an efficient and inexpensive data-collection method; however, online surveying is not a panacea. In this article, we provide some guidelines for alleviating or avoiding the criticisms and pitfalls suggested of online survey methods and explore two case studies demonstrating different approaches to online surveying. The first was a mixed-mode study of visitors to 52 participating National Wildlife Refuges. The response rate was 72%, with over half of respondents completing the survey online, resulting in cost-savings and efficiencies that would not have otherwise been realized. The second highlighted an online-only approach targeting specialized users of satellite imagery. Through branching and skipping, the online mode allowed flexibilities in administration impractical in a mail survey. The response rate of 53% was higher than typical for online surveys. Both case studies provide examples of appropriate uses of online surveying.

The costs of avoiding environmental impacts from shale-gas surface infrastructure.

PubMed

Milt, Austin W; Gagnolet, Tamara D; Armsworth, Paul R

2016-12-01

Growing energy demand has increased the need to manage conflicts between energy production and the environment. As an example, shale-gas extraction requires substantial surface infrastructure, which fragments habitats, erodes soils, degrades freshwater systems, and displaces rare species. Strategic planning of shale-gas infrastructure can reduce trade-offs between economic and environmental objectives, but the specific nature of these trade-offs is not known. We estimated the cost of avoiding impacts from land-use change on forests, wetlands, rare species, and streams from shale-energy development within leaseholds. We created software for optimally siting shale-gas surface infrastructure to minimize its environmental impacts at reasonable construction cost. We visually assessed sites before infrastructure optimization to test whether such inspection could be used to predict whether impacts could be avoided at the site. On average, up to 38% of aggregate environmental impacts of infrastructure could be avoided for 20% greater development costs by spatially optimizing infrastructure. However, we found trade-offs between environmental impacts and costs among sites. In visual inspections, we often distinguished between sites that could be developed to avoid impacts at relatively low cost (29%) and those that could not (20%). Reductions in a metric of aggregate environmental impact could be largely attributed to potential displacement of rare species, sedimentation, and forest fragmentation. Planners and regulators can estimate and use heterogeneous trade-offs among development sites to create industry-wide improvements in environmental performance and do so at reasonable costs by, for example, leveraging low-cost avoidance of impacts at some sites to offset others. This could require substantial effort, but the results and software we provide can facilitate the process. © 2016 Society for Conservation Biology.

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

PubMed Central

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-01-01

Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

PURPA 210 avoided cost rates: Economic and implementation issues

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

Devine, M.D.; Chartock, M.A.; Gunn, E.M.

The purpose of Section 210 of the Public Utilities Regulatory Policies Act (PURPA) was to promote the utilization of waste and renewable fuels and cogeneration processes for increasing electric power supplies. It represents a radical change in policy by allowing financially unregulated parties to generate power in ''qualifying facilities'' and by requiring utilities to purchase this power at the utilities' marginal (or ''avoided'') cost. PURPA 210 has clearly had a major impact as measured by the actual and proposed number of new qualifying facilities; however, implementation has been difficult due to the adversarial nature of the process for negotiating ormore » setting the avoided cost rates. This paper reviews the pertinent PURPA rules and regulations, analyzes the status of current avoided cost rates that have been established, and discusses implementation issues and options for resolving those issues.« less

Current and future avoidable cost of smoking--estimates for Sweden 2007.

PubMed

Bolin, Kristian; Borgman, Benny; Gip, Christina; Wilson, Koo

2011-11-01

To estimate current and future avoidable smoking-attributable costs in Sweden for the year 2007. Disease specific smoking-attributable proportions were calculated for Swedish smoking patterns and applied to estimate costs for smoking-related diseases based on data from public registers. Avoidable future effects of smoking were calculated employing a Markov simulation model. The estimated total cost in 2007 was USD 1.6 billion, or USD 181 per capita. Healthcare (direct) cost accounted for 30% of the total cost. The number of deaths was 97 per 100,000 inhabitants (79 in 2001); the number of years of potential life lost 1,227 per 100,000 inhabitants (1012 in 2001); and the number of years of potential productive life lost 226 (185 in 2001) per 100,000 inhabitants. Avoidable future lifetime costs, per 100,000 inhabitants, amounted to USD 19 million (healthcare), 14,000 years of potential life lost, corresponding to a present value of USD 158 million. Total avoidable cost of current smoking amounted to USD 16 billion. In spite of declining smoking-prevalence rates during the last 30 years, smoking-attributable deaths increased between 2001 and 2007. The number of life years lost per death decreased somewhat, indicating that the age distribution of those dying shifted further towards older age. Simulations indicate that smoking-cessation among young smokers yields considerable more benefits each year than smoking-cessation among older smokers. The health benefits that accrued in 2007, as a result of declining smoking prevalence since 1980, correspond to more than the total cost of smoking in that year. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

An Advanced Programming Technique for a Cost-Effective Hardware-Independent Realization of Naval Software Systems. Final Technical Report, Part II.

ERIC Educational Resources Information Center

Computer Symbolic, Inc., Washington, DC.

A pseudo assembly language, PAL, was developed and specified for use as the lowest level in a general, multilevel programing system for the realization of cost-effective, hardware-independent Naval software. The language was developed as part of the system called FIRMS (Fast Iterative Recursive Macro System) and is sufficiently general to allow…

Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016.

PubMed

Li, Rui; Simmons, Katharine B; Bertolli, Jeanne; Rivera-Garcia, Brenda; Cox, Shanna; Romero, Lisa; Koonin, Lisa M; Valencia-Prado, Miguel; Bracero, Nabal; Jamieson, Denise J; Barfield, Wanda; Moore, Cynthia A; Mai, Cara T; Korhonen, Lauren C; Frey, Meghan T; Perez-Padilla, Janice; Torres-Muñoz, Ricardo; Grosse, Scott D

2017-01-01

We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus-related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus-associated microcephaly [ZAM]). The estimates are influenced by the contraception methods used, the frequency of ZAM, and the lifetime incremental cost of ZAM. Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention. Increasing contraceptive access for women who want to delay or avoid pregnancy in Puerto Rico during a Zika virus outbreak can substantially reduce the number of cases of ZAM and healthcare costs.

Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016

PubMed Central

Simmons, Katharine B.; Bertolli, Jeanne; Rivera-Garcia, Brenda; Cox, Shanna; Romero, Lisa; Koonin, Lisa M.; Valencia-Prado, Miguel; Bracero, Nabal; Jamieson, Denise J.; Barfield, Wanda; Moore, Cynthia A.; Mai, Cara T.; Korhonen, Lauren C.; Frey, Meghan T.; Perez-Padilla, Janice; Torres-Muñoz, Ricardo; Grosse, Scott D.

2017-01-01

We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus–related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus–associated microcephaly [ZAM]). The estimates are influenced by the contraception methods used, the frequency of ZAM, and the lifetime incremental cost of ZAM. Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention. Increasing contraceptive access for women who want to delay or avoid pregnancy in Puerto Rico during a Zika virus outbreak can substantially reduce the number of cases of ZAM and healthcare costs. PMID:27805547

Optimizing emissions targets for residential recycling programmes: Why 'more' is not necessarily better with respect to diversion.

PubMed

Lakhan, Calvin

2016-11-01

This study highlights the economic and environmental challenges of recycling in Ontario, specifically examining the effect of attempting to increase the emissions target for the province's household recycling programme. The findings from the cost model analysis found that Ontario's Blue Box programme reduces overall carbon emissions by approximately 1.8 million tonnes every year. This study also found that targeting specific materials for recovery could result in a scenario where the province could improve both overall diversion and emissions offsets while reducing material management costs. Under our modelled scenario, as the tonnes of greenhouse gases (GHGs) avoided increases, the system cost per tonne of GHG avoided initial declines. However, after avoiding 2.05 million tonnes of GHGs, the system cost/tonne GHG avoided increases. To achieve an emissions target in excess of 2.05 million tonnes, the province will have to start recycling higher cost non-core materials (composite materials, other plastics, etc.). © The Author(s) 2016.

Cost as a barrier to accessing dental care: findings from a Canadian population-based study.

PubMed

Thompson, Brandy; Cooney, Peter; Lawrence, Herenia; Ravaghi, Vahid; Quiñonez, Carlos

2014-01-01

The aim of this study is to determine the demographic and socioeconomic characteristics of Canadians who report cost barriers to dental care. An analysis of data collected from the 2007/09 Canadian Health Measures Survey was undertaken from a sample of 5,586 Canadian participants aged 6-79. Cost barriers to dental care were operationalized through two questions: "In the past 12 months, have you avoided going to a dental professional because of the cost of dental care?" and "In the past 12 months, have you avoided having all the dental treatment that was recommended because of the cost?" Logistic regressions were conducted to identify relationships between covariates and positive responses to these questions. Approximately 17.3 percent of respondents had avoided a dental professional because of cost within the previous year, and 16.5 percent had declined recommended dental treatment because of cost. Adjusted estimates demonstrate that respondents with lower incomes and without dental insurance were over four times more likely to avoid a dental professional because of cost and approximately two and a half times more likely to decline recommended dental treatment because of cost. Nearly one out of five Canadians surveyed reported cost barriers to dental care. This study provides valuable baseline information for future studies to assess whether financial barriers to dental care are getting better or worse for Canadians. © 2014 American Association of Public Health Dentistry.

Design for a Crane Metallic Structure Based on Imperialist Competitive Algorithm and Inverse Reliability Strategy

NASA Astrophysics Data System (ADS)

Fan, Xiao-Ning; Zhi, Bo

2017-07-01

Uncertainties in parameters such as materials, loading, and geometry are inevitable in designing metallic structures for cranes. When considering these uncertainty factors, reliability-based design optimization (RBDO) offers a more reasonable design approach. However, existing RBDO methods for crane metallic structures are prone to low convergence speed and high computational cost. A unilevel RBDO method, combining a discrete imperialist competitive algorithm with an inverse reliability strategy based on the performance measure approach, is developed. Application of the imperialist competitive algorithm at the optimization level significantly improves the convergence speed of this RBDO method. At the reliability analysis level, the inverse reliability strategy is used to determine the feasibility of each probabilistic constraint at each design point by calculating its α-percentile performance, thereby avoiding convergence failure, calculation error, and disproportionate computational effort encountered using conventional moment and simulation methods. Application of the RBDO method to an actual crane structure shows that the developed RBDO realizes a design with the best tradeoff between economy and safety together with about one-third of the convergence speed and the computational cost of the existing method. This paper provides a scientific and effective design approach for the design of metallic structures of cranes.

Least dissipation cost as a design principle for robustness and function of cellular networks

NASA Astrophysics Data System (ADS)

Han, Bo; Wang, Jin

2008-03-01

From a study of the budding yeast cell cycle, we found that the cellular network evolves to have the least cost for realizing its biological function. We quantify the cost in terms of the dissipation or heat loss characterized through the steady-state properties: the underlying landscape and the associated flux. We found that the dissipation cost is intimately related to the stability and robustness of the network. With the least dissipation cost, the network becomes most stable and robust under mutations and perturbations on the sharpness of the response from input to output as well as self-degradations. The least dissipation cost may provide a general design principle for the cellular network to survive from the evolution and realize the biological function.

Avoidable costs of comprehensive case management.

PubMed

Issel, L M; Anderson, R A

1999-01-01

Comprehensive case management has become an industry standard and its pervasiveness raises questions about the ubiquitous need for this service. Analyzed from the perspective of transaction cost analysis and access, we argue that in some cases comprehensive case management is an avoidable cost incurred because of system problems that limit access to otherwise eligible clients. Implications are discussed.

Clinical and economic consequences of vancomycin and fidaxomicin for the treatment of Clostridium difficile infection in Canada.

PubMed

Wagner, Monika; Lavoie, Louis; Goetghebeur, Mireille

2014-03-01

Clostridium difficile infection (CDI) represents a public health problem with increasing incidence and severity. To evaluate the clinical and economic consequences of vancomycin compared with fidaxomicin in the treatment of CDI from the Canadian health care system perspective. A decision-tree model was developed to compare vancomycin and fidaxomicin for the treatment of severe CDI. The model assumed identical initial cure rates and included first recurrent episodes of CDI (base case). Treatment of patients presenting with recurrent CDI was examined as an alternative analysis. Costs included were for study medication, physician services and hospitalization. Cost effectiveness was measured as incremental cost per recurrence avoided. Sensitivity analyses of key input parameters were performed. In a cohort of 1000 patients with an initial episode of severe CDI, treatment with fidaxomicin led to 137 fewer recurrences at an incremental cost of $1.81 million, resulting in an incremental cost of $13,202 per recurrence avoided. Among 1000 patients with recurrent CDI, 113 second recurrences were avoided at an incremental cost of $18,190 per second recurrence avoided. Incremental costs per recurrence avoided increased with increasing proportion of cases caused by the NAP1/B1/027 strain. Results were sensitive to variations in recurrence rates and treatment duration but were robust to variations in other parameters. The use of fidaxomicin is associated with a cost increase for the Canadian health care system. Clinical benefits of fidaxomicin compared with vancomycin depend on the proportion of cases caused by the NAP1/B1/027 strain in patients with severe CDI.

Barriers to implementation of workplace health interventions: an economic perspective.

PubMed

Cherniack, Martin; Lahiri, Supriya

2010-09-01

To identify insurance related, structural, and workplace cultural barriers to the implementation of effective preventive and upstream clinical interventions in the working age adult population. Analysis of avoided costs from perspective of health economics theory and from empiric observations from large studies; presentation of data from our own cost-plus model on integrating health promotion and ergonomics. We identify key avoided costs issues as a misalignment of interests between employers, insurers, service institutions, and government. Conceptual limitations of neoclassical economics are attributable to work culture and supply-driven nature of health care. Effective valuation of avoided costs is a necessary condition for redirecting allocations and incentives. Key content for valuation models is discussed.

Goal-Directed Fluid Therapy Guided by Cardiac Monitoring During High-Risk Abdominal Surgery in Adult Patients: Cost-Effectiveness Analysis of Esophageal Doppler and Arterial Pulse Pressure Waveform Analysis.

PubMed

Legrand, Guillaume; Ruscio, Laura; Benhamou, Dan; Pelletier-Fleury, Nathalie

2015-07-01

Several minimally invasive techniques for cardiac output monitoring such as the esophageal Doppler (ED) and arterial pulse pressure waveform analysis (APPWA) have been shown to improve surgical outcomes compared with conventional clinical assessment (CCA). To evaluate the cost-effectiveness of these techniques in high-risk abdominal surgery from the perspective of the French public health insurance fund. An analytical decision model was constructed to compare the cost-effectiveness of ED, APPWA, and CCA. Effectiveness data were defined from meta-analyses of randomized clinical trials. The clinical end points were avoidance of hospital mortality and avoidance of major complications. Hospital costs were estimated by the cost of corresponding diagnosis-related groups. Both goal-directed therapy strategies evaluated were more effective and less costly than CCA. Perioperative mortality and the rate of major complications were reduced by the use of ED and APPWA. Cost reduction was mainly due to the decrease in the rate of major complications. APPWA was dominant compared with ED in 71.6% and 27.6% and dominated in 23.8% and 20.8% of the cases when the end point considered was "major complications avoided" and "death avoided," respectively. Regarding cost per death avoided, APPWA was more likely to be cost-effective than ED in a wide range of willingness to pay. Cardiac output monitoring during high-risk abdominal surgery is cost-effective and is associated with a reduced rate of hospital mortality and major complications, whatever the device used. The two devices evaluated had negligible costs compared with the observed reduction in hospital costs. Our comparative studies suggest a larger effect with APPWA that needs to be confirmed by further studies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Athena: Advanced air launched space booster

NASA Astrophysics Data System (ADS)

Booker, Corey G.; Ziemer, John; Plonka, John; Henderson, Scott; Copioli, Paul; Reese, Charles; Ullman, Christopher; Frank, Jeremy; Breslauer, Alan; Patonis, Hristos

1994-06-01

The infrastructure for routine, reliable, and inexpensive access of space is a goal that has been actively pursued over the past 50 years, but has yet not been realized. Current launch systems utilize ground launching facilities which require the booster vehicle to plow up through the dense lower atmosphere before reaching space. An air launched system on the other hand has the advantage of being launched from a carrier aircraft above this dense portion of the atmosphere and hence can be smaller and lighter compared to its ground based counterpart. The goal of last year's Aerospace Engineering Course 483 (AE 483) was to design a 227,272 kg (500,000 lb.) air launched space booster which would beat the customer's launch cost on existing launch vehicles by at least 50 percent. While the cost analysis conducted by the class showed that this goal could be met, the cost and size of the carrier aircraft make it appear dubious that any private company would be willing to invest in such a project. To avoid this potential pitfall, this year's AE 483 class was to design as large an air launched space booster as possible which can be launched from an existing or modification to an existing aircraft. An initial estimate of the weight of the booster is 136,363 kg (300,000 lb.) to 159,091 kg (350,000 lb.).

Athena: Advanced air launched space booster

NASA Technical Reports Server (NTRS)

Booker, Corey G.; Ziemer, John; Plonka, John; Henderson, Scott; Copioli, Paul; Reese, Charles; Ullman, Christopher; Frank, Jeremy; Breslauer, Alan; Patonis, Hristos

1994-01-01

The infrastructure for routine, reliable, and inexpensive access of space is a goal that has been actively pursued over the past 50 years, but has yet not been realized. Current launch systems utilize ground launching facilities which require the booster vehicle to plow up through the dense lower atmosphere before reaching space. An air launched system on the other hand has the advantage of being launched from a carrier aircraft above this dense portion of the atmosphere and hence can be smaller and lighter compared to its ground based counterpart. The goal of last year's Aerospace Engineering Course 483 (AE 483) was to design a 227,272 kg (500,000 lb.) air launched space booster which would beat the customer's launch cost on existing launch vehicles by at least 50 percent. While the cost analysis conducted by the class showed that this goal could be met, the cost and size of the carrier aircraft make it appear dubious that any private company would be willing to invest in such a project. To avoid this potential pitfall, this year's AE 483 class was to design as large an air launched space booster as possible which can be launched from an existing or modification to an existing aircraft. An initial estimate of the weight of the booster is 136,363 kg (300,000 lb.) to 159,091 kg (350,000 lb.).

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

PubMed

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-06-23

This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Avoidable cost of alcohol abuse in Canada.

PubMed

Rehm, Jürgen; Patra, Jayadeep; Gnam, William H; Sarnocinska-Hart, Anna; Popova, Svetlana

2011-01-01

To estimate avoidable burden and avoidable costs of alcohol abuse in Canada for the year 2002. A policy effectiveness approach was used. The impact of six effective and cost-effective alcohol policy interventions aimed to reduce alcohol consumption was modeled. In addition, the effect of privatized alcohol sales that would increase alcohol consumption and alcohol-attributable costs was also modeled. The effects of these interventions were compared with the baseline (aggregate) costs obtained from the second Canadian Study of Social Costs Attributable to Substance Abuse. It was estimated that by implementing six cost-effective policies from about 900 million to two billion Canadian dollars per year could be saved in Canada. The greatest savings due to the implementation of these interventions would be achieved in the lowering of productivity losses, followed by health care, and criminality. Substantial increases in burden and cost would occur if Canadian provinces were to privatize alcohol sales. The implementation of proven effective population-based interventions would reduce alcohol-attributable burden and its costs in Canada to a considerable degree. Copyright © 2010 S. Karger AG, Basel.

Air pollution, avoidance behaviour and children's respiratory health: evidence from England.

PubMed

Janke, Katharina

2014-12-01

Despite progress in air pollution control, concerns remain over the health impact of poor air quality. Governments increasingly issue air quality information to enable vulnerable groups to avoid exposure. Avoidance behaviour potentially biases estimates of the health effects of air pollutants. But avoidance behaviour imposes a cost on individuals and therefore may not be taken in all circumstances. This paper exploits panel data at the English local authority level to estimate the relationship between children's daily hospital emergency admissions for respiratory diseases and common air pollutants, while allowing for avoidance behaviour in response to air pollution warnings. A 1% increase in nitrogen dioxide or ozone concentrations increases hospital admissions by 0.1%. For the subset of asthma admissions - where avoidance is less costly - there is evidence of avoidance behaviour. Ignoring avoidance behaviour, however, does not result in statistically significant underestimation of the health effect of air pollution. Copyright © 2014 Elsevier B.V. All rights reserved.

Applying economic evaluation to public health interventions: the case of interventions to promote physical activity.

PubMed

Trueman, Paul; Anokye, Nana Kwame

2013-03-01

This paper explores the application of alternative approaches to economic evaluation of public health interventions, using a worked example of exercise referral schemes (ERSs). Cost-utility (CUA) and cost-consequence analyses (CCA) were used to assess the cost-effectiveness of ERSs. For the CUA, evidence was synthesized using a decision analytic model that adopts a lifetime horizon and NHS/Personal Social Services perspective. Outcomes were expressed as incremental cost per quality-adjusted life-year (QALY). CCA was conducted from a partial-societal perspective, including health and non-healthcare costs and benefits. Outcomes were reported in natural units, such as cases of strokes or CHD avoided. Compared with usual care, the incremental cost per QALY of ERS is £20 876. Based on a cohort of 100 000 individuals, CCA estimates cost of ERS at £22 million to the healthcare provider and £12 million to participants. The benefits of ERS include additional 3900 people becoming physically active, 51 cases of CHD avoided, 16 cases of stroke avoided, 86 cases of diabetes avoided and a gain of ∼800 QALYs. CCA might provide greater transparency than CUA in reporting the outcomes of public health interventions and have greater resonance with stakeholders involved in commissioning these interventions.

Development of a Low-Cost UAV Doppler Radar Data System

NASA Technical Reports Server (NTRS)

Knuble, Joseph; Li, Lihua; Heymsfield, Gerry

2005-01-01

A viewgraph presentation on the design of a low cost unmanned aerial vehicle (UAV) doppler radar data system is presented. The topics include: 1) Science and Mission Background; 2) Radar Requirements and Specs; 3) Radar Realization: RF System; 4) Processing of RF Signal; 5) Data System Design Process; 6) Can We Remove the DSP? 7) Determining Approximate Speed Requirements; 8) Radar Realization: Data System; 9) Data System Operation; and 10) Results.

The relationships of physician practice characteristics to quality of care and costs.

PubMed

Kralewski, John; Dowd, Bryan; Knutson, David; Tong, Junliang; Savage, Megan

2015-06-01

Medical group practices are central to many of the proposals for health care reform, but little is known about the relationship between practice-level characteristics and the quality and cost of care. Practice characteristics from a 2009 national survey of 211 group practices were linked to Medicare claims data for beneficiaries attributed to the practices. Multivariate regression was used to examine the relationship between practice characteristics and claims-computable measures of screening and monitoring, avoidable utilization, risk-adjusted per-beneficiary per-year (PBPY) costs, and the practice's net revenue. Several characteristics of group practices are predictive of screening and monitoring measures. Those measures, in turn, are predictive of lower values of avoidable utilization measures that contribute to higher PBPY costs. The effects of group practice characteristics on avoidable utilization, cost, and practice net revenue appear to work primarily through improved screening and monitoring. Practice characteristics influence costs indirectly through a set of statistically significant relationships among screening and monitoring measures and avoidable utilization. However, these relationships are not the only pathways connecting practice characteristics to cost and those additional pathways contain substantial "noise" adding uncertainty to the estimated direct effects. Some of the attributes thought to be important characteristics of accountable care organizations and medical homes appear to be associated with lower quality and no improvement in cost. © Health Research and Educational Trust.

National economic impact of tirofiban for unstable angina and myocardial infarction without ST elevation; example from the United Kingdom.

PubMed

Bakhai, Ameet; Flather, Marcus D; Collinson, Julian R; Stevens, Warren; Normand, Charles; Alemao, Evo; Itzler, Robbin; Ben-Joseph, Rami

2003-10-01

Acute coronary syndromes without ST elevation are a major health and economic burden. Treatments such as glycoprotein IIb/IIIa antagonists like tirofiban reduce the risk of complications but the cost impact of these agents including cost offsets of avoiding complications are needed particularly in Europe. We used treatment patterns from the Prospective Registry of Acute Ischemic Syndromes in the UK, risk reductions derived from the PRISM-PLUS trial and cost estimates from the CHKS database to estimate the impact of tirofiban on PRAIS-UK patients with and without complications and subgroups at higher risk of complications. These subgroups (and proportions) were patients: (1) aged 60 or over with abnormal electrocardiograms (58%), (2) with ST depression or bundle branch block on admission (30%) and (3) with ST depression, bundle branch block or MI on admission (37%). Total cost of care in the UK at 6 months for the estimated 87339 acute coronary syndromes admissions annually was pound 213 million, which would increase by pound 33 million (15.7%) if tirofiban were given to all patients, avoiding 2422 complications at a mean cost per event avoided of pound 13388. Among the subgroups, the mean cost per event avoided ranges from pound 10856 for subgroup 1 to pound 5953 for subgroup 3. Treating the latter subgroup, would avoid 1977 events at a cost of pound 12 million (5.5%). The use of tirofiban in the UK to treat acute coronary syndromes patients without ST elevation provides an important therapeutic advantage at modest proportional increase in cost, particularly if targeted to higher risk subgroups as recommended in the European guidelines.

Cost avoidance associated with optimal stroke care in Canada.

PubMed

Krueger, Hans; Lindsay, Patrice; Cote, Robert; Kapral, Moira K; Kaczorowski, Janusz; Hill, Michael D

2012-08-01

Evidence-based stroke care has been shown to improve patient outcomes and may reduce health system costs. Cost savings, however, are poorly quantified. This study assesses 4 aspects of stroke management (rapid assessment and treatment services, thrombolytic therapy, organized stroke units, and early home-supported discharge) and estimates the potential for cost avoidance in Canada if these services were provided in a comprehensive fashion. Several independent data sources, including the Canadian Institute of Health Information Discharge Abstract Database, the 2008-2009 National Stroke Audit, and the Acute Cerebrovascular Syndrome Registry in the province of British Columbia, were used to assess the current status of stroke care in Canada. Evidence from the literature was used to estimate the effect of providing optimal stroke care on rates of acute care hospitalization, length of stay in hospital, discharge disposition (including death), changes in quality of life, and costs avoided. Comprehensive and optimal stroke care in Canada would decrease the number of annual hospital episodes by 1062 (3.3%), the number of acute care days by 166 000 (25.9%), and the number of residential care days by 573 000 (12.8%). The number of deaths in the hospital would be reduced by 1061 (14.9%). Total avoidance of costs was estimated at $682 million annually ($307.4 million in direct costs, $374.3 million in indirect costs). The costs of stroke care in Canada can be substantially reduced, at the same time as improving patient outcomes, with the greater use of known effective treatment modalities.

Motion interference analysis and optimal control of an electronic controlled bamboo-dance mechanism

NASA Astrophysics Data System (ADS)

Liu, Xiaohong; Xu, Liang; Hu, Xiaobin

2017-08-01

An electric bamboo-dance mechanism was designed and developed to realize mechanism of automation and mechanization. For coherent and fluent motion, ANSYS finite element analysis was applied on movement interference. Static structural method was used for analyzing dynamic deflection and deformation of the slender rod, while modal analysis was applied on frequency analysis to avoid second deformation caused by resonance. Therefore, the deformation in vertical and horizontal direction was explored and reasonable optimization was taken to avoid interference.

Do hospital mergers reduce costs?

PubMed

Schmitt, Matt

2017-03-01

Proponents of hospital consolidation claim that mergers lead to significant cost savings, but there is little systematic evidence backing these claims. For a large sample of hospital mergers between 2000 and 2010, I estimate difference-in-differences models that compare cost trends at acquired hospitals to cost trends at hospitals whose ownership did not change. I find evidence of economically and statistically significant cost reductions at acquired hospitals. On average, acquired hospitals realize cost savings between 4 and 7 percent in the years following the acquisition. These results are robust to a variety of different control strategies, and do not appear to be easily explained by post-merger changes in service and/or patient mix. I then explore several extensions of the results to examine (a) whether the acquiring hospital/system realizes cost savings post-merger and (b) if cost savings depend on the size of the acquirer and/or the geographic overlap of the merging hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

From Science to Finance-A Tool for Deriving Economic Implications from the Results of Dietary Supplement Clinical Studies.

PubMed

Shanahan, Christopher J; de Lorimier, Robert

2016-01-01

This article examines evidence showing that the use of key dietary supplements can reduce overall disease treatment-related hospital utilization costs associated with coronary heart disease (CHD) in the United States among those at a high risk of experiencing a costly, disease-related event. Results show that the potential avoided hospital utilization costs related to the use of omega-3 supplements at preventive intake levels among the target population can be as much as $2.06 billion on average per year from 2013 to 2020. The potential net savings in avoided CHD-related hospital utilization costs after accounting for the cost of omega-3 dietary supplements at preventive daily intake levels would be more than $3.88 billion in cumulative health care cost savings from 2013 to 2020. Furthermore, the use of folic acid, B6, and B12 among the target population at preventive intake levels could yield avoided CHD-related hospital utilization costs savings of an average savings of $1.52 billion per year from 2013 to 2020. The potential net savings in avoided CHD-related health care costs after accounting for the cost of folic acid, B6, and B12 utilization at preventive daily intake levels would be more than $5.23 billion in cumulative health care cost net savings during the same period. Thus, targeted dietary supplement regimens are recommended as a means to help control rising societal health care costs, and as a means for high-risk individuals to minimize the chance of having to deal with potentially costly events and to invest in increased quality of life.

Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings.

PubMed

McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona; Giles, Margaret

2016-11-01

Since 2005, the Western Australian paediatric burn unit has provided a state-wide clinical consultancy and support service for the assessment and management of acute and rehabilitative burn patients via its telehealth service. Since then, the use of this telehealth service has steadily increased as it has become imbedded in the model of care for paediatric burn patients. Primarily, the service involves acute and long term patient reviews conducted by the metropolitan-located burn unit in contact with health practitioners, advising patients and their families who reside outside the metropolitan area thereby avoiding unnecessary transfers and inpatient bed days. A further benefit of the paediatric burn service using telehealth is more efficient use of tertiary level burn unit beds, with only those patients meeting clinical criteria for admission being transferred. To conduct a retrospective audit of avoided transfers and bed days in 2005/06-2012/13 as a result of the use of the paediatric Burns Telehealth Service and estimate their cost savings in 2012/13. A retrospective chart audit identified activity, avoided unnecessary acute and scar review patient transfers, inpatient bed days and their associated avoided costs to the tertiary burn unit and patient travel funding. Over the period 2005/06-2012/13 the audit identified 4,905 avoided inpatient bed days, 364 avoided acute patient transfers and 1,763 avoided follow up review transfers for a total of 1,312 paediatric burn patients as a result of this telehealth service. This paper presents the derivation of these outcomes and an estimation of their cost savings in 2012/13 of AUD 1.89million. This study demonstrates avoided patient transfers, inpatient bed days and associated costs as the result of an integrated burns telehealth service. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Finding a needle in the haystack: the costs and cost-effectiveness of syphilis diagnosis and treatment during pregnancy to prevent congenital syphilis in Kalomo District of Zambia.

PubMed

Larson, Bruce A; Lembela-Bwalya, Deophine; Bonawitz, Rachael; Hammond, Emily E; Thea, Donald M; Herlihy, Julie

2014-01-01

In March 2012, The Elizabeth Glaser Pediatric AIDS Foundation trained maternal and child health workers in Southern Province of Zambia to use a new rapid syphilis test (RST) during routine antenatal care. A recent study by Bonawitz et al. (2014) evaluated the impact of this roll out in Kalomo District. This paper estimates the costs and cost-effectiveness from the provider's perspective under the actual conditions observed during the first year of the RST roll out. Information on materials used and costs were extracted from program records. A decision-analytic model was used to evaluate the costs (2012 USD) and cost-effectiveness. Basic parameters needed for the model were based on the results from the evaluation study. During the evaluation study, 62% of patients received a RST, and 2.8% of patients tested were positive (and 10.4% of these were treated). Even with very high RST sensitivity and specificity (98%), true prevalence of active syphilis would be substantially less (estimated at <0.7%). For 1,000 new ANC patients, costs of screening and treatment were estimated at $2,136, and the cost per avoided disability-adjusted-life year lost (DALY) was estimated at $628. Costs change little if all positives are treated (because prevalence is low and treatment costs are small), but the cost-per-DALY avoided falls to just $66. With full adherence to guidelines, costs increase to $3,174 per 1,000 patients and the cost-per-DALY avoided falls to $60. Screening for syphilis is only useful for reducing adverse birth outcomes if patients testing positive are actually treated. Even with very low prevalence of syphilis (a needle in the haystack), cost effectiveness improves dramatically if those found positive are treated; additional treatment costs little but DALYs avoided are substantial. Without treatment, the needle is essentially found and thrown back into the haystack.

Designing PURPA (Public Utilities Regulatory Act) power purchase auctions: Theory and practice. [Cogenerated electricity purchasing model

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

Rothkopf, M.H.; Kahn, E.P.; Teisberg, T.J.

The Public Utilities Regulatory Act (PURPA) requires there to be procedures for electric utilities to buy electric power from qualifying cogenerators and small power producers (QFs) at rates up to ''avoided cost.'' This has led to price-posting procedures at prices calculated as the utility's marginal cost. Unexpectedly large sales at these prices and slow adjustment to falling energy cost are partially responsible for payments to QFs in excess of the utility's true avoided cost. Using competitive bidding instead of posted prices has been proposed as a way to avoid this outcome. This report reviews bidding theory and explores four issuesmore » that arise in deisigning auction systems for the purchase of power from QFs under PURPA. 77 refs., 6 figs., 15 tabs.« less

Designing PURPA (Public Utilities Regulatory Policies Act) power purchase auctions: Theory and practice. [Buys from cogenerators and small power generators

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

Not Available

The Public Utilities Regulatory Act (PURPA) requires there to be procedures for electric utilities to buy electric power from qualifying cogenerators and small power producers (QFs) at rates up to ''avoided cost''. This has led to price-posting procedures at prices calculated as the utility's marginal cost. Unexpectedly large sales at these prices and slow adjustment to falling energy cost are partially responsible for payments to QFs in excess of the utility's true avoided cost. Using competitive bidding instead of posted prices has been proposed as a way to avoid this outcome. This report reviews bidding theory and explores four issuesmore » that arise in designing auction systems for the purchase of power from QFs under PURPA.« less

Attentional Flexibility During Approach and Avoidance Motivational States: The Role of Context in Shifts of Attentional Breadth

PubMed Central

Calcott, Rebecca D.; Berkman, Elliot T.

2014-01-01

In the present studies, we aimed to understand how approach and avoidance states affect attentional flexibility by examining attentional shifts on a trial-by-trial basis. We also examined how a novel construct in this area, task context, might interact with motivation to influence attentional flexibility. Participants completed a modified composite letter task in which the ratio of global to local targets was varied by block, making different levels of attentional focus beneficial to performance on different blocks. Study 1 demonstrated that, in the absence of a motivation manipulation, switch costs were lowest on blocks with an even ratio of global and local trials and were higher on blocks with an uneven ratio. Other participants completed the task while viewing pictures (Studies 2 and 3) and assuming arm positions (Studies 2 and 4) to induce approach, avoidance, and neutral motivational states. Avoidance motivation reduced switch costs in evenly proportioned contexts, whereas approach motivation reduced switch costs in mostly global contexts. Additionally, approach motivation imparted a similar switch cost magnitude across different contexts, whereas avoidance and neutral states led to variable switch costs depending on the context. Subsequent analyses revealed that these effects were driven largely by faster switching to local targets on mostly global blocks in the approach condition. These findings suggest that avoidance facilitates attentional shifts when switches are frequent, whereas approach facilitates responding to rare or unexpected local stimuli. The main implication of these results is that motivation has different effects on attentional shifts depending on the context. PMID:24294866

Searching for a business case for quality in Medicaid managed care.

PubMed

Greene, Sandra B; Reiter, Kristin L; Kilpatrick, Kerry E; Leatherman, Sheila; Somers, Stephen A; Hamblin, Allison

2008-01-01

Despite the prevalence of evidence-based interventions to improve quality in health care systems, there is a paucity of documented evidence of a financial return on investment (ROI) for these interventions from the perspective of the investing entity. To report on a demonstration project designed to measure the business case for selected quality interventions in high-risk high-cost patient populations in 10 Medicaid managed care organizations across the United States. Using claims and enrollment data gathered over a 3-year period and data on the costs of designing, implementing, and operating the interventions, ROIs were computed for 11 discrete evidence-based quality-enhancing interventions. A complex case management program to treat adults with multiple comorbidities achieved the largest ROI of 12.21:1. This was followed by an ROI of 6.35:1 for a program which treated children with asthma with a history of high emergency room (ER) use and/or inpatient admissions for their disease. An intervention for high-risk pregnant mothers produced a 1.26:1 ROI, and a program for adult patients with diabetes resulted in a 1.16:1 return. The remaining seven interventions failed to show positive returns, although four sites came close to realizing sufficient savings to offset investment costs. Evidence-based interventions designed to improve the quality of patient care may have the best opportunity to yield a positive financial return if it is focused on high-risk high-cost populations and conditions associated with avoidable emergency and inpatient utilization. Developing the necessary tracking systems for the claims and financial investments is critical to perform accurate financial ROI analyses.

In situ realization of particlelike scattering states in a microwave cavity

NASA Astrophysics Data System (ADS)

Böhm, Julian; Brandstötter, Andre; Ambichl, Philipp; Rotter, Stefan; Kuhl, Ulrich

2018-02-01

We realize scattering states in a lossy and chaotic two-dimensional microwave cavity which follow bundles of classical particle trajectories. To generate such particlelike scattering states, we measure the system's complex transmission matrix and apply an adapted Wigner-Smith time-delay formalism to it. The necessary shaping of the incident wave is achieved in situ using phase- and amplitude-regulated microwave antennas. Our experimental findings pave the way for establishing spatially confined communication channels that avoid possible intruders or obstacles in wave-based communication systems.

Health economic evaluation of vaccination strategies for the prevention of herpes zoster and postherpetic neuralgia in Germany.

PubMed

Ultsch, Bernhard; Weidemann, Felix; Reinhold, Thomas; Siedler, Anette; Krause, Gérard; Wichmann, Ole

2013-09-26

Herpes zoster (HZ) is a self-limiting painful skin rash affecting mostly individuals from 50 years of age. The main complication is postherpetic neuralgia (PHN), a long-lasting pain after rash has resolved. A HZ-vaccine has recently been licensed in Europe for individuals older than 50 years. To support an informed decision-making for a potential vaccination recommendation, we conducted a health economic evaluation to identify the most cost-effective vaccination strategy. We developed a static Markov-cohort model, which compared a vaccine-scenario with no vaccination. The cohort entering the model was 50 years of age, vaccinated at age 60, and stayed over life-time in the model. Transition probabilities were based on HZ/PHN-epidemiology and demographic data from Germany, as well as vaccine efficacy (VE) data from clinical trials. Costs for vaccination and HZ/PHN-treatment (in Euros; 2010), as well as outcomes were discounted equally with 3% p.a. We accounted results from both, payer and societal perspective. We calculated benefit-cost-ratio (BCR), number-needed-to-vaccinate (NNV), and incremental cost-effectiveness ratios (ICERs) for costs per HZ-case avoided, per PHN-case avoided, and per quality-adjusted life-year (QALY) gained. Different target age-groups were compared to identify the most cost-effective vaccination strategy. Base-case-analysis as well as structural, descriptive-, and probabilistic-sensitivity-analyses (DSA, PSA) were performed. When vaccinating 20% of a cohort of 1 million 50 year old individuals at the age of 60 years, approximately 20,000 HZ-cases will be avoided over life-time. The NNV to avoid one HZ (PHN)-case was 10 (144). However, with a BCR of 0.34 this vaccination-strategy did not save costs. The base-case-analysis yielded an ICER of 1,419 (20,809) Euros per avoided HZ (PHN)-case and 28,146 Euros per QALY gained. Vaccination at the age of 60 was identified in most (sensitivity) analyses to be the most cost-effective vaccination strategy. In DSA, vaccine price and VE were shown to be the most critical input-data. According to our evaluation, HZ-vaccination is expected to avoid HZ/PHN-cases and gain QALYs to higher costs. However, the vaccine price had the highest impact on the ICERs. Among different scenarios, targeting individuals aged 60 years seems to represent the most cost-effective vaccination-strategy.

Differential Cost Avoidance and Successful Criminal Careers: Random or Rational?

ERIC Educational Resources Information Center

Kazemian, Lila; Le Blanc, Marc

2007-01-01

Using a sample of adjudicated French Canadian males from the Montreal Two Samples Longitudinal Study, this article investigates individual and social characteristics associated with differential cost avoidance. The main objective of this study is to determine whether such traits are randomly distributed across differential degrees of cost…

Estimating the avoided fuel-reatment costs of wildfire

Treesearch

Geoffrey H. Donovan; Thomas C. Brown

2008-01-01

Although the importance of wildfire to fire-adapted ecosystems is widely recognized, wildfire management has historically placed less emphasis on the beneficial effects of wildfire. We estimate the avoided fuel treatment cost for 10 ponderosa pine (Pinus ponderosa) stands on the Umatilla National Forest in the Pacific Northwest. Results show that...

Smooth Upgrade of Existing Passive Optical Networks With Spectral-Shaping Line-Coding Service Overlay

NASA Astrophysics Data System (ADS)

Hsueh, Yu-Li; Rogge, Matthew S.; Shaw, Wei-Tao; Kim, Jaedon; Yamamoto, Shu; Kazovsky, Leonid G.

2005-09-01

A simple and cost-effective upgrade of existing passive optical networks (PONs) is proposed, which realizes service overlay by novel spectral-shaping line codes. A hierarchical coding procedure allows processing simplicity and achieves desired long-term spectral properties. Different code rates are supported, and the spectral shape can be properly tailored to adapt to different systems. The computation can be simplified by quantization of trigonometric functions. DC balance is achieved by passing the dc residual between processing windows. The proposed line codes tend to introduce bit transitions to avoid long consecutive identical bits and facilitate receiver clock recovery. Experiments demonstrate and compare several different optimized line codes. For a specific tolerable interference level, the optimal line code can easily be determined, which maximizes the data throughput. The service overlay using the line-coding technique leaves existing services and field-deployed fibers untouched but fully functional, providing a very flexible and economic way to upgrade existing PONs.

Low-Cost Avoidance Behaviors are Resistant to Fear Extinction in Humans

PubMed Central

Vervliet, Bram; Indekeu, Ellen

2015-01-01

Elevated levels of fear and avoidance are core symptoms across the anxiety disorders. It has long been known that fear serves to motivate avoidance. Consequently, fear extinction has been the primary focus in pre-clinical anxiety research for decades, under the implicit assumption that removing the motivator of avoidance (fear) would automatically mitigate the avoidance behaviors as well. Although this assumption has intuitive appeal, it has received little scientific scrutiny. The scarce evidence from animal studies is mixed, while the assumption remains untested in humans. The current study applied an avoidance conditioning protocol in humans to investigate the effects of fear extinction on the persistence of low-cost avoidance. Online danger-safety ratings and skin conductance responses documented the dynamics of conditioned fear across avoidance and extinction phases. Anxiety- and avoidance-related questionnaires explored individual differences in rates of avoidance. Participants first learned to click a button during a predictive danger signal, in order to cancel an upcoming aversive electrical shock (avoidance conditioning). Next, fear extinction was induced by presenting the signal in the absence of shocks while button-clicks were prevented (by removing the button in Experiment 1, or by instructing not to click the button in Experiment 2). Most importantly, post-extinction availability of the button caused a significant return of avoidant button-clicks. In addition, trait-anxiety levels correlated positively with rates of avoidance during a predictive safety signal, and with the rate of pre- to post-extinction decrease during this signal. Fear measures gradually decreased during avoidance conditioning, as participants learned that button-clicks effectively canceled the shock. Preventing button-clicks elicited a sharp increase in fear, which subsequently extinguished. Fear remained low during avoidance testing, but danger-safety ratings increased again when button-clicks were subsequently prevented. Together, these results show that low-cost avoidance behaviors can persist following fear extinction and induce increased threat appraisal. On the other hand, fear extinction did reduce augmented rates of unnecessary avoidance during safety in trait-anxious individuals, and instruction-based response prevention was more effective than removal of response cues. More research is needed to characterize the conditions under which fear extinction might mitigate avoidance. PMID:26733837

Assessing the economic value of avoiding hospital admissions by shifting the management of gram+ acute bacterial skin and skin-structure infections to an outpatient care setting.

PubMed

Ektare, V; Khachatryan, A; Xue, M; Dunne, M; Johnson, K; Stephens, J

2015-01-01

To estimate, from a US payer perspective, the cost offsets of treating gram positive acute bacterial skin and skin-structure infections (ABSSSI) with varied hospital length of stay (LOS) followed by outpatient care, as well as the cost implications of avoiding hospital admission. Economic drivers of care were estimated using a literature-based economic model incorporating inpatient and outpatient components. The model incorporated equal efficacy, adverse events (AE), resource use, and costs from literature. Costs of once- and twice-daily outpatient infusions to achieve a 14-day treatment were analyzed. Sensitivity analyses were performed. Costs were adjusted to 2015 US$. Total non-drug medical cost for treatment of ABSSSI entirely in the outpatient setting to avoid hospital admission was the lowest among all scenarios and ranged from $4039-$4924. Total non-drug cost for ABSSSI treated in the inpatient setting ranged from $9813 (3 days LOS) to $18,014 (7 days LOS). Inpatient vs outpatient cost breakdown was: 3 days inpatient ($6657)/11 days outpatient ($3156-$3877); 7 days inpatient ($15,017)/7 days outpatient ($2495-$2997). Sensitivity analyses revealed a key outpatient cost driver to be peripherally inserted central catheter (PICC) costs (average per patient cost of $873 for placement and $205 for complications). Drug and indirect costs were excluded and resource use was not differentiated by ABSSSI type. It was assumed that successful ABSSSI treatment takes up to 14 days per the product labels, and that once-daily and twice-daily antibiotics have equal efficacy. Shifting ABSSSI care to outpatient settings may result in medical cost savings greater than 53%. Typical outpatient scenarios represent 14-37% of total medical cost, with PICC accounting for 28-43% of the outpatient burden. The value of new ABSSSI therapies will be driven by eliminating the need for PICC line, reducing length of stay and the ability to completely avoid a hospital stay.

Tunable thin film filters for intelligent WDM networks

NASA Astrophysics Data System (ADS)

Cahill, Michael; Bartolini, Glenn; Lourie, Mark; Domash, Lawrence

2006-08-01

Optical transmission systems have evolved rapidly in recent years with the emergence of new technologies for gain management, wavelength multiplexing, tunability, and switching. WDM networks are increasingly expected to be agile, flexible, and reconfigurable which in turn has led to a need for monitoring to be more widely distributed within the network. Automation of many actions performed on these networks, such as channel provisioning and power balancing, can only be realized by the addition of optical channel monitors (OCMs). These devices provide information about the optical transmission system including the number of optical channels, channel identification, wavelength, power, and in some cases optical signal-to-noise ratio (OSNR). Until recently OCMs were costly and bulky and thus the number of OCMs used in optical networks was often kept to a minimum. We describe a family of tunable thin film filters which have greatly reduced the cost and physical footprint of channel monitors, making possible 'monitoring everywhere' for intelligent optical networks which can serve long haul, metro and access requirements from a single technology platform. As examples of specific applications we discuss network issues such as auto provisioning, wavelength collision avoidance, power balancing, OSNR balancing, gain equalization, alien wavelength recognition, interoperability, and other requirements assigned to the emerging concept of an Optical Control Plane.

Laser Direct Writing Process for Making Electrodes and High-k Sol-Gel ZrO2 for Boosting Performances of MoS2 Transistors.

PubMed

Kwon, Hyuk-Jun; Jang, Jaewon; Grigoropoulos, Costas P

2016-04-13

A series of two-dimensional (2D) transition metal dichalcogenides (TMDCs), including molybdenum disulfide (MoS2), can be attractive materials for photonic and electronic applications due to their exceptional properties. Among these unique properties, high mobility of 2D TMDCs enables realization of high-performance nanoelectronics based on a thin film transistor (TFT) platform. In this contribution, we report highly enhanced field effect mobility (μ(eff) = 50.1 cm(2)/(V s), ∼2.5 times) of MoS2 TFTs through the sol-gel processed high-k ZrO2 (∼22.0) insulator, compared to those of typical MoS2/SiO2/Si structures (μ(eff) = 19.4 cm(2)/(V s)) because a high-k dielectric layer can suppress Coulomb electron scattering and reduce interface trap concentration. Additionally, in order to avoid costly conventional mask based photolithography and define the patterns, we employ a simple laser direct writing (LDW) process. This process allows precise and flexible control with reasonable resolution (up to ∼10 nm), depending on the system, and enables fabrication of arbitrarily patterned devices. Taking advantage of continuing developments in laser technology offers a substantial cost decrease, and LDW may emerge as a promising technology.

Component Cost Analysis of Large Scale Systems

NASA Technical Reports Server (NTRS)

Skelton, R. E.; Yousuff, A.

1982-01-01

The ideas of cost decomposition is summarized to aid in the determination of the relative cost (or 'price') of each component of a linear dynamic system using quadratic performance criteria. In addition to the insights into system behavior that are afforded by such a component cost analysis CCA, these CCA ideas naturally lead to a theory for cost-equivalent realizations.

The four faces of mass customization.

PubMed

Gilmore, J H; Pine, B J

1997-01-01

Virtually all executives today recognize the need to provide outstanding service to customers. Focusing on the customer, however, is both an imperative and a potential curse. In their desire to become customer driven, many companies have resorted to inventing new programs and procedures to meet every customer's request. But as customers and their needs grow increasingly diverse, such an approach has become a surefire way to add unnecessary cost and complexity to operations. Companies around the world have embraced mass customization in an attempt to avoid those pitfalls. Readily available information technology and flexible work processes permit them to customize goods or services for individual customers in high volumes at low cost. But many managers have discovered that mass customization itself can produce unnecessary cost and complexity. They are realizing that they did not examine thoroughly enough what kind of customization their customers would value before they plunged ahead. That is understandable. Until now, no framework has existed to help managers determine the type of customization they should pursue. James Gilmore and Joseph Pine provide managers with just such a framework. They have identified four distinct approaches to customization. When designing or redesigning a product, process, or business unit, managers should examine each approach for possible insights into how to serve their customers best. In some cases, a single approach will dominate the design. More often, however, managers will need a mix of some or all of the four approaches to serve their own particular set of customers.

32 CFR Appendix to Part 162 - Reporting Procedures

Code of Federal Regulations, 2014 CFR

2014-07-01

... generated. e. Projected Life-Cycle Savings. For each PIF project provide the estimated amount of savings the project is projected to earn over the project's economic life. f. Projected Life-Cycle Cost Avoidance. For... Projected Life-Cycle Savings. e. Total Projected Life-Cycle Cost Avoidance. 3. CSI. Each DoD Component that...

Building a Better Learning Environment.

ERIC Educational Resources Information Center

Dentch, Matthew

2000-01-01

Explains how an environmentally friendly (Green Building) educational facility can be cost effective and enhance student performance. The concepts behind a Green Building, the areas where cost savings are possible, and some examples of realized cost savings are highlighted. Green Building funding issues are discussed. (GR)

Five-year cost-effectiveness of the Patient Empowerment Programme (PEP) for type 2 diabetes mellitus in primary care.

PubMed

Lian, Jinxiao; McGhee, Sarah M; So, Ching; Chau, June; Wong, Carlos K H; Wong, William C W; Lam, Cindy L K

2017-09-01

This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus (DM) in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. Outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a 5-year follow-up period and the number needed to treat (NNT) to avoid 1 event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT. The PEP cost per subject from the societal perspective was US$247. There was a significantly lower cumulative incidence of all-cause mortality (2.9% vs 4.6%, P < .001), any DM complication (9.5% vs 10.8%, P = .001) and CVD events (6.8% vs 7.6%, P = .018), in the PEP group. The costs per death from any cause, DM complication or case of CVD avoided were US$14 465, US$19 617 and US$30 796, respectively. The extra amount allocated to managing PEP was small and it appears cost-effective in the short-term as an addition to RAMP. © 2017 John Wiley & Sons Ltd.

Barriers to movement: Modelling energetic costs of avoiding marine wind farms amongst breeding seabirds.

PubMed

Masden, Elizabeth A; Haydon, Daniel T; Fox, Anthony D; Furness, Robert W

2010-07-01

Proposals for wind farms in areas of known importance for breeding seabirds highlight the need to understand the impacts of these structures. Using an energetic modelling approach, we examine the effects of wind farms as barriers to movement on seabirds of differing morphology. Additional costs, expressed in relation to typical daily energetic expenditures, were highest per unit flight for seabirds with high wing loadings, such as cormorants. Taking species-specific differences into account, costs were relatively higher in terns, due to the high daily frequency of foraging flights. For all species, costs of extra flight to avoid a wind farm appear much less than those imposed by low food abundance or adverse weather, although such costs will be additive to these. We conclude that adopting a species-specific approach is essential when assessing the impacts of wind farms on breeding seabird populations, to fully anticipate the effects of avoidance flights. Copyright 2010 Elsevier Ltd. All rights reserved.

The costs (or benefits) associated with attended objects do little to influence inattentional blindness.

PubMed

Stothart, Cary R; Wright, Timothy J; Simons, Daniel J; Boot, Walter R

2017-02-01

We sometimes fail to notice unexpected objects or events when our attention is directed elsewhere, a phenomenon called inattentional blindness. We explored whether unexpected objects that shared the color of consequential objects would be noticed more often. In three pre-registered experiments, participants played a custom video game in which they avoided both low- and high-cost missiles (Experiment 1 and 2) or tried to hit rewarding missiles while avoiding costly ones (Experiment 3). After participants had played the game for about 8min, an unexpected object moved across the screen. Although participants selectively avoided more costly missiles when playing, they were no more likely to notice an unexpected object when its color was associated with greater costs. Apparently, people are no more likely to notice unexpected objects that are associated with negative consequences. Future research should examine whether objects that are themselves consequential are noticed more frequently. Copyright © 2016 Elsevier B.V. All rights reserved.

Evaluating investments in typhoid vaccines in two slums in Kolkata, India.

PubMed

Cook, Joseph; Sur, Dipika; Clemens, John; Whittington, Dale

2009-12-01

New-generation vaccines against typhoid fever have the potential to reduce the burden of disease in areas where the disease is endemic. The case for public expenditure on typhoid Vi polysaccharide vaccines for two low-income, high-incidence slums (Narkeldanga and Tiljala) in Kolkata, India, was examined. Three measures of the economic benefits of the vaccines were used: private and public cost-of-illness (COI) avoided; avoided COI plus mortality risk-reduction benefits; and willingness-to-pay (WTP) derived from stated preference (contingent valuation) studies conducted in Tiljala in 2004. Benefits and costs were examined from a social perspective. The study represents a unique opportunity to evaluate typhoid-vaccine programmes using a wealth of new site-specific epidemiological and economic data. Three typhoid-vaccination strategies (targeting only enrolled school children, targeting all children, and targeting adults and children) would most likely pass a social cost-benefit test, unless benefits are restricted to include only avoided COI. All three strategies would be considered 'very cost-effective' using the standard comparisons of cost per disability-adjusted life-year avoided with per-capita gross domestic product. However, at an average total cost per immunized person of approximately US$ 1.1, a typhoid-vaccination programme would absorb a sixth of existing public-sector spending on health (on a per-capita basis) in India. Because there appears to be significant private economic demand for typhoid vaccines, the Government could design a financially-sustainable programme with user-fees. The results show that a programme where adults pay a higher fee to subsidize vaccines for children (who have higher incidence) would avoid more cases than a uniform user-fee and still achieve revenue-neutrality.

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

Sathaye, Jayant; Andrasko, Ken; Chan, Peter

Greenhouse gas emissions from the forestry sector are estimated to be 8.4 GtCO2-eq./year or about 17percent of the global emissions. We estimate that the cost forreducing deforestation is low in Africa and several times higher in Latin America and Southeast Asia. These cost estimates are sensitive to the uncertainties of how muchunsustainable high-revenue logging occurs, little understood transaction and program implementation costs, and barriers to implementation including governance issues. Due to lack of capacity in the affected countries, achieving reduction or avoidance of carbon emissions will require extensive REDD-plus programs. Preliminary REDD-plus Readiness cost estimates and program descriptions for Indonesia,more » Democratic Republic of the Congo, Ghana, Guyana and Mexico show that roughly one-third of potential REDD-plus mitigation benefits might come from avoided deforestation and the rest from avoided forest degradation and other REDD-plus activities.« less

Active Collision Avoidance for Planetary Landers

NASA Technical Reports Server (NTRS)

Rickman, Doug; Hannan, Mike; Srinivasan, Karthik

2015-01-01

The use of automotive radar systems are being evaluated for collision avoidance in planetary landers. Our focus is to develop a low-cost, light-weight collision avoidance system that overcomes the drawbacks identified with optical-based systems. We also seek to complement the Autonomous Landing and Hazard Avoidance Technology system by providing mission planners an alternative system that can be used on low-cost, small robotic missions and in close approach. Our approach takes advantage of how electromagnetic radiation interacts with solids. As the wavelength increases, the sensitivity of the radiation to isolated solids of a specific particle size decreases. Thus, rocket exhaust-blown dust particles, which have major significance in visible wavelengths, have much less significance at radar wavelengths.

Health economic evaluation of vaccination strategies for the prevention of herpes zoster and postherpetic neuralgia in Germany

PubMed Central

2013-01-01

Background Herpes zoster (HZ) is a self-limiting painful skin rash affecting mostly individuals from 50 years of age. The main complication is postherpetic neuralgia (PHN), a long-lasting pain after rash has resolved. A HZ-vaccine has recently been licensed in Europe for individuals older than 50 years. To support an informed decision-making for a potential vaccination recommendation, we conducted a health economic evaluation to identify the most cost-effective vaccination strategy. Methods We developed a static Markov-cohort model, which compared a vaccine-scenario with no vaccination. The cohort entering the model was 50 years of age, vaccinated at age 60, and stayed over life-time in the model. Transition probabilities were based on HZ/PHN-epidemiology and demographic data from Germany, as well as vaccine efficacy (VE) data from clinical trials. Costs for vaccination and HZ/PHN-treatment (in Euros; 2010), as well as outcomes were discounted equally with 3% p.a. We accounted results from both, payer and societal perspective. We calculated benefit-cost-ratio (BCR), number-needed-to-vaccinate (NNV), and incremental cost-effectiveness ratios (ICERs) for costs per HZ-case avoided, per PHN-case avoided, and per quality-adjusted life-year (QALY) gained. Different target age-groups were compared to identify the most cost-effective vaccination strategy. Base-case-analysis as well as structural, descriptive-, and probabilistic-sensitivity-analyses (DSA, PSA) were performed. Results When vaccinating 20% of a cohort of 1 million 50 year old individuals at the age of 60 years, approximately 20,000 HZ-cases will be avoided over life-time. The NNV to avoid one HZ (PHN)-case was 10 (144). However, with a BCR of 0.34 this vaccination-strategy did not save costs. The base-case-analysis yielded an ICER of 1,419 (20,809) Euros per avoided HZ (PHN)-case and 28,146 Euros per QALY gained. Vaccination at the age of 60 was identified in most (sensitivity) analyses to be the most cost-effective vaccination strategy. In DSA, vaccine price and VE were shown to be the most critical input-data. Conclusions According to our evaluation, HZ-vaccination is expected to avoid HZ/PHN-cases and gain QALYs to higher costs. However, the vaccine price had the highest impact on the ICERs. Among different scenarios, targeting individuals aged 60 years seems to represent the most cost-effective vaccination-strategy. PMID:24070414

Broadening Your Employee Benefit Portfolio.

ERIC Educational Resources Information Center

Blaski, Nancy J.; And Others

1989-01-01

Cost increases and realization of the diverse needs of employees have prompted organizations to review the cost and value of employee benefits. Examines alternatives including "cafeteria plans," managed care programs, and disability income plans. (MLF)

Assessing Treatment Effects of Inhaled Corticosteroids on Medical Expenses and Exacerbations among COPD Patients: Longitudinal Analysis of Managed Care Claims

PubMed Central

Akazawa, Manabu; Stearns, Sally C; Biddle, Andrea K

2008-01-01

Objective To assess costs, effectiveness, and cost-effectiveness of inhaled corticosteroids (ICS) augmenting bronchodilator treatment for chronic obstructive pulmonary disease (COPD). Data Sources Claims between 1997 and 2005 from a large managed care database. Study Design Individual-level, fixed-effects regression models estimated the effects of initiating ICS on medical expenses and likelihood of severe exacerbation. Bootstrapping provided estimates of the incremental cost per severe exacerbation avoided. Data Extraction Methods COPD patients aged 40 or older with ≥15 months of continuous eligibility were identified. Monthly observations for 1 year before and up to 2 years following initiation of bronchodilators were constructed. Principal Findings ICS treatment reduced monthly risk of severe exacerbation by 25 percent. Total costs with ICS increased for 16 months, but declined thereafter. ICS use was cost saving 46 percent of the time, with an incremental cost-effectiveness ratio of $2,973 per exacerbation avoided; for patients ≥50 years old, ICS was cost saving 57 percent of time. Conclusions ICS treatment reduces exacerbations, with an increase in total costs initially for the full sample. Compared with younger patients with COPD, patients aged 50 or older have reduced costs and improved outcomes. The estimated cost per severe exacerbation avoided, however, may be high for either group because of uncertainty as reflected by the large standard errors of the parameter estimates. PMID:18671750

The Syntax and Pragmatics of Fronting in Germanic

ERIC Educational Resources Information Center

Light, Caitlin

2012-01-01

Across the Germanic language family, we find a type of movement traditionally termed "topicalization," which may be realized in Germanic languages which possess the so-called Verb-Second (V2) constraint, as well as those without it. I will henceforward call this phenomenon "fronting" to avoid theoretical assumptions. This…

The Complexity of Developmental Predictions from Dual Process Models

ERIC Educational Resources Information Center

Stanovich, Keith E.; West, Richard F.; Toplak, Maggie E.

2011-01-01

Drawing developmental predictions from dual-process theories is more complex than is commonly realized. Overly simplified predictions drawn from such models may lead to premature rejection of the dual process approach as one of many tools for understanding cognitive development. Misleading predictions can be avoided by paying attention to several…

Development Of Performance Specifications For Collision Avoidance Systems For Lane Change Merging And Backing, Task 2 - Interim Report: Functional Goals Establishment

DOT National Transportation Integrated Search

1995-02-01

">IN ADDITION TO THE MOST BASIC GOAL OF ELIMINATING THE "BLIND SPOT", SIGNIFICANT CRASH AVOIDANCEOPPORTUNITIES CAN BE REALIZED BY GUARDING AGAINST "FAST CLOSING" VEHICLES DURING LANE CHANGE AND MERGING. THESE "FAST APPROACH" COLLISIONS, THOUGH INFREQ...

26 CFR 1.61-12 - Income from discharge of indebtedness.

Code of Federal Regulations, 2010 CFR

2010-04-01

... TAX (CONTINUED) INCOME TAXES (CONTINUED) Definition of Gross Income, Adjusted Gross Income, and... the principal purposes of seeking a confirmation under the Bankruptcy Act is the avoidance of income tax, income is not realized by a taxpayer in the case of a cancellation or reduction of his...

Development of cost effective fenceline monitoring approaches to support advanced leak detection and repair strategies

EPA Science Inventory

Cost-effective fence line and process monitoring systems to support advanced leak detection and repair (LDAR) strategies can enhance protection of public health, facilitate worker safety, and help companies realize cost savings by reducing lost product. The U.S. EPA Office of Re...

29 CFR 102.54 - Initiation of formal compliance proceedings; issuance of compliance specification and notice of...

Code of Federal Regulations, 2011 CFR

2011-07-01

... the purposes and policies of the Act or to avoid unnecessary costs or delay, the Regional Director may... policies of the Act or to avoid unnecessary costs or delay, the Regional Director may consolidate with a... formal proceeding, the Regional Director may issue and serve on all parties a compliance specification in...

29 CFR 102.54 - Initiation of formal compliance proceedings; issuance of compliance specification and notice of...

Code of Federal Regulations, 2010 CFR

2010-07-01

... the purposes and policies of the Act or to avoid unnecessary costs or delay, the Regional Director may... policies of the Act or to avoid unnecessary costs or delay, the Regional Director may consolidate with a... formal proceeding, the Regional Director may issue and serve on all parties a compliance specification in...

Tradespace and Affordability - Phase 1

DTIC Science & Technology

2013-07-09

assessment options Cost-effectiveness, risk reduction leverage/ROI, rework avoidance Tool, data, scenario availability Contract Number: H98230-08-D-0171...Prepare FED assessment plans and earned value milestones Try to relate earned value to risk -exposure avoided rather than budgeted cost F. Begin...evaluate and iterate plans and enablers I. Assess readiness for Commitment Review Shortfalls identified as risks and covered by risk mitigation

Benchmarking in pathology: development of an activity-based costing model.

PubMed

Burnett, Leslie; Wilson, Roger; Pfeffer, Sally; Lowry, John

2012-12-01

Benchmarking in Pathology (BiP) allows pathology laboratories to determine the unit cost of all laboratory tests and procedures, and also provides organisational productivity indices allowing comparisons of performance with other BiP participants. We describe 14 years of progressive enhancement to a BiP program, including the implementation of 'avoidable costs' as the accounting basis for allocation of costs rather than previous approaches using 'total costs'. A hierarchical tree-structured activity-based costing model distributes 'avoidable costs' attributable to the pathology activities component of a pathology laboratory operation. The hierarchical tree model permits costs to be allocated across multiple laboratory sites and organisational structures. This has enabled benchmarking on a number of levels, including test profiles and non-testing related workload activities. The development of methods for dealing with variable cost inputs, allocation of indirect costs using imputation techniques, panels of tests, and blood-bank record keeping, have been successfully integrated into the costing model. A variety of laboratory management reports are produced, including the 'cost per test' of each pathology 'test' output. Benchmarking comparisons may be undertaken at any and all of the 'cost per test' and 'cost per Benchmarking Complexity Unit' level, 'discipline/department' (sub-specialty) level, or overall laboratory/site and organisational levels. We have completed development of a national BiP program. An activity-based costing methodology based on avoidable costs overcomes many problems of previous benchmarking studies based on total costs. The use of benchmarking complexity adjustment permits correction for varying test-mix and diagnostic complexity between laboratories. Use of iterative communication strategies with program participants can overcome many obstacles and lead to innovations.

Spaceborne GPS: Current Status and Future Visions

NASA Technical Reports Server (NTRS)

Bauer, Frank H.; Hartman, Kate; Lightsey, E. Glenn

1998-01-01

The Global Positioning System (GPS), developed by the Department of Defense is quickly revolutionizing the architecture of future spacecraft and spacecraft systems. Significant savings in spacecraft life cycle cost, in power, and in mass can be realized by exploiting GPS technology in spaceborne vehicles. These savings are realized because GPS is a systems sensor--it combines the ability to sense space vehicle trajectory, attitude, time, and relative ranging between vehicles into one package. As a result, a reduced spacecraft sensor complement can be employed and significant reductions in space vehicle operations cost can be realized through enhanced on-board autonomy. This paper provides an overview of the current status of spaceborne GPS, a description of spaceborne GPS receivers available now and in the near future, a description of the 1997-2000 GPS flight experiments, and the spaceborne GPS team's vision for the future.

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

"Watch out!": Effects of instructed threat and avoidance on human free-operant approach-avoidance behavior.

PubMed

Schlund, Michael W; Treacher, Kay; Preston, Oli; Magee, Sandy K; Richman, David M; Brewer, Adam T; Cameron, Gemma; Dymond, Simon

2017-01-01

Approach-avoidance paradigms create a competition between appetitive and aversive contingencies and are widely used in nonhuman research on anxiety. Here, we examined how instructions about threat and avoidance impact control by competing contingencies over human approach-avoidance behavior. Additionally, Experiment 1 examined the effects of threat magnitude (money loss amount) and avoidance cost (fixed ratio requirements), whereas Experiment 2 examined the effects of threat information (available, unavailable and inaccurate) on approach-avoidance. During the task, approach responding was modeled by reinforcing responding with money on a FR schedule. By performing an observing response, participants produced an escalating "threat meter". Instructions stated that the threat meter levels displayed the current probability of losing money, when in fact loss only occurred when the level reached the maximum. Instructions also stated pressing an avoidance button lowered the threat level. Overall, instructions produced cycles of approach and avoidance responding with transitions from approach to avoidance when threat was high and transitions back to approach after avoidance reduced threat. Experiment 1 revealed increasing avoidance cost, but not threat magnitude, shifted approach-avoidance transitions to higher threat levels and increased anxiety ratings, but did not influence the frequency of approach-avoidance cycles. Experiment 2 revealed when threat level information was available or absent earnings were high, but earnings decreased when inaccurate threat information was incompatible with contingencies. Our findings build on prior nonhuman and human approach-avoidance research by highlighting how instructed threat and avoidance can impact human AA behavior and self-reported anxiety. © 2017 Society for the Experimental Analysis of Behavior.

Optimal consensus algorithm integrated with obstacle avoidance

NASA Astrophysics Data System (ADS)

Wang, Jianan; Xin, Ming

2013-01-01

This article proposes a new consensus algorithm for the networked single-integrator systems in an obstacle-laden environment. A novel optimal control approach is utilised to achieve not only multi-agent consensus but also obstacle avoidance capability with minimised control efforts. Three cost functional components are defined to fulfil the respective tasks. In particular, an innovative nonquadratic obstacle avoidance cost function is constructed from an inverse optimal control perspective. The other two components are designed to ensure consensus and constrain the control effort. The asymptotic stability and optimality are proven. In addition, the distributed and analytical optimal control law only requires local information based on the communication topology to guarantee the proposed behaviours, rather than all agents' information. The consensus and obstacle avoidance are validated through simulations.

Rape avoidance behavior among Slovak women.

PubMed

Prokop, Pavol

2013-05-28

Rape has been a recurrent adaptive problem for many species, including humans. Rape is costly to women in terms of disease transmission, partner abandonment, and unwanted pregnancy (among other costs). Therefore, behavioral strategies which allow women to avoid coercive men may have been favored by selection. In line with this evolutionary reasoning, the current research documented that physically stronger women and those in a committed romantic relationship reported more rape avoidance behavior. In addition, virgin women tended to perform more rape avoidance behavior compared with their non-virgin counterparts. Women with high conception risk perceived themselves as physically stronger, which may protect them against a potential rapist. Fear of unwanted pregnancy from rape decreased as age increased, reflecting higher fertility among younger participants. However, older women reported more rape avoidance behavior, which contradicts evolutionary predictions. The results provide some support for evolutionary hypotheses of rape avoidance behavior which suggest that woman's perception of rape is influenced by parental investment and perceived physical condition.

A scenario for inflationary magnetogenesis without strong coupling problem

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

Tasinato, Gianmassimo; Institute of Cosmology and Gravitation, University of Portsmouth,Portsmouth, PO1 3FX

2015-03-23

Cosmological magnetic fields pervade the entire universe, from small to large scales. Since they apparently extend into the intergalactic medium, it is tantalizing to believe that they have a primordial origin, possibly being produced during inflation. However, finding consistent scenarios for inflationary magnetogenesis is a challenging theoretical problem. The requirements to avoid an excessive production of electromagnetic energy, and to avoid entering a strong coupling regime characterized by large values for the electromagnetic coupling constant, typically allow one to generate only a tiny amplitude of magnetic field during inflation. We propose a scenario for building gauge-invariant models of inflationary magnetogenesismore » potentially free from these issues. The idea is to derivatively couple a dynamical scalar, not necessarily the inflaton, to fermionic and electromagnetic fields during the inflationary era. Such couplings give additional freedom to control the time-dependence of the electromagnetic coupling constant during inflation. This fact allows us to find conditions to avoid the strong coupling problems that affect many of the existing models of magnetogenesis. We do not need to rely on a particular inflationary set-up for developing our scenario, that might be applied to different realizations of inflation. On the other hand, specific requirements have to be imposed on the dynamics of the scalar derivatively coupled to fermions and electromagnetism, that we are able to satisfy in an explicit realization of our proposal.« less

A scenario for inflationary magnetogenesis without strong coupling problem

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

Tasinato, Gianmassimo, E-mail: gianmassimo.tasinato@port.ac.uk

2015-03-01

Cosmological magnetic fields pervade the entire universe, from small to large scales. Since they apparently extend into the intergalactic medium, it is tantalizing to believe that they have a primordial origin, possibly being produced during inflation. However, finding consistent scenarios for inflationary magnetogenesis is a challenging theoretical problem. The requirements to avoid an excessive production of electromagnetic energy, and to avoid entering a strong coupling regime characterized by large values for the electromagnetic coupling constant, typically allow one to generate only a tiny amplitude of magnetic field during inflation. We propose a scenario for building gauge-invariant models of inflationary magnetogenesismore » potentially free from these issues. The idea is to derivatively couple a dynamical scalar, not necessarily the inflaton, to fermionic and electromagnetic fields during the inflationary era. Such couplings give additional freedom to control the time-dependence of the electromagnetic coupling constant during inflation. This fact allows us to find conditions to avoid the strong coupling problems that affect many of the existing models of magnetogenesis. We do not need to rely on a particular inflationary set-up for developing our scenario, that might be applied to different realizations of inflation. On the other hand, specific requirements have to be imposed on the dynamics of the scalar derivatively coupled to fermions and electromagnetism, that we are able to satisfy in an explicit realization of our proposal.« less

Medical cost and frequent mental distress among the non-elderly US adult population.

PubMed

Bruning, John; Arif, Ahmed A; Rohrer, James E

2014-03-01

Frequent mental distress (FMD) is an important measure of perceived poor mental health. With the rising cost of health care, it is not uncommon for working adults to delay seeking care. The objective of this study was to determine the relationship between avoidance of medical care due to cost and FMD among the non-elderly US population. We analyzed data from 282 044 non-elderly US population from a 2008 Behavioral Risk Factor Surveillance System survey. Multivariable logistic regression models were used to assess the association between avoidance of medical care due to cost and FMD adjusted for covariates. The overall prevalence of FMD in the non-elderly population was 11.1%; whereas it was 24.2% for those reporting avoiding medical care due to cost. Approximately 18% of the population had no health insurance coverage and the prevalence of FMD was significantly greater in this group. The odds of FMD were >2-fold elevated for respondents who were unable to see a doctor because of cost (adjusted odds ratio: 2.40, 99% confidence interval: 2.19, 2.63). These findings highlight the need for affordable medical care for reducing mental distress and improving population health.

Case Study: Realizing the Value of Nurse Practitioners in Long-Term Care.

PubMed

Cole, M Suzanne

2017-01-01

Presently only about 9% of seniors over the age of 75 live in residential care facilities but the anticipated exponential growth of the senior population will put increasing pressure on the need for supportive, continuing care services in the years ahead (CIHI 2017a). They are on average 86 years of age with a diagnosis of dementia (67%) and some cognitive and/or functional impairment (98%) (CIHI 2017b). These compromised seniors are also more likely to use hospital services than others, and in many jurisdictions occupy acute care beds for extended periods because ongoing management of their complex conditions is often not possible within long-term care (LTC) homes. In addition, unnecessary and futile care at the end of life often leads to suffering for individuals and their families (Dobbins 2016), which might otherwise be avoided with the presence of institutionally based providers such as nurse practitioners (NPs). Christian and Barker (2009) identified NPs as a valuable resource to prevent unnecessary hospitalizations which often lead to complications and devastating results for seniors. Although evidence of the positive impact of NPs working in LTC facilities dates back to the 1970s, very few organizations have created and obtained funding support for these positions in LTC settings. This case study illustrates the impact of the NP role in a New Brunswick LTC facility; demonstrating the value of a model that includes an NP collaborating with physicians, nurses and allied health professionals. As shown in this case, the presence of an NP clearly impacted a reduction in emergency room visits and hospitalizations, events that more often than not accelerate further physical, mental and functional decline particularly among the frail elderly. Christian and Barker (2009) described the significant consequences of hospitalization for the elderly patient including irreversible decline in function, delirium and exposure to iatrogenic disease. Having an NP available within LTC affords the residents ongoing monitoring that allows for preemptive and proactive care. NPs providing oversight to the collaborative management of the care of LTC residents has the potential to not only realize cost-avoidance for the healthcare system but also enhance the quality of care for residents and their families. © 2017 Longwoods Publishing.

Why revisit your cost-accounting strategy.

PubMed

Arredondo, Ricky

2014-07-01

Healthcare entities seeking to develop effective cost-accounting systems should take six steps to avoid potential pitfalls: Secure broad executive-level support for the effort. Ensure systems are in place to analyze the disparate data. Define measurable objectives to ensure that implementation achieves desired results. Give due consideration to implementation planning. Train support staff sufficiently to avoid underutilization. Develop a sufficiently broad base of staff support for the system.

Gender Bias Communication in the Classroom.

ERIC Educational Resources Information Center

Orick, Lisa M.

This document examines the concept of gender bias communication in the classroom and how educators can avoid it. Gender bias communication is a set of behaviors that reflect bias or stereotyping, but which is not against the law. In the classroom, a teacher may treat male and female students differently without even realizing it. For instance, a…

Broadband Light Collection Efficiency Enhancement of Carbon Nanotube Excitons Coupled to Metallo-Dielectric Antenna Arrays

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

Shayan, Kamran; Rabut, Claire; Kong, Xiaoqing

The realization of on-chip quantum networks ideally requires lossless interfaces between photons and solid-state quantum emitters. We propose and demonstrate on-chip arrays of metallo-dielectric antennas (MDA) that are tailored toward efficient and broadband light collection from individual embedded carbon nanotube quantum emitters by trapping air gaps on chip that form cavity modes. Scalable implementation is realized by employing polymer layer dry-transfer techniques that avoid solvent incompatibility issues, as well as a planar design that avoids solid-immersion lenses. Cryogenic measurements demonstrate 7-fold enhanced exciton intensity when compared to emitters located on bare wafers, corresponding to a light collection efficiency (LCE) upmore » to 92% in the best case (average LCE of 69%) into a narrow output cone of +/-15 degrees that enables a priori fiber-to-chip butt coupling. The demonstrated MDA arrays are directly compatible with other quantum systems, particularly 2D materials, toward enabling efficient on-chip quantum light sources or spin-photon interfaces requiring unity light collection, both at cryogenic or room temperature.« less

Nonadiabatic holonomic quantum computation in decoherence-free subspaces.

PubMed

Xu, G F; Zhang, J; Tong, D M; Sjöqvist, Erik; Kwek, L C

2012-10-26

Quantum computation that combines the coherence stabilization virtues of decoherence-free subspaces and the fault tolerance of geometric holonomic control is of great practical importance. Some schemes of adiabatic holonomic quantum computation in decoherence-free subspaces have been proposed in the past few years. However, nonadiabatic holonomic quantum computation in decoherence-free subspaces, which avoids a long run-time requirement but with all the robust advantages, remains an open problem. Here, we demonstrate how to realize nonadiabatic holonomic quantum computation in decoherence-free subspaces. By using only three neighboring physical qubits undergoing collective dephasing to encode one logical qubit, we realize a universal set of quantum gates.

Integrating funds for health and social care: an evidence review.

PubMed

Mason, Anne; Goddard, Maria; Weatherly, Helen; Chalkley, Martin

2015-07-01

Integrated funds for health and social care are one possible way of improving care for people with complex care requirements. If integrated funds facilitate coordinated care, this could support improvements in patient experience, and health and social care outcomes, reduce avoidable hospital admissions and delayed discharges, and so reduce costs. In this article, we examine whether this potential has been realized in practice. We propose a framework based on agency theory for understanding the role that integrated funding can play in promoting coordinated care, and review the evidence to see whether the expected effects are realized in practice. We searched eight electronic databases and relevant websites, and checked reference lists of reviews and empirical studies. We extracted data on the types of funding integration used by schemes, their benefits and costs (including unintended effects), and the barriers to implementation. We interpreted our findings with reference to our framework. The review included 38 schemes from eight countries. Most of the randomized evidence came from Australia, with nonrandomized comparative evidence available from Australia, Canada, England, Sweden and the US. None of the comparative evidence isolated the effect of integrated funding; instead, studies assessed the effects of 'integrated financing plus integrated care' (i.e. 'integration') relative to usual care. Most schemes (24/38) assessed health outcomes, of which over half found no significant impact on health. The impact of integration on secondary care costs or use was assessed in 34 schemes. In 11 schemes, integration had no significant effect on secondary care costs or utilisation. Only three schemes reported significantly lower secondary care use compared with usual care. In the remaining 19 schemes, the evidence was mixed or unclear. Some schemes achieved short-term reductions in delayed discharges, but there was anecdotal evidence of unintended consequences such as premature hospital discharge and heightened risk of readmission. No scheme achieved a sustained reduction in hospital use. The primary barrier was the difficulty of implementing financial integration, despite the existence of statutory and regulatory support. Even where funds were successfully pooled, budget holders' control over access to services remained limited. Barriers in the form of differences in performance frameworks, priorities and governance were prominent amongst the UK schemes, whereas difficulties in linking different information systems were more widespread. Despite these barriers, many schemes - including those that failed to improve health or reduce costs - reported that access to care had improved. Some of these schemes revealed substantial levels of unmet need and so total costs increased. It is often assumed in policy that integrating funding will promote integrated care, and lead to better health outcomes and lower costs. Both our agency theory-based framework and the evidence indicate that the link is likely to be weak. Integrated care may uncover unmet need. Resolving this can benefit both individuals and society, but total care costs are likely to rise. Provided that integration delivers improvements in quality of life, even with additional costs, it may, nonetheless, offer value for money. © The Author(s) 2015.

Integrating funds for health and social care: an evidence review

PubMed Central

Goddard, Maria; Weatherly, Helen; Chalkley, Martin

2015-01-01

Objectives Integrated funds for health and social care are one possible way of improving care for people with complex care requirements. If integrated funds facilitate coordinated care, this could support improvements in patient experience, and health and social care outcomes, reduce avoidable hospital admissions and delayed discharges, and so reduce costs. In this article, we examine whether this potential has been realized in practice. Methods We propose a framework based on agency theory for understanding the role that integrated funding can play in promoting coordinated care, and review the evidence to see whether the expected effects are realized in practice. We searched eight electronic databases and relevant websites, and checked reference lists of reviews and empirical studies. We extracted data on the types of funding integration used by schemes, their benefits and costs (including unintended effects), and the barriers to implementation. We interpreted our findings with reference to our framework. Results The review included 38 schemes from eight countries. Most of the randomized evidence came from Australia, with nonrandomized comparative evidence available from Australia, Canada, England, Sweden and the US. None of the comparative evidence isolated the effect of integrated funding; instead, studies assessed the effects of ‘integrated financing plus integrated care’ (i.e. ‘integration’) relative to usual care. Most schemes (24/38) assessed health outcomes, of which over half found no significant impact on health. The impact of integration on secondary care costs or use was assessed in 34 schemes. In 11 schemes, integration had no significant effect on secondary care costs or utilisation. Only three schemes reported significantly lower secondary care use compared with usual care. In the remaining 19 schemes, the evidence was mixed or unclear. Some schemes achieved short-term reductions in delayed discharges, but there was anecdotal evidence of unintended consequences such as premature hospital discharge and heightened risk of readmission. No scheme achieved a sustained reduction in hospital use. The primary barrier was the difficulty of implementing financial integration, despite the existence of statutory and regulatory support. Even where funds were successfully pooled, budget holders’ control over access to services remained limited. Barriers in the form of differences in performance frameworks, priorities and governance were prominent amongst the UK schemes, whereas difficulties in linking different information systems were more widespread. Despite these barriers, many schemes – including those that failed to improve health or reduce costs – reported that access to care had improved. Some of these schemes revealed substantial levels of unmet need and so total costs increased. Conclusions It is often assumed in policy that integrating funding will promote integrated care, and lead to better health outcomes and lower costs. Both our agency theory-based framework and the evidence indicate that the link is likely to be weak. Integrated care may uncover unmet need. Resolving this can benefit both individuals and society, but total care costs are likely to rise. Provided that integration delivers improvements in quality of life, even with additional costs, it may, nonetheless, offer value for money. PMID:25595287

Modular space station phase B extension program cost and schedules. Volume 1: Cost and schedule estimating process and results

NASA Technical Reports Server (NTRS)

Frassinelli, G. J.

1972-01-01

Cost estimates and funding schedules are presented for a given configuration and costing ground rules. Cost methodology is described and the cost evolution from a baseline configuration to a selected configuration is given, emphasizing cases in which cost was a design driver. Programmatic cost avoidance techniques are discussed.

Estimation of velocity structure around a natural gas reservoir at Yufutsu, Japan, by microtremor survey

NASA Astrophysics Data System (ADS)

Shiraishi, H.; Asanuma, H.; Tezuka, K.

2010-12-01

Seismic reflection survey has been commonly used for exploration and time-lapse monitoring of oil/gas resources. Seismic reflection images typically have reasonable reliability and resolution for commercial production. However, cost consideration sometimes avoids deployment of widely distributed array or repeating survey in cases of time lapse monitoring or exploration of small-scale reservoir. Hence, technologies to estimate structures and physical properties around the reservoir with limited cost would be effectively used. Microtremor survey method (MSM) has an ability to realize long-term monitoring of reservoir with low cost, because this technique has a passive nature and minimum numbers of the monitoring station is four. MSM has been mainly used for earthquake disaster prevention, because velocity structure of S-wave is directly estimated from velocity dispersion of the Rayleigh wave. The authors experimentally investigated feasibility of the MSM survey for exploration of oil/gas reservoir. The field measurement was carried out around natural gas reservoir at Yufutsu, Hokkaido, Japan. Four types of arrays with array radii of 30m, 100m, 300m and 600m are deployed in each area. Dispersion curves of the velocity of Rayleigh wave were estimated from observed microtremors, and S-wave velocity structures were estimated by an inverse analysis of the dispersion curves with genetic algorism (GA). The estimated velocity structures showed good consistency with one dimensional velocity structure by previous reflection surveys up to 4-5 km. We also found from the field experiment that a data of 40min is effective to estimate the velocity structure even the seismometers are deployed along roads with heavy traffic.

Integrated Silicon Carbide Power Electronic Block

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

Radhakrishnan, Rahul

2017-11-07

Research involved in this project is aimed at monolithically integrating an anti-parallel diode to the SiC MOSFET switch, so as to avoid having to use an external anti-parallel diode in power circuit applications. SiC MOSFETs are replacing Si MOSFETs and IGBTs in many applications, yet the high bandgap of the body diode in SiC MOSFET and consequent need for an external anti-parallel diode increases costs and discourages circuit designers from adopting this technology. Successful demonstration and subsequent commercialization of this technology would reduce SiC MOSFET cost and additionally reduce component count as well as other costs at the power circuitmore » level. In this Phase I project, we have created multiple device designs, set up a process for device fabrication at the 150mm SiC foundry XFAB Texas, demonstrated unit-processes for device fabrication in short loops and started full flow device fabrication. Key findings of the development activity were: The limits of coverage of photoresist over the topology of thick polysilicon structures covered with oxide, which required larger feature dimensions to overcome; and The insufficient process margin for removing oxide spacers from polysilicon field ring features which could result in loss of some features without further process development No fundamental obstacles were uncovered during the process development. Given sufficient time for additional development it is likely that processes could be tuned to realize the monolithically integrated SiC JBS diode and MOSFET. Sufficient funds were not available in this program to resolve processing difficulties and fabricate the devices.« less

Costs and benefits of rapid screening of methicillin-resistant Staphylococcus aureus carriage in intensive care units: a prospective multicenter study

PubMed Central

2012-01-01

Introduction Pre-emptive isolation of suspected methicillin-resistant Staphylococcus aureus (MRSA) carriers is a cornerstone of successful MRSA control policies. Implementation of such strategies is hampered when using conventional cultures with diagnostic delays of three to five days, as many non-carriers remain unnecessarily isolated. Rapid diagnostic testing (RDT) reduces the amount of unnecessary isolation days, but costs and benefits have not been accurately determined in intensive care units (ICUs). Methods Embedded in a multi-center hospital-wide study in 12 Dutch hospitals we quantified cost per isolation day avoided using RDT for MRSA, added to conventional cultures, in ICUs. BD GeneOhm™ MRSA PCR (IDI) and Xpert MRSA (GeneXpert) were subsequently used during 17 and 14 months, and their test characteristics were calculated with conventional culture results as reference. We calculated the number of pre-emptive isolation days avoided and incremental costs of adding RDT. Results A total of 163 patients at risk for MRSA carriage were screened and MRSA prevalence was 3.1% (n = 5). Duration of isolation was 27.6 and 21.4 hours with IDI and GeneXpert, respectively, and would have been 96.0 hours when based on conventional cultures. The negative predictive value was 100% for both tests. Numbers of isolation days were reduced by 44.3% with PCR-based screening at the additional costs of €327.84 (IDI) and €252.14 (GeneXpert) per patient screened. Costs per isolation day avoided were €136.04 (IDI) and €121.76 (GeneXpert). Conclusions In a low endemic setting for MRSA, RDT safely reduced the number of unnecessary isolation days on ICUs by 44%, at the costs of €121.76 to €136.04 per isolation day avoided. PMID:22314204

A hybrid optimization approach in non-isothermal glass molding

NASA Astrophysics Data System (ADS)

Vu, Anh-Tuan; Kreilkamp, Holger; Krishnamoorthi, Bharathwaj Janaki; Dambon, Olaf; Klocke, Fritz

2016-10-01

Intensively growing demands on complex yet low-cost precision glass optics from the today's photonic market motivate the development of an efficient and economically viable manufacturing technology for complex shaped optics. Against the state-of-the-art replication-based methods, Non-isothermal Glass Molding turns out to be a promising innovative technology for cost-efficient manufacturing because of increased mold lifetime, less energy consumption and high throughput from a fast process chain. However, the selection of parameters for the molding process usually requires a huge effort to satisfy precious requirements of the molded optics and to avoid negative effects on the expensive tool molds. Therefore, to reduce experimental work at the beginning, a coupling CFD/FEM numerical modeling was developed to study the molding process. This research focuses on the development of a hybrid optimization approach in Non-isothermal glass molding. To this end, an optimal configuration with two optimization stages for multiple quality characteristics of the glass optics is addressed. The hybrid Back-Propagation Neural Network (BPNN)-Genetic Algorithm (GA) is first carried out to realize the optimal process parameters and the stability of the process. The second stage continues with the optimization of glass preform using those optimal parameters to guarantee the accuracy of the molded optics. Experiments are performed to evaluate the effectiveness and feasibility of the model for the process development in Non-isothermal glass molding.

Spaceborne GPS Current Status and Future Visions

NASA Technical Reports Server (NTRS)

Bauer, Frank H.; Hartman, Kate; Lightsey, E. Glenn

1998-01-01

The Global Positioning System (GPS), developed by the Department of Defense, is quickly revolutionizing the architecture of future spacecraft and spacecraft systems. Significant savings in spacecraft life cycle cost, in power, and in mass can be realized by exploiting Global Positioning System (GPS) technology in spaceborne vehicles. These savings are realized because GPS is a systems sensor-it combines the ability to sense space vehicle trajectory, attitude, time, and relative ranging between vehicles into one package. As a result, a reduced spacecraft sensor complement can be employed on spacecraft and significant reductions in space vehicle operations cost can be realized through enhanced on- board autonomy. This paper provides an overview of the current status of spaceborne GPS, a description of spaceborne GPS receivers available now and in the near future, a description of the 1997-1999 GPS flight experiments and the spaceborne GPS team's vision for the future.

48 CFR 31.105 - Construction and architect-engineer contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., include unallowable interest costs, or use improper cost of money rates or computations. Contracting... contracts, including cost-reimbursement subcontracts thereunder; (2) Negotiating indirect cost rates; (3... appropriate they serve to express the parties' understanding and avoid possible subsequent disputes or...

The Use of Parenteral Nutrition Support in an Acute Care Hospital and the Cost Implications of Short-term Parenteral Nutrition.

PubMed

Wong, Alvin Tc; Ong, Jeannie Pl; Han, Hsien Hwei

2016-06-01

Parenteral nutrition (PN) is indicated for patients who are unable to progress to oral or enteral nutrition. There are no local studies done on estimating the cost of PN in acute settings. The aims of this study are to describe the demographics, costs of PN and manpower required; and to determine the avoidable PN costs for patients and hospital on short-term PN. Patient data between October 2011 and December 2013 were reviewed. Data collected include demographics, length of stay (LOS), and the indication/duration of PN. PN administration cost was based on the cost of the PN bags, blood tests and miscellaneous items, adjusted to subsidy levels. Manpower costs were based on the average hourly rate. Costs for PN and manpower were approximately S$1.2 million for 2791 PN days. Thirty-six cases (18.8%) of 140 PN days were short-term and considered to be avoidable where patients progressed to oral/enteral diet within 5 days. These short-term cases totalled $59,154.42, where $42,183.15 was payable by the patients. The daily costs for PN is also significantly higher for patients on short-term PN (P <0.001). In our acute hospital, 90% of patients referred for PN were surgical patients. Majority of the cost comes from the direct daily cost of the bag and blood tests, while extensive manpower cost was borne by the hospital; 18.8% of our cohort had short-term avoidable PN. Daily PN may cost up to 60% more in patients receiving short-term PN. Clinicians should assess patient's suitability for oral/enteral feeding to limit the use of short-term PN.

Anesthetic management of external cephalic version.

PubMed

Chalifoux, Laurie A; Sullivan, John T

2013-09-01

Breech presentation is common at term and its reduction through external cephalic version represents a noninvasive opportunity to avoid cesarean delivery and the associated maternal morbidity. In addition to uterine relaxants, neuraxial anesthesia is associated with increased success of version procedures when surgical anesthetic dosing is used. The intervention is likely cost effective given the effect size and the avoided high costs of cesarean delivery. Copyright © 2013 Elsevier Inc. All rights reserved.

[Cost-benefit analysis of a school-based smoking prevention program].

PubMed

Hormigo Amaro, Jordi; García-Altés, Anna; López, M José; Bartoll, Xavier; Nebot, Manel; Ariza, Carles

2009-01-01

To analyze the efficiency of a school-based smoking prevention program in Barcelona (PASE.bcn program). A cost-benefit analysis was performed. As costs we included those corresponding to the design and implementation of the program. As benefits we considered healthcare costs and the productivity losses avoided. This study was conducted from a societal perspective, and the estimations of costs and benefits related to 2005. Assuming an effectiveness of 1%, the PASE.bcn program would achieve a total benefit of 1,558,311.46euro. The healthcare benefits per prevented smoker were 1997.57euro, and the indirect benefits per prevented smoker were 21,260.80euro. Given the total cost of the school-based program (68,526.03euro), the cost-benefit ratio was 22.74. From a societal perspective, the benefits of school-based tobacco prevention programs, in terms of healthcare costs and productivity losses avoided, are far greater than the costs. These results support universal application of this type of intervention.

Ensembles and Experiments in Classical and Quantum Physics

NASA Astrophysics Data System (ADS)

Neumaier, Arnold

A philosophically consistent axiomatic approach to classical and quantum mechanics is given. The approach realizes a strong formal implementation of Bohr's correspondence principle. In all instances, classical and quantum concepts are fully parallel: the same general theory has a classical realization and a quantum realization. Extending the ''probability via expectation'' approach of Whittle to noncommuting quantities, this paper defines quantities, ensembles, and experiments as mathematical concepts and shows how to model complementarity, uncertainty, probability, nonlocality and dynamics in these terms. The approach carries no connotation of unlimited repeatability; hence it can be applied to unique systems such as the universe. Consistent experiments provide an elegant solution to the reality problem, confirming the insistence of the orthodox Copenhagen interpretation on that there is nothing but ensembles, while avoiding its elusive reality picture. The weak law of large numbers explains the emergence of classical properties for macroscopic systems.

Rapid and Quantitative Detection of Vibrio parahemolyticus by the Mixed-Dye-Based Loop-Mediated Isothermal Amplification Assay on a Self-Priming Compartmentalization Microfluidic Chip.

PubMed

Pang, Bo; Ding, Xiong; Wang, Guoping; Zhao, Chao; Xu, Yanan; Fu, Kaiyue; Sun, Jingjing; Song, Xiuling; Wu, Wenshuai; Liu, Yushen; Song, Qi; Hu, Jiumei; Li, Juan; Mu, Ying

2017-12-27

Vibrio parahemolyticus (VP) mostly isolated from aquatic products is one of the major causes of bacterial food-poisoning events worldwide, which could be reduced using a promising on-site detection method. Herein, a rapid and quantitative method for VP detection was developed by applying a mixed-dye-loaded loop-mediated isothermal amplification (LAMP) assay on a self-priming compartmentalization (SPC) microfluidic chip, termed on-chip mixed-dye-based LAMP (CMD-LAMP). In comparison to conventional approaches, CMD-LAMP was advantageous on the limit of detection, which reached down to 1 × 10 3 CFU/mL in food-contaminated samples without the pre-enrichment of bacteria. Additionally, as a result of the use of a mixed dye and SPC chip, the quantitative result could be easily acquired, avoiding the requirement of sophisticated instruments and tedious operation. Also, CMD-LAMP was rapid and cost-effective. Conclusively, CMD-LAMP has great potential in realizing the on-site quantitative analysis of VP for food safety.

An in-situ measuring method for planar straightness error

NASA Astrophysics Data System (ADS)

Chen, Xi; Fu, Luhua; Yang, Tongyu; Sun, Changku; Wang, Zhong; Zhao, Yan; Liu, Changjie

2018-01-01

According to some current problems in the course of measuring the plane shape error of workpiece, an in-situ measuring method based on laser triangulation is presented in this paper. The method avoids the inefficiency of traditional methods like knife straightedge as well as the time and cost requirements of coordinate measuring machine(CMM). A laser-based measuring head is designed and installed on the spindle of a numerical control(NC) machine. The measuring head moves in the path planning to measure measuring points. The spatial coordinates of the measuring points are obtained by the combination of the laser triangulation displacement sensor and the coordinate system of the NC machine, which could make the indicators of measurement come true. The method to evaluate planar straightness error adopts particle swarm optimization(PSO). To verify the feasibility and accuracy of the measuring method, simulation experiments were implemented with a CMM. Comparing the measurement results of measuring head with the corresponding measured values obtained by composite measuring machine, it is verified that the method can realize high-precise and automatic measurement of the planar straightness error of the workpiece.

Verifier-based three-party authentication schemes using extended chaotic maps for data exchange in telecare medicine information systems.

PubMed

Lee, Tian-Fu

2014-12-01

Telecare medicine information systems provide a communicating platform for accessing remote medical resources through public networks, and help health care workers and medical personnel to rapidly making correct clinical decisions and treatments. An authentication scheme for data exchange in telecare medicine information systems enables legal users in hospitals and medical institutes to establish a secure channel and exchange electronic medical records or electronic health records securely and efficiently. This investigation develops an efficient and secure verified-based three-party authentication scheme by using extended chaotic maps for data exchange in telecare medicine information systems. The proposed scheme does not require server's public keys and avoids time-consuming modular exponential computations and scalar multiplications on elliptic curve used in previous related approaches. Additionally, the proposed scheme is proven secure in the random oracle model, and realizes the lower bounds of messages and rounds in communications. Compared to related verified-based approaches, the proposed scheme not only possesses higher security, but also has lower computational cost and fewer transmissions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Al₂O₃ Coatings on Magnesium Alloy Deposited by the Fluidized Bed (FB) Technique.

PubMed

Baiocco, Gabriele; Rubino, Gianluca; Tagliaferri, Vincenzo; Ucciardello, Nadia

2018-01-09

Magnesium alloys are widely employed in several industrial domains for their outstanding properties. They have a high strength-weight ratio, with a density that is lower than aluminum (33% less), and feature good thermal properties, dimensional stability, and damping characteristics. However, they are vulnerable to oxidation and erosion-corrosion phenomena when applied in harsh service conditions. To avoid the degradation of magnesium, several coating methods have been presented in the literature; however, all of them deal with drawbacks that limit their application in an industrial environment, such as environmental pollution, toxicity of the coating materials, and high cost of the necessary machinery. In this work, a plating of Al₂O₃ film on a magnesium alloy realized by the fluidized bed (FB) technique and using alumina powder is proposed. The film growth obtained through this cold deposition process is analyzed, investigating the morphology as well as tribological and mechanical features and corrosion behavior of the plated samples. The resulting Al₂O₃ coatings show consistent improvement of the tribological and anti-corrosive performance of the magnesium alloy.

Al2O3 Coatings on Magnesium Alloy Deposited by the Fluidized Bed (FB) Technique

PubMed Central

Rubino, Gianluca; Ucciardello, Nadia

2018-01-01

Magnesium alloys are widely employed in several industrial domains for their outstanding properties. They have a high strength-weight ratio, with a density that is lower than aluminum (33% less), and feature good thermal properties, dimensional stability, and damping characteristics. However, they are vulnerable to oxidation and erosion-corrosion phenomena when applied in harsh service conditions. To avoid the degradation of magnesium, several coating methods have been presented in the literature; however, all of them deal with drawbacks that limit their application in an industrial environment, such as environmental pollution, toxicity of the coating materials, and high cost of the necessary machinery. In this work, a plating of Al2O3 film on a magnesium alloy realized by the fluidized bed (FB) technique and using alumina powder is proposed. The film growth obtained through this cold deposition process is analyzed, investigating the morphology as well as tribological and mechanical features and corrosion behavior of the plated samples. The resulting Al2O3 coatings show consistent improvement of the tribological and anti-corrosive performance of the magnesium alloy. PMID:29315222

A bat algorithm with mutation for UCAV path planning.

PubMed

Wang, Gaige; Guo, Lihong; Duan, Hong; Liu, Luo; Wang, Heqi

2012-01-01

Path planning for uninhabited combat air vehicle (UCAV) is a complicated high dimension optimization problem, which mainly centralizes on optimizing the flight route considering the different kinds of constrains under complicated battle field environments. Original bat algorithm (BA) is used to solve the UCAV path planning problem. Furthermore, a new bat algorithm with mutation (BAM) is proposed to solve the UCAV path planning problem, and a modification is applied to mutate between bats during the process of the new solutions updating. Then, the UCAV can find the safe path by connecting the chosen nodes of the coordinates while avoiding the threat areas and costing minimum fuel. This new approach can accelerate the global convergence speed while preserving the strong robustness of the basic BA. The realization procedure for original BA and this improved metaheuristic approach BAM is also presented. To prove the performance of this proposed metaheuristic method, BAM is compared with BA and other population-based optimization methods, such as ACO, BBO, DE, ES, GA, PBIL, PSO, and SGA. The experiment shows that the proposed approach is more effective and feasible in UCAV path planning than the other models.

Molecular Materials for Nonaqueous Flow Batteries with a High Coulombic Efficiency and Stable Cycling.

PubMed

Milton, Margarita; Cheng, Qian; Yang, Yuan; Nuckolls, Colin; Hernández Sánchez, Raúl; Sisto, Thomas J

2017-12-13

This manuscript presents a working redox battery in organic media that possesses remarkable cycling stability. The redox molecules have a solubility over 1 mol electrons/liter, and a cell with 0.4 M electron concentration is demonstrated with steady performance >450 cycles (>74 days). Such a concentration is among the highest values reported in redox flow batteries with organic electrolytes. The average Coulombic efficiency of this cell during cycling is 99.868%. The stability of the cell approaches the level necessary for a long lifetime nonaqueous redox flow battery. For the membrane, we employ a low cost size exclusion cellulose membrane. With this membrane, we couple the preparation of nanoscale macromolecular electrolytes to successfully avoid active material crossover. We show that this cellulose-based membrane can support high voltages in excess of 3 V and extreme temperatures (-20 to 110 °C). These extremes in temperature and voltage are not possible with aqueous systems. Most importantly, the nanoscale macromolecular platforms we present here for our electrolytes can be readily tuned through derivatization to realize the promise of organic redox flow batteries.

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

Rittmann, Bruce; Krajmalnik‐Brown, Rosa; Zevin, Alexander

The grandest challenge facing human society today is providing large amounts of energy and industrial chemicals that are renewable and carbon-neutral. An outstanding opportunity lies in employing photosynthetic microorganisms, which have the potential to generate energy and chemical feedstock from sunlight and CO 2 at rates 10 to 100 times greater than plants. Major challenges for solar-powered production using photosynthetic microorganisms are associated with the harvesting and downstream processing of biomass to yield the usable energy or material feedstock e.g. The technical challenges and costs of downstream processing could be avoided if, powered by solar energy, the photosynthetic microorganisms weremore » to convert CO 2 directly to the desired product, which they release for direct harvesting. This approach creates a true photosynthetic factory, our goal for Photosynthetic Factory Direct! Our team is able to genetically modify the cyanobacterium Synechocystis sp. PCC 6803 so that it produces and excretes a range of renewable energy and chemical products directly from CO 2 and sunlight. Essential to realizing the potential of the photosynthetic factory is an engineered Advanced Photobioreactor (APBR) for reliable synthesis and harvest of the products.« less

No evidence of inbreeding avoidance despite demonstrated survival costs in a polygynous rodent.

PubMed

Olson, L E; Blumstein, D T; Pollinger, J R; Wayne, R K

2012-02-01

Individuals are generally predicted to avoid inbreeding because of detrimental fitness effects. However, several recent studies have shown that limited inbreeding is tolerated by some vertebrate species. Here, we examine the costs and benefits of inbreeding in a largely polygynous rodent, the yellow-bellied marmot (Marmota flaviventris). We use a pedigree constructed from 8 years of genetic data to determine the relatedness of all marmots in our study population and examine offspring survival, annual male reproductive success, relatedness between breeding pairs and the effects of group composition on likelihood of male reproduction to assess inbreeding in this species. We found decreased survival in inbred offspring, but equal net reproductive success among males that inbred and those that avoided it. Relatedness between breeding pairs was greater than that expected by chance, indicating that marmots do not appear to avoid breeding with relatives. Further, male marmots do not avoid inbreeding: males mate with equal frequency in groups composed of both related and unrelated females and in groups composed of only female relatives. Our results demonstrate that inbreeding can be tolerated in a polygynous species if the reproductive costs of inbreeding are low and individuals that mate indiscriminately do not suffer decreased reproductive success. © 2011 Blackwell Publishing Ltd.

Optimization of the thermogauge furnace for realizing high temperature fixed points

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

Wang, T.; Dong, W.; Liu, F.

2013-09-11

The thermogauge furnace was commonly used in many NMIs as a blackbody source for calibration of the radiation thermometer. It can also be used for realizing the high temperature fixed point(HTFP). According to our experience, when realizing HTFP we need the furnace provide relative good temperature uniformity to avoid the possible damage to the HTFP. To improve temperature uniformity in the furnace, the furnace tube was machined near the tube ends with a help of a simulation analysis by 'ansys workbench'. Temperature distributions before and after optimization were measured and compared at 1300 °C, 1700°C, 2500 °C, which roughly correspondmore » to Co-C(1324 °C), Pt-C(1738 °C) and Re-C(2474 °C), respectively. The results clearly indicate that through machining the tube the temperature uniformity of the Thermogage furnace can be remarkably improved. A Pt-C high temperature fixed point was realized in the modified Thermogauge furnace subsequently, the plateaus were compared with what obtained using old heater, and the results were presented in this paper.« less

Relationship Between Quality of Comorbid Condition Care and Costs for Cancer Survivors

PubMed Central

Snyder, Claire F.; Herbert, Robert J.; Blackford, Amanda L.; Neville, Bridget A.; Wolff, Antonio C.; Carducci, Michael A.; Earle, Craig C.

2016-01-01

Purpose: To estimate the association between cancer survivors’ comorbid condition care quality and costs; to determine whether the association differs between cancer survivors and other patients. Methods: Using the SEER–Medicare-linked database, we identified survivors of breast, prostate, and colorectal cancers who were diagnosed in 2004, enrolled in Medicare fee-for-service for at least 12 months before diagnosis, and survived ≥ 3 years. Quality of care was assessed using nine process indicators for chronic conditions, and a composite indicator representing seven avoidable outcomes. Total costs on the basis of Medicare amount paid were grouped as inpatient and outpatient. We examined the association between care quality and costs for cancer survivors, and compared this association among 2:1 frequency-matched noncancer controls, using comparisons of means and generalized linear regressions. Results: Our sample included 8,661 cancer survivors and 17,332 matched noncancer controls. Receipt of recommended care was associated with higher outpatient costs for eight indicators, and higher inpatient and total costs for five indicators. For three measures (visit every 6 months for patients with chronic obstructive pulmonary disease or diabetes, and glycosylated hemoglobin or fructosamine every 6 months for patients with diabetes), costs for cancer survivors who received recommended care increased less than for noncancer controls. The absence of avoidable events was associated with lower costs of each type. An annual eye examination for patients with diabetes was associated with lower inpatient costs. Conclusion: Higher-quality processes of care may not reduce short-term costs, but the prevention of avoidable outcomes reduces costs. The association between quality and cost was similar for cancer survivors and noncancer controls. PMID:27165487

A Cost-effectiveness Analysis of Early vs Late Tracheostomy.

PubMed

Liu, C Carrie; Rudmik, Luke

2016-10-01

The timing of tracheostomy in critically ill patients requiring mechanical ventilation is controversial. An important consideration that is currently missing in the literature is an evaluation of the economic impact of an early tracheostomy strategy vs a late tracheostomy strategy. To evaluate the cost-effectiveness of the early tracheostomy strategy vs the late tracheostomy strategy. This economic analysis was performed using a decision tree model with a 90-day time horizon. The economic perspective was that of the US health care third-party payer. The primary outcome was the incremental cost per tracheostomy avoided. Probabilities were obtained from meta-analyses of randomized clinical trials. Costs were obtained from the published literature and the Healthcare Cost and Utilization Project database. A multivariate probabilistic sensitivity analysis was performed to account for uncertainty surrounding mean values used in the reference case. The reference case demonstrated that the cost of the late tracheostomy strategy was $45 943.81 for 0.36 of effectiveness. The cost of the early tracheostomy strategy was $31 979.12 for 0.19 of effectiveness. The incremental cost-effectiveness ratio for the late tracheostomy strategy compared with the early tracheostomy strategy was $82 145.24 per tracheostomy avoided. With a willingness-to-pay threshold of $50 000, the early tracheostomy strategy is cost-effective with 56% certainty. The adaptation of an early vs a late tracheostomy strategy depends on the priorities of the decision-maker. Up to a willingness-to-pay threshold of $80 000 per tracheostomy avoided, the early tracheostomy strategy has a higher probability of being the more cost-effective intervention.

Cubesat in-situ degradation detector (CIDD)

NASA Astrophysics Data System (ADS)

Rievers, Benny; Milke, Alexander; Salden, Daniel

2015-07-01

The design of the thermal control and management system (TCS) is a central task in satellite design. In order to evaluate and dimensionize the properties of the TCS, material parameters specifying the conductive and radiative properties of the different TCS components have to be known including their respective variations within the mission lifetime. In particular the thermo-optical properties of the outer surfaces including critical TCS components such as radiators and thermal insulation are subject to degradation caused by interaction with the space environment. The evaluation of these material parameters by means of ground testing is a time-consuming and expensive endeavor. Long-term in-situ measurements on board the ISS or large satellites not only realize a better implementation of the influence of the space environment but also imply high costs. Motivated by this we propose the utilization of low-cost nano-satellite systems to realize material tests within space at a considerably reduced cost. We present a nanosat-scale degradation sensor concept which realizes low power consumption and data rates compatible with nanosat boundaries at UHF radio. By means of a predefined measurement and messaging cycle temperature curves are measured and evaluated on ground to extract the change of absorptivity and emissivity over mission lifetime.

The global role of health care delivery science: learning from variation to build health systems that avoid waste and harm.

PubMed

Mulley, Albert G

2013-09-01

This paper addresses the fourth theme of the Indiana Global Health Research Working Conference, Clinical Effectiveness and Health Systems Research. It explores geographic variation in health care delivery and health outcomes as a source of learning how to achieve better health outcomes at lower cost. It focuses particularly on the relationship between investments made in capacities to deliver different health care services to a population and the value thereby created by that care for individual patients. The framing begins with the dramatic variation in per capita health care expenditures across the nations of the world, which is largely explained by variations in national wealth. The 1978 Declaration of Alma Ata is briefly noted as a response to such inequities with great promise that has not as yet been realized. This failure to realize the promise of Alma Ata grows in significance with the increasing momentum for universal health coverage that is emerging in the current global debate about post-2015 development goals. Drawing upon work done at Dartmouth over more than three decades, the framing then turns to within-country variations in per capita expenditures, utilization of different services, and health outcomes. A case is made for greater attention to the question of value by bringing better information to bear at both the population and individual levels. Specific opportunities to identify and reduce waste in health care, and the harm that is so often associated with it, are identified by learning from outcome variations and practice variations.

[To promote universal eye health to push forward sustaining development of the prevention of blindness in China].

PubMed

Zhao, Jialiang

2014-03-01

Action plan for the prevention of avoidable blindness and visual impairment for 2014-2019 endorsed by 66(th) World Health Assembly is an important document for promoting the global prevention of blindness. This action plan summarized the experiences and lessons in the global prevention of avoidable blindness and visual impairment from 2009 to 2013, raised the global goal for the prevention of blindness-the reduction in prevalence of avoidable visual impairment by 25% by 2019 from the baseline of 2010, set up the monitoring indicators for realizing the global goal. This document can be served as a roadmap to consolidate joint efforts aimed at working towards universal eye health in the world. This action plan must give a deep and important impact on the prevention of blindness in China.We should implement the action plan for the prevention of avoidable blindness and visual impairment for 2014-2019 to push forward sustaining development of the prevention of blindness in China.

Fuzzy Inference Based Obstacle Avoidance Control of Electric Powered Wheelchair Considering Driving Risk

NASA Astrophysics Data System (ADS)

Kiso, Atsushi; Murakami, Hiroki; Seki, Hirokazu

This paper describes a novel obstacle avoidance control scheme of electric powered wheelchairs for realizing the safe driving in various environments. The “electric powered wheelchair” which generates the driving force by electric motors is expected to be widely used as a mobility support system for elderly people and disabled people; however, the driving performance must be further improved because the number of driving accidents caused by elderly operator's narrow sight and joystick operation errors is increasing. This paper proposes a novel obstacle avoidance control scheme based on fuzzy algorithm to prevent driving accidents. The proposed control system determines the driving direction by fuzzy algorithm based on the information of the joystick operation and distance to obstacles measured by ultrasonic sensors. Fuzzy rules to determine the driving direction are designed surely to avoid passers-by and walls considering the human's intent and driving environments. Some driving experiments on the practical situations show the effectiveness of the proposed control system.

Preferences of Male and Female Students for TSA Competitive Events

ERIC Educational Resources Information Center

Mitts, Charles R.; Haynie, W. J., III

2010-01-01

Arguably a major issue facing technology education (TE) since its inception has been its failure to attract and keep female students. This article explains one primary reason female students may be avoiding TE courses, presents a research-tested set of tools that TE teachers can use to help fix the problem, and offers a new realizable pathway…

Measuring Virtual Simulations Value in Training Exercises - USMC Use Case

DTIC Science & Technology

2015-12-04

and cost avoidance and Capt Jonathan Richardson, PM TRASYS, who was the primary author for the After-Action Documentation and Analysis Report ...REFERENCES Cermak J. & McGurk M. (2010, July). Putting a Value On Training. McKinsey Quarterly. Retrieved June 10, 2015 from http://www.mckinsey.com...www.hqmc.marines.mil/Portals/142/Docs/2015CPG_Color.pdf Gordon, S. & Cooley, T. (2013) Phase One Final Report : Cost Avoidance Study of USMC Simulation

Impact of pharmacy student interventions in an urban family medicine clinic.

PubMed

Ginzburg, Regina

2014-06-17

To determine the number of interventions made by pharmacy students at an urban family medicine clinic and the acceptance rate of these recommendations by the healthcare providers. The secondary objective was to investigate the cost avoidance value of the interventions. A prospective, unblinded study was conducted to determine the number and cost avoidance value of clinical interventions made by pharmacy students completing advanced pharmacy practice experiences (APPEs) in an urban family medicine clinic. Eighteen students completed this experience in the 8 months studied. Of the 718 interventions performed, 77% were accepted by physicians, including 58% of the 200 interventions that required immediate action. Projected avoidance was estimated at $61,855. The clinical interventions by pharmacy students were generally well received by healthcare providers and resulted in significant cost savings. Pharmacy students can play an important role in a family medicine clinic.

Cost savings of outpatient versus standard inpatient total knee arthroplasty

PubMed Central

Huang, Adrian; Ryu, Jae-Jin; Dervin, Geoffrey

2017-01-01

Background With diminishing reimbursement rates and strained public payer budgets, a high-volume inpatient procedure, such as total knee arthroplasty (TKA), is a common target for improving cost efficiencies. Methods This prospective case–control study compared the cost-minimization of same day discharge (SDD) versus inpatient TKA. We examined if and where cost savings can be realized and the magnitude of savings that can be achieved without compromising quality of care. Outcome variables, including detailed case costs, return to hospital rates and complications, were documented and compared between the first 20 SDD cases and 20 matched inpatient controls. Results In every case–control match, the SDD TKA was less costly than the inpatient procedure and yielded a median cost savings of approximately 30%. The savings came primarily from costs associated with the inpatient encounter, such as surgical ward, pharmacy and patient meal costs. At 1 year, there were no major complications and no return to hospital or readmission encounters for either group. Conclusion Our results are consistent with previously published data on the cost savings associated with short stay or outpatient TKA. We have gone further by documenting where those savings were in a matched cohort design. Furthermore, we determined where cost savings could be realized during the patient encounter and to what degree. In carefully selected patients, outpatient TKA is a feasible alternative to traditional inpatient TKA and is significantly less costly. Furthermore, it was deemed to be safe in the perioperative period. PMID:28234591

House Construction: How To Reduce Costs

Treesearch

Jerry O. Newman; Norman C. Teter; Constance D. O' Brien

1969-01-01

You're building a house and want to keep down the cost. How can you do it? First, plan carefully "on paper" before you start construction. By doing so, you can avoid costly mistakesinthebuildingandinthe purchase of materials. Careful planning and proper design will reduce not only the initial cost but also the cost of furnishings, utilities, and...

75 FR 25981 - Cost Accounting Standards: Harmonization of Cost Accounting Standards 412 and 413 With the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

...), invites public comments concerning the harmonization of Cost Accounting Standards 412 and 413 with the... cost that is based on currently accrued benefits that have been valued using corporate bond rates... that avoid undue cost or contribution volatility. The Board agrees with the public comments that since...

Changing of the Bulbs.

ERIC Educational Resources Information Center

Baba, Keith

1995-01-01

Explains how a school's use of compact fluorescents can reduce operating costs and maintain performance. Indicates that energy cost savings can repay the initial costs of buying incandescent bulbs in as short as 12 months with continuing savings thereafter. Tips for avoiding costly mistakes in lighting retrofits are highlighted. (GR)

A Novel Approach to Photonic Generation and Modulation of Ultra-Wideband Pulses

NASA Astrophysics Data System (ADS)

Xiang, Peng; Guo, Hao; Chen, Dalei; Zhu, Huatao

2016-01-01

A novel approach to photonic generation of ultra-wideband (UWB) signals is proposed in this paper. The proposed signal generator is capable of generating UWB doublet pulses with flexible reconfigurability, and many different pulse modulation formats, including the commonly used pulse-position modulation (PPM) and bi-phase modulation (BPM) can be realized. Moreover, the photonic UWB pulse generator is capable of generating UWB signals with a tunable spectral notch-band, which is desirable to realize the interference avoidance between UWB and other narrow band systems, such as Wi-Fi. A mathematical model describing the proposed system is developed and the generation of UWB signals with different modulation formats is demonstrated via computer simulations.

Mobile health care operations and return on investment in predominantly underserved children with asthma: the breathmobile program.

PubMed

Morphew, Tricia; Scott, Lyne; Li, Marilyn; Galant, Stanley P; Wong, Webster; Garcia Lloret, Maria I; Jones, Felita; Bollinger, Mary Elizabeth; Jones, Craig A

2013-08-01

Underserved populations have limited access to care. Improved access to effective asthma care potentially improves quality of life and reduces costs associated with emergency department (ED) visits. The purpose of this study is to examine return on investment (ROI) for the Breathmobile Program in terms of improved patient quality-adjusted life years saved and reduced costs attributed to preventable ED visits for 2010, with extrapolation to previous years of operation. It also examines cost-benefit related to reduced morbidity (ED visits, hospitalizations, and school absenteeism) for new patients to the Breathmobile Program during 2008-2009 who engaged in care (≥3 visits). This is a retrospective analysis of data for 15,986 pediatric patients, covering 88,865 visits, participating in 4 Southern California Breathmobile Programs (November 16, 1995-December 31, 2010). The ROI calculation expressed the cost-benefit ratio as the net benefits (ED costs avoided+relative value of quality-adjusted life years saved) over the per annum program costs (∼$500,000 per mobile). The ROI across the 4 California programs in 2010 was $6.73 per dollar invested. Annual estimated emergency costs avoided in the 4 regions were $2,541,639. The relative value of quality-adjusted life years saved was $24,381,000. For patients new to the Breathmobile Program during 2008-2009 who engaged in care (≥3 visits), total annual morbidity costs avoided per patient were $1395. This study suggests that mobile health care is a cost-effective strategy to deliver medical care to underserved populations, consistent with the Triple Aims of Therapy.

[Contrast-enhanced ultrasound for the characterization of incidental liver lesions - an economical evaluation in comparison with multi-phase computed tomography].

PubMed

Giesel, F L; Delorme, S; Sibbel, R; Kauczor, H-U; Krix, M

2009-06-01

The aim of the study was to conduct a cost-minimization analysis of contrast-enhanced ultrasound (CEUS) compared to multi-phase computed tomography (M-CT) as the diagnostic standard for diagnosing incidental liver lesions. Different scenarios of a cost-covering realization of CEUS in the ambulant sector in the general health insurance system of Germany were compared to the current cost situation. The absolute savings potential was estimated using different approaches for the calculation of the incidence of liver lesions which require further characterization. CEUS was the more cost-effective method in all scenarios in which CEUS examinations where performed at specialized centers (122.18-186.53 euro) compared to M-CT (223.19 euro). With about 40 000 relevant liver lesions per year, systematic implementation of CEUS would result in a cost savings of 4 m euro per year. However, the scenario of a cost-covering CEUS examination for all physicians who perform liver ultrasound would be the most cost-intensive approach (e. g., 407.87 euro at an average utilization of the ultrasound machine of 25 %, and a CEUS ratio of 5 %). A cost-covering realization of the CEUS method can result in cost savings in the German healthcare system. A centralized approach as proposed by the DEGUM should be targeted.

Cost and benefit estimates of partially-automated vehicle collision avoidance technologies.

PubMed

Harper, Corey D; Hendrickson, Chris T; Samaras, Constantine

2016-10-01

Many light-duty vehicle crashes occur due to human error and distracted driving. Partially-automated crash avoidance features offer the potential to reduce the frequency and severity of vehicle crashes that occur due to distracted driving and/or human error by assisting in maintaining control of the vehicle or issuing alerts if a potentially dangerous situation is detected. This paper evaluates the benefits and costs of fleet-wide deployment of blind spot monitoring, lane departure warning, and forward collision warning crash avoidance systems within the US light-duty vehicle fleet. The three crash avoidance technologies could collectively prevent or reduce the severity of as many as 1.3 million U.S. crashes a year including 133,000 injury crashes and 10,100 fatal crashes. For this paper we made two estimates of potential benefits in the United States: (1) the upper bound fleet-wide technology diffusion benefits by assuming all relevant crashes are avoided and (2) the lower bound fleet-wide benefits of the three technologies based on observed insurance data. The latter represents a lower bound as technology is improved over time and cost reduced with scale economies and technology improvement. All three technologies could collectively provide a lower bound annual benefit of about $18 billion if equipped on all light-duty vehicles. With 2015 pricing of safety options, the total annual costs to equip all light-duty vehicles with the three technologies would be about $13 billion, resulting in an annual net benefit of about $4 billion or a $20 per vehicle net benefit. By assuming all relevant crashes are avoided, the total upper bound annual net benefit from all three technologies combined is about $202 billion or an $861 per vehicle net benefit, at current technology costs. The technologies we are exploring in this paper represent an early form of vehicle automation and a positive net benefit suggests the fleet-wide adoption of these technologies would be beneficial from an economic and social perspective. Copyright © 2016 Elsevier Ltd. All rights reserved.

Vaccination against herpes zoster and postherpetic neuralgia in France: a cost-effectiveness analysis.

PubMed

Bresse, Xavier; Annemans, Lieven; Préaud, Emmanuelle; Bloch, Karine; Duru, Gérard; Gauthier, Aline

2013-06-01

This study assesses the cost-effectiveness of vaccination against herpes zoster (HZ) and postherpetic neuralgia in France, using a published Markov model. The cost-effectiveness of vaccinating individuals aged from 65 years or between 70 and 79 years was evaluated over their lifetime, from a third-party payer perspective. French-specific data were combined with results from clinical studies and international quality-of-life-based (EuroQol five-dimension questionnaire) utilities from the literature. HZ vaccination was highly cost effective in both populations. Incremental cost-effective ratios were estimated between €9513 and 12,304 per quality-adjusted life year gained, corresponding to €2240-2651 per HZ case avoided and €3539-4395 per postherpetic neuralgia case avoided. In addition to epidemiological and clinical evidence, economic evidence also supports the implementation of HZ vaccination in France.

Economic costs of low safety belt usage in motor vehicle crashes in Kentucky.

DOT National Transportation Integrated Search

2005-10-01

By passing legislation in 2006 to mandate primary enforcement of the Kentucky state law requiring safety belt use for motor vehicle occupants, the state could expect to realize an overall savings of at least $118 million in direct medical costs over ...

The cost-effectiveness of beta-radiation therapy for treatment of in-stent restenosis: an analysis at 290-day follow-up.

PubMed

Beusterien, Kathleen M; Plante, Kathryn M; Waksman, Ron; Raizner, Albert E; Annis, Marijke; Goss, Thomas F

2002-01-01

We studied the cost-effectiveness of percutaneous coronary intervention (PCI) plus beta-radiation (Radiotherapy) vs. PCI alone for treating in-stent restenosis. We analyzed medical resource data collected at US sites during the Intimal Hyperplasia Inhibition with beta In-stent Trial (INHIBIT) to compare the incremental costs between Radiotherapy and PCI alone for each repeat target lesion revascularization (TLR) avoided. Costs were assigned for cardiac-related medical services using the Medicare payer perspective. Radiotherapy increased initial inpatient costs by US$3360 (P<.001). In the Radiotherapy and PCI alone groups, the mean per-patient rates for TLR were 0.13 vs. 0.30 (P=.001), and mean per-patient total costs were US$19,286 vs. US$18,349 (P<.001), respectively. The incremental cost of Radiotherapy relative to PCI alone was US$5512 per TLR avoided, which compares favorably to the observed mean per-patient cost of treating restenosis (US$16,852). beta-radiation is a cost-effective adjunct to PCI in treating patients with in-stent restenosis.

Cost savings from a telemedicine model of care in northern Queensland, Australia.

PubMed

Thaker, Darshit A; Monypenny, Richard; Olver, Ian; Sabesan, Sabe

2013-09-16

To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. Retrospective cost-savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of $442 276. The cost for project establishment was $36 000, equipment/maintenance was $143 271, and staff was $261 520. The estimated travel expense avoided was $762 394; this figure included the costs of travel for patients and escorts of $658 760, aeromedical retrievals of $52 400 and travel for specialists of $47 634, as well as an estimate of accommodation costs for a proportion of patients of $3600. This resulted in a net saving of $320 118. Costs would have to increase by 72% to negate the savings. The teleoncology model of care at the TCC resulted in net savings, mainly due to avoidance of travel costs. Such savings could be redirected to enhancing rural resources and service capabilities. This teleoncology model is applicable to geographically distant areas requiring lengthy travel.

Allergen avoidance.

PubMed

Woodcock, A; Custovic, A

2000-12-09

Allergen exposure is a risk factor for sensitisation, prevalence and severity of allergic disease. Effective allergen avoidance strategies have been devised. The cost-benefit in public health terms should be established by prospective controlled studies that are under way around the world.

Evidence for frequent incest in a cooperatively breeding mammal.

PubMed

Nichols, H J; Cant, M A; Hoffman, J I; Sanderson, J L

2014-12-01

As breeding between relatives often results in inbreeding depression, inbreeding avoidance is widespread in the animal kingdom. However, inbreeding avoidance may entail fitness costs. For example, dispersal away from relatives may reduce survival. How these conflicting selection pressures are resolved is challenging to investigate, but theoretical models predict that inbreeding should occur frequently in some systems. Despite this, few studies have found evidence of regular incest in mammals, even in social species where relatives are spatio-temporally clustered and opportunities for inbreeding frequently arise. We used genetic parentage assignments together with relatedness data to quantify inbreeding rates in a wild population of banded mongooses, a cooperatively breeding carnivore. We show that females regularly conceive to close relatives, including fathers and brothers. We suggest that the costs of inbreeding avoidance may sometimes outweigh the benefits, even in cooperatively breeding species where strong within-group incest avoidance is considered to be the norm.

Evidence for frequent incest in a cooperatively breeding mammal

PubMed Central

Nichols, H. J.; Cant, M. A.; Hoffman, J. I.; Sanderson, J. L.

2014-01-01

As breeding between relatives often results in inbreeding depression, inbreeding avoidance is widespread in the animal kingdom. However, inbreeding avoidance may entail fitness costs. For example, dispersal away from relatives may reduce survival. How these conflicting selection pressures are resolved is challenging to investigate, but theoretical models predict that inbreeding should occur frequently in some systems. Despite this, few studies have found evidence of regular incest in mammals, even in social species where relatives are spatio-temporally clustered and opportunities for inbreeding frequently arise. We used genetic parentage assignments together with relatedness data to quantify inbreeding rates in a wild population of banded mongooses, a cooperatively breeding carnivore. We show that females regularly conceive to close relatives, including fathers and brothers. We suggest that the costs of inbreeding avoidance may sometimes outweigh the benefits, even in cooperatively breeding species where strong within-group incest avoidance is considered to be the norm. PMID:25540153

Fear of feces? Trade-offs between disease risk and foraging drive animal activity around raccoon latrines

USGS Publications Warehouse

Weinstein, Sara B.; Moura, Chad W.; Mendez, Jon Francis; Lafferty, Kevin D.

2017-01-01

Fear of predation alters prey behavior, which can indirectly alter entire landscapes. A parasite-induced ecology of fear might also exist if animals avoid parasite-contaminated resources when infection costs outweigh foraging benefits. To investigate whether animals avoid parasite contaminated sites, and if such avoidance balances disease costs and foraging gains, we monitored animal behavior at raccoon latrines – sites that concentrate both seeds and pathogenic parasite eggs. Using wildlife cameras, we documented over 40 potentially susceptible vertebrate species in latrines and adjacent habitat. Latrine contact rates reflected background activity, diet preferences and disease risk. Disease-tolerant raccoons and rats displayed significant site attraction, while susceptible birds and small mammals avoided these high-risk sites. This suggests that parasites, like predators, might create a landscape of fear for vulnerable hosts. Such non-consumptive parasite effects could alter disease transmission, population dynamics, and even ecosystem structure.

Military Hybrid Vehicle Survey

DTIC Science & Technology

2011-08-03

III Composite 4.3% Integrated starter generator for engine shut down, regenerative braking and avoidance of inefficient engine operation [28]. FMTV...eliminating the inefficiencies associated with idling, vehicle braking and low engine speed part load efficiency, many improvements can be realized...literature. They can be divided into the following two categories : (1) Time dependent speed profiles, shown in Figure 4, usually defined by the federal

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

No evidence for inbreeding avoidance in a natural population of song sparrows (Melospiza melodia).

PubMed

Keller, L F; Arcese, P

1998-09-01

We studied mate choice and inbreeding avoidance a natural population of song sparrows (Melospiza melodia) on Mandarte Island, Canada. Inbreeding occurred regularly: 59% all matings were between known relatives. We tested for inbreeding avoidance by comparing the observed levels of inbreeding to those expected if mate choice had been random with respect to relatedness. Independent of our assumptions about the availability of mates in the random mating model, we found that the expected and observed distributions of inbreeding coefficients were similar, as was the expected and observed frequency of close (f >/= 0.125) inbreeding. Furthermore, there was no difference in relatedness observed pairs and those that would have resulted had birds mated instead with their nearest neighbors. The only evidence to suggest any inbreeding avoidance was a reduced rate of parent-offspring matings as compared to one random mating model but not the other. Hence, despite substantial inbreeding depression in this population, we found little evidence for inbreeding avoidance through mate choice. We present a simple model to suggest that variation in inbreeding avoidance behaviors in birds may arise from differences in survival rates: in species with low survival rates, the costs of forfeiting matings to avoid inbreeding may exceed the costs of inbreeding.

Evolution of Inbreeding Avoidance and Inbreeding Preference through Mate Choice among Interacting Relatives.

PubMed

Duthie, A Bradley; Reid, Jane M

2016-12-01

While extensive population genetic theory predicts conditions favoring evolution of self-fertilization versus outcrossing, there is no analogous theory that predicts conditions favoring evolution of inbreeding avoidance or inbreeding preference enacted through mate choice given obligate biparental reproduction. Multiple interacting processes complicate the dynamics of alleles underlying such inbreeding strategies, including sexual conflict, distributions of kinship, genetic drift, purging of mutation load, direct costs, and restricted kin discrimination. We incorporated these processes into an individual-based model to predict conditions where selection should increase or decrease frequencies of alleles causing inbreeding avoidance or inbreeding preference when females or males controlled mating. Selection for inbreeding avoidance occurred given strong inbreeding depression when either sex chose mates, while selection for inbreeding preference occurred given very weak inbreeding depression when females chose but never occurred when males chose. Selection for both strategies was constrained by direct costs and restricted kin discrimination. Purging was negligible, but allele frequencies were strongly affected by drift in small populations, while selection for inbreeding avoidance was weak in larger populations because inbreeding risk decreased. Therefore, while selection sometimes favored alleles underlying inbreeding avoidance or preference, evolution of such strategies may be much more restricted and stochastic than is commonly presumed.

Sovereign cat bonds and infrastructure project financing.

PubMed

Croson, David; Richter, Andreas

2003-06-01

We examine the opportunities for using catastrophe-linked securities (or equivalent forms of nondebt contingent capital) to reduce the total costs of funding infrastructure projects in emerging economies. Our objective is to elaborate on methods to reduce the necessity for unanticipated (emergency) project funding immediately after a natural disaster. We also place the existing explanations of sovereign-level contingent capital into a catastrophic risk management framework. In doing so, we address the following questions. (1) Why might catastrophe-linked securities be useful to a sovereign nation, over and above their usefulness for insurers and reinsurers? (2) Why are such financial instruments ideally suited for protecting infrastructure projects in emerging economies, under third-party sponsorship, from low-probability, high-consequence events that occur as a result of natural disasters? (3) How can the willingness to pay of a sovereign government in an emerging economy (or its external project sponsor), who values timely completion of infrastructure projects, for such instruments be calculated? To supplement our treatment of these questions, we use a multilayer spreadsheet-based model (in Microsoft Excel format) to calculate the overall cost reductions possible through the judicious use of catastrophe-based financial tools. We also report on numerical comparative statics on the value of contingent-capital financing to avoid project disruption based on varying costs of capital, probability and consequences of disasters, the feasibility of strategies for mid-stage project abandonment, and the timing of capital commitments to the infrastructure investment. We use these results to identify high-priority applications of catastrophe-linked securities so that maximal protection can be realized if the total number of catastrophe instruments is initially limited. The article concludes with potential extensions to our model and opportunities for future research.

Predicting Avoidance of Skin Damage Feedback among College Students

PubMed Central

Dwyer, Laura A.; Shepperd, James A.; Stock, Michelle L.

2015-01-01

Background Showing people a personal ultraviolet (UV) photograph depicting skin damage can be an effective method for changing sun protection cognitions and behaviors. Purpose We examined whether people opt not to see their UV photograph if given a choice. We also examined predictors of avoidance of skin damage feedback. Methods College students (N = 257) completed questionnaires, viewed example UV photographs, and received the opportunity to see a UV photograph of their face. Results Over one-third of participants opted not to see their UV photograph. Greater perceived risk of sun damage and having fewer coping resources corresponded with greater avoidance, particularly among participants who reported infrequent sun protection behavior. Conclusion The health benefits of UV photography are realized only if people are willing to view the photograph. Our findings suggest the need for interventions that increase receptivity to viewing one’s UV photograph. PMID:25894276

77 FR 12590 - Winchester Industries; Analysis of Proposed Consent Order To Aid Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... homeowners can realize by replacing their windows, including the home's geographic location, size, insulation... insulation in a specific region). The performance standard imposed under this Part constitutes fencing-in... costs, heating and cooling costs, U-factor, solar heat gain coefficient, R-value, K-value, insulating...

Recalculating the Economic Cost of Suicide

ERIC Educational Resources Information Center

Yang, Bijou; Lester, David

2007-01-01

These authors argue that estimates of the net economic cost of suicide should go beyond accounting for direct medical costs and indirect costs from loss of earnings by those who commit suicide. There are potential savings from (a) not having to treat the depressive and other psychiatric disorders of those who kill themselves; (b) avoidance of…

Financial Impact of Direct-Acting Oral Anticoagulants in Medicaid: Budgetary Assessment Based on Number Needed to Treat.

PubMed

Fairman, Kathleen A; Davis, Lindsay E; Kruse, Courtney R; Sclar, David A

2017-04-01

Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT). Medicaid utilization files, 2009 through second quarter 2015, were used to estimate OAC cost accounting for generic/brand statutory minimum (13/23%) and assumed maximum (13/50%) manufacturer rebates. NNTs were calculated from clinical trial reports to estimate avoided medical events for a hypothetical population of 500,000 enrollees (approximate NVAF prevalence × Medicaid enrollment) under two DOAC market share scenarios: 2015 actual and 50% increase. Medical service costs were based on published sources. Costs were inflation-adjusted (2015 US$). From 2009-2015, OAC reimbursement per claim increased by 173 and 279% under maximum and minimum rebate scenarios, respectively, while DOAC market share increased from 0 to 21%. Compared with a warfarin-only counterfactual, counts of ischemic strokes, intracranial hemorrhages, and systemic embolisms declined by 36, 280, and 111, respectively; counts of gastrointestinal hemorrhages increased by 794. Avoided events and reduced monitoring, respectively, offset 3-5% and 15-24% of increased drug cost. Net of offsets, DOAC-related cost increases were US$258-US$464 per patient per year (PPPY) in 2015 and US$309-US$579 PPPY after market share increase. Avoided medical events offset a small portion of DOAC-related drug cost increase. NNT-based calculations provide a transparent source of budgetary-impact information for new medications.

Cost-Effectiveness Analysis of Nasal Continuous Positive Airway Pressure Versus Nasal High Flow Therapy as Primary Support for Infants Born Preterm.

PubMed

Huang, Li; Roberts, Calum T; Manley, Brett J; Owen, Louise S; Davis, Peter G; Dalziel, Kim M

2018-05-01

To compare the cost-effectiveness of 2 common "noninvasive" modes of respiratory support for infants born preterm. An economic evaluation was conducted as a component of a multicenter, randomized control trial from 2013 to 2015 enrolling infants born preterm at ≥28 weeks of gestation with respiratory distress, <24 hours old, who had not previously received endotracheal intubation and mechanical ventilation or surfactant. The economic evaluation was conducted from a healthcare sector perspective and the time horizon was from birth until death or first discharge. The cost-effectiveness of continuous positive airway pressure (CPAP) vs high-flow with "rescue" CPAP backup and high-flow without rescue CPAP backup (as sole primary support) were analyzed by using the hospital cost of inpatient stay in a tertiary center and the rates of endotracheal intubation and mechanical ventilation during admission. Hospital inpatient cost records for 435 infants enrolled in all Australian centers were obtained. With "rescue" CPAP backup, an incremental cost-effectiveness ratio was estimated of A$179 000 (US$123 000) per ventilation avoided if CPAP was used compared with high flow. Without rescue CPAP backup, cost per ventilation avoided was A$7000 (US$4800) if CPAP was used compared with high flow. As sole primary support, CPAP is highly likely to be cost-effective compared with high flow. Neonatal units choosing to use only one device should apply CPAP as primary respiratory support. Compared with high-flow with rescue CPAP backup, CPAP is unlikely to be cost-effective if willingness to pay per ventilation avoided is less than A$179 000 (US$123 000). Copyright © 2018 Elsevier Inc. All rights reserved.

A Budget Impact Model of Hemophilia Bypassing Agent Prophylaxis Relative to Recombinant Factor VIIa On-Demand.

PubMed

Mehta, Darshan A; Oladapo, Abiola O; Epstein, Joshua D; Novack, Aaron R; Neufeld, Ellis J; Hay, Joel W

2016-02-01

Hemophilia patients use factor-clotting concentrates (factor VIII for hemophilia A and factor IX for hemophilia B) for improved blood clotting. These products are used to prevent or stop bleeding episodes. However, some hemophilia patients develop inhibitors (i.e., the patient's immune system develops antibodies against these factor concentrates). Hence, these patients do not respond well to the factor concentrates. A majority of hemophilia patients with inhibitors are managed on-demand with the following bypassing agents: recombinant factor VIIa (rFVIIa) and activated prothrombin complex concentrate (aPCC). The recently published U.S. registries Dosing Observational Study in Hemophilia (DOSE) and Hemostasis and Thrombosis Research Society (HTRS) reported higher rFVIIa on-demand use for bleed management than previously described. To estimate aPCC and rFVIIa prophylaxis costs relative to rFVIIa on-demand treatment cost based on rFVIIa doses reported in U.S. registries. A literature-based cost model was developed assuming a base case on-demand annual bleed rate (ABR) of 28.7 per inhibitor patient, which was taken from a randomized phase 3 clinical trial. The doses for rFVIIa on-demand were taken from the median dose per bleed reported by the DOSE and HTRS registries. Model inputs for aPCC and rFVIIa prophylaxis (i.e., dosing and efficacy) were derived from respective randomized clinical trials. Cost analysis was from the U.S. payer perspective, and only direct drug costs were considered. The drug cost was based on the Medicare Part B 2014 average sale price (ASP). Two-way sensitivity and threshold analyses were performed by simultaneously varying on-demand ABR, prophylaxis efficacy, and unit drug cost. In addition to studying relative costs associated with on-demand and prophylaxis treatments, relative cost per bleeding episode avoided were also calculated for aPCC and rFVIIa prophylaxis treatments. The prophylaxis efficacy reported in the trials were used to determine the number of bleeding episodes avoided. Based on the median on-demand dose of 695 mcg per kg per bleed, reported by the DOSE registry, the annual rFVIIa on-demand cost was $34,009 per kg of body weight. The annual rFVIIa on-demand cost was $22,020 per kg of body weight when the median dose of 450 mcg per kg per bleed reported by the HTRS registry was considered. The annual cost rose to $38,461 per kg of body weight when the rFVIIa on-demand dose of 786 mcg per kg per bleed among patients infusing an initial dose ≥ 250 mcg per kg was considered. The aPCC (85 units per kg per every other day) and rFVIIa (90 mcg per kg per every day) annual prophylaxis costs were $26,536 and $60,700, respectively. Also, aPCC and rFVIIa prophyaxis treatments were estimated to prevent a total of 20.8 and 12.9 annual bleeding episodes, respectively. When compared with the on-demand dose of 695 mcg per kg per bleed (DOSE registry), the annual aPCC and rFVIIa prophylaxis costs were 21.9% lower and 78.4% higher, respectively. Additionally, aPCC prophylaxis saved $360 per kg for each bleeding episode avoided. rFVIIa prophylaxis cost $2,066 per kg for each bleeding episode avoided. Compared with the on-demand dose of 450 mcg per kg per bleed (HTRS registry), aPCC and rFVIIa prophylaxis costs were 20.5% and 174.9% higher, respectively. In this case, aPCC and rFVIIa prophylaxis treatment costs were $217 per kg and $2,995 per kg, respectively, for each bleeding episode avoided. aPCC and rFVIIa prophylaxis costs were 31.0% lower and 57.8% higher, respectively, when compared with the rFVIIa on-demand dose of 786 mcg per kg per bleed, among patients infusing an initial dose ≥ 250 mcg per kg (HTRS registry). In this case, aPCC prophylaxis saved $573 per kg for each bleeding episode avoided, while rFVIIa prophylaxis costs $1,724 per kg for each bleeding episode avoided. Results of the 2-way sensitivity analyses were robust in the majority of the scenarios considered. aPCC prophylaxis may be cost saving for managing hemophilia patients with inhibitors who bleed frequently and infuse significant quantities of rFVIIa on-demand.

Clinical pharmacy travel medicine services: a new frontier.

PubMed

Jackson, Adam B; Humphries, Tammy L; Nelson, Kent M; Helling, Dennis K

2004-12-01

Travel to remote destinations has increased dramatically in recent years. The Clinical Pharmacy International Travel Clinic (CPITC) was established in 1991 in the Kaiser Permanente Colorado Region to provide pre-travel advice to members to decrease their risk of travel-related diseases. The CPITC is unique from other travel medicine clinics because it is a pharmacist-run telepharmacy service. The team includes an infectious diseases physician, an infectious diseases clinical pharmacy specialist, 4 clinical pharmacists, and a pharmacy technician. The clinical pharmacists provide consultations via telephone. Both patient- and trip-related information are gathered to assess the traveler's health risks. Recommendations are provided regarding food- and water-borne diseases, insect-borne diseases, sexually transmitted diseases, and diseases related to animal bites. Additionally, detailed information is provided on vaccines that may be needed to protect travelers against various diseases. The travel consult is documented electronically. A copy of the consult, along with a booklet that provides travel information, is mailed to the patient. Success of the CPITC is demonstrated in several ways. The clinic initially served Kaiser Permanente members in the Colorado Region. The service has expanded and now also provides travel consults to Kaiser Permanente members in the Northwest and Ohio Regions. Patient satisfaction is high, and significant cost-savings have been realized secondary to avoiding the use of unnecessary vaccinations and medications. The CPITC allows resources to be leveraged and provides one center where individuals trained in travel medicine provide information to members, thus improving efficiency and decreasing cost.

Arsenic and fluoride contaminated groundwaters: A review of current technologies for contaminants removal.

PubMed

Jadhav, Sachin V; Bringas, Eugenio; Yadav, Ganapati D; Rathod, Virendra K; Ortiz, Inmaculada; Marathe, Kumudini V

2015-10-01

Chronic contamination of groundwaters by both arsenic (As) and fluoride (F) is frequently observed around the world, which has severely affected millions of people. Fluoride and As are introduced into groundwaters by several sources such as water-rock interactions, anthropogenic activities, and groundwater recharge. Coexistence of these pollutants can have adverse effects due to synergistic and/or antagonistic mechanisms leading to uncertain and complicated health effects, including cancer. Many developing countries are beset with the problem of F and As laden waters, with no affordable technologies to provide clean water supply. The technologies available for the simultaneous removal are akin to chemical treatment, adsorption and membrane processes. However, the presence of competing ions such as phosphate, silicate, nitrate, chloride, carbonate, and sulfate affect the removal efficiency. Highly efficient, low-cost and sustainable technology which could be used by rural populations is of utmost importance for simultaneous removal of both pollutants. This can be realized by using readily available low cost materials coupled with proper disposal units. Synthesis of inexpensive and highly selective nanoadsorbents or nanofunctionalized membranes is required along with encapsulation units to isolate the toxicant loaded materials to avoid their re-entry in aquifers. A vast number of reviews have been published periodically on removal of As or F alone. However, there is a dearth of literature on the simultaneous removal of both. This review critically analyzes this important issue and considers strategies for their removal and safe disposal. Copyright © 2015 Elsevier Ltd. All rights reserved.

Medication Waste Reduction in Pediatric Pharmacy Batch Processes

PubMed Central

Veltri, Michael A.; Hamrock, Eric; Mollenkopf, Nicole L.; Holt, Kristen; Levin, Scott

2014-01-01

OBJECTIVES: To inform pediatric cart-fill batch scheduling for reductions in pharmaceutical waste using a case study and simulation analysis. METHODS: A pre and post intervention and simulation analysis was conducted during 3 months at a 205-bed children's center. An algorithm was developed to detect wasted medication based on time-stamped computerized provider order entry information. The algorithm was used to quantify pharmaceutical waste and associated costs for both preintervention (1 batch per day) and postintervention (3 batches per day) schedules. Further, simulation was used to systematically test 108 batch schedules outlining general characteristics that have an impact on the likelihood for waste. RESULTS: Switching from a 1-batch-per-day to a 3-batch-per-day schedule resulted in a 31.3% decrease in pharmaceutical waste (28.7% to 19.7%) and annual cost savings of $183,380. Simulation results demonstrate how increasing batch frequency facilitates a more just-in-time process that reduces waste. The most substantial gains are realized by shifting from a schedule of 1 batch per day to at least 2 batches per day. The simulation exhibits how waste reduction is also achievable by avoiding batch preparation during daily time periods where medication administration or medication discontinuations are frequent. Last, the simulation was used to show how reducing batch preparation time per batch provides some, albeit minimal, opportunity to decrease waste. CONCLUSIONS: The case study and simulation analysis demonstrate characteristics of batch scheduling that may support pediatric pharmacy managers in redesign toward minimizing pharmaceutical waste. PMID:25024671

Medication waste reduction in pediatric pharmacy batch processes.

PubMed

Toerper, Matthew F; Veltri, Michael A; Hamrock, Eric; Mollenkopf, Nicole L; Holt, Kristen; Levin, Scott

2014-04-01

To inform pediatric cart-fill batch scheduling for reductions in pharmaceutical waste using a case study and simulation analysis. A pre and post intervention and simulation analysis was conducted during 3 months at a 205-bed children's center. An algorithm was developed to detect wasted medication based on time-stamped computerized provider order entry information. The algorithm was used to quantify pharmaceutical waste and associated costs for both preintervention (1 batch per day) and postintervention (3 batches per day) schedules. Further, simulation was used to systematically test 108 batch schedules outlining general characteristics that have an impact on the likelihood for waste. Switching from a 1-batch-per-day to a 3-batch-per-day schedule resulted in a 31.3% decrease in pharmaceutical waste (28.7% to 19.7%) and annual cost savings of $183,380. Simulation results demonstrate how increasing batch frequency facilitates a more just-in-time process that reduces waste. The most substantial gains are realized by shifting from a schedule of 1 batch per day to at least 2 batches per day. The simulation exhibits how waste reduction is also achievable by avoiding batch preparation during daily time periods where medication administration or medication discontinuations are frequent. Last, the simulation was used to show how reducing batch preparation time per batch provides some, albeit minimal, opportunity to decrease waste. The case study and simulation analysis demonstrate characteristics of batch scheduling that may support pediatric pharmacy managers in redesign toward minimizing pharmaceutical waste.

Development of a module for Cost-Benefit analysis of risk reduction measures for natural hazards for the CHANGES-SDSS platform

NASA Astrophysics Data System (ADS)

Berlin, Julian; Bogaard, Thom; Van Westen, Cees; Bakker, Wim; Mostert, Eric; Dopheide, Emile

2014-05-01

Cost benefit analysis (CBA) is a well know method used widely for the assessment of investments either in the private and public sector. In the context of risk mitigation and the evaluation of risk reduction alternatives for natural hazards its use is very important to evaluate the effectiveness of such efforts in terms of avoided monetary losses. However the current method has some disadvantages related to the spatial distribution of the costs and benefits, the geographical distribution of the avoided damage and losses, the variation in areas that are benefited in terms of invested money and avoided monetary risk. Decision-makers are often interested in how the costs and benefits are distributed among different administrative units of a large area or region, so they will be able to compare and analyse the cost and benefits per administrative unit as a result of the implementation of the risk reduction projects. In this work we first examined the Cost benefit procedure for natural hazards, how the costs are assessed for several structural and non-structural risk reduction alternatives, we also examined the current problems of the method such as the inclusion of cultural and social considerations that are complex to monetize , the problem of discounting future values using a defined interest rate and the spatial distribution of cost and benefits. We also examined the additional benefits and the indirect costs associated with the implementation of the risk reduction alternatives such as the cost of having a ugly landscape (also called negative benefits). In the last part we examined the current tools and software used in natural hazards assessment with support to conduct CBA and we propose design considerations for the implementation of the CBA module for the CHANGES-SDSS Platform an initiative of the ongoing 7th Framework Programme "CHANGES of the European commission. Keywords: Risk management, Economics of risk mitigation, EU Flood Directive, resilience, prevention, cost benefit analysis, spatial distribution of costs and benefits

Health service costs and clinical gains of psychotherapy for personality disorders: a randomized controlled trial of day-hospital-based step-down treatment versus outpatient treatment at a specialist practice

PubMed Central

2013-01-01

Background Day-hospital-based treatment programmes have been recommended for poorly functioning patients with personality disorders (PD). However, more research is needed to confirm the cost-effectiveness of such extensive programmes over other, presumably simpler, treatment formats. Methods This study compared health service costs and psychosocial functioning for PD patients randomly allocated to either a day-hospital-based treatment programme combining individual and group psychotherapy in a step-down format, or outpatient individual psychotherapy at a specialist practice. It included 107 PD patients, 46% of whom had borderline PD, and 40% of whom had avoidant PD. Costs included the two treatment conditions and additional primary and secondary in- and outpatient services. Psychosocial functioning was assessed using measures of global (observer-rated GAF) and occupational (self-report) functioning. Repeated assessments over three years were analysed using mixed models. Results The costs of step-down treatment were higher than those of outpatient treatment, but these high costs were compensated by considerably lower costs of other health services. However, costs and clinical gains depended on the type of PD. For borderline PD patients, cost-effectiveness did not differ by treatment condition. Health service costs declined during the trial, and functioning improved to mild impairment levels (GAF > 60). For avoidant PD patients, considerable adjuvant health services expanded the outpatient format. Clinical improvements were nevertheless superior to the step-down condition. Conclusion Our results indicate that decisions on treatment format should differentiate between PD types. For borderline PD patients, the costs and gains of step-down and outpatient treatment conditions did not differ. For avoidant PD patients, the outpatient format was a better alternative, leaning, however, on costly additional health services in the early phase of treatment. Trial registration Clinical Trials NCT00378248 PMID:24268099

Quality improvement and cost reduction realized by a purchaser through diabetes disease management.

PubMed

Snyder, James W; Malaskovitz, Joyce; Griego, Janet; Persson, Jeffrey; Flatt, Kristy

2003-01-01

This report documents the clinical improvements and costs experienced by a purchaser after introduction of a diabetes disease management program. A purchaser contracted with American Healthways, a disease management organization, to initiate a diabetes disease management program called Diabetes Decisions. Started in 1998, the program grew to include 662 participants. The results reported are based on the continuously participating population (12 months of participation in the program for the reporting year). Participants were entered into American Healthways' clinical information system and risk-stratified, and an individualized treatment plan was devised. Outbound telephone calls by specially trained nurses were a key intervention. Data were collected on key process measures, financial parameters, and participant satisfaction. By year 3, there were 422 continuously participating participants. From baseline to the third year of the program, significant increases in frequency of A1C testing (21.3% to 82.2%), dilated retinal exams (17.2% to 70.7%), and performance of foot exams (2.0% to 75.6%) were noted. For 166 participants with five A1C determinations, A1C values dropped from 8.89% to 7.88%. Participants experienced a 36% drop in inpatient costs. Without adjustment for medical inflation, total medical costs decreased by 26.8% from the baseline period, dropping to $268.63 per diabetes participant per month (PDPPM) by year 3, a gross savings of $98.49 PDPPM. After subtracting the fees paid to Diabetes Decisions, a net savings of $986,538 was realized. This yielded a return on investment of 3.37. By investing in a diabetes disease management program, a purchaser was able to realize significant improvements in clinical care, substantial cost savings, and a favorable return on investment.

Collision avoidance system cost-benefit analysis : volume I - technical manual

DOT National Transportation Integrated Search

1981-09-01

Collision-avoidance systems under development in the U.S.A., Japan and Germany were evaluated. The performance evaluation showed that the signal processing and the control law of a system were the key parameters that decided the system's capability, ...

Levelized Cost and Levelized Avoided Cost of New Generation Resources in the Annual Energy Outlook

EIA Publications

2017-01-01

This paper presents average values of levelized costs for generating technologies entering service in 2019, 2022, and 2040 as represented in the National Energy Modeling System (NEMS) for the Annual Energy Outlook 2017 (AEO2017) Reference case.

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

Impact of stereotactic 11-g vacuum-assisted breast biopsy on cost of diagnosis in Austria.

PubMed

Gruber, R; Walter, E; Helbich, T H

2011-01-01

To determine the frequency with which stereotactic 11-g vacuum-assisted breast biopsy (11-g SVAB) obviates an open surgical biopsy (OSB), to compare the costs of these two biopsy methods, and to estimate the potential cost savings attributable to 11-g SVAB in the diagnosis of suspicious breast lesions in patients in Austria. We retrospectively reviewed 318 consecutive breast lesions of BI-RADS categories IV and V (microcalcifications n=166; masses n=152) on which 11-g SVAB and OSB were performed. Cost savings were calculated using nationally allowed flat rates and patient charges. Costs were measured from a hospital and a socioeconomic perspective. Common clinical scenarios and sensitivity analyses assessed the extent of achievable cost savings. 11-g SVAB obviated the need for an OSB in 93 (29%) of 318 women. Overall cost savings per 11-g SVAB over OSB were € 242 per case from a hospital perspective, and € 422 per case from a socioeconomic perspective. The use of 11-g SVAB decreased the cost of diagnosis by 7% from a hospital perspective, and by 10% from a socioeconomic perspective. In Austria, annual national savings of over 5 million Euro could be realized with the use of 11-g SVAB for the diagnosis of suspicious breast lesions. Although savings per case are modest, the national health care system realizes significant cost reduction as women benefit from a faster and less invasive approach to diagnosis. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Constrained trajectory optimization for kinematically redundant arms

NASA Technical Reports Server (NTRS)

Carignan, Craig R.; Tarrant, Janice M.

1990-01-01

Two velocity optimization schemes for resolving redundant joint configurations are compared. The Extended Moore-Penrose Technique minimizes the joint velocities and avoids obstacles indirectly by adjoining a cost gradient to the solution. A new method can incorporate inequality constraints directly to avoid obstacles and singularities in the workspace. A four-link arm example is used to illustrate singularity avoidance while tracking desired end-effector paths.

Cost-effectiveness analysis of early versus non-early intervention in acute migraine based on evidence from the 'Act when Mild' study.

PubMed

Slof, John

2012-05-01

In spite of the important progress made in the abortive treatment of acute migraine episodes since the introduction of triptans, reduction of pain and associated symptoms is in many cases still not as effective nor as fast as would be desirable. Recent research pays more attention to the timing of the treatment, and taking triptans early in the course of an attack when pain is still mild has been found more efficacious than the usual strategy of waiting for the attack to develop to a higher pain intensity level. To investigate the cost effectiveness of early versus non-early intervention with almotriptan in acute migraine. An economic evaluation was conducted from the perspectives of French society and the French public health system based on patient-level data collected in the AwM (Act when Mild) study, a placebo-controlled trial that compared the response to early and non-early treatment of acute migraine with almotriptan. Incremental cost-effectiveness ratios (ICERs) were determined in terms of QALYs, migraine hours and productive time lost. Costs were expressed in Euros (year 2010 values). Bootstrapping was used to derive cost-effectiveness acceptability curves. Early treatment has shown to lead to shorter attack duration, less productive time lost, better quality of life, and is, with 92% probability, overall cost saving from a societal point of view. In terms of drug costs only, however, non-early treatment is less expensive. From the public health system perspective, the (bootstrap) mean ICER of early treatment amounts to €0.38 per migraine hour avoided, €1.29 per hour of productive time lost avoided, and €14,296 per QALY gained. Considering willingness-to-pay values of approximately €1 to avoid an hour of migraine, €10 to avoid the loss of a productive hour, or €30,000 to gain one QALY, the approximate probability that early treatment is cost effective is 90%, 90% and 70%, respectively. These results remain robust in different scenarios for the major elements of the economic evaluation. Compared with non-early treatment, a strategy of early treatment of acute migraine with almotriptan when pain is still mild is, with high probability, cost saving from the French societal perspective and can be considered cost effective from the public health system point of view.

Impact of pharmacist interventions on cost avoidance in an ambulatory cancer center.

PubMed

Randolph, Laura A; Walker, Cheri K; Nguyen, Ann T; Zachariah, Subi R

2018-01-01

Objective To provide a foundation to justify the presence of a full-time clinical pharmacist in the ambulatory cancer center in addition to an existing centralized pharmacist through cost avoidance calculation and patient and staff satisfaction surveys. Methods The prospective, pilot study took place in an ambulatory cancer center over four weeks in 2014. Cost avoidance values were assigned to interventions performed by a pharmacy resident, who was present in the ambulatory cancer center during clinic hours, along with a centralized oncology pharmacist routinely working with the cancer center. Anonymous patient and staff satisfaction surveys based on a 5-point Likert scale were distributed to assess the perceived benefit of a pharmacist located in the ambulatory cancer center. Results Data collection took place over approximately one month. After evaluation of 962 interventions from both pharmacists, the estimated cost avoidance was US$282,741 per pharmacist per year, yielding a net benefit of US$138,441. The most common interventions made by the resident included chemotherapy regimen review (n = 290, 69%) and patient counseling (n = 102, 24%), while the majority of the centralized pharmacist's interventions was chemotherapy regimen review (n = 525, 97%). Results from the anonymous patient and staff surveys revealed an overall positive perception of the pharmacy resident while in the ambulatory cancer center. Conclusion A full-time clinical pharmacist in an ambulatory cancer center is both financially beneficial and positively perceived by patients and staff.

Avoided electricity subsidy payments can finance substantial appliance efficiency incentive programs: Case study of Mexico

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

Leventis, Greg; Gopal, Anand; Rue du Can, Stephane de la

Numerous countries use taxpayer funds to subsidize residential electricity for a variety of socioeconomic objectives. These subsidies lower the value of energy efficiency to the consumer while raising it for the government. Further, while it would be especially helpful to have stringent Minimum Energy Performance Standards (MEPS) for appliances and buildings in this environment, they are hard to strengthen without imposing a cost on ratepayers. In this secondbest world, where the presence of subsidies limits the government’s ability to strengthen standards, we find that avoided subsidies are a readily available source of financing for energy efficiency incentive programs. Here, wemore » introduce the LBNL Energy Efficiency Revenue Analysis (LEERA) model to estimate the appliance efficiency improvements that can be achieved in Mexico by the revenue neutral financing of incentive programs from avoided subsidy payments. LEERA uses the detailed techno-economic analysis developed by LBNL for the Super-efficient Equipment and Appliance Deployment (SEAD) Initiative to calculate the incremental costs of appliance efficiency improvements. We analyze Mexico’s tariff structures and the long-run marginal cost of supply to calculate the marginal savings for the government from appliance efficiency. We find that avoided subsidy payments alone can finance incentive programs that cover the full incremental cost of refrigerators that are 27% more efficient and TVs that are 32% more efficient than baseline models. We find less substantial market transformation potential for room ACs primarily because AC energy savings occur at less subsidized tariffs.« less

ITOS/space shuttle study

NASA Technical Reports Server (NTRS)

1971-01-01

The results are reported of a study to explore the potential cost reductions in the operational ITOS weather satellite program as a consequence of shuttle/bug availability for satellite placement and retrieval, and satellite servicing and maintenance. The study program was divided into shuttle impact on equipment and testing costs, and shuttle impact on overall future ITOS operational program costs, and shuttle impact on configuration. It is concluded that savings in recurring spacecraft costs can be realized in the 1978 ITOS program, if a space shuttle is utilized.

Identifying the Factors That Facilitate or Hinder Advance Planning by Persons With Dementia

PubMed Central

Hirschman, Karen B.; Kapo, Jennifer M.; Karlawish, Jason H. T.

2009-01-01

We performed semistructured interviews with 30 family members of patients with advanced dementia to identify the factors that facilitate or hinder advance planning by persons with dementia. All interviews were analyzed using qualitative data analysis techniques. The majority (77%) of family members reported that their relative had some form of written advance directive, and at least half reported previous discussions about health care preferences (57%), living situation or placement issues (50%), and finances or estate planning (60%) with the patient. Family members reported some themes that prompted planning and others that were barriers to planning. Events that most often triggered planning were medical, living situation, or financial issues associated with a friend or family member of the patient (57%). Barriers to planning included both passive and active avoidance. The most common form of passive avoidance was not realizing the importance of planning until it was too late to have the discussion (63%). The most common form of active avoidance was avoiding the discussion (53%). These data suggest potentially remediable strategies to address barriers to advance planning discussions. PMID:18580595

The New LMK Primary Standard for Dew-Point Sensor Calibration: Evaluation of the High-Range Saturator Efficiency

NASA Astrophysics Data System (ADS)

Hudoklin, Domen; Drnovšek, Janko

2008-10-01

In the field of hygrometry, a primary dew-point standard can be realized according to several proven principles, such as single-pressure (1-P), two-pressure (2-P), or divided flow. Different realizations have been introduced by various national laboratories, each resulting in a stand-alone complex generation system. Recent trends in generator design favor the single-pressure principle without recirculation because it promises theoretically lower uncertainty and because it avoids problems regarding the leak tightness of the recirculation. Instead of recirculation, the efficiency of saturation, the key factor, is increased by preconditioning the inlet gas entering the saturator. For preconditioning, a presaturator or purifier is used to bring the dew point of the inlet stream close to the saturator temperature. The purpose of the paper is to identify the minimum requirements for the preconditioning system and the main saturator to assure efficient saturation for the LMK generator. Moreover, the aim is also to find out if the preconditioning system can be avoided despite the rather simple construction of the main saturator. If this proves to be the case, the generator design can be simplified while maintaining an accurate value of the generated dew point. Experiments were carried out within the scope of improving our existing primary generator in the above-ambient dew-point range up to +70°C. These results show the generated dew point is within the measurement uncertainty for any dew-point value of the inlet gas. Thus, the preconditioning subsystem can be avoided, which leads to a simplified generator design.

Hospital cost accounting: implementing the system successfully.

PubMed

Burik, D; Duvall, T J

1985-05-01

To successfully implement a cost accounting system, certain key steps should be undertaken. These steps include developing and installing software; developing cost center budgets and inter-cost center allocations; developing service item standard costs; generating cost center level and patient level standard cost reports and reconciling these costs to actual costs; generating product line profitability reports and reconciling these reports to the financial statements; and providing ad hoc reporting capabilities. By following these steps, potential problems in the implementation process can be anticipated and avoided.

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

Pierrehumbert, Raymond

There are a number of crises that a potentially habitable planet must avoid or surmount if its potential is to be realized. These include the runaway greenhouse, loss of atmosphere by chemical or physical processes, and long-lasting global glaciation. In this lecture I will present research on the climate dynamics governing such processes, with particular emphasis on the lessons to be learned from the cases of Early Mars and the Neoproterozoic Snowball Earth.

26 CFR 1.1248-1 - Treatment of gain from certain sales or exchanges of stock in certain foreign corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for Determining Capital Gains and Losses § 1.1248-1 Treatment of gain from certain sales or exchanges... purposes the avoidance of Federal income taxes, then no amount is includible in the gross income of such... redemption of stock to pay death taxes) applies; (2) Gain realized on exchanges to which section 356...

Defense AT&L (Volume 35, Number 6, November-December 2006)

DTIC Science & Technology

2006-12-01

our view of reality is inherently unstable. That is, when we realize our current cultural preferences, frame- works, mental models , doctrines...manufacturing rules and procedures (con- trols). IDEF0 function modeling has since been adopted for other applications such as business process... negotiating busy intersections, and avoiding obstacles. The DARPA Grand Challenge Web site <http://www.darpa.mil/grandchallenge>is the primary resource for

Comparing outcomes and costs between contingent and combined first-trimester screening strategies for Down's syndrome.

PubMed

Martín, I; Gibert, M J; Aulesa, C; Alsina, M; Casals, E; Bauça, J M

2015-06-01

To compare a contingent strategy with a combined strategy for prenatal detection of Down's syndrome (DS) in terms of cost, outcomes and safety. The contingent strategy was based on a simulation, removing measurement of the free beta subunit of human chorionic gonadotropin (free βhCG) and calculating the DS risk retrospectively in 32,371 pregnant women who had been screened with the combined strategy in the first trimester. In the contingent strategy, a risk between 1:31 and 1:1000 in the first trimester indicated further testing in the second trimester (alpha-fetoprotein, inhibin A, unconjugated oestriol and free βhCG). The cut-off risk values for the contingent and combined strategies in the first trimester were 1:30 and 1:250, respectively, and the cut-off risk value for integrated screening in the second trimester was 1:250. Costs were compared in terms of avoided DS births, and the ratio of loss of healthy fetuses following invasive procedures per avoided DS birth was calculated. The combined strategy had sensitivity of 40/44 (90.9%) and a false-positive rate of 2.8%. Corresponding values for the contingent strategy were 39/44 (88.6%) and 1.3%, respectively. Only 11% of pregnant women required tests in the second trimester, and the approximate cost reduction for each avoided DS birth was 5000€. The ratio of lost healthy fetuses following invasive procedures per avoided DS birth improved by up to 0.65. The contingent strategy has similar effectiveness to the combined strategy, but has lower costs and fewer invasive procedures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

77 FR 12591 - THV Holdings LLC; Analysis of Proposed Consent Order To Aid Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... homeowners can realize by replacing their windows, including the home's geographic location, size, insulation... having a specific level of insulation in a specific region). The performance standard imposed under this... consumption, energy savings, energy costs, heating and cooling costs, U-factor, solar heat gain coefficient, R...

San Diego's High School Dropout Crisis

ERIC Educational Resources Information Center

Wilson, James C.

2012-01-01

This article highlights San Diego's dropout problem and how much it's costing the city and the state. Most San Diegans do not realize the enormous impact high school dropouts on their city. The California Dropout Research Project, located at the University of California at Santa Barbara, has estimated the lifetime cost of one class or cohort of…

HIPAA Readiness Collaborative in Hawaii.

PubMed

Chun, Marva; Forbes, Susan; Gose, Steven; Kumabe, Brenda; Loo, Jeffrey; Nichols, Lorraine; Rosa, Luis; Sherrill, Laura; Turner, Jim

2002-01-01

The vision of Hawaii's HIPAA Readiness Collaborative (HRC) effort is to realize the positive potential of HIPAA through a collaborative process that engages the entire healthcare delivery system. Goals include reducing the cost of healthcare through streamlining, reducing the cost of HIPAA implementation for HRC participants, and improving the interoperability between facilities through use of standard technologies.

Financial Aid Facts at California Community Colleges

ERIC Educational Resources Information Center

Institute for College Access & Success, 2010

2010-01-01

While California community college (CCC) system fees are much lower than tuition at community colleges in other states or other colleges in California, the total cost of attending a CCC--which includes books, housing, transportation, and food--is higher than most people realize. The illusion of low cost may lead CCC students to forgo valuable…

75 FR 68044 - Regulation To Mitigate the Misfueling of Vehicles and Engines With Gasoline Containing Greater...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

... (RVP) to accompany the transfer of gasoline blended with ethanol and a national survey of retail... Addition 3. General PTD Requirements C. Retail Fuel Dispenser Label and Fuel Ethanol Content Survey D.... Labeling Costs 2. PTD Costs 3. Survey Costs 4. Avoided Motor Vehicle and Nonroad Product Repair Costs G...

Collision avoidance system cost-benefit analysis : volume III - appendices F-M

DOT National Transportation Integrated Search

1981-09-01

Collision-avoidance systems under development in the U.S.A., Japan and Germany were evaluated. The performance evaluation showed that the signal processing and the control law of a system were the key parameters that decided the system's capability, ...

Collision avoidance system cost-benefit analysis : volume II - appendices A-E

DOT National Transportation Integrated Search

1981-09-01

Collision-avoidance systems under development in the U.S.A., Japan and Germany were evaluated. The performance evaluation showed that the signal processing and the control law of a system were the key parameters that decided the system's capability, ...

Monitoring of live and woody elements

NASA Astrophysics Data System (ADS)

Guastini, Enrico; Preti, Federico

2013-04-01

This study deals with surveys operated on crib walls in Casentino and Versilia (Tuscany), where Salix alba cuttings did not develop as expected from literature data. After more then 10 years since realization and and an initial very high survival rate, a few plants are yet alive among those put in place and the root strengthening is localized in the first 0.30 m just below the structure front face, while at further depth the detected root area ratio (R.A.R.) does not determine a noticeable increase in soil cohesion (Guastini et al., 2012). Mortality curve in willow cuttings is comparable with growing curve in Alnus nigra plants born in front of the structure, due to shading as failing cause. Assessing quantitatively the residual strength of the timber elements and estimating their possible duration allow comparison with the time needed for a complete stabilisation of the para-natural succession. The two spans of time must be almost similar to avoid unexpected collapse of the frame or unacceptable costs for oversized structures. Since the realization of a new live crib-wall in Casentino we sampled Alnus and Salix cuttings to compare rooting, survivability and evolution in randomized block design. Tests with Resistograph carried out on timber elements gives a good relationship between test results and density; through the non-destructive test it is possible to differentiate portions of wood with a noticeable residual strength from the decayed parts without any more load bearing capacity. MOR value (flexural strength) of timber elements has been estimated on the basis of the effective section verified by the Resistograph (Guastini et al., 2012), and then confirmed through rupture in bending of the same elements (Wood Technology DEISTAF lab), by proving the non-destructive test utility.

Trade-offs between predator avoidance and electric shock avoidance in hermit crabs demonstrate a non-reflexive response to noxious stimuli consistent with prediction of pain.

PubMed

Magee, Barry; Elwood, Robert W

2016-09-01

Arthropods have long been thought to respond to noxious stimuli by reflex reaction. One way of testing if this is true is to provide the animal with a way to avoid the stimulus but to vary the potential cost of avoidance. If avoidance varies with potential cost then a decision making process is evident and the behaviour is not a mere reflex. Here we examine the responses of hermit crabs to electric shock within their shell when also exposed to predator or non-predator odours or to no odour. The electric shocks start with low voltage but increase in voltage with each repetition to determine how odour affects the voltage at which the shell is abandoned. There was no treatment effect on the voltage at which hermit crabs left their shells, however, those exposed to predator odours were less likely to evacuate their shells compared with no odour or low concentrations of non-predator odour. However, highly concentrated non-predator also inhibited evacuation. The data show that these crabs trade-off avoidance of electric shock with predator avoidance. They are thus not responding purely by reflex and the data are thus consistent with predictions of pain but do not prove pain. Copyright © 2016 Elsevier B.V. All rights reserved.

Simplified Life-Cycle Cost Estimation

NASA Technical Reports Server (NTRS)

Remer, D. S.; Lorden, G.; Eisenberger, I.

1983-01-01

Simple method for life-cycle cost (LCC) estimation avoids pitfalls inherent in formulations requiring separate estimates of inflation and interest rates. Method depends for validity observation that interest and inflation rates closely track each other.

Apparent impact: the hidden cost of one-shot trades

NASA Astrophysics Data System (ADS)

Mastromatteo, Iacopo

2015-06-01

We study the problem of the execution of a moderate size order in an illiquid market within the framework of a solvable Markovian model. We suppose that in order to avoid impact costs, a trader decides to execute her order through a unique trade, waiting for enough liquidity to accumulate at the best quote. We find that despite the absence of a proper price impact, such trader faces an execution cost arising from a non-vanishing correlation among volume at the best quotes and price changes. We characterize analytically the statistics of the execution time and its cost by mapping the problem to the simpler one of calculating a set of first-passage probabilities on a semi-infinite strip. We finally argue that price impact cannot be completely avoided by conditioning the execution of an order to a more favorable liquidity scenario.

Cost effectiveness of a systematic guidelines-based approach to the prevention and management of vascular disease in a primary care setting.

PubMed

Kamboj, Laveena; Oh, Paul; Levine, Mitchell; Kammila, Srinu; Casey, William; Harterre, Don; Goeree, Ron

2016-01-15

In Ontario, Canada, the Comprehensive Vascular Disease Prevention and Management Initiative (CVDPMI) was undertaken to improve the vascular health in communities. The CVDPMI significantly improved cardiovascular (CV) risk factor profiles from baseline to follow-up visits including the 10 year Framingham Risk Score (FRS). Although the CVDPMI improved CV risk, the economic value of this program had not been evaluated. We examined the cost effectiveness of the CVDPMI program compared to no CVDPMI program in adult patients identified at risk for an initial or subsequent vascular event in a primary care setting. A one year and a ten year cost effectiveness analyses were conducted. To determine the uncertainty around the cost per life year gained ratio, a non-parametric bootstrap analysis was conducted. The overall population base case analysis at one year resulted in a cost per CV event avoided of $70,423. FRS subgroup analyses showed the high risk cohort (FRS >20%) had an incremental cost effectiveness ratio (ICER) that was dominant. In the moderate risk subgroup (FRS 10%-20%) the ICER was $47,439 per CV event avoided and the low risk subgroup (FRS <10%) showed a highly cost ineffective result of greater than $5 million per CV event avoided. The ten year analysis resulted in a dominant ICER. At one year, the CVDPMI program is economically acceptable for patients at moderate to high risk for CV events. The CVDPMI results in increased life expectancy at an incremental cost saving to the healthcare system over a ten year period. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Economical effectiveness of vaccination of cohort of children aged 2 years against chickenpox in the Russian Federation].

PubMed

Kostinov, M P; Zverev, V V

2012-01-01

Perform calculation of the economical effectiveness of realization of a program of vaccination of children aged 2 years against chickenpox (CP) in the Russian Federation. Data of Federal service on customers rights protection and human well-being surveillance on evaluation of morbidity and losses caused by CP in the Russian Federation in 2008 - 2010 were used. A cohort of children (1 760 000) aged 2 years subject to vaccination against CP in 2011, evaluation of cost of 1 case of the infection, the amount of losses per vaccination of 1 child were approximately determined; analysis of prevented losses by implementation ofvaccination program by using mathematical modeling methods was performed. Without vaccination program in the Russian Federation the cost of losses per 1 case of CP related to hospitalization and outpatient visits as well as temporary disability of one of the parent in various age groups was: for children aged 1 - 2 years--8 333 RUB (Russian rubles), 3 - 6 years--21 171 RUB, 7 - 14 years--21 295 RUB. The cost of vaccination against CP of 1 child including 2 doses of vaccines with physician examination and vaccination procedure would be 1600 RUB. In the case of realization of vaccination program against CP in 2011 of children aged 2 years its cost would be 2 488.9 million RUB. Cost prevention already exceeds the cost of vaccination in 1 age cohort of children at year 2 and in 5 years the amount of prevented losses would exceed 15 billion RUB per 1 vaccinated cohort and would continue to increase steadily. The performed calculations show that vaccination against CP in the Russian Federation is a highly efficient investment. Self-sufficiency of a program implemented in 2011 may be obtained already at the start of year 2 after the realization and by 2016 the net economical benefit would be around 8 milliards RUB.

Health impact and monetary cost of exposure to particulate matter emitted from biomass burning in large cities.

PubMed

Sarigiannis, Dimosthenis Α; Karakitsios, Spyros P; Kermenidou, Marianthi V

2015-08-15

The study deals with the assessment of health impact and the respective economic cost attributed to particulate matter (PM) emitted into the atmosphere from biomass burning for space heating, focusing on the differences between the warm and cold seasons in 2011-2012 and 2012-2013 in Thessaloniki (Greece). Health impact was assessed based on estimated exposure levels and the use of established WHO concentration-response functions (CRFs) for all-cause mortality, infant mortality, new chronic bronchitis cases, respiratory and cardiac hospital admissions. Monetary cost was based on the valuation of the willingness-to-pay/accept (WTP/WTA), to avoid or compensate for the loss of welfare associated with illness. Results showed that long term mortality during the 2012-2013 winter increased by 200 excess deaths in a city of almost 900,000 inhabitants or 3540 years of life lost, corresponding to an economic cost of almost 200-250m€. New chronic bronchitis cases dominate morbidity estimates (490 additional new cases corresponding to a monetary cost of 30m€). Estimated health and monetary impacts are more severe during the cold season, despite its smaller duration (4 months). Considering that the increased ambient air concentrations (and the integral of outdoor/indoor exposure) are explained by shifting from oil to biomass for domestic heating purposes, several alternative scenarios were evaluated. Policy scenario analysis revealed that significant public health and monetary benefits (up to 2b€ in avoided mortality and 130m€ in avoided illness) might be obtained by limiting the biomass share in the domestic heat energy mix. Fiscal policy affecting fuels/technologies used for domestic heating needs to be reconsidered urgently, since the net tax loss from avoided oil taxation due to reduced consumption was further compounded by the public health cost of increased mid-term morbidity and mortality. Copyright © 2015 Elsevier B.V. All rights reserved.

Ultrathin dendrimer-graphene oxide composite film for stable cycling lithium-sulfur batteries.

PubMed

Liu, Wen; Jiang, Jianbing; Yang, Ke R; Mi, Yingying; Kumaravadivel, Piranavan; Zhong, Yiren; Fan, Qi; Weng, Zhe; Wu, Zishan; Cha, Judy J; Zhou, Henghui; Batista, Victor S; Brudvig, Gary W; Wang, Hailiang

2017-04-04

Lithium-sulfur batteries (Li-S batteries) have attracted intense interest because of their high specific capacity and low cost, although they are still hindered by severe capacity loss upon cycling caused by the soluble lithium polysulfide intermediates. Although many structure innovations at the material and device levels have been explored for the ultimate goal of realizing long cycle life of Li-S batteries, it remains a major challenge to achieve stable cycling while avoiding energy and power density compromises caused by the introduction of significant dead weight/volume and increased electrochemical resistance. Here we introduce an ultrathin composite film consisting of naphthalimide-functionalized poly(amidoamine) dendrimers and graphene oxide nanosheets as a cycling stabilizer. Combining the dendrimer structure that can confine polysulfide intermediates chemically and physically together with the graphene oxide that renders the film robust and thin (<1% of the thickness of the active sulfur layer), the composite film is designed to enable stable cycling of sulfur cathodes without compromising the energy and power densities. Our sulfur electrodes coated with the composite film exhibit very good cycling stability, together with high sulfur content, large areal capacity, and improved power rate.

A Bat Algorithm with Mutation for UCAV Path Planning

PubMed Central

Wang, Gaige; Guo, Lihong; Duan, Hong; Liu, Luo; Wang, Heqi

2012-01-01

Path planning for uninhabited combat air vehicle (UCAV) is a complicated high dimension optimization problem, which mainly centralizes on optimizing the flight route considering the different kinds of constrains under complicated battle field environments. Original bat algorithm (BA) is used to solve the UCAV path planning problem. Furthermore, a new bat algorithm with mutation (BAM) is proposed to solve the UCAV path planning problem, and a modification is applied to mutate between bats during the process of the new solutions updating. Then, the UCAV can find the safe path by connecting the chosen nodes of the coordinates while avoiding the threat areas and costing minimum fuel. This new approach can accelerate the global convergence speed while preserving the strong robustness of the basic BA. The realization procedure for original BA and this improved metaheuristic approach BAM is also presented. To prove the performance of this proposed metaheuristic method, BAM is compared with BA and other population-based optimization methods, such as ACO, BBO, DE, ES, GA, PBIL, PSO, and SGA. The experiment shows that the proposed approach is more effective and feasible in UCAV path planning than the other models. PMID:23365518

Resource Isolation Method for Program’S Performance on CMP

NASA Astrophysics Data System (ADS)

Guan, Ti; Liu, Chunxiu; Xu, Zheng; Li, Huicong; Ma, Qiang

2017-10-01

Data center and cloud computing are more popular, which make more benefits for customers and the providers. However, in data center or clusters, commonly there is more than one program running on one server, but programs may interference with each other. The interference may take a little effect, however, the interference may cause serious drop down of performance. In order to avoid the performance interference problem, the mechanism of isolate resource for different programs is a better choice. In this paper we propose a light cost resource isolation method to improve program’s performance. This method uses Cgroups to set the dedicated CPU and memory resource for a program, aiming at to guarantee the program’s performance. There are three engines to realize this method: Program Monitor Engine top program’s resource usage of CPU and memory and transfer the information to Resource Assignment Engine; Resource Assignment Engine calculates the size of CPU and memory resource should be applied for the program; Cgroups Control Engine divide resource by Linux tool Cgroups, and drag program in control group for execution. The experiment result show that making use of the resource isolation method proposed by our paper, program’s performance can be improved.

Progress and problems for randomized clinical trials: from streptomycin to the era of megatrials.

PubMed

Hilbrich, Lutz; Sleight, Peter

2006-09-01

Randomized clinical trials (RCTs) are the definitive contributors to evidence-based medicine. RCTs assessing serious outcomes in cardiovascular disease have grown, with 'megatrials' becoming more common with the realization that wrong conclusions resulted from random error in inadequately sized trials. Simple design and a heterogeneous patient population were early features, but multinational trials have increased in scientific, logistical, bureaucratic, regulatory, and legal complexity. These studies now exceed the financial means of academia or medical charities. Governments have left the bill with the pharmaceutical industry, encouraging a symbiosis with academics, who contribute medical and scientific expertise, and access to patients. Industry provides pharmacological, pharmaceutical, technical and regulatory know-how, good clinical practice expertise, and legal assistance during the trial. Study supervision is then in the hands of an independent steering committee and associated subcommittees, until appropriate dissemination of results. Prospectively defined interaction with the sponsor facilitates unbiased design and conduct, but arrangements need careful implementation to avoid conflicts of interest. The patient is protected by a strong data safety monitoring board that is wholly independent. Megatrials are under threat from over-regulation, increasing costs, and difficulties in execution. These issues merit urgent public and political education and debate.

Towards Real-time, On-board, Hardware-Supported Sensor and Software Health Management for Unmanned Aerial Systems

NASA Technical Reports Server (NTRS)

Schumann, Johann; Rozier, Kristin Y.; Reinbacher, Thomas; Mengshoel, Ole J.; Mbaya, Timmy; Ippolito, Corey

2013-01-01

Unmanned aerial systems (UASs) can only be deployed if they can effectively complete their missions and respond to failures and uncertain environmental conditions while maintaining safety with respect to other aircraft as well as humans and property on the ground. In this paper, we design a real-time, on-board system health management (SHM) capability to continuously monitor sensors, software, and hardware components for detection and diagnosis of failures and violations of safety or performance rules during the flight of a UAS. Our approach to SHM is three-pronged, providing: (1) real-time monitoring of sensor and/or software signals; (2) signal analysis, preprocessing, and advanced on the- fly temporal and Bayesian probabilistic fault diagnosis; (3) an unobtrusive, lightweight, read-only, low-power realization using Field Programmable Gate Arrays (FPGAs) that avoids overburdening limited computing resources or costly re-certification of flight software due to instrumentation. Our implementation provides a novel approach of combining modular building blocks, integrating responsive runtime monitoring of temporal logic system safety requirements with model-based diagnosis and Bayesian network-based probabilistic analysis. We demonstrate this approach using actual data from the NASA Swift UAS, an experimental all-electric aircraft.

Cost-Effectiveness of Peginterferon Beta-1a and Alemtuzumab in Relapsing-Remitting Multiple Sclerosis.

PubMed

Dashputre, Ankur A; Kamal, Khalid M; Pawar, Gauri

2017-06-01

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, affecting 2.5 million people globally and 400,000 people in the United States. While no cure exists for MS, the goal is to manage the disease using disease-modifying therapies (DMTs), which have been shown to slow disease progression and prevent relapses. Relapsing-remitting MS (RRMS) is the most common form of MS at the time of diagnosis. Peginterferon beta-1a (PEG) and alemtuzumab (ALT) were recently approved and have demonstrated good clinical outcomes, including reduced relapse rates in clinical trials. High costs associated with these DMTs necessitates cost-effectiveness analyses to understand their overall value in RRMS management. To assess the cost-effectiveness of (a) Model 1: PEG relative to intramuscular interferon beta-1a (IM IFN), subcutaneous interferon beta-1b (SC IFN), glatiramer acetate 20 mg per mL (GA), fingolimod (FIN), natalizumab (NAT), and dimethyl fumarate (DMF), and (b) Model 2: ALT relative to subcutaneous interferon beta-1a 44 μg (IFN beta-1a 44 μg). Both analyses were conducted from a U.S. third-party payer perspective. Two static decision models were used to compare the cost-effectiveness of PEG and ALT over a 1-year and a 2-year time horizon, respectively. Model inputs were drug acquisition costs (wholesale acquisition cost from RED BOOK); drug administration and monitoring costs (package inserts and Centers for Medicare & Medicaid Services 2015 Physician Fee Schedule); relapse rates and relapse rate reduction (clinical trials); and cost of managing relapses (published literature). All costs were adjusted to 2015 U.S. dollars using the medical care component of the Consumer Price Index. Outcomes measured were total cost of therapy per patient, cost per relapse avoided, and incremental cost-effectiveness ratios (ICERs) calculated as cost per relapse avoided. Sensitivity analysis was conducted to test model robustness given the uncertainty of model inputs and study assumptions. Model 1 results showed that PEG dominated IM IFN and GA, compared with SC IFN; PEG had an ICER of $1,978,000 per relapse avoided. Compared with FIN, NAT, and DMF, PEG was less expensive and less effective. Model 2 showed that ALT had an ICER of $25,276 per relapse avoided relative to IFN beta-1a 44 μg. In patients with RRMS, PEG is a viable alternative when compared with the DMTs in our model. Deciding whether to choose PEG over other DMTs would depend on multiple factors. On the other hand, ALT had an ICER of $25,276 cost per relapse avoided relative to IFN beta-1a 44 μg. The study results will assist payers in evaluating different medication choices for effective therapy. No outside funding supported this study. Kamal has received research funding from Novartis Pharmaceuticals and the College of Psychiatric and Neurologic Pharmacists and also serves as a consultant for the Lynx Group. Dashputre and Pawar report no conflicts of interest. Study concept and design were primarily contributed by Dashputre, along with Kamal and Pawar. Dashputre took the lead in data collection, along with Kamal, and data analysis was performed by Dashputre, Kamal, and Pawar. The manuscript was written and revised primarily by Dashputre, along with Kamal and Pawar.

18 CFR 292.304 - Rates for purchases.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PRODUCTION AND COGENERATION Arrangements Between Electric Utilities and Qualifying Cogeneration and Small... reasonable to the electric consumer of the electric utility and in the public interest; and (ii) Not... requires any electric utility to pay more than the avoided costs for purchases. (b) Relationship to avoided...

Avoiding or restricting defectors in public goods games?

PubMed

Han, The Anh; Pereira, Luís Moniz; Lenaerts, Tom

2015-02-06

When creating a public good, strategies or mechanisms are required to handle defectors. We first show mathematically and numerically that prior agreements with posterior compensations provide a strategic solution that leads to substantial levels of cooperation in the context of public goods games, results that are corroborated by available experimental data. Notwithstanding this success, one cannot, as with other approaches, fully exclude the presence of defectors, raising the question of how they can be dealt with to avoid the demise of the common good. We show that both avoiding creation of the common good, whenever full agreement is not reached, and limiting the benefit that disagreeing defectors can acquire, using costly restriction mechanisms, are relevant choices. Nonetheless, restriction mechanisms are found the more favourable, especially in larger group interactions. Given decreasing restriction costs, introducing restraining measures to cope with public goods free-riding issues is the ultimate advantageous solution for all participants, rather than avoiding its creation. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

[Pharmacogenetics--implications for health management and health care economics].

PubMed

Weihrauch, Thomas R

2002-07-15

Pharmacogenetics, which is principally concerned with drug efficacy and safety, will change the way future health care is practiced. The growing understanding of the genetic basis for drug response and use of this knowledge to predict the response of an individual patient offer new opportunities to meet the changing needs of health care systems and the demands placed upon them. For the individual patient, overall quality of life should be higher as physicians will be able to select the most effective and safest treatments for them. However, the cost of patient evaluation will need to be weighed against the additional therapeutic benefit and savings made by avoidance of unnecessary and inadequate drug use and adverse drug responses. Getting the right medicine at the right dose to the patient first time and avoidance of "try and see" prescribing also have the potential to reduce costs due a reduction in number of visits to the physician required to obtain satisfactory treatment. Application of pharmacogenetics to drug development has the potential to streamline the drug development process. Disease and therapy differentiation may lead to stratification of patient groups, and it is possible that the fragmented indications will not represent commercially attractive markets to the pharmaceutical industry with current marketing paradigms. However, the ability to target patients more accurately may represent considerable commercial value within a given market sector. Changes in health care policy and structure will be needed so that short-term budget constraints are not allowed to take precedence over mid- to long-term benefits. In order to realize the potential of pharmacogenetics, tailored communication/education programs for the key stakeholders--patients and patient groups, health care professionals, regulators, health care industry (biotechnology, pharmaceutical and diagnostic companies), health care payers, governments, and academia--will be necessary. Pharmacogenetics is likely to be introduced according to need, clinical validity and value, with resources first being directed at diseases for which it is vital to prescribe the right drug at the right dose from the outset, e.g. in cancer.

Variance analysis refines overhead cost control.

PubMed

Cooper, J C; Suver, J D

1992-02-01

Many healthcare organizations may not fully realize the benefits of standard cost accounting techniques because they fail to routinely report volume variances in their internal reports. If overhead allocation is routinely reported on internal reports, managers can determine whether billing remains current or lost charges occur. Healthcare organizations' use of standard costing techniques can lead to more realistic performance measurements and information system improvements that alert management to losses from unrecovered overhead in time for corrective action.

RIGHT-SIZED OR DOWNSIZED: COMPARISON OF COSTS VERSUS CAPABILITY TO MAINTAIN INTRA-THEATER AIRLIFT

DTIC Science & Technology

2015-12-01

AU/ACSC/2015 AIR COMMAND AND STAFF COLLEGE DISTANCE LEARNING AIR UNIVERSITY RIGHT -SIZED OR DOWNSIZED: COMPARISON OF COSTS VERSUS...aircraft and “ right -sizing” units will allow the Air Force to realize the cost efficiencies it is hoping to gain. Balancing this with maintaining...minimum of two aircraft available for surge capabilities are necessary considerations when determining the “ right -size” of a unit. Possessing too

Natural Gas as an Instrument of Russian State Power (Letort Paper)

DTIC Science & Technology

2011-10-01

effects the price increase had on the Ukrainian industry as a whole; and does not account for the costs to the Ukrainian economy of the 2006 and...a political consideration); and the differential cost of sanctions among the senders (largely an economic factor). First, allies hardly ever agree...sanctions is extremely hard to realize. 5 Second, the cost of imposing sanctions is sim- ply greater for some sender states than the potential

The cost-effectiveness of a patient centred pressure ulcer prevention care bundle: Findings from the INTACT cluster randomised trial.

PubMed

Whitty, Jennifer A; McInnes, Elizabeth; Bucknall, Tracey; Webster, Joan; Gillespie, Brigid M; Banks, Merrilyn; Thalib, Lukman; Wallis, Marianne; Cumsille, Jose; Roberts, Shelley; Chaboyer, Wendy

2017-10-01

Pressure ulcers are serious, avoidable, costly and common adverse outcomes of healthcare. To evaluate the cost-effectiveness of a patient-centred pressure ulcer prevention care bundle compared to standard care. Cost-effectiveness and cost-benefit analyses of pressure ulcer prevention performed from the health system perspective using data collected alongside a cluster-randomised trial. Eight tertiary hospitals in Australia. Adult patients receiving either a patient-centred pressure ulcer prevention care bundle (n=799) or standard care (n=799). Direct costs related to the intervention and preventative strategies were collected from trial data and supplemented by micro-costing data on patient turning and skin care from a 4-week substudy (n=317). The time horizon for the economic evaluation matched the trial duration, with the endpoint being diagnosis of a new pressure ulcer, hospital discharge/transfer or 28days; whichever occurred first. For the cost-effectiveness analysis, the primary outcome was the incremental costs of prevention per additional hospital acquired pressure ulcer case avoided, estimated using a two-stage cluster-adjusted non-parametric bootstrap method. The cost-benefit analysis estimated net monetary benefit, which considered both the costs of prevention and any difference in length of stay. All costs are reported in AU$(2015). The care bundle cost AU$144.91 (95%CI: $74.96 to $246.08) more per patient than standard care. The largest contributors to cost were clinical nurse time for repositioning and skin inspection. In the cost-effectiveness analysis, the care bundle was estimated to cost an additional $3296 (95%CI: dominant to $144,525) per pressure ulcer avoided. This estimate is highly uncertain. Length of stay was unexpectedly higher in the care bundle group. In a cost-benefit analysis which considered length of stay, the net monetary benefit for the care bundle was estimated to be -$2320 (95%CI -$3900, -$1175) per patient, suggesting the care bundle was not a cost-effective use of resources. A pressure ulcer prevention care bundle consisting of multicomponent nurse training and patient education may promote best practice nursing care but may not be cost-effective in preventing hospital acquired pressure ulcer. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cost effectiveness of enoxaparin as prophylaxis against venous thromboembolic complications in acutely ill medical inpatients: modelling study from the hospital perspective in Germany.

PubMed

Schädlich, Peter K; Kentsch, Michael; Weber, Manfred; Kämmerer, Wolfgang; Brecht, Josef Georg; Nadipelli, Vijay; Huppertz, Eduard

2006-01-01

To estimate, from the hospital perspective in Germany, the cost effectiveness of the low-molecular-weight heparin (LMWH) subcutaneous enoxaparin sodium 40 mg once daily (ENOX) relative to no pharmacological prophylaxis (NPP) and relative to subcutaneous unfractionated heparin (UFH) 5,000 IU three times daily (low-dose UFH [LDUFH]). Each is used in addition to elastic bandages/compression stockings and physiotherapy in the prevention of venous thromboembolic events (VTE) in immobilised acutely ill medical inpatients without impaired renal function or extremes of body weight. The incremental cost-effectiveness ratios (ICERs) of the 'additional cost for ENOX per clinical VTE avoided versus NPP' and 'additional cost for ENOX per episode of major bleeding avoided versus LDUFH' were chosen as target variables. The target variables were quantified using a modelling approach based on the decision-tree technique. Resource use during thromboprophylaxis, diagnosis and treatment of VTEs, episode of major bleeding and secondary pneumonia after pulmonary embolism (PE) was collected from a hospital survey. Costs were exclusively those to hospitals incurred by staff expenses, drugs, devices, disposables, laboratory tests and equipment for diagnostic procedures. These costs were determined by multiplying utilised resource items by the price or tariff of each item as of the first quarter of 2003. Safety and efficacy values of the comparators were taken from the MEDENOX (prophylaxis in MEDical patients with ENOXaparin) and the THE-PRINCE (THromboEmbolism-PRevention IN Cardiac or respiratory disease with Enoxaparin) trials and from a meta-analysis. The evaluation encompassed 8 (6-14) days of thromboprophylaxis plus time to treat VTE and episode of major bleeding in hospital. Point estimates of all model parameters were applied exclusively in the base-case analysis. There were incremental costs of euro 1,106 for ENOX per clinical VTE avoided versus NPP (1 euro approximately equals 1.07 US dollars; average of the first quarter of 2003). ENOX dominated LDUFH: cost savings of euro 55,825 were obtained and 7.7 episodes of major bleeding were avoided by ENOX compared with LDUFH, each per 1000 patients. In comprehensive sensitivity analyses, the robustness of the model and its results was shown. Results of this evaluation suggest that, in immobilised acutely ill medical inpatients, ENOX may offer hospitals in Germany a very cost-effective option for thromboprophylaxis compared with NPP and a cost-saving alternative compared with LDUFH.

The lartge-area picosecond photo-detector (LAPPD) project

NASA Astrophysics Data System (ADS)

Varner, Gary

2012-03-01

The technological revolution that replaced the bulky Cathode Ray Tube with a wide variety of thin, reduced-cost display technologies, has yet to be realized for photosensors. Such a low-cost, robust and flexible photon detector, capable of efficient single photon measurement with good spatial and temporal resolution, would have numerous scientific, medical and industrial applications. To address the significant technological challenges of realizing such a disruptive technology, the Large Area Picosecond Photo-Detector (LAPPD) collaboration was formed, and has been strongly supported by the Department of Energy. This group leverages the inter-disciplinary capabilities and facilities at Argonne National Laboratory, the Berkeley Space Sciences Laboratory (SSL), electronics expertise at the Universities of Chicago and Hawaii, and close work with industrial partners to extend the known technologies. Advances in theory-inspired design and in-situ photocathode characterization during growth, Atomic Layer Deposition (ALD) for revolutionizing micro-channel plate fabrication, and compact, wave-form sampling CMOS ASIC readout of micro striplines are key tools toward realizing a viable LAPPD device. Progress toward a first 8" x 8" demonstrator module will be presented.

The neglected topic: presentation of cost information in patient decision AIDS.

PubMed

Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

2015-05-01

Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration. © The Author(s) 2015.

CPR for Rural School Districts: Emerging Alternatives in Curriculum, Program and Reorganization.

ERIC Educational Resources Information Center

Thurston, Paul; Clauss, Joanne

Justification for school district consolidation is made on the basis of either reducing cost or increasing educational quality. Some cost reduction may be realized through certain economies of scale in some consolidations but it is by no means automatic. The Illinois State Board of Education emphasizes the relationship between high school size and…

Not Another Budget Cut! Money-Saving Ideas for Campus Organizations.

ERIC Educational Resources Information Center

Oxendine, W. H. "Butch," Jr.

1997-01-01

Twenty ideas for reducing program costs are offered to campus activities programmers. They include using technology wisely, avoiding excess outlay of funds, trading for services, seeking donations and sponsors, co-sponsoring events, buying supplies in bulk, requesting discounts, avoiding unnecessary sales taxes, using telephone services…

Valuing reduced antibiotic use for pediatric acute otitis media.

PubMed

Meropol, Sharon B

2008-04-01

The 2004 American Academy of Pediatrics acute otitis media guidelines urge parents to weigh the benefits of reduced antibiotic use, adverse drug events, and future resistance versus risks of extra costs and sick days resulting from guideline use. The value of decreased antibiotic resistance has not been quantified. The objective was to perform cost-utility analysis, estimating the resistance value of implementing the guidelines for acute otitis media treatment for children <2 years of age. Outcomes were described with a common denominator and the value of avoiding resistance was estimated using a parental perspective. Decision analysis results were used for outcome probabilities. Published utilities were used to describe outcomes in quality-adjusted life-day units. The minimum resistance benefit value, where the benefits of the American Academy of Pediatrics guidelines would at least balance their costs, was defined as the guidelines' incremental costs minus their other benefits. For a child 2 to <6 months of age presenting to a primary care physician with possible otitis media, parents would need to value the resistance benefit at 0.77 quality-adjusted life-days per antibiotic prescription avoided for the guidelines' benefits to balance their costs. For the 6- to <24-month-old group, results were 0.67 quality-adjusted life-days per prescription avoided. Results were sensitive to the dollar cost utility; when willingness to pay ranged from $20,000 to $200,000 per quality-adjusted life-year, results ranged from 0.36 and 0.30 quality-adjusted life-days up to 4.10 and 3.57 quality-adjusted life-days for the 2- to <6-month-old and 6- to <24-month-old groups, respectively. Costs were driven by missed parent work days. From a societal perspective, trading 0.30 to 4 quality-adjusted life-days to avoid 1 antibiotic course might be desirable; from a parental perspective, this may not be as desirable. Parent demand for antibiotics may be rational when driven by the value of parent time. Other approaches that have the potential to reduce antibiotic use, such as wider use of influenza vaccine and improved rapid viral diagnostic techniques, might be more successful.

Applications of ethylene vinyl acetate as an encapsulation material for terrestrial photovoltaic modules

NASA Technical Reports Server (NTRS)

Cuddihy, E. F.; Coulbert, C. D.; Liang, R. H.; Gupta, A.; Willis, P.; Baum, B.

1983-01-01

Terrestrial photovoltaic modules must undergo substantial reductions in cost in order to become economically attractive as practical devices for large scale production of electricity. Part of the cost reductions must be realized by the encapsulation materials that are used to package, protect, and support the solar cells, electrical interconnects, and other ancillary components. As many of the encapsulation materials are polymeric, cost reductions necessitate the use of low cost polymers. The performance and status of ethylene vinyl acetate, a low cost polymer that is being investigated as an encapsulation material for terrestrial photovoltaic modules, are described.

Wall System Saves Initial HVAC Costs

ERIC Educational Resources Information Center

Modern Schools, 1976

1976-01-01

The superior insulating characteristics of an exterior wall system has enabled a Massachusetts school district to realize a savings on electric heating, ventilating, and air-conditioning systems. (Author/MLF)

An integrated approach to realizing high-performance liquid-junction quantum dot sensitized solar cells

PubMed Central

McDaniel, Hunter; Fuke, Nobuhiro; Makarov, Nikolay S.; Pietryga, Jeffrey M.; Klimov, Victor I.

2013-01-01

Solution-processed semiconductor quantum dot solar cells offer a path towards both reduced fabrication cost and higher efficiency enabled by novel processes such as hot-electron extraction and carrier multiplication. Here we use a new class of low-cost, low-toxicity CuInSexS2−x quantum dots to demonstrate sensitized solar cells with certified efficiencies exceeding 5%. Among other material and device design improvements studied, use of a methanol-based polysulfide electrolyte results in a particularly dramatic enhancement in photocurrent and reduced series resistance. Despite the high vapour pressure of methanol, the solar cells are stable for months under ambient conditions, which is much longer than any previously reported quantum dot sensitized solar cell. This study demonstrates the large potential of CuInSexS2−x quantum dots as active materials for the realization of low-cost, robust and efficient photovoltaics as well as a platform for investigating various advanced concepts derived from the unique physics of the nanoscale size regime. PMID:24322379

Big things come in bundled packages: implications of bundled payment systems in health care reimbursement reform.

PubMed

Delisle, Dennis R

2013-01-01

With passage of the Affordable Care Act, the ever-evolving landscape of health care braces for another shift in the reimbursement paradigm. As health care costs continue to rise, providers are pressed to deliver efficient, high-quality care at flat to minimally increasing rates. Inherent systemwide inefficiencies between payers and providers at various clinical settings pose a daunting task for enhancing collaboration and care coordination. A change from Medicare's fee-for-service reimbursement model to bundled payments offers one avenue for resolution. Pilots using such payment models have realized varying degrees of success, leading to the development and upcoming implementation of a bundled payment initiative led by the Center for Medicare and Medicaid Innovation. Delivery integration is critical to ensure high-quality care at affordable costs across the system. Providers and payers able to adapt to the newly proposed models of payment will benefit from achieving cost reductions and improved patient outcomes and realize a competitive advantage.

What Is the Return on Investment for Implementation of a Crew Resource Management Program at an Academic Medical Center?

PubMed

Moffatt-Bruce, Susan D; Hefner, Jennifer L; Mekhjian, Hagop; McAlearney, John S; Latimer, Tina; Ellison, Chris; McAlearney, Ann Scheck

Crew Resource Management (CRM) training has been used successfully within hospital units to improve quality and safety. This article presents a description of a health system-wide implementation of CRM focusing on the return on investment (ROI). The costs included training, programmatic fixed costs, time away from work, and leadership time. Cost savings were calculated based on the reduction in avoidable adverse events and cost estimates from the literature. Between July 2010 and July 2013, roughly 3000 health system employees across 12 areas were trained, costing $3.6 million. The total number of adverse events avoided was 735-a 25.7% reduction in observed relative to expected events. Savings ranged from a conservative estimate of $12.6 million to as much as $28.0 million. Therefore, the overall ROI for CRM training was in the range of $9.1 to $24.4 million. CRM presents a financially viable way to systematically organize for quality improvement.

Business Case Analysis for Replacing the Mazak 30Y Mill-Turn Machine in SM-39. Summary

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

Booth, Steven Richard; Dinehart, Timothy Grant; Benson, Faith Ann

2015-03-19

Business case studies are being looked at to support procurement of new machines and capital equipment in the SM-39 and TA-03-0102 machine shops. The first effort conducted economic analysis of replacing the Mazak 30Y Mill-Turn Machine located in SM-39. To determine the value of switching machinery, a baseline scenario was compared with a future scenario where new machinery was purchased and installed. The conditions under the two scenarios were defined via interviews with subject matter experts in terms of one-time and periodic costs. The results of the analysis were compiled in a life-cycle cost/benefit table. The costs of procuring, installing,more » and maintaining a new machine were balanced against the costs avoided by replacing older machinery. Productivity savings were included as a measure to show the costs avoided by being able to produce parts at a quicker and more efficient pace.« less

Improving OR Efficiency.

PubMed

Vassell, Patricia

2016-08-01

The high-cost/high-revenue environment of the OR requires special attention from managers to scrutinize and reduce costs. In the OR, nonlabor cost savings (ie, no staff member will be laid off or reclassified to realize cost savings) can typically be identified most readily. Operational costs in the OR are affected by start times, turnover times, cancellation rates, and adequate supplies, equipment, and staffing. Inefficiency in the OR can increase costs and lead to dissatisfied patients, physicians, and staff members. This article describes concepts that contribute to efficiency in the OR and illustrates the importance of staff member engagement in achieving desired outcomes. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Treating Dehydration at Home Avoids Healthcare Costs Associated With Emergency Department Visits and Hospital Readmissions for Adult Patients Receiving Home Parenteral Support.

PubMed

Konrad, Denise; Roberts, Scott; Corrigan, Mandy L; Hamilton, Cindy; Steiger, Ezra; Kirby, Donald F

2017-06-01

Administration of home parenteral support (HPS) has proven to be cost-effective over hospital care. Avoiding hospital readmissions became more of a focus for healthcare institutions in 2012 with the implementation of the Affordable Care Act. In 2010, our service developed a protocol to treat dehydration at home for HPS patients by ordering additional intravenous fluids to be kept on hand and to focus patient education on the symptoms of dehydration. A retrospective analysis was completed through a clinical management database to identify HPS patients with dehydration. The hospital finance department and homecare pharmacy were utilized to determine potential cost avoidance. In 2009, 64 episodes (77%) of dehydration were successfully treated at home versus 6 emergency department (ED) visits (7.5%) and 13 readmissions (15.5%). In 2010, we successfully treated 170 episodes (84.5%) at home, with 9 episodes (4.5%) requiring ED visits and 22 hospital readmissions (11%). The number of dehydration episodes per patient was significantly higher in 2010 ( P < .001) and may be attributed to a shift in the patient population, with more patients having malabsorption as the indication for therapy in 2010 ( P = .003). There were more than twice as many episodes of dehydration identified and treated at home in 2010 versus 2009. Our protocol helped educate and provide the resources required to resolve dehydration at home when early signs were recognized. By reducing ED visits and hospital readmissions, healthcare costs were avoided by a factor of 29 when home treatment was successful.

Expedited Holonomic Quantum Computation via Net Zero-Energy-Cost Control in Decoherence-Free Subspace.

PubMed

Pyshkin, P V; Luo, Da-Wei; Jing, Jun; You, J Q; Wu, Lian-Ao

2016-11-25

Holonomic quantum computation (HQC) may not show its full potential in quantum speedup due to the prerequisite of a long coherent runtime imposed by the adiabatic condition. Here we show that the conventional HQC can be dramatically accelerated by using external control fields, of which the effectiveness is exclusively determined by the integral of the control fields in the time domain. This control scheme can be realized with net zero energy cost and it is fault-tolerant against fluctuation and noise, significantly relaxing the experimental constraints. We demonstrate how to realize the scheme via decoherence-free subspaces. In this way we unify quantum robustness merits of this fault-tolerant control scheme, the conventional HQC and decoherence-free subspace, and propose an expedited holonomic quantum computation protocol.

Expedited Holonomic Quantum Computation via Net Zero-Energy-Cost Control in Decoherence-Free Subspace

PubMed Central

Pyshkin, P. V.; Luo, Da-Wei; Jing, Jun; You, J. Q.; Wu, Lian-Ao

2016-01-01

Holonomic quantum computation (HQC) may not show its full potential in quantum speedup due to the prerequisite of a long coherent runtime imposed by the adiabatic condition. Here we show that the conventional HQC can be dramatically accelerated by using external control fields, of which the effectiveness is exclusively determined by the integral of the control fields in the time domain. This control scheme can be realized with net zero energy cost and it is fault-tolerant against fluctuation and noise, significantly relaxing the experimental constraints. We demonstrate how to realize the scheme via decoherence-free subspaces. In this way we unify quantum robustness merits of this fault-tolerant control scheme, the conventional HQC and decoherence-free subspace, and propose an expedited holonomic quantum computation protocol. PMID:27886234

Customer satisfaction planning and industrial engineering move hospital towards in-house stockless program.

PubMed

Burton, R; Mauk, D

1993-03-01

By integrating customer satisfaction planning and industrial engineering techniques when examining internal costs and efficiencies, materiel managers are able to better realize what concepts will best meet their customers' needs. Defining your customer(s), applying industrial engineering techniques, completing work sampling studies, itemizing recommendations and benefits to each alternative, performing feasibility and cost-analysis matrixes and utilizing resources through productivity monitoring will get you on the right path toward selecting concepts to use. This article reviews the above procedures as they applied to one hospital's decision-making process to determine whether to incorporate a stockless inventory program. Through an analysis of customer demand, the hospital realized that stockless was the way to go, but not by outsourcing the function--the hospital incorporated an in-house stockless inventory program.

Realization of synaptic learning and memory functions in Y2O3 based memristive device fabricated by dual ion beam sputtering

NASA Astrophysics Data System (ADS)

Das, Mangal; Kumar, Amitesh; Singh, Rohit; Than Htay, Myo; Mukherjee, Shaibal

2018-02-01

Single synaptic device with inherent learning and memory functions is demonstrated based on a forming-free amorphous Y2O3 (yttria) memristor fabricated by dual ion beam sputtering system. Synaptic functions such as nonlinear transmission characteristics, long-term plasticity, short-term plasticity and ‘learning behavior (LB)’ are achieved using a single synaptic device based on cost-effective metal-insulator-semiconductor (MIS) structure. An ‘LB’ function is demonstrated, for the first time in the literature, for a yttria based memristor, which bears a resemblance to certain memory functions of biological systems. The realization of key synaptic functions in a cost-effective MIS structure would promote much cheaper synapse for artificial neural network.

The potential benefits of a new poliovirus vaccine for long-term poliovirus risk management.

PubMed

Duintjer Tebbens, Radboud J; Thompson, Kimberly M

2016-12-01

To estimate the incremental net benefits (INBs) of a hypothetical ideal vaccine with all of the advantages and no disadvantages of existing oral and inactivated poliovirus vaccines compared with current vaccines available for future outbreak response. INB estimates based on expected costs and polio cases from an existing global model of long-term poliovirus risk management. Excluding the development costs, an ideal poliovirus vaccine could offer expected INBs of US$1.6 billion. The ideal vaccine yields small benefits in most realizations of long-term risks, but great benefits in low-probability-high-consequence realizations. New poliovirus vaccines may offer valuable insurance against long-term poliovirus risks and new vaccine development efforts should continue as the world gathers more evidence about polio endgame risks.

Global economic potential for reducing carbon dioxide emissions from mangrove loss.

PubMed

Siikamäki, Juha; Sanchirico, James N; Jardine, Sunny L

2012-09-04

Mangroves are among the most threatened and rapidly disappearing natural environments worldwide. In addition to supporting a wide range of other ecological and economic functions, mangroves store considerable carbon. Here, we consider the global economic potential for protecting mangroves based exclusively on their carbon. We develop unique high-resolution global estimates (5' grid, about 9 × 9 km) of the projected carbon emissions from mangrove loss and the cost of avoiding the emissions. Using these spatial estimates, we derive global and regional supply curves (marginal cost curves) for avoided emissions. Under a broad range of assumptions, we find that the majority of potential emissions from mangroves could be avoided at less than $10 per ton of CO(2). Given the recent range of market price for carbon offsets and the cost of reducing emissions from other sources, this finding suggests that protecting mangroves for their carbon is an economically viable proposition. Political-economy considerations related to the ability of doing business in developing countries, however, can severely limit the supply of offsets and increases their price per ton. We also find that although a carbon-focused conservation strategy does not automatically target areas most valuable for biodiversity, implementing a biodiversity-focused strategy would only slightly increase the costs.

Repeated intermittent ulipristal acetate in the treatment of uterine fibroids: a cost-effectiveness analysis.

PubMed

Geale, Kirk; Saridogan, Ertan; Lehmann, Matthieu; Arriagada, Pablo; Hultberg, Marcus; Henriksson, Martin

2017-01-01

There are limited treatment options available for women with moderate to severe symptoms of uterine fibroids (UFs) who wish to avoid surgery. For these women, treatment with standard pharmaceuticals such as contraceptives is often insufficient to relieve symptoms, and patients may require surgery despite their wish to avoid it. Clinical trials demonstrate that ulipristal acetate 5 mg (UPA) is an effective treatment for this patient group, but its cost-effectiveness has not been assessed in this population. A decision-analytic model was developed to simulate a cohort of patients in this population under treatment with UPA followed by surgery as needed compared to treatment with iron and non-steroidal anti-inflammatory drug (NSAID) followed by surgery as needed (best supportive care, BSC). The analysis took the perspective of the National Health Service (NHS) in England, UK, and was based on the published UPA clinical trials. Results were calculated for the long-term costs and quality-adjusted life years (QALYs) for each treatment arm and combined into an incremental cost-effectiveness ratio (ICER) as the primary outcome. The impact of parameter uncertainty on the results was assessed using scenario, deterministic, and probabilistic sensitivity analyses. The results show that treating patients with the UPA strategy, instead of the BSC strategy, results in an additional cost of £1,115 and a gain of 0.087 QALYs, resulting in an ICER of £12,850. Given commonly accepted cost-effectiveness thresholds in England, the use of UPA as a repeated, intermittent treatment for women with moderate to severe symptoms of UF wishing to avoid surgery is likely to be a cost-effective intervention when compared to BSC.

Optimizing Value and Avoiding Problems in Building Schools.

ERIC Educational Resources Information Center

Brevard County School Board, Cocoa, FL.

This report describes school design and construction delivery processes used by the School Board of Brevard County (Cocoa, Florida) that help optimize value, avoid problems, and eliminate the cost of maintaining a large facility staff. The project phases are examined from project definition through design to construction. Project delivery…

Interspecific interference competition at the resource patch scale: do large herbivores spatially avoid elephants while accessing water?

PubMed

Ferry, Nicolas; Dray, Stéphane; Fritz, Hervé; Valeix, Marion

2016-11-01

Animals may anticipate and try to avoid, at some costs, physical encounters with other competitors. This may ultimately impact their foraging distribution and intake rates. Such cryptic interference competition is difficult to measure in the field, and extremely little is known at the interspecific level. We tested the hypothesis that smaller species avoid larger ones because of potential costs of interference competition and hence expected them to segregate from larger competitors at the scale of a resource patch. We assessed fine-scale spatial segregation patterns between three African herbivore species (zebra Equus quagga, kudu Tragelaphus strepsiceros and giraffe Giraffa camelopardalis) and a megaherbivore, the African elephant Loxodonta africana, at the scale of water resource patches in the semi-arid ecosystem of Hwange National Park, Zimbabwe. Nine waterholes were monitored every two weeks during the dry season of a drought year, and observational scans of the spatial distribution of all herbivores were performed every 15 min. We developed a methodological approach to analyse such fine-scale spatial data. Elephants increasingly used waterholes as the dry season progressed, as did the probability of co-occurrence and agonistic interaction with elephants for the three study species. All three species segregated from elephants at the beginning of the dry season, suggesting a spatial avoidance of elephants and the existence of costs of being close to them. However, contrarily to our expectations, herbivores did not segregate from elephants the rest of the dry season but tended to increasingly aggregate with elephants as the dry season progressed. We discuss these surprising results and the existence of a trade-off between avoidance of interspecific interference competition and other potential factors such as access to quality water, which may have relative associated costs that change with the time of the year. © 2016 The Authors. Journal of Animal Ecology © 2016 British Ecological Society.

In the absence of a "landscape of fear": How lions, hyenas, and cheetahs coexist.

PubMed

Swanson, Alexandra; Arnold, Todd; Kosmala, Margaret; Forester, James; Packer, Craig

2016-12-01

Aggression by top predators can create a "landscape of fear" in which subordinate predators restrict their activity to low-risk areas or times of day. At large spatial or temporal scales, this can result in the costly loss of access to resources. However, fine-scale reactive avoidance may minimize the risk of aggressive encounters for subordinate predators while maintaining access to resources, thereby providing a mechanism for coexistence. We investigated fine-scale spatiotemporal avoidance in a guild of African predators characterized by intense interference competition. Vulnerable to food stealing and direct killing, cheetahs are expected to avoid both larger predators; hyenas are expected to avoid lions. We deployed a grid of 225 camera traps across 1,125 km 2 in Serengeti National Park, Tanzania, to evaluate concurrent patterns of habitat use by lions, hyenas, cheetahs, and their primary prey. We used hurdle models to evaluate whether smaller species avoided areas preferred by larger species, and we used time-to-event models to evaluate fine-scale temporal avoidance in the hours immediately surrounding top predator activity. We found no evidence of long-term displacement of subordinate species, even at fine spatial scales. Instead, hyenas and cheetahs were positively associated with lions except in areas with exceptionally high lion use. Hyenas and lions appeared to actively track each, while cheetahs appear to maintain long-term access to sites with high lion use by actively avoiding those areas just in the hours immediately following lion activity. Our results suggest that cheetahs are able to use patches of preferred habitat by avoiding lions on a moment-to-moment basis. Such fine-scale temporal avoidance is likely to be less costly than long-term avoidance of preferred areas: This may help explain why cheetahs are able to coexist with lions despite high rates of lion-inflicted mortality, and highlights reactive avoidance as a general mechanism for predator coexistence.

Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception.

PubMed

Trussell, James; Henry, Nathaniel; Hassan, Fareen; Prezioso, Alexander; Law, Amy; Filonenko, Anna

2013-02-01

This study evaluated the total costs of unintended pregnancy (UP) in the United States (US) from a third-party health care payer perspective and explored the potential role for long-acting reversible contraception (LARC) in reducing UP and resulting health care expenditure. An economic model was constructed to estimate direct costs of UP as well as the proportion of UP costs that could be attributed to imperfect contraceptive adherence. The model considered all women requiring reversible contraception in the US: the pattern of contraceptive use and the rates of UP were derived from published sources. The costs of UP in the United States and the proportion of total cost that might be avoided by improved adherence through increased use of LARC were estimated. Annual medical costs of UP in the United States were estimated to be $4.6 billion, and 53% of these were attributed to imperfect contraceptive adherence. If 10% of women aged 20-29 years switched from oral contraception to LARC, total costs would be reduced by $288 million per year. Imperfect contraceptive adherence leads to substantial UP and high, avoidable costs. Improved uptake of LARC may generate health care cost savings by reducing contraceptive non-adherence. Copyright © 2013 Elsevier Inc. All rights reserved.

Cost-effectiveness of atorvastatin in the prevention of cardiovascular events in diabetic patients: a French adaptation of CARDS.

PubMed

Lafuma, Antoine; Colin, Xavier; Solesse, Anne

2008-05-01

We estimated the cost-effectiveness of atorvastatin in the primary prevention of cardiovascular events in patients with type 2 diabetes using data from the Collaborative AtoRvastatin Diabetes Study (CARDS). A total of 2838 patients aged 40-75 years with type 2 diabetes and no documented history of cardiovascular disease and without elevated low-density-lipoprotein cholesterol were recruited in the UK and in Ireland. Patients were randomly allocated to atorvastatin 10mg daily (n=1428) or placebo (n=1410) and were followed up for a median of 3.9 years. Direct treatment costs and effectiveness were analysed to provide estimates of cost per event avoided and cost per life-year gained over the trial period and over a patient's lifetime. The incremental cost-effectiveness ratio over the trial period was estimated to be Euro 3862 per clinical event avoided. Over the patient's lifetime, the incremental cost per life-year gained was Euro 2506 when considering cardiovascular deaths, and Euro 1418 per year when considering all-cause death. Primary prevention of cardiovascular disease with atorvastatin is cost-effective in patients with type 2 diabetes, with the incremental cost-effectiveness ratio for this intervention falling within the current acceptance threshold.

Burden of unintended pregnancy in the United States: Potential savings with increased use of long-acting reversible contraception

PubMed Central

Trussell, James; Henry, Nathaniel; Hassan, Fareen; Prezioso, Alexander; Law, Amy; Filonenko, Anna

2013-01-01

Background This study evaluated the total costs of unintended pregnancy (UP) in the United States from a third -party health care payer perspective and explored the potential role for long-acting reversible contraception (LARC) in reducing UP and resulting health care expenditure. Study Design An economic model was constructed to estimate direct costs of UP as well as the proportion of UP costs that could be attributed to imperfect contraceptive adherence. The model considered all US women requiring reversible contraception: the pattern of contraceptive use and rates of UP were derived from published sources. The costs of UP in the United States and the proportion of total cost that might be avoided by improved adherence through increased use of LARC were estimated. Results Annual medical costs of UP in the United States were estimated to be $4.5 billion, and 53% of these were attributed to imperfect contraceptive adherence. If 10% of women aged 20–29 years switched from oral contraception to LARC, total costs would be reduced by $288 million per year. Conclusions Imperfect contraceptive adherence leads to substantial unintended pregnancy and high, avoidable costs. Improved uptake of LARC may generate health care cost savings by reducing contraceptive non-adherence. PMID:22959904

Effectiveness and benefit-cost of peer-based workplace substance abuse prevention coupled with random testing.

PubMed

Miller, Ted R; Zaloshnja, Eduard; Spicer, Rebecca S

2007-05-01

Few studies have evaluated the impact of workplace substance abuse prevention programs on occupational injury, despite this being a justification for these programs. This paper estimates the effectiveness and benefit-cost ratio of a peer-based substance abuse prevention program at a U.S. transportation company, implemented in phases from 1988 to 1990. The program focuses on changing workplace attitudes toward on-the-job substance use in addition to training workers to recognize and intervene with coworkers who have a problem. The program was strengthened by federally mandated random drug and alcohol testing (implemented, respectively, in 1990 and 1994). With time-series analysis, we analyzed the association of monthly injury rates and costs with phased program implementation, controlling for industry injury trend. The combination of the peer-based program and testing was associated with an approximate one-third reduction in injury rate, avoiding an estimated $48 million in employer costs in 1999. That year, the peer-based program cost the company $35 and testing cost another $35 per employee. The program avoided an estimated $1850 in employer injury costs per employee in 1999, corresponding to a benefit-cost ratio of 26:1. The findings suggest that peer-based programs buttressed by random testing can be cost-effective in the workplace.

Unmanned Aircraft Systems in the National Airspace System: A Formal Methods Perspective

NASA Technical Reports Server (NTRS)

Munoz, Cesar A.; Dutle, Aaron; Narkawicz, Anthony; Upchurch, Jason

2016-01-01

As the technological and operational capabilities of unmanned aircraft systems (UAS) have grown, so too have international efforts to integrate UAS into civil airspace. However, one of the major concerns that must be addressed in realizing this integration is that of safety. For example, UAS lack an on-board pilot to comply with the legal requirement that pilots see and avoid other aircraft. This requirement has motivated the development of a detect and avoid (DAA) capability for UAS that provides situational awareness and maneuver guidance to UAS operators to aid them in avoiding and remaining well clear of other aircraft in the airspace. The NASA Langley Research Center Formal Methods group has played a fundamental role in the development of this capability. This article gives a selected survey of the formal methods work conducted in support of the development of a DAA concept for UAS. This work includes specification of low-level and high-level functional requirements, formal verification of algorithms, and rigorous validation of software implementations.

Cost-effectiveness of droxidopa in patients with neurogenic orthostatic hypotension: post-hoc economic analysis of Phase 3 clinical trial data.

PubMed

François, Clément; Hauser, Robert A; Aballéa, Samuel; Dorey, Julie; Kharitonova, Elizaveta; Hewitt, L Arthur

2016-01-01

Falls are associated with neurogenic orthostatic hypotension (nOH) and are an economic burden on the US healthcare system. Droxidopa is approved by the US FDA to treat symptomatic nOH. This study estimates the cost-effectiveness of droxidopa vs standard of care from a US payer perspective. A Markov model was used to predict numbers of falls and treatment responses using data from a randomized, double-blind trial of patients with Parkinson's disease and nOH who received optimized droxidopa therapy or placebo for 8 weeks. The severity of falls, utility values, and injury-related costs were derived from published studies. Model outcomes included number of falls, number of quality-adjusted life-years (QALYs), and direct costs. Incremental cost-effectiveness ratios (ICERs) were calculated. Outcomes were extrapolated over 12 months. Patients receiving droxidopa had fewer falls compared with those receiving standard of care and gained 0.33 QALYs/patient. Estimated droxidopa costs were $30,112, with estimated cost savings resulting from fall avoidance of $14,574 over 12 months. Droxidopa was cost-effective vs standard of care, with ICERs of $47,001/QALY gained, $24,866 per avoided fall with moderate/major injury, and $1559 per avoided fall with no/minor injury. The main drivers were fall probabilities and fear of fall-related inputs. A limitation of the current study is the reliance on falls data from a randomized controlled trial where the placebo group served as the proxy for standard of care. Data from a larger patient population, reflecting 'real-life' patient use and/or comparison with other agents used to treat nOH, would have been a useful complement, but these data were not available. Using Markov modeling, droxidopa appears to be a cost-effective option compared with standard of care in US clinical practice for the treatment of nOH.

Development challenges of secondary and small airports in California.

DOT National Transportation Integrated Search

2012-06-01

This study investigates the development of secondary and smaller airports in California. Low-Cost Carrier (LCC) business is growing at these airports because they offer reduced operating costs, and they have adequate capacity to help LCCs avoid battl...

Better health outcomes at lower costs: the benefits of primary care utilisation for chronic disease management in remote Indigenous communities in Australia's Northern Territory.

PubMed

Zhao, Yuejen; Thomas, Susan L; Guthridge, Steven L; Wakerman, John

2014-10-04

Indigenous residents living in remote communities in Australia's Northern Territory experience higher rates of preventable chronic disease and have poorer access to appropriate health services compared to other Australians. This study compared health outcomes and costs at different levels of primary care utilisation to determine if primary care represents an efficient use of resources for Indigenous patients with common chronic diseases namely hypertension, diabetes, ischaemic heart disease, chronic obstructive pulmonary disease and renal disease. This was an historical cohort study involving a total of 14,184 Indigenous residents, aged 15 years and over, who lived in remote communities and used a remote clinic or public hospital from 2002 to 2011. Individual level demographic and clinical data were drawn from primary care and hospital care information systems using a unique patient identifier. A propensity score was used to improve comparability between high, medium and low primary care utilisation groups. Incremental cost-effectiveness ratios and acceptability curves were used to analyse four health outcome measures: total and, avoidable hospital admissions, deaths and years of life lost. Compared to the low utilisation group, medium and high levels of primary care utilisation were associated with decreases in total and avoidable hospitalisations, deaths and years of life lost. Higher levels of primary care utilisation for renal disease reduced avoidable hospitalisations by 82-85%, deaths 72-75%, and years of life lost 78-81%. For patients with ischaemic heart disease, the reduction in avoidable hospitalisations was 63-78%, deaths 63-66% and years of life lost 69-73%. In terms of cost-effectiveness, primary care for renal disease and diabetes ranked as more cost-effective, followed by hypertension and ischaemic heart disease. Primary care for chronic obstructive pulmonary disease was the least cost-effective of the five conditions. Primary care in remote Indigenous communities was shown to be associated with cost-savings to public hospitals and health benefits to individual patients. Investing $1 in primary care in remote Indigenous communities could save $3.95-$11.75 in hospital costs, in addition to health benefits for individual patients. These findings may have wider applicability in strengthening primary care in the face of high chronic disease prevalence globally.

A Management Project to Determine the Potential Cost Avoidance Due to the Application of Managed Care Mechanisms on CHAMPUS Inpatient Mental Health Care in Colorado Springs, Colorado

DTIC Science & Technology

1990-05-11

PROJECT TO DETERMINE THE POTENTIAL COST AVOIDANCE 0 aDUE TO THE APPLICATION OF MANAGED CARE MECHANISMS C 0 ON CHAMPUS INPATIENT MENTAL HEALTH CARE IN m...endeavor to make this project clear, M z -4 consistent and accurate. I would also like to thank Captain Mike mx ~ T Rogers and his staff in the Evans...D-1 E. Diagnostic Criteria and Treatment Screens for Diagnoses Code 2962, Major Depression ........ E-1 Mental Health 1 Abstract Managed

EDOVE: Energy and Depth Variance-Based Opportunistic Void Avoidance Scheme for Underwater Acoustic Sensor Networks

PubMed Central

Eun, Yongsoon

2017-01-01

Underwater Acoustic Sensor Network (UASN) comes with intrinsic constraints because it is deployed in the aquatic environment and uses the acoustic signals to communicate. The examples of those constraints are long propagation delay, very limited bandwidth, high energy cost for transmission, very high signal attenuation, costly deployment and battery replacement, and so forth. Therefore, the routing schemes for UASN must take into account those characteristics to achieve energy fairness, avoid energy holes, and improve the network lifetime. The depth based forwarding schemes in literature use node’s depth information to forward data towards the sink. They minimize the data packet duplication by employing the holding time strategy. However, to avoid void holes in the network, they use two hop node proximity information. In this paper, we propose the Energy and Depth variance-based Opportunistic Void avoidance (EDOVE) scheme to gain energy balancing and void avoidance in the network. EDOVE considers not only the depth parameter, but also the normalized residual energy of the one-hop nodes and the normalized depth variance of the second hop neighbors. Hence, it avoids the void regions as well as balances the network energy and increases the network lifetime. The simulation results show that the EDOVE gains more than 15% packet delivery ratio, propagates 50% less copies of data packet, consumes less energy, and has more lifetime than the state of the art forwarding schemes. PMID:28954395

EDOVE: Energy and Depth Variance-Based Opportunistic Void Avoidance Scheme for Underwater Acoustic Sensor Networks.

PubMed

Bouk, Safdar Hussain; Ahmed, Syed Hassan; Park, Kyung-Joon; Eun, Yongsoon

2017-09-26

Underwater Acoustic Sensor Network (UASN) comes with intrinsic constraints because it is deployed in the aquatic environment and uses the acoustic signals to communicate. The examples of those constraints are long propagation delay, very limited bandwidth, high energy cost for transmission, very high signal attenuation, costly deployment and battery replacement, and so forth. Therefore, the routing schemes for UASN must take into account those characteristics to achieve energy fairness, avoid energy holes, and improve the network lifetime. The depth based forwarding schemes in literature use node's depth information to forward data towards the sink. They minimize the data packet duplication by employing the holding time strategy. However, to avoid void holes in the network, they use two hop node proximity information. In this paper, we propose the Energy and Depth variance-based Opportunistic Void avoidance (EDOVE) scheme to gain energy balancing and void avoidance in the network. EDOVE considers not only the depth parameter, but also the normalized residual energy of the one-hop nodes and the normalized depth variance of the second hop neighbors. Hence, it avoids the void regions as well as balances the network energy and increases the network lifetime. The simulation results show that the EDOVE gains more than 15 % packet delivery ratio, propagates 50 % less copies of data packet, consumes less energy, and has more lifetime than the state of the art forwarding schemes.

Innovating the Standard Procurement System Through Electronic Commerce Technologies

DTIC Science & Technology

1999-12-01

commerce are emerging almost daily as businesses continue to realize the overwhelming ability of agent applications to reduce costs and improve ...processed using the SPS. The result may reduce cycle time, assist contracting professionals, improve the acquisition process, save money and aid...of innovation processes, and it offers enormous potential for helping organizations achieve major improvements in terms of process cost , time

76 FR 66235 - Bar Code Technologies for Drugs and Biological Products; Retrospective Review Under Executive...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... costs and benefits of the rule and to identify any relevant changes in technology that have occurred... access to care; Whether the public health benefits of an action have been realized; Whether the public or... reviewing under E.O. 13563 is the Bar Code Final Rule. The Agency plans to reassess its costs and benefits...

Reformation of PURPA contracts: Strategies for success in power marketing

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

Scalzo, P.J.

With the passage of the Energy Policy Act of 1992, real competition entered into the world of electric utilities. A slide presentations is given on reformation of Public Utility Regulatory Policies Act (PURPA) Contracts for success in power marketing strategies. Two ways to compete: Be the least cost provider or add value and `sell hard`. The PURPA vision was to increase efficiency in power generation, utilize renewable or waste fuels, and bolster the independent producers. Cogenerators and small power producers qualified. Utility planners predicted, avoided cost, utility loads, and oil and gas prices to increase. However, avoided costs, and oilmore » and gase prices declined. Two scenarios are discussed for contract reformation: Contract buyouts, and renegotiation of contracts. Options for for dealing with existing fuel agreements are presented.« less

The economic impact of state ordered avoided cost rates for photovoltaic generated electricity

NASA Astrophysics Data System (ADS)

Bottaro, D.; Wheatley, N. J.

Various methods the states have devised to implement federal policy regarding the Public Utility Regulatory Policies Act (PURPA) of 1978, which requires that utilities pay their full 'avoided costs' to small power producers for the energy and capacity provided, are examined. The actions of several states are compared with rates estimated using utility expansion and rate-setting models, and the potential break-even capital costs of a photovoltaic system are estimated using models which calculate photovoltaic worth. The potential for the development of photovoltaics has been increased by the PURPA regulations more from the guarantee of utility purchase of photovoltaic power than from the high buy-back rates paid. The buy-back rate is high partly because of the surprisingly high effective capacity of photovoltaic systems in some locations.

A Study of Organizational Downsizing and Information Management Strategies.

DTIC Science & Technology

1992-09-01

Projected $100,000 at plants. per month savings from using miniframes . Networked Standardized "Best practices." 3 mainframes and applications. Whatever worked...The projected $1.2 million savings realized from going from mainframes to miniframes is to avoid having to reduce the budget by that amount in other...network hardware Turned in mainframe and replaced it with two miniframes ; networked new minis with systems at plants Networked mainframes and PCs Acquired

JPRS Report, Near East and South Asia.

DTIC Science & Technology

1989-02-03

homeland and because of the effect this will have— the unification of national interests and goals, which can be considered the primary pillar in the...avoiding negative social and economic effects from the employment of foreign workers and the danger that their continued presence poses to our values and...8217 words that are intended for domestic consumption and that talk of liberation, of the strategic balance and so forth—the masses have realized the

Early Life Crises of Habitable Planets

ScienceCinema

Pierrehumbert, Raymond

2018-05-11

There are a number of crises that a potentially habitable planet must avoid or surmount if its potential is to be realized. These include the runaway greenhouse, loss of atmosphere by chemical or physical processes, and long-lasting global glaciation. In this lecture I will present research on the climate dynamics governing such processes, with particular emphasis on the lessons to be learned from the cases of Early Mars and the Neoproterozoic Snowball Earth.

Reducing Wind Curtailment through Transmission Expansion in a Wind Vision Future

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

Jorgensen, Jennie; Mai, Trieu; Brinkman, Greg

The Department of Energy's 2015 Wind Vision study, which analyzed an ambitious scenario where wind power served 35% of U.S. electricity consumption in 2050, showed the potential for wind energy to provide substantial health, environmental, and economic benefits. Using a commercial unit commitment and economic dispatch model, we build on this research by assessing the hourly operational feasibility of a similar high wind future in the Western United States. Our detailed simulations found no hours of unmet load or reserve violations with more than 35% potential wind (and 12% potential solar) available on the system, which highlights the technical possibilitymore » of integrating large amounts of wind energy. However, absent significant changes to the western grid, we find that substantial wind curtailment could be an issue, as it could degrade the potential for wind power to reduce fuel costs and lowering the emission benefits. To assess the value of transmission to mitigate wind curtailment, we model a suite of transmission expansion scenarios. We find that wind curtailment could be reduced by approximately half under a scenario where new transmission is based only on proposed projects. This avoided wind curtailment could lower annual production costs and reduce carbon dioxide emissions substantially. Greater transmission expansion was found to yield further benefits, although the marginal benefits of these new lines were found to decline. Overall, these results suggest that power systems operation can be realized with more than 35% wind penetration, but that transmission expansion is likely to play a vital role.« less

[Orthogonal Vector Projection Algorithm for Spectral Unmixing].

PubMed

Song, Mei-ping; Xu, Xing-wei; Chang, Chein-I; An, Ju-bai; Yao, Li

2015-12-01

Spectrum unmixing is an important part of hyperspectral technologies, which is essential for material quantity analysis in hyperspectral imagery. Most linear unmixing algorithms require computations of matrix multiplication and matrix inversion or matrix determination. These are difficult for programming, especially hard for realization on hardware. At the same time, the computation costs of the algorithms increase significantly as the number of endmembers grows. Here, based on the traditional algorithm Orthogonal Subspace Projection, a new method called. Orthogonal Vector Projection is prompted using orthogonal principle. It simplifies this process by avoiding matrix multiplication and inversion. It firstly computes the final orthogonal vector via Gram-Schmidt process for each endmember spectrum. And then, these orthogonal vectors are used as projection vector for the pixel signature. The unconstrained abundance can be obtained directly by projecting the signature to the projection vectors, and computing the ratio of projected vector length and orthogonal vector length. Compared to the Orthogonal Subspace Projection and Least Squares Error algorithms, this method does not need matrix inversion, which is much computation costing and hard to implement on hardware. It just completes the orthogonalization process by repeated vector operations, easy for application on both parallel computation and hardware. The reasonability of the algorithm is proved by its relationship with Orthogonal Sub-space Projection and Least Squares Error algorithms. And its computational complexity is also compared with the other two algorithms', which is the lowest one. At last, the experimental results on synthetic image and real image are also provided, giving another evidence for effectiveness of the method.

Operation and maintenance cost-cutting

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

Hollingshead, T.W.

This presentation by Timothy W. Hollingshead, Technical Services Manager, Pacific Gas and Electric, is about cutting costs in the Operation and Maintenance phase of geothermal energy production. The necessity of cost control, keeping workers well-trained and avoiding OSHA fines, taking advantages of new technologies, and establishing predictive maintenance programs are some of the issues discussed in this article.

Improving Learning and Reducing Costs: Fifteen Years of Course Description

ERIC Educational Resources Information Center

Twigg, Carol A.

2015-01-01

Recognizing that tuition increases can no longer be used as a safety valve to avoid dealing with the underlying issues of why costs increase so much, campuses have begun the hard work of cost containment. After sharpening priorities, sometimes making tough choices in light of those priorities, campuses are still groping for ways to wrestle costs…

Cost-effectiveness analysis of the introduction of the human papillomavirus vaccine in Honduras.

PubMed

Aguilar, Ida Berenice Molina; Mendoza, Lourdes Otilia; García, Odalys; Díaz, Iris; Figueroa, Jacqueline; Duarte, Rosa María; Perdomo, Gabriel; Garcia, Ana Gabriela Felix; Janusz, Cara Bess

2015-05-07

Cervical cancer is the leading cause of cancer deaths in Honduras. With the availability of a vaccine to prevent human papillomavirus (HPV), the causative agent for cervical cancer, the Honduran Secretary of Health undertook a cost-effectiveness analysis of introducing the HPV vaccine to support their national decision-making process. A national multidisciplinary team conducted this analysis with the CERVIVAC model, developed by the London School of Hygiene and Tropical Medicine in collaboration with the Pan American Health Organization's ProVac Initiative. The cumulative costs and health benefits of introducing the HPV vaccine were assessed over the lifetime of one single cohort of 11-year-old girls. We assumed a three-dose series with 95% vaccination coverage of the cohort using a mixture of school-based and facility-based delivery. To estimate national cervical cancer cases and deaths, we used United Nations demographic projections and GLOBOCAN estimates based on registry data from El Salvador, Guatemala, and Nicaragua. Based on estimates from the World Health Organization (WHO) and the Division of Intensified Cooperation with Countries (ICO), we assumed that 70% of cervical cancer would be due to vaccine types HPV16 and HPV18. We used a vaccine dose price of US$ 13.45 and evidence from the scientific literature to estimate vaccine effectiveness. National information was used to estimate health service utilization and costs of cervical cancer treatment. All costs and health benefits were discounted at 3%. Upon fully vaccinating 86,906 11-year old girls, 2250 (undiscounted) cervical cancer cases and 1336 (undiscounted) deaths would be prevented over the lifetime of the cohort. After discounting future health benefits at 3% per year, the equivalent cases and deaths prevented were 421 and 170. HPV vaccination is estimated to cost around US$ 5 million per vaccinated cohort, but this would be offset by around US$ 1 million in avoided costs borne by the government to treat cervical cancer. Furthermore, 4349 discounted disability adjusted life years (DALYs) could be avoided at a cost of US$ 926 per DALY avoided, making HPV vaccination in Honduras a highly cost-effective intervention. The net cost of HPV vaccination per DALY avoided is less than the WHO threshold for cost-effectiveness. However, at a cost of around US$ 5 million per vaccinated cohort, an important element to consider in this discussion is the budgetary implications that the introduction of the HPV vaccine would cause for the country. When comparing the costs and benefits of HPV vaccine introduction in Honduras, it is clear that this intervention would be highly cost-effective and that the intervention would greatly reduce cervical cancer disease. For these reasons, it is in the country's best interest to explore financing opportunities that could support the vaccine's introduction. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Treatment of Capital Costs in Educational Projects

ERIC Educational Resources Information Center

Bezeau, Lawrence

1975-01-01

Failure to account for the cost and depreciation of capital leads to suboptimal investments in education, specifically to excessively capital intensive instructional technologies. This type of error, which is particularly serious when planning for developing countries, can be easily avoided. (Author)

Cost-effectiveness of childhood rotavirus vaccination in Germany.

PubMed

Aidelsburger, Pamela; Grabein, Kristin; Böhm, Katharina; Dietl, Markus; Wasem, Jürgen; Koch, Judith; Ultsch, Bernhard; Weidemann, Felix; Wichmann, Ole

2014-04-07

Rotavirus (RV) causes a highly contagious gastroenteritis especially in children under five years of age. Since 2006 two RV-vaccines are available in Europe (Rotarix(®) and RotaTeq(®)). To support informed decision-making within the German Standing Committee on Vaccination (STIKO) the cost-effectiveness of these two vaccines was evaluated for the German healthcare setting. A Markov model was developed to evaluate the cost-effectiveness from the statutory health insurance (SHI) and from the societal perspective. RV-cases prevented, RV-associated hospitalizations avoided, and quality-adjusted life years (QALY) gained were considered as health outcomes. RV-incidences were calculated based on data from the national mandatory disease reporting system. RV-vaccine efficacy was determined as pooled estimates based on data from randomized controlled trials. Vaccine list prices and price catalogues were used for cost-assessment. Effects and costs were discounted with an annual discount rate of 3%. The base-case analysis (SHI-perspective) resulted in an incremental cost-effectiveness and cost-utility ratio for Rotarix(®) of € 184 per RV-case prevented, € 2457 per RV-associated hospitalization avoided, and € 116,973 per QALY gained. For RotaTeq(®), the results were € 234 per RV-case prevented, € 2622 per RV-associated hospitalization avoided, and € 142,732 per QALY gained. Variation of various parameters in sensitivity analyses showed effects on the ICERs without changing the overall trend of base-case results. When applying base-case results to the 2012 birthcohort in Germany with 80% vaccination coverage, an estimated 206,000-242,000 RV-cases and 18,000 RV-associated hospitalizations can be prevented in this birthcohort over five years for an incremental cost of 44.5-48.2 million €. Our analyses demonstrate that routine RV-vaccination could prevent a substantial number of RV-cases and hospitalizations in the German healthcare system, but the saved treatment costs are counteracted by costs for vaccination. However, with vaccine prices reduced by ∼62-66%, RV-vaccination could even become a cost-saving preventive measure. Copyright © 2014 Elsevier Ltd. All rights reserved.

Launch vehicle systems design analysis

NASA Technical Reports Server (NTRS)

Ryan, Robert; Verderaime, V.

1993-01-01

Current launch vehicle design emphasis is on low life-cycle cost. This paper applies total quality management (TQM) principles to a conventional systems design analysis process to provide low-cost, high-reliability designs. Suggested TQM techniques include Steward's systems information flow matrix method, quality leverage principle, quality through robustness and function deployment, Pareto's principle, Pugh's selection and enhancement criteria, and other design process procedures. TQM quality performance at least-cost can be realized through competent concurrent engineering teams and brilliance of their technical leadership.

Strategies for designing an efficient insurance fertility benefit: a 21st century approach.

PubMed

Jones, Howard W; Allen, Brian D

2009-06-01

Creating a 21st century insurance benefit for infertility should be cost effective. Savings can be realized by eliminating hidden infertility costs, eliminating payments for ineffective treatments, and providing coverage for effective 21st century treatments, thus reducing costs associated with iatrogenic multiple pregnancies. The new benefit allows patients to attempt 21st century forms of infertility treatments while being managed by certified infertility providers. Industry and insurance carriers might save money by examination and implementation of this concept.

Standardization and program effect analysis (Study 2.4). Volume 2: Equipment commonality analysis. [cost savings of using flight-proven components in designing spacecraft

NASA Technical Reports Server (NTRS)

Shiokari, T.

1975-01-01

The feasibility and cost savings of using flight-proven components in designing spacecraft were investigated. The components analyzed were (1) large space telescope, (2) stratospheric aerosol and gas equipment, (3) mapping mission, (4) solar maximum mission, and (5) Tiros-N. It is concluded that flight-proven hardware can be used with not-too-extensive modification, and significant savings can be realized. The cost savings for each component are presented.

Concurrency in product realization

NASA Astrophysics Data System (ADS)

Kelly, Michael J.

1994-03-01

Technology per se does not provide a competitive advantage. Timely exploitation of technology is what gives the competitive edge, and this demands a major shift in the product development process and management of the industrial enterprise. `Teaming to win' is more than a management theme; it is the disciplined engineering practice that is essential to success in today's global marketplace. Teaming supports the concurrent engineering practices required to integrate the activities of people responsible for product realization through achievement of shorter development cycles, lower costs, and defect-free products.

Implications of Transaction Costs for Acquisition Program Cost Breaches

DTIC Science & Technology

2013-06-01

scope of the work, communicating the basis on which the estimate is built, identifying the quality of the data, determining the level of risk, and...projects such as bases, schools, missile storage facilities, maintenance facilities, medical/ dental clinics, libraries, and military family housing...was established as a threshold for measuring cost growth. This prevents a program from rebaselining to avoid a Nunn- McCurdy cost threshold breach. In

7 CFR 701.36 - Schemes and devices and claims avoidances.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Schemes and devices and claims avoidances. 701.36... RELATED PROGRAMS PREVIOUSLY ADMINISTERED UNDER THIS PART § 701.36 Schemes and devices and claims..., any scheme or device designed to evade the maximum cost-share limitation that applies to the ECP or to...

Pre-treatment predictors and in-treatment factors associated with change in avoidant and dependent personality disorder traits among patients with social phobia.

PubMed

Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold; Martinsen, Egil; Gude, Tore; Hedley, Liv Margaret; Abrahamsen, Gun

2010-01-01

We examined changes in avoidant and dependent personality disorder dimensions, and pre-treatment and in-treatment factors associated with such changes in 77 patients, randomized to medication-free residential cognitive (CT) or residential interpersonal therapy for social phobia. Personality disorders and personality dimensions according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were assessed at pre-treatment and at one-year post-treatment. Both treatments were associated with a decrease in avoidant and dependent personality dimensions; dependent dimension decreased more in CT. Changes in cognitive factors predicted changes in both personality dimensions, whereas changes in symptoms or interpersonal factors did not. Change in the cognitive factor estimated cost was the most powerful predictor in the avoidant dimension, as it was the only predictor that remained significant in the forward regression analyses. Change in the cognitive factor estimated cost, and treatment were the most powerful predictors of change in the dependent dimension. Pre-treatment use of anxiolytics predicted larger changes in both PD dimensions.

Improving population management through pharmacist-primary care integration: a pilot study.

PubMed

Kennedy, Amanda G; Chen, Harry; Corriveau, Michele; MacLean, Charles D

2015-02-01

Pharmacists have unique skills that may benefit primary care practices. The objective of this demonstration project was to determine the impact of integrating pharmacists into patient-centered medical homes, with a focus on population management. Pharmacists were partnered into 5 primary care practices in Vermont 1 day per week to provide direct patient care, population-based medication management, and prescriber education. The main measures included a description of drug therapy problems identified and cost avoidance models. The pharmacists identified 708 drug therapy problems through direct patient care (336/708; 47.5%), population-based strategies (276/708; 38.9%), and education (96/708; 13.6%). Common population-based strategies included adjusting doses and discontinuing unnecessary medications. Pharmacists' recommendations to correct drug therapy problems were accepted by prescribers 86% of the time, when data about acceptance were known. Of the 49 recommendations not accepted, 47/49 (96%) were population-based and 2/49 (4%) were related to direct patient care. The cost avoidance model suggests $2.11 in cost was avoided for every $1.00 spent on a pharmacist ($373,092/$176,690). There was clear value in integrating pharmacists into primary care teams. Their inclusion prevented adverse drug events, avoided costs, and improved patient outcomes. Primary care providers should consider pharmacists well suited to offer direct patient care, population-based management, and prescriber education to their practices. To be successful, pharmacists must have full permission to document findings in the primary care practices' electronic health records. Given that many pharmacist services do not involve billable activities, sustainability requires identifying alternative funding mechanisms that do not rely on a traditional fee-for-service approach.

Cost-Effectiveness Analysis of Isavuconazole vs. Voriconazole as First-Line Treatment for Invasive Aspergillosis.

PubMed

Harrington, Rachel; Lee, Edward; Yang, Hongbo; Wei, Jin; Messali, Andrew; Azie, Nkechi; Wu, Eric Q; Spalding, James

2017-01-01

Invasive aspergillosis (IA) is associated with a significant clinical and economic burden. The phase III SECURE trial demonstrated non-inferiority in clinical efficacy between isavuconazole and voriconazole. No studies have evaluated the cost-effectiveness of isavuconazole compared to voriconazole. The objective of this study was to evaluate the costs and cost-effectiveness of isavuconazole vs. voriconazole for the first-line treatment of IA from the US hospital perspective. An economic model was developed to assess the costs and cost-effectiveness of isavuconazole vs. voriconazole in hospitalized patients with IA. The time horizon was the duration of hospitalization. Length of stay for the initial admission, incidence of readmission, clinical response, overall survival rates, and experience of adverse events (AEs) came from the SECURE trial. Unit costs were from the literature. Total costs per patient were estimated, composed of drug costs, costs of AEs, and costs of hospitalizations. Incremental costs per death avoided and per additional clinical responders were reported. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were conducted. Base case analysis showed that isavuconazole was associated with a $7418 lower total cost per patient than voriconazole. In both incremental costs per death avoided and incremental costs per additional clinical responder, isavuconazole dominated voriconazole. Results were robust in sensitivity analysis. Isavuconazole was cost saving and dominant vs. voriconazole in most DSA. In PSA, isavuconazole was cost saving in 80.2% of the simulations and cost-effective in 82.0% of the simulations at the $50,000 willingness to pay threshold per additional outcome. Isavuconazole is a cost-effective option for the treatment of IA among hospitalized patients. Astellas Pharma Global Development, Inc.

Aging mothers' and their adult daughters' perceptions of conflict behaviors.

PubMed

Fingerman, K L

1995-12-01

Aging parents tend to perceive greater compatibility between themselves and offspring than do off-spring, but there is little research examining differences in perceptions of conflicts. Ninety-six older mothers (M age = 76) and their daughters (M age = 44) together selected a conflictual incident, then individually rated the degree to which they and the other person had engaged in destructive, constructive, or avoidant conflict behaviors. Mothers and daughters reported using constructive approaches more than other approaches. Mothers claimed to engage in constructive behaviors more than daughters recognized. Daughters reported engaging in destructive and avoidant behaviors more than mothers realized. Mothers also thought daughters felt better about the incident than daughters reported feeling about it. Findings suggest older mothers' underestimate daughters' negative behaviors and feelings in conflict situations.

Stent fracture in the superficial femoral and proximal popliteal arteries: literature summary and economic impacts.

PubMed

Neil, Nancy

2013-06-01

To summarize available evidence regarding stent fracture in the femoropopliteal region. We searched PubMed, 2000-2011, using MeSH search terms "stents," "popliteal artery," and "femoral artery." We identified 29 original studies reporting 0% to 65% incidence of stent fracture. Fracture-related repeat revascularization could be avoided in the absence of device failure. Recently published data suggest that even a 5% rate of fracture-related reintervention would generate $118.4 million in health care cost in the United States. These excess procedures would also result in major complications and deaths that might have been avoided in the absence of stent fracture. Reported incidence and clinical relevance of femoropopliteal stent fractures vary across studies. Stent fracture may lead to repeat revascularization. These reinterventions create considerable--and potentially avoidable--economic burden for patients and payers. Further, these costs are effectively invisible wherever stent fractures are not systematically documented as the reason for reintervention.

Excise tax avoidance: the case of state cigarette taxes.

PubMed

DeCicca, Philip; Kenkel, Donald; Liu, Feng

2013-12-01

We conduct an applied welfare economics analysis of cigarette tax avoidance. We develop an extension of the standard formula for the optimal Pigouvian corrective tax to incorporate the possibility that consumers avoid the tax by making purchases in nearby lower tax jurisdictions. To provide a key parameter for our formula, we estimate a structural endogenous switching regression model of border-crossing and cigarette prices. In illustrative calculations, we find that for many states, after taking into account tax avoidance the optimal tax is at least 20% smaller than the standard Pigouvian tax that simply internalizes external costs. Our empirical estimate that tax avoidance strongly responds to the price differential is the main reason for this result. We also use our results to examine the benefits of replacing avoidable state excise taxes with a harder-to-avoid federal excise tax on cigarettes. Copyright © 2013 Elsevier B.V. All rights reserved.

Excise Tax Avoidance: The Case of State Cigarette Taxes

PubMed Central

DeCicca, Philip; Kenkel, Donald; Liu, Feng

2013-01-01

We conduct an applied welfare economics analysis of cigarette tax avoidance. We develop an extension of the standard formula for the optimal Pigouvian corrective tax to incorporate the possibility that consumers avoid the tax by making purchases in nearby lower-tax jurisdictions. To provide a key parameter for our formula, we estimate a structural endogenous switching regression model of border-crossing and cigarette prices. In illustrative calculations, we find that for many states, after taking into account tax avoidance the optimal tax is at least 20 percent smaller than the standard Pigouvian tax that simply internalizes external costs. Our empirical estimate that tax avoidance strongly responds to the price differential is the main reason for this result. We also use our results to examine the benefits of replacing avoidable state excise taxes with a harder-to-avoid federal excise tax on cigarettes. PMID:24140760

Coal-Fired Power Plant Heat Rate Reductions

EPA Pesticide Factsheets

View a report that identifies systems and equipment in coal-fired power plants where efficiency improvements can be realized, and provides estimates of the resulting net plant heat rate reductions and costs for implementation.

Estimates of the direct and indirect cost savings associated with heart disease that could be avoided through dietary change in the United States.

PubMed

Cawley, John; Meyerhoefer, Chad; Gillingham, Leah G; Kris-Etherton, Penny; Jones, Peter J H

2017-02-01

Diets high in saturated fat are associated with elevated risk of heart disease. This study estimates the savings in direct (medical care) costs and indirect (job absenteeism) costs in the US from reductions in heart disease associated with substituting monounsaturated fats (MUFA) for saturated fats. A four-part model of the medical care cost savings from avoided heart disease was estimated using data on 247,700 adults from the 2000-2010 Medical Expenditure Panel Survey (MEPS). The savings from reduced job absenteeism due to avoided heart disease was estimated using a zero-inflated negative binomial model of the number of annual work loss days applied to data on 164,577 adults from the MEPS. Estimated annual savings in medical care expenditures resulting from a switch from a diet high in saturated fat to a high-MUFA diet totaled ∼ $25.7 billion (95% CI = $6.0-$45.4 billion) in 2010, with private insurance plans saving $7.9 billion (95% CI = $1.8-$14.0 billion), Medicare saving $9.4 billion (95% CI = $2.1-$16.7 billion), Medicaid saving $1.4 billion (95% CI = $0.2-$2.5 billion), and patients saving $2.2 billion (95% CI = $0.5-$3.8 billion). The annual savings in terms of reduced job absenteeism ranges from a lower bound of $600 million (95% CI = $100 million to $1.0 billion) to an upper bound of $1.2 billion (95% CI = $0.2-$2.1 billion) for 2010. The data cover only the non-institutionalized population. Decreased costs due to any decreases in the severity of heart disease are not included. Cost savings do not include any reduction in informal care at home. Diets high in saturated fat impose substantial medical care costs and job absenteeism costs, and substantial savings could be achieved by substituting MUFA for saturated fat.

A Low-Cost, Effective, Fumes Exhaust System.

ERIC Educational Resources Information Center

Jacobs, C. O.

1979-01-01

Discusses the importance of avoiding welding fumes. The sources of these fumes are presented in a table. Criticizes currently used ventilation systems and reviews the Occupational Safety and Health Act requirements. Describes a low-cost exhaust system developed for agricultural mechanics laboratories. (LRA)

Middle-Aged Thinking.

ERIC Educational Resources Information Center

Nixon, Charles W.

1998-01-01

Examines renovation issues involving 30- and 40-year-old school facilities. Explores ways a school district can renovate old buildings to first-class cost-effective facilities while avoiding excessive transition costs. Discussions include installation of new technology and the resulting wiring demands, and developing more energy-efficient heating…

Superfund: conscripting industry support for environmental cleanup

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

Gulick, T.E.

The Superfund is notable in its attempt to charge the costs of environmental damage to those commercial interests that contributed to the damage. The approach should appeal to the Reagan administration's fiscal austerity program. It realizes the attendant costs to the benefits of our technologically productive society and recognizes that those costs must be paid either as environmental precautions or as cleanup costs, property damage, and disease. This article examines the major problems addressed by Superfund, describing the major provisions of the Act, discussing previously available remedies, and considering some of the problems that may arise with implementation. 126 references.

Singular cosmological evolution using canonical and ghost scalar fields

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

Nojiri, Shin'ichi; Odintsov, S.D.; Oikonomou, V.K.

2015-09-01

We demonstrate that finite time singularities of Type IV can be consistently incorporated in the Universe's cosmological evolution, either appearing in the inflationary era, or in the late-time regime. While using only one scalar field instabilities can in principle occur at the time of the phantom-divide crossing, when two fields are involved we are able to avoid such instabilities. Additionally, the two-field scalar-tensor theories prove to be able to offer a plethora of possible viable cosmological scenarios, at which various types of cosmological singularities can be realized. Amongst others, it is possible to describe inflation with the appearance of amore » Type IV singularity, and phantom late-time acceleration which ends in a Big Rip. Finally, for completeness, we also present the Type IV realization in the context of suitably reconstructed F(R) gravity.« less

Mode selection in square resonator microlasers for widely tunable single mode lasing.

PubMed

Tang, Ming-Ying; Sui, Shao-Shuai; Yang, Yue-De; Xiao, Jin-Long; Du, Yun; Huang, Yong-Zhen

2015-10-19

Mode selection in square resonator semiconductor microlasers is demonstrated by adjusting the width of the output waveguide coupled to the midpoint of one side. The simulation and experimental results reveal that widely tunable single mode lasing can be realized in square resonator microlasers. Through adjusting the width of the output waveguide, the mode interval of the high-Q modes can reach four times of the longitudinal mode interval. Therefore, mode hopping can be efficiently avoided and the lasing wavelength can be tuned continuously by tuning the injection current. For a 17.8-μm-side-length square microlaser with a 1.4-μm-width output waveguide, mode-hopping-free single-mode operation is achieved with a continuous tuning range of 9.2 nm. As a result, the control of the lasing mode is realized for the square microlasers.

Cost effectiveness of budesonide/formoterol added to tiotropium bromide versus placebo added to tiotropium bromide in patients with chronic obstructive pulmonary disease: Australian, Canadian and Swedish healthcare perspectives.

PubMed

Mittmann, Nicole; Hernandez, Paul; Mellström, Carl; Brannman, Lance; Welte, Tobias

2011-05-01

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease associated with increasing morbidity and mortality and an economic burden that stretches beyond the patient to healthcare systems. Avoiding exacerbations and subsequent hospitalizations is an important clinical aim and can avoid significant costs associated with the disease. International guidelines recommend the addition of an inhaled corticosteroid (ICS) to a long-acting β₂-adrenoceptor agonist (LABA) for patients with severe to very severe COPD and a history of exacerbations. To evaluate retrospectively over a 3-month period, the cost effectiveness of budesonide/formoterol added to tiotropium bromide (tiotropium) compared with placebo added to tiotropium in COPD patients eligible for ICS/LABA combination therapy, based on the CLIMB study (NCT00496470). A cost-effectiveness analysis of data from the 12-week, randomized, double-blind CLIMB study of COPD patients (n = 659; eligible for ICS/LABA; aged ≥ 40 years) comparing budesonide/formoterol (Symbicort® Turbuhaler® 320/9 μg twice daily) added to tiotropium (18 μg daily) or placebo added to tiotropium was conducted. A severe exacerbation was defined as a requirement for systemic glucocorticosteroids and/or ED visit and/or hospitalization. The effectiveness variable used for this analysis was the number of severe exacerbations avoided. Direct costs (medications, hospitalizations, ED and GP visits) were calculated by applying year 2009 unit costs from Australia ($A), Canada ($Can) and Sweden (Swedish krona [SEK]) to the study's pooled resource use. One-way sensitivity analyses for each country's mean incremental cost-effectiveness ratio and sensitivity to overall exacerbations were conducted. Bootstrapping was performed to estimate the variation around resource use, exacerbations and each country's mean incremental cost-effectiveness ratio. The mean number of severe exacerbations per patient 3-month period was 0.11 in the budesonide/formoterol added to tiotropium arm and 0.29 in the placebo added to tiotropium arm--a 62% reduction in the rate of severe exacerbations. Treatment with budesonide/formoterol added to tiotropium costs less in Australia and Canada (-$A90 [-€58] and -$Can4.51 [-€3]) and only slightly more in Sweden (SEK444 [€43]), i.e. the savings associated with fewer exacerbations more than offset the additional budesonide/formoterol drug cost in Australia and Canada, and partially offset it in Sweden. In the Australian and Canadian perspectives, budesonide/formoterol added to tiotropium was a dominant treatment (fewer exacerbations at a lower cost) compared with placebo added to tiotropium. In Sweden, the estimated incremental cost per avoided exacerbation was SEK2502 (€244.40). Budesonide/formoterol added to tiotropium was the dominant strategy compared with placebo added to tiotropium based on a 12-week study in COPD patients eligible for ICS/LABA combination therapy in Australia and Canada, and appears to be a cost-effective strategy in Sweden.

Architectures of fiber optic network in telecommunications

NASA Astrophysics Data System (ADS)

Vasile, Irina B.; Vasile, Alexandru; Filip, Luminita E.

2005-08-01

The operators of telecommunications have targeted their efforts towards realizing applications using broad band fiber optics systems in the access network. Thus, a new concept related to the implementation of fiber optic transmission systems, named FITL (Fiber In The Loop) has appeared. The fiber optic transmission systems have been extensively used for realizing the transport and intercommunication of the public telecommunication network, as well as for assuring the access to the telecommunication systems of the great corporations. Still, the segment of the residential users and small corporations did not benefit on large scale of this technology implementation. For the purpose of defining fiber optic applications, more types of architectures were conceived, like: bus, ring, star, tree. In the case of tree-like networks passive splitters (that"s where the name of PON comes from - Passive Optical Network-), which reduce significantly the costs of the fiber optic access, by separating the costs of the optical electronic components. That's why the passive fiber optics architectures (PON represent a viable solution for realizing the access at the user's loop. The main types of fiber optics architectures included in this work are: FTTC (Fiber To The Curb); FTTB (Fiber To The Building); FTTH (Fiber To The Home).

Flexible microwave PIN diodes and switches employing transferrable single-crystal Si nanomembranes on plastic substrates

NASA Astrophysics Data System (ADS)

Qin, Guoxuan; Yuan, Hao-Chih; Celler, George K.; Zhou, Weidong; Ma, Zhenqiang

2009-12-01

This paper reports the realization of flexible RF/microwave PIN diodes and switches using transferrable single-crystal Si nanomembranes (SiNM) that are monolithically integrated on low-cost, flexible plastic substrates. High frequency response is obtained through the realization of low parasitic resistance achieved with heavy ion implantation before nanomembrane release and transfer. The flexible lateral SiNM PIN diodes exhibit typical rectifying characteristics with insertion loss and isolation better than 0.9 dB and 19.6 dB, respectively, from DC to 5 GHz, as well as power handling up to 22.5 dBm without gain compression. A single-pole single-throw (SPST) flexible RF switch employing shunt-series PIN diode configuration has achieved insertion loss and isolation better than 0.6 dB and 22.9 dB, respectively, from DC to 5 GHz. Furthermore, the SPST microwave switch shows performance improvement and robustness under mechanical deformation conditions. The study demonstrates the considerable potential of using properly processed transferrable SiNM for microwave passive components. Future investigations on transferrable SiNMs will lead to eventual realization of monolithic microwave integrated systems on low-cost flexible substrates.

The High Cost of Complexity in Experimental Design and Data Analysis: Type I and Type II Error Rates in Multiway ANOVA.

ERIC Educational Resources Information Center

Smith, Rachel A.; Levine, Timothy R.; Lachlan, Kenneth A.; Fediuk, Thomas A.

2002-01-01

Notes that the availability of statistical software packages has led to a sharp increase in use of complex research designs and complex statistical analyses in communication research. Reports a series of Monte Carlo simulations which demonstrate that this complexity may come at a heavier cost than many communication researchers realize. Warns…

Avoiding Braess' Paradox Through Collective Intelligence

NASA Technical Reports Server (NTRS)

Wolpert , David H.; Tumer, Kagan

1999-01-01

In an Ideal Shortest Path Algorithm (ISPA), at each moment each router in a network sends all of its traffic down the path that will incur the lowest cost to that traffic. In the limit of an infinitesimally small amount of traffic for a particular router, its routing that traffic via an ISPA is optimal, as far as cost incurred by that traffic is concerned. We demonstrate though that in many cases, due to the side-effects of one router's actions on another routers performance, having routers use ISPA's is suboptimal as far as global aggregate cost is concerned, even when only used to route infinitesimally small amounts of traffic. As a particular example of this we present an instance of Braess' paradox for ISPA'S, in which adding new links to a network decreases overall throughput. We also demonstrate that load-balancing, in which the routing decisions are made to optimize the global cost incurred by all traffic currently being routed, is suboptimal as far as global cost averaged across time is concerned. This is also due to "side-effects", in this case of current routing decision on future traffic. The theory of COllective INtelligence (COIN) is concerned precisely with the issue of avoiding such deleterious side-effects. We present key concepts from that theory and use them to derive an idealized algorithm whose performance is better than that of the ISPA, even in the infinitesimal limit. We present experiments verifying this, and also showing that a machine-learning-based version of this COIN algorithm in which costs are only imprecisely estimated (a version potentially applicable in the real world) also outperforms the ISPA, despite having access to less information than does the ISPA. In particular, this COIN algorithm avoids Braess' paradox.

[Organizational and management companies models].

PubMed

Tomei, G; Tomei, F; Fiaschetti, M; De Sio, S; Tria, M; Schifano, M P; Monti, C; Tasciotti, Z; Panfili, T; Caciari, A; Sancini, A

2010-01-01

With the legislative decree 81/08 and s.m.i. it's explicitly defined a model of management and corporate organization that can contribute to prevent security risks in work environments. The realization of the model is not obligatory, but desirable because the result of its implementation is a decrease of company's risks and costs for safety. Our study group has developed the structure of an organizational and management model for corporate safety and the tools necessary for its realization. The realization of a model is structured in various phases: initial exam, safety policy, planification, implementation, monitoring, system retest and improvement. Such a model, in continuous evolution, is based on the responsibilities of the different corporate figures through an accurate analysis of the measured risks and the measures adopted.

Costs of colour change in fish: food intake and behavioural decisions.

PubMed

Rodgers, Gwendolen M; Gladman, Nicholas W; Corless, Hannah F; Morrell, Lesley J

2013-07-15

Many animals, particularly reptiles, amphibians, fish and cephalopods, have the ability to change their body colour, for functions including thermoregulation, signalling and predator avoidance. Many fish plastically darken their body colouration in response to dark visual backgrounds, and this functions to reduce predation risk. Here, we tested the hypotheses that colour change in fish (1) carries with it an energetic cost and (2) affects subsequent shoal and habitat choice decisions. We demonstrate that guppies (Poecilia reticulata) change colour in response to dark and light visual backgrounds, and that doing so carries an energetic cost in terms of food consumption. By increasing food intake, however, guppies are able to maintain growth rates and meet the energetic costs of changing colour. Following colour change, fish preferentially choose habitats and shoals that match their own body colouration, and maximise crypsis, thus avoiding the need for further colour change but also potentially paying an opportunity cost associated with restriction to particular habitats and social associates. Thus, colour change to match the background is complemented by behavioural strategies, which should act to maximise fitness in variable environments.

Fiscal scarcity and the inevitability of bedside budget balancing.

PubMed

Morreim, E H

1989-05-01

Until recently, generous third-party reimbursements enabled physicians to pursue each patient's interests with little regard to costs. Conscious rationing was required only episodically as some particular commodity, eg, transplant organs, was too scarce to meet demand, or as some patients lacked basic access to the health care system. Cost containment and the economic reorganization of medicine introduce a new sort of scarcity, requiring a different sort of rationing. "Fiscal scarcity," the general contraction of health care dollars, means that because every medical decision has its cost, every decision is now subject to scrutiny for its economic as well as its medical wisdom. Therefore, every detail of medicine is an allocation problem. Many observers argue that physicians can nevertheless avoid directly trading patients' interests against economic considerations: through "efficiency protocols" that eliminate marginal benefits, through turning economic rationing decisions over to outside parties, through avoiding cost constraints until society has established a just health care allocation system. This article shows that none of these proposals permits the physician to escape cost-cutting at the bedside.

Cost-effectiveness analysis of strategies using new immunological diagnostic tests of latent tuberculosis infection before TNF-blockers therapy.

PubMed

Freund, Romain; Granger, Benjamin; Francois, Cécile; Carcelain, Guislaine; Ravaud, Philippe; Mariette, Xavier; Fautrel, Bruno

2018-02-01

Several tests have been proposed to detect latent tuberculosis (LTB). To evaluate the cost-effectiveness of different interferon-gamma release assays based strategies used to screen LTB before tumour necrosis factor (TNF) blockers initiation. Consecutive patients with rheumatoid arthritis, spondyloarthritis or Crohn's disease for whom TNF-blockers were considered, were recruited in 15 tertiary care centres. All were screened for LTB with tuberculin skin test (TST), QuantiFERON TB Gold ® in tube (QFT) and T-SPOT.TB ® (TSpot) on the same day. Cost-minimization and cost-effectiveness analysis, testing 8 screening test combinations, were conducted. Effectiveness was defined as the percentage of LTB treatment avoided and compared with TST alone. Cost were elicited in the payer perspective, included all the costs related to the screening procedure. No tuberculosis reactivation was observed after TNF-blocker initiation. TST followed by QFT if TST was positive was found as the best screening strategy, i.e. the less costly (-54€ compared to reference) and most effective (effectiveness 0.93), resulting in an incremental cost-effectiveness ratio of -192€ per treatment avoided. A probabilistic sensitivity analysis confirmed this result in 72.3% of simulations. TST followed by QFT if TST was positive is the most cost-effective strategy in screening for LTB in patients before starting anti-TNF therapy. NCT00811343. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Cost effectiveness of recycling: A systems model

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

Tonjes, David J., E-mail: david.tonjes@stonybrook.edu; Waste Reduction and Management Institute, School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794-5000; Center for Bioenergy Research and Development, Advanced Energy Research and Technology Center, Stony Brook University, 1000 Innovation Rd., Stony Brook, NY 11794-6044

Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have alsomore » found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.« less

Elements of Regolith Simulant's Cost Structure

NASA Technical Reports Server (NTRS)

Rickman, Douglas L.

2009-01-01

The cost of lunar regolith simulants is much higher than many users anticipate. After all, it is nothing more than broken rock. This class will discuss the elements which make up the cost structure for simulants. It will also consider which elements can be avoided under certain circumstances and which elements might be altered by the application of additional research and development.

Costing and competition.

PubMed

Bates, K; Brignall, S

1994-01-01

Working for patients established a new system of contracts between providers and purchasers of healthcare, with prices based on full costs, avoiding cross-subsidization. The new regime necessitates greatly improved costing systems, to improve the efficiency of service provision by creating price competition between providers. Ken Bates and Stan Brignall argue that non-price competition also occurs, with providers 'differentiating' on quality of service/product, flexibility or innovation.

Cascading costs: an economic nitrogen cycle.

PubMed

Moomaw, William R; Birch, Melissa B L

2005-09-01

The chemical nitrogen cycle is becoming better characterized in terms of fluxes and reservoirs on a variety of scales. Galloway has demonstrated that reactive nitrogen can cascade through multiple ecosystems causing environmental damage at each stage before being denitrified to N(2). We propose to construct a parallel economic nitrogen cascade (ENC) in which economic impacts of nitrogen fluxes can be estimated by the costs associated with each stage of the chemical cascade. Using economic data for the benefits of damage avoided and costs of mitigation in the Chesapeake Bay basin, we have constructed an economic nitrogen cascade for the region. Since a single ton of nitrogen can cascade through the system, the costs also cascade. Therefore evaluating the benefits of mitigating a ton of reactive nitrogen released needs to consider the damage avoided in all of the ecosystems through which that ton would cascade. The analysis reveals that it is most cost effective to remove a ton of nitrogen coming from combustion since it has the greatest impact on human health and creates cascading damage through the atmospheric, terrestrial, aquatic and coastal ecosystems. We will discuss the implications of this analysis for determining the most cost effective policy option for achieving environmental quality goals.

Cascading costs: an economic nitrogen cycle.

PubMed

Moomaw, William R; Birch, Melissa B L

2005-12-01

The chemical nitrogen cycle is becoming better characterized in terms of fluxes and reservoirs on a variety of scales. Galloway has demonstrated that reactive nitrogen can cascade through multiple ecosystems causing environmental damage at each stage before being denitrified to N2. We propose to construct a parallel economic nitrogen cascade (ENC) in which economic impacts of nitrogen fluxes can be estimated by the costs associated with each stage of the chemical cascade. Using economic data for the benefits of damage avoided and costs of mitigation in the Chesapeake Bay basin, we have constructed an economic nitrogen cascade for the region. Since a single tonne of nitrogen can cascade through the system, the costs also cascade. Therefore evaluating the benefits of mitigating a tonne of reactive nitrogen released needs to consider the damage avoided in all of the ecosystems through which that tonne would cascade. The analysis reveals that it is most cost effective to remove a tonne of nitrogen coming from combustion since it has the greatest impact on human health and creates cascading damage through the atmospheric, terrestrial, aquatic and coastal ecosystems. We will discuss the implications of this analysis for determining the most cost effective policy option for achieving environmental quality goals.

Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals.

PubMed

Banks, M D; Graves, N; Bauer, J D; Ash, S

2013-01-01

This study estimates the economic outcomes of a nutrition intervention to at-risk patients compared with standard care in the prevention of pressure ulcer. Statistical models were developed to predict 'cases of pressure ulcer avoided', 'number of bed days gained' and 'change to economic costs' in public hospitals in 2002-2003 in Queensland, Australia. Input parameters were specified and appropriate probability distributions fitted for: number of discharges per annum; incidence rate for pressure ulcer; independent effect of pressure ulcer on length of stay; cost of a bed day; change in risk in developing a pressure ulcer associated with nutrition support; annual cost of the provision of a nutrition support intervention for at-risk patients. A total of 1000 random re-samples were made and the results expressed as output probability distributions. The model predicts a mean 2896 (s.d. 632) cases of pressure ulcer avoided; 12, 397 (s.d. 4491) bed days released and corresponding mean economic cost saving of euros 2 869 526 (s.d. 2 078 715) with a nutrition support intervention, compared with standard care. Nutrition intervention is predicted to be a cost-effective approach in the prevention of pressure ulcer in at-risk patients.

Cost-effectiveness of an advance notification letter to increase colorectal cancer screening.

PubMed

Cronin, Paula; Goodall, Stephen; Lockett, Trevor; O'Keefe, Christine M; Norman, Richard; Church, Jody

2013-07-01

The aim of this study is to evaluate the cost-effectiveness of a patient-direct mailed advance notification letter on participants of a National Bowel Cancer Screening Program (NBCSP) in Australia, which was launched in August 2006 and offers free fecal occult blood testing to all Australians turning 50, 55, or 65 years of age in any given year. This study followed a hypothetical cohort of 50-year-old, 55-year-old, and 65-year-old patients undergoing fecal occult blood test (FOBT) screening through a decision analytic Markov model. The intervention compared two strategies: (i) advance letter, NBCSP, and FOBT compared with (ii) NBCSP and FOBT. The main outcome measures were life-years gained (LYG), quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio. An advance notification screening letter would yield an additional 54 per 100,000 colorectal cancer deaths avoided compared with no letter. The estimated cost-effectiveness was $3,976 per LYG and $6,976 per QALY gained. An advance notification letter in the NBCSP may have a significant impact on LYG and cancer deaths avoided. It is cost-effective and offers a feasible strategy that could be rolled out across other screening program at an acceptable cost.

Developing hydropower in Washington state. Volume 2: An electricity marketing manual

NASA Astrophysics Data System (ADS)

James, J. W.; McCoy, G. A.

1982-03-01

An electricity marketing manual for the potential small and micro-hydroelectric project developer within the state of Washington is presented. Public utility regulatory policies (PURPA) requires electric utilities to interconnect with and pay a rate based on their full avoided costs for the purchase of electrical output from qualifying small power production facilities. The determination of avoided costs, as business organizational considerations, utility interface concerns, interconnection requirements, metering options, and liability and wheeling are discussed. The utility responses are summarized, legislation which is of importance to hydropower developers and the powers and functions of the authorities responsible for enforcing the mandate of PURPA are described.

A practical approach to instrument selection, evaluation, basic financial management and implementation in pathology and research.

PubMed

Mina, Ashraf; Favaloro, Emmanuel J; Koutts, Jerry

2008-01-01

In response to increasingly complex demands in terms of productivity and budgets, there is a critical need to avoid mistakes during instrument selection that will be financially costly, and adversely affect customers, staff, productivity and test turnaround time. As there is no "one size fits all", guidelines must be appropriate to permit informed decision making. A Medline search was conducted to assess background knowledge in this area, using the terms "laboratory instrument selection" and "laboratory instrument evaluation". Searches returned over 800 articles, of which only seven were directly related to the topic of the search, with most outdated, and suggesting a paucity of appropriate information. Additional resources used included the American Association of Clinical Chemistry (AACC) website and the Internet. Appropriate criteria for instrument selection were established in the current report based on subjective and objective (technical) evaluations. Additionally, a sound and simple financial approach is also suggested to help in making informed decisions and avoid costly mistakes. We propose that such a process as outlined in our report will protect laboratories from making costly and avoidable mistakes in the acquisition of major equipment.

You Can't See the Real Me: Attachment Avoidance, Self-Verification, and Self-Concept Clarity.

PubMed

Emery, Lydia F; Gardner, Wendi L; Carswell, Kathleen L; Finkel, Eli J

2018-03-01

Attachment shapes people's experiences in their close relationships and their self-views. Although attachment avoidance and anxiety both undermine relationships, past research has primarily emphasized detrimental effects of anxiety on the self-concept. However, as partners can help people maintain stable self-views, avoidant individuals' negative views of others might place them at risk for self-concept confusion. We hypothesized that avoidance would predict lower self-concept clarity and that less self-verification from partners would mediate this association. Attachment avoidance was associated with lower self-concept clarity (Studies 1-5), an effect that was mediated by low self-verification (Studies 2-3). The association between avoidance and self-verification was mediated by less self-disclosure and less trust in partner feedback (Study 4). Longitudinally, avoidance predicted changes in self-verification, which in turn predicted changes in self-concept clarity (Study 5). Thus, avoidant individuals' reluctance to trust or become too close to others may result in hidden costs to the self-concept.

The relative effectiveness of managed care penetration and the healthcare safety net in reducing avoidable hospitalizations.

PubMed

Pracht, Etienne E; Orban, Barbara L; Comins, Meg M; Large, John T; Asin-Oostburg, Virginia

2011-01-01

Avoidable hospitalizations represent a key indicator for access to, and the quality of, primary care. Therefore, understanding their behavior is essential in terms of management of healthcare resources and costs. This analysis examines the affect of 2 healthcare strategies on the rate of avoidable hospitalization, managed care and the healthcare safety net. The avoidable hospitalizations definition developed by Weissman et al. (1992) was used to identify relevant inpatient episodes. A 2-stage simultaneous equations multivariate regression model with instrumental variables was used to estimate the relative influence of HMO penetration and the composition of local hospital markets on the rate of avoidable hospitalizations. Control variables in the model include healthcare supply and demand, demographic, socioeconomic, and health status characteristics. Increased market presence of public hospitals significantly reduced avoidable hospitalizations. HMO penetration did not influence the rate of avoidable hospitalizations. The results suggest that public investments in healthcare facilities and infrastructure are more effective in reducing avoidable hospitalizations. © 2011 National Association for Healthcare Quality.

Avoiding the Energy Crunch.

ERIC Educational Resources Information Center

Rowland, Dave

2001-01-01

Explores strategies for upgrading facility energy equipment that can cut energy costs and help substantially cover the costs of capital asset improvements. Discusses use of performance contracts to help schools leverage their operating budgets. Highlights how energy savings helped one school district finance $9.4 million in retrofits. (GR)

Modeling the Fear Effect in Predator-Prey Interactions with Adaptive Avoidance of Predators.

PubMed

Wang, Xiaoying; Zou, Xingfu

2017-06-01

Recent field experiments on vertebrates showed that the mere presence of a predator would cause a dramatic change of prey demography. Fear of predators increases the survival probability of prey, but leads to a cost of prey reproduction. Based on the experimental findings, we propose a predator-prey model with the cost of fear and adaptive avoidance of predators. Mathematical analyses show that the fear effect can interplay with maturation delay between juvenile prey and adult prey in determining the long-term population dynamics. A positive equilibrium may lose stability with an intermediate value of delay and regain stability if the delay is large. Numerical simulations show that both strong adaptation of adult prey and the large cost of fear have destabilizing effect while large population of predators has a stabilizing effect on the predator-prey interactions. Numerical simulations also imply that adult prey demonstrates stronger anti-predator behaviors if the population of predators is larger and shows weaker anti-predator behaviors if the cost of fear is larger.

Teaching high-value, cost-conscious care to residents: the Alliance for Academic Internal Medicine–American College of Physicians Curriculum.

PubMed

Smith, Cynthia D

2012-08-21

Health care expenditures are projected to reach nearly 20% of the U.S. gross domestic product by 2020. Up to $765 billion of this spending has been identified as potentially avoidable; many of the avoidable costs have been attributed to unnecessary services. Postgraduate trainees have historically received little specific training in the stewardship of health care resources and minimal feedback on resource utilization and its effect on the cost of care. This article describes a new curriculum that was developed collaboratively by the Alliance for Academic Internal Medicine and the American College of Physicians to address this training gap. The curriculum introduces a simple, stepwise framework for delivering high-value care and focuses on teaching trainees to incorporate high-value, cost-conscious care principles into their clinical practice. It consists of ten 1-hour, case-based, interactive sessions designed to be flexibly incorporated into the existing conference structure of a residency training program.

Cost-effective bidirectional digitized radio-over-fiber systems employing sigma delta modulation

NASA Astrophysics Data System (ADS)

Lee, Kyung Woon; Jung, HyunDo; Park, Jung Ho

2016-11-01

We propose a cost effective digitized radio-over-fiber (D-RoF) system employing a sigma delta modulation (SDM) and a bidirectional transmission technique using phase modulated downlink and intensity modulated uplink. SDM is transparent to different radio access technologies and modulation formats, and more suitable for a downlink of wireless system because a digital to analog converter (DAC) can be avoided at the base station (BS). Also, Central station and BS share the same light source by using a phase modulation for the downlink and an intensity modulation for the uplink transmission. Avoiding DACs and light sources have advantages in terms of cost reduction, power consumption, and compatibility with conventional wireless network structure. We have designed a cost effective bidirectional D-RoF system using a low pass SDM and measured the downlink and uplink transmission performance in terms of error vector magnitude, signal spectra, and constellations, which are based on the 10MHz LTE 64-QAM standard.

Ozone Contamination in Aircraft Cabins. Appendix B: Overview papers. Flight 8 planning to avoid high ozone

NASA Technical Reports Server (NTRS)

Belmont, A. D.

1979-01-01

The problem of preventing cabin ozone from exceeding a given standard was investigated. Statistical analysis of vertical distribution of ozone is summarized. The cost, logistics, maintenance, ability to forecast ozone, and avoiding high ozone concentrations are presented. Filtering approaches and the requirements to remove ozone toxicity are discussed.

Development of a low cost, low temperature cryocooler using the Gifford McMahon cycle

NASA Astrophysics Data System (ADS)

Ramanayaka, A.; Mani, R.

2008-03-01

Although Helium is the second most abundant element, its concentration in the earth's atmosphere is fairly low and constant, as the portion that escapes from the atmosphere is replace by new emission. Historically, Helium was extracted as a byproduct of natural gas production, and stored in gas fields in a National Helium Reserve, in an attempt to conserve this interesting element. National policy has changed and the cost of liquid Helium has increased rapidly in the recent past. These new circumstances have created new interest in alternative eco-friendly methods to realizing and maintaining low temperatures in the laboratory. There have been number of successful attempts at making low temperature closed cycle Helium refrigerators by modifying an existing closed cycle system, and usually the regenerator has been replaced in order to achieve the desired results. Here, we discus our attempt to fabricate a low cost, low temperature closed cycle Helium refrigerator starting from a 15K Gifford McMahon system. We reexamine the barriers to realizing lower temperature here and our attempts at overcoming them.

Retrospective Assessment of Cost Savings From Prevention

PubMed Central

Grosse, Scott D.; Berry, Robert J.; Tilford, J. Mick; Kucik, James E.; Waitzman, Norman J.

2016-01-01

Introduction Although fortification of food with folic acid has been calculated to be cost saving in the U.S., updated estimates are needed. This analysis calculates new estimates from the societal perspective of net cost savings per year associated with mandatory folic acid fortification of enriched cereal grain products in the U.S. that was implemented during 1997–1998. Methods Estimates of annual numbers of live-born spina bifida cases in 1995–1996 relative to 1999–2011 based on birth defects surveillance data were combined during 2015 with published estimates of the present value of lifetime direct costs updated in 2014 U.S. dollars for a live-born infant with spina bifida to estimate avoided direct costs and net cost savings. Results The fortification mandate is estimated to have reduced the annual number of U.S. live-born spina bifida cases by 767, with a lower-bound estimate of 614. The present value of mean direct lifetime cost per infant with spina bifida is estimated to be $791,900, or $577,000 excluding caregiving costs. Using a best estimate of numbers of avoided live-born spina bifida cases, fortification is estimated to reduce the present value of total direct costs for each year's birth cohort by $603 million more than the cost of fortification. A lower-bound estimate of cost savings using conservative assumptions, including the upper-bound estimate of fortification cost, is $299 million. Conclusions The estimates of cost savings are larger than previously reported, even using conservative assumptions. The analysis can also inform assessments of folic acid fortification in other countries. PMID:26790341

Patch-based iterative conditional geostatistical simulation using graph cuts

NASA Astrophysics Data System (ADS)

Li, Xue; Mariethoz, Gregoire; Lu, DeTang; Linde, Niklas

2016-08-01

Training image-based geostatistical methods are increasingly popular in groundwater hydrology even if existing algorithms present limitations that often make real-world applications difficult. These limitations include a computational cost that can be prohibitive for high-resolution 3-D applications, the presence of visual artifacts in the model realizations, and a low variability between model realizations due to the limited pool of patterns available in a finite-size training image. In this paper, we address these issues by proposing an iterative patch-based algorithm which adapts a graph cuts methodology that is widely used in computer graphics. Our adapted graph cuts method optimally cuts patches of pixel values borrowed from the training image and assembles them successively, each time accounting for the information of previously stitched patches. The initial simulation result might display artifacts, which are identified as regions of high cost. These artifacts are reduced by iteratively placing new patches in high-cost regions. In contrast to most patch-based algorithms, the proposed scheme can also efficiently address point conditioning. An advantage of the method is that the cut process results in the creation of new patterns that are not present in the training image, thereby increasing pattern variability. To quantify this effect, a new measure of variability is developed, the merging index, quantifies the pattern variability in the realizations with respect to the training image. A series of sensitivity analyses demonstrates the stability of the proposed graph cuts approach, which produces satisfying simulations for a wide range of parameters values. Applications to 2-D and 3-D cases are compared to state-of-the-art multiple-point methods. The results show that the proposed approach obtains significant speedups and increases variability between realizations. Connectivity functions applied to 2-D models transport simulations in 3-D models are used to demonstrate that pattern continuity is preserved.

JEOS. The JANUS earth observation satellite

NASA Astrophysics Data System (ADS)

Molette, P.; Jouan, J.

The JANUS multimission platform has been designed to minimize the cost of the satellite (by a maximum reuse of equipment from other proprogrammes) and of its associated launch by Aŕiane (by a piggy-back configuration optimized for Ariane 4). The paper describes the application of the JANUS platform to an Earth observation mission with the objective to provide a given country with a permanent monitoring of its earth resources by exploitation of spaceborne imagery. According to this objective, and to minimize the overall system and operational cost, the JANUS Earth Observation Satellite (JEOS) will provide a limited coverage with real time transmission of image data, thus avoiding need for on-board storage and simplifying operations. The JEOS operates on a low earth, near polar sun synchronous orbit. Launched in a piggy-back configuration on Ariane 4, with a SPOT or ERS spacecraft, it reaches its operational orbit after a drift orbit of a few weeks maximum. In its operational mode, the JEOS is 3-axis stabilised, earth pointed. After presentation of the platform, the paper describes the solid state push-broom camera which is composed of four optical lenses mounted on a highly stable optical bench. Each lens includes an optics system, reused from an on-going development, and two CCD linear arrays of detectors. The camera provides four registered channels in visible and near IR bands. The whole optical bench is supported by a rotating mechanism which allows rotation of the optical axis in the across-track direction. The JEOS typical performance for a 700 km altitude is then summarized: spatial resolution 30 m, swath width 120 km, off-track capability 325 km,… The payload data handling and transmission electronics, derived from the French SPOT satellite, realizes the processing, formatting, and transmission to the ground; this allows reuse of the standard SPOT receiving stations. The camera is only operated when the spacecraft is within the visibility of the ground station, and image data are directly transmitted to the ground station by the spacecraft X-band transmitter. Finally, the paper presents a set of typical Earth observation missions which can be realized with JEOS, for countries which wish to have their own observation system, possibly also as a complement to the SPOT and/or LANDSAT observation data.

Costs and cost-effectiveness of training traditional birth attendants to reduce neonatal mortality in the Lufwanyama Neonatal Survival study (LUNESP).

PubMed

Sabin, Lora L; Knapp, Anna B; MacLeod, William B; Phiri-Mazala, Grace; Kasimba, Joshua; Hamer, Davidson H; Gill, Christopher J

2012-01-01

The Lufwanyama Neonatal Survival Project ("LUNESP") was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs) to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness. We calculated LUNESP's financial and economic costs and the economic cost of implementation for a forecasted ten-year program (2011-2020). In each case, we calculated the incremental cost per death avoided and disability-adjusted life years (DALYs) averted in real 2011 US dollars. The forecasted 10-year program analysis included a base case as well as 'conservative' and 'optimistic' scenarios. Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. The estimated financial and economic costs of LUNESP were $118,574 and $127,756, respectively, or $49,469 and $53,550 per year. Fixed costs accounted for nearly 90% of total costs. For the 10-year program, discounted total and annual program costs were $256,455 and $26,834 respectively; for the base case, optimistic, and conservative scenarios, the estimated cost per death avoided was $1,866, $591, and $3,024, and cost per DALY averted was $74, $24, and $120, respectively. Outcomes were robust to variations in local costs, but sensitive to variations in intervention effect size, number of births attended by TBAs, and the extent of foreign consultants' participation. Based on established guidelines, the strategy of using trained TBAs to reduce neonatal mortality was 'highly cost effective'. We strongly recommend consideration of this approach for other remote rural populations with limited access to health care.

Cost effectiveness of a pharmacist-led information technology intervention for reducing rates of clinically important errors in medicines management in general practices (PINCER).

PubMed

Elliott, Rachel A; Putman, Koen D; Franklin, Matthew; Annemans, Lieven; Verhaeghe, Nick; Eden, Martin; Hayre, Jasdeep; Rodgers, Sarah; Sheikh, Aziz; Avery, Anthony J

2014-06-01

We recently showed that a pharmacist-led information technology-based intervention (PINCER) was significantly more effective in reducing medication errors in general practices than providing simple feedback on errors, with cost per error avoided at £79 (US$131). We aimed to estimate cost effectiveness of the PINCER intervention by combining effectiveness in error reduction and intervention costs with the effect of the individual errors on patient outcomes and healthcare costs, to estimate the effect on costs and QALYs. We developed Markov models for each of six medication errors targeted by PINCER. Clinical event probability, treatment pathway, resource use and costs were extracted from literature and costing tariffs. A composite probabilistic model combined patient-level error models with practice-level error rates and intervention costs from the trial. Cost per extra QALY and cost-effectiveness acceptability curves were generated from the perspective of NHS England, with a 5-year time horizon. The PINCER intervention generated £2,679 less cost and 0.81 more QALYs per practice [incremental cost-effectiveness ratio (ICER): -£3,037 per QALY] in the deterministic analysis. In the probabilistic analysis, PINCER generated 0.001 extra QALYs per practice compared with simple feedback, at £4.20 less per practice. Despite this extremely small set of differences in costs and outcomes, PINCER dominated simple feedback with a mean ICER of -£3,936 (standard error £2,970). At a ceiling 'willingness-to-pay' of £20,000/QALY, PINCER reaches 59 % probability of being cost effective. PINCER produced marginal health gain at slightly reduced overall cost. Results are uncertain due to the poor quality of data to inform the effect of avoiding errors.

Costs and Cost-Effectiveness of Training Traditional Birth Attendants to Reduce Neonatal Mortality in the Lufwanyama Neonatal Survival Study (LUNESP)

PubMed Central

Sabin, Lora L.; Knapp, Anna B.; MacLeod, William B.; Phiri-Mazala, Grace; Kasimba, Joshua; Hamer, Davidson H.; Gill, Christopher J.

2012-01-01

Background The Lufwanyama Neonatal Survival Project (“LUNESP”) was a cluster randomized, controlled trial that showed that training traditional birth attendants (TBAs) to perform interventions targeting birth asphyxia, hypothermia, and neonatal sepsis reduced all-cause neonatal mortality by 45%. This companion analysis was undertaken to analyze intervention costs and cost-effectiveness, and factors that might improve cost-effectiveness. Methods and Findings We calculated LUNESP's financial and economic costs and the economic cost of implementation for a forecasted ten-year program (2011–2020). In each case, we calculated the incremental cost per death avoided and disability-adjusted life years (DALYs) averted in real 2011 US dollars. The forecasted 10-year program analysis included a base case as well as ‘conservative’ and ‘optimistic’ scenarios. Uncertainty was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. The estimated financial and economic costs of LUNESP were $118,574 and $127,756, respectively, or $49,469 and $53,550 per year. Fixed costs accounted for nearly 90% of total costs. For the 10-year program, discounted total and annual program costs were $256,455 and $26,834 respectively; for the base case, optimistic, and conservative scenarios, the estimated cost per death avoided was $1,866, $591, and $3,024, and cost per DALY averted was $74, $24, and $120, respectively. Outcomes were robust to variations in local costs, but sensitive to variations in intervention effect size, number of births attended by TBAs, and the extent of foreign consultants' participation. Conclusions Based on established guidelines, the strategy of using trained TBAs to reduce neonatal mortality was ‘highly cost effective’. We strongly recommend consideration of this approach for other remote rural populations with limited access to health care. PMID:22545117

The economic burden of inadequate consumption of vegetables and fruit in Canada.

PubMed

Ekwaru, John Paul; Ohinmaa, Arto; Loehr, Sarah; Setayeshgar, Solmaz; Thanh, Nguyen Xuan; Veugelers, Paul J

2017-02-01

Public health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the economic burden attributable to the inadequate consumption of vegetables and fruit in Canada. We accessed the Canadian Community Health Survey to assess the inadequacy in the consumption of vegetables and fruit and published meta-analyses to assemble risk estimates for chronic diseases. Based on these inadequacy and risk estimates, we calculated the population-attributable fraction and avoidable direct and indirect costs to society. Direct costs include those for hospital care, physician services and drugs in 2015. About 80 % of women and 89 % of men consume inadequate amounts of vegetables and fruit. We estimated this to result in an economic burden of $CAN 3·3 billion per year, of which 30·5 % is direct health-care costs and 69·5 % is indirect costs due to productivity losses. A modest 1 percentage point annual reduction in the prevalence of inadequate vegetables and fruit consumption over the next 20 years would avoid approximately $CAN 10·8 billion, and an increase of one serving of vegetables and fruit per day would avoid approximately $CAN 9·2 billion. Further investments in the promotion of vegetables and fruit will prevent chronic disease and substantially reduce direct and indirect health-care costs.

[Economic evaluation of routine vaccination of 15 month old children against chicken-pox-zoster].

PubMed

Forcén, T; Garuz, R; Cabasés, J; Ruiz de Ocenda, M; Martínez, J A; Izko, J

2000-01-01

An economic, cost-effectiveness evaluation was carried out that compared a hypothetical program of routine mass vaccination against the chicken-pox-zoster virus in children aged 15 months in the Foral Community of Navarra against the present strategy of vaccination that is restricted to the high risk population. Decision trees based on Markov models were used to calculate the costs of the health care of cases of infection and the costs of the effects of the vaccination program. The efficacy of the vaccination is 90-95%, and the scenario produces an immunogenicity of at least ten years, with a coverage of 90%. Account was taken of both the direct costs of health care and the indirect costs, with 1995 Pesetas taken as a constant, due to the loss in productivity of a family member, and a social view point was adopted for evaluating the study The index of cost-effectiveness reflects the additional cost or saving for each case of avoided infection brought about by vaccinating the children in comparison with vaccinating only those persons belonging to the high risk population sectors. The cost per avoided case is situated between 3,500 Ptas and 4,000 Ptas. For each Peseta invested in the vaccination program there would be a reimbursement of 0.45 Pesetas. The routine vaccination program produces an incremental cost. Only in the case of a reduction in the price of the vaccine by more than 50% would the cost-effectiveness index offer a net social profit.

Heart Disease Patients' Averting Behavior, Costs of Illness, and Willingness to Pay to Avoid Angina Episodes - Final Report (1988)

EPA Pesticide Factsheets

This report examines the cost effectiveness of control options which reduce nitrate deposition to the Chesapeake watershed and to the tidal Bay. The report analyzes current estimates of the reductions expected in the ozone transport region.

Automated beam monitoring and diagnosis for CO2 lasers

NASA Astrophysics Data System (ADS)

Mann, Stefan; Boeske, Lars; Kaierle, Stefan; Kreutz, Ernst-Wolfgang; Poprawe, Reinhart

2002-06-01

The usage of a quality management, in combination with a standard certification, is nearly inevitable for today's industrial manufacturing. In laser materials processing, a periodical beam diagnosis is to be executed as a quality-maintaining measure with any change of the workpiece geometry to guarantee an unambiguous allocation of the beam quality factors. Otherwise changes in the beam quality, caused by pollution, aging or defect of the optical components, remain unidentified for a long time, leading to impairments of the treatment quality or even costly down-times. As a solution a diagnosis system is integrated into a laser system. Data sources like measuring instruments, sensors and laser control transmit the diagnosis data to a diagnosis PC. A user-friendly software, based on Fuzzy algorithms, enables the operator to retrace changes in the beam quality to failures of the laser system. All diagnosis data are getting archived in a databank. The access to the archived data through the World Wide Web allows remote diagnoses. With the help of the beam diagnosis system failures can be discovered in advance, and losses of production can be avoided. The gained transparency of the beam characteristic values facilitates the integration of the laser system in the quality management. A prototype installation has been realized and latest results will be demonstrated.

A real-time multi-scale 2D Gaussian filter based on FPGA

NASA Astrophysics Data System (ADS)

Luo, Haibo; Gai, Xingqin; Chang, Zheng; Hui, Bin

2014-11-01

Multi-scale 2-D Gaussian filter has been widely used in feature extraction (e.g. SIFT, edge etc.), image segmentation, image enhancement, image noise removing, multi-scale shape description etc. However, their computational complexity remains an issue for real-time image processing systems. Aimed at this problem, we propose a framework of multi-scale 2-D Gaussian filter based on FPGA in this paper. Firstly, a full-hardware architecture based on parallel pipeline was designed to achieve high throughput rate. Secondly, in order to save some multiplier, the 2-D convolution is separated into two 1-D convolutions. Thirdly, a dedicate first in first out memory named as CAFIFO (Column Addressing FIFO) was designed to avoid the error propagating induced by spark on clock. Finally, a shared memory framework was designed to reduce memory costs. As a demonstration, we realized a 3 scales 2-D Gaussian filter on a single ALTERA Cyclone III FPGA chip. Experimental results show that, the proposed framework can computing a Multi-scales 2-D Gaussian filtering within one pixel clock period, is further suitable for real-time image processing. Moreover, the main principle can be popularized to the other operators based on convolution, such as Gabor filter, Sobel operator and so on.

A Hybrid Metaheuristic DE/CS Algorithm for UCAV Three-Dimension Path Planning

PubMed Central

Wang, Gaige; Guo, Lihong; Duan, Hong; Wang, Heqi; Liu, Luo; Shao, Mingzhen

2012-01-01

Three-dimension path planning for uninhabited combat air vehicle (UCAV) is a complicated high-dimension optimization problem, which primarily centralizes on optimizing the flight route considering the different kinds of constrains under complicated battle field environments. A new hybrid metaheuristic differential evolution (DE) and cuckoo search (CS) algorithm is proposed to solve the UCAV three-dimension path planning problem. DE is applied to optimize the process of selecting cuckoos of the improved CS model during the process of cuckoo updating in nest. The cuckoos can act as an agent in searching the optimal UCAV path. And then, the UCAV can find the safe path by connecting the chosen nodes of the coordinates while avoiding the threat areas and costing minimum fuel. This new approach can accelerate the global convergence speed while preserving the strong robustness of the basic CS. The realization procedure for this hybrid metaheuristic approach DE/CS is also presented. In order to make the optimized UCAV path more feasible, the B-Spline curve is adopted for smoothing the path. To prove the performance of this proposed hybrid metaheuristic method, it is compared with basic CS algorithm. The experiment shows that the proposed approach is more effective and feasible in UCAV three-dimension path planning than the basic CS model. PMID:23193383

Genetic rescue of an insular population of large mammals

PubMed Central

Hogg, John T; Forbes, Stephen H; Steele, Brian M; Luikart, Gordon

2006-01-01

Natural populations worldwide are increasingly fragmented by habitat loss. Isolation at small population size is thought to reduce individual and population fitness via inbreeding depression. However, little is known about the time-scale over which adverse genetic effects may develop in natural populations or the number and types of traits likely to be affected. The benefits of restoring gene flow to isolates are therefore also largely unknown. In contrast, the potential costs of migration (e.g. disease spread) are readily apparent. Management for ecological connectivity has therefore been controversial and sometimes avoided. Using pedigree and life-history data collected during 25 years of study, we evaluated genetic decline and rescue in a population of bighorn sheep founded by 12 individuals in 1922 and isolated at an average size of 42 animals for 10–12 generations. Immigration was restored experimentally, beginning in 1985. We detected marked improvements in reproduction, survival and five fitness-related traits among descendants of the 15 recent migrants. Trait values were increased by 23–257% in maximally outbred individuals. This is the first demonstration, to our knowledge, of increased male and female fitness attributable to outbreeding realized in a fully competitive natural setting. Our findings suggest that genetic principles deserve broader recognition as practical management tools with near-term consequences for large-mammal conservation. PMID:16777743

Climate impacts on hydropower and consequences for global electricity supply investment needs

DOE PAGES

Turner, Sean W. D.; Hejazi, Mohamad; Kim, Son H.; ...

2017-11-15

Climate change is projected to increase hydropower generation in some parts of the world and decrease it in others. Here we explore the possible consequences of these impacts for the electricity supply sector at the global scale. Regional hydropower projections are developed by forcing a coupled global hydrological and dam model with downscaled, bias-corrected climate realizations. Consequent impacts on power sector composition and associated emissions and investment costs are explored using the Global Change Assessment Model (GCAM). We find that climate-driven changes in hydropower generation may shift power demands onto and away from carbon intensive technologies. This then causes significantlymore » altered power sector CO 2 emissions in several hydro-dependent regions, although the net global impact is modest. For drying regions, we estimate a global, cumulative investment need of approximately one trillion dollars (±$500 billion) this century to make up for deteriorated hydropower generation caused by climate change. Total investments avoided are of a similar magnitude across regions projected to experience increased precipitation. Investment risks and opportunities are concentrated in hydro-dependent countries for which significant climate change is expected. Various countries throughout the Balkans, Latin America and Southern Africa are most vulnerable, whilst Norway, Canada, and Bhutan emerge as clear beneficiaries.« less

An advanced scanning method for space-borne hyper-spectral imaging system

NASA Astrophysics Data System (ADS)

Wang, Yue-ming; Lang, Jun-Wei; Wang, Jian-Yu; Jiang, Zi-Qing

2011-08-01

Space-borne hyper-spectral imagery is an important means for the studies and applications of earth science. High cost efficiency could be acquired by optimized system design. In this paper, an advanced scanning method is proposed, which contributes to implement both high temporal and spatial resolution imaging system. Revisit frequency and effective working time of space-borne hyper-spectral imagers could be greatly improved by adopting two-axis scanning system if spatial resolution and radiometric accuracy are not harshly demanded. In order to avoid the quality degradation caused by image rotation, an idea of two-axis rotation has been presented based on the analysis and simulation of two-dimensional scanning motion path and features. Further improvement of the imagers' detection ability under the conditions of small solar altitude angle and low surface reflectance can be realized by the Ground Motion Compensation on pitch axis. The structure and control performance are also described. An intelligent integration technology of two-dimensional scanning and image motion compensation is elaborated in this paper. With this technology, sun-synchronous hyper-spectral imagers are able to pay quick visit to hot spots, acquiring both high spatial and temporal resolution hyper-spectral images, which enables rapid response of emergencies. The result has reference value for developing operational space-borne hyper-spectral imagers.

Avoiding numerical pitfalls in social force models

NASA Astrophysics Data System (ADS)

Köster, Gerta; Treml, Franz; Gödel, Marion

2013-06-01

The social force model of Helbing and Molnár is one of the best known approaches to simulate pedestrian motion, a collective phenomenon with nonlinear dynamics. It is based on the idea that the Newtonian laws of motion mostly carry over to pedestrian motion so that human trajectories can be computed by solving a set of ordinary differential equations for velocity and acceleration. The beauty and simplicity of this ansatz are strong reasons for its wide spread. However, the numerical implementation is not without pitfalls. Oscillations, collisions, and instabilities occur even for very small step sizes. Classic solution ideas from molecular dynamics do not apply to the problem because the system is not Hamiltonian despite its source of inspiration. Looking at the model through the eyes of a mathematician, however, we realize that the right hand side of the differential equation is nondifferentiable and even discontinuous at critical locations. This produces undesirable behavior in the exact solution and, at best, severe loss of accuracy in efficient numerical schemes even in short range simulations. We suggest a very simple mollified version of the social force model that conserves the desired dynamic properties of the original many-body system but elegantly and cost efficiently resolves several of the issues concerning stability and numerical resolution.

Transmission-Type 2-Bit Programmable Metasurface for Single-Sensor and Single-Frequency Microwave Imaging

PubMed Central

Li, Yun Bo; Li, Lian Lin; Xu, Bai Bing; Wu, Wei; Wu, Rui Yuan; Wan, Xiang; Cheng, Qiang; Cui, Tie Jun

2016-01-01

The programmable and digital metamaterials or metasurfaces presented recently have huge potentials in designing real-time-controlled electromagnetic devices. Here, we propose the first transmission-type 2-bit programmable coding metasurface for single-sensor and single- frequency imaging in the microwave frequency. Compared with the existing single-sensor imagers composed of active spatial modulators with their units controlled independently, we introduce randomly programmable metasurface to transform the masks of modulators, in which their rows and columns are controlled simultaneously so that the complexity and cost of the imaging system can be reduced drastically. Different from the single-sensor approach using the frequency agility, the proposed imaging system makes use of variable modulators under single frequency, which can avoid the object dispersion. In order to realize the transmission-type 2-bit programmable metasurface, we propose a two-layer binary coding unit, which is convenient for changing the voltages in rows and columns to switch the diodes in the top and bottom layers, respectively. In our imaging measurements, we generate the random codes by computer to achieve different transmission patterns, which can support enough multiple modes to solve the inverse-scattering problem in the single-sensor imaging. Simple experimental results are presented in the microwave frequency, validating our new single-sensor and single-frequency imaging system. PMID:27025907

Transmission-Type 2-Bit Programmable Metasurface for Single-Sensor and Single-Frequency Microwave Imaging.

PubMed

Li, Yun Bo; Li, Lian Lin; Xu, Bai Bing; Wu, Wei; Wu, Rui Yuan; Wan, Xiang; Cheng, Qiang; Cui, Tie Jun

2016-03-30

The programmable and digital metamaterials or metasurfaces presented recently have huge potentials in designing real-time-controlled electromagnetic devices. Here, we propose the first transmission-type 2-bit programmable coding metasurface for single-sensor and single- frequency imaging in the microwave frequency. Compared with the existing single-sensor imagers composed of active spatial modulators with their units controlled independently, we introduce randomly programmable metasurface to transform the masks of modulators, in which their rows and columns are controlled simultaneously so that the complexity and cost of the imaging system can be reduced drastically. Different from the single-sensor approach using the frequency agility, the proposed imaging system makes use of variable modulators under single frequency, which can avoid the object dispersion. In order to realize the transmission-type 2-bit programmable metasurface, we propose a two-layer binary coding unit, which is convenient for changing the voltages in rows and columns to switch the diodes in the top and bottom layers, respectively. In our imaging measurements, we generate the random codes by computer to achieve different transmission patterns, which can support enough multiple modes to solve the inverse-scattering problem in the single-sensor imaging. Simple experimental results are presented in the microwave frequency, validating our new single-sensor and single-frequency imaging system.

A tri-fold hybrid classification approach for diagnostics with unexampled faulty states

NASA Astrophysics Data System (ADS)

Tamilselvan, Prasanna; Wang, Pingfeng

2015-01-01

System health diagnostics provides diversified benefits such as improved safety, improved reliability and reduced costs for the operation and maintenance of engineered systems. Successful health diagnostics requires the knowledge of system failures. However, with an increasing system complexity, it is extraordinarily difficult to have a well-tested system so that all potential faulty states can be realized and studied at product testing stage. Thus, real time health diagnostics requires automatic detection of unexampled system faulty states based upon sensory data to avoid sudden catastrophic system failures. This paper presents a trifold hybrid classification (THC) approach for structural health diagnosis with unexampled health states (UHS), which comprises of preliminary UHS identification using a new thresholded Mahalanobis distance (TMD) classifier, UHS diagnostics using a two-class support vector machine (SVM) classifier, and exampled health states diagnostics using a multi-class SVM classifier. The proposed THC approach, which takes the advantages of both TMD and SVM-based classification techniques, is able to identify and isolate the unexampled faulty states through interactively detecting the deviation of sensory data from the exampled health states and forming new ones autonomously. The proposed THC approach is further extended to a generic framework for health diagnostics problems with unexampled faulty states and demonstrated with health diagnostics case studies for power transformers and rolling bearings.

[(68)Ga-labeled peptides for clinical trials - production according to the German Drug Act: the Göttingen experience].

PubMed

Meller, Birgit; Angerstein, C; Liersch, T; Ghadimi, M; Sahlmann, C-O; Meller, J

2012-01-01

The AMG implies far-reaching implications for the synthesis of new radiopharmaceuticals for clinical trials. As a part of the DFG-funded Clinical Research Group (KFO 179) a project designated "Immuno-PET for assessment of early response to radiochemotherapy of advanced rectal cancer" was initiated. This trial is focused on a trivalent bispecific humanized monoclonal antibody, and a 68Ga-labeled peptide. Following the new regulatory framework we established a GMP-compliant cleanroom laboratory and applied for a manufacturing permission. During the project constructural, personnel and organizational conditions for a successful application were established, including a quality management system. A GMP-conform cleanroom laboratory class C was constructed, equipped with a two-chamber lock. The actual manufacturing is performed in a closed system with subsequent sterile filtration. The manufacturing processes have been automatised and validated as well as the necessary quality controls. The manufacturing permission was granted after an official inspection. The new German Drug Act is considered as a break in the production practice of nuclear medicine. The early involvement and communication with the authorities avoids time-consuming and costly planning errors. It is much to be hoped that the new legal situation in Germany will not cause serious impairments in the realization of clinical trials in German nuclear medicine.

A hybrid metaheuristic DE/CS algorithm for UCAV three-dimension path planning.

PubMed

Wang, Gaige; Guo, Lihong; Duan, Hong; Wang, Heqi; Liu, Luo; Shao, Mingzhen

2012-01-01

Three-dimension path planning for uninhabited combat air vehicle (UCAV) is a complicated high-dimension optimization problem, which primarily centralizes on optimizing the flight route considering the different kinds of constrains under complicated battle field environments. A new hybrid metaheuristic differential evolution (DE) and cuckoo search (CS) algorithm is proposed to solve the UCAV three-dimension path planning problem. DE is applied to optimize the process of selecting cuckoos of the improved CS model during the process of cuckoo updating in nest. The cuckoos can act as an agent in searching the optimal UCAV path. And then, the UCAV can find the safe path by connecting the chosen nodes of the coordinates while avoiding the threat areas and costing minimum fuel. This new approach can accelerate the global convergence speed while preserving the strong robustness of the basic CS. The realization procedure for this hybrid metaheuristic approach DE/CS is also presented. In order to make the optimized UCAV path more feasible, the B-Spline curve is adopted for smoothing the path. To prove the performance of this proposed hybrid metaheuristic method, it is compared with basic CS algorithm. The experiment shows that the proposed approach is more effective and feasible in UCAV three-dimension path planning than the basic CS model.

Novel gold nanoparticle trimer reporter probe combined with dry-reagent cotton thread immunoassay device for rapid human ferritin test.

PubMed

Mao, Xun; Du, Ting-E; Meng, Lili; Song, Tingting

2015-08-19

We reported here for the first time on the use of cotton thread combined with novel gold nanoparticle trimer reporter probe for low-cost, sensitive and rapid detection of a lung cancer related biomarker, human ferritin. A model system comprising ferritin as an analyte and a pair of monoclonal antibodies was used to demonstrate the proof-of-concept on the dry-reagent natural cotton thread immunoassay device. Results indicated that the using of novel gold nanoparticle trimer reporter probe greatly improved the sensitivity comparing with traditional gold nanoparticle reporter probe on the cotton thread immunoassay device. The assay avoids multiple incubation and washing steps performed in most conventional protein analyses. Although qualitative tests are realized by observing the color change of the test zone, quantitative data are obtained by recording the optical responses of the test zone with a commercial scanner and corresponding analysis software. Under optimal conditions, the cotton thread immunoassay device was capable of measuring 10 ng/mL human ferritin under room temperature which is sensitive enough for clinical diagnosis. Moreover, the sample solution employed in the assays is just 8 μL, which is much less than traditional lateral flow strip based biosensors. Copyright © 2015 Elsevier B.V. All rights reserved.

Advanced Optics for a Full Quasi-Optical Front Steering ECRH Upper Launcher for ITER

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

Moro, A.; Alessi, E.; Bruschi, A.

2009-11-26

A full quasi-optical setup for the internal optics of the Front Steering Electron Cyclotron Resonance Heating (ECRH) Upper Launcher for ITER was designed, proving to be feasible and favorable in terms of additional flexibility and cost reduction with respect to the former design. This full quasi-optical solution foresees the replacement of the mitre-bends in the final section of the launcher with dedicated free-space mirrors to realize the last changes of directions in the launcher. A description of the launcher is given and its advantages presented. The parameters of the expected output beams as well as preliminary evaluations of truncation effectsmore » with the physical optics GRASP code are shown. Moreover, a study of mitre-bends replacement with single mirrors for multiple beams is described. In principle it could allow the beams to be larger at the mirror locations (with a further decrease of the peak power density due to partial overlapping) and has the additional advantage to get a larger opening with compressed beams to avoid conflicts with side-walls port. Constraints on the setup, arising both from the resulting beam characteristics in the space of free parameters and from mechanical requirements are taken into account in the analysis.« less

Climate impacts on hydropower and consequences for global electricity supply investment needs

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

Turner, Sean W. D.; Hejazi, Mohamad; Kim, Son H.

Climate change is projected to increase hydropower generation in some parts of the world and decrease it in others. Here we explore the possible consequences of these impacts for the electricity supply sector at the global scale. Regional hydropower projections are developed by forcing a coupled global hydrological and dam model with downscaled, bias-corrected climate realizations. Consequent impacts on power sector composition and associated emissions and investment costs are explored using the Global Change Assessment Model (GCAM). We find that climate-driven changes in hydropower generation may shift power demands onto and away from carbon intensive technologies. This then causes significantlymore » altered power sector CO 2 emissions in several hydro-dependent regions, although the net global impact is modest. For drying regions, we estimate a global, cumulative investment need of approximately one trillion dollars (±$500 billion) this century to make up for deteriorated hydropower generation caused by climate change. Total investments avoided are of a similar magnitude across regions projected to experience increased precipitation. Investment risks and opportunities are concentrated in hydro-dependent countries for which significant climate change is expected. Various countries throughout the Balkans, Latin America and Southern Africa are most vulnerable, whilst Norway, Canada, and Bhutan emerge as clear beneficiaries.« less

Impact of Tactical and Strategic Weather Avoidance on Separation Assurance

NASA Technical Reports Server (NTRS)

Refai, Mohamad S.; Windhorst, Robert

2011-01-01

The ability to keep flights away from weather hazards while maintaining aircraft-to-aircraft separation is critically important. The Advanced Airspace Concept is an automation concept that implements a ground-based strategic conflict resolution algorithm for management of aircraft separation. The impact of dynamic and uncertain weather avoidance on this concept is investigated. A strategic weather rerouting system is integrated with the Advanced Airspace Concept, which also provides a tactical weather avoidance algorithm, in a fast time simulation of the Air Transportation System. Strategic weather rerouting is used to plan routes around weather in the 20 minute to two-hour time horizon. To address forecast uncertainty, flight routes are revised at 15 minute intervals. Tactical weather avoidance is used for short term trajectory adjustments (30 minute planning horizon) that are updated every minute to address any weather conflicts (instances where aircraft are predicted to pass through weather cells) that are left unresolved by strategic weather rerouting. The fast time simulation is used to assess the impact of tactical weather avoidance on the performance of automated conflict resolution as well as the impact of strategic weather rerouting on both conflict resolution and tactical weather avoidance. The results demonstrate that both tactical weather avoidance and strategic weather rerouting increase the algorithm complexity required to find aircraft conflict resolutions. Results also demonstrate that tactical weather avoidance is prone to higher airborne delay than strategic weather rerouting. Adding strategic weather rerouting to tactical weather avoidance reduces total airborne delays for the reported scenario by 18% and reduces the number of remaining weather violations by 13%. Finally, two features are identified that have proven important for strategic weather rerouting to realize these benefits; namely, the ability to revise reroutes and the use of maneuvers that start far ahead of encountering a weather cell when rerouting around weather.

Cost-effectiveness analysis of implementing an antimicrobial stewardship program in critical care units.

PubMed

Ruiz-Ramos, Jesus; Frasquet, Juan; Romá, Eva; Poveda-Andres, Jose Luis; Salavert-Leti, Miguel; Castellanos, Alvaro; Ramirez, Paula

2017-06-01

To evaluate the cost-effectiveness of antimicrobial stewardship (AS) program implementation focused on critical care units based on assumptions for the Spanish setting. A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed. Model variables and costs, along with their distributions, were obtained from the literature. The study was performed from the Spanish National Health System (NHS) perspective, including only direct costs. The Incremental Cost-Effectiveness Ratio (ICER) was analysed regarding the ability of the program to reduce multi-drug resistant bacteria. Uncertainty in ICERs was evaluated with probabilistic sensitivity analyses. In the short-term, implementing an AS reduces the consumption of antimicrobials with a net benefit of €71,738. In the long-term, the maintenance of the program involves an additional cost to the system of €107,569. Cost per avoided resistance was €7,342, and cost-per-life-years gained (LYG) was €9,788. Results from the probabilistic sensitivity analysis showed that there was a more than 90% likelihood that an AS would be cost-effective at a level of €8,000 per LYG. Wide variability of economic results obtained from the implementation of this type of AS program and short information on their impact on patient evolution and any resistance avoided. Implementing an AS focusing on critical care patients is a long-term cost-effective tool. Implementation costs are amortized by reducing antimicrobial consumption to prevent infection by multidrug-resistant pathogens.

Cost effectiveness of pegfilgrastim versus filgrastim after high-dose chemotherapy and autologous stem cell transplantation in patients with lymphoma and myeloma: an economic evaluation of the PALM Trial.

PubMed

Perrier, Lionel; Lefranc, Anne; Pérol, David; Quittet, Philippe; Schmidt-Tanguy, Aline; Siani, Carole; de Peretti, Christian; Favier, Bertrand; Biron, Pierre; Moreau, Philippe; Bay, Jacques Olivier; Lissandre, Séverine; Jardin, Fabrice; Espinouse, Daniel; Sebban, Catherine

2013-04-01

Use of the recombinant human granulocyte colony-stimulating factor (rhG-CSF) filgrastim accelerates neutrophil recovery following myelosuppressive chemotherapy. Since filgrastim requires multiple daily administrations, forms of rhG-CSF with a longer half life, including pegfilgrastim, have been developed. Pegfilgrastim is safe and effective in supporting neutrophil recovery and reducing febrile neutropenia after conventional chemotherapy. Pegfilgrastim has also been successfully used to support patients undergoing peripheral blood stem cell (PBSC) transplantation for haematological malignancies. To our knowledge, no cost-effectiveness analysis (CEA) of pegfilgrastim in this setting has been published yet. We undertook a CEA to compare a single injection of pegfilgrastim versus repeated administrations of filgrastim in patients who had undergone PBSC transplantation for lymphoma or myeloma. The CEA was set in France and covered a period of 100 ± 10 days from transplant. The CEA was designed as part of an open-label, multicentre, randomized phase II trial. Costs were assessed from the hospital's point of view and are expressed in 2009 euros. Costs computation focused on inpatient, outpatient, and home care. Costs in the two arms of the study were compared using the Mann-Whitney test. When differences were statistically significant, multiple regression analyses were performed in order to identify cost drivers. Incremental cost-effectiveness ratios (ICER) were calculated for the major endpoints of the trial; i.e., duration of febrile neutropenia (absolute neutrophil count [ANC] <0.5 × 10(9)/L and temperature ≥38 °C), duration of neutropenia (ANC <1.0 × 10(9)/L and ANC <0.5 × 10(9)/L), duration of thrombopenia (platelets <50 × 10(9)/L and <20 × 10(9)/L), and days with a temperature ≥38 °C). Uncertainty around the ICER was captured by a probabilistic analysis using a non-parametric bootstrap method. 151 patients were enrolled at ten French centres from October 2008 to September 2009. The mean total cost in the pegfilgrastim arm of the study (n = 74) was 25,024 (SD 9,945). That in the filgrastim arm (n = 76) was 28,700 (SD 20,597). Pegfilgrastim strictly dominated filgrastim for days of febrile neutropenia avoided, days of neutropenia (ANC <1.0 × 10(9)/L) avoided, days of thrombopenia (platelets <20 × 10(9)/L) avoided, and days with temperature ≥38 °C) avoided. Pegfilgrastim was less costly and less effective than filgrastim for the number of days with ANC <0.5 × 10(9)/L avoided and the number of days with platelets <50.0 × 10(9)/L avoided. Taking uncertainty into account, the probabilities that pegfilgrastim strictly dominated filgrastim were 67 % for febrile neutropenia, 86 % for neutropenia (ANC <1.0 × 10(9)/L), 59 % for thrombopenia (platelets <20 × 10(9)/L), 86 % for temperature ≥38 °C, 32 % for neutropenia (ANC <0.5 × 10(9)/L), and 43 % for thrombopenia (platelets <50 × 10(9)/L). Conversely, the probability that filgrastim strictly dominated pegfilgrastim for neutropenia (ANC <0.5 × 10(9)/L) is 5 %. This study found no evidence that the use of pegfilgrastim is associated with greater cost in lymphoma and myeloma patients after high-dose chemotherapy and PBSC transplantation.

Reduction of Total Ownership Cost

DTIC Science & Technology

2003-09-30

preparation of the Technology Development Strategy, which addresses technology risk for a new weapon system. If there is a misstep...requirements for a new system may be transfixed by the technical performance and may not clearly establish requirements for ownership cost to achieve...important to the PM than TOC goals that will not be realized until long after the PM has departed for a new assignment or retired. If PMs and their

The Cost and Financing of the Right to Education in India: Can We Fill the Financing Gap?

ERIC Educational Resources Information Center

Mehrotra, Santosh

2012-01-01

India's Parliament passed the Right to Education Act in 2009, which entitles all children 6-14 years old to at least eight years of schooling. This paper examines the cost of achieving this right to education, and asks whether India can fill the financing gap that must be filled if the right is to be realized. The paper notes the very considerable…

Asymptotically Optimal Motion Planning for Learned Tasks Using Time-Dependent Cost Maps

PubMed Central

Bowen, Chris; Ye, Gu; Alterovitz, Ron

2015-01-01

In unstructured environments in people’s homes and workspaces, robots executing a task may need to avoid obstacles while satisfying task motion constraints, e.g., keeping a plate of food level to avoid spills or properly orienting a finger to push a button. We introduce a sampling-based method for computing motion plans that are collision-free and minimize a cost metric that encodes task motion constraints. Our time-dependent cost metric, learned from a set of demonstrations, encodes features of a task’s motion that are consistent across the demonstrations and, hence, are likely required to successfully execute the task. Our sampling-based motion planner uses the learned cost metric to compute plans that simultaneously avoid obstacles and satisfy task constraints. The motion planner is asymptotically optimal and minimizes the Mahalanobis distance between the planned trajectory and the distribution of demonstrations in a feature space parameterized by the locations of task-relevant objects. The motion planner also leverages the distribution of the demonstrations to significantly reduce plan computation time. We demonstrate the method’s effectiveness and speed using a small humanoid robot performing tasks requiring both obstacle avoidance and satisfaction of learned task constraints. Note to Practitioners Motivated by the desire to enable robots to autonomously operate in cluttered home and workplace environments, this paper presents an approach for intuitively training a robot in a manner that enables it to repeat the task in novel scenarios and in the presence of unforeseen obstacles in the environment. Based on user-provided demonstrations of the task, our method learns features of the task that are consistent across the demonstrations and that we expect should be repeated by the robot when performing the task. We next present an efficient algorithm for planning robot motions to perform the task based on the learned features while avoiding obstacles. We demonstrate the effectiveness of our motion planner for scenarios requiring transferring a powder and pushing a button in environments with obstacles, and we plan to extend our results to more complex tasks in the future. PMID:26279642

Design of the storage location based on the ABC analyses

NASA Astrophysics Data System (ADS)

Jemelka, Milan; Chramcov, Bronislav; Kříž, Pavel

2016-06-01

The paper focuses on process efficiency and saving storage costs. Maintaining inventory through putaway strategy takes personnel time and costs money. The aim is to control inventory in the best way. The ABC classification based on Villefredo Pareto theory is used for a design of warehouse layout. New design of storage location reduces the distance of fork-lifters, total costs and it increases inventory process efficiency. The suggested solutions and evaluation of achieved results are described in detail. Proposed solutions were realized in real warehouse operation.

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

PubMed

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

2014-09-15

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

Elements of Regolith Simulant's Cost Structure--Why Rock Is NOT Cheap

NASA Technical Reports Server (NTRS)

Rickman, Douglas L.

2009-01-01

The cost of lunar regolith simulants is much higher than many users anticipate. After all, it is nothing more than broken rock. This class will discuss the elements which make up the cost structure for simulants. It will also consider which elements can be avoided under certain circumstances and which elements might be altered by the application of additional research and development.

Cost-effectiveness of drug-eluting coronary stents in Quebec, Canada.

PubMed

Brophy, James M; Erickson, Lonny J

2005-01-01

The aim of this investigation was to assess the incremental cost-effectiveness of replacing bare metal coronary stents (BMS) with drug-eluting stents (DES) in the Province of Quebec, Canada. The strategy used was a cost-effectiveness analysis from the perspective of the health-care provider, in the province of Quebec, Canada (population 7.5 million). The main outcome measure was the cost per avoided revascularization intervention. Based on the annual Quebec rate of 14,000 angioplasties with an average of 1.7 stents per procedure and a purchase cost of $2,600 Canadian dollar (CDN) for DES, 100 percent substitution of BMS with DES would require an additional $45.1 million CDN of funding. After the benefits of reduced repeat revascularization interventions are included, the incremental cost would be $35.2 million CDN. The cost per avoided revascularization intervention (18 percent coronary artery bypass graft, 82 percent percutaneous coronary intervention [PCI]) would be $23,067 CDN. If DES were offered selectively to higher risk populations, for example, a 20 percent subgroup with a relative restenosis risk of 2.5 times the current bare metal rate, the incremental cost of the program would be $4.9 million CDN at a cost of $7,800 per avoided revascularization procedure. Break-even costs for the program would occur at DES purchase cost of $1,161 for 100 percent DES use and $1,627 for selective 20 percent DES use for high-risk patients for restenosis (RR = 2.5). Univariate and Monte Carlo sensitivity analyses indicate that the parameters most affecting the analysis are the capacity to select patients at high risk of restenosis, the average number of stents used per PCI, baseline restenosis rates for BMS, the effectiveness ratio of restenosis prevention for DES versus BMS, the cost of DES, and the revascularization rate after initial PCI. Sensitivity analyses suggest little additional health benefits but escalating cost-effectiveness ratios once a DES penetration of 40 percent has been attained. Under current conditions in Quebec, Canada, selective use of DES in high-risk patients is the most acceptable strategy in terms of cost-effectiveness. Results of such an analysis would be expected to be similar in other countries with key model parameters similar to those used in this model. This model provides an example of how to evaluate the cost-effectiveness of selective use of a new technology in high-risk patients.

Impacts of 12-dose regimen for latent tuberculosis infection: Treatment completion rate and cost-effectiveness in Taiwan.

PubMed

Huang, Yi-Wen; Yang, Shun-Fa; Yeh, Yen-Po; Tsao, Thomas Chang-Yao; Tsao, Shih-Ming

2016-08-01

Treatment of latent tuberculosis infection (LTBI) is essential for eradicating tuberculosis (TB). Moreover, the patient adherence is crucial in determining the effectiveness of TB control. Isoniazid given by DOTS daily for 9 months (9H) is the standard treatment for LTBI in Taiwan. However, the completion rate is low due to the long treatment period and its side effects. The combined regimen using a high dose of rifapentine/isoniazid once weekly for 12 weeks (3HP) has been used as an alternative treatment option for LTBI in the United States. This may result in a higher completion rate. In this pilot study, patient adherence and cost of these 2 treatment regimens were investigated. Thus, we aimed to assess the treatment completion rate and costs of 3HP and compare to those with 9H.Data from 691 cases of LTBI treatments including 590 cases using the conventional regimen and 101 cases with rifapentine/Isoniazid were collected. The cost was the sum of the cost of treatment with Isoniazid for 9 months or with rifapentin/Isoniazid for 3 months of all contacts. The effectiveness was the cost of cases of tuberculosis avoided.In this study, the treatment completion rate for patients prescribed with the 3 months rifapentine/isoniazid regimen (97.03%) was higher than those given the conventional 9-month isoniazid regimen (87.29%) (P <0.001). The cost of 3HP and 9H was US$261.24 and US$717.3, respectively. The cost-effectiveness ratio with isoniazid for 9 months was US$ 15392/avoided 1 case of tuberculosis and US$ 5225/avoided 1 case of tuberculosis with 3HP. In addition, when compared with the conventional regimen, there were fewer patients discontinued with rifapentine/isoniazid regimen due to undesirable side effects.This was the first study to compare the 2 treatment regimens in Taiwan, and it showed that a short-term high-dosage rifapentine/isoniazid treatment regimen reduced costs and resulted in higher treatment completion than the standard LTBI isoniazid treatment.

A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region

ERIC Educational Resources Information Center

McGregor, Margaret J.; Baumbusch, Jennifer; Abu-Laban, Riyad B.; McGrail, Kimberlyn M.; Andrusiek, Dug; Globerman, Judith; Berg, Shannon; Cox, Michelle B.; Salomons, Kia; Volker, Jan; Ronald, Lisa

2011-01-01

Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with…

Format conversion between CAD data and GIS data based on ArcGIS

NASA Astrophysics Data System (ADS)

Xie, Qingqing; Wei, Bo; Zhang, Kailin; Wang, Zhichao

2015-12-01

To make full use of the data resources and realize a sharing for the different types of data in different industries, a method of format conversion between CAD data and GIS data based on ArcGIS was proposed. To keep the integrity of the converted data, some key steps to process CAD data before conversion were made in AutoCAD. For examples, deleting unnecessary elements such as title, border and legend avoided the appearance of unnecessary elements after conversion, as layering data again by a national standard avoided the different types of elements to appear in a same layer after conversion. In ArcGIS, converting CAD data to GIS data was executed by the correspondence of graphic element classification between AutoCAD and ArcGIS. In addition, an empty geographic database and feature set was required to create in ArcGIS for storing the text data of CAD data. The experimental results show that the proposed method avoids a large amount of editing work in data conversion and maintains the integrity of spatial data and attribute data between before and after conversion.

Reducing energy costs in nursing homes

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

Not Available

The handbook presents ideas and techniques for energy conservation in nursing homes. Case studies were developed of nursing homes located in different parts of the US. The typical nursing home assessed was proprietary, of intermediate-care level, medicaid-certified, and had less than 200 beds. Specific energy conservation measures were analyzed to determine the energy and dollar savings that could be realized. These include reducing heat loss through the building shell; reducing hot water costs; recovering the heat generated by dryers; reducing lighting costs; reducing heating and cooling costs, and analyzing fuels and fuel rates. A case for converting electric clothes dryersmore » to gas was analyzed. (MCW)« less

40 CFR 1042.850 - Exemptions and hardship relief.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regulations in this chapter to avoid the impending violation. (2) Send the Designated Compliance Officer a... without significant modification of your vessel, you may ask us to determine that a remanufacturing system is not considered available for your vessel because the cost would exceed the total marginal cost...

Making a Low-Cost Soda Can Ethanol Burner for Out-of-Laboratory Flame Test Demonstrations and Experiments

ERIC Educational Resources Information Center

Yu, Henson L. Lee; Domingo, Perfecto N., Jr.; Yanza, Elliard Roswell S.; Guidote, Armando M., Jr.

2015-01-01

This article demonstrates how to make a low-cost ethanol burner utilizing soda cans. It burns with a light blue flame suitable for out-of-laboratory flame test demonstrations where interference from a yellow flame needs to be avoided.

77 FR 69673 - Self-Regulatory Organizations; Chicago Stock Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-20

... Organizations; Chicago Stock Exchange, Inc.; Notice of Filing and Immediate Effectiveness of Proposed Rule... costs and burdens associated with handling and recording orders that were rarely executed. \\5\\ The... actually exacerbated the operational costs which the Exchange sought to avoid by creating the order...

The Effects of Source Water Quality on Drinking Water Treatment Costs: A Review and Synthesis of Empirical Literature - Ecological Economics

EPA Science Inventory

Watershed protection, and associated in situ water quality improvements, has received considerable attention as a means of mitigating health risks and avoiding expenditures at drinking water treatment plants (DWTPs). This study reviews the extant cost function literature linking ...

An Insurance Crisis Looms--Again.

ERIC Educational Resources Information Center

Henke, Cliff

1993-01-01

The insurance industry has experienced a round of claims costs as a result of recent natural disasters. These costs are passed on to customers. To avoid higher premiums, student-transportation systems can take the following money-saving steps: raise the deductible; beef up driver training; focus on driver retention; and get the fleet's loss…

Research Libraries' Costs of Doing Business (and Strategies for Avoiding Them)

ERIC Educational Resources Information Center

Greenstein, Daniel

2004-01-01

With today's relatively flat budgets, research libraries are finding their buying power further diminished by the hyperinflationary costs of library materials. Yet technology innovation, coupled with organizational restructuring, is enabling libraries not only to provide more high-quality information services but also to achieve unparalleled…

Legionnaire's disease avoidance planning.

PubMed

Broadbent, Clive

2007-09-01

Hospital-acquired infection is the cause of about 5,000 deaths a year in the UK. In New Zealand, there are more than three times as many such deaths as from the annual road toll. The costs in loss of income, in pain and suffering and in direct costs to hospitals are staggering.

Planck 2015 results. XII. Full focal plane simulations

NASA Astrophysics Data System (ADS)

Planck Collaboration; Ade, P. A. R.; Aghanim, N.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Banday, A. J.; Barreiro, R. B.; Bartlett, J. G.; Bartolo, N.; Battaner, E.; Benabed, K.; Benoît, A.; Benoit-Lévy, A.; Bernard, J.-P.; Bersanelli, M.; Bielewicz, P.; Bock, J. J.; Bonaldi, A.; Bonavera, L.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Boulanger, F.; Bucher, M.; Burigana, C.; Butler, R. C.; Calabrese, E.; Cardoso, J.-F.; Castex, G.; Catalano, A.; Challinor, A.; Chamballu, A.; Chiang, H. C.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Colombo, L. P. L.; Combet, C.; Couchot, F.; Coulais, A.; Crill, B. P.; Curto, A.; Cuttaia, F.; Danese, L.; Davies, R. D.; Davis, R. J.; de Bernardis, P.; de Rosa, A.; de Zotti, G.; Delabrouille, J.; Delouis, J.-M.; Désert, F.-X.; Dickinson, C.; Diego, J. M.; Dolag, K.; Dole, H.; Donzelli, S.; Doré, O.; Douspis, M.; Ducout, A.; Dupac, X.; Efstathiou, G.; Elsner, F.; Enßlin, T. A.; Eriksen, H. K.; Fergusson, J.; Finelli, F.; Forni, O.; Frailis, M.; Fraisse, A. A.; Franceschi, E.; Frejsel, A.; Galeotta, S.; Galli, S.; Ganga, K.; Ghosh, T.; Giard, M.; Giraud-Héraud, Y.; Gjerløw, E.; González-Nuevo, J.; Górski, K. M.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Gudmundsson, J. E.; Hansen, F. K.; Hanson, D.; Harrison, D. L.; Henrot-Versillé, S.; Hernández-Monteagudo, C.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hornstrup, A.; Hovest, W.; Huffenberger, K. M.; Hurier, G.; Jaffe, A. H.; Jaffe, T. R.; Jones, W. C.; Juvela, M.; Karakci, A.; Keihänen, E.; Keskitalo, R.; Kiiveri, K.; Kisner, T. S.; Kneissl, R.; Knoche, J.; Kunz, M.; Kurki-Suonio, H.; Lagache, G.; Lamarre, J.-M.; Lasenby, A.; Lattanzi, M.; Lawrence, C. R.; Leonardi, R.; Lesgourgues, J.; Levrier, F.; Liguori, M.; Lilje, P. B.; Linden-Vørnle, M.; Lindholm, V.; López-Caniego, M.; Lubin, P. M.; Macías-Pérez, J. F.; Maggio, G.; Maino, D.; Mandolesi, N.; Mangilli, A.; Maris, M.; Martin, P. G.; Martínez-González, E.; Masi, S.; Matarrese, S.; McGehee, P.; Meinhold, P. R.; Melchiorri, A.; Melin, J.-B.; Mendes, L.; Mennella, A.; Migliaccio, M.; Mitra, S.; Miville-Deschênes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Moss, A.; Munshi, D.; Murphy, J. A.; Naselsky, P.; Nati, F.; Natoli, P.; Netterfield, C. B.; Nørgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; Oxborrow, C. A.; Paci, F.; Pagano, L.; Pajot, F.; Paoletti, D.; Pasian, F.; Patanchon, G.; Pearson, T. J.; Perdereau, O.; Perotto, L.; Perrotta, F.; Pettorino, V.; Piacentini, F.; Piat, M.; Pierpaoli, E.; Pietrobon, D.; Plaszczynski, S.; Pointecouteau, E.; Polenta, G.; Pratt, G. W.; Prézeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J. P.; Rebolo, R.; Reinecke, M.; Remazeilles, M.; Renault, C.; Renzi, A.; Ristorcelli, I.; Rocha, G.; Roman, M.; Rosset, C.; Rossetti, M.; Roudier, G.; Rubiño-Martín, J. A.; Rusholme, B.; Sandri, M.; Santos, D.; Savelainen, M.; Scott, D.; Seiffert, M. D.; Shellard, E. P. S.; Spencer, L. D.; Stolyarov, V.; Stompor, R.; Sudiwala, R.; Sutton, D.; Suur-Uski, A.-S.; Sygnet, J.-F.; Tauber, J. A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Tristram, M.; Tucci, M.; Tuovinen, J.; Valenziano, L.; Valiviita, J.; Van Tent, B.; Vielva, P.; Villa, F.; Wade, L. A.; Wandelt, B. D.; Wehus, I. K.; Welikala, N.; Yvon, D.; Zacchei, A.; Zonca, A.

2016-09-01

We present the 8th full focal plane simulation set (FFP8), deployed in support of the Planck 2015 results. FFP8 consists of 10 fiducial mission realizations reduced to 18 144 maps, together with the most massive suite of Monte Carlo realizations of instrument noise and CMB ever generated, comprising 104 mission realizations reduced to about 106 maps. The resulting maps incorporate the dominant instrumental, scanning, and data analysis effects, and the remaining subdominant effects will be included in future updates. Generated at a cost of some 25 million CPU-hours spread across multiple high-performance-computing (HPC) platforms, FFP8 is used to validate and verify analysis algorithms and their implementations, and to remove biases from and quantify uncertainties in the results of analyses of the real data.

Computer simulation and discussion of high-accuracy laser direction finding in real time

NASA Astrophysics Data System (ADS)

Chen, Wenyi; Chen, Yongzhi

1997-12-01

On condition that CCD is used as the sensor, there are at least five methods that can be used to realize laser's direction finding with high accuracy. They are: image matching method, radiation center method, geometric center method, center of rectangle envelope method and center of maximum run length method. The first three can get the highest accuracy but working in real-time it is too complicated to realize and the cost is very expansive. The other two can also get high accuracy, and it is not difficult to realize working in real time. By using a single-chip microcomputer and an ordinary CCD camera a very simple system can get the position information of a laser beam. The data rate is 50 times per second.

Creating mold-free buildings: a key to avoiding health effects of indoor molds.

PubMed

Small, Bruce M

2003-08-01

In view of the high costs of building diagnostics and repair subsequent to water damage--as well as the large medical diagnostic and healthcare costs associated with mold growth in buildings--commitment to a philosophy of proactive preventive maintenance for home, apartment, school, and commercial buildings could result in considerable cost savings and avoidance of major health problems among building occupants. The author identifies common causes of mold growth in buildings and summarizes key building design and construction principles essential for preventing mold contamination indoors. Physicians and healthcare workers must be made aware of conditions within buildings that can give rise to mold growth, and of resulting health problems. Timely advice provided to patients already sensitized by exposure to molds could save these individuals, and their families, from further exposures as a result of inadequate building maintenance or an inappropriate choice of replacement housing.

Investigation of another approach in topology optimization

NASA Astrophysics Data System (ADS)

Krotkikh, A. A.; Maximov, P. V.

2018-05-01

The paper presents investigation of another approach in topology optimization. The authors realized the method of topology optimization with using ideas of the SIMP method which was created by Martin P. Bends0e. There are many ways in objective function formulation of topology optimization methods. In terms of elasticity theory, the objective function of the SIMP method is a compliance of an object which should be minimized. The main idea of this paper was avoiding the filtering procedure in the SIMP method. Reformulation of the statement of the problem in terms of function minimization allows us to solve this by big variety of methods. The authors decided to use the interior point method which was realized in Wolfram Mathematica. This way can generate side effects which should be investigated for preventing their appearing in future. Results comparison of the SIMP method and the suggested method are presented in paper and analyzed.

Dislocation Majorana zero modes in perovskite oxide 2DEG

PubMed Central

Chung, Suk Bum; Chan, Cheung; Yao, Hong

2016-01-01

Much of the current experimental efforts for detecting Majorana zero modes have been centered on probing the boundary of quantum wires with strong spin-orbit coupling. The same type of Majorana zero mode can also be realized at crystalline dislocations in 2D superconductors with the nontrivial weak topological indices. Unlike at an Abrikosov vortex, at such a dislocation, there is no other low-lying midgap state than the Majorana zero mode so that it avoids usual complications encountered in experimental detections such as scanning tunneling microscope (STM) measurements. We will show that, using the anisotropic dispersion of the t2g orbitals of Ti or Ta atoms, such a weak topological superconductivity can be realized when the surface two-dimensional electronic gas (2DEG) of SrTiO3 or KTaO3 becomes superconducting, which can occur through either intrinsic pairing or proximity to existing s-wave superconductors. PMID:27139319

Ge nanopillar solar cells epitaxially grown by metalorganic chemical vapor deposition

PubMed Central

Kim, Youngjo; Lam, Nguyen Dinh; Kim, Kangho; Park, Won-Kyu; Lee, Jaejin

2017-01-01

Radial junction solar cells with vertically aligned wire arrays have been widely studied to improve the power conversion efficiency. In this work, we report the first Ge nanopillar solar cell. Nanopillar arrays are selectively patterned on p-type Ge (100) substrates using nanosphere lithography and deep reactive ion etching processes. Nanoscale radial and planar junctions are realized by an n-type Ge emitter layer which is epitaxially grown by MOCVD using isobutylgermane. In situ epitaxial surface passivation is employed using an InGaP layer to avoid high surface recombination rates and Fermi level pinning. High quality n-ohmic contact is realized by protecting the top contact area during the nanopillar patterning. The short circuit current density and the power conversion efficiency of the Ge nanopillar solar cell are demonstrated to be improved up to 18 and 30%, respectively, compared to those of the Ge solar cell with a planar surface. PMID:28209964

Realization and optimization of AES algorithm on the TMS320DM6446 based on DaVinci technology

NASA Astrophysics Data System (ADS)

Jia, Wen-bin; Xiao, Fu-hai

2013-03-01

The application of AES algorithm in the digital cinema system avoids video data to be illegal theft or malicious tampering, and solves its security problems. At the same time, in order to meet the requirements of the real-time, scene and transparent encryption of high-speed data streams of audio and video in the information security field, through the in-depth analysis of AES algorithm principle, based on the hardware platform of TMS320DM6446, with the software framework structure of DaVinci, this paper proposes the specific realization methods of AES algorithm in digital video system and its optimization solutions. The test results show digital movies encrypted by AES128 can not play normally, which ensures the security of digital movies. Through the comparison of the performance of AES128 algorithm before optimization and after, the correctness and validity of improved algorithm is verified.

The Precautionary Principle and Electric and Magnetic Fields

PubMed Central

Jamieson, Dale; Wartenberg, Daniel

2001-01-01

Current environmental regulation represents a paternalistic policy, more concerned to avoid false positives than false negatives, limiting opportunities for individuals to make choices between risk-avoidance and risk-taking alternatives. For example, many exposures to magnetic fields could be reduced at little or no cost but are not considered seriously, owing to the uncertainty of risk and the concern to avoid false positives. Even though precautionary approaches that focus on avoiding false negatives often do not lead to adverse economic consequences or irrational choices, such approaches usually are not taken. The value of autonomy and the proper role of governmental paternalism with respect to environmental policy need to be considered more carefully in environmental decision making. PMID:11527754

The Cost-Effectiveness of Emergency Hormonal Contraception with Ulipristal Acetate versus Levonorgestrel for Minors in France

PubMed Central

Schmid, Ramona

2015-01-01

Objective To evaluate the cost-effectiveness of ulipristal acetate and levonorgestrel in minors in France, and analyze whether it is worthwhile to provide ulipristal acetate to minors free of charge. Methods The cost-effectiveness of two emergency contraceptive methods was compared based on a decision-analytical model. Pregnancy rates, outcomes of unintended pregnancies, and resource utilization were derived from the literature. Resources and their costs were considered until termination or a few days after delivery. Deterministic and probabilistic sensitivity analyses were performed. Results The cost of an unintended pregnancy in a French minor is estimated to be 1,630 € (range 1,330 € – 1,803 €). Almost 4 million € (3.1 € – 13.7 € million) in unintended pregnancy spending in 2010 could have been saved by the use of ulipristal acetate instead of levonorgestrel. The incremental cost of ulipristal acetate compared to levonorgestrel is 3.30 € per intake, or 418 € per pregnancy avoided (intake within 72 hours). In the intake within 24 hours subgroup, ulipristal acetate was found to be more efficacious at a lower cost compared to levonorgestrel. Conclusions Ulipristal acetate dominates levonorgestrel when taken within 24 hours after unprotected intercourse, i.e., it is more effective at a lower cost. When taken within 72 hours, ulipristal acetate is a cost- effective alternative to levonorgestrel, given that the cost of avoiding an additional pregnancy with ulipristal acetate is less than the average cost of these pregnancies. In the light of these findings, it is worthwhile to provide free access to minors. PMID:26422259

A cost-consequences analysis of a primary care librarian question and answering service.

PubMed

McGowan, Jessie; Hogg, William; Zhong, Jianwei; Zhao, Xue

2012-01-01

Cost consequences analysis was completed from randomized controlled trial (RCT) data for the Just-in-time (JIT) librarian consultation service in primary care that ran from October 2005 to April 2006. The service was aimed at providing answers to clinical questions arising during the clinical encounter while the patient waits. Cost saving and cost avoidance were also analyzed. The data comes from eighty-eight primary care providers in the Ottawa area working in Family Health Networks (FHNs) and Family Health Groups (FHGs). We conducted a cost consequences analysis based on data from the JIT project. We also estimated the potential economic benefit of JIT librarian consultation service to the health care system. The results show that the cost per question for the JIT service was $38.20. The cost could be as low as $5.70 per question for a regular service. Nationally, if this service was implemented and if family physicians saw additional patients when the JIT service saved them time, up to 61,100 extra patients could be seen annually. A conservative estimate of the cost savings and cost avoidance per question for JIT was $11.55. The cost per question, if the librarian service was used at full capacity, is quite low. Financial savings to the health care system might exceed the cost of the service. Saving physician's time during their day could potentially lead to better access to family physicians by patients. Implementing a librarian consultation service can happen quickly as the time required to train professional librarians to do this service is short.

The Cost-Effectiveness of Emergency Hormonal Contraception with Ulipristal Acetate versus Levonorgestrel for Minors in France.

PubMed

Schmid, Ramona

2015-01-01

To evaluate the cost-effectiveness of ulipristal acetate and levonorgestrel in minors in France, and analyze whether it is worthwhile to provide ulipristal acetate to minors free of charge. The cost-effectiveness of two emergency contraceptive methods was compared based on a decision-analytical model. Pregnancy rates, outcomes of unintended pregnancies, and resource utilization were derived from the literature. Resources and their costs were considered until termination or a few days after delivery. Deterministic and probabilistic sensitivity analyses were performed. The cost of an unintended pregnancy in a French minor is estimated to be 1,630 € (range 1,330 € - 1,803 €). Almost 4 million € (3.1 € - 13.7 € million) in unintended pregnancy spending in 2010 could have been saved by the use of ulipristal acetate instead of levonorgestrel. The incremental cost of ulipristal acetate compared to levonorgestrel is 3.30 € per intake, or 418 € per pregnancy avoided (intake within 72 hours). In the intake within 24 hours subgroup, ulipristal acetate was found to be more efficacious at a lower cost compared to levonorgestrel. Ulipristal acetate dominates levonorgestrel when taken within 24 hours after unprotected intercourse, i.e., it is more effective at a lower cost. When taken within 72 hours, ulipristal acetate is a cost- effective alternative to levonorgestrel, given that the cost of avoiding an additional pregnancy with ulipristal acetate is less than the average cost of these pregnancies. In the light of these findings, it is worthwhile to provide free access to minors.

Modular high power diode lasers with flexible 3D multiplexing arrangement optimized for automated manufacturing

NASA Astrophysics Data System (ADS)

Könning, Tobias; Bayer, Andreas; Plappert, Nora; Faßbender, Wilhelm; Dürsch, Sascha; Küster, Matthias; Hubrich, Ralf; Wolf, Paul; Köhler, Bernd; Biesenbach, Jens

2018-02-01

A novel 3-dimensional arrangement of mirrors is used to re-arrange beams from 1-D and 2-D high power diode laser arrays. The approach allows for a variety of stacking geometries, depending on individual requirements. While basic building blocks, including collimating optics, always remain the same, most adaptations can be realized by simple rearrangement of a few optical components. Due to fully automated alignment processes, the required changes can be realized in software by changing coordinates, rather than requiring customized mechanical components. This approach minimizes development costs due to its flexibility, while reducing overall product cost by using similar building blocks for a variety of products and utilizing a high grade of automation. The modules can be operated with industrial grade water, lowering overall system and maintenance cost. Stackable macro coolers are used as the smallest building block of the system. Each cooler can hold up to five diode laser bars. Micro optical components, collimating the beam, are mounted directly to the cooler. All optical assembly steps are fully automated. Initially, the beams from all laser bars propagate in the same direction. Key to the concept is an arrangement of deflectors, which re-arrange the beams into a 2-D array of the desired shape and high fill factor. Standard multiplexing techniques like polarization- or wavelengths-multiplexing have been implemented as well. A variety of fiber coupled modules ranging from a few hundred watts of optical output power to multiple kilowatts of power, as well as customized laser spot geometries like uniform line sources, have been realized.

Development of a low-cost temperature data monitoring. An upgrade for hot box apparatus

NASA Astrophysics Data System (ADS)

de Rubeis, T.; Nardi, I.; Muttillo, M.

2017-11-01

The monitoring phase has gained a fundamental role in the energy efficiency evaluation of a system. Number and typology of the probes depend on the physical quantity to be monitored, and on the size and complexity of the system. Moreover, a measurement equipment should be designed to allow the employment of probes different for number and measured physical quantities. For this reason, a scalable equipment represents a good way for easily carrying out a system monitoring. Proprietary software and high costs characterize instruments of current use, thus limiting the possibilities to realize customized monitoring. In this paper, a temperature measuring instrument, conceived, designed, and realized for real time applications, is presented. The proposed system is based on digital thermometers and on open-source code. A remarkable feature of the instrument is the possibility of acquiring data from a high and variable number of probes (order of hundred), assuring flexibility of the software, since it can be programmed, and low-cost of the hardware components. The contemporary use of multiple temperature probes suggested to apply this instrument for a hot box apparatus, although the software can be set for recording different physical quantities. A hot box compliant with standard EN ISO 8990 should be equipped with several temperature probes to investigate heat exchanges of a specimen wall and thermal field of the chambers. In this work, preliminary tests have been carried out focusing only on the evaluation of the prototypal system’s performance. The tests were realized by comparing different sensors, such as thermocouples and resistance thermometers, traditionally employed in hot box experiments. A preliminary test was realized imposing a dynamic condition with a thermoelectric Peltier cell. Data obtained by digital thermometers DS18B20, compared with the ones of Pt100 probes, show a good correlation. Based on these encouraging results, a further test was carried out in hot box, comparing the data measured by digital thermometers, Pt100 and T-type thermocouples. In this case also, the analyses show a good correlation between either digital thermometers and analog sensors. From these results, it is reasonable to foresee that this measuring instrument could help those willing to realize or refurbish a hot box apparatus, and those who want to undertake temperature monitoring.

Lieb-Schultz-Mattis-type filling constraints in the 1651 magnetic space groups

NASA Astrophysics Data System (ADS)

Watanabe, Haruki

2018-04-01

We present a systematic study of the filling constraints to realize a "trivial" insulator symmetric under magnetic space group M . The filling ν must be an integer multiple of mM to avoid spontaneous symmetry breaking or fractionalization in gapped phases. We improve the value of mM in the literature and prove the tightness of the constraint for the majority of magnetic space groups. The result may shed light on the material search of exotic magnets with fractionalization.

Advanced solar receiver conceptual design study

NASA Technical Reports Server (NTRS)

Kesseli, J. B.; Lacy, D. E.

1987-01-01

High temperature solar dynamic Brayton and Stirling receivers are investigated as candidate electrical power generating systems for future LEO missions. These receivers are smaller and more efficient than conventional receivers, and they offer less structural complexity and fewer thermal stress problems. Use of the advanced Direct Absorption Storage Receiver allows many of the problems associated with working with high-volumetric-change phase-change materials to be avoided. A specific mass reduction of about 1/3 with respect to the baseline receiver has been realized.

New telescopic crown protocol for partially edentulous patients: report of 32 cases.

PubMed

Longoni, Salvatore; Apruzzese, Domenico; Careddu, Giovanni; Sartori, Matteo; Davide, Roberto

2005-10-01

In some periodontal cases, biomechanical, esthetic, medical, or economic concerns make it difficult for clinicians to employ either traditional therapy or restoration with an implant-supported prosthesis. To avoid any compromise and ensure a good result in such cases, we chose a removable telescopic prosthesis on natural teeth. In this paper we present a new clinical and technical method for the telescopic prosthesis, and we show that this is a predictable, reliable solution that is easy to realize, inexpensive, and comfortable for patients.

Cost-effectiveness of preventive oral health care in medical offices for young Medicaid enrollees.

PubMed

Stearns, Sally C; Rozier, R Gary; Kranz, Ashley M; Pahel, Bhavna T; Quiñonez, Rocio B

2012-10-01

To estimate the cost-effectiveness of a medical office-based preventive oral health program in North Carolina called Into the Mouths of Babes (IMB). Observational study using Medicaid claims data (2000-2006). Medical staff delivered IMB services in medical offices, and dentists provided dental services in offices or hospitals. A total of 209 285 children enrolled in Medicaid at age 6 months. Into the Mouths of Babes visits included screening, parental counseling, topical fluoride application, and referral to dentists, if needed. The cost-effectiveness analysis used the Medicaid program perspective and a propensity score-matched sample with regression analysis to compare children with 4 or more vs 0 IMB visits. Dental treatments and Medicaid payments for children up to age 6 years enabled assessment of the likelihood of whether IMB was cost-saving and, if not, the additional payments per hospital episode avoided. Into the Mouths of Babes is 32% likely to be cost-saving, with discounting of benefits and payments. On average, IMB visits cost $11 more than reduced dental treatment payments per person. The program almost breaks even if future benefits from prevention are not discounted, and it would be cost-saving with certainty if IMB services could be provided at $34 instead of $55 per visit. The program is cost-effective with 95% certainty if Medicaid is willing to pay $2331 per hospital episode avoided. Into the Mouths of Babes improves dental health for additional payments that can be weighed against unmeasured hospitalization costs.

A nurse-run walk-in clinic: cost-effective alternative to non-urgent emergency department use by the uninsured.

PubMed

Bicki, Alexandra; Silva, Adam; Joseph, Valerie; Handoko, Ryan; Rico, Sheryl-vi; Burns, Jacqueline; Simonelli, Anna; Harrop, Jordan; Nedow, Jennifer; De Groot, Anne S

2013-12-01

Non-urgent healthcare problems are responsible for more than 9 million visits to the emergency department (ED) in US hospitals each year, largely due to patients' lack of access to a primary care physician. To avoid costly and unnecessary ED usage for non-urgent health problems, a walk-in clinic run by nurses (CHEER Clinic) was developed as an extension of the services provided by an existing free clinic in a low-income neighborhood of Providence, RI, with the goal of providing uninsured patients with a convenient, no-cost means of accessing healthcare. An evaluation and cost-effectiveness analysis of the clinic's first 5 months of operation were performed. During this pilot period, 256 patients were seen. When incorporating the quality-adjusted-life-year value of preventive services rendered, an estimated $1.28 million in future healthcare costs was avoided. Dividing these cost-savings by the clinic's operational cost yielded a mean return on investment of $34 per $1 invested. Adding nurse-run walk-in hours at a free clinic significantly expanded access to healthcare for uninsured patients and was cost-effective for both the clinic and the patient. Ultimately, replication of this model in community clinics serving the uninsured could reduce ED burden by treating a substantial number of non-urgent medical concerns at a lower cost than would be incurred for treatment of the same problems in EDs.

[Economic evaluation of a program of coordination between levels for complex chronic patients' management].

PubMed

Allepuz Palau, Alejandro; Piñeiro Méndez, Pilar; Molina Hinojosa, José Carlos; Jou Ferre, Victoria; Gabarró Julià, Lourdes

2015-03-01

The complex chronic patient program (CCP) of the Alt Penedès aims to improve the coordination of care. The objective was to evaluate the relationship between the costs associated with the program, and its results in the form of avoided admissions. Dost-effectiveness analysis from the perspective of the health System based on a before-after study. Alt Penedès. Health services utilisation (hospital [admissions, emergency visits, day-care hospital] and primary care visits). CCP Program results were compared with those prior to its implementation. The cost assigned to each resource corresponded to the hospital CatSalut's concert and ICS fees for primary care. A sensitivity analysis using boot strapping was performed. The intervention was considered cost-effective if the incremental cost-effectiveness ratio (ICER) did not exceed the cost of admission (€ 1,742.01). 149 patients were included. Admissions dropped from 212 to 145. The ICER was €1,416.3 (94,892.9€/67). Sensitivity analysis showed that in 95% of cases the cost might vary between €70,847.3 and €121,882.5 and avoided admissions between 30 and 102. In 72.4% of the simulations the program was cost-effective. Sensitivity analysis showed that in most situations the PCC Program would be cost-effective, although in a percentage of cases the program could raise overall cost of care, despite always reducing the number of admissions. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Photovoltaics and electric utilities

NASA Astrophysics Data System (ADS)

Bright, R.; Leigh, R.; Sills, T.

1981-12-01

The long term value of grid connected, residential photovoltaic (PV) systems is determined. The value of the PV electricity is defined as the full avoided cost in accordance with the Public Utilities Regulatory Policies Act of 1978. The avoided cost is computed using a long range utility planning approach to measure revenue requirement changes in response to the time phased introduction of PV systems into the grid. A case study approach to three utility systems is used. The changing value of PV electricity over a twenty year period from 1985 is presented, and the fuel and capital savings due to FY are analyzed. These values are translated into measures of breakeven capital investment under several options of power interchange and pricing.

Annual waste reduction activities report. Issue 1

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

NONE

1991-03-18

This report discusses the waste minimization activities for the Pinellas Plant. The Pinellas Plant deals with low-level radioactive wastes, solvents, scrap metals and various other hazardous materials. This program has realized cost savings through recycling and reuse of materials.

Investigation of schedules for traffic signal timing optimization.

DOT National Transportation Integrated Search

2005-01-01

Traffic signal optimization is recognized as one of the most cost-effective ways to improve urban mobility; however the extent of the benefits realized could significantly depend on how often traffic signal re-optimization occurs. Using a case study ...

GCT Bayonne’s Drayage Truck Appointment System

EPA Pesticide Factsheets

Global Container Terminals (GCT) has implemented an advanced truck appointment system at its GCT Bayonne facility at the Port of New York and New Jersey that has realized benefits in terms of cost savings, turn times, the environment, and congestion.

Wireless Success Story - Industrial Technologies Program (ITP)

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

none,

This success story presents the results of wireless research by Sensors & Automation, a sub-program of the U.S. Department of Energy (DOE) Industrial Technologies Program (ITP). The prioritized research resulted in success with realized energy and cost savings.

Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries.

PubMed

Massad, Eduardo; Behrens, Ben C; Coutinho, Francisco A B; Behrens, Ronald H

2011-05-17

In a number of malaria endemic regions, tourists and travellers face a declining risk of travel associated malaria, in part due to successful malaria control. Many millions of visitors to these regions are recommended, via national and international policy, to use chemoprophylaxis which has a well recognized morbidity profile. To evaluate whether current malaria chemo-prophylactic policy for travellers is cost effective when adjusted for endemic transmission risk and duration of exposure. a framework, based on partial cost-benefit analysis was used. Using a three component model combining a probability component, a cost component and a malaria risk component, the study estimated health costs avoided through use of chemoprophylaxis and costs of disease prevention (including adverse events and pre-travel advice for visits to five popular high and low malaria endemic regions) and malaria transmission risk using imported malaria cases and numbers of travellers to malarious countries. By calculating the minimal threshold malaria risk below which the economic costs of chemoprophylaxis are greater than the avoided health costs we were able to identify the point at which chemoprophylaxis would be economically rational. The threshold incidence at which malaria chemoprophylaxis policy becomes cost effective for UK travellers is an accumulated risk of 1.13% assuming a given set of cost parameters. The period a travellers need to remain exposed to achieve this accumulated risk varied from 30 to more than 365 days, depending on the regions intensity of malaria transmission. The cost-benefit analysis identified that chemoprophylaxis use was not a cost-effective policy for travellers to Thailand or the Amazon region of Brazil, but was cost-effective for travel to West Africa and for those staying longer than 45 days in India and Indonesia.

Retrospective Assessment of Cost Savings From Prevention: Folic Acid Fortification and Spina Bifida in the U.S.

PubMed

Grosse, Scott D; Berry, Robert J; Mick Tilford, J; Kucik, James E; Waitzman, Norman J

2016-05-01

Although fortification of food with folic acid has been calculated to be cost saving in the U.S., updated estimates are needed. This analysis calculates new estimates from the societal perspective of net cost savings per year associated with mandatory folic acid fortification of enriched cereal grain products in the U.S. that was implemented during 1997-1998. Estimates of annual numbers of live-born spina bifida cases in 1995-1996 relative to 1999-2011 based on birth defects surveillance data were combined during 2015 with published estimates of the present value of lifetime direct costs updated in 2014 U.S. dollars for a live-born infant with spina bifida to estimate avoided direct costs and net cost savings. The fortification mandate is estimated to have reduced the annual number of U.S. live-born spina bifida cases by 767, with a lower-bound estimate of 614. The present value of mean direct lifetime cost per infant with spina bifida is estimated to be $791,900, or $577,000 excluding caregiving costs. Using a best estimate of numbers of avoided live-born spina bifida cases, fortification is estimated to reduce the present value of total direct costs for each year's birth cohort by $603 million more than the cost of fortification. A lower-bound estimate of cost savings using conservative assumptions, including the upper-bound estimate of fortification cost, is $299 million. The estimates of cost savings are larger than previously reported, even using conservative assumptions. The analysis can also inform assessments of folic acid fortification in other countries. Published by Elsevier Inc.

A cost-effectiveness analysis comparing different strategies to implement noninvasive prenatal testing into a Down syndrome screening program.

PubMed

Ayres, Alice C; Whitty, Jennifer A; Ellwood, David A

2014-10-01

Currently, noninvasive prenatal testing (NIPT) is only recommended in high-risk women following conventional Down syndrome (DS) screening, and it has not yet been included in the Australian DS screening program. To evaluate the cost-effectiveness of different strategies of NIPT for DS screening in comparison with current practice. A decision-analytic approach modelled a theoretical cohort of 300,000 singleton pregnancies. The strategies compared were the following: current practice, NIPT as a second-tier investigation, NIPT only in women >35 years, NIPT only in women >40 years and NIPT for all women. The direct costs (low and high estimates) were derived using both health system costs and patient out-of-pocket expenses. The number of DS cases detected and procedure-related losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness. Universal NIPT costs an additional $134,636,832 compared with current practice, but detects 123 more DS cases (at an incremental cost of $1,094,608 per case) and avoids 90 PRL. NIPT for women >40 years was the most cost-effective strategy, costing an incremental $81,199 per additional DS case detected and avoiding 95 PRL. The cost of NIPT needs to decrease significantly if it is to replace current practice on a purely cost-effectiveness basis. However, it may be beneficial to use NIPT as first-line screening in selected high-risk patients. Further evaluation is needed to consider the longer-term costs and benefits of screening. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Process development and exergy cost sensitivity analysis of a hybrid molten carbonate fuel cell power plant and carbon dioxide capturing process

NASA Astrophysics Data System (ADS)

Mehrpooya, Mehdi; Ansarinasab, Hojat; Moftakhari Sharifzadeh, Mohammad Mehdi; Rosen, Marc A.

2017-10-01

An integrated power plant with a net electrical power output of 3.71 × 105 kW is developed and investigated. The electrical efficiency of the process is found to be 60.1%. The process includes three main sub-systems: molten carbonate fuel cell system, heat recovery section and cryogenic carbon dioxide capturing process. Conventional and advanced exergoeconomic methods are used for analyzing the process. Advanced exergoeconomic analysis is a comprehensive evaluation tool which combines an exergetic approach with economic analysis procedures. With this method, investment and exergy destruction costs of the process components are divided into endogenous/exogenous and avoidable/unavoidable parts. Results of the conventional exergoeconomic analyses demonstrate that the combustion chamber has the largest exergy destruction rate (182 MW) and cost rate (13,100 /h). Also, the total process cost rate can be decreased by reducing the cost rate of the fuel cell and improving the efficiency of the combustion chamber and heat recovery steam generator. Based on the total avoidable endogenous cost rate, the priority for modification is the heat recovery steam generator, a compressor and a turbine of the power plant, in rank order. A sensitivity analysis is done to investigate the exergoeconomic factor parameters through changing the effective parameter variations.

Adaptation of Dubins Paths for UAV Ground Obstacle Avoidance When Using a Low Cost On-Board GNSS Sensor.

PubMed

Kikutis, Ramūnas; Stankūnas, Jonas; Rudinskas, Darius; Masiulionis, Tadas

2017-09-28

Current research on Unmanned Aerial Vehicles (UAVs) shows a lot of interest in autonomous UAV navigation. This interest is mainly driven by the necessity to meet the rules and restrictions for small UAV flights that are issued by various international and national legal organizations. In order to lower these restrictions, new levels of automation and flight safety must be reached. In this paper, a new method for ground obstacle avoidance derived by using UAV navigation based on the Dubins paths algorithm is presented. The accuracy of the proposed method has been tested, and research results have been obtained by using Software-in-the-Loop (SITL) simulation and real UAV flights, with the measurements done with a low cost Global Navigation Satellite System (GNSS) sensor. All tests were carried out in a three-dimensional space, but the height accuracy was not assessed. The GNSS navigation data for the ground obstacle avoidance algorithm is evaluated statistically.

Adaptation of Dubins Paths for UAV Ground Obstacle Avoidance When Using a Low Cost On-Board GNSS Sensor

PubMed Central

Kikutis, Ramūnas; Stankūnas, Jonas; Rudinskas, Darius; Masiulionis, Tadas

2017-01-01

Current research on Unmanned Aerial Vehicles (UAVs) shows a lot of interest in autonomous UAV navigation. This interest is mainly driven by the necessity to meet the rules and restrictions for small UAV flights that are issued by various international and national legal organizations. In order to lower these restrictions, new levels of automation and flight safety must be reached. In this paper, a new method for ground obstacle avoidance derived by using UAV navigation based on the Dubins paths algorithm is presented. The accuracy of the proposed method has been tested, and research results have been obtained by using Software-in-the-Loop (SITL) simulation and real UAV flights, with the measurements done with a low cost Global Navigation Satellite System (GNSS) sensor. All tests were carried out in a three-dimensional space, but the height accuracy was not assessed. The GNSS navigation data for the ground obstacle avoidance algorithm is evaluated statistically. PMID:28956839

2014 Summer Series - Mark Jacobson - Roadmaps for Transitioning All 50 US States to Wind, Water and Solar Power

NASA Image and Video Library

2014-07-08

Global warming, air pollution, and energy insecurity are three of the most significant problems facing the world today. This talk discusses the development of technical and economic plans to convert the energy infrastructure of each of the 50 United States to those powered by 100% wind, water, and sunlight (WWS) for all purposes, namely electricity, transportation, industry, and heating/cooling, after energy efficiency measures have been accounted for. The plans call for all new energy to be WWS by 2020, ~80% conversion of existing energy by 2030, and 100% by 2050 through aggressive policy measures and natural transition. Resource availability, footprint and spacing areas required, jobs created, energy costs, avoided costs from air pollution mortality and morbidity and climate damage, methods of ensuring reliability of the grid, and impacts of offshore wind farms on hurricane dissipation are discussed. Air pollution reductions alone due to the plan would eliminate ~60,000 U.S. premature mortalities, avoiding costs equivalent to 3.2% of the United States GDP. Climate cost reductions are of similar order. The plans stabilize energy prices because fuel costs are zero.

Dealing with electronic waste: modeling the costs and environmental benefits of computer monitor disposal.

PubMed

Macauley, Molly; Palmer, Karen; Shih, Jhih-Shyang

2003-05-01

The importance of information technology to the world economy has brought about a surge in demand for electronic equipment. With rapid technological change, a growing fraction of the increasing stock of many types of electronics becomes obsolete each year. We model the costs and benefits of policies to manage 'e-waste' by focusing on a large component of the electronic waste stream-computer monitors-and the environmental concerns associated with disposal of the lead embodied in cathode ray tubes (CRTs) used in most monitors. We find that the benefits of avoiding health effects associated with CRT disposal appear far outweighed by the costs for a wide range of policies. For the stock of monitors disposed of in the United States in 1998, we find that policies restricting or banning some popular disposal options would increase disposal costs from about US dollar 1 per monitor to between US dollars 3 and US dollars 20 per monitor. Policies to promote a modest amount of recycling of monitor parts, including lead, can be less expensive. In all cases, however, the costs of the policies exceed the value of the avoided health effects of CRT disposal.

Social cost of leptospirosis cases attributed to the 2011 disaster striking Nova Friburgo, Brazil.

PubMed

Pereira, Carlos; Barata, Martha; Trigo, Aline

2014-04-15

The aim of this study was to estimate the social cost of the leptospirosis cases that were attributed to the natural disaster of January 2011 in Nova Friburgo (State of Rio de Janeiro, Brazil) through a partial economic assessment. This study utilized secondary data supplied by the Municipal Health Foundation of Nova Friburgo. Income scenarios based on the national and state minimum wages and on average income of the local population were employed. The total social cost of leptospirosis cases attributed to the 2011 disaster may range between US$21,500 and US$66,000 for the lower income scenario and between US$23,900 and US$100,800 for that of higher income. Empirical therapy represented a total avoided cost of US$14,800, in addition to a reduction in lethality. An estimated 31 deaths were avoided among confirmed cases of the disease, and no deaths resulted from the leptospirosis cases attributed to the natural disaster. There has been a significant post-disaster rise in leptospirosis incidence in the municipality, which illustrates the potential for increased cases--and hence costs--of this illness following natural disasters, which justifies the adoption of preventive measures in environmental health.

The Application of Magnesium Alloys in Aircraft Interiors — Changing the Rules

NASA Astrophysics Data System (ADS)

Davis, Bruce

The commercial aircraft market is forecast to steadily grow over the next two decades. Part of this growth is driven by the desire of airlines to replace older models in their fleet with newer, more fuel efficient designs, to realize lower operating costs and to address the rising cost of aviation fuel. As such the aircraft OEMs are beginning to set more and more demanding mass targets on their new platforms.

Oversight overload: harried hospitals say the growing number of billing audits they face could actually increase costs.

PubMed

Daly, Rich

2011-11-21

Providers say the administration's growing emphasis on billing audits is pushing them to the limit and threatens to increase their costs. Many billing problems stem from simple errors, not fraud, they say. "When you get into the nuts and bolts of some of these programs you realize it's not as easy as taking the overpayment line out of the budget," says Michael Regier, of VHA.

Tactical Utility of Tailored Systems

DTIC Science & Technology

2015-07-10

create a procurement system to produce materiel at a cost low enough to make equipment disposable. Further cost savings may be realized by upgrading...replacement parts. With the advent of 3-d printing and digital manufacturing, a new part may be procured as easily as scanning a bar code and pressing...9/11 Commission Report “Imagination is not a gift usually associated with bureaucracies. It is therefore crucial to find a way of routinizing, even

It's so hard to be fair.

PubMed

Brockner, Joel

2006-03-01

When employees believe they are being treated fairly-when they feel heard, when they understand how and why important decisions are made, and when they believe they are respected-their companies will benefit. Research shows that practicing process fairness reduces legal costs from wrongful-termination suits, lowers employee turnover, helps generate support for new strategic initiatives, and fosters a culture that promotes innovation. What's more, it costs little financially to implement Yet few companies practice it consistently. Joel Brockner examines this paradox, exploring psychological and other reasons that cause managers to resist embracing process fairness. The fact that it's relatively inexpensive to implement, for instance, may be why some numbers-oriented executives undervalue it. Many managers believe that they practice process fairness, but 360-degree feedback tells another story. Some corporate policies actually undermine it--such as when the legal department won't let managers fully explain decisions for fear that disclosure could expose the firm to lawsuits. And, frequently, managers simply follow the all-too-human tendency to avoid uncomfortable situations. But the good news is that organizations can take concrete steps to promote greater process fairness. Many studies have shown that training programs make a big difference, and the author describes the most effective format. In addition, warning your managers that they may experience negative emotions when practicing fair process will help prepare them to cope with those feelings. Finally, role modeling fair process on the executive level will help spread the practice throughout the organization. The fact is, process fairness is the responsibility of all executives, at all levels and in all functions; it cannot be delegated to HR. The sooner managers realize that and work to make it a company norm, the better off the organization will be.

[QR-Code based patient tracking: a cost-effective option to improve patient safety].

PubMed

Fischer, M; Rybitskiy, D; Strauß, G; Dietz, A; Dressler, C R

2013-03-01

Hospitals are implementing a risk management system to avoid patient or surgery mix-ups. The trend is to use preoperative checklists. This work deals specifically with a type of patient identification, which is realized by storing patient data on a patient-fixed medium. In 127 ENT surgeries data relevant for patient identification were encrypted in a 2D-QR-Code. The code, as a separate document coming with the patient chart or as a patient wristband, has been decrypted in the OR and the patient data were presented visible for all persons. The decoding time, the compliance of the patient data, as well as the duration of the patient identification was compared with the traditional patient identification by inspection of the patient chart. A total of 125 QR codes were read. The time for the decrypting of QR-Code was 5.6 s, the time for the screen view for patient identification was 7.9 s, and for a comparison group of 75 operations traditional patient identification was 27.3 s. Overall, there were 6 relevant information errors in the two parts of the experiment. This represents a ratio of 0.6% for 8 relevant classes per each encrypted QR code. This work allows a cost effective way to technically support patient identification based on electronic patient data. It was shown that the use in the clinical routine is possible. The disadvantage is a potential misinformation from incorrect or missing information in the HIS, or due to changes of the data after the code was created. The QR-code-based patient tracking is seen as a useful complement to the already widely used identification wristband. © Georg Thieme Verlag KG Stuttgart · New York.

The myth of secure computing.

PubMed

Austin, Robert D; Darby, Christopher A

2003-06-01

Few senior executives pay a whole lot of attention to computer security. They either hand off responsibility to their technical people or bring in consultants. But given the stakes involved, an arm's-length approach is extremely unwise. According to industry estimates, security breaches affect 90% of all businesses every year and cost some $17 billion. Fortunately, the authors say, senior executives don't need to learn about the more arcane aspects of their company's IT systems in order to take a hands-on approach. Instead, they should focus on the familiar task of managing risk. Their role should be to assess the business value of their information assets, determine the likelihood that those assets will be compromised, and then tailor a set of risk abatement processes to their company's particular vulnerabilities. This approach, which views computer security as an operational rather than a technical challenge, is akin to a classic quality assurance program in that it attempts to avoid problems rather than fix them and involves all employees, not just IT staffers. The goal is not to make computer systems completely secure--that's impossible--but to reduce the business risk to an acceptable level. This article looks at the types of threats a company is apt to face. It also examines the processes a general manager should spearhead to lessen the likelihood of a successful attack. The authors recommend eight processes in all, ranging from deciding how much protection each digital asset deserves to insisting on secure software to rehearsing a response to a security breach. The important thing to realize, they emphasize, is that decisions about digital security are not much different from other cost-benefit decisions. The tools general managers bring to bear on other areas of the business are good models for what they need to do in this technical space.

Rationale for hedging initiatives: Empirical evidence from the energy industry

NASA Astrophysics Data System (ADS)

Dhanarajata, Srirajata

Theory offers different rationales for hedging including (i) financial distress and bankruptcy cost, (ii) capacity to capture attractive investment opportunities, (iii) information asymmetry, (iv) economy of scale, (v) substitution for hedging, (vi) managerial risk aversion, and (vii) convexity of tax schedule. The purpose of this dissertation is to empirically test the explanatory power of the first five theoretical rationales on hedging done by oil and gas exploration and production (E&P) companies. The level of hedging is measured by the percentage of production effectively hedged, calculated based on the concept of delta and delta-gamma hedging. I employ Tobit regression, principal components, and panel data analysis on dependent and raw independent variables. Tobit regression is applied due to the fact that the dependent variable used in the analysis is non-negative. Principal component analysis helps to reduce the dimension of explanatory variables while panel data analysis combines/pools the data that is a combination of time-series and cross-sectional. Based on the empirical results, leverage level is consistently found to be a significant factor on hedging activities, either due to an attempt to avoid financial distress by the firm, or an attempt to control agency cost by debtholders, or both. The effect of capital expenditures and discretionary cash flows are both indeterminable due possibly to a potential mismatch in timing of realized cash flow items and hedging decision. Firm size is found to be positively related to hedging supporting economy of scale hypothesis, which is introduced in past literature, as well as the argument that large firm usually are more sophisticated and should be more willing and more comfortable to use hedge instruments than smaller firms.

Motorcycle crashes potentially preventable by three crash avoidance technologies on passenger vehicles.

PubMed

Teoh, Eric R

2018-07-04

The objective of this study was to identify and quantify the motorcycle crash population that would be potential beneficiaries of 3 crash avoidance technologies recently available on passenger vehicles. Two-vehicle crashes between a motorcycle and a passenger vehicle that occurred in the United States during 2011-2015 were classified by type, with consideration of the functionality of 3 classes of passenger vehicle crash avoidance technologies: frontal crash prevention, lane maintenance, and blind spot detection. Results were expressed as the percentage of crashes potentially preventable by each type of technology, based on all known types of 2-vehicle crashes and based on all crashes involving motorcycles. Frontal crash prevention had the largest potential to prevent 2-vehicle motorcycle crashes with passenger vehicles. The 3 technologies in sum had the potential to prevent 10% of fatal 2-vehicle crashes and 23% of police-reported crashes. However, because 2-vehicle crashes with a passenger vehicle represent fewer than half of all motorcycle crashes, these technologies represent a potential to avoid 4% of all fatal motorcycle crashes and 10% of all police-reported motorcycle crashes. Refining the ability of passenger vehicle crash avoidance systems to detect motorcycles represents an opportunity to improve motorcycle safety. Expanding the capabilities of these technologies represents an even greater opportunity. However, even fully realizing these opportunities can affect only a minority of motorcycle crashes and does not change the need for other motorcycle safety countermeasures such as helmets, universal helmet laws, and antilock braking systems.

A top-down approach to heliostat cost reduction

NASA Astrophysics Data System (ADS)

Larmuth, James N.; Landamn, Willem A.; Gauché, Paul

2016-05-01

The Technology Innovation Agency (TIA) has funded a South African central receiver collector technology development project, called Helio100. The project aims to provide South Africa's first commercially viable heliostat technology, which is both low in cost and offers high local content potential. A top-down approach is employed for heliostat cost reduction. This approach incorporates interlinked tools which move from high level cost analyses based on qualitative data during early stages of conceptual design, to detailed quantitative analyses in the final stages of design. Low cost heliostat designs are realized by the incorporation of both a top-down and bottom-up method. The current H100 design results in heliostat costs of 155/m2 at 20 000 units p.a. while further industrialisation results in heliostat costs of 126/m2 at 20 000 units.

Observational study and estimate of cost savings from use of a health information exchange in an academic emergency department.

PubMed

Carr, Christine Marie; Gilman, Charles Samuel; Krywko, Diann Marie; Moore, Haley Elizabeth; Walker, Brenda J; Saef, Steven Howard

2014-02-01

Federal initiatives to improve health care information sharing have led to the development of a new type of regional electronic medical record known as a health information exchange (HIE). Our aim was to investigate the ability of an HIE to decrease health services use for emergency department (ED) patients. We performed an observational, prospective study using a voluntary, anonymous survey among clinicians at an urban academic ED. All ED clinicians were eligible to participate. Survey items addressed clinician perception of whether information from the HIE avoided the use of hospital resources, improved quality of care, and reduced length of stay (LOS). Cost savings were estimated by multiplying the number of services the clinicians completing our survey reported they avoided through use of the HIE by the costs of those services at our facility. The study was approved by the Institutional Review Board at the study site. The study was conducted between August and December of 2011. There were 18,529 patient encounters during the study period and 60 clinicians at the study site who were eligible to participate. The clinicians consulted the HIE for 5.39% of these encounters (998 patients). Surveys were completed by the clinicians caring for 13.8% (n = 138) of these patients. Of the completed surveys, 76% (105 surveys) referenced patients for whom the HIE was found to contain information on the patient under care by the clinician participant. These 105 patients formed the sample on which our analysis was based. Within this sample of patients, the following studies were reported to have been avoided by the clinicians participating in our survey: values are percent of patients for whom a study was reported to have been avoided (actual number of studies avoided): laboratory/microbiology: 30.5% (32 studies); radiologic studies: 47.6% (50 studies); consultations: 19% (20 consultations); and admissions: 11.4% (12 admissions). Calculated cost savings based on these estimates were as follows: laboratory/microbiology: $462.85; radiologic studies: $160,893.00; consultations: $3,990.00; and admissions: $118,131.84. Total savings: $283,477. Clinicians participating in the study reported improved quality of care for 86.7% of their patients, as well as a mean time savings of 120.8 minutes. According to clinician estimates, use of an HIE in this urban academic ED resulted in reduced use of hospital resources, noteworthy cost savings, decreased LOS, and improved quality of care. Limitations included the observational nature of the study, selection bias, the Hawthorne effect, and cost estimates being from a single institution. Allowance was not made for additional services used because of information obtained from the HIE. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of a pharmacist-managed hypertension program on health system costs: an evaluation of the Study of Cardiovascular Risk Intervention by Pharmacists-Hypertension (SCRIP-HTN).

PubMed

Houle, Sherilyn K D; Chuck, Anderson W; McAlister, Finlay A; Tsuyuki, Ross T

2012-06-01

To quantify the potential cost savings of a community pharmacy-based hypertension management program based on the results of the Study of Cardiovascular Risk Intervention by Pharmacists-Hypertension (SCRIP-HTN) study in terms of avoided cardiovascular events-myocardial infarction, stroke, and heart failure hospitalization, and to compare these cost savings with the cost of the pharmacist intervention program. An economic model was developed to estimate the potential cost avoidance in direct health care resources from reduced cardiovascular events over a 1-year period. The SCRIP-HTN study found that patients with diabetes mellitus and hypertension who were receiving the pharmacist intervention had a greater mean reduction in systolic blood pressure of 5.6 mm Hg than patients receiving usual care. For our model, published meta-analysis data were used to compute cardiovascular event absolute risk reductions associated with a 5.6-mm Hg reduction in systolic blood pressure over 6 months. Costs/event were obtained from administrative data, and probabilistic sensitivity analyses were performed to assess the robustness of the results. Two program scenarios were evaluated-one with monthly follow-up for a total of 1 year with sustained blood pressure reduction, and the other in which pharmacist care ended after the 6-month program but the effects on systolic blood pressure diminished over time. The cost saving results from the economic model were then compared with the costs of the program. Annual estimated cost savings (in 2011 Canadian dollars) from avoided cardiovascular events were $265/patient (95% confidence interval [CI] $63-467) if the program lasted 1 year or $221/patient (95%CI $72-371) if pharmacist care ceased after 6 months with an assumed loss of effect afterward. Estimated pharmacist costs were $90/patient for 6 months or $150/patient for 1 year, suggesting that pharmacist-managed programs are cost saving, with the annual net total cost savings/patient estimated to be $131 for a program lasting 6 months or $115 for a program lasting 1 year. Our model found that community pharmacist interventions capable of reducing systolic blood pressure by 5.6 mm Hg within 6 months are cost saving and result in improved patient outcomes. Wider adoption of pharmacist-managed hypertension care for patients with diabetes and hypertension is encouraged. © 2012 Pharmacotherapy Publications, Inc.

New Propellants and Cryofuels

NASA Technical Reports Server (NTRS)

Palasezski, Bryan; Sullivan, Neil S.; Hamida, Jaha; Kokshenev, V.

2006-01-01

The proposed research will investigate the stability and cryogenic properties of solid propellants that are critical to NASA s goal of realizing practical propellant designs for future spacecraft. We will determine the stability and thermal properties of a solid hydrogen-liquid helium stabilizer in a laboratory environment in order to design a practical propellant. In particular, we will explore methods of embedding atomic species and metallic nano-particulates in hydrogen matrices suspended in liquid helium. We will also measure the characteristic lifetimes and diffusion of atomic species in these candidate cryofuels. The most promising large-scale advance in rocket propulsion is the use of atomic propellants; most notably atomic hydrogen stabilized in cryogenic environments, and metallized-gelled liquid hydrogen (MGH) or densified gelled hydrogen (DGH). The new propellants offer very significant improvements over classic liquid oxygen/hydrogen fuels because of two factors: (1) the high energy-release, and (ii) the density increase per unit energy release. These two changes can lead to significant reduced mission costs and increased payload to orbit weight ratios. An achievable 5 to 10 percent improvement in specific impulse for the atomic propellants or MGH fuels can result in a doubling or tripling of system payloads. The high-energy atomic propellants must be stored in a stabilizing medium such as solid hydrogen to inhibit or delay their recombination into molecules. The goal of the proposed research is to determine the stability and thermal properties of the solid hydrogen-liquid helium stabilizer. Magnetic resonance techniques will be used to measure the thermal lifetimes and the diffusive motions of atomic species stored in solid hydrogen grains. The properties of metallic nano-particulates embedded in hydrogen matrices will also be studied and analyzed. Dynamic polarization techniques will be developed to enhance signal/noise ratios in order to be able to detect low concentrations of the introduced species. The required lifetimes for atomic hydrogen and other species can only be realized at low temperatures to avoid recombination of atoms before use as a fuel.

Economics of One Health: Costs and benefits of integrated West Nile virus surveillance in Emilia-Romagna.

PubMed

Paternoster, Giulia; Babo Martins, Sara; Mattivi, Andrea; Cagarelli, Roberto; Angelini, Paola; Bellini, Romeo; Santi, Annalisa; Galletti, Giorgio; Pupella, Simonetta; Marano, Giuseppe; Copello, Francesco; Rushton, Jonathan; Stärk, Katharina D C; Tamba, Marco

2017-01-01

Since 2013 in Emilia-Romagna, Italy, surveillance information generated in the public health and in the animal health sectors has been shared and used to guide public health interventions to mitigate the risk of West Nile virus (WNV) transmission via blood transfusion. The objective of the current study was to identify and estimate the costs and benefits associated with this One Health surveillance approach, and to compare it to an approach that does not integrate animal health information in blood donations safety policy (uni-sectoral scenario). Costs of human, animal, and entomological surveillance, sharing of information, and triggered interventions were estimated. Benefits were quantified as the averted costs of potential human cases of WNV neuroinvasive disease associated to infected blood transfusion. In the 2009-2015 period, the One Health approach was estimated to represent a cost saving of €160,921 compared to the uni-sectoral scenario. Blood donation screening was the main cost for both scenarios. The One Health approach further allowed savings of €1.21 million in terms of avoided tests on blood units. Benefits of the One Health approach due to short-term costs of hospitalization and compensation for transfusion-associated disease potentially avoided, were estimated to range from €0 to €2.98 million according to the probability of developing WNV neuroinvasive disease after receiving an infected blood transfusion.

Cost of oviposition site selection in a water strider Aquarius paludum insularis: egg mortality increases with oviposition depth.

PubMed

Hirayama, Hiroyuki; Kasuya, Eiiti

2010-06-01

Females generally avoid selecting sites for oviposition which have a high predation risk to increase offspring survival. Previous studies have focused on costs to ovipositing females. However, although offspring may also incur costs by being oviposited at low predation risk sites, no studies have focused on costs to offspring. Such costs to offspring were examined by using Aquarius paludum insularis, females of which avoid eggs parasitism by ovipositing at deep sites. Deep sites are safe from egg parasitism but may be unsuitable for hatching due to environmental factors. We examined the costs to offspring at deep sites by comparing the hatching rate, the duration to hatching and the proportion of drowned larvae between eggs that were set at three levels of water depth (0 cm, 25 cm and 50 cm depth). While the hatching rate at 50 cm was lower than that at 0 cm, the rate at 25 cm did not differ from that at 0 cm. Duration to hatching and the proportion of drowned larvae did not differ between the three depths. It is suggested that the declining survival rate of A. paludum eggs was due to increased water pressure at greater depth. Such a cost may exist in other species and such an observation may aid in understanding oviposition site selection. Copyright 2010 Elsevier Ltd. All rights reserved.

PGD for all cystic fibrosis carrier couples: novel strategy for preventive medicine and cost analysis.

PubMed

Tur-Kaspa, I; Aljadeff, G; Rechitsky, S; Grotjan, H E; Verlinsky, Y

2010-08-01

Over 1000 children affected with cystic fibrosis (CF) are born annually in the USA. Since IVF with preimplantation genetic diagnosis (PGD) is an alternative to raising a sick child or to aborting an affected fetus, a cost-benefit analysis was performed for a national IVF-PGD program for preventing CF. The amount spent to deliver healthy children for all CF carrier-couples by IVF-PGD was compared with the average annual and lifetime direct medical costs per CF patient avoided. Treating annually about 4000 CF carrier-couples with IVF-PGD would result in 3715 deliveries of non-affected children at a cost of $57,467 per baby. Because the average annual direct medical cost per CF patient was $63,127 and life expectancy is 37 years, savings would be $2.3 million per patient and $2.2 billion for all new CF patients annually in lifetime treatment costs. Cumulated net saving of an IVF-PGD program for all carrier-couples for 37 years would be $33.3 billion. A total of 618,714 cumulative years of patients suffering because of CF and thousands of abortions could be prevented. A national IVF-PGD program is a highly cost-effective novel modality of preventive medicine and would avoid most births of individuals affected with debilitating genetic disease. 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Population-level consequences of antipredator behavior: a metaphysiological model based on the functional ecology of the leaf-eared mouse.

PubMed

Ramos-Jiliberto, Rodrigo; González-Olivares, Eduardo; Bozinovic, Francisco

2002-08-01

We present a predator-prey metaphysiological model, based on the available behavioral and physiological information of the sigmodontine rodent Phyllotis darwini. The model is focused on the population-level consequences of the antipredator behavior, performed by the rodent population, which is assumed to be an inducible response of predation avoidance. The decrease in vulnerability is explicitly considered to have two associated costs: a decreasing foraging success and an increasing metabolic loss. The model analysis was carried out on a reduced form of the system by means of numerical and analytical tools. We evaluated the stability properties of equilibrium points in the phase plane, and carried out bifurcation analyses of rodent equilibrium density under varying conditions of three relevant parameters. The bifurcation parameters chosen represent predator avoidance effectiveness (A), foraging cost of antipredator behavior (C(1)'), and activity-metabolism cost (C(4)'). Our analysis suggests that the trade-offs involved in antipredator behavior plays a fundamental role in the stability properties of the system. Under conditions of high foraging cost, stability decreases as antipredator effectiveness increases. Under the complementary scenario (not considering the highest foraging costs), the equilibria are either stable when both costs are low, or unstable when both costs are higher, independent of antipredator effectiveness. No evidence of stabilizing effects of antipredator behavior was found. Copyright 2002 Elsevier Science (USA).

Budget-impact model for colonoscopy cost calculation and comparison between 2 litre PEG+ASC and sodium picosulphate with magnesium citrate or sodium phosphate oral bowel cleansing agents.

PubMed

Gruss, H-J; Cockett, A; Leicester, R J

2012-01-01

With the availability of several bowel cleansing agents, physicians and hospitals performing colonoscopies will often base their choice of cleansing agent purely on acquisition cost. Therefore, an easy to use budget impact model has been developed and established as a tool to compare total colon preparation costs between different established bowel cleansing agents. The model was programmed in Excel and designed as a questionnaire evaluating information on treatment costs for a range of established bowel cleansing products. The sum of costs is based on National Health Service reference costs for bowel cleansing products. Estimations are made for savings achievable when using a 2-litre polyethylene glycol with ascorbate components solution (PEG+ASC) in place of other bowel cleansing solutions. Test data were entered into the model to confirm validity and sensitivity. The model was then applied to a set of audit cost data from a major hospital colonoscopy unit in the UK. Descriptive analysis of the test data showed that the main cost drivers in the colonoscopy process are the procedure costs and costs for bed days rather than drug acquisition costs, irrespective of the cleansing agent. Audit data from a colonoscopy unit in the UK confirmed the finding with a saving of £107,000 per year in favour of PEG+ASC when compared to sodium picosulphate with magnesium citrate solution (NaPic+MgCit). For every patient group the model calculated overall cost savings. This was irrespective of the higher drug expenditure associated with the use of PEG+ASC for bowel preparation. Savings were mainly realized through reduced costs for repeat colonoscopy procedures and associated costs, such as inpatient length of stay. The budget impact model demonstrated that the primary cost driver was the procedure cost for colonoscopy. Savings can be realized through the use of PEG+ASC despite higher drug acquisition costs relative to the comparator products. From a global hospital funding perspective, the acquisition costs of bowel preparations should not be used as the primary reason to select the preferred treatment agent, but should be part of the consideration, with an emphasis on the clinical outcome.

Use of a decision-analytic model to support the use of a new oral US contrast agent in patients with abdominal pain.

PubMed

Bree, R L; Arnold, R J; Pettit, K G; Kaniecki, D J; O'haeri, C; LaFrance, N D; Toaff, A L

2001-03-01

The authors performed this study to compare the cost and diagnostic abilities of ultrasound (US) performed with and without the use of an oral contrast material recently approved by the U.S. Food and Drug Administration. An interactive decision-analytic model was constructed to compare US performed with and without contrast material (SonoRx; Bracco Diagnostics) for the evaluation of patients with abdominal pain who were suspected of having pancreatic disease. The model considered all resources that might be used to evaluate a patient suspected of having pancreatic disease (eg, US, computed tomography [CT], endoscopic retrograde cholangiopancreatography, fine-needle aspiration biopsy, and open biopsy). The literature and an expert panel were the clinical data sources. Cost estimates were based on Medicare and non-Medicare reimbursements. The primary cost-effectiveness measure was the cost to achieve a diagnosis. SonoRx-enhanced US was less expensive than unenhanced US ($714 vs $808, respectively, with Medicare costs; $1,612 vs $1,878, respectively, with non-Medicare costs) and as effective (0.785 vs 0.782, respectively). SonoRx-enhanced US was more cost-effective than unenhanced US ($909 vs $1,034, respectively, with Medicare costs; $2,052 vs $2,401, respectively, with non-Medicare costs). This relationship was maintained throughout extensive sensitivity analyses. SonoRx-enhanced US is more cost-effective than unenhanced US, primarily because it avoids the need for CT. CT may be avoided owing to the higher probability of obtaining optimal US scans with oral contrast material.

Immigrant screening for latent tuberculosis in Norway: a cost-effectiveness analysis.

PubMed

Haukaas, Fredrik Salvesen; Arnesen, Trude Margrete; Winje, Brita Askeland; Aas, Eline

2017-05-01

The incidence of tuberculosis (TB) disease has increased in Norway since the mid-1990s. Immigrants are screened, and some are treated, for latent TB infection (LTBI) to prevent TB disease (reactivation). In this study, we estimated the costs of both treating and screening for LTBI and TB disease, which has not been done previously in Norway. We developed a model to indicate the cost-effectiveness of four different screening algorithms for LTBI using avoided TB disease cases as the health outcome. Further, we calculated the expected value of perfect information (EVPI), and indicated areas of LTBI screening that could be changed to improve cost-effectiveness. The costs of treating LTBI and TB disease were estimated to be €1938 and €15,489 per case, respectively. The model evaluates four algorithms, and suggests three cost-effective algorithms depending on the cost-effectiveness threshold. Screening all immigrants with interferon-gamma release assays (IGRA) requires the highest threshold (€28,400), followed by the algorithms "IGRA on immigrants with risk factors" and "no LTBI screening." EVPI is approximately €5 per screened immigrant. The costs for a cohort of 20,000 immigrants followed through 10 years range from €12.2 million for the algorithm "screening and treatment for TB disease but no LTBI screening," to €14 million for "screening all immigrants for both TB disease and LTBI with IGRA." The results suggest that the cost of TB disease screening and treatment is the largest contributor to total costs, while LTBI screening and treatment costs are relatively small. Increasing the proportion of IGRA-positive immigrants who are treated decreases the costs per avoided case substantially.

The Economic Impact of Malignant Catarrhal Fever on Pastoralist Livelihoods

PubMed Central

Lankester, Felix; Lugelo, Ahmed; Kazwala, Rudovick; Keyyu, Julius; Cleaveland, Sarah; Yoder, Jonathan

2015-01-01

This study is the first to partially quantify the potential economic benefits that a vaccine, effective at protecting cattle against malignant catarrhal fever (MCF), could accrue to pastoralists living in East Africa. The benefits would result from the removal of household resource and management costs that are traditionally incurred avoiding the disease. MCF, a fatal disease of cattle caused by a virus transmitted from wildebeest calves, has plagued Maasai communities in East Africa for generations. The threat of the disease forces the Maasai to move cattle to less productive grazing areas to avoid wildebeest during calving season when forage quality is critical. To assess the management and resource costs associated with moving, we used household survey data. To estimate the costs associated with changes in livestock body condition that result from being herded away from wildebeest calving grounds, we exploited an ongoing MCF vaccine field trial and we used a hedonic price regression, a statistical model that allows estimation of the marginal contribution of a good’s attributes to its market price. We found that 90 percent of households move, on average, 82 percent of all cattle away from home to avoid MCF. In doing so, a herd’s productive contributions to the household was reduced, with 64 percent of milk being unavailable for sale or consumption by the family members remaining at the boma (the children, women, and the elderly). In contrast cattle that remained on the wildebeest calving grounds during the calving season (and survived MCF) remained fully productive to the family and gained body condition compared to cattle that moved away. This gain was, however, short-lived. We estimated the market value of these condition gains and losses using hedonic regression. The value of a vaccine for MCF is the removal of the costs incurred in avoiding the disease. PMID:25629896

Cost effectiveness of high-sensitivity troponin compared to conventional troponin among patients presenting with undifferentiated chest pain: A trial based analysis.

PubMed

Kaambwa, Billingsley; Ratcliffe, Julie; Horsfall, Matthew; Astley, Carolyn; Karnon, Jonathan; Coates, Penelope; Arstall, Margaret; Zeitz, Christopher; Worthley, Matthew; Beltrame, John; Chew, Derek P

2017-07-01

Patients with low and intermediate risk chest pain features comprise the greatest proportion presenting to emergency services for evaluation of suspected acute coronary syndromes (ACS). The efficient and timely identification of patients with these features remains a major challenge within clinical practice. Troponin assays are increasingly being used for the determination of risk among patients presenting with chest pain potentially facilitating more appropriate care. To date, no economic evaluation comparing high-sensitivity troponin T (hs-TnT) reporting to standard troponin T (c-TnT) reporting in the routine management of suspected ACS and based on longer-term clinical outcomes has been conducted. An economic evaluation was conducted with 1937 participants randomized to either hs-TnT (n=973) or c-TnT (n=964) with 12month follow-up. The primary outcome measure was the number of cumulative combined outcomes of all-cause mortality and new or recurrent ACS avoided. Mean per participant Australian Medicare costs were higher in the hs-TnT arm compared to the c-TnT arm (by $1285/patient). Mean total adverse clinical outcomes avoided were higher in the hs-TnT arm (by 0.0120/patient) resulting in an incremental cost-effectiveness ratio (ICER) of $108,552/adverse clinical outcome avoided. An ICER of $49,030/adverse clinical outcome avoided was obtained when the analysis was restricted to patients below the threshold of normal Troponin testing (actual c-TnT levels <30ng/L). hs-TnT reporting leads to fewer adverse clinical events but at a high ICER. For the routine implementation of hs-TnT to be more cost-effective, substantial changes in clinical practice will be required. Australian New Zealand Clinical Trials Registry (ACTRN12614000189628). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365726. Copyright © 2017 Elsevier B.V. All rights reserved.

[A wireless mobile monitoring system based on bluetooth technology].

PubMed

Sun, Shou-jun; Wu, Kai; Wu, Xiao-Ming

2006-09-01

This paper presents a wireless mobile monitoring system based on Bluetooth technology. This system realizes the remote mobile monitoring of multiple physiological parameters, and has the characters of easy use, low cost, good reliability and strong capability of anti-jamming.

Pollution, Health, and Avoidance Behavior: Evidence from the Ports of Los Angeles

ERIC Educational Resources Information Center

Moretti, Enrico; Neidell, Matthew

2011-01-01

A pervasive problem in estimating the costs of pollution is that optimizing individuals may compensate for increases in pollution by reducing their exposure, resulting in estimates that understate the full welfare costs. To account for this issue, measurement error, and environmental confounding, we estimate the health effects of ozone using daily…

The Cost-Quality Debate in School Finance Legislation: Do Dollars Make a Difference?

ERIC Educational Resources Information Center

McDermott, John E.; Klein, Stephen P.

1974-01-01

The appropriateness of using the judicial process as a forum for resolving the cost-quality debate in educational finance is discussed in an attempt to discover some intermediate ground, which would permit the judicial machinery to operate but avoids settling the scientific dispute. Existing judicial standards of educational opportunity are…

Techno-economic assessment of polymer membrane systems for postcombustion carbon capture at coal-fired power plants.

PubMed

Zhai, Haibo; Rubin, Edward S

2013-03-19

This study investigates the feasibility of polymer membrane systems for postcombustion carbon dioxide (CO(2)) capture at coal-fired power plants. Using newly developed performance and cost models, our analysis shows that membrane systems configured with multiple stages or steps are capable of meeting capture targets of 90% CO(2) removal efficiency and 95+% product purity. A combined driving force design using both compressors and vacuum pumps is most effective for reducing the cost of CO(2) avoided. Further reductions in the overall system energy penalty and cost can be obtained by recycling a portion of CO(2) via a two-stage, two-step membrane configuration with air sweep to increase the CO(2) partial pressure of feed flue gas. For a typical plant with carbon capture and storage, this yielded a 15% lower cost per metric ton of CO(2) avoided compared to a plant using a current amine-based capture system. A series of parametric analyses also is undertaken to identify paths for enhancing the viability of membrane-based capture technology.

Evaluation of food waste disposal options by LCC analysis from the perspective of global warming: Jungnang case, South Korea.

PubMed

Kim, Mi-Hyung; Song, Yul-Eum; Song, Han-Byul; Kim, Jung-Wk; Hwang, Sun-Jin

2011-01-01

The costs associated with eight food waste disposal options, dry feeding, wet feeding, composting, anaerobic digestion, co-digestion with sewage sludge, food waste disposer, incineration, and landfilling, were evaluated in the perspective of global warming and energy and/or resource recovery. An expanded system boundary was employed to compare by-products. Life cycle cost was analyzed through the entire disposal process, which included discharge, separate collection, transportation, treatment, and final disposal stages, all of which were included in the system boundary. Costs and benefits were estimated by an avoided impact. Environmental benefits of each system per 1 tonne of food waste management were estimated using carbon prices resulting from CO(2) reduction by avoided impact, as well as the prices of by-products such as animal feed, compost, and electricity. We found that the cost of landfilling was the lowest, followed by co-digestion. The benefits of wet feeding systems were the highest and landfilling the lowest. Copyright © 2011 Elsevier Ltd. All rights reserved.

Use of Midlevel Practitioners to Achieve Labor Cost Savings in the Primary Care Practice of an MCO

PubMed Central

Roblin, Douglas W; Howard, David H; Becker, Edmund R; Kathleen Adams, E; Roberts, Melissa H

2004-01-01

Objective To estimate the savings in labor costs per primary care visit that might be realized from increased use of physician assistants (PAs) and nurse practitioners (NPs) in the primary care practices of a managed care organization (MCO). Study Setting/Data Sources Twenty-six capitated primary care practices of a group model MCO. Data on approximately two million visits provided by 206 practitioners were extracted from computerized visit records for 1997–2000. Computerized payroll ledgers were the source of annual labor costs per practice from 1997–2000. Study Design Likelihood of a visit attended by a PA/NP versus MD was modeled using logistic regression, with practice fixed effects, by department (adult medicine, pediatrics) and year. Parameter estimates and practice fixed effects from these regressions were used to predict the proportion of PA/NP visits per practice per year given a standard case mix. Least squares regressions, with practice fixed effects, were used to estimate the association of this standardized predicted proportion of PA/NP visits with average annual practitioner and total labor costs per visit, controlling for other practice characteristics. Results On average, PAs/NPs attended one in three adult medicine visits and one in five pediatric medicine visits. Likelihood of a PA/NP visit was significantly higher than average among patients presenting with minor acute illness (e.g., acute pharyngitis). In adult medicine, likelihood of a PA/NP visit was lower than average among older patients. Practitioner labor costs per visit and total labor costs per visit were lower (p<.01 and p=.08, respectively) among practices with greater use of PAs/NPs, standardized for case mix. Conclusions Primary care practices that used more PAs/NPs in care delivery realized lower practitioner labor costs per visit than practices that used less. Future research should investigate the cost savings and cost-effectiveness potential of delivery designs that change staffing mix and division of labor among clinical disciplines. PMID:15149481

Potential cost savings of medication therapy management in safety-net clinics.

PubMed

Truong, Hoai-An; Groves, C Nicole; Congdon, Heather B; Dang, Diem-Thanh Tanya; Botchway, Rosemary; Thomas, Jennifer

2015-01-01

To evaluate potential cost savings based on estimated cost avoidance from medication therapy management (MTM) services delivered in safety-net clinics over 4 years. High-risk patients taking multiple medications and with chronic conditions were referred for MTM services in primary care safety-net clinics in Maryland from October 1, 2009, to September 30, 2013. Medication-related problems (MRPs) were identified and pharmacists' costs determined to evaluate the estimated cost savings and return on investment (ROI). A range of potential economic outcomes for each MRP identified was assigned to a cost avoidance for outpatient visit, urgent care visit, emergency department visit, and/or hospitalization. Over 4 years, 246 patients received MTM, nearly 2,100 medications were reviewed, and 814 MRPs were identified. The most common MRPs identified were subtherapeutic doses, nonadherence, and untreated indications, with respective prevalences of 38%, 19%, and 16%. The corresponding costs of medical services were estimated at $115,220-$614,570 for all MRPs identified, yielding a mean of $141.55-$755.00 per identified MRP. Pharmacists' expenses for encounters were calculated at a total expenditure of $57,307.50 for 16,965 minutes. ROI based on the time spent during billable face-to-face encounters ranged from 1:5 to 1:25. Pharmacist-provided MTM in safety-net clinics yielded potential economic benefits to the organization. The Primary Care Coalition of Montgomery County plans to expand MTM services to additional clinics to improve patient care and increase cost savings through preventable medical services.

Improving Life-Cycle Cost Management of Spacecraft Missions

NASA Technical Reports Server (NTRS)

Clardy, Dennon

2010-01-01

This presentation will explore the results of a recent NASA Life-Cycle Cost study and how project managers can use the findings and recommendations to improve planning and coordination early in the formulation cycle and avoid common pitfalls resulting in cost overruns. The typical NASA space science mission will exceed both the initial estimated and the confirmed life-cycle costs by the end of the mission. In a fixed-budget environment, these overruns translate to delays in starting or launching future missions, or in the worst case can lead to cancelled missions. Some of these overruns are due to issues outside the control of the project; others are due to the unpredictable problems (unknown unknowns) that can affect any development project. However, a recent study of life-cycle cost growth by the Discovery and New Frontiers Program Office identified a number of areas that are within the scope of project management to address. The study also found that the majority of the underlying causes for cost overruns are embedded in the project approach during the formulation and early design phases, but the actual impacts typically are not experienced until late in the project life cycle. Thus, project management focus in key areas such as integrated schedule development, management structure and contractor communications processes, heritage and technology assumptions, and operations planning, can be used to validate initial cost assumptions and set in place management processes to avoid the common pitfalls resulting in cost overruns.

Efficient realization of 3D joint inversion of seismic and magnetotelluric data with cross gradient structure constraint

NASA Astrophysics Data System (ADS)

Luo, H.; Zhang, H.; Gao, J.

2016-12-01

Seismic and magnetotelluric (MT) imaging methods are generally used to characterize subsurface structures at various scales. The two methods are complementary to each other and the integration of them is helpful for more reliably determining the resistivity and velocity models of the target region. Because of the difficulty in finding empirical relationship between resistivity and velocity parameters, Gallardo and Meju [2003] proposed a joint inversion method enforcing resistivity and velocity models consistent in structure, which is realized by minimizing cross gradients between two models. However, it is extremely challenging to combine two different inversion systems together along with the cross gradient constraints. For this reason, Gallardo [2007] proposed a joint inversion scheme that decouples the seismic and MT inversion systems by iteratively performing seismic and MT inversions as well as cross gradient minimization separately. This scheme avoids the complexity of combining two different systems together but it suffers the issue of balancing between data fitting and structure constraint. In this study, we have developed a new joint inversion scheme that avoids the problem encountered by the scheme of Gallardo [2007]. In the new scheme, seismic and MT inversions are still separately performed but the cross gradient minimization is also constrained by model perturbations from separate inversions. In this way, the new scheme still avoids the complexity of combining two different systems together and at the same time the balance between data fitting and structure consistency constraint can be enforced. We have tested our joint inversion algorithm for both 2D and 3D cases. Synthetic tests show that joint inversion better reconstructed the velocity and resistivity models than separate inversions. Compared to separate inversions, joint inversion can remove artifacts in the resistivity model and can improve the resolution for deeper resistivity structures. We will also show results applying the new joint seismic and MT inversion scheme to southwest China, where several MT profiles are available and earthquakes are very active.

Characterization of Phenacoccus solenopsis (Tinsley) (Homoptera: Pseudococcidae) Resistance to Emamectin Benzoate: Cross-Resistance Patterns and Fitness Cost Analysis.

PubMed

Afzal, M B S; Shad, S A

2016-06-01

Cotton mealybug Phenacoccus solenopsis (Tinsley) (Homoptera: Pseudococcidae) is a sucking pest of worldwide importance causing huge losses by feeding upon cotton in various parts of the world. Because of the importance of this pest, this research was carried out to select emamectin resistance in P. solenopsis in the laboratory to study cross-resistance, stability, realized heritability, and fitness cost of emamectin resistance. After selection from third generation (G3) to G6, P. solenopsis developed very high emamectin resistance (159.24-fold) when compared to a susceptible unselected population (Unsel pop). Population selected to emamectin benzoate conferred moderate (45.81-fold), low (14.06-fold), and no cross-resistance with abamectin, cypermethrin, and profenofos, respectively compared to the Unsel pop. A significant decline in emamectin resistance was observed in the resistant population when not exposed to emamectin from G7 to G13. The estimated realized heritability (h (2)) for emamectin resistance was 0.84. A high fitness cost was associated with emamectin resistance in P. solenopsis. Results of this study may be helpful in devising insecticide resistance management strategies for P. solenopsis.

Recent Advances in Fluorescence Lifetime Analytical Microsystems: Contact Optics and CMOS Time-Resolved Electronics.

PubMed

Wei, Liping; Yan, Wenrong; Ho, Derek

2017-12-04

Fluorescence spectroscopy has become a prominent research tool with wide applications in medical diagnostics and bio-imaging. However, the realization of combined high-performance, portable, and low-cost spectroscopic sensors still remains a challenge, which has limited the technique to the laboratories. A fluorescence lifetime measurement seeks to obtain the characteristic lifetime from the fluorescence decay profile. Time-correlated single photon counting (TCSPC) and time-gated techniques are two key variations of time-resolved measurements. However, commercial time-resolved analysis systems typically contain complex optics and discrete electronic components, which lead to bulkiness and a high cost. These two limitations can be significantly mitigated using contact sensing and complementary metal-oxide-semiconductor (CMOS) implementation. Contact sensing simplifies the optics, whereas CMOS technology enables on-chip, arrayed detection and signal processing, significantly reducing size and power consumption. This paper examines recent advances in contact sensing and CMOS time-resolved circuits for the realization of fully integrated fluorescence lifetime measurement microsystems. The high level of performance from recently reported prototypes suggests that the CMOS-based contact sensing microsystems are emerging as sound technologies for application-specific, low-cost, and portable time-resolved diagnostic devices.

Recent Advances in Fluorescence Lifetime Analytical Microsystems: Contact Optics and CMOS Time-Resolved Electronics

PubMed Central

Yan, Wenrong; Ho, Derek

2017-01-01

Fluorescence spectroscopy has become a prominent research tool with wide applications in medical diagnostics and bio-imaging. However, the realization of combined high-performance, portable, and low-cost spectroscopic sensors still remains a challenge, which has limited the technique to the laboratories. A fluorescence lifetime measurement seeks to obtain the characteristic lifetime from the fluorescence decay profile. Time-correlated single photon counting (TCSPC) and time-gated techniques are two key variations of time-resolved measurements. However, commercial time-resolved analysis systems typically contain complex optics and discrete electronic components, which lead to bulkiness and a high cost. These two limitations can be significantly mitigated using contact sensing and complementary metal-oxide-semiconductor (CMOS) implementation. Contact sensing simplifies the optics, whereas CMOS technology enables on-chip, arrayed detection and signal processing, significantly reducing size and power consumption. This paper examines recent advances in contact sensing and CMOS time-resolved circuits for the realization of fully integrated fluorescence lifetime measurement microsystems. The high level of performance from recently reported prototypes suggests that the CMOS-based contact sensing microsystems are emerging as sound technologies for application-specific, low-cost, and portable time-resolved diagnostic devices. PMID:29207568

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

Shafer, A.L.; Purdy, S.; Tempelis, D.

The La Paz County Regional Landfill is a 65 hectare (160 acre) municipal waste site located near the western border of Arizona between the cities of Parker and Quartzsite. The site is operated under a public/private partnership between the County of La Paz and Browning-Ferris Industries, Inc. (BFI). The County owns the landfill and infrastructure and BFI is responsible for facility improvements, environmental compliance, and daily operations. Following the initial permitting and construction of the first landfill cell, a value engineering review was conducted on the site design and permit requirements. Based on this review, substantial cost saving opportunities weremore » identified. In order to implement the value engineering ideas, the site permit was modified and a new Solid Waste Facilities Plan was Submitted to the Arizona Department of Environmental Quality. This paper discusses the value engineering modifications that were conducted, the revisions to the permits, and the relative cost savings that were realized. The areas addressed include the liner system design, closure design, disposal capacity, and operations plan. Through the use of alternative liners a cost savings of well over 50 percent (as compared to the original permit) will be realized over the life of the landfill.« less

Effect of environmental parameters on habitat structural weight and cost

NASA Technical Reports Server (NTRS)

Bock, E.; Lambrou, F., Jr.; Simon, M.

1979-01-01

Space-settlement conceptual designs were previously accomplished using earth-normal physiological conditions. The habitat weight and cost penalties associated with this conservative design approach are quantified. These penalties are identified by comparison of conservative earth-normal designs with habitats designed to less than earth-normal conditions. Physiological research areas are also recommended as a necessary prerequisite to realizing these potential weight and cost savings. Major habitat structural elements, that is, pressure shell and radiation shielding, for populations of 100, 10,000, and 1,000,000, are evaluated for effects of atmospheric pressure, pseudogravity level, radiation shielding thickness, and habitat configuration.

Costs of performance based maintenance for local roads: Case study Albania

NASA Astrophysics Data System (ADS)

Jokanović, Igor; Grujić, Bojana; Zeljić, Dragana; Grujić, Žarko; Svilar, Mila

2017-12-01

The provision and maintenance of road infrastructure is a major global business, consequently it is essential that road maintenance services are provided in the most cost effective manner. Without regular maintenance, roads can rapidly fall into disrepair, preventing realization of the longer term impacts of road improvements on development, such as increased agricultural production and growth in school enrollment, which is of particular importance for a network of local (access) roads. Inadequate local roads maintenance in Albania is proposed to be solved by implementing performance based maintenance approach for which the costing exercise is presented within the paper.

Reported Energy and Cost Savings from the DOE ESPC Program: FY 2015

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

Slattery, Bob S.

2017-01-01

The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 151 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project.

The connotation interpretation of high-efficiency agriculture under the perspective of a combined agriculture with tourism

NASA Astrophysics Data System (ADS)

Zhou, Jie; Zhang, Feng-tai; Gai, Yuan-jin; Deng, Bao-kun; Shao, Ji-xin; An, You-zhi

2017-08-01

Through literature review, the article points out that the existing of the high-efficiency agriculture definition is limited to results oriented thinking, apparently lack of process oriented thinking. Combined with the connotation of fusion agriculture and tourism, respectively from the time and space utilization efficiency, cash cost, elements of input and output form, etc, gives high-efficiency agriculture a new connotation. Under the perspective of a combined agriculture with tourism, efficient use of time and space, low realized cost, less costs and output form of agriculture, this is highly effective agriculture.

An advanced communications synthesizer

NASA Astrophysics Data System (ADS)

Scherer, Ernst F.

1994-02-01

With the proliferation of smaller and lower cost EHF terminals, the fast-hopping microwave synthesizer subsystem is rapidly becoming the limiting factor for further size and cost reduction. A new approach, based on a high-speed direct digital synthesizer (DDS) and a very fast voltage controlled oscillator (VCO) tracking loop, has yielded a highly integrable design with true low-cost potential. A frequency range of 1 to 20 GHz can be covered by a simple substitution of the VCO module. This advanced synthesizer realization promises a generic solution to a large class of synthesizer requirements, greatly facilitating standardization and promoting modular system concepts.

Planck 2015 results: XII. Full focal plane simulations

DOE PAGES

Ade, P. A. R.; Aghanim, N.; Arnaud, M.; ...

2016-09-20

In this paper, we present the 8th full focal plane simulation set (FFP8), deployed in support of the Planck 2015 results. FFP8 consists of 10 fiducial mission realizations reduced to 18 144 maps, together with the most massive suite of Monte Carlo realizations of instrument noise and CMB ever generated, comprising 10 4 mission realizations reduced to about 10 6 maps. The resulting maps incorporate the dominant instrumental, scanning, and data analysis effects, and the remaining subdominant effects will be included in future updates. Finally, generated at a cost of some 25 million CPU-hours spread across multiple high-performance-computing (HPC) platforms,more » FFP8 is used to validate and verify analysis algorithms and their implementations, and to remove biases from and quantify uncertainties in the results of analyses of the real data.« less

Law on Health, 10 November 1987.

PubMed

1989-01-01

The following are provisions of this Aargau, Switzerland Law relating to assisted reproduction: "Article 50. (1) A woman can be artificially inseminated if she is married, and a written consent is submitted by both partners, as long as natural procreation is not possible. The medical procedure of artificial insemination must be performed by a physician. (2) Artificial insemination inside the body with sperm other than the husband's is allowed if a prior insemination with the husband's sperm was unsuccessful or impossible or if by allowing this procedure congenital diseases can be avoided. (3) Insemination outside the body is only allowed if all other methods of treatment appear hopeless. It may only be realized with the sperm of the husband and the egg of the wife. It may only be realized in hospitals with a gynecology and maternity department with general permission of the state health department. Each embryo must be implanted. (4) Gametes may only be kept alive during the treatment period. Experimentation on and manipulation of embryos as well as of the hereditary characteristics of the gametes and embryos is forbidden. Measures undertaken to influence the sex or other attributes of the child are prohibited. Therapeutical measures on embryos are permissible to avoid a serious illness and as long as the hereditary characteristics are not changed. (5) Commercial sperm banks, insemination with the sperm and eggs of deceased people, surrogate-motherhood, egg donations as well as the transfer of embryos to third persons are not allowed."

Predicting structures in the Zone of Avoidance

NASA Astrophysics Data System (ADS)

Sorce, Jenny G.; Colless, Matthew; Kraan-Korteweg, Renée C.; Gottlöber, Stefan

2017-11-01

The Zone of Avoidance (ZOA), whose emptiness is an artefact of our Galaxy dust, has been challenging observers as well as theorists for many years. Multiple attempts have been made on the observational side to map this region in order to better understand the local flows. On the theoretical side, however, this region is often simply statistically populated with structures but no real attempt has been made to confront theoretical and observed matter distributions. This paper takes a step forward using constrained realizations (CRs) of the local Universe shown to be perfect substitutes of local Universe-like simulations for smoothed high-density peak studies. Far from generating completely `random' structures in the ZOA, the reconstruction technique arranges matter according to the surrounding environment of this region. More precisely, the mean distributions of structures in a series of constrained and random realizations (RRs) differ: while densities annihilate each other when averaging over 200 RRs, structures persist when summing 200 CRs. The probability distribution function of ZOA grid cells to be highly overdense is a Gaussian with a 15 per cent mean in the random case, while that of the constrained case exhibits large tails. This implies that areas with the largest probabilities host most likely a structure. Comparisons between these predictions and observations, like those of the Puppis 3 cluster, show a remarkable agreement and allow us to assert the presence of the, recently highlighted by observations, Vela supercluster at about 180 h-1 Mpc, right behind the thickest dust layers of our Galaxy.

The psychology of doing nothing: forms of decision avoidance result from reason and emotion.

PubMed

Anderson, Christopher J

2003-01-01

Several independent lines of research bear on the question of why individuals avoid decisions by postponing them, failing to act, or accepting the status quo. This review relates findings across several different disciplines and uncovers 4 decision avoidance effects that offer insight into this common but troubling behavior: choice deferral, status quo bias, omission bias, and inaction inertia. These findings are related by common antecedents and consequences in a rational-emotional model of the factors that predispose humans to do nothing. Prominent components of the model include cost-benefit calculations, anticipated regret, and selection difficulty. Other factors affecting decision avoidance through these key components, such as anticipatory negative emotions, decision strategies, counterfactual thinking, and preference uncertainty, are also discussed.

Deterrence with China: Avoiding Nuclear Miscalculation

DTIC Science & Technology

2014-01-01

When each nation can manage these three elements in the correct way, the cost -benefit calculations of each side should favor deterrence of a...under pressure to justify the cost of its plans to replace its SSBN fleet. After a recent 2-year delay in the planned SSBN replacement program, any...of CPGS may prove advantageous in some scenarios,31 but those advantages do not come with- out a cost to nuclear deterrence stability with China—a

Successful commercialization of nanophotonic technology

NASA Astrophysics Data System (ADS)

Jaiswal, Supriya L.; Clarke, Roger B. M.; Hyde, Sam C. W.

2006-08-01

The exploitation of nanotechnology from proof of principle to realizable commercial applications encounters considerable challenges in regards to high volume, large scale, low cost manufacturability and social ethics. This has led to concerns over converting powerful intellectual property into realizable, industry attractive technologies. At The Technology Partnership we specifically address the issue of successful integration of nanophotonics into industry in markets such as biomedical, ophthalmic, energy, telecommunications, and packaging. In this paper we draw on a few examples where we have either developed industrial scale nanophotonic technology or engineering platforms which may be used to fortify nano/microphotonic technologies and enhance their commercial viability.

Benchmarking processes for managing large international space programs

NASA Technical Reports Server (NTRS)

Mandell, Humboldt C., Jr.; Duke, Michael B.

1993-01-01

The relationship between management style and program costs is analyzed to determine the feasibility of financing large international space missions. The incorporation of management systems is considered to be essential to realizing low cost spacecraft and planetary surface systems. Several companies ranging from large Lockheed 'Skunk Works' to small companies including Space Industries, Inc., Rocket Research Corp., and Orbital Sciences Corp. were studied. It is concluded that to lower the prices, the ways in which spacecraft and hardware are developed must be changed. Benchmarking of successful low cost space programs has revealed a number of prescriptive rules for low cost managements, including major changes in the relationships between the public and private sectors.

Dynamic large eddy simulation: Stability via realizability

NASA Astrophysics Data System (ADS)

Mokhtarpoor, Reza; Heinz, Stefan

2017-10-01

The concept of dynamic large eddy simulation (LES) is highly attractive: such methods can dynamically adjust to changing flow conditions, which is known to be highly beneficial. For example, this avoids the use of empirical, case dependent approximations (like damping functions). Ideally, dynamic LES should be local in physical space (without involving artificial clipping parameters), and it should be stable for a wide range of simulation time steps, Reynolds numbers, and numerical schemes. These properties are not trivial, but dynamic LES suffers from such problems over decades. We address these questions by performing dynamic LES of periodic hill flow including separation at a high Reynolds number Re = 37 000. For the case considered, the main result of our studies is that it is possible to design LES that has the desired properties. It requires physical consistency: a PDF-realizable and stress-realizable LES model, which requires the inclusion of the turbulent kinetic energy in the LES calculation. LES models that do not honor such physical consistency can become unstable. We do not find support for the previous assumption that long-term correlations of negative dynamic model parameters are responsible for instability. Instead, we concluded that instability is caused by the stable spatial organization of significant unphysical states, which are represented by wall-type gradient streaks of the standard deviation of the dynamic model parameter. The applicability of our realizability stabilization to other dynamic models (including the dynamic Smagorinsky model) is discussed.

Cost analysis for efficient management: diabetes treatment at a public district hospital in Thailand.

PubMed

Riewpaiboon, Arthorn; Chatterjee, Susmita; Piyauthakit, Piyanuch

2011-10-01

OBJECTIVE  The study estimated cost of illness from the provider's perspective for diabetic patients who received treatment during the fiscal year 2008 at Waritchaphum Hospital, a 30-bed public district hospital in Sakhon Nakhon province in northeastern Thailand. METHODS  This retrospective, prevalence-based cost-of-illness study looked at 475 randomly selected diabetic patients, identified by the World Health Organization's International Classification of Diseases, 10th revision, codes E10-E14. Data were collected from the hospital financial records and medical records of each participant and were analysed with a stepwise multiple regression. KEY FINDINGS  The study found that the average public treatment cost per patient per year was US$94.71 at 2008 prices. Drug cost was the highest cost component (25% of total cost), followed by inpatient cost (24%) and outpatient visit cost (17%). A cost forecasting model showed that length of stay, hospitalization, visits to the provincial hospital, duration of disease and presence of diabetic complications (e.g. diabetic foot complications and nephropathy) were the significant predictor variables (adjusted R(2) = 0.689). CONCLUSIONS  According to the fitted model, avoiding nephropathy and foot complications would save US$19 386 and US$39 134 respectively per year. However, these savings are missed savings for the study year and the study hospital only and not projected savings, as that would depend on the number of diabetic patients managed in the year, the ratio of complicated to non-complicated cases and effectiveness of the prevention programmes. Nonetheless, given the high avoidable cost associated with complications of diabetes, healthcare providers in Thailand should focus on initiatives that delay the progression of complications in diabetic patients. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

The resource costs of wound care in Bradford and Airedale primary care trust in the UK.

PubMed

Vowden, K; Vowden, P; Posnett, J

2009-03-01

To estimate the resource costs of providing wound care for the 488,000 catchment population of the Bradford and Airedale primary care trust (PCT). A wound survey was carried out over a one-week period in March 2007 covering three hospitals in two acute trusts, district nurses, nursing homes and residential homes within the geographical area defined by the PCT. The survey included information on the frequency of dressing change, treatment time and district nurse travel time. The resource costs of wound care in the PCT were estimated by combining this information with representative costs for the UK National Health Service and information on dressing spend. Prevalence of patients with a wound was 3.55 per 1000 population. The majority of wounds were surgical/trauma (48%), leg/foot (28%) and pressure ulcers (21%). Prevalence of wounds among hospital inpatients was 30.7%. Of these, 11.6% were pressure ulcers, of which 66% were hospital-acquired. The attributable cost of wound care in 2006-2007 was pounds 9.89 million: pounds 2.03 million per 100,000 population and 1.44% of the local health-care budget. Costs included pounds 1.69 million spending on dressings, 45.4 full-time nurses (valued at pounds 3.076 million) and 60-61 acute hospital beds (valued at pounds 5.13 million). The cost of wound care is significant. The most important components are the costs of wound-related hospitalisation and the opportunity cost of nurse time. The 32% of patients treated in hospital accounted for 63% of total costs. Putting in place care pathways to avoid hospitalisation and avoiding the development of hospital-acquired pressure ulcers and other wound complications are important ways to reduce costs. John Posnett is an employee of Smith & Nephew.