Understanding the Effects of Sampling on Healthcare Risk Modeling for the Prediction of Future High-Cost Patients

NASA Astrophysics Data System (ADS)

Moturu, Sai T.; Liu, Huan; Johnson, William G.

Rapidly rising healthcare costs represent one of the major issues plaguing the healthcare system. Data from the Arizona Health Care Cost Containment System, Arizona's Medicaid program provide a unique opportunity to exploit state-of-the-art machine learning and data mining algorithms to analyze data and provide actionable findings that can aid cost containment. Our work addresses specific challenges in this real-life healthcare application with respect to data imbalance in the process of building predictive risk models for forecasting high-cost patients. We survey the literature and propose novel data mining approaches customized for this compelling application with specific focus on non-random sampling. Our empirical study indicates that the proposed approach is highly effective and can benefit further research on cost containment in the healthcare industry.

Benefit/cost comparison for utility SMES applications

NASA Astrophysics Data System (ADS)

Desteese, J. G.; Dagle, J. E.

1991-08-01

This paper summarizes eight case studies that account for the benefits and costs of superconducting magnetic energy storage (SMES) in system-specific utility applications. Four of these scenarios are hypothetical SMES applications in the Pacific Northwest, where relatively low energy costs impose a stringent test on the viability of the concept. The other four scenarios address SMES applications on high-voltage, direct-current (HVDC) transmission lines. While estimated SMES benefits are based on a previously reported methodology, this paper presents results of an improved cost-estimating approach that includes an assumed reduction in the cost of the power conditioning system (PCS) from approximately $160/kW to $80/kW. The revised approach results in all the SMES scenarios showing higher benefit/cost ratios than those reported earlier. However, in all but two cases, the value of any single benefit is still less than the unit's levelized cost. This suggests, as a general principle, that the total value of multiple benefits should always be considered if SMES is to appear cost effective in many utility applications. These results should offer utilities further encouragement to conduct more detailed analyses of SMES benefits in scenarios that apply to individual systems.

Potential for the Use of Energy Savings Performance Contracts to Reduce Energy Consumption and Provide Energy and Cost Savings in Non-Building Applications

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

Williams, Charles; Green, Andrew S.; Dahle, Douglas

2013-08-01

The findings of this study indicate that potential exists in non-building applications to save energy and costs. This potential could save billions of federal dollars, reduce reliance on fossil fuels, increase energy independence and security, and reduce greenhouse gas emissions. The Federal Government has nearly twenty years of experience with achieving similar energy cost reductions, and letting the energy costs savings pay for themselves, by applying energy savings performance contracts (ESPC) inits buildings. Currently, the application of ESPCs is limited by statute to federal buildings. This study indicates that ESPCs can be a compatible and effective contracting tool for achievingmore » savings in non-building applications.« less

Assessing value-for-money in maternal and newborn health.

PubMed

Banke-Thomas, Aduragbemi; Madaj, Barbara; Kumar, Shubha; Ameh, Charles; van den Broek, Nynke

2017-01-01

Responding to increasing demands to demonstrate value-for-money (VfM) for maternal and newborn health interventions, and in the absence of VfM analysis in peer-reviewed literature, this paper reviews VfM components and methods, critiques their applicability, strengths and weakness and proposes how VfM assessments can be improved. VfM comprises four components: economy, efficiency, effectiveness and cost-effectiveness. Both 'economy' and 'efficiency' can be assessed with detailed cost analysis utilising costs obtained from programme accounting data or generic cost databases. Before-and-after studies, case-control studies or randomised controlled trials can be used to assess 'effectiveness'. To assess 'cost-effectiveness', cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-benefit analysis (CBA) or social return on investment (SROI) analysis are applicable. Generally, costs can be obtained from programme accounting data or existing generic cost databases. As such 'economy' and 'efficiency' are relatively easy to assess. However, 'effectiveness' and 'cost-effectiveness' which require establishment of the counterfactual are more difficult to ascertain. Either a combination of CEA or CUA with tools for assessing other VfM components, or the independent use of CBA or SROI are alternative approaches proposed to strengthen VfM assessments. Cross-cutting themes such as equity, sustainability, scalability and cultural acceptability should also be assessed, as they provide critical contextual information for interpreting VfM assessments. To select an assessment approach, consideration should be given to the purpose, data availability, stakeholders requiring the findings and perspectives of programme beneficiaries. Implementers and researchers should work together to improve the quality of assessments. Standardisation around definitions, methodology and effectiveness measures to be assessed would help.

The common engine concept for ALS application - A cost reduction approach

NASA Technical Reports Server (NTRS)

Bair, E. K.; Schindler, C. M.

1989-01-01

Future launch systems require the application of propulsion systems which have been designed and developed to meet mission model needs while providing high degrees of reliability and cost effectiveness. Vehicle configurations which utilize different propellant combinations for booster and core stages can benefit from a common engine approach where a single engine design can be configured to operate on either set of propellants and thus serve as either a booster or core engine. Engine design concepts and mission application for a vehicle employing a common engine are discussed. Engine program cost estimates were made and cost savings, over the design and development of two unique engines, estimated.

Incorporating social network effects into cost-effectiveness analysis: a methodological contribution with application to obesity prevention

PubMed Central

Konchak, Chad; Prasad, Kislaya

2012-01-01

Objectives To develop a methodology for integrating social networks into traditional cost-effectiveness analysis (CEA) studies. This will facilitate the economic evaluation of treatment policies in settings where health outcomes are subject to social influence. Design This is a simulation study based on a Markov model. The lifetime health histories of a cohort are simulated, and health outcomes compared, under alternative treatment policies. Transition probabilities depend on the health of others with whom there are shared social ties. Setting The methodology developed is shown to be applicable in any healthcare setting where social ties affect health outcomes. The example of obesity prevention is used for illustration under the assumption that weight changes are subject to social influence. Main outcome measures Incremental cost-effectiveness ratio (ICER). Results When social influence increases, treatment policies become more cost effective (have lower ICERs). The policy of only treating individuals who span multiple networks can be more cost effective than the policy of treating everyone. This occurs when the network is more fragmented. Conclusions (1) When network effects are accounted for, they result in very different values of incremental cost-effectiveness ratios (ICERs). (2) Treatment policies can be devised to take network structure into account. The integration makes it feasible to conduct a cost-benefit evaluation of such policies. PMID:23117559

Laser Printing for a Variety of Library Applications.

ERIC Educational Resources Information Center

Kelly, Glen J.

1988-01-01

Summarizes the current status of laser printers in terms of cost, hardware and software requirements, measurement and operational considerations, ease of use, and maintenance. The cost effectiveness of laser printing in libraries for applications such as spine labels, purchase orders, and reports, is explored. (9 notes with references) (CLB)

Ageing Mechanisms and Control. Specialists’ Meeting on Life Management Techniques for Ageing Air Vehicles (Les mecanismes vieillissants et le controle) (Reunions des specialistes des techniques de gestion du cycle de vie pour vehicules aeriens vieillissants)

DTIC Science & Technology

2003-02-01

Beam Weld Repair and Qualification of Titanium Fan Blades for Military Gas Turbine Engines”, NATO-RTO-AVT Workshop on Cost Effective Applications of...announced in the Meeting Announcement Research of Extension of the Life Cycle of Helicopter Rotor Blade in Hungary 39 by M. Balaskó, G. Endröczi, J...and Power Systems MP-069(I), February 2003 Low Cost Composite Structures / Cost Effective Application of Titanium Alloys in Military Platforms MP-069

Intersatellite Link (ISL) application to commercial communications satellites. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Young, S. Lee

1987-01-01

Based on a comprehensive evaluation of the fundamental Intersatellite Link (ISL) systems characteristics, potential applications of ISLs to domestic, regional, and global commercial satellite communications were identified, and their cost-effectiveness and other systems benefits quantified wherever possible. Implementation scenarios for the cost-effective communications satellite systems employing ISLs were developed for the first launch in 1993 to 1994 and widespread use of ISLs in the early 2000's. Critical technology requirements for both the microwave (60 GHz) and optical (0.85 micron) ISL implementations were identified, and their technology development programs, including schedule and cost estimates, were derived.

Light extraction from organic light-emitting diodes for lighting applications by sand-blasting substrates.

PubMed

Chen, Shuming; Kwok, Hoi Sing

2010-01-04

Light extraction from organic light-emitting diodes (OLEDs) by scattering the light is one of the effective methods for large-area lighting applications. In this paper, we present a very simple and cost-effective method to rough the substrates and hence to scatter the light. By simply sand-blasting the edges and back-side surface of the glass substrates, a 20% improvement of forward efficiency has been demonstrated. Moreover, due to scattering effect, a constant color over all viewing angles and uniform light pattern with Lambertian distribution has been obtained. This simple and cost-effective method may be suitable for mass production of large-area OLEDs for lighting applications.

Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.

PubMed

Lalloo, Ratilal; Kroon, Jeroen; Tut, Ohnmar; Kularatna, Sanjeewa; Jamieson, Lisa M; Wallace, Valda; Boase, Robyn; Fernando, Surani; Cadet-James, Yvonne; Scuffham, Paul A; Johnson, Newell W

2015-08-29

The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.

Application study of filamentary composites in a commercial jet aircraft fuselage

NASA Technical Reports Server (NTRS)

Johnson, R. W.; June, R. R.

1972-01-01

A study of applications of filamentary composite materials to aircraft fuselage structure was performed. General design criteria were established and material studies conducted using the 727-200 forebody as the primary structural component. Three design approaches to the use of composites were investigated: uniaxial reinforcement of metal structure, uniaxial and biaxial reinforcement of metal structure, and an all-composite design. Materials application studies for all three concepts were conducted on fuselage shell panels, keel beam, floor beams, floor panels, body frames, fail-safe straps, and window frames. Cost benefit studies were conducted and developmental program costs estimated. On the basis of weight savings, cost effectiveness, developmental program costs, and potential for early application on commercial aircraft, the unaxial design is recommended for a 5-year flight service evaluation program.

Exploiting Redundancy and Application Scalability for Cost-Effective, Time-Constrained Execution of HPC Applications on Amazon EC2

DOE PAGES

Marathe, Aniruddha P.; Harris, Rachel A.; Lowenthal, David K.; ...

2015-12-17

The use of clouds to execute high-performance computing (HPC) applications has greatly increased recently. Clouds provide several potential advantages over traditional supercomputers and in-house clusters. The most popular cloud is currently Amazon EC2, which provides fixed-cost and variable-cost, auction-based options. The auction market trades lower cost for potential interruptions that necessitate checkpointing; if the market price exceeds the bid price, a node is taken away from the user without warning. We explore techniques to maximize performance per dollar given a time constraint within which an application must complete. Specifically, we design and implement multiple techniques to reduce expected cost bymore » exploiting redundancy in the EC2 auction market. We then design an adaptive algorithm that selects a scheduling algorithm and determines the bid price. We show that our adaptive algorithm executes programs up to seven times cheaper than using the on-demand market and up to 44 percent cheaper than the best non-redundant, auction-market algorithm. We extend our adaptive algorithm to incorporate application scalability characteristics for further cost savings. In conclusion, we show that the adaptive algorithm informed with scalability characteristics of applications achieves up to 56 percent cost savings compared to the expected cost for the base adaptive algorithm run at a fixed, user-defined scale.« less

Cost effective spectral sensor solutions for hand held and field applications

NASA Astrophysics Data System (ADS)

Reetz, Edgar; Correns, Martin; Notni, Gunther

2015-05-01

Optical spectroscopy is without doubt one of the most important non-contact measurement principles. It is used in a wide range of applications from bio-medical to industrial fields. One recent trend is to miniaturize spectral sensors to address new areas of application. The most common spectral sensor type is based on diffraction gratings, while other types are based on micro mechanical systems (MEMS) or filter technologies. The authors represent the opinion that there is a potentially wide spread field of applications for spectrometers, but the market limits the range of applications since they cannot keep up with targeted cost requirements for consumer products. The present article explains an alternative approach for miniature multichannel spectrometer to enhance robustness for hand held field applications at a cost efficient price point.

Value Engineering. Technical Manual. School Facilities Development Procedures Manual.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

Value Engineering (VE) is a cost-optimizing technique used to analyze design quality and cost-effectiveness. The application of VE procedures to the design and construction of school facilities has been adopted by the state of Washington. This technical manual provides guidance in developing the scope and applicability of VE to school projects; in…

Cost-Effectiveness Analysis of Universal Influenza Vaccination: Application of Susceptible-Infectious-Complication-Recovery Model.

PubMed

Yang, Kuen-Cheh; Hung, Hui-Fang; Chen, Meng-Kan; Chen, Li-Sheng; Fann, Jean Ching-Yuan; Chiu, Sherry Yueh-Hsia; Yen, Amy-Ming Fang; Huang, Kuo-Chin; Chen, Hsiu-Hsi; Wang, Sen-Te

2018-06-12

Despite the fact that vaccination is an effective primary prevention strategy for containing influenza outbreak, health policymakers show great concern over enormous costs involved in universal immunization particularly when resources are limited. We conducted a two-arm cost-effectiveness analysis (CEA) that takes into account the aspect of herd immunity, using a study cohort that was composed of 100,000 residents with the make-up of demographic characteristics identical to those of the underlying population in Taipei County, Taiwan, during the epidemic influenza season of 2001-2002. The parameters embedded in the dynamic process of infection were estimated by the application of the newly proposed susceptible-infection-complication-recovery model to the empirical data in order to compute the number of deaths and complications averted due to universal vaccination compared to non-vaccination. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curve (CEAC) given maximum amount of willingness-to-pay (WTP) were calculated to delineate the results of the two-arm CEA. Incremental costs involved in the vaccinated group as opposed to the unvaccinated group was $1,195 for reducing one additional complication and $805 for averting one additional death, allowing for herd immunity. The corresponding figures were higher for the results without considering herd immunity. Given the ceiling ratio of willingness-to-pay (WTP) equal to $10,000 (approximately two-thirds of the GDP), the probability of being cost-effective for vaccination was 100% and 96.7% for averting death and complications, respectively. Universal vaccination against seasonal influenza was very cost-effective particularly when herd immunity is considered. The probability of being cost-effective was almost certain given the maximum amount of WTP within two-thirds of the GDP. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Recent advances in low-cost microfluidic platforms for diagnostic applications.

PubMed

Tomazelli Coltro, Wendell Karlos; Cheng, Chao-Min; Carrilho, Emanuel; de Jesus, Dosil Pereira

2014-08-01

The use of inexpensive materials and cost-effective manufacturing processes for mass production of microfluidic devices is very attractive and has spurred a variety of approaches. Such devices are particularly suited for diagnostic applications in limited resource settings. This review describes the recent and remarkable advances in the use of low-cost substrates for the development of microfluidic devices for diagnostics and clinical assays. Thus, a plethora of new and improved fabrication methods, designs, capabilities, detections, and applications of microfluidic devices fabricated with paper, plastic, and threads are covered. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

WLC Preface

NASA Astrophysics Data System (ADS)

Miret, Josep M.; Sebé, Francesc

Low-cost devices are the key component of several applications: RFID tags permit an automated supply chain management while smart cards are a secure means of storing cryptographic keys required for remote and secure authentication in e-commerce and e-government applications. These devices must be cheap in order to permit their cost-effective massive manufacturing and deployment. Unfortunately, their low cost limits their computational power. Other devices such as nodes of sensor networks suffer from an additional constraint, namely, their limited battery life. Secure applications designed for these devices cannot make use of classical cryptographic primitives designed for full-fledged computers.

Design guide for low cost standardized payloads, volume 1

NASA Technical Reports Server (NTRS)

1972-01-01

Concept point designs of low cost and refurbishable spacecraft, subsystems, and modules revealed payload program savings up to 50 percent. The general relationship of payload approaches to program costs; cost reductions from low cost standardized payloads; cost effective application of payload reliability, MMD, repair, and refurbishment; and implementation of standardization for future spacecraft are discussed. Shuttle interfaces and support equipment for future payloads are also considered

Differentiated protection services with failure probability guarantee for workflow-based applications

NASA Astrophysics Data System (ADS)

Zhong, Yaoquan; Guo, Wei; Jin, Yaohui; Sun, Weiqiang; Hu, Weisheng

2010-12-01

A cost-effective and service-differentiated provisioning strategy is very desirable to service providers so that they can offer users satisfactory services, while optimizing network resource allocation. Providing differentiated protection services to connections for surviving link failure has been extensively studied in recent years. However, the differentiated protection services for workflow-based applications, which consist of many interdependent tasks, have scarcely been studied. This paper investigates the problem of providing differentiated services for workflow-based applications in optical grid. In this paper, we develop three differentiated protection services provisioning strategies which can provide security level guarantee and network-resource optimization for workflow-based applications. The simulation demonstrates that these heuristic algorithms provide protection cost-effectively while satisfying the applications' failure probability requirements.

Cost-effectiveness of the sequential application of tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia.

PubMed

Rochau, Ursula; Sroczynski, Gaby; Wolf, Dominik; Schmidt, Stefan; Jahn, Beate; Kluibenschaedl, Martina; Conrads-Frank, Annette; Stenehjem, David; Brixner, Diana; Radich, Jerald; Gastl, Günther; Siebert, Uwe

2015-01-01

Several tyrosine kinase inhibitors (TKIs) are approved for chronic myeloid leukemia (CML) therapy. We evaluated the long-term cost-effectiveness of seven sequential therapy regimens for CML in Austria. A cost-effectiveness analysis was performed using a state-transition Markov model. As model parameters, we used published trial data, clinical, epidemiological and economic data from the Austrian CML registry and national databases. We performed a cohort simulation over a life-long time-horizon from a societal perspective. Nilotinib without second-line TKI yielded an incremental cost-utility ratio of 121,400 €/quality-adjusted life year (QALY) compared to imatinib without second-line TKI after imatinib failure. Imatinib followed by nilotinib after failure resulted in 131,100 €/QALY compared to nilotinib without second-line TKI. Nilotinib followed by dasatinib yielded 152,400 €/QALY compared to imatinib followed by nilotinib after failure. Remaining strategies were dominated. The sequential application of TKIs is standard-of-care, and thus, our analysis points toward imatinib followed by nilotinib as the most cost-effective strategy.

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

PubMed

Fleck, Leonard M

2018-04-01

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

Time-based management of patient processes.

PubMed

Kujala, Jaakko; Lillrank, Paul; Kronström, Virpi; Peltokorpi, Antti

2006-01-01

The purpose of this paper is to present a conceptual framework that would enable the effective application of time based competition (TBC) and work in process (WIP) concepts in the design and management of effective and efficient patient processes. This paper discusses the applicability of time-based competition and work-in-progress concepts to the design and management of healthcare service production processes. A conceptual framework is derived from the analysis of both existing research and empirical case studies. The paper finds that a patient episode is analogous to a customer order-to-delivery chain in industry. The effective application of TBC and WIP can be achieved by focusing on through put time of a patient episode by reducing the non-value adding time components and by minimizing time categories that are main cost drivers for all stakeholders involved in the patient episode. The paper shows that an application of TBC in managing patient processes can be limited if there is no consensus about optimal care episode in the medical community. In the paper it is shown that managing patient processes based on time and cost analysis enables one to allocate the optimal amount of resources, which would allow a healthcare system to minimize the total cost of specific episodes of illness. Analysing the total cost of patient episodes can provide useful information in the allocation of limited resources among multiple patient processes. This paper introduces a framework for health care managers and researchers to analyze the effect of reducing through put time to the total cost of patient episodes.

Efficient use of animal manure on cropland--economic analysis.

PubMed

Araji, A A; Abdo, Z O; Joyce, P

2001-09-01

Manure contains all the macro- and microelements needed for plant growth; however, it represents one of the most underutilized resources in the US. The major problem with the use of manure on cropland is the direct effect of its composition on application cost. This cost is a function of the mineralization process of organic matter. The mineralization process is influenced by the properties of the manure, properties of the soil, moisture, and temperature. This study evaluates the simultaneous effect of these variables on the optimal use of manure on cropland. The results show that the properties of manure and soil significantly affect the mineralization of organic nitrogen and thus the optimal quantity of manure required to satisfy the nutrient requirement of crops in a given rotation system. Manure application costs range from a low of 18% of the cost of commercial fertilizer for chicken manure applied to one type of soil, to a high of 125% of the cost of commercial fertilizer for cow manure applied to another type of soil. The maximum distance to transfer manure to the field, that will equate its application cost to the cost of commercial fertilizer, ranges from a high of 35 km (22 miles) for chicken manure applied to one type of soil, to a low of 1 km (0.62 miles) for cow manure applied to another type of soil. For rotation system 2, manure application costs range from a low of 37% of the cost of commercial fertilizer for chicken manure applied to one type of soil, to a high of 136% of the cost of commercial fertilizer for cow manure applied to another type of soil. The maximum distance to transfer manure to the field, that will equate its cost to the cost of commercial fertilizer, ranges from a high of 20 km (12.5 miles) for chicken manure applied to one type of soil, to a low of 0 km (0 miles) for cow manure applied to another type of soil.

[Development of an Operational Model for the Application of Planning-Programming-Budgeting Systems in Local School Districts. Program Budgeting Note 3, Cost-Effectiveness Analysis: What Is It?

ERIC Educational Resources Information Center

State Univ. of New York, Buffalo. Western New York School Study Council.

Cost effectiveness analysis is used in situations where benefits and costs are not readily converted into a money base. Five elements can be identified in such an analytic process: (1) The objective must be defined in terms of what it is and how it is attained; (2) alternatives to the objective must be clearly definable; (3) the costs must be…

Benefits of barrier fuel on fuel cycle economics

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

Crowther, R.L.; Kunz, C.L.

1988-01-01

Barrier fuel rod cladding was developed to eliminate fuel rod failures from pellet/cladding stress/corrosion interaction and to eliminate the associated need to restrict the rate at which fuel rod power can be increased. The performance of barrier cladding has been demonstrated through extensive testing and through production application to many boiling water reactors (BWRs). Power reactor data have shown that barrier fuel rod cladding has a significant beneficial effect on plant capacity factor and plant operating costs and significantly increases fuel reliability. Independent of the fuel reliability benefit, it is less obvious that barrier fuel has a beneficial effect ofmore » fuel cycle costs, since barrier cladding is more costly to fabricate. Evaluations, measurements, and development activities, however, have shown that the fuel cycle cost benefits of barrier fuel are large. This paper is a summary of development activities that have shown that application of barrier fuel significantly reduces BWR fuel cycle costs.« less

Low-cost carbon thick-film strain sensors for implantable applications

NASA Astrophysics Data System (ADS)

Gutierrez, Christian A.; Meng, Ellis

2010-09-01

The suitability of low-cost carbon thick-film strain sensors embedded within a biomedical grade silicone rubber (Silastic® MDX4-4210) for implantable applications is investigated. These sensors address the need for robust cost-effective implantable strain sensing technology for the closed loop operation of function-restoring neural prosthetic systems. Design, fabrication and characterization of the sensors are discussed in the context of the application to strain/fullness measurements of the urinary bladder as part of the neuroprosthetic treatment of lower urinary tract dysfunction. The fabrication process, utilizing off-the-shelf screen-printing materials, is convenient and cost effective while achieving resolutions down to 75 µm. This method can also be extended to produce multilayer embedded devices by superposition of different screen-printable materials. Uniaxial loading performance, temperature dependence and long-term soak testing are used to validate suitability for implantation while proof-of-concept operation (up to 40% strain) is demonstrated on a bench-top latex balloon bladder model.

USAF solar thermal applications overview

NASA Technical Reports Server (NTRS)

Hauger, J. S.; Simpson, J. A.

1981-01-01

Process heat applications were compared to solar thermal technologies. The generic process heat applications were analyzed for solar thermal technology utilization, using SERI's PROSYS/ECONOMAT model in an end use matching analysis and a separate analysis was made for solar ponds. Solar technologies appear attractive in a large number of applications. Low temperature applications at sites with high insolation and high fuel costs were found to be most attractive. No one solar thermal technology emerges as a clearly universal or preferred technology, however,, solar ponds offer a potential high payoff in a few, selected applications. It was shown that troughs and flat plate systems are cost effective in a large number of applications.

A cost-effective analysis of fibrin sealants versus no sealant following open right hemihepatectomy for colorectal liver metastases.

PubMed

Pandanaboyana, Sanjay; Bell, Richard; Shah, Nehal; Lodge, J Peter A; Hidalgo, Ernest; Toogood, Giles J; Prasad, K Raj

2017-06-01

There is paucity of data regarding the cost-effectiveness of fibrin sealants during liver surgery. This study aimed to assess the cost-effectiveness of fibrin sealants following right hemihepatectomy for colorectal liver metastases. A prospectively maintained database between 2004 and 2013 was reviewed to identify patients who underwent a right hemihepatectomy with and without fibrin sealant application. Perioperative and post-operative outcomes were analysed to assess its cost-effectiveness. One hundred and sixty-three right hemihepatectomies were performed, of which 79 were in the fibrin sealant treatment group and 84 were in the no sealant group. No difference was seen between fibrin sealant and no sealant with regard to bile leak (P = 0.366), intra-abdominal collections (P = 0.200) and overall post-operative complications (P = 0.480). Operating costs were significantly cheaper in the no sealant group (P = 0.010). There was no difference seen in median post-operative stay between fibrin sealant versus no treatment (8 versus 9 days, P = 0.327), median total bed cost (£3900 versus £4300, P = 0.400), mean transfusion cost per patient (P = 0.201) and overall cost (£6706.15 versus £6555.80, P = 0.792). Fibrin sealant application to cut surface during liver surgery confers no cost benefit and their routine use may not be recommended. © 2014 Royal Australasian College of Surgeons.

Technology for low cost solid rocket boosters.

NASA Technical Reports Server (NTRS)

Ciepluch, C.

1971-01-01

A review of low cost large solid rocket motors developed at the Lewis Research Center is given. An estimate is made of the total cost reduction obtainable by incorporating this new technology package into the rocket motor design. The propellant, case material, insulation, nozzle ablatives, and thrust vector control are discussed. The effect of the new technology on motor cost is calculated for a typical expandable 260-in. booster application. Included in the cost analysis is the influence of motor performance variations due to specific impulse and weight changes. It is found for this application that motor costs may be reduced by up to 30% and that the economic attractiveness of future large solid rocket motors will be improved when the new technology is implemented.

The Application of Quantity Discounts in Army Procurements (Field Test).

DTIC Science & Technology

1980-04-01

Work Directive (PWD). d. The amended PWD is forwarded to the Procurement and Production (PP) control where quantity increments and delivery schedules are...counts on 97 Army Stock Fund small purchases (less than $10,000) and received 10 I be * 0p cebe * )~ Cb 111 cost effective discounts on 46 or 47.4% of...discount but the computed annualized cost for the QD increment was larger than the computed annualized cost for the EOQ, this was not a cost effective

Applications of cost-effectiveness methodologies in behavioral medicine.

PubMed

Kaplan, Robert M; Groessl, Erik J

2002-06-01

In 1996, the Panel on Cost-Effectiveness in Health and Medicine developed standards for cost-effectiveness analysis. The standards include the use of a societal perspective, that treatments be evaluated in comparison with the best available alternative (rather than with no care at all), and that health benefits be expressed in standardized units. Guidelines for cost accounting were also offered. Among 24,562 references on cost-effectiveness in Medline between 1995 and 2000, only a handful were relevant to behavioral medicine. Only 19 studies published between 1983 and 2000 met criteria for further evaluation. Among analyses that were reported, only 2 studies were found consistent with the Panel's criteria for high-quality analyses, although more recent studies were more likely to meet methodological standards. There are substantial opportunities to advance behavioral medicine by performing standardized cost-effectiveness analyses.

Cost-effectiveness of coronary artery disease screening in asymptomatic patients with type 2 diabetes and other atherogenic risk factors in Japan: factors influencing on international application of evidence-based guidelines.

PubMed

Hayashino, Yasuaki; Shimbo, Takuro; Tsujii, Satoru; Ishii, Hitoshi; Kondo, Hirokazu; Nakamura, Tsukasa; Nagata-Kobayashi, Shizuko; Fukui, Tsuguya

2007-05-16

Screening for coronary artery disease (CAD) in asymptomatic diabetic patients with atherogenic risk factors is recommended by the American College of Cardiology/American Diabetes Association. It is not clear whether these guidelines apply to the Japanese population with a different epidemiology of CAD. This study evaluates the applicability of the U.S. guidelines to Japan, taking account of cost-effectiveness. A cost-effectiveness analysis using a Markov model was performed to measure the clinical benefit and cost of CAD screening in asymptomatic patients with diabetes and additional atherogenic risk factors. We evaluated cohorts of patients stratified by age, gender, and atherogenic risks. The incremental cost-effectiveness of not screening, exercise electrocardiography, exercise echocardiography, and exercise single-photon emission-tomography (SPECT) was calculated. The data used were obtained from the literature. Outcomes are expressed as US dollars per quality-adjusted life year (QALY). Compared with not screening, the incremental cost-effectiveness ratio (ICER) of exercise electrocardiography was $31,400/QALY for 60-year-old asymptomatic diabetic men, and 46,600 for 65-year-old women with hypertension and smoking. The ICER of exercise echocardiography was $31,500/QALY and of SPECT was $326,000/QALY, compared with the next dominant strategy. Sensitivity analyses found that these results varied according to age, gender, the combination of additional atherogenic risk factors, and the frequency of screening. From a societal perspective the U.S. guidelines on screening for CAD in high risk diabetic patients are applicable to the Japanese population. However, the population subjected to screening should be carefully selected to obtain greatest benefit from screening.

Eco-Environmental Factors in Green Roof Application in Indian Cities

NASA Astrophysics Data System (ADS)

Mukherjee, M.

2014-09-01

Green-roof is the cost-effective environmental mitigation strategy for urban areas [1]. Its application is limited in India primarily due to inadequate understanding about its cost-benefit analysis and technicalities of its maintenance. Increasing awareness about green roof can alter conservative attitude towards its application. So, this work presents a quantified study on green-roof types, cost and environmental benefits while considering different geo-urban climate scenarios for cities of Kolkata, Mumbai, Chennai and New Delhi. Cost estimation for extensive and intensive green-roof with reference to commonly used roof in urban India is also worked out. Attributes considered for environmental discussion are energy savings related to thermal heat gain through roof, roof-top storm-water drainage and sound attenuation. The comparative study confirms that further focused study on individual cities would identify city-specific objectives for green-roof application; strategies like awareness, capacity building programmes, incentives, demonstration projects etc. can be worked out accordingly for wider application of green-roof in Indian cities.

The Optimal Observation Problem applied to a rating curve estimation including the "cost-to-wait"

NASA Astrophysics Data System (ADS)

Raso, Luciano; Werner, Micha; Weijs, Steven

2013-04-01

In order to manage a system, a decision maker (DM) tries to make the best decision under uncertainty, having partial knowledge on the effects of his/her decision. Observations reduce uncertainty, but are costly. Deciding what to observe and when to stop observing is a complementary problem that the DM has to face. The Optimal Observation Problem (OOP) offers a solution to the questions: (1) which observation is more effective? And (2) Is the next observation worth its cost? We show an application of the OOP to a rating curve estimation in the White Carter River (Scotland). The cost of extra gauging is compensated by the value of better decisions, that reduce the costs due to floods. The observational decision is then whether to gauge, and when. In the application, we include the "cost-to-wait" in the cost structure. The Algorithm find thus an optimal trade-off between getting less informative data now or wait for more informative, but later. The OOP can be used to plan a measurement campaign, also taking into account that the rating curve can change.

Rapid assessment of Schistosoma mansoni: the validity, applicability and cost-effectiveness of the Lot Quality Assurance Sampling method in Uganda

PubMed Central

Brooker, Simon; Kabatereine, Narcis B.; Myatt, Mark; Stothard, J. Russell; Fenwick, Alan

2007-01-01

Summary Rapid and accurate identification of communities at highest risk of morbidity from schistosomiasis is key for sustainable control. Although school questionnaires can effectively and inexpensively identify communities with a high prevalence of Schistosoma haematobium, parasitological screening remains the preferred option for S. mansoni. To help reduce screening costs, we investigated the validity of Lot Quality Assurance Sampling (LQAS) in classifying schools according categories of S. mansoni prevalence in Uganda, and explored its applicability and cost-effectiveness. First, we evaluated several sampling plans using computer simulation and then field tested one sampling plan in 34 schools in Uganda. Finally, cost-effectiveness of different screening and control strategies (including mass treatment without prior screening) was determined, and sensitivity analysis undertaken to assess the effect of infection levels and treatment costs. In identifying schools with prevalence ≥50%, computer simulations showed that LQAS had high levels of sensitivity and specificity (>90%) at sample sizes <20. The method also provides an ability to classify communities into three prevalence categories. Field testing showed that LQAS where 15 children were sampled had excellent diagnostic performance (sensitivity: 100%, specificity: 96.4%, positive predictive value: 85.7% and negative predictive value: 92.3%). Screening using LQAS was more cost-effective than mass treating all schools (US$ 218 vs. US$ 482 / high prevalence school treated). Threshold analysis indicated that parasitological screening and mass treatment would become equivalent for settings where prevalence exceeds 50% in 75% of schools and for treatment costs of US$ 0.19 per schoolchild. We conclude that, in Uganda, LQAS provides a rapid, valid, and cost-effective method for guiding decision makers in allocating finite resources for the control of schistosomiasis. PMID:15960703

Rapid assessment of Schistosoma mansoni: the validity, applicability and cost-effectiveness of the Lot Quality Assurance Sampling method in Uganda.

PubMed

Brooker, Simon; Kabatereine, Narcis B; Myatt, Mark; Russell Stothard, J; Fenwick, Alan

2005-07-01

Rapid and accurate identification of communities at highest risk of morbidity from schistosomiasis is key for sustainable control. Although school questionnaires can effectively and inexpensively identify communities with a high prevalence of Schistosoma haematobium, parasitological screening remains the preferred option for S. mansoni. To help reduce screening costs, we investigated the validity of Lot Quality Assurance Sampling (LQAS) in classifying schools according to categories of S. mansoni prevalence in Uganda, and explored its applicability and cost-effectiveness. First, we evaluated several sampling plans using computer simulation and then field tested one sampling plan in 34 schools in Uganda. Finally, cost-effectiveness of different screening and control strategies (including mass treatment without prior screening) was determined, and sensitivity analysis undertaken to assess the effect of infection levels and treatment costs. In identifying schools with prevalences > or =50%, computer simulations showed that LQAS had high levels of sensitivity and specificity (>90%) at sample sizes <20. The method also provides an ability to classify communities into three prevalence categories. Field testing showed that LQAS where 15 children were sampled had excellent diagnostic performance (sensitivity: 100%, specificity: 96.4%, positive predictive value: 85.7% and negative predictive value: 92.3%). Screening using LQAS was more cost-effective than mass treating all schools (US$218 vs. US$482/high prevalence school treated). Threshold analysis indicated that parasitological screening and mass treatment would become equivalent for settings where prevalence > or =50% in 75% of schools and for treatment costs of US$0.19 per schoolchild. We conclude that, in Uganda, LQAS provides a rapid, valid and cost-effective method for guiding decision makers in allocating finite resources for the control of schistosomiasis.

Printed electronic on flexible and glass substrates

NASA Astrophysics Data System (ADS)

Futera, Konrad; Jakubowska, Małgorzata; Kozioł, Grażyna

2010-09-01

Organic electronics is a platform technology that enables multiple applications based on organic electronics but varied in specifications. Organic electronics is based on the combination of new materials and cost-effective, large area production processes that provide new fields of application. Organic electronic by its size, weight, flexibility and environmental friendliness electronics enables low cost production of numerous electrical components and provides for such promising fields of application as: intelligent packaging, low cost RFID, flexible solar cells, disposable diagnostic devices or games, and printed batteries [1]. The paper presents results of inkjetted electronics elements on flexible and glass substrates. The investigations was target on characterizing shape, surface and geometry of printed structures. Variety of substrates were investigated, within some, low cost, non specialized substrate, design for other purposes than organic electronic.

The Cost-Effectiveness of Raising Teacher Quality

ERIC Educational Resources Information Center

Yeh, Stuart S.

2009-01-01

Econometric studies suggest that student achievement may be improved if high-performing teachers are substituted for low-performing teachers. Drawing upon a recent study linking teacher performance on licensure exams with gains in student achievement, an analysis was conducted to determine the cost-effectiveness of requiring teacher applicants to…

47 CFR 54.636 - Eligible participant-constructed and owned network facilities for consortium applicants.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Support for Health Care Providers Healthcare Connect Fund § 54.636 Eligible participant-constructed and... proposals. Requests for proposals must provide sufficient detail so that cost-effectiveness can be evaluated... its own network facilities is the most cost-effective option after competitive bidding, pursuant to...

47 CFR 54.636 - Eligible participant-constructed and owned network facilities for consortium applicants.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Support for Health Care Providers Healthcare Connect Fund § 54.636 Eligible participant-constructed and... proposals. Requests for proposals must provide sufficient detail so that cost-effectiveness can be evaluated... its own network facilities is the most cost-effective option after competitive bidding, pursuant to...

Low-Budget, Cost-Effective OCR: Optical Character Recognition for MS-DOS Micros.

ERIC Educational Resources Information Center

Perez, Ernest

1990-01-01

Discusses optical character recognition (OCR) for use with MS-DOS microcomputers. Cost effectiveness is considered, three types of software approaches to character recognition are explained, hardware and operation requirements are described, possible library applications are discussed, future OCR developments are suggested, and a list of OCR…

42 CFR 56.704 - Grant evaluation and award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 319(g) of the Act and applicable regulations of this part, taking into consideration: (a) The cost-effectiveness of the application; and (b) The number of centers and entities to be served by the applicant. ...

7 CFR 4288.21 - Application review and scoring.

Code of Federal Regulations, 2013 CFR

2013-01-01

... projects based on the cost, cost-effectiveness, and capacity of projects to reduce fossil fuels. The cost... economically produce energy from renewable biomass to replace its dependence on fossil fuels. Projects with... projects on simple payback as well as the percentage of fossil fuel reduction. (a) Review. The Agency will...

7 CFR 4288.21 - Application review and scoring.

Code of Federal Regulations, 2014 CFR

2014-01-01

... projects based on the cost, cost-effectiveness, and capacity of projects to reduce fossil fuels. The cost... economically produce energy from renewable biomass to replace its dependence on fossil fuels. Projects with... projects on simple payback as well as the percentage of fossil fuel reduction. (a) Review. The Agency will...

7 CFR 4288.21 - Application review and scoring.

Code of Federal Regulations, 2012 CFR

2012-01-01

... projects based on the cost, cost-effectiveness, and capacity of projects to reduce fossil fuels. The cost... economically produce energy from renewable biomass to replace its dependence on fossil fuels. Projects with... projects on simple payback as well as the percentage of fossil fuel reduction. (a) Review. The Agency will...

Effective Prototype Costing Policies in Research Universities: Are They Possible?

ERIC Educational Resources Information Center

McClure, Maureen W.; Abu-Duhou, Ibtisam

Policy problems of prototype costing at research universities are discussed, based on a case study of a clinical treatment prototype program at a research university hospital. Prototypes programs generate reproducible knowledge with useful applications and are primarily developed in professional schools. The potential of using costing prototypes…

Nanofiltration technology in water treatment and reuse: applications and costs.

PubMed

Shahmansouri, Arash; Bellona, Christopher

2015-01-01

Nanofiltration (NF) is a relatively recent development in membrane technology with characteristics that fall between ultrafiltration and reverse osmosis (RO). While RO membranes dominate the seawater desalination industry, NF is employed in a variety of water and wastewater treatment and industrial applications for the selective removal of ions and organic substances, as well as certain niche seawater desalination applications. The purpose of this study was to review the application of NF membranes in the water and wastewater industry including water softening and color removal, industrial wastewater treatment, water reuse, and desalination. Basic economic analyses were also performed to compare the profitability of using NF membranes over alternative processes. Although any detailed cost estimation is hampered by some uncertainty (e.g. applicability of estimation methods to large-scale systems, labor costs in different areas of the world), NF was found to be a cost-effective technology for certain investigated applications. The selection of NF over other treatment technologies, however, is dependent on several factors including pretreatment requirements, influent water quality, treatment facility capacity, and treatment goals.

Fertility preservation for social indications: a cost-based decision analysis.

PubMed

Hirshfeld-Cytron, Jennifer; Grobman, William A; Milad, Magdy P

2012-03-01

Age-related infertility remains a problem that assisted reproductive techniques (ART) have limited ability to overcome. Correspondingly, because an increasing number of women are choosing to delay childbearing, fertility preservation strategies, initially intended for patients undergoing gonadotoxic therapies, are being applied to this group of healthy women. Studies supporting the effectiveness of this practice are lacking. Decision analytic techniques. We compared the cost-effectiveness of three strategies for women planning delayed childbearing until age 40: oocyte cryopreservation at age 25, ovarian tissue cryopreservation (OTC) at age 25, and no assisted reproduction until spontaneous conception had been attempted. Not applicable. Not applicable. Cost-effectiveness, which was defined as the cost per live birth. In this analysis, the strategy of foregoing fertility preservation at age 25 and then choosing ART only after not spontaneously conceiving at age 40 was the most cost-effective option. OTC was dominated by the other strategies. Sensitivity analyses demonstrated the robustness of the model; no analysis existed in which OTC was not dominated by oocyte cryopreservation. Increasing the cost of an IVF cycle beyond $22,000 was the only situation in which oocyte cryopreservation was the most preferred strategy. Neither oocyte cryopreservation nor OTC appear to be cost-effective under current circumstances for otherwise healthy women planning delayed childbearing. This analysis should give pause to the current practice of offering fertility preservation based only on the desire for delayed childbearing. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Ion propulsion cost effectivity

NASA Technical Reports Server (NTRS)

Zafran, S.; Biess, J. J.

1978-01-01

Ion propulsion modules employing 8-cm thrusters and 30-cm thrusters were studied for Multimission Modular Spacecraft (MMS) applications. Recurring and nonrecurring cost elements were generated for these modules. As a result, ion propulsion cost drivers were identified to be Shuttle charges, solar array, power processing, and thruster costs. Cost effective design approaches included short length module configurations, array power sharing, operation at reduced thruster input power, simplified power processing units, and power processor output switching. The MMS mission model employed indicated that nonrecurring costs have to be shared with other programs unless the mission model grows. Extended performance missions exhibited the greatest benefits when compared with monopropellant hydrazine propulsion.

Assessing value-for-money in maternal and newborn health

PubMed Central

Madaj, Barbara; Kumar, Shubha

2017-01-01

Responding to increasing demands to demonstrate value-for-money (VfM) for maternal and newborn health interventions, and in the absence of VfM analysis in peer-reviewed literature, this paper reviews VfM components and methods, critiques their applicability, strengths and weakness and proposes how VfM assessments can be improved. VfM comprises four components: economy, efficiency, effectiveness and cost-effectiveness. Both ‘economy’ and ‘efficiency’ can be assessed with detailed cost analysis utilising costs obtained from programme accounting data or generic cost databases. Before-and-after studies, case–control studies or randomised controlled trials can be used to assess ‘effectiveness’. To assess ‘cost-effectiveness’, cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-benefit analysis (CBA) or social return on investment (SROI) analysis are applicable. Generally, costs can be obtained from programme accounting data or existing generic cost databases. As such ‘economy’ and ‘efficiency’ are relatively easy to assess. However, ‘effectiveness’ and ‘cost-effectiveness’ which require establishment of the counterfactual are more difficult to ascertain. Either a combination of CEA or CUA with tools for assessing other VfM components, or the independent use of CBA or SROI are alternative approaches proposed to strengthen VfM assessments. Cross-cutting themes such as equity, sustainability, scalability and cultural acceptability should also be assessed, as they provide critical contextual information for interpreting VfM assessments. To select an assessment approach, consideration should be given to the purpose, data availability, stakeholders requiring the findings and perspectives of programme beneficiaries. Implementers and researchers should work together to improve the quality of assessments. Standardisation around definitions, methodology and effectiveness measures to be assessed would help. PMID:29081998

The 1988 Inland Waterway Review

DTIC Science & Technology

1988-11-01

Maintenance Costs ............. 91 Table 4.3 Major Rehabilitation Projects: ............................... 92 Table 4.4 Scheduled Constructed Projects in the...Maintenance Costs .......................... 100 Figure 4.7 Operations and Maintenance Costs Per Ton Mile in 1986 For Inland Waterways Suspect to Fuel Tax...application of study and construction cost -sharing. It also increased waterway fuel taxes and created the Inland Waterways Users Board. In effect, the Act

[Application of skin adhesives in head and neck surgery: analysis of cosmetic results, applicability and cost-effectiveness of cyanoacrylate-based adhesives].

PubMed

Graefe, H; Wollenberg, B; Brocks, C

2008-09-01

In this work cyanoacrylate-based skin adhesives used in Germany for skin closure in head and neck surgery are compared with respect to ease of application, cost-effectiveness and cosmetic results. We compared 25 wounds sealed with a skin adhesive with 25 suture-sealed wounds. Bonding of surgical wounds with glue had a high level of acceptance in all patients. The tedious, time-consuming and sometimes painful postoperative removal of many sutures in patients is omitted. Patients can shower soon afterwards without additional protection as the adhesive provides a waterproof barrier. Problems of wound healing can immediately be detected through the transparent skin adhesive. Cosmetic long-term results of skin closure by adhesives are comparable to suture-sealed wounds. The adhesives available on the market differ mainly in the form of the applicator, the viscosity on application, as well as the strength after hardening. The application is easy to implement and significantly faster than conventional suturing. Apart from the cost savings of materials compared to the use of skin sutures and investment of Steri-Strips, expensive anesthesia and surgical time can also be saved.

Thresholds for the cost-effectiveness of interventions: alternative approaches.

PubMed

Marseille, Elliot; Larson, Bruce; Kazi, Dhruv S; Kahn, James G; Rosen, Sydney

2015-02-01

Many countries use the cost-effectiveness thresholds recommended by the World Health Organization's Choosing Interventions that are Cost-Effective project (WHO-CHOICE) when evaluating health interventions. This project sets the threshold for cost-effectiveness as the cost of the intervention per disability-adjusted life-year (DALY) averted less than three times the country's annual gross domestic product (GDP) per capita. Highly cost-effective interventions are defined as meeting a threshold per DALY averted of once the annual GDP per capita. We argue that reliance on these thresholds reduces the value of cost-effectiveness analyses and makes such analyses too blunt to be useful for most decision-making in the field of public health. Use of these thresholds has little theoretical justification, skirts the difficult but necessary ranking of the relative values of locally-applicable interventions and omits any consideration of what is truly affordable. The WHO-CHOICE thresholds set such a low bar for cost-effectiveness that very few interventions with evidence of efficacy can be ruled out. The thresholds have little value in assessing the trade-offs that decision-makers must confront. We present alternative approaches for applying cost-effectiveness criteria to choices in the allocation of health-care resources.

Optimizing molluscicide treatment strategies in different control stages of schistosomiasis in the People's Republic of China.

PubMed

Yang, Guo-Jing; Sun, Le-Ping; Hong, Qing-Biao; Zhu, Hong-Ru; Yang, Kun; Gao, Qi; Zhou, Xiao-Nong

2012-11-14

The application of chemical molluscicides is still one of the most effective measures for schistosomiasis control in P. R. China. By applying diverse molluscicide treatment scenarios on different snail densities in the field, we attempted to understand the cost-effectiveness of molluscicide application so as to prescribe an optimal management approach to control intermediate host snail Oncomelania hupensis under acceptable thresholds based on the goal of the National Schistosomiasis Control Programme. The molluscicidal field trial was carried out in the marshland of an island along the Yangtze River, Jiangsu province, P.R. China in October 2010. Three plots in the island representing low-density, medium-density and high-density groups were identified after the baseline survey on snail density. Each snail density plot was divided into four experimental units in which molluscicide (50% niclosamide ethanolamine salt wettable powder) was applied once, twice, trice and four times, respectively. The logistic regression model to correlate snail mortality rate with the covariates of number of molluscicidal treatment and snail density, and a linear regression model to investigate the relationship between cost-effectiveness and number of molluscicidal treatment as well as snail density were established. The study revealed that increase in the number of molluscicide treatments led to increased snail mortality across all three population density groups. The most cost-effective regimen was seen in the high snail density group with a single molluscicide treatment. For both high and low density groups, the more times molluscicide were applied, the less cost-effectiveness was. However, for the median density group, the level of cost-effectiveness for two applications was slightly higher than that in one time. We concluded that different stages of the national schistosomiasis control/elimination programme, namely morbidity control, transmission control and transmission interruption, should utilize different molluscicide treatment strategies to maximize cost-effectiveness.

Principles and methods of managerial cost-accounting systems.

PubMed

Suver, J D; Cooper, J C

1988-01-01

An introduction to cost-accounting systems for pharmacy managers is provided; terms are defined and examples of specific applications are given. Cost-accounting systems determine, record, and report the resources consumed in providing services. An effective cost-accounting system must provide the information needed for both internal and external reports. In accounting terms, cost is the value given up to secure an asset. In determining how volumes of activity affect costs, fixed costs and variable costs are calculated; applications include pricing strategies, cost determinations, and break-even analysis. Also discussed are the concepts of direct and indirect costs, opportunity costs, and incremental and sunk costs. For most pharmacy department services, process costing, an accounting of intermediate outputs and homogeneous units, is used; in determining the full cost of providing a product or service (e.g., patient stay), job-order costing is used. Development of work-performance standards is necessary for monitoring productivity and determining product costs. In allocating pharmacy department costs, a ratio of costs to charges can be used; this method is convenient, but microcosting (specific identification of the costs of products) is more accurate. Pharmacy managers can use cost-accounting systems to evaluate the pharmacy's strategies, policies, and services and to improve budgets and reports.

Cost-effectiveness Analysis Appraisal and Application: An Emergency Medicine Perspective.

PubMed

April, Michael D; Murray, Brian P

2017-06-01

Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policymakers have any formal training in CEA methodology. This paper provides an introduction to the interpretation and use of CEA with a focus on application to emergency medicine problems and settings. It applies a previously published CEA to the hypothetical case of a patient presenting to the ED with chest pain who requires risk stratification. This paper uses a widely cited checklist to appraise the CEA. This checklist serves as a vehicle for presenting basic CEA terminology and concepts. General topics of focus include measurement of costs and outcomes, incremental analysis, and sensitivity analysis. Integrated throughout the paper are recommendations for good CEA practice with emphasis on the guidelines published by the U.S. Panel on Cost-Effectiveness in Health and Medicine. Unique challenges for emergency medicine CEAs discussed include the projection of long-term outcomes from emergent interventions, costing ED services, and applying study results to diverse patient populations across various ED settings. The discussion also includes an overview of the limitations inherent in applying CEA results to clinical practice to include the lack of incorporation of noncost considerations in CEA (e.g., ethics). After reading this article, emergency medicine leaders and researchers will have an enhanced understanding of the basics of CEA critical appraisal and application. The paper concludes with an overview of economic evaluation resources for readers interested in conducting ED-based economic evaluation studies. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Time-Series Modeling and Simulation for Comparative Cost-Effective Analysis in Cancer Chemotherapy: An Application to Platinum-Based Regimens for Advanced Non-small Cell Lung Cancer.

PubMed

Chisaki, Yugo; Nakamura, Nobuhiko; Yano, Yoshitaka

2017-01-01

The purpose of this study was to propose a time-series modeling and simulation (M&S) strategy for probabilistic cost-effective analysis in cancer chemotherapy using a Monte-Carlo method based on data available from the literature. The simulation included the cost for chemotherapy, for pharmaceutical care for adverse events (AEs) and other medical costs. As an application example, we describe the analysis for the comparison of four regimens, cisplatin plus irinotecan, carboplatin plus paclitaxel, cisplatin plus gemcitabine (GP), and cisplatin plus vinorelbine, for advanced non-small cell lung cancer. The factors, drug efficacy explained by overall survival or time to treatment failure, frequency and severity of AEs, utility value of AEs to determine QOL, the drugs' and other medical costs in Japan, were included in the model. The simulation was performed and quality adjusted life years (QALY) and incremental cost-effectiveness ratios (ICER) were calculated. An index, percentage of superiority (%SUP) which is the rate of the increased cost vs. QALY-gained plots within the area of positive QALY-gained and also below some threshold values of the ICER, was calculated as functions of threshold values of the ICER. An M&S process was developed, and for the simulation example, the GP regimen was the most cost-effective, in case of threshold values of the ICER=$70000/year, the %SUP for the GP are more than 50%. We developed an M&S process for probabilistic cost-effective analysis, this method would be useful for decision-making in choosing a cancer chemotherapy regimen in terms of pharmacoeconomic.

Bayesian models for cost-effectiveness analysis in the presence of structural zero costs

PubMed Central

Baio, Gianluca

2014-01-01

Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd. PMID:24343868

Bayesian models for cost-effectiveness analysis in the presence of structural zero costs.

PubMed

Baio, Gianluca

2014-05-20

Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

CLEAR: Cross-Layer Exploration for Architecting Resilience

DTIC Science & Technology

2017-03-01

benchmark analysis, also provides cost-effective solutions (~1% additional energy cost for the same 50× improvement). This paper addresses the...core (OoO-core) [Wang 04], across 18 benchmarks . Such extensive exploration enables us to conclusively answer the above cross-layer resilience...analysis of the effects of soft errors on application benchmarks , provides a highly effective soft error resilience approach. 3. The above

Novel Structured Metal Bipolar Plates for Low Cost Manufacturing

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

Wang, Conghua

Bipolar plates are an important component in fuel cell stacks and accounts for more than 75% of stack weight and volume, and 20% of the stack cost. The technology development of metal bipolar plates can effectively reduce the fuel cells stack weight and volume over 50%. The challenge is to protect metal plate from corrosion at low cost for the broad commercial applications. While most of today’s PEM fuel cell metallic bipolar plate technologies use some precious metal, the focus of this SBIR project is to develop a low cost, novel nano-structured metal bipolar plate coating technology without using anymore » precious metal. The technology must meet the performance and cost requirements for automobile applications.« less

More sense for less cents: Cost effective servicing of remote sensing satellites

NASA Technical Reports Server (NTRS)

Lee, Jeannie; Misencik, Tom; Robertson, Bill; Sliney, Jack

1993-01-01

This paper addresses the design considerations for Earth observation spacecraft bus and payload subsystems such that cost-effective spacecraft maintainability is enhanced through optimized reliability and the application of robotic on-orbit support. In the past, for most satellites, maintainability has been associated with the clever application of telemetry reconfiguration and the use of redundant systems as necessary over the life cycle of the spacecraft. This presentation addresses the opportunities and challenges of leveraging the extensive work already accomplished in the development of on-orbit servicing technologies.

Benefit-cost methodology study with example application of the use of wind generators

NASA Technical Reports Server (NTRS)

Zimmer, R. P.; Justus, C. G.; Mason, R. M.; Robinette, S. L.; Sassone, P. G.; Schaffer, W. A.

1975-01-01

An example application for cost-benefit methodology is presented for the use of wind generators. The approach adopted for the example application consisted of the following activities: (1) surveying of the available wind data and wind power system information, (2) developing models which quantitatively described wind distributions, wind power systems, and cost-benefit differences between conventional systems and wind power systems, and (3) applying the cost-benefit methodology to compare a conventional electrical energy generation system with systems which included wind power generators. Wind speed distribution data were obtained from sites throughout the contiguous United States and were used to compute plant factor contours shown on an annual and seasonal basis. Plant factor values (ratio of average output power to rated power) are found to be as high as 0.6 (on an annual average basis) in portions of the central U. S. and in sections of the New England coastal area. Two types of wind power systems were selected for the application of the cost-benefit methodology. A cost-benefit model was designed and implemented on a computer to establish a practical tool for studying the relative costs and benefits of wind power systems under a variety of conditions and to efficiently and effectively perform associated sensitivity analyses.

Nudging Waste Diversion at Western State Colorado University: Application of Behavioral Insights

ERIC Educational Resources Information Center

McCoy, Kimberly; Oliver, Justin J.; Borden, D. Scott; Cohn, Scott I.

2018-01-01

Purpose: This paper aims to test a nudge, or intervention, designed through behavioral insights at a university campus to discover cost-effective means for increasing recycling participation and methods for estimating waste removal cost savings. Design/methodology/approach: A series of studies were conducted demonstrating the effectiveness of…

Considerations on communications network protocols in deep space

NASA Technical Reports Server (NTRS)

Clare, L. P.; Agre, J. R.; Yan, T.

2001-01-01

Communications supporting deep space missions impose numerous unique constraints that impact the architectural choices made for cost-effectiveness. We are entering the era where networks that exist in deep space are needed to support planetary exploration. Cost-effective performance will require a balanced integration of applicable widely used standard protocols with new and innovative designs.

Cost effectiveness of on- and off-field conservation practices designed to reduce nitrogen in downstream water

USDA-ARS?s Scientific Manuscript database

The objective of this analysis is to estimate and compare the cost-effectiveness of on- and off-field approaches to reducing nitrogen loadings. On-field practices include improving the timing, rate, and method of nitrogen application. Off-field practices include restoring wetlands and establishing v...

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

Liu, Jia

Biorefineries convert biomass into many useful intermediates. For bio-based products to be used for fuel, energy, chemical, and many other applications, water needs to be removed from these aqueous products. Membrane separation technologies can significantly reduce separation energy consumption compared with conventional separation processes such as distillation. Nanoporous inorganic membranes have superior pervaporation performance with excellent organic fouling resistance. However, their commercial applications are limited due to high membrane costs and poor production reproducibility. A novel cost-effective inorganic membrane fabrication technology has been developed with low cost materials and using an advanced membrane fabrication technology. Low cost precursor material formulationmore » was successfully developed with desired material properties for membrane fabrication. An advanced membrane fabrication process was developed using the novel membrane materials to enable the fabrication of separation membranes of various geometries. The structural robustness and separation performance of the low cost inorganic membranes were evaluated. The novel inorganic membranes demonstrated high structural integrity and were effective in pervaporation removal of water.« less

Energy-efficient membrane separations in the sweetener industry. Final report for Phase I

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

Babcock, W.C.

1984-02-14

The objective of the program is to investigate the use of membrane processes as energy-efficient alternatives to conventional separation processes in current use in the corn sweetener industry. Two applications of membranes were studied during the program: (1) the concentration of corn steep water by reverse osmosis; and (2) the concentration of dilute wastes called sweetwater with a combination of reverse osmosis and a process known as countercurrent reverse osmosis. Laboratory experiments were conducted for both applications, and the results were used to conduct technical and economic analyses of the process. It was determined that the concentration of steep watermore » by reverse osmosis plus triple-effect evaporation offers savings of a factor of 2.5 in capital costs and a factor of 4.5 in operating costs over currently used triple-effect evaporation. In the concentration of sweetwater by reverse osmosis and countercurrent reverse osmosis, capital costs would be about the same as those for triple-effect evaporation, but operating costs would be only about one-half those of triple-effect evaporation.« less

Applying risk adjusted cost-effectiveness (RAC-E) analysis to hospitals: estimating the costs and consequences of variation in clinical practice.

PubMed

Karnon, Jonathan; Caffrey, Orla; Pham, Clarabelle; Grieve, Richard; Ben-Tovim, David; Hakendorf, Paul; Crotty, Maria

2013-06-01

Cost-effectiveness analysis is well established for pharmaceuticals and medical technologies but not for evaluating variations in clinical practice. This paper describes a novel methodology--risk adjusted cost-effectiveness (RAC-E)--that facilitates the comparative evaluation of applied clinical practice processes. In this application, risk adjustment is undertaken with a multivariate matching algorithm that balances the baseline characteristics of patients attending different settings (e.g., hospitals). Linked, routinely collected data are used to analyse patient-level costs and outcomes over a 2-year period, as well as to extrapolate costs and survival over patient lifetimes. The study reports the relative cost-effectiveness of alternative forms of clinical practice, including a full representation of the statistical uncertainty around the mean estimates. The methodology is illustrated by a case study that evaluates the relative cost-effectiveness of services for patients presenting with acute chest pain across the four main public hospitals in South Australia. The evaluation finds that services provided at two hospitals were dominated, and of the remaining services, the more effective hospital gained life years at a low mean additional cost and had an 80% probability of being the most cost-effective hospital at realistic cost-effectiveness thresholds. Potential determinants of the estimated variation in costs and effects were identified, although more detailed analyses to identify specific areas of variation in clinical practice are required to inform improvements at the less cost-effective institutions. Copyright © 2012 John Wiley & Sons, Ltd.

Cost-effectiveness of robotic-assisted laparoscopic procedures in urologic surgery in the USA.

PubMed

Sleeper, Joshua; Lotan, Yair

2011-01-01

New technologies such as robotic-assisted surgery are constantly introduced clinically without a complete understanding of benefits and costs. This article will discuss general concepts of health economics and apply them to the application of robotic-assisted surgery to urologic procedures. Utilization of robotic surgery has increased dramatically in recent years. This has been most dramatic in the treatment of prostate cancer. The robot adds significant costs from acquisition, maintenance and recurrent instrument costs. These added costs, thus far, have not been associated with significant improvement in outcomes over 'pure' laparoscopy or open procedures. In order for the robot to be cost effective, there needs to be an improvement in efficacy over alternative approaches, and a decrease in costs of the robot or instrumentation. Robotic surgery has not been found to be cost effective in urology. Future studies may yet reveal indirect benefits that are not yet obvious.

Methodology evaluation: Effects of independent verification and intergration on one class of application

NASA Technical Reports Server (NTRS)

Page, J.

1981-01-01

The effects of an independent verification and integration (V and I) methodology on one class of application are described. Resource profiles are discussed. The development environment is reviewed. Seven measures are presented to test the hypothesis that V and I improve the development and product. The V and I methodology provided: (1) a decrease in requirements ambiguities and misinterpretation; (2) no decrease in design errors; (3) no decrease in the cost of correcting errors; (4) a decrease in the cost of system and acceptance testing; (5) an increase in early discovery of errors; (6) no improvement in the quality of software put into operation; and (7) a decrease in productivity and an increase in cost.

The sunk cost effect across species: A review of persistence in a course of action due to prior investment.

PubMed

Magalhães, Paula; Geoffrey White, K

2016-05-01

The sunk cost effect is the bias or tendency to persist in a course of action due to prior investments of effort, money or time. At the time of the only review on the sunk cost effect across species (Arkes & Ayton, 1999), research with nonhuman animals had been ecological in its nature, and the findings about the effect of past investments on current choice were inconclusive. However, in the last decade a new line of experimental laboratory-based research has emerged with the promise of revolutionizing the way we approach the study of the sunk cost effect in nonhumans. In the present review we challenge Arkes and Ayton's conclusion that the sunk cost effect is exclusive to humans, and describe evidence for the sunk cost effect in nonhuman animals. By doing so, we also challenge the current explanations for the sunk cost effect in humans, as they are not applicable to nonhumans. We argue that a unified theory is called for, because different independent variables, in particular, investment amount, have the same influence on the sunk cost effect across species. Finally, we suggest possible psychological mechanisms shared across different species, contrast and depreciation, that could explain the sunk cost effect. © 2016 Society for the Experimental Analysis of Behavior.

10 CFR 455.63 - Cost-effectiveness testing.

Code of Federal Regulations, 2013 CFR

2013-01-01

... measure to be determined by life-cycle cost analysis or if the applicant requests such an analysis. (1) A life-cycle cost analysis, showing a savings-to-investment ratio greater than or equal to one over the useful life of the energy conservation measure or 15 years, whichever is less, shall be conducted in...

10 CFR 455.63 - Cost-effectiveness testing.

Code of Federal Regulations, 2012 CFR

2012-01-01

... measure to be determined by life-cycle cost analysis or if the applicant requests such an analysis. (1) A life-cycle cost analysis, showing a savings-to-investment ratio greater than or equal to one over the useful life of the energy conservation measure or 15 years, whichever is less, shall be conducted in...

10 CFR 455.63 - Cost-effectiveness testing.

Code of Federal Regulations, 2014 CFR

2014-01-01

... measure to be determined by life-cycle cost analysis or if the applicant requests such an analysis. (1) A life-cycle cost analysis, showing a savings-to-investment ratio greater than or equal to one over the useful life of the energy conservation measure or 15 years, whichever is less, shall be conducted in...

Baby Budgeting: Oocyte Cryopreservation in Women Delaying Reproduction Can Reduce Cost per Live Birth

PubMed Central

Devine, Kate; Mumford, Sunni L.; Goldman, Kara N.; Hodes-Wertz, Brooke; Druckenmiller, Sarah; Propst, Anthony M.; Noyes, Nicole

2015-01-01

Objective To determine whether oocyte cryopreservation (OC) for deferred reproduction is cost-effective per live birth using a model constructed from observed clinical practice. Design Decision-tree mathematical model with sensitivity analyses. Setting Not applicable. Patients A simulated cohort of women wishing to delay childbearing until age 40 years. Interventions Not applicable. Main Outcome Measure Cost per live birth. Results Our primary model predicted that OC at age 35 years by women planning to defer pregnancy attempts until age 40 would decrease cost per live birth to $39,946 (and increase odds of live birth to 62% by the end of the model),indicating OC to be a cost-effective strategy relative to forgoing OC, which was associated with a predicted cost per live birth of $55,060 (and 42% chance of live birth). If fresh autologous ART was added at age 40 prior to thawing oocytes, 74% obtained a live birth, though at an increased cost of $61,887. Separate sensitivity analyses demonstrated that OC remained cost-effective so long as patients underwent OC prior to age 38, more than 49% of those not obtaining a spontaneously conceived live birth returned to thaw oocytes, and likelihood of obtaining a spontaneously conceived live birth after six months’ attempts at age 40 was less than 35%. Conclusions In women who plan to delay childbearing until age 40, oocyte cryopreservation before 38 years of age reduces the cost to obtain a live birth. PMID:25813281

Does the use of efficacy or effectiveness evidence in cost-effectiveness analysis matter?

PubMed

Dilokthornsakul, Piyameth; Chaiyakunapruk, Nathorn; Campbell, Jonathan D

2017-01-02

To test the association of clinical evidence type, efficacy-based or effectiveness-based ("E"), versus whether or not asthma interventions' cost-effectiveness findings are favorable. We conducted a systematic review of PubMed, EMBASE, Tufts CEA registry, Cochrane CENTRAL, and the UK National Health Services Economic Evaluation Database from 2009 to 2014. All cost-effectiveness studies evaluating asthma medication(s) were included. Clinical evidence type, "E," was classified as efficacy-based if the evidence was from an explanatory randomized controlled trial(s) or meta-analysis, while evidence from pragmatic trial(s) or observational study(s) was classified as effectiveness-based. We defined three times the World Health Organization cost-effectiveness willingness-to-pay (WTP) threshold or less as a favorable cost-effectiveness finding. Logistic regression tested the likelihood of favorable versus unfavorable cost-effectiveness findings against the type of "E." 25 cost-effectiveness studies were included. Ten (40.0%) studies were effectiveness-based, yet 15 (60.0%) studies were efficacy-based. Of 17 studies using endpoints that could be compared to WTP threshold, 7 out of 8 (87.5%) effectiveness-based studies yielded favorable cost-effectiveness results, whereas 4 out of 9 (44.4%) efficacy-based studies yielded favorable cost-effectiveness results. The adjusted odds ratio was 15.12 (95% confidence interval; 0.59 to 388.75) for effectiveness-based versus efficacy-based achieving favorable cost-effectiveness findings. More asthma cost-effectiveness studies used efficacy-based evidence. Studies using effectiveness-based evidence trended toward being more likely to disseminate favorable cost-effective findings than those using efficacy. Health policy decision makers should pay attention to the type of clinical evidence used in cost-effectiveness studies for accurate interpretation and application.

Application of exercise ECG stress test in the current high cost modern-era healthcare system.

PubMed

Vaidya, Gaurang Nandkishor

Exercise electrocardiogram (ECG) tests boasts of being more widely available, less resource intensive, lower cost and absence of radiation. In the presence of a normal baseline ECG, an exercise ECG test is able to generate a reliable and reproducible result almost comparable to Technitium-99m sestamibi perfusion imaging. Exercise ECG changes when combined with other clinical parameters obtained during the test has the potential to allow effective redistribution of scarce resources by excluding low risk patients with significant accuracy. As we look towards a future of rising healthcare costs, increased prevalence of cardiovascular disease and the need for proper allocation of limited resources; exercise ECG test offers low cost, vital and reliable disease interpretation. This article highlights the physiology of the exercise ECG test, patient selection, effective interpretation, describe previously reported scores and their clinical application in today's clinical practice. Copyright © 2017. Published by Elsevier B.V.

Measuring the cost impact of hospital information systems: 1987-1994.

PubMed

Borzekowski, Ron

2009-09-01

This study measures the impact of information technology (IT) use on hospital operating costs during the late 1980s and early 1990s. Using a proprietary eight-year panel dataset (1987-1994) that catalogues application-level automation for the complete census of the 3000 U.S. hospitals with more than 100 beds, this study finds that both financial/administrative and clinical IT systems at the most thoroughly automated hospitals are associated with declining costs three and five years after adoption. At the application level, declining costs are associated with the adoption of some of the newest technologies, including systems designed for cost management, the administration of managed care contracts, and for both financial and clinical decision support. The association of cost declines with lagged IT as well as the cost patterns at the less automated hospitals both provide some evidence of learning effects.

Products from NASA's In-Space Propulsion Technology Program Applicable to Low-Cost Planetary Missions

NASA Technical Reports Server (NTRS)

Anderson, David J.; Pencil, Eric; Vento, Daniel; Peterson, Todd; Dankanich, John; Hahne, David; Munk, Michelle M.

2011-01-01

Since September 2001 NASA s In-Space Propulsion Technology (ISPT) program has been developing technologies for lowering the cost of planetary science missions. Recently completed is the high-temperature Advanced Material Bipropellant Rocket (AMBR) engine providing higher performance for lower cost. Two other cost saving technologies nearing completion are the NEXT ion thruster and the Aerocapture technology project. Also under development are several technologies for low cost sample return missions. These include a low cost Hall effect thruster (HIVHAC) which will be completed in 2011, light weight propellant tanks, and a Multi-Mission Earth Entry Vehicle (MMEEV). This paper will discuss the status of the technology development, the cost savings or performance benefits, and applicability of these in-space propulsion technologies to NASA s future Discovery, and New Frontiers missions, as well as their relevance for sample return missions.

34 CFR 366.37 - What procedures does the Director of the DSU (Director) use in making a grant for a new center?

Code of Federal Regulations, 2010 CFR

2010-07-01

... involvement of individuals with significant disabilities by the applicant. (v) The budget and cost-effectiveness of the applicant. (vi) The evaluation plan of the applicant. (vii) The ability of the applicant to...

Performance and cost benefits associated with nonimaging secondary concentrators used in point-focus dish solar thermal applications

NASA Astrophysics Data System (ADS)

Ogallagher, J.; Winston, R.

1987-09-01

Using nonimaging secondary concentrators in point-focus applications may permit the development of more cost-effective concentrator systems by either improving performance or reducing costs. Secondaries may also increase design flexibility. The major objective of this study was to develop as complete an understanding as possible of the quantitative performance and cost effects associated with deploying nonimaging secondary concentrators at the focal zone of point-focus solar thermal concentrators. A performance model was developed that uses a Monte Carlo ray-trace procedure to determine the focal plane distribution of a paraboloidal primary as a function of optical parameters. It then calculates the corresponding optimized concentration and thermal efficiency as a function of temperature with and without the secondary. To examine the potential cost benefits associated with secondaries, a preliminary model for the rational optimization of performance versus cost trade-offs was developed. This model suggests a possible 10 to 20 percent reduction in the cost of delivered energy when secondaries are used. This is a lower limit, and the benefits may even be greater if using a secondary permits the development of inexpensive primary technologies for which the performance would not otherwise be viable.

Integrated cost-effectiveness analysis of agri-environmental measures for water quality.

PubMed

Balana, Bedru B; Jackson-Blake, Leah; Martin-Ortega, Julia; Dunn, Sarah

2015-09-15

This paper presents an application of integrated methodological approach for identifying cost-effective combinations of agri-environmental measures to achieve water quality targets. The methodological approach involves linking hydro-chemical modelling with economic costs of mitigation measures. The utility of the approach was explored for the River Dee catchment in North East Scotland, examining the cost-effectiveness of mitigation measures for nitrogen (N) and phosphorus (P) pollutants. In-stream nitrate concentration was modelled using the STREAM-N and phosphorus using INCA-P model. Both models were first run for baseline conditions and then their effectiveness for changes in land management was simulated. Costs were based on farm income foregone, capital and operational expenditures. The costs and effects data were integrated using 'Risk Solver Platform' optimization in excel to produce the most cost-effective combination of measures by which target nutrient reductions could be attained at a minimum economic cost. The analysis identified different combination of measures as most cost-effective for the two pollutants. An important aspect of this paper is integration of model-based effectiveness estimates with economic cost of measures for cost-effectiveness analysis of land and water management options. The methodological approach developed is not limited to the two pollutants and the selected agri-environmental measures considered in the paper; the approach can be adapted to the cost-effectiveness analysis of any catchment-scale environmental management options. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pell Grant Validation Imposes Some Costs and Does Not Greatly Reduce Award Errors: New Strategies Are Needed. Report to the Honorable Paul Simon, United States Senate.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

Efforts of the U.S. Department of Education to verify data submitted by applicants to the Pell Grant program were analyzed by the General Accounting Office. The effects of carrying out the Department's policy or methodology, called "validation," on financial aid applicants and colleges were assessed. Costs of 1982-1983 validation on…

Evaluating the costs and effectiveness of cardiovascular therapies: who cares about economic analyses?

PubMed

Califf, Robert M

2002-10-15

The field of cardiovascular medicine is providing important insights about how the costs and effectiveness of diagnostic and therapeutic technologies are managed. As health-care budgets have taken up more of the economy and as employers and patients have become concerned about the escalating costs of health care, we have entered an era in which individual practitioners must become concerned with the costs of a service relative to its benefits. Further, increasing numbers of effective therapies in a time when finances are notably constrained, we clearly cannot use all effective therapies in all patients. Increasingly, therefore, we must assess the value derived from spending incremental money on health care products and services. This exercise has been termed cost-effectiveness analysis. The case of the platelet glycoprotein IIb/IIIa inhibitor, abciximab, is used to illustrate many of the issues surrounding the collection, interpretation, and (mis) application of cost-effectiveness data. Copyright 2002 John Wiley & Sons, Ltd.

The once and future application of cost-effectiveness analysis.

PubMed

Berger, M L

1999-09-01

Cost-effectiveness analysis (CEA) is used by payers to make coverage decisions, by providers to make formulary decisions, and by large purchasers/employers and policymakers to choose health care performance measures. However, it continues to be poorly utilized in the marketplace because of overriding financial imperatives to control costs and a low apparent willingness to pay for quality. There is no obvious relationship between the cost-effectiveness of life-saving interventions and their application. Health care decision makers consider financial impact, safety, and effectiveness before cost-effectiveness. WHY IS CEA NOT MORE WIDELY APPLIED? Most health care providers have a short-term parochial financial perspective, whereas CEA takes a long-term view that captures all costs, benefits, and hazards, regardless of to whom they accrue. In addition, a history of poor standardization of methods, unrealistic expectations that CEA could answer fundamental ethical and political issues, and society's failure to accept the need for allocating scarce resources more judiciously, have contributed to relatively little use of the method by decision makers. HOW WILL CEA FIND GREATER UTILITY IN THE FUTURE? As decision makers take a longer-term view and understand that CEA can provide a quantitative perspective on important resource allocation decisions, including the distributional consequences of alternative choices, CEA is likely to find greater use. However, it must be embedded within a framework that promotes confidence in the social justice of health care decision making through ongoing dialogue about how the value of health and health care are defined.

Design of a lightweight, cost effective thimble-like sensor for haptic applications based on contact force sensors.

PubMed

Ferre, Manuel; Galiana, Ignacio; Aracil, Rafael

2011-01-01

This paper describes the design and calibration of a thimble that measures the forces applied by a user during manipulation of virtual and real objects. Haptic devices benefit from force measurement capabilities at their end-point. However, the heavy weight and cost of force sensors prevent their widespread incorporation in these applications. The design of a lightweight, user-adaptable, and cost-effective thimble with four contact force sensors is described in this paper. The sensors are calibrated before being placed in the thimble to provide normal and tangential forces. Normal forces are exerted directly by the fingertip and thus can be properly measured. Tangential forces are estimated by sensors strategically placed in the thimble sides. Two applications are provided in order to facilitate an evaluation of sensorized thimble performance. These applications focus on: (i) force signal edge detection, which determines task segmentation of virtual object manipulation, and (ii) the development of complex object manipulation models, wherein the mechanical features of a real object are obtained and these features are then reproduced for training by means of virtual object manipulation.

Design of a Lightweight, Cost Effective Thimble-Like Sensor for Haptic Applications Based on Contact Force Sensors

PubMed Central

Ferre, Manuel; Galiana, Ignacio; Aracil, Rafael

2011-01-01

This paper describes the design and calibration of a thimble that measures the forces applied by a user during manipulation of virtual and real objects. Haptic devices benefit from force measurement capabilities at their end-point. However, the heavy weight and cost of force sensors prevent their widespread incorporation in these applications. The design of a lightweight, user-adaptable, and cost-effective thimble with four contact force sensors is described in this paper. The sensors are calibrated before being placed in the thimble to provide normal and tangential forces. Normal forces are exerted directly by the fingertip and thus can be properly measured. Tangential forces are estimated by sensors strategically placed in the thimble sides. Two applications are provided in order to facilitate an evaluation of sensorized thimble performance. These applications focus on: (i) force signal edge detection, which determines task segmentation of virtual object manipulation, and (ii) the development of complex object manipulation models, wherein the mechanical features of a real object are obtained and these features are then reproduced for training by means of virtual object manipulation. PMID:22247677

[Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].

PubMed

Machado, Flávia Mori Sarti; Simões, Arlete Naresse

2008-02-01

To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy. Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58). The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

7 CFR Appendix A to Part 277 - Principles for Determining Costs Applicable to Administration of the Food Stamp Program by State...

Code of Federal Regulations, 2010 CFR

2010-01-01

... on the fundamental premises that: (a) State agencies are responsible for the efficient and effective... State agency in writing of the disapproval, the reason for the disapproval and the effective date. Costs... allowable. (2) Advertising. Advertising media includes newspapers, magazines, radio and television programs...

Assessing the Battery Cost at Which Plug-In Hybrid Medium-Duty Parcel Delivery Vehicles Become Cost-Effective

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

Ramroth, L. A.; Gonder, J. D.; Brooker, A. D.

2013-04-01

The National Renewable Energy Laboratory (NREL) validated diesel-conventional and diesel-hybrid medium-duty parcel delivery vehicle models to evaluate petroleum reductions and cost implications of hybrid and plug-in hybrid diesel variants. The hybrid and plug-in hybrid variants are run on a field data-derived design matrix to analyze the effect of drive cycle, distance, engine downsizing, battery replacements, and battery energy on fuel consumption and lifetime cost. For an array of diesel fuel costs, the battery cost per kilowatt-hour at which the hybridized configuration becomes cost-effective is calculated. This builds on a previous analysis that found the fuel savings from medium duty plug-inmore » hybrids more than offset the vehicles' incremental price under future battery and fuel cost projections, but that they seldom did so under present day cost assumptions in the absence of purchase incentives. The results also highlight the importance of understanding the application's drive cycle specific daily distance and kinetic intensity.« less

Development and application of Model of Resource Utilization, Costs, and Outcomes for Stroke (MORUCOS): an Australian economic model for stroke.

PubMed

Mihalopoulos, Catherine; Cadilhac, Dominique A; Moodie, Marjory L; Dewey, Helen M; Thrift, Amanda G; Donnan, Geoffrey A; Carter, Robert C

2005-01-01

To outline the development, structure, data assumptions, and application of an Australian economic model for stroke (Model of Resource Utilization, Costs, and Outcomes for Stroke [MORUCOS]). The model has a linked spreadsheet format with four modules to describe the disease burden and treatment pathways, estimate prevalence-based and incidence-based costs, and derive life expectancy and quality of life consequences. The model uses patient-level, community-based, stroke cohort data and macro-level simulations. An interventions module allows options for change to be consistently evaluated by modifying aspects of the other modules. To date, model validation has included sensitivity testing, face validity, and peer review. Further validation of technical and predictive accuracy is needed. The generic pathway model was assessed by comparison with a stroke subtypes (ischemic, hemorrhagic, or undetermined) approach and used to determine the relative cost-effectiveness of four interventions. The generic pathway model produced lower costs compared with a subtypes version (total average first-year costs/case AUD$ 15,117 versus AUD$ 17,786, respectively). Optimal evidence-based uptake of anticoagulation therapy for primary and secondary stroke prevention and intravenous thrombolytic therapy within 3 hours of stroke were more cost-effective than current practice (base year, 1997). MORUCOS is transparent and flexible in describing Australian stroke care and can effectively be used to systematically evaluate a range of different interventions. Adjusting results to account for stroke subtypes, as they influence cost estimates, could enhance the generic model.

Cost and performance model for redox flow batteries

NASA Astrophysics Data System (ADS)

Viswanathan, Vilayanur; Crawford, Alasdair; Stephenson, David; Kim, Soowhan; Wang, Wei; Li, Bin; Coffey, Greg; Thomsen, Ed; Graff, Gordon; Balducci, Patrick; Kintner-Meyer, Michael; Sprenkle, Vincent

2014-02-01

A cost model is developed for all vanadium and iron-vanadium redox flow batteries. Electrochemical performance modeling is done to estimate stack performance at various power densities as a function of state of charge and operating conditions. This is supplemented with a shunt current model and a pumping loss model to estimate actual system efficiency. The operating parameters such as power density, flow rates and design parameters such as electrode aspect ratio and flow frame channel dimensions are adjusted to maximize efficiency and minimize capital costs. Detailed cost estimates are obtained from various vendors to calculate cost estimates for present, near-term and optimistic scenarios. The most cost-effective chemistries with optimum operating conditions for power or energy intensive applications are determined, providing a roadmap for battery management systems development for redox flow batteries. The main drivers for cost reduction for various chemistries are identified as a function of the energy to power ratio of the storage system. Levelized cost analysis further guide suitability of various chemistries for different applications.

Low Cost Carbon Fibre: Applications, Performance and Cost Models - Chapter 17

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

Warren, Charles David; Wheatley, Dr. Alan; Das, Sujit

2014-01-01

Weight saving in automotive applications has a major bearing on fuel economy. It is generally accepted that, typically, a 10% weight reduction in an automobile will lead to a 6-8% improvement in fuel economy. In this respect, carbon fibre composites are extremely attractive in their ability to provide superlative mechanical performance per unit weight. That is why they are specified for high-end uses such as Formula 1 racing cars and the latest aircraft (e.g. Boeing 787, Airbus A350 and A380), where they comprise over 50% by weight of the structure However, carbon fibres are expensive and this renders their compositesmore » similarly expensive. Research has been carried out at Oak Ridge National Laboratories (ORNL), Tennessee, USA for over a decade with the aim of reducing the cost of carbon fibre such that it becomes a cost-effective option for the automotive industry. Aspects of this research relating to the development of low cost carbon fibre have been reported in Chapter 3 of this publication. In this chapter, the practical industrial applications of low-cost carbon fibre are presented, together with considerations of the performance and cost models which underpin the work.« less

Cost-effective, transfer-free, flexible resistive random access memory using laser-scribed reduced graphene oxide patterning technology.

PubMed

Tian, He; Chen, Hong-Yu; Ren, Tian-Ling; Li, Cheng; Xue, Qing-Tang; Mohammad, Mohammad Ali; Wu, Can; Yang, Yi; Wong, H-S Philip

2014-06-11

Laser scribing is an attractive reduced graphene oxide (rGO) growth and patterning technology because the process is low-cost, time-efficient, transfer-free, and flexible. Various laser-scribed rGO (LSG) components such as capacitors, gas sensors, and strain sensors have been demonstrated. However, obstacles remain toward practical application of the technology where all the components of a system are fabricated using laser scribing. Memory components, if developed, will substantially broaden the application space of low-cost, flexible electronic systems. For the first time, a low-cost approach to fabricate resistive random access memory (ReRAM) using laser-scribed rGO as the bottom electrode is experimentally demonstrated. The one-step laser scribing technology allows transfer-free rGO synthesis directly on flexible substrates or non-flat substrates. Using this time-efficient laser-scribing technology, the patterning of a memory-array area up to 100 cm(2) can be completed in 25 min. Without requiring the photoresist coating for lithography, the surface of patterned rGO remains as clean as its pristine state. Ag/HfOx/LSG ReRAM using laser-scribing technology is fabricated in this work. Comprehensive electrical characteristics are presented including forming-free behavior, stable switching, reasonable reliability performance and potential for 2-bit storage per memory cell. The results suggest that laser-scribing technology can potentially produce more cost-effective and time-effective rGO-based circuits and systems for practical applications.

[Cost-effectiveness of the deep vein thrombosis diagnosis process in primary care].

PubMed

Fuentes Camps, Eva; Luis del Val García, José; Bellmunt Montoya, Sergi; Hmimina Hmimina, Sara; Gómez Jabalera, Efren; Muñoz Pérez, Miguel Ángel

2016-04-01

To analyse the cost effectiveness of the application of diagnostic algorithms in patients with a first episode of suspected deep vein thrombosis (DVT) in Primary Care compared with systematic referral to specialised centres. Observational, cross-sectional, analytical study. Patients from hospital emergency rooms referred from Primary Care to complete clinical evaluation and diagnosis. A total of 138 patients with symptoms of a first episode of DVT were recruited; 22 were excluded (no Primary Care report, symptoms for more than 30 days, anticoagulant treatment, and previous DVT). Of the 116 patients finally included, 61% women and the mean age was 71 years. Variables from the Wells and Oudega clinical probability scales, D-dimer (portable and hospital), Doppler ultrasound, and direct costs generated by the three algorithms analysed: all patients were referred systematically, referral according to Wells and Oudega scale. DVT was confirmed in 18.9%. The two clinical probability scales showed a sensitivity of 100% (95% CI: 85.1 to 100) and a specificity of about 40%. With the application of the scales, one third of all referrals to hospital emergency rooms could have been avoided (P<.001). The diagnostic cost could have been reduced by € 8,620 according to Oudega and € 9,741 according to Wells, per 100 patients visited. The application of diagnostic algorithms when a DVT is suspected could lead to better diagnostic management by physicians, and a more cost effective process. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

The human role in space (THURIS) applications study. Final briefing

NASA Technical Reports Server (NTRS)

Maybee, George W.

1987-01-01

The THURIS (The Human Role in Space) application is an iterative process involving successive assessments of man/machine mixes in terms of performance, cost and technology to arrive at an optimum man/machine mode for the mission application. The process begins with user inputs which define the mission in terms of an event sequence and performance time requirements. The desired initial operational capability date is also an input requirement. THURIS terms and definitions (e.g., generic activities) are applied to the input data converting it into a form which can be analyzed using the THURIS cost model outputs. The cost model produces tabular and graphical outputs for determining the relative cost-effectiveness of a given man/machine mode and generic activity. A technology database is provided to enable assessment of support equipment availability for selected man/machine modes. If technology gaps exist for an application, the database contains information supportive of further investigation into the relevant technologies. The present study concentrated on testing and enhancing the THURIS cost model and subordinate data files and developing a technology database which interfaces directly with the user via technology readiness displays. This effort has resulted in a more powerful, easy-to-use applications system for optimization of man/machine roles. Volume 1 is an executive summary.

Blister pouches for effective reagent storage and release for low cost point-of-care diagnostic applications

NASA Astrophysics Data System (ADS)

Smith, Suzanne; Sewart, Rene; Land, Kevin; Roux, Pieter; Gärtner, Claudia; Becker, Holger

2016-03-01

Lab-on-a-chip devices are often applied to point-of-care diagnostic solutions as they are low-cost, compact, disposable, and require only small sample volumes. For such devices, various reagents are required for sample preparation and analysis and, for an integrated solution to be realized, on-chip reagent storage and automated introduction are required. This work describes the implementation and characterization of effective liquid reagent storage and release mechanisms utilizing blister pouches applied to various point-of-care diagnostic device applications. The manufacturing aspects as well as performance parameters are evaluated.

Development of an all-metal thick film cost effective metallization system for solar cells

NASA Technical Reports Server (NTRS)

Ross, B.; Parker, J.

1983-01-01

Improved thick film solar cell contacts for the high volume production of low cost silicon solar arrays are needed. All metal screenable pastes made from economical base metals and suitable for application to low to high conductivity silicon were examined. Silver fluoride containing copper pastes and fluorocarbon containing copper pastes were discussed. The effect of hydrogen on the adhesion of metals to silicon was investigated. A cost analysis of various paste materials is provided.

7 CFR 4288.10 - Applicant eligibility.

Code of Federal Regulations, 2014 CFR

2014-01-01

... least minimum points for cost-effectiveness under § 4288.21(b)(1). (4) Percentage of reduction of fossil fuel use. The application must be awarded at least minimum points for percentage of reduction of fossil...

7 CFR 4288.10 - Applicant eligibility.

Code of Federal Regulations, 2013 CFR

2013-01-01

... least minimum points for cost-effectiveness under § 4288.21(b)(1). (4) Percentage of reduction of fossil fuel use. The application must be awarded at least minimum points for percentage of reduction of fossil...

7 CFR 4288.10 - Applicant eligibility.

Code of Federal Regulations, 2012 CFR

2012-01-01

... least minimum points for cost-effectiveness under § 4288.21(b)(1). (4) Percentage of reduction of fossil fuel use. The application must be awarded at least minimum points for percentage of reduction of fossil...

Nanoliposome encapsulated anesthetics for local anesthesia application.

PubMed

Vahabi, Sepideh; Eatemadi, Ali

2017-02-01

The systemic administration of opioids leads to potentially severe and undesirable and side effects like sedation and drowsiness, vomiting and nausea, allergies, respiratory depression, and neutrophil dysfunction. The application of nanotechnology in medical field has drawn a great attention in recent times. Several treatments available are tedious and expensive. Application of nanotechnology brings about faster cure and cost effectiveness. Nanoliposomes are one of the widely used names for nanoparticles used in medicine. Recently, nanoliposomes are used as a crucial novel drug delivery systems. The use of nanoliposomal formulation brings about a good results to pain control, rapid patient recovery, increased patient comfort, treatment costs reduction, and shortens length of hospitalization. This review presents a brief description about the achievements in the field of nanoscience and nanotechnology related to the application of nanoliposomes in anesthesia. Copyright © 2016. Published by Elsevier Masson SAS.

SES Multi-Purpose Ship Study. Transport Application. Volume 1. Technical Summary.

DTIC Science & Technology

1980-07-01

suitability for marine applications. Aluminum provides the lightest structure but the material cost is high, fabrication relatively difficult, the structure...and its application in Mili- tary Transportb and was prepared by the staff of the Navy’s Surface Effect Ship Acquisition Proje~~he study report...manu- facture of large surface effect craft, and a wealth of corporate knowledge and * expertise residing in the U.S. Navy Surface Effect Ships

Quantifying Friction Effects of Molybdenum Disulfide, Tungsten Disulfide, Hexagonal Boron Nitride, and Lubalox as Bullet Coating

DTIC Science & Technology

2012-07-30

is not cost effective for most applications . 15. SUBJECT TERMS armor penetration, brass, copper, full metal jacket, steel penetrator 16... applications . Introduction High barrel friction reduces the muzzle velocity of bullets that is important in maintaining long range trajectories...be effective in a variety of high-temperature and high-pressure applications .[2-4] However, the problem of reducing the force required to push a

Printing enzymatic reactions.

PubMed

Tian, Junfei; Shen, Wei

2011-02-07

We used relief and planographic printing methods to print the catalytic effect of an enzyme, but not the enzyme molecules, onto paper. Printing enzymatic reactions have applications in bioactive papers, low-cost diagnostics, anti-counterfeiting devices and advanced packaging materials. These methods can create novel printing effects on commodity surfaces for advanced applications.

Multimedia Instructional Tools' Impact on Student Motivation and Learning Strategies in Computer Applications Courses

ERIC Educational Resources Information Center

Chapman, Debra; Wang, Shuyan

2015-01-01

Multimedia instructional tools (MMIT) have been identified as a way effectively and economically present instructional material. MMITs are commonly used in introductory computer applications courses as MMITs should be effective in increasing student knowledge and positively impact motivation and learning strategies, without increasing costs. This…

Modeling the value for money of changing clinical practice change: a stochastic application in diabetes care.

PubMed

Hoomans, Ties; Abrams, Keith R; Ament, Andre J H A; Evers, Silvia M A A; Severens, Johan L

2009-10-01

Decision making about resource allocation for guideline implementation to change clinical practice is inevitably undertaken in a context of uncertainty surrounding the cost-effectiveness of both clinical guidelines and implementation strategies. Adopting a total net benefit approach, a model was recently developed to overcome problems with the use of combined ratio statistics when analyzing decision uncertainty. To demonstrate the stochastic application of the model for informing decision making about the adoption of an audit and feedback strategy for implementing a guideline recommending intensive blood glucose control in type 2 diabetes in primary care in the Netherlands. An integrated Bayesian approach to decision modeling and evidence synthesis is adopted, using Markov Chain Monte Carlo simulation in WinBUGs. Data on model parameters is gathered from various sources, with effectiveness of implementation being estimated using pooled, random-effects meta-analysis. Decision uncertainty is illustrated using cost-effectiveness acceptability curves and frontier. Decisions about whether to adopt intensified glycemic control and whether to adopt audit and feedback alter for the maximum values that decision makers are willing to pay for health gain. Through simultaneously incorporating uncertain economic evidence on both guidance and implementation strategy, the cost-effectiveness acceptability curves and cost-effectiveness acceptability frontier show an increase in decision uncertainty concerning guideline implementation. The stochastic application in diabetes care demonstrates that the model provides a simple and useful tool for quantifying and exploring the (combined) uncertainty associated with decision making about adopting guidelines and implementation strategies and, therefore, for informing decisions about efficient resource allocation to change clinical practice.

Can Economic Model Transparency Improve Provider Interpretation of Cost-effectiveness Analysis? Evaluating Tradeoffs Presented by the Second Panel on Cost-effectiveness in Health and Medicine.

PubMed

Padula, William V; McQueen, Robert Brett; Pronovost, Peter J

2017-11-01

The Second Panel on Cost-Effectiveness in Health and Medicine convened on December 7, 2016 at the National Academy of Medicine to disseminate their recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses (CEAs). Following its summary, panel proceedings included lengthy discussions including the field's struggle to disseminate findings efficiently through peer-reviewed literature to target audiences. With editors of several medical and outcomes research journals in attendance, there was consensus that findings of cost-effectiveness analyses do not effectively reach other researchers or health care providers. The audience members suggested several solutions including providing additional training to clinicians in cost-effectiveness research and requiring that cost-effectiveness models are made publicly available. However, there remains the questions of whether making economic modelers' work open-access through journals is fair under the defense that these models remain one's own intellectual property, or whether journals can properly manage the peer-review process specifically for cost-effectiveness analyses. In this article, we elaborate on these issues and provide some suggested solutions that may increase the dissemination and application of cost-effectiveness literature to reach its intended audiences and ultimately benefit the patient. Ultimately, it is our combined view as economic modelers and clinicians that cost-effectiveness results need to reach the clinician to improve the efficiency of medical practice, but that open-access models do not improve clinician access or interpretation of the economics of medicine.

Pharmacoeconomics and macular degeneration.

PubMed

Brown, Gary C; Brown, Melissa M; Brown, Heidi; Godshalk, Ashlee N

2007-05-01

To describe pharmacoeconomics and its relationship to drug interventions. Pharmacoeconomics is the branch of economics which applies cost-minimization, cost-benefit, cost-effectiveness and cost-utility analyses to compare the economics of different pharmaceutical products or to compare drug therapy to other treatments. Among the four instruments, cost-utility analysis is the most sophisticated, relevant and clinically applicable as it measures the value conferred by drugs for the monies expended. Value-based medicine incorporates cost-utility principles but with strict standardization of all input and output parameters to allow the comparability of analyses, unlike the current situation in the healthcare literature. Pharmacoeconomics is assuming an increasingly important role with regard to whether drugs are listed on the drug formulary of a country or province. It has been estimated that the application of standardized, value-based medicine drug analyses can save over 35% from a public healthcare insurer drug formulary while maintaining or improving patient care.

Design and cost drivers in 2-D braiding

NASA Technical Reports Server (NTRS)

Morales, Alberto

1993-01-01

Fundamentally, the braiding process is a highly efficient, low cost method for combining single yarns into circumferential shapes, as evidenced by the number of applications for continuous sleeving. However, this braiding approach cannot fully demonstrate that it can drastically reduce the cost of complex shape structural preforms. Factors such as part geometry, machine design and configuration, materials used, and operating parameters are described as key cost drivers and what is needed to minimize their effect on elevating the cost of structural braided preforms.

Hybrid fuel cell/diesel generation total energy system, part 2

NASA Astrophysics Data System (ADS)

Blazek, C. F.

1982-11-01

Meeting the Goldstone Deep Space Communications Complex (DGSCC) electrical and thermal requirements with the existing system was compared with using fuel cells. Fuel cell technology selection was based on a 1985 time frame for installation. The most cost-effective fuel feedstock for fuel cell application was identified. Fuels considered included diesel oil, natural gas, methanol and coal. These fuel feedstocks were considered not only on the cost and efficiency of the fuel conversion process, but also on complexity and integration of the fuel processor on system operation and thermal energy availability. After a review of fuel processor technology, catalytic steam reformer technology was selected based on the ease of integration and the economics of hydrogen production. The phosphoric acid fuel cell was selected for application at the GDSCC due to its commercial readiness for near term application. Fuel cell systems were analyzed for both natural gas and methanol feedstock. The subsequent economic analysis indicated that a natural gas fueled system was the most cost effective of the cases analyzed.

Hybrid fuel cell/diesel generation total energy system, part 2

NASA Technical Reports Server (NTRS)

Blazek, C. F.

1982-01-01

Meeting the Goldstone Deep Space Communications Complex (DGSCC) electrical and thermal requirements with the existing system was compared with using fuel cells. Fuel cell technology selection was based on a 1985 time frame for installation. The most cost-effective fuel feedstock for fuel cell application was identified. Fuels considered included diesel oil, natural gas, methanol and coal. These fuel feedstocks were considered not only on the cost and efficiency of the fuel conversion process, but also on complexity and integration of the fuel processor on system operation and thermal energy availability. After a review of fuel processor technology, catalytic steam reformer technology was selected based on the ease of integration and the economics of hydrogen production. The phosphoric acid fuel cell was selected for application at the GDSCC due to its commercial readiness for near term application. Fuel cell systems were analyzed for both natural gas and methanol feedstock. The subsequent economic analysis indicated that a natural gas fueled system was the most cost effective of the cases analyzed.

Cost-effective lightweight mirrors for aerospace and defense

NASA Astrophysics Data System (ADS)

Woodard, Kenneth S.; Comstock, Lovell E.; Wamboldt, Leonard; Roy, Brian P.

2015-05-01

The demand for high performance, lightweight mirrors was historically driven by aerospace and defense (A&D) but now we are also seeing similar requirements for commercial applications. These applications range from aerospace-like platforms such as small unmanned aircraft for agricultural, mineral and pollutant aerial mapping to an eye tracking gimbaled mirror for optometry offices. While aerospace and defense businesses can often justify the high cost of exotic, low density materials, commercial products rarely can. Also, to obtain high performance with low overall optical system weight, aspheric surfaces are often prescribed. This may drive the manufacturing process to diamond machining thus requiring the reflective side of the mirror to be a diamond machinable material. This paper summarizes the diamond machined finishing and coating of some high performance, lightweight designs using non-exotic substrates to achieve cost effective mirrors. The results indicate that these processes can meet typical aerospace and defense requirements but may also be competitive in some commercial applications.

Research of Influence Modification of Natural Concentrate on Quality Metal

NASA Astrophysics Data System (ADS)

Fedoseev, S. N.; Gizatulin, R. A.; Korotkova, E. A.

2016-08-01

Questions of increase of mechanical, technological and service properties of metal at minimum cost to produce it are relevant for the metallurgical enterprises. Modification of complex steel alloys containing reactive elements is one of the effective ways to improve the quality of steel. At the same time the direct costs for the use of modifiers are 0.2-0.3%, which little effect on the cost of production. The paper presents the results of the application of natural concentrates as a modifier steel. The effects on the metal quality changes due to the impact of the modification concentrates demonstrate the effectiveness of their application. As a result of modification decreased the content of nonmetallic inclusions and grain size. Reduction of impurity modified metal of was the cause more high plastic properties, especially, impact strength at ordinary and low temperatures of tests. Based on the experimental data evaluated hardening mechanisms that lead to a significant improvement of physic-mechanical properties of the metal workpiece after administration modifier.

Kodak Optical Disk and Microfilm Technologies Carve Niches in Specific Applications.

ERIC Educational Resources Information Center

Gallenberger, John; Batterton, John

1989-01-01

Describes the Eastman Kodak Company's microfilm and optical disk technologies and their applications. Topics discussed include WORM technology; retrieval needs and cost effective archival storage needs; engineering applications; jukeboxes; optical storage options; systems for use with mainframes and microcomputers; and possible future…

Activity-based costing and its application in a Turkish university hospital.

PubMed

Yereli, Ayşe Necef

2009-03-01

Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey. Copyright (c) AORN, Inc, 2009.

Review Article "Valuating the intangible effects of natural hazards - review and analysis of the costing methods"

NASA Astrophysics Data System (ADS)

Markantonis, V.; Meyer, V.; Schwarze, R.

2012-05-01

The "intangible" or "non-market" effects are those costs of natural hazards which are not, or at least not easily measurable in monetary terms, as for example, impacts on health, cultural heritage or the environment. The intangible effects are often not included in costs assessments of natural hazards leading to an incomplete and biased cost assessment. However, several methods exist which try to estimate these effects in a non-monetary or monetary form. The objective of the present paper is to review and evaluate methods for estimating the intangible effects of natural hazards, specifically related to health and environmental effects. Existing methods are analyzed and compared using various criteria, research gaps are identified, application recommendations are provided, and valuation issues that should be addressed by the scientific community are highlighted.

RFID in the healthcare supply chain: usage and application.

PubMed

Kumar, Sameer; Swanson, Eric; Tran, Thuy

2009-01-01

The purposes of this study are to first, determine the most efficient and cost effective portions of the healthcare supply chain in which radio frequency identification devices (RFID) can be implemented. Second, provide specific examples of RFID implementation and show how these business applications will add to the effectiveness of the healthcare supply chain. And third, to describe the current state of RFID technology and to give practical information for managers in the healthcare sector to make sound decisions about the possible implementation of RFID technology within their organizations. Healthcare industry literature was reviewed and examples of specific instances of RFID implementation were examined using an integrated simulation model developed with Excel, @Risk and Visio software tools. Analysis showed that the cost of implementing current RFID technology is too expensive for broad and sweeping implementation within the healthcare sector at this time. However, several example applications have been identified in which this technology can be effectively leveraged in a cost-effective way. This study shows that RFID technology has come a long way in the recent past and has potential to improve healthcare sector productivity and efficiency. Implementation by large companies such as Wal-mart has helped to make the technology become much more economical in its per unit cost as well as its supporting equipment and training costs. The originality of this study lies in the idea that few practical and pragmatic approaches have been taken within the academic field of study for the implementation of RFID into the healthcare supply chain. Much of the research has focused on specific companies or portions of the supply chain and not the entire supply chain. Also, many of the papers have discussed the future of the supply chain that is heavily dependent on advances in RFID technology. A few viable applications of how RFID technology can be implemented in the healthcare supply chain are presented and how the current state of technology limits the broad use and implementation of this technology in the healthcare industry.

[Cost-effectiveness of public health practices: a literature review of public health interventions from the Mesoamerican Health Initiative].

PubMed

Valencia-Mendoza, Atanacio; Danese-dlSantos, Laura G; Sosa-Rubí, Sandra G; Aracena-Genao, Belkis

2011-01-01

Present and analyze cost-effectiveness information of public health interventions proposed by the Mesoamerican Health Initiative in child nutrition, vaccination, malaria, dengue, and maternal, neonatal, and reproductive health. A systematic literature review was conducted on cost-effectiveness studies published between January 2000 and August 2009 on interventions related to the health areas previously mentioned. Studies were included if they measured effectiveness in terms of Disability-Adjusted Life Year (DALY) or death averted. Child nutrition and maternal and neonatal health interventions were found to be highly cost-effective (most of them below US$200 per DALY averted for nutritional interventions and US$100 for maternal and neonatal health). For dengue, information on cost-effectiveness was found just for application of larvicides, which resulted in a cost per DALY averted ranking from US$40.79 to US$345.06. Malarial interventions were found to be cost-effective (below US$150 per DALY averted or US$4,000 per death averted within Africa). In the case of pneumococcus and rotavirus vaccination, cost-effectiveness estimates were always above one GDP per capita per DALY averted. In Mesoamerica there are still important challenges in child nutrition, vaccination, malaria, dengue and maternal, neonatal, and reproductive health, challenges that could be addressed by scaling-up technically feasible and cost-effective interventions.

Applied Virtual Reality in Reusable Launch Vehicle Design, Operations Development, and Training

NASA Technical Reports Server (NTRS)

Hale, Joseph P.

1997-01-01

Application of Virtual Reality (VR) technology offers much promise to enhance and accelerate the development of Reusable Launch Vehicle (RLV) infrastructure and operations while simultaneously reducing developmental and operational costs. One of the primary cost areas in the RLV concept that is receiving special attention is maintenance and refurbishment operations. To produce and operate a cost effective RLV, turnaround cost must be minimized. Designing for maintainability is a necessary requirement in developing RLVs. VR can provide cost effective methods to design and evaluate components and systems for maintenance and refurbishment operations. The National Aeronautics and Space Administration (NASA)/Marshall Space Flight Center (MSFC) is beginning to utilize VR for design, operations development, and design analysis for RLVs. A VR applications program has been under development at NASA/MSFC since 1989. The objectives of the MSFC VR Applications Program are to develop, assess, validate, and utilize VR in hardware development, operations development and support, mission operations training and science training. The NASA/MSFC VR capability has also been utilized in several applications. These include: 1) the assessment of the design of the late Space Station Freedom Payload Control Area (PCA), the control room from which onboard payload operations are managed; 2) a viewing analysis of the Tethered Satellite System's (TSS) "end-of-reel" tether marking options; 3) development of a virtual mockup of the International Space Welding Experiment for science viewing analyses from the Shuttle Remote Manipulator System elbow camera and as a trainer for ground controllers; and 4) teleoperations using VR. This presentation will give a general overview of the MSFC VR Applications Program and describe the use of VR in design analyses, operations development, and training for RLVs.

7 CFR 1944.254 - Program costs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE... supplies (including food) necessary to provide services; (iv) Operational costs of a transportation service... development of the application and plan of operations before the effective date of CHSP grant award; (vi...

Recent field studies on the use of Bacillus thuringiensis to control the gypsy moth (Lymantria dispar L.)

Treesearch

Normand R. Dubois

1985-01-01

Efforts to improve the effective use of B. thuringiensis and reduce its application costs has stimulated the development of higher potency formulation. Recent field studies have shown that a single application at 30 BIU/ha (12 BIU/acre) is as effective as the split double application of 20 BIU/ha (8 BIU/acre) formerly recommended. Also results of...

Development and application of a probabilistic method for wildfire suppression cost modeling

Treesearch

Matthew P. Thompson; Jessica R. Haas; Mark A. Finney; David E. Calkin; Michael S. Hand; Mark J. Browne; Martin Halek; Karen C. Short; Isaac C. Grenfell

2015-01-01

Wildfire activity and escalating suppression costs continue to threaten the financial health of federal land management agencies. In order to minimize and effectively manage the cost of financial risk, agencies need the ability to quantify that risk. A fundamental aim of this research effort, therefore, is to develop a process for generating risk-based metrics for...

Timing of Bag Application and Removal in Controlled Mass Pollination

Treesearch

F.E. Bridgwater; D.L. Bramlett; V.D. Hipkins

1999-01-01

Controlled mass pollination (CMP) among outstanding parents is one way to increase genetic gains from traditional wind-pollinated seed orchards, but the economic success of CMP depends on both genetic gains and costs. CMP has been shown. to be cost-effective (Bridgwater et al. 1998) even when costs were adjusted for risk (Byram and Bridgwater 1999, These Proceedings...

Value Engineering. "A Working Tool for Cost Control in the Design of Educational Facilities."

ERIC Educational Resources Information Center

Lawrence, Jerry

Value Engineering (VE) is a cost optimizing technique used to analyze design quality and cost-effectiveness. The application of VE procedures to the design and construction of school facilities has been adopted by the state of Washington. By using VE, the optimum value for every life cycle dollar spent on a facility is obtained by identifying not…

Prevention of gram-positive infections in peritoneal dialysis patients in Hong Kong: a cost-effectiveness analysis.

PubMed

Wong, Carlos; Luk, In-Wa; Ip, Margaret; You, Joyce H S

2014-04-01

Gram-positive bacteria are the major causative pathogens of peritonitis and exit site infection in patients undergoing peritoneal dialysis (PD). We investigated the cost-effectiveness of regular application of mupirocin at the exit site in PD recipients from the perspective of health care providers in Hong Kong. A decision tree was designed to simulate outcomes of incident PD patients with and without regular application of mupirocin over a 1-year period. Outcome measures included total direct medical costs, quality-adjusted life-years (QALYs) gained, and gram-positive infection-related mortality rate. Model inputs were derived from the literature. Sensitivity analyses evaluated the impact of uncertainty in all model variables. In a base case analysis, the mupirocin group had a higher expected QALY value (0.6496 vs 0.6456), a lower infection-related mortality rate (0.18% vs 1.64%), and a lower total cost per patient (US $258 vs $1661) compared with the control group. The rate of gram-positive peritonitis without mupirocin and the risk of gram-positive peritonitis with mupirocin were influential factors. In 10,000 Monte Carlo simulations, the mupirocin group had significantly lower associated costs, higher QALYs, and a lower mortality rate 99.9% of the time. Topical mupirocin appears to be a cost-effective preventive measure against gram-positive infection in incident patients undergoing PD. The cost-effectiveness of mupirocin is affected by the level of infection risk reduction and subject to resistance against mupirocin. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Cost-Effectiveness Analysis of Morcellation Hysterectomy for Myomas.

PubMed

Bortoletto, Pietro; Einerson, Brett D; Miller, Emily S; Milad, Magdy P

2015-01-01

To estimate the cost-effectiveness of eliminating morcellation in the surgical treatment of leiomyomas from a societal perspective. Cost-effectiveness analysis. Not applicable. A theoretical cohort of women undergoing hysterectomy for myoma disease large enough to require morcellation. None. None. A decision analysis model was constructed using probabilities, costs, and utility data from published sources. A cost-effectiveness analysis analyzing both quality-adjusted life years (QALYs) and cases of disseminated cancer was performed to determine the incremental cost-effectiveness ratio (ICER) of eliminating morcellation as a tool in the surgical treatment of leiomyomas. Costs and utilities were discounted using standard methodology. The base case included health care system costs and costs incurred by the patient for surgery-related disability. One-way sensitivity analyses were performed to assess the effect of various assumptions. The cost to prevent 1 case of disseminated cancer was $10 540 832. A strategy of nonmorcellation hysterectomy via laparotomy costed more ($30 359.92 vs $20 853.15) and yielded more QALYs (21.284 vs 21.280) relative to morcellation hysterectomy. The ICER for nonmorcellation hysterectomy compared with morcellation hysterectomy was $2 184 172 per QALY. Health care costs (prolonged hospitalizations) and costs to patients of prolonged time away from work were the primary drivers of cost differential between the 2 strategies. Even when the incidence of occult sarcoma in leiomyoma surgery was ranged to twice that reported in the literature (.98%), the ICER for nonmorcellation hysterectomy was $644 393.30. Eliminating morcellation hysterectomy as a treatment for myomas is not cost-effective under a wide variety of probability and cost assumptions. Performing laparotomy for all patients who might otherwise be candidates for morcellation hysterectomy is a costly policy from a societal perspective. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Assessing the impact of manure application method on runoff phosphorus using controlled and natural rainfall

USDA-ARS?s Scientific Manuscript database

Land application of manure is a cost-effective method for recycling nutrients from livestock operations. Increasingly, there has been interest in promoting alternative methods of manure application that minimize nonpoint source phosphorus pollution. Watershed and nutrient trading programs rely upon ...

Cost-effectiveness models for dental caries prevention programmes among Chilean schoolchildren.

PubMed

Mariño, R; Fajardo, J; Morgan, M

2012-12-01

This study aims to estimate the cost-effectiveness from a societal perspective of seven dental caries prevention programmes among schoolchildren in Chile: three community-based programmes: water-fluoridation, salt-fluoridation and dental sealants; and four school-based programmes: milk-fluoridation; fluoridated mouthrinses (FMR); APF-Gel, and supervised toothbrushing with fluoride toothpaste. Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating each programme, using a societal perspective, were identified and estimated. The comparator was non-intervention. Health outcomes were measured as dental caries averted over a 6-year period. Costs were estimated as direct treatment costs, programmes costs and costs of productivity losses as a result of each dental caries prevention programme. Incremental cost-effectiveness ratios were calculated for each programme. Sensitivity analyses were conducted over key parameters. Primary cost-effectiveness analysis (discounted) indicated that four programmes showed net social savings by the DMFT averted. These savings encompassed a range of values per diseased tooth averted; US$16.21 (salt-fluoridation), US$14.89 (community water fluoridation); US$14.78 (milk fluoridation); and US$8.63 (FMR). Individual programmes using an APF-Gel application, dental sealants, and supervised tooth brushing using fluoridated toothpaste, represent costs for the society per diseased tooth averted of US$21.30, US$11.56 and US$8.55, respectively. Based on cost required to prevent one carious tooth among schoolchildren, salt fluoridation was the most cost-effective, with APF-Gel ranking as least cost-effective. Findings confirm that most community/school-based dental caries interventions are cost-effective uses of society's financial resources. The models used are conservative and likely to underestimate the real benefits of each intervention.

Cost-effectiveness analysis of telemedical devices for pre-clinical traffic accident emergency rescue in Germany.

PubMed

Auerbach, H; Schreyögg, J; Busse, R

2006-01-01

The purpose of this study is to assess the cost-effectiveness (net costs per life year gained) of telemedical devices for pre-clinical traffic accident emergency rescue in Germany. Two equipment versions of a telemedical device are compared from a societal perspective with the baseline in Germany, i.e. the non-application of telemedicine in emergency rescues. The analysis is based on retrospective statistical data covering a period of 10 years with discounted costs not adjusted for inflation. Due to the uncertainty of data, certain assumptions and estimates were necessary. The outcome is measured in terms of "life years gained" by reducing therapy-free intervals and improvements in first-aid provided by laypersons. The introduction of the basic equipment version, "Automatic Accident Alert", is associated with net costs per life year gained of euro 247,977 (at baseline assumptions). The full equipment version of the telemedical device would lead to estimated net costs of euro 239,524 per life year gained. Multi-way sensitivity-analysis with best and worst case scenarios suggests that decreasing system costs would disproportionately reduce total costs, and that rapid market penetration would largely increase the system's benefit, while simultaneously reducing costs. The net costs per life year gained in the application of the two versions of the telemedical device for pre-clinical emergency rescue of traffic accidents are estimated as quite high. However, the implementation of the device as part of a larger European co-ordinated initiative is more realistic.

Chesapeake Bay nutrient pollution: contribution from the land application of sewage sludge in Virginia.

PubMed

Land, Lynton S

2012-11-01

Human health concerns and the dissemination of anthropogenic substances with unknown consequences are the reasons most often given why disposal of municipal sewage sludge in landfills or using the organic waste as biofuel is preferable to land application. But no "fertilizer" causes more nitrogen pollution than sludge when applied according to Virginia law. Poultry litter is the only other "fertilizer" that causes more phosphorus pollution than sludge. Cost savings by the few farmers in Virginia who use sludge are far less than the costs of the nitrogen pollution they cause. A ban on the land application of all forms of animal waste is very cost-effective and would reduce Chesapeake Bay nutrient pollution by 25%. Copyright © 2012 Elsevier Ltd. All rights reserved.

Integrated orbital servicing and payloads study. Volume 2: Technical and cost analysis

NASA Technical Reports Server (NTRS)

1975-01-01

The details and background used in the investigation of orbital servicing and payloads are presented. Topics discussed include review of previous models, application of servicing to communications satellites, assessment of spacecraft servicing, cost of servicing, and launch vehicle effects on spacecraft.

The costs of nurse turnover: part 1: an economic perspective.

PubMed

Jones, Cheryl Bland

2004-12-01

Nurse turnover is costly for healthcare organizations. Administrators and nurse executives need a reliable estimate of nurse turnover costs and the origins of those costs if they are to develop effective measures of reducing nurse turnover and its costs. However, determining how to best capture and quantify nurse turnover costs can be challenging. Part 1 of this series conceptualizes nurse turnover via human capital theory and presents an update of a previously developed method for determining the costs of nurse turnover, the Nursing Turnover Cost Calculation Method. Part 2 (January 2005) presents a recent application of the methodology in an acute care hospital.

Economics of internal and external energy storage in solar power plant operation

NASA Technical Reports Server (NTRS)

Manvi, R.; Fujita, T.

1977-01-01

A simple approach is formulated to investigate the effect of energy storage on the bus-bar electrical energy cost of solar thermal power plants. Economic analysis based on this approach does not require detailed definition of a specific storage system. A wide spectrum of storage system candidates ranging from hot water to superconducting magnets can be studied based on total investment and a rough knowledge of energy in and out efficiencies. Preliminary analysis indicates that internal energy storage (thermal) schemes offer better opportunities for energy cost reduction than external energy storage (nonthermal) schemes for solar applications. Based on data and assumptions used in JPL evaluation studies, differential energy costs due to storage are presented for a 100 MWe solar power plant by varying the energy capacity. The simple approach presented in this paper provides useful insight regarding the operation of energy storage in solar power plant applications, while also indicating a range of design parameters where storage can be cost effective.

Resin transfer molding of textile preforms for aircraft structural applications

NASA Technical Reports Server (NTRS)

Hasko, Gregory H.; Dexter, H. Benson; Weideman, Mark H.

1992-01-01

The NASA LaRC is conducting and supporting research to develop cost-effective fabrication methods that are applicable to primary composite aircraft structures. One of the most promising fabrication methods that has evolved is resin transfer molding (RTM) of dry textile material forms. RTM has been used for many years for secondary structures, but has received increased emphasis because it is an excellent method for applying resin to damage-tolerant textile preforms at low cost. Textile preforms based on processes such as weaving, braiding, knitting, stitching, and combinations of these have been shown to offer significant improvements in damage tolerance compared to laminated tape composites. The use of low-cost resins combined with textile preforms could provide a major breakthrough in achieving cost-effective composite aircraft structures. RTM uses resin in its lowest cost form, and storage and spoilage costs are minimal. Near net shape textile preforms are expected to be cost-effective because automated machines can be used to produce the preforms, post-cure operations such as machining and fastening are minimized, and material scrap rate may be reduced in comparison with traditional prepreg molding. The purpose of this paper is to discuss experimental and analytical techniques that are under development at NASA Langley to aid the engineer in developing RTM processes for airframe structural elements. Included are experimental techniques to characterize preform and resin behavior and analytical methods that were developed to predict resin flow and cure kinetics.

Impact: a low cost, reconfigurable, digital beamforming common module building block for next generation phased arrays

NASA Astrophysics Data System (ADS)

Paulsen, Lee; Hoffmann, Ted; Fulton, Caleb; Yeary, Mark; Saunders, Austin; Thompson, Dan; Chen, Bill; Guo, Alex; Murmann, Boris

2015-05-01

Phased array systems offer numerous advantages to the modern warfighter in multiple application spaces, including Radar, Electronic Warfare, Signals Intelligence, and Communications. However, a lack of commonality in the underlying technology base for DoD Phased Arrays has led to static systems with long development cycles, slow technology refreshes in response to emerging threats, and expensive, application-specific sub-components. The IMPACT module (Integrated Multi-use Phased Array Common Tile) is a multi-channel, reconfigurable, cost-effective beamformer that provides a common building block for multiple, disparate array applications.

Randomized evaluation of a web based interview process for urology resident selection.

PubMed

Shah, Satyan K; Arora, Sanjeev; Skipper, Betty; Kalishman, Summers; Timm, T Craig; Smith, Anthony Y

2012-04-01

We determined whether a web based interview process for resident selection could effectively replace the traditional on-site interview. For the 2010 to 2011 match cycle, applicants to the University of New Mexico urology residency program were randomized to participate in a web based interview process via Skype or a traditional on-site interview process. Both methods included interviews with the faculty, a tour of facilities and the opportunity to ask current residents any questions. To maintain fairness the applicants were then reinterviewed via the opposite process several weeks later. We assessed comparative effectiveness, cost, convenience and satisfaction using anonymous surveys largely scored on a 5-point Likert scale. Of 39 total participants (33 applicants and 6 faculty) 95% completed the surveys. The web based interview was less costly to applicants (mean $171 vs $364, p=0.05) and required less time away from school (10% missing 1 or more days vs 30%, p=0.04) compared to traditional on-site interview. However, applicants perceived the web based interview process as less effective than traditional on-site interview, with a mean 6-item summative effectiveness score of 21.3 vs 25.6 (p=0.003). Applicants and faculty favored continuing the web based interview process in the future as an adjunct to on-site interviews. Residency interviews can be successfully conducted via the Internet. The web based interview process reduced costs and improved convenience. The findings of this study support the use of videoconferencing as an adjunct to traditional interview methods rather than as a replacement. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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

Green, William; Xiong, Chi; Khater, Marwan

Due to the high radiative forcing of methane, fugitive natural gas leaks pose a significant challenge to the near-term environmental viability of oil and gas extraction. Reducing the subsequent environmental impact requires cost-effective sensor nodes for reliable, rapid, and continuous identification of extraneous methane emissions. The efficacy of laser spectroscopy has been widely demonstrated in both environmental and medical applications due to its sensitivity and specificity to the target analyte. However, the present cost and the lack of manufacturing scalability of free-space optical systems can limit their viability for economical wide-area sensor networks in localized leak detection applications. In thismore » paper, we will review the development and performance of a cost-effective silicon photonic sensing platform. This platform uses silicon photonic waveguide and packaging integration technologies to enable on-chip evanescent field spectroscopy of methane.« less

Integrated Optical Circuit Engineering For Optical Fiber Gyrocopes

NASA Astrophysics Data System (ADS)

Bristow, Julian P.; We, Albert C.; Keur, M.; Lukas, Greg; Ott, Daniel M...; Sriram, S.

1988-03-01

Fiber optic gyroscopes are of interest for low-cost, high performance rotation sensors. Integrated optical implementations of the processing optics offer the hope of mass-production, and associated cost reductions. The development of a suitable integrated optical system has been reported by other authors at a wavelength of 850nm [1]. Despite strong technical advantages at 1.3μm wavelength [2], no results have yet appeared. This wavelength is preferred for telecommunications applications applications, thus significantly reduced fiber costs may be realized. Lithium niobate is relatively immune from the photorefractive effect at this wavelength, whereas it is not at at 850nm [3].

Using skype as an alternative for residency selection interviews.

PubMed

Edje, Louito; Miller, Christine; Kiefer, Jacklyn; Oram, David

2013-09-01

Residency interviews can place significant time and financial burdens on applicants. To determine whether the use of Skype as a screening tool during interview season in a family medicine residency is cost-effective and time-efficient for the applicant and the residency program. We surveyed 2 groups of medical students during interviews for our family medicine program. Thirty-two students were interviewed via our face-to-face, traditional interview (TI) process, and 10 students, the second group, who did not meet the program's standard interview selection criteria for TI, underwent our Skype interview (SI) process. Using an unpaired t test, we found that the applicants' costs of an SI were significantly less than a TI, $566 (95% confidence interval [CI] $784-$349, P < .001). Direct cash savings plus indirect salary savings to the program were $5,864, with a time savings of 7 interview days. Three of the applicants who were participants in the SI limb of the study were in our final rank order list. For interviewing in family medicine residencies, use of Skype may be a cost-effective and time-efficient screening tool for both the applicant and the program. Alternate uses of SI may include the time-sensitive, postmatch Supplemental Offer and Acceptance Program.

Using Skype as an Alternative for Residency Selection Interviews

PubMed Central

Edje, Louito; Miller, Christine; Kiefer, Jacklyn; Oram, David

2013-01-01

Background Residency interviews can place significant time and financial burdens on applicants. Objective To determine whether the use of Skype as a screening tool during interview season in a family medicine residency is cost-effective and time-efficient for the applicant and the residency program. Methods We surveyed 2 groups of medical students during interviews for our family medicine program. Thirty-two students were interviewed via our face-to-face, traditional interview (TI) process, and 10 students, the second group, who did not meet the program's standard interview selection criteria for TI, underwent our Skype interview (SI) process. Results Using an unpaired t test, we found that the applicants' costs of an SI were significantly less than a TI, $566 (95% confidence interval [CI] $784–$349, P < .001). Direct cash savings plus indirect salary savings to the program were $5,864, with a time savings of 7 interview days. Three of the applicants who were participants in the SI limb of the study were in our final rank order list. Conclusions For interviewing in family medicine residencies, use of Skype may be a cost-effective and time-efficient screening tool for both the applicant and the program. Alternate uses of SI may include the time-sensitive, postmatch Supplemental Offer and Acceptance Program. PMID:24404318

Application of Boosting Regression Trees to Preliminary Cost Estimation in Building Construction Projects

PubMed Central

2015-01-01

Among the recent data mining techniques available, the boosting approach has attracted a great deal of attention because of its effective learning algorithm and strong boundaries in terms of its generalization performance. However, the boosting approach has yet to be used in regression problems within the construction domain, including cost estimations, but has been actively utilized in other domains. Therefore, a boosting regression tree (BRT) is applied to cost estimations at the early stage of a construction project to examine the applicability of the boosting approach to a regression problem within the construction domain. To evaluate the performance of the BRT model, its performance was compared with that of a neural network (NN) model, which has been proven to have a high performance in cost estimation domains. The BRT model has shown results similar to those of NN model using 234 actual cost datasets of a building construction project. In addition, the BRT model can provide additional information such as the importance plot and structure model, which can support estimators in comprehending the decision making process. Consequently, the boosting approach has potential applicability in preliminary cost estimations in a building construction project. PMID:26339227

Application of Boosting Regression Trees to Preliminary Cost Estimation in Building Construction Projects.

PubMed

Shin, Yoonseok

2015-01-01

Among the recent data mining techniques available, the boosting approach has attracted a great deal of attention because of its effective learning algorithm and strong boundaries in terms of its generalization performance. However, the boosting approach has yet to be used in regression problems within the construction domain, including cost estimations, but has been actively utilized in other domains. Therefore, a boosting regression tree (BRT) is applied to cost estimations at the early stage of a construction project to examine the applicability of the boosting approach to a regression problem within the construction domain. To evaluate the performance of the BRT model, its performance was compared with that of a neural network (NN) model, which has been proven to have a high performance in cost estimation domains. The BRT model has shown results similar to those of NN model using 234 actual cost datasets of a building construction project. In addition, the BRT model can provide additional information such as the importance plot and structure model, which can support estimators in comprehending the decision making process. Consequently, the boosting approach has potential applicability in preliminary cost estimations in a building construction project.

Is Military Advertising Effective? An Estimation Methodology and Applications to Recruiting in the 1980’s and 90s

DTIC Science & Technology

2003-01-01

This report documents research findings from a RAND project titled The Relative Cost Effectiveness of Military Advertising , the goal of which was to...develop and apply a methodology for assessing the cost effectiveness of the services’ advertising programs and to provide guidance for a more...examines issues related to the effectiveness of recruiting advertising during the 1980s and 1990s. It describes the policy context, summarizes the current

Microcomputer-Based Organizational Survey Assessment: Applications to Training.

DTIC Science & Technology

1987-08-01

organizations, a growing need for efficient, flexible and cost effective training programs becomes paramount. To cope with these increased training demands, many...and cost effective training programs becomes paramount. To cnpe with these increased training demands, many orga- nizations have turned to Computer...organizational setings the need for better training will .,, For continue to increase (Wexley & Latham, 1981). Recent surveys of the literature document

Some like it hot, some like it cold: Temperature dependent biotechnological applications and improvements in extremophilic enzymes.

PubMed

Siddiqui, Khawar Sohail

2015-12-01

The full biotechnological exploitation of enzymes is still hampered by their low activity, low stability and high cost. Temperature-dependent catalytic properties of enzymes are a key to efficient and cost-effective translation to commercial applications. Organisms adapted to temperature extremes are a rich source of enzymes with broad ranging thermal properties which, if isolated, characterized and their structure-function-stability relationship elucidated, could underpin a variety of technologies. Enzymes from thermally-adapted organisms such as psychrophiles (low-temperature) and thermophiles (high-temperature) are a vast natural resource that is already under scrutiny for their biotechnological potential. However, psychrophilic and thermophilic enzymes show an activity-stability trade-off that necessitates the use of various genetic and chemical modifications to further improve their properties to suit various industrial applications. This review describes in detail the properties and biotechnological applications of both cold-adapted and thermophilic enzymes. Furthermore, the review critically examines ways to improve their value for biotechnology, concluding by proposing an integrated approach involving thermally-adapted, genetically and magnetically modified enzymes to make biocatalysis more efficient and cost-effective. Copyright © 2015 Elsevier Inc. All rights reserved.

The effect of poultry manure application rate and AlCl3 treatment on bacterial fecal indicators in runoff

USDA-ARS?s Scientific Manuscript database

The land application of poultry litter was once considered to be the disposal of a ‘waste’ byproduct of the poultry industry, however, now due to increasing costs associated with inorganic fertilizer the application of this residual is becoming more desirable. Proper land application is paramount t...

Preventing recurrent ankle sprains: Is the use of an App more cost-effective than a printed Booklet? Results of a RCT.

PubMed

Van Reijen, M; Vriend, I; van Mechelen, W; Verhagen, E A

2018-02-01

Recurrent ankle sprains can be reduced by following a neuromuscular training (NMT) program via a printed Booklet or a mobile application. Regarding the high incidence of ankle sprains, cost-effectiveness regarding implementation can have a large effect on total societal costs. In this economic analysis, we evaluated whether the method of implementing a proven effective NMT program using an App or a Booklet resulted in differences in injury incidence rates leading to costs and hence to differences in cost-effectiveness. In total, 220 athletes with a previous ankle sprain were recruited for this randomized controlled trial with a follow-up of 12 months. Half of the athletes used the freely available "Strengthen your ankle" App and the other half received a printed Booklet. After the 8-week program, athletes were questioned monthly on their recurrent injuries. Primary outcome measures were incidence density of ankle injury and incremental cost-effectiveness ratio (ICER). During follow-up, 31 athletes suffered from a recurrent ankle sprain that led to costs resulting in a hazard ratio of 1.13 (95% CI: 0.56-2.27). The incremental cost-effectiveness ratio of the App group in comparison with the Booklet group was €361.52. The CE plane shows that there was neither a difference in effects nor in costs between both intervention methods. This study showed that the method of implementing the NMT program using an App or a Booklet led to similar cost-effectiveness ratios and the same occurrence of recurrent injuries leading to costs. Both the App and the Booklet can be used to prevent recurrent ankle injuries, showing no differences in (cost-) effectiveness at 12-month follow-up. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Case Study on the Application of a Structured Experimental Method for Optimal Parameter Design of a Complex Control System

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2015-01-01

This report documents a case study on the application of Reliability Engineering techniques to achieve an optimal balance between performance and robustness by tuning the functional parameters of a complex non-linear control system. For complex systems with intricate and non-linear patterns of interaction between system components, analytical derivation of a mathematical model of system performance and robustness in terms of functional parameters may not be feasible or cost-effective. The demonstrated approach is simple, structured, effective, repeatable, and cost and time efficient. This general approach is suitable for a wide range of systems.

Long life, low cost, rechargeable AgZn battery for non-military applications

NASA Astrophysics Data System (ADS)

Brown, Curtis C.

1996-03-01

Of the rechargeable (secondary) battery systems with mature technology, the silver oxide-zinc system (AgZn) safely offers the highest power and energy (watts and watt hours) per unit of volume and mass. As a result they have long been used for aerospace and defense applications where they have also proven their high reliability. In the past, the expense associated with the cost of silver and the resulting low production volume have limited their commercial application. However, the relative low cost of silver now make this system feasible in many applications where high energy and reliability are required. One area of commercial potential is power for a new generation of sophisticated, portable medical equipment. AgZn batteries have recently proven ``enabling technology'' for power critical, advanced medical devices. By extending the cycle calendar life to the system (offers both improved performance and lower operating cost), a combination is achieved which may enable a wide range of future electrical devices. Other areas where AgZn batteries have been used in nonmilitary applications to provide power to aid in the development of commercial equipment have been: (a) Electrically powered vehicles; (b) Remote sensing in nuclear facilities; (c) Special effects equipment for movies; (d) Remote sensing in petroleum pipe lines; (e) Portable computers; (f) Fly by wire systems for commercial aircraft; and (g) Robotics. However none of these applications have progressed to the level where the volume required will significantly lower cost.

10 CFR 600.162 - Enforcement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the funding period in which the termination takes effect. (d) Relationship to debarment and suspension... applicable to the action involved. (c) Effects of suspension and termination. Costs of a recipient resulting...

10 CFR 600.243 - Enforcement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of the funding period in which the termination takes effect. (d) Relationship to debarment and... applicable to the action involved. (c) Effects of suspension and termination. Costs of grantee or subgrantee...

44 CFR 13.43 - Enforcement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of the funding period in which the termination takes effect. (d) Relationship to Debarment and... applicable to the action involved. (c) Effects of suspension and termination. Costs of grantee or subgrantee...

10 CFR 600.162 - Enforcement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the funding period in which the termination takes effect. (d) Relationship to debarment and suspension... applicable to the action involved. (c) Effects of suspension and termination. Costs of a recipient resulting...

10 CFR 600.243 - Enforcement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of the funding period in which the termination takes effect. (d) Relationship to debarment and... applicable to the action involved. (c) Effects of suspension and termination. Costs of grantee or subgrantee...

44 CFR 13.43 - Enforcement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of the funding period in which the termination takes effect. (d) Relationship to Debarment and... applicable to the action involved. (c) Effects of suspension and termination. Costs of grantee or subgrantee...

Personalized treatment of women with early breast cancer: a risk-group specific cost-effectiveness analysis of adjuvant chemotherapy accounting for companion prognostic tests OncotypeDX and Adjuvant!Online.

PubMed

Jahn, Beate; Rochau, Ursula; Kurzthaler, Christina; Hubalek, Michael; Miksad, Rebecca; Sroczynski, Gaby; Paulden, Mike; Bundo, Marvin; Stenehjem, David; Brixner, Diana; Krahn, Murray; Siebert, Uwe

2017-10-16

Due to high survival rates and the relatively small benefit of adjuvant therapy, the application of personalized medicine (PM) through risk stratification is particularly beneficial in early breast cancer (BC) to avoid unnecessary harms from treatment. The new 21-gene assay (OncotypeDX, ODX) is a promising prognostic score for risk stratification that can be applied in conjunction with Adjuvant!Online (AO) to guide personalized chemotherapy decisions for early BC patients. Our goal was to evaluate risk-group specific cost effectiveness of adjuvant chemotherapy for women with early stage BC in Austria based on AO and ODX risk stratification. A previously validated discrete event simulation model was applied to a hypothetical cohort of 50-year-old women over a lifetime horizon. We simulated twelve risk groups derived from the joint application of ODX and AO and included respective additional costs. The primary outcomes of interest were life-years gained, quality-adjusted life-years (QALYs), costs and incremental cost-effectiveness (ICER). The robustness of results and decisions derived were tested in sensitivity analyses. A cross-country comparison of results was performed. Chemotherapy is dominated (i.e., less effective and more costly) for patients with 1) low ODX risk independent of AO classification; and 2) low AO risk and intermediate ODX risk. For patients with an intermediate or high AO risk and an intermediate or high ODX risk, the ICER is below 15,000 EUR/QALY (potentially cost effective depending on the willingness-to-pay). Applying the AO risk classification alone would miss risk groups where chemotherapy is dominated and thus should not be considered. These results are sensitive to changes in the probabilities of distant recurrence but not to changes in the costs of chemotherapy or the ODX test. Based on our modeling study, chemotherapy is effective and cost effective for Austrian patients with an intermediate or high AO risk and an intermediate or high ODX risk. In other words, low ODX risk suggests chemotherapy should not be considered but low AO risk may benefit from chemotherapy if ODX risk is high. Our analysis suggests that risk-group specific cost-effectiveness analysis, which includes companion prognostic tests are essential in PM.

[Economic evaluation and rationale for human health risk management decisions].

PubMed

Fokin, S G; Bobkova, T E

2011-01-01

The priority task of human health maintenance and improvement is risk management using the new economic concepts based on the assessment of potential and real human risks from exposure to poor environmental factors and on the estimation of cost-benefit and cost-effectiveness ratios. The application of economic tools to manage a human risk makes it possible to assess various measures both as a whole and their individual priority areas, to rank different scenarios in terms of their effectiveness, to estimate costs per unit of risk reduction and benefit increase (damage decrease).

Investigation of Low Cost Sensor-Based Leak Detection System for Fence Line Applications

EPA Science Inventory

With recent technological advances, low-cost time-resolved sensors may become effective tools to support time-integrated passive sampling strategies by helping to decipher origin of emissions in real-time. As part of the Petroleum Refinery Risk and Technology Review, New Source ...

Student Housing Cost Study.

ERIC Educational Resources Information Center

California Univ., Berkeley. Univ. Residential Building System.

Target costs for the University Residential Building System (URBS) Project of the University of California are presented. Findings depict the effectiveness of building design and material applications and should be useful in guiding future student housing design work, whether the design utilizes the URBS system or not. Ten recently constructed…

Trustees and Toxic Waste: New Concern in the Boardroom.

ERIC Educational Resources Information Center

Wallach, Paul G.

1987-01-01

Although environmental compliance is a significant cost of college operations, very few colleges have made a bona fide effort to develop cost-effective compliance strategies. Colleges are no longer being passed over in the application of the environment laws, including the stringent new criminal provisions. (MLW)

40 CFR 35.2030 - Facilities planning.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., the selected alternative is cost effective (i.e., is the most economical means of meeting the applicable effluent, water quality and public health requirements over the design life of the facility while... 10,000 or less, consideration must be given to appropriate low cost technologies such as facultative...

40 CFR 35.2030 - Facilities planning.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., the selected alternative is cost effective (i.e., is the most economical means of meeting the applicable effluent, water quality and public health requirements over the design life of the facility while... 10,000 or less, consideration must be given to appropriate low cost technologies such as facultative...

40 CFR 35.2030 - Facilities planning.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., the selected alternative is cost effective (i.e., is the most economical means of meeting the applicable effluent, water quality and public health requirements over the design life of the facility while... 10,000 or less, consideration must be given to appropriate low cost technologies such as facultative...

40 CFR 35.2030 - Facilities planning.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., the selected alternative is cost effective (i.e., is the most economical means of meeting the applicable effluent, water quality and public health requirements over the design life of the facility while... 10,000 or less, consideration must be given to appropriate low cost technologies such as facultative...

Applications Research of Microbial Ecological Preparation in Sea Cucumber Culture

NASA Astrophysics Data System (ADS)

Jiang, Jiahui; Wang, Guangyu

2017-12-01

At present, micro ecological preparation is widely applied in aquaculture with good effect. The application of micro ecological preparation in sea cucumber culture can effectively improve the economic benefits. The micro ecological preparation can play the role of inhibiting harmful bacteria, purifying water quality and saving culture cost in the process of sea cucumber culture. We should select appropriate bacteria, guarantee stable environment and use with long-term in the applications of microbial ecological preparation in sea cucumber culture to obtain good effects.

Cost-effectiveness comparison of five interventions to increase mammography screening.

PubMed

Saywell, R M; Champion, V L; Skinner, C S; McQuillen, D; Martin, D; Maraj, M

1999-11-01

Mammography is the primary method used for breast cancer screening. However, compliance with recommended screening practices is still below acceptable levels. This study examined the cost-effectiveness of five combinations of physician recommendation and telephone or in-person individualized counseling strategies for increasing compliance with mammography. There were 808 participants who were randomly assigned to one of six groups. A logistic regression model with compliance as the dependent variable and group as the independent variable was used to test for significant differences and a ratio of cost to improvement in mammogram compliance evaluated the cost-effectiveness. Three of the interventions (in-person, telephone plus letter, and in-person plus letter) had significantly better compliance rates compared with the control, physician letter, or telephone alone. However, when considering costs, only one emerged as the superior strategy. The cost-effectiveness ratios for the five interventions show that telephone-plus-letter is the most cost-effective strategy, achieving a 35.6% mammography compliance at a marginal cost of $0.78 per 1% increase in women screened. A tailored phone prompt and physician reminder is an effective and economical intervention to increase mammography. Future research should confirm this finding and address its applicability to practice. Copyright 1999 American Health Foundation and Academic Press.

Application of the WFD cost proportionality principle to diffuse pollution mitigation: a case study for Scottish Lochs.

PubMed

Vinten, A J A; Martin-Ortega, J; Glenk, K; Booth, P; Balana, B B; MacLeod, M; Lago, M; Moran, D; Jones, M

2012-04-30

The Water Framework Directive (WFD) aims to deliver good ecological status (GES) for Europe's waters. It prescribes the use of economic principles, such as derogation from GES on grounds of disproportionate costs of mitigation. This paper proposes an application of the proportionality principle to mitigation of phosphorus (P) pollution of 544 Scottish lochs at national and local water body scales. P loading estimates were derived from a national diffuse pollution screening tool. For 293 of these lochs (31% of the loch area), GES already occurred. Mitigation cost-effectiveness was assessed using combined mitigation cost curves for managed grassland, rough grazing, arable land, sewage and septic tank sources. These provided sufficient mitigation (92% of national P load) for GES to be achieved on another 31% of loch area at annualised cost of £2.09 m/y. Mitigation of the residual P loading preventing other lochs achieving GES was considered by using a "mop-up" cost of £200/kg P (assumed cost effectiveness of removal of P directly from lochs), leading to a total cost of £189 m/y. Lochs were ranked by mitigation costs per loch area to give a national scale marginal mitigation cost curve. A published choice experiment valuation of WFD targets for Scottish lochs was used to estimate marginal benefits at national scale and combined with the marginal cost curve. This gave proportionate costs of £5.7 m/y leading to GES in 72% of loch area. Using national mean marginal benefits with a scheme to estimate changes in individual loch value with P loading gave proportionate costs of £25.6 m/y leading to GES in 77% of loch area (491 lochs). Copyright © 2011 Elsevier Ltd. All rights reserved.

A Total Cost of Ownership Model for Low Temperature PEM Fuel Cells in Combined Heat and Power and Backup Power Applications

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

University of California, Berkeley; Wei, Max; Lipman, Timothy

2014-06-23

A total cost of ownership model is described for low temperature proton exchange membrane stationary fuel cell systems for combined heat and power (CHP) applications from 1-250kW and backup power applications from 1-50kW. System designs and functional specifications for these two applications were developed across the range of system power levels. Bottom-up cost estimates were made for balance of plant costs, and detailed direct cost estimates for key fuel cell stack components were derived using design-for-manufacturing-and-assembly techniques. The development of high throughput, automated processes achieving high yield are projected to reduce the cost for fuel cell stacks to the $300/kWmore » level at an annual production volume of 100 MW. Several promising combinations of building types and geographical location in the U.S. were identified for installation of fuel cell CHP systems based on the LBNL modelling tool DER CAM. Life-cycle modelling and externality assessment were done for hotels and hospitals. Reduced electricity demand charges, heating credits and carbon credits can reduce the effective cost of electricity ($/kWhe) by 26-44percent in locations such as Minneapolis, where high carbon intensity electricity from the grid is displaces by a fuel cell system operating on reformate fuel. This project extends the scope of existing cost studies to include externalities and ancillary financial benefits and thus provides a more comprehensive picture of fuel cell system benefits, consistent with a policy and incentive environment that increasingly values these ancillary benefits. The project provides a critical, new modelling capacity and should aid a broad range of policy makers in assessing the integrated costs and benefits of fuel cell systems versus other distributed generation technologies.« less

The cost effectiveness of vancomycin for preventing infections after shoulder arthroplasty: a break-even analysis.

PubMed

Hatch, M Daniel; Daniels, Stephen D; Glerum, Kimberly M; Higgins, Laurence D

2017-03-01

Increasing methicillin resistance and recognition of Propionibacterium acnes as a cause of infection in shoulder arthroplasty has led to the adoption of local vancomycin powder application as a more effective method to prevent expensive periprosthetic infections. However, no study has analyzed the cost effectiveness of vancomycin powder for preventing infection after shoulder replacement. Cost data for infection-related care of 16 patients treated for deep periprosthetic shoulder infection was collected from our institution for the break-even analysis. An equation was developed and applied to the data to determine how effective vancomycin powder would need to be at reducing a baseline infection rate to make prophylactic use cost effective. The efficacy of vancomycin (absolute risk reduction [ARR]) was evaluated at different unit costs, baseline infection rates, and average costs of treating infection. We determined vancomycin to be cost effective if the initial infection rate decreased by 0.04% (ARR). Using the current costs of vancomycin reported in the literature (range: $2.50/1000 mg to $44/1000 mg), we determined vancomycin to be cost effective with an ARR range of 0.01% at a cost of $2.50/1000 mg to 0.19% at $44/1000 mg. Baseline infection rate does not influence the ARR obtained at any specific cost of vancomycin or the cost of treating infection. We have derived and used a break-even equation to assess efficacy of prophylactic antibiotics during shoulder surgery. We further demonstrated the prophylactic administration of local vancomycin powder during shoulder arthroplasty to be a highly cost-effective practice. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

41 CFR 105-72.702 - Enforcement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the funding period in which the termination takes effect. (d) Relationship to debarment and suspension... applicable to the action involved. (c) Effects of suspension and termination. Costs of a recipient resulting...

29 CFR 97.43 - Enforcement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... end of the funding period in which the termination takes effect. (d) Relationship to debarment and... applicable to the action involved. (c) Effects of suspension and termination. Costs of grantee or subgrantee...

29 CFR 97.43 - Enforcement.

Code of Federal Regulations, 2012 CFR

2012-07-01

... end of the funding period in which the termination takes effect. (d) Relationship to debarment and... applicable to the action involved. (c) Effects of suspension and termination. Costs of grantee or subgrantee...

29 CFR 97.43 - Enforcement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... end of the funding period in which the termination takes effect. (d) Relationship to debarment and... applicable to the action involved. (c) Effects of suspension and termination. Costs of grantee or subgrantee...

Cost-effectiveness of alendronate in the treatment of postmenopausal women in 9 European countries--an economic evaluation based on the fracture intervention trial.

PubMed

Ström, O; Borgström, F; Sen, S S; Boonen, S; Haentjens, P; Johnell, O; Kanis, J A

2007-08-01

Treatment with alendronate (Fosamax) has been shown to significantly reduce the risk of fragility fractures. Cost-effectiveness of treatment was assessed in nine European countries in a Markov model and was generally found to be cost effective in women with a previous spine fracture. Treatment with alendronate (Fosamax) reduces the risk of osteoporotic fractures at the spine, hip and wrist in women with and without prevalent vertebral fracture. Cost-effectiveness estimates in one country may not be applicable elsewhere due to differences in fracture risks, costs and drug prices. The aim of this study was to assess the cost-effectiveness of treating postmenopausal women with alendronate in nine European countries, comprising Belgium, Denmark, France, Germany, Italy, Norway, Spain, Sweden, and the UK. A Markov model was populated with data for the nine European populations. Effect of treatment was taken from the Fracture Intervention Trial, which recruited women with low BMD alone or with a prior vertebral fracture. The cost per QALY gained of treating postmenopausal women with prior vertebral fractures ranged in the base case from "cost saving" in the Scandinavian countries to 15,000 in Italy. Corresponding estimates for women without prior vertebral fractures ranged from "cost saving" to 40,000. In relation to thresholds generally used, the analysis suggests that alendronate is very cost effective in the treatment of women with previous vertebral fracture, and in women without previous vertebral fracture, cost-effectiveness depends on the country setting, discount rates, and chosen monetary thresholds.

Operations analysis (study 2.1): Shuttle upper stage software requirements

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1974-01-01

An investigation of software costs related to space shuttle upper stage operations with emphasis on the additional costs attributable to space servicing was conducted. The questions and problem areas include the following: (1) the key parameters involved with software costs; (2) historical data for extrapolation of future costs; (3) elements of the basic software development effort that are applicable to servicing functions; (4) effect of multiple servicing on complexity of the operation; and (5) are recurring software costs significant. The results address these questions and provide a foundation for estimating software costs based on the costs of similar programs and a series of empirical factors.

Good research practices for measuring drug costs in cost-effectiveness analyses: a societal perspective: the ISPOR Drug Cost Task Force report--Part II.

PubMed

Garrison, Louis P; Mansley, Edward C; Abbott, Thomas A; Bresnahan, Brian W; Hay, Joel W; Smeeding, James

2010-01-01

Major guidelines regarding the application of cost-effectiveness analysis (CEA) have recommended the common and widespread use of the "societal perspective" for purposes of consistency and comparability. The objective of this Task Force subgroup report (one of six reports from the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force (DCTF)]) was to review the definition of this perspective, assess its specific application in measuring drug costs, identify any limitations in theory or practice, and make recommendations regarding potential improvements. Key articles, books, and reports in the methodological literature were reviewed, summarized, and integrated into a draft review and report. This draft report was posted for review and comment by ISPOR membership. Numerous comments and suggestions were received, and the report was revised in response to them. The societal perspective can be defined by three conditions: 1) the inclusion of time costs, 2) the use of opportunity costs, and 3) the use of community preferences. In practice, very few, if any, published CEAs have met all of these conditions, though many claim to have taken a societal perspective. Branded drug costs have typically used actual acquisition cost rather than the much lower social opportunity costs that would reflect only short-run manufacturing and distribution costs. This practice is understandable, pragmatic, and useful to current decision-makers. Nevertheless, this use of CEA focuses on static rather than dynamic efficacy and overlooks the related incentives for innovation. Our key recommendation is that current CEA practice acknowledge and embrace this limitation by adopting a new standard for the reference case as one of a "limited societal" or "health systems" perspective, using acquisition drug prices while including indirect costs and community preferences. The field of pharmacoeconomics also needs to acknowledge the limitations of this perspective when it comes to important questions of research and development costs, and incentives for innovation.

Effectiveness of low-cost electromagnetic shielding using nail-together galvanized steel: Test results. Final report

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

Williams, P.F.; Kennedy, E.L.; McCormack, R.G.

1992-09-01

The sensitivity of modern electronic equipment has increased the need for costly electromagnetic shielding. To reduce this cost, the U.S. Army Construction Engineering Research Laboratories (USACERL) has developed a new concept for shielding design that uses 28-gauge galvanized steel and standard galvanized nails. In this study, an electromagnetically shielded structure using the concept was designed, built, and evaluated for shielding effectiveness. The galvanized material was mounted to the standard USACERL test aperture and nailed to the wooden module frame, and the shielding effectiveness of the new construction design was measured using radio frequency antennas and receivers. Evaluations showed that themore » nail-together structure proved adequate for many shielding applications. However, while the galvanized steel met most shielding application requirements, this process added multiple seams to the structure, which decreased shielding in many instances by as much as 40 dB. Electromagnetic shielding, Electromagnetic pulse C3I Facilities.« less

Flexible copper-indium-diselenide films and devices for space applications

NASA Technical Reports Server (NTRS)

Armstrong, J. H.; Pistole, C. O.; Misra, M. S.; Kapur, V. K.; Basol, B. M.

1991-01-01

With the ever increasing demands on space power systems, it is imperative that low cost, lightweight, reliable photovoltaics be developed. One avenue of pursuit for future space power applications is the use of low cost, lightweight flexible PV cells and arrays. Most work in this area assumes the use of flexible amorphous silicon (a-Si), despite its inherent instability and low efficiencies. However, polycrystalline thin film PV such as copper-indium-diselenide (CIS) are inherently more stable and exhibit better performance than a-Si. Furthermore, preliminary data indicate that CIS also offers exciting properties with respect to space applications. However, CIS has only heretofore only produced on rigid substrates. The implications of flexible CIS upon present and future space power platforms was explored. Results indicate that space qualified CIS can dramatically reduce the cost of PV, and in most cases, can be substituted for silicon (Si) based on end-of-life (EOL) estimations. Furthermore, where cost is a prime consideration, CIS can become cost effective than gallium arsenide (GaAs) in some applications. Second, investigations into thin film deposition on flexible substrates were made, and data from these tests indicate that fabrication of flexible CIS devices is feasible. Finally, data is also presented on preliminary TCO/CdS/CuInSe2/Mo devices.

Space Shuttle capabilities, constraints, and cost

NASA Technical Reports Server (NTRS)

Lee, C. M.

1980-01-01

The capabilities, constraints, and costs of the Space Transportation System (STS), which combines reusable and expendable components, are reviewed, and an overview of the current planning activities for operating the STS in an efficient and cost-effective manner is presented. Traffic forecasts, performance constraints and enhancements, and potential new applications are discussed. Attention is given to operating costs, pricing policies, and the steps involved in 'getting on board', which includes all the interfaces between NASA and the users necessary to come to launch service agreements.

Synthesis and characterization of low cost magnetorheological (MR) fluids

NASA Astrophysics Data System (ADS)

Sukhwani, V. K.; Hirani, H.

2007-04-01

Magnetorheological fluids have great potential for engineering applications due to their variable rheological behavior. These fluids find applications in dampers, brakes, shock absorbers, and engine mounts. However their relatively high cost (approximately US600 per liter) limits their wide usage. Most commonly used magnetic material "Carbonyl iron" cost more than 90% of the MR fluid cost. Therefore for commercial viability of these fluids there is need of alternative economical magnetic material. In the present work synthesis of MR fluid has been attempted with objective to produce low cost MR fluid with high sedimentation stability and greater yield stress. In order to reduce the cost, economical electrolytic Iron powder (US 10 per Kg) has been used. Iron powder of relatively larger size (300 Mesh) has been ball milled to reduce their size to few microns (1 to 10 microns). Three different compositions have been prepared and compared for MR effect produced and stability. All have same base fluid (Synthetic oil) and same magnetic phase i.e. Iron particles but they have different additives. First preparation involves organic additives Polydimethylsiloxane (PDMS) and Stearic acid. Other two preparations involve use of two environmental friendly low-priced green additives guar gum (US 2 per Kg) and xanthan gum (US 12 per Kg) respectively. Magnetic properties of Iron particles have been measured by Vibrating Sample Magnetometer (VSM). Morphology of Iron particles and additives guar gum and xanthan gum has been examined by Scanning Electron Microscopy (SEM) and Particles Size Distribution (PSD) has been determined using Particle size analyzer. Microscopic images of particles, MH plots and stability of synthesized MR fluids have been reported. The prepared low cost MR fluids showed promising performance and can be effectively used for engineering applications demanding controllability in operations.

21 CFR 99.205 - Application for exemption from the requirement to file a supplemental application.

Code of Federal Regulations, 2010 CFR

2010-04-01

... characterizing the safety and effectiveness of the drug or device, including data from the study described in the... effectiveness of the use, a summary of those data, and any documentation resulting from prior discussions with... minus the costs of goods sold and marketing and administrative expenses attributable to the new use of...

Investigation of a Low Cost Sensor-Based Leak Detection System for Fence Line Applications

EPA Science Inventory

With recent technological advances, low-cost time-resolved sensors may become effective tools to support time-integrated passive sampling strategies by helping to decipher origin of emissions in real-time. As part of the Petroleum Refinery Risk and Technology Review, New Source P...

SSL Pricing and Efficacy Trend Analysis for Utility Program Planning

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

Tuenge, J. R.

2013-10-01

Report to help utilities and energy efficiency organizations forecast the order in which important SSL applications will become cost-effective and estimate when each "tipping point" will be reached. Includes performance trend analysis from DOE's LED Lighting Facts® and CALiPER programs plus cost analysis from various sources.

Smart truck driver assistant : a cost effective solution for real time management of container delivery to trucks: [research brief].

DOT National Transportation Integrated Search

2015-12-01

In this project, we developed a mobile application (app) that utilizes the rich environment and features of smartphones. Our app uses the widely available resources of smartphones (at no additional cost to drivers or terminals) to collect data from p...

Preservation treatment for wood bridge application

Treesearch

Jake Bigelow; Stan Lebow; Carol A. Clausen; Lowell Greimann; Terry J. Wipf

2009-01-01

Timber can often be a cost-effective construction material for new bridges. The durability of the bridge greatly depends on proper attention to construction details and fabrication, as well as proper preservative treatment before, during, and after construction. Material repair and replacement costs for bridges are a considerable expense for highway agencies. To...

A Low Cost Course Information Syndication System

ERIC Educational Resources Information Center

Ajayi, A. O.; Olajubu, E. A.; Bello, S. A.; Soriyan, H. A.; Obamuyide, A. V.

2011-01-01

This study presents a cost effective, reliable, and convenient mobile web-based system to facilitate the dissemination of course information to students, to support interaction that goes beyond the classroom. The system employed the Really Simple Syndication (RSS) technology and was developed using Rapid Application Development (RAD) methodology.…

The economics of improving medication adherence in osteoporosis: validation and application of a simulation model.

PubMed

Patrick, Amanda R; Schousboe, John T; Losina, Elena; Solomon, Daniel H

2011-09-01

Adherence to osteoporosis treatment is low. Although new therapies and behavioral interventions may improve medication adherence, questions are likely to arise regarding their cost-effectiveness. Our objectives were to develop and validate a model to simulate the clinical outcomes and costs arising from various osteoporosis medication adherence patterns among women initiating bisphosphonate treatment and to estimate the cost-effectiveness of a hypothetical intervention to improve medication adherence. We constructed a computer simulation using estimates of fracture rates, bisphosphonate treatment effects, costs, and utilities for health states drawn from the published literature. Probabilities of transitioning on and off treatment were estimated from administrative claims data. Patients were women initiating bisphosphonate therapy from the general community. We evaluated a hypothetical behavioral intervention to improve medication adherence. Changes in 10-yr fracture rates and incremental cost-effectiveness ratios were evaluated. A hypothetical intervention with a one-time cost of $250 and reducing bisphosphonate discontinuation by 30% had an incremental cost-effectiveness ratio (ICER) of $29,571 per quality-adjusted life year in 65-yr-old women initiating bisphosphonates. Although the ICER depended on patient age, intervention effectiveness, and intervention cost, the ICERs were less than $50,000 per quality-adjusted life year for the majority of intervention cost and effectiveness scenarios evaluated. Results were sensitive to bisphosphonate cost and effectiveness and assumptions about the rate at which intervention and treatment effects decline over time. Our results suggests that behavioral interventions to improve osteoporosis medication adherence will likely have favorable ICERs if their efficacy can be sustained.

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

PubMed

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

2016-12-20

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

One Health approach to cost-effective rabies control in India

PubMed Central

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

2016-01-01

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

21 CFR 1403.43 - Enforcement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

45 CFR 602.43 - Enforcement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... normally at the end of the funding period in which the termination takes effect. (d) Relationship to... regulation applicable to the action involved. (c) Effects of suspension and termination. Costs of grantee or...

28 CFR 66.43 - Enforcement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

45 CFR 1157.43 - Enforcement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

34 CFR 80.43 - Enforcement.

Code of Federal Regulations, 2012 CFR

2012-07-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

13 CFR 143.43 - Enforcement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

13 CFR 143.43 - Enforcement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

45 CFR 1183.43 - Enforcement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

45 CFR 1174.43 - Enforcement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

49 CFR 18.43 - Enforcement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... suspended or expired normally at the end of the funding period in which the termination takes effect. (d... statute or regulation applicable to the action involved. (c) Effects of suspension and termination. Costs...

Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature

PubMed Central

Wilffert, Bob; Boersma, Cornelis; Annemans, Lieven; Vegter, Stefan; van Boven, Job F. M.; Postma, Maarten J.

2016-01-01

Objective Due to extended application of pharmacogenetic and pharmacogenomic screening (PGx) tests it is important to assess whether they provide good value for money. This review provides an update of the literature. Methods A literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies’ overall quality was assessed with the Quality of Health Economic Studies (QHES) instrument. Results We found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing. Conclusions Application of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests’ efficacy remains of utmost importance. PMID:26752539

A cost-effectiveness comparison of three tailored interventions to increase mammography screening.

PubMed

Saywell, Robert M; Champion, Victoria L; Skinner, Celette Sugg; Menon, Usha; Daggy, Joanne

2004-10-01

Mammography is the primary method used for breast cancer screening. However, adherence to recommended screening practices is still below acceptable levels. This study examined the cost-effectiveness of three combinations of tailored telephone and mailed intervention strategies for increasing adherence to mammography. There were 1044 participants who were randomly assigned to one of four groups. A logistic regression model with adherence as the dependent variable and group as the independent variable was used to test for significant differences, and a ratio of cost/improvement in mammogram adherence evaluated the cost-effectiveness. All three of the interventions (tailored telephone, tailored mail, and tailored telephone and mail) had significantly better adherence rates compared with the control group (usual care). However, when also considering costs, one emerged as the superior strategy. The cost-effectiveness ratios for the three interventions show that the tailored mail (letter) was the most cost-effective strategy, achieving 43.3% mammography adherence at a marginal cost of dollar 0.39 per 1% increase in women screened. The tailored mail plus telephone achieved greater adherence (49.4%), but at a higher cost (dollar 0.56 per 1% increase in women screened). A tailored mail reminder is an effective and economical intervention to increase mammography adherence. Future research should confirm this finding and address its applicability to practice in other settings.

A cost-benefit analysis of long-term management options for forests following contamination with 137Cs.

PubMed

Shaw, G; Robinson, C; Holm, E; Frissel, M J; Crick, M

2001-01-01

This paper provides a description of a cost-benefit analysis applied to determine the cost effectiveness, or otherwise, of nine management strategies potentially applicable to forests contaminated with 137Cs. The management strategies were considered singly and in a number of likely combinations. A management strategy was considered to be cost-effective if it resulted in a lower overall monetary detriment than was incurred if use of the contaminated forest was continued on a 'business as usual' basis. Only the banning of mushroom collection and restriction of public access proved to be cost-effective management strategies on the basis of this definition. However, even these strategies only proved cost-effective at high levels of 137Cs contamination, at which net savings in detriment in the form of public dose were achieved. Cost-effective savings of doses to forest workers were never achieved at any of the contamination levels considered in this study. It is suggested that novel alternative uses of contaminated forests are required which could provide added value to the standing crop in return for small increases in public and worker doses. One such use might be biofuel production.

Application of composite materials to turbofan engine fan exit guide vanes

NASA Technical Reports Server (NTRS)

Smith, G. T.

1980-01-01

A program was conducted by NASA with the JT9D engine manufacturer to develop a lightweight, cost effective, composite material fan exit guide vane design having satisfactory structural durability for commerical engine use. Based on the results of a previous company supported program, eight graphite/epoxy and graphite-glass/epoxy guide vane designs were evaluated and four were selected for fabrication and testing. Two commercial fabricators each fabricated 13 vanes. Fatigue tests were used to qualify the selected design configurations under nominally dry, 38 C (100 F) and fully wet and 60 C (140 F) environmental conditions. Cost estimates for a production rate of 1000 vanes per month ranged from 1.7 to 2.6 times the cost of an all aluminum vane. This cost is 50 to 80 percent less than the initial program target cost ratio which was 3 times the cost of an aluminum vane. Application to the JT9D commercial engine is projected to provide a weight savings of 236 N (53 lb) per engine.

Integrated Testing, Simulation and Analysis of Electric Drive Options for Medium-Duty Parcel Delivery Vehicles: Preprint

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

Ramroth, L. A.; Gonder, J.; Brooker, A.

2012-09-01

The National Renewable Energy Laboratory verified diesel-conventional and diesel-hybrid parcel delivery vehicle models to evaluate petroleum reduction and cost implications of plug-in hybrid gasoline and diesel variants. These variants are run on a field-data-derived design matrix to analyze the effects of drive cycle, distance, battery replacements, battery capacity, and motor power on fuel consumption and lifetime cost. Two cost scenarios using fuel prices corresponding to forecasted highs for 2011 and 2030 and battery costs per kilowatt-hour representing current and long-term targets compare plug-in hybrid lifetime costs with diesel conventional lifetime costs. Under a future cost scenario of $100/kWh battery energymore » and $5/gal fuel, plug-in hybrids are cost effective. Assuming a current cost of $700/kWh and $3/gal fuel, they rarely recoup the additional motor and battery cost. The results highlight the importance of understanding the application's drive cycle, daily driving distance, and kinetic intensity. For instances in the current-cost scenario where the additional plug-in hybrid cost is regained in fuel savings, the combination of kinetic intensity and daily distance travelled does not coincide with the usage patterns observed in the field data. If the usage patterns were adjusted, the hybrids could become cost effective.« less

Mobile phones to support adherence to antiretroviral therapy: what would it cost the Indian National AIDS Control Programme?

PubMed

Rodrigues, Rashmi; Bogg, Lennart; Shet, Anita; Kumar, Dodderi Sunil; De Costa, Ayesha

2014-01-01

Adherence to antiretroviral treatment (ART) is critical to maintaining health and good clinical outcomes in people living with HIV/AIDS. To address poor treatment adherence, low-cost interventions using mobile communication technology are being studied. While there are some studies that show an effect of mobile phone reminders on adherence to ART, none has reported on the costs of such reminders for national AIDS programmes. This paper aims to study the costs of mobile phone reminder strategies (mHealth interventions) to support adherence in the context of India's National AIDS Control Program (NACP). The study was undertaken at two tertiary level teaching hospitals that implement the NACP in Karnataka state, South India. Costs for a mobile phone reminder application to support adherence, implemented at these sites (i.e. weekly calls, messages or both) were studied. Costs were collected based on the concept of avoidable costs specific to the application. The costs that were assessed were one-time costs and recurrent costs that included fixed and variable costs. A sequential procedure for costing was used. Costs were calculated at national-programme level, individual ART-centre level and individual patient level from the NACP's perspective. The assessed costs were pooled to obtain an annual cost per patient. The type of application, number of ART centres and number of patients on ART were varied in a sensitivity analysis of costs. The Indian NACP would incur a cost of between 79 and 110 INR (USD 1.27-1.77) per patient per year, based on the type of reminder, the number of patients on ART and the number of functioning ART centres. The total programme costs for a scale-up of the mHealth intervention to reach the one million patients expected to be on treatment by 2017 is estimated to be 0.36% of the total five-year national-programme budget. The cost of the mHealth intervention for ART-adherence support in the context of the Indian NACP is low and is facilitated by the low cost of mobile communication in the country. Extending the use of mobile communication applications beyond adherence support under the national programme could be done relatively inexpensively.

Mobile phones to support adherence to antiretroviral therapy: what would it cost the Indian National AIDS Control Programme?

PubMed Central

Rodrigues, Rashmi; Bogg, Lennart; Shet, Anita; Kumar, Dodderi Sunil; De Costa, Ayesha

2014-01-01

Introduction Adherence to antiretroviral treatment (ART) is critical to maintaining health and good clinical outcomes in people living with HIV/AIDS. To address poor treatment adherence, low-cost interventions using mobile communication technology are being studied. While there are some studies that show an effect of mobile phone reminders on adherence to ART, none has reported on the costs of such reminders for national AIDS programmes. This paper aims to study the costs of mobile phone reminder strategies (mHealth interventions) to support adherence in the context of India's National AIDS Control Program (NACP). Methods The study was undertaken at two tertiary level teaching hospitals that implement the NACP in Karnataka state, South India. Costs for a mobile phone reminder application to support adherence, implemented at these sites (i.e. weekly calls, messages or both) were studied. Costs were collected based on the concept of avoidable costs specific to the application. The costs that were assessed were one-time costs and recurrent costs that included fixed and variable costs. A sequential procedure for costing was used. Costs were calculated at national-programme level, individual ART-centre level and individual patient level from the NACP's perspective. The assessed costs were pooled to obtain an annual cost per patient. The type of application, number of ART centres and number of patients on ART were varied in a sensitivity analysis of costs. Results The Indian NACP would incur a cost of between 79 and 110 INR (USD 1.27–1.77) per patient per year, based on the type of reminder, the number of patients on ART and the number of functioning ART centres. The total programme costs for a scale-up of the mHealth intervention to reach the one million patients expected to be on treatment by 2017 is estimated to be 0.36% of the total five-year national-programme budget. Conclusions The cost of the mHealth intervention for ART-adherence support in the context of the Indian NACP is low and is facilitated by the low cost of mobile communication in the country. Extending the use of mobile communication applications beyond adherence support under the national programme could be done relatively inexpensively. PMID:25186918

THE APPLICATION AND DEVELOPMENT OF APPROPRIATE TOOLS AND TECHNOLOGIES FOR COST-EFFECTIVE CARBON SEQUESTRATION

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

Bill Stanley; Sandra Brown; Ellen Hawes

2002-09-01

The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research projects is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects,more » providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas impacts. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: advanced videography testing; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.« less

Enhancing steel properties through in situ formation of ultrahard ceramic surface

PubMed Central

Pahlevani, Farshid; Kumar, Rahul; Gorjizadeh, Narjes; Hossain, Rumana; Cholake, Sagar T; Privat, Karen; Sahajwalla, Veena

2016-01-01

Abrasion and corrosion resistant steel has attracted considerable interest for industrial application as a means of minimising the costs associated with product/component failures and/or short replacement cycles. These classes of steels contain alloying elements that increase their resistance to abrasion and corrosion. Their benefits, however, currently come at a potentially prohibitive cost; such high performance steel products are both more technically challenging and more expensive to produce. Although these methods have proven effective in improving the performance of more expensive, high-grade steel components, they are not economically viable for relatively low cost steel products. New options are needed. In this study, a complex industrial waste stream has been transformed in situ via precisely controlled high temperature reactions to produce an ultrahard ceramic surface on steel. This innovative ultrahard ceramic surface increases both the hardness and compressive strength of the steel. Furthermore, by modifying the composition of the waste input and the processing parameters, the ceramic surface can be effectively customised to match the intended application of the steel. This economical new approach marries industry demands for more cost-effective, durable steel products with global imperatives to address resource depletion and environmental degradation through the recovery of resources from waste. PMID:27929096

Enhancing steel properties through in situ formation of ultrahard ceramic surface.

PubMed

Pahlevani, Farshid; Kumar, Rahul; Gorjizadeh, Narjes; Hossain, Rumana; Cholake, Sagar T; Privat, Karen; Sahajwalla, Veena

2016-12-08

Abrasion and corrosion resistant steel has attracted considerable interest for industrial application as a means of minimising the costs associated with product/component failures and/or short replacement cycles. These classes of steels contain alloying elements that increase their resistance to abrasion and corrosion. Their benefits, however, currently come at a potentially prohibitive cost; such high performance steel products are both more technically challenging and more expensive to produce. Although these methods have proven effective in improving the performance of more expensive, high-grade steel components, they are not economically viable for relatively low cost steel products. New options are needed. In this study, a complex industrial waste stream has been transformed in situ via precisely controlled high temperature reactions to produce an ultrahard ceramic surface on steel. This innovative ultrahard ceramic surface increases both the hardness and compressive strength of the steel. Furthermore, by modifying the composition of the waste input and the processing parameters, the ceramic surface can be effectively customised to match the intended application of the steel. This economical new approach marries industry demands for more cost-effective, durable steel products with global imperatives to address resource depletion and environmental degradation through the recovery of resources from waste.

Development of a wireless displacement measurement system using acceleration responses.

PubMed

Park, Jong-Woong; Sim, Sung-Han; Jung, Hyung-Jo; Spencer, Billie F

2013-07-01

Displacement measurements are useful information for various engineering applications such as structural health monitoring (SHM), earthquake engineering and system identification. Most existing displacement measurement methods are costly, labor-intensive, and have difficulties particularly when applying to full-scale civil structures because the methods require stationary reference points. Indirect estimation methods converting acceleration to displacement can be a good alternative as acceleration transducers are generally cost-effective, easy to install, and have low noise. However, the application of acceleration-based methods to full-scale civil structures such as long span bridges is challenging due to the need to install cables to connect the sensors to a base station. This article proposes a low-cost wireless displacement measurement system using acceleration. Developed with smart sensors that are low-cost, wireless, and capable of on-board computation, the wireless displacement measurement system has significant potential to impact many applications that need displacement information at multiple locations of a structure. The system implements an FIR-filter type displacement estimation algorithm that can remove low frequency drifts typically caused by numerical integration of discrete acceleration signals. To verify the accuracy and feasibility of the proposed system, laboratory tests are carried out using a shaking table and on a three storey shear building model, experimentally confirming the effectiveness of the proposed system.

Development of a Wireless Displacement Measurement System Using Acceleration Responses

PubMed Central

Park, Jong-Woong; Sim, Sung-Han; Jung, Hyung-Jo; Spencer, Billie F.

2013-01-01

Displacement measurements are useful information for various engineering applications such as structural health monitoring (SHM), earthquake engineering and system identification. Most existing displacement measurement methods are costly, labor-intensive, and have difficulties particularly when applying to full-scale civil structures because the methods require stationary reference points. Indirect estimation methods converting acceleration to displacement can be a good alternative as acceleration transducers are generally cost-effective, easy to install, and have low noise. However, the application of acceleration-based methods to full-scale civil structures such as long span bridges is challenging due to the need to install cables to connect the sensors to a base station. This article proposes a low-cost wireless displacement measurement system using acceleration. Developed with smart sensors that are low-cost, wireless, and capable of on-board computation, the wireless displacement measurement system has significant potential to impact many applications that need displacement information at multiple locations of a structure. The system implements an FIR-filter type displacement estimation algorithm that can remove low frequency drifts typically caused by numerical integration of discrete acceleration signals. To verify the accuracy and feasibility of the proposed system, laboratory tests are carried out using a shaking table and on a three storey shear building model, experimentally confirming the effectiveness of the proposed system. PMID:23881123

What Works Clearinghouse Quick Review: "Expanding College Opportunities for High-Achieving, Low Income Students"

ERIC Educational Resources Information Center

What Works Clearinghouse, 2013

2013-01-01

This study examined the effects of providing low-income, high-achieving high school seniors with college application guidance and information about the costs of college. The "application guidance" included information about deadlines and requirements for college applications at nearby institutions, at the state's flagship institution, and at in-…

Ultra-Low-Cost Room Temperature SiC Thin Films

NASA Technical Reports Server (NTRS)

Faur, Maria

1997-01-01

The research group at CSU has conducted theoretical and experimental research on 'Ultra-Low-Cost Room Temperature SiC Thin Films. The effectiveness of a ultra-low-cost room temperature thin film SiC growth technique on Silicon and Germanium substrates and structures with applications to space solar sells, ThermoPhotoVoltaic (TPV) cells and microelectronic and optoelectronic devices was investigated and the main result of this effort are summarized.

Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

PubMed

Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

2013-01-01

Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a multitude of factors. Further analyses using a quasi-experimental design would be useful to programme implementers and policy makers as they face decisions regarding which HIV prevention activities to prioritize.

Applicability of Zeolite Based Systems for Ammonia Removal and Recovery From Wastewater.

PubMed

Das, Pallabi; Prasad, Bably; Singh, Krishna Kant Kumar

2017-09-01

  Ammonia discharged in industrial effluents bears deleterious effects and necessitates remediation. Integrated systems devoted to recovery of ammonia in a useful form and remediation of the same addresses the challenges of waste management and its utilization. A comparative performance evaluation study was undertaken to access the suitability of different zeolite based systems (commercial zeolites and zeolites synthesized from fly ash) for removal of ammonia followed by its subsequent release. Four main parameters which were studied to evaluate the applicability of such systems for large scale usage are cost-effectiveness, ammonia removal efficiency, performance on regeneration, and ammonia release percentage. The results indicated that synthetic zeolites outperformed zeolites synthesized from fly ash, although the later proved to be more efficient in terms of total cost incurred. Process technology development in this direction will be a trade-of between cost and ammonia removal and release efficiencies.

Technological hurdles to the application of intercalated graphite fibers

NASA Technical Reports Server (NTRS)

Gaier, James R.

1988-01-01

Before intercalated graphite fibers can be developed as an effective power material, there are several technological hurdles which must be overcome. These include the environmental stability, homogeneity and bulk properties, connection procedures, and costs. Strides were made within the last several years in stability and homogeneity of intercalated graphite fibers. Bulk properties and connection procedures are areas of active research now. Costs are still prohibitive for all but the most demanding applications. None of these problems, however, appear to be unsolvable, and their solution may result in wide spread GOC application. The development of a relatively simple technology application, such as EMI shielding, would stimulate the solution of scale-up problems. Once this technology is developed, then more demanding applications, such as power bus bars, may be possible.

Cost-effectiveness of root caries preventive treatments.

PubMed

Schwendicke, Falk; Göstemeyer, Gerd

2017-01-01

With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cost-effectiveness of competing strategies for management of recurrent Clostridium difficile infection: a decision analysis.

PubMed

Konijeti, Gauree G; Sauk, Jenny; Shrime, Mark G; Gupta, Meera; Ananthakrishnan, Ashwin N

2014-06-01

Clostridium difficile infection (CDI) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. The cost-effectiveness of newer treatments for recurrent CDI has not been examined, yet would be important to inform clinical practice. The aim of this study was to analyze the cost effectiveness of competing strategies for recurrent CDI. We constructed a decision-analytic model comparing 4 treatment strategies for first-line treatment of recurrent CDI in a population with a median age of 65 years: metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplant (FMT). We modeled up to 2 additional recurrences following the initial recurrence. We assumed FMT delivery via colonoscopy as our base case, but conducted sensitivity analyses based on different modes of delivery. Willingness-to-pay threshold was set at $50 000 per quality-adjusted life-year. At our base case estimates, initial treatment of recurrent CDI using FMT colonoscopy was the most cost-effective strategy, with an incremental cost-effectiveness ratio of $17 016 relative to oral vancomycin. Fidaxomicin and metronidazole were both dominated by FMT colonoscopy. On sensitivity analysis, FMT colonoscopy remained the most cost-effective strategy at cure rates >88.4% and CDI recurrence rates <14.9%. Fidaxomicin required a cost <$1359 to meet our cost-effectiveness threshold. In clinical settings where FMT is not available or applicable, the preferred strategy appears to be initial treatment with oral vancomycin. In this decision analysis examining treatment strategies for recurrent CDI, we demonstrate that FMT colonoscopy is the most cost-effective initial strategy for management of recurrent CDI.

Low concentrator PV optics optimization

NASA Astrophysics Data System (ADS)

Sharp, Leonard; Chang, Ben

2008-08-01

Purpose: Cost reduction is a major focus of the solar industry. Thin film technologies and concentration systems are viable ways to reducing cost, with unique strengths and weakness for both. Most of the concentrating PV work focuses on high concentration systems for reducing energy cost. Meanwhile, many believe that low concentrators provide significant cost reduction potential while addressing the mainstream PV market with a product that acts as a flat panel replacement. This paper analyzes the relative benefit of asymmetric vs. symmetric optics for low-concentrators in light of specific PV applications. Approach: Symmetric and asymmetric concentrating PV module performance is evaluated using computer simulation to determine potential value across various geographic locations and applications. The selected optic design is modeled against standard cSi flat panels and thin film to determine application fit, system level energy density and economic value. Results: While symmetric designs may seem ideal, asymmetric designs have an advantage in energy density. Both designs are assessed for aperture, optimum concentration ratio, and ideal system array configuration. Analysis of performance across climate specific effects (diffuse, direct and circumsolar) and location specific effects (sunpath) are also presented. The energy density and energy production of low concentrators provide a compelling value proposition. More significantly, the choice of optics for a low concentrating design can affect real world performance. With the goal of maximizing energy density and return on investment, this paper presents the advantages of asymmetric optic concentration and illustrates the value of this design within specific PV applications.

An examination of sources of sensitivity of consumer surplus estimates in travel cost models.

PubMed

Blaine, Thomas W; Lichtkoppler, Frank R; Bader, Timothy J; Hartman, Travis J; Lucente, Joseph E

2015-03-15

We examine sensitivity of estimates of recreation demand using the Travel Cost Method (TCM) to four factors. Three of the four have been routinely and widely discussed in the TCM literature: a) Poisson verses negative binomial regression; b) application of Englin correction to account for endogenous stratification; c) truncation of the data set to eliminate outliers. A fourth issue we address has not been widely modeled: the potential effect on recreation demand of the interaction between income and travel cost. We provide a straightforward comparison of all four factors, analyzing the impact of each on regression parameters and consumer surplus estimates. Truncation has a modest effect on estimates obtained from the Poisson models but a radical effect on the estimates obtained by way of the negative binomial. Inclusion of an income-travel cost interaction term generally produces a more conservative but not a statistically significantly different estimate of consumer surplus in both Poisson and negative binomial models. It also generates broader confidence intervals. Application of truncation, the Englin correction and the income-travel cost interaction produced the most conservative estimates of consumer surplus and eliminated the statistical difference between the Poisson and the negative binomial. Use of the income-travel cost interaction term reveals that for visitors who face relatively low travel costs, the relationship between income and travel demand is negative, while it is positive for those who face high travel costs. This provides an explanation of the ambiguities on the findings regarding the role of income widely observed in the TCM literature. Our results suggest that policies that reduce access to publicly owned resources inordinately impact local low income recreationists and are contrary to environmental justice. Copyright © 2014 Elsevier Ltd. All rights reserved.

24 CFR 1003.300 - Application requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... pertinent to the application process. (b) Costs incurred by applicant. Costs incurred by an applicant prior... eligible ICDBG expenses. (c) HUD will not normally reimburse or recognize costs incurred before HUD... and approve written requests to recognize and reimburse costs incurred after submission of the...

Cost-effectiveness of a new strategy to identify uncomplicated gallstone disease patients that will benefit from a cholecystectomy.

PubMed

Lamberts, Mark P; Özdemir, Cihan; Drenth, Joost P H; van Laarhoven, Cornelis J H M; Westert, Gert P; Kievit, Wietske

2017-06-01

The aim of this study was to determine the cost-effectiveness of a new strategy for the preoperative detection of patients that will likely benefit from a cholecystectomy, using simple criteria that can be applied by surgeons. Criteria for a cholecystectomy indication are: (1) having episodic pain; (2) onset of pain 1 year or less before the outpatient clinic visit. The cost-effectiveness of the new strategy was evaluated against current practice using a decision analytic model. The incremental cost-effectiveness of applying criteria for a cholecystectomy for a patient with abdominal pain and gallstones was compared to applying no criteria. The incremental cost-effectiveness ratio (ICER) was expressed as extra costs to be invested to gain one more patient with absence of pain. Scenarios were analyzed to assess the influence of applying different criteria. The new strategy of applying one out of two criteria resulted in a 4 % higher mean proportion of patients with absence of pain compared to current practice with similar costs. The 95 % upper limit of the ICER was €4114 ($4633) per extra patient with relief of upper abdominal pain. Application of two out of two criteria resulted in a 3 % lower mean proportion of patients with absence of pain with lower costs. The new strategy of using one out of two strict selection criteria may be an effective but also a cost-effective method to reduce the proportion of patients with pain after cholecystectomy.

Telemedicine: legal and licensure issues

NASA Astrophysics Data System (ADS)

Wood, Michael B.; Whelan, Leo J.

1995-10-01

The National Information Infrastructure program offers a great opportunity for the United States to capitalize on remarkable technological advancements over a broad range of applications benefiting society. One such application, telemedicine, has the potential to offer widespread access to sophisticated medical care, curtailed health care delivery costs, and homogeneous health and health-related educational opportunities. However, there are a variety of barriers to widespread application of telemedicine once the technical infrastructure of the information highway is well established and ubiquitous. These barriers include technical limitations, reimbursement issues, equipment and networking costs, and appropriate scientific studies to document efficacy and cost effectiveness. These issues may prove to be only transient disincentives which can be surmounted. Additional barriers exist, however, that may not be as readily resolved by traditional methods of analysis and more widespread practice applications. These political and regulatory obstacles will require clarification of the issues and solutions based on national consensus. It is the purpose of this discussion to amplify on these particular barriers which include licensure and tort jurisdiction.

A review on the geoenvironmental and geoecological integrated technology for environmental remediation in Vietnam: approaches, contributions, challenges and perspectives

NASA Astrophysics Data System (ADS)

Trong Nhuan, Mai; Hoang Ha, Nguyen Thi; Hoai, Ta Thi; Dang Quy, Tran

2017-06-01

Geoenvironmental and geoecological integrated technology (GGIT) is a cost-effective and environment-friendly technology that encompasses the applications of earth science principles and functions of geological environment and ecosystems to assimilate and minimize the spread of pollutants, to enhance the sorption capacity and environmental remediation. On the basis of the integrated approaches such as system, anthropogenic activities - ecosystem - environment interaction, effectiveness and feasibility, GGIT has provided significant applications in Vietnam such as waste containment and remediation and environmental protection. The results of a pilot scale using iron mine drainage sludge and common reed (Phragmites australis) for wastewater treatment in a Pb-Zn mine in northern Vietnam indicated the effective and potential application of GGIT. However, GGIT has many challenges in limited funding conditions, constraints in the initial development of GGIT, incomplete transfer to users, and quantitative assessment of pollutant cleanup by natural environments and ecosystems. Environmental pollution quote, impacts to exposed organisms, increasing demands for application of low-cost technologies, the availability of potential sorbents, indigenous plants, and ecosystems for environmental remediation, and collaboration will promote development, contribution, and implementation of GGIT applications in Vietnam.

Towards practical implementation of biophotonics-based solutions for cost-effective monitoring of food quality control (Conference Presentation)

NASA Astrophysics Data System (ADS)

Meglinski, Igor; Popov, Alexey; Bykov, Alexander

2017-03-01

Biophotonics-based diagnostic and imaging modalities have been widely used in various applications associated with the non-invasive imaging of the internal structure of a range biological media from a range of cells cultures to biological tissues. With the fast growing interest in food securities there remains strong demand to apply reliable and cost effective biophotonics-based technologies for rapid screening of freshness, internal defects and quality of major agricultural products. In current presentation the results of application of optical coherence tomography (OCT) and encapsulated optical bio-sensors for quantitative assessment of freshness of agricultural products, such as meat and sea foods, are presented, and their further perspectives are discussed.

Cost-effectiveness of hysteroscopy screening for infertile women.

PubMed

Kasius, Jenneke C; Eijkemans, René J C; Mol, Ben W J; Fauser, Bart C J M; Fatemi, Human M; Broekmans, Frank J M

2013-06-01

This study assessed the cost-effectiveness of office hysteroscopy screening prior to IVF. Therefore, the cost-effectiveness of two distinct strategies - hysteroscopy after two failed IVF cycles (Failedhyst) and routine hysteroscopy prior to IVF (Routinehyst) - was compared with the reference strategy of no hysteroscopy (Nohyst). When present, intrauterine pathology was treated during hysteroscopy. Two models were constructed and evaluated in a decision analysis. In model I, all patients had an increase in pregnancy rate after screening hysteroscopy prior to IVF; in model II, only patients with intrauterine pathology would benefit. For each strategy, the total costs and live birth rates after a total of three IVF cycles were assessed. For model I (all patients benefit from hysteroscopy), Routinehyst was always cost-effective compared with Nohyst or Failedhyst. For the Routinehyst strategy, a monetary profit would be obtained in the case where hysteroscopy would increase the live birth rate after IVF by ≥ 2.8%. In model II (only patients with pathology benefit from hysteroscopy), Routinehyst also dominated Failedhyst. However, hysteroscopy performance resulted in considerable costs. In conclusion, the application of a routine hysteroscopy prior to IVF could be cost-effective. However, randomized trials confirming the effectiveness of hysteroscopy are needed. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia.

PubMed

Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D; Garcia, Patricia J; Bronzan, Rachel; Gill, Michelle M; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W; Newman, Lori

2015-06-01

Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Although this analysis found screening using RPR to be relatively cheap, most (>70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. Copyright © 2015 International Federation of Gynecology and Obstetrics. All rights reserved.

The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia

PubMed Central

Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D.; Garcia, Patricia J.; Bronzan, Rachel; Gill, Michelle M.; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W.; Newman, Lori

2015-01-01

Objective Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Methods Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Results Although this analysis found screening using RPR to be relatively cheap, most (> 70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. Conclusion This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. PMID:25963907

41 CFR 109-1.5301 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... responsible for developing a cost effective high risk property management system, covering all operational... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Applicability. 109-1.5301 Section 109-1.5301 Public Contracts and Property Management Federal Property Management...

41 CFR 109-1.5301 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... responsible for developing a cost effective high risk property management system, covering all operational... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Applicability. 109-1.5301 Section 109-1.5301 Public Contracts and Property Management Federal Property Management...

Thin Client Architecture: The Promise and the Problems.

ERIC Educational Resources Information Center

Machovec, George S.

1997-01-01

Describes thin clients, a networking technology that allows organizations to provide software applications over networked workstations connected to a central server. Topics include corporate settings; major advantages, including cost effectiveness and increased computer security; problems; and possible applications for large public and academic…

Application of cathodic prevention in a new concrete bridge deck in Virginia.

DOT National Transportation Integrated Search

2003-01-01

Corrosion of reinforcement in concrete bridges has been a major factor in limiting the service life of many such structures. As part of a concerted effort to identify cost-effective options for eliminating corrosion of reinforcement, the application ...

Cost-effectiveness analysis of the diarrhea alleviation through zinc and oral rehydration therapy (DAZT) program in rural Gujarat India: an application of the net-benefit regression framework.

PubMed

Shillcutt, Samuel D; LeFevre, Amnesty E; Fischer-Walker, Christa L; Taneja, Sunita; Black, Robert E; Mazumder, Sarmila

2017-01-01

This study evaluates the cost-effectiveness of the DAZT program for scaling up treatment of acute child diarrhea in Gujarat India using a net-benefit regression framework. Costs were calculated from societal and caregivers' perspectives and effectiveness was assessed in terms of coverage of zinc and both zinc and Oral Rehydration Salt. Regression models were tested in simple linear regression, with a specified set of covariates, and with a specified set of covariates and interaction terms using linear regression with endogenous treatment effects was used as the reference case. The DAZT program was cost-effective with over 95% certainty above $5.50 and $7.50 per appropriately treated child in the unadjusted and adjusted models respectively, with specifications including interaction terms being cost-effective with 85-97% certainty. Findings from this study should be combined with other evidence when considering decisions to scale up programs such as the DAZT program to promote the use of ORS and zinc to treat child diarrhea.

Economics of food irradiation

NASA Astrophysics Data System (ADS)

Kunstadt, Peter; Eng, P.; Steeves, Colyn; Beaulieu, Daniel; Eng, P.

1993-07-01

The number of products being radiation processed worldwide is constantly increasing and today includes such diverse items as medical disposables, fruits and vegetables, spices, meats, seafoods and waste products. This range of products to be processed has resulted in a wide range of irradiator designs and capital and operating cost requirements. This paper discusses the economics of low dose food irradiation applications and the effects of various parameters on unit processing costs. It provides a model for calculating specific unit processing costs by correlating known capital costs with annual operating costs and annual throughputs. It is intended to provide the reader with a general knowledge of how unit processing costs are derived.

The impact of inclusion criteria in health economic assessments.

PubMed

Richter, Anke; Thieda, Patricia; Thaler, Kylie; Gartlehner, Gerald

2011-05-01

The debate surrounding whether the findings of efficacy studies are applicable to real-world treatment situations is ongoing. The issue of lack of applicability due to a lack of clinical heterogeneity could be addressed by employing less restrictive inclusion criteria. Given that health economic assessments based on cost-effectiveness measures are required by many governments and insurance providers, the impact of this choice may be far reaching. The objective of this article was to explore the use of a pilot study to examine the impact of inclusion criteria on cost-effectiveness results and clinical heterogeneity. A health economic assessment was conducted using QRISK®2 and simulation modelling of different population groups within the pilot study in Lower Austria. Patients were referred by their family physicians to 'Active Prevention' (Vorsorge Aktiv), a community-based lifestyle intervention focused on exercise and nutritional programmes. Cardiovascular risk factors were recorded before and after the intervention and translated to cardiovascular events. As expected, enforcing restrictive inclusion criteria produced stronger and more irrefutable computations - in the expected number of events, the number of deaths, the incremental cost per life-year saved and in the 95% confidence interval. These findings provide insight into the issues surrounding clinical heterogeneity and the need for restrictive inclusion criteria. This is not a full health economic assessment of the intervention. While inclusion criteria provide stronger results by limiting populations to those who would benefit the most, they must be enforced, both within and outside the clinical trial setting. Enforcement has costs, both monetary and arising from unintended negative consequences of enforcement mechanisms. All these considerations will affect the results realized by the payer organization. A pilot study can reveal whether an intervention may be cost effective 'enough' without restrictive inclusion criteria and can enable researchers to search for population subgroups in which the intervention remains cost effective. When the pilot study does not indicate sufficiently strong cost-effectiveness results, the broader trade-offs between clinical heterogeneity and the strength of the submission package to the reimbursement agency can be discussed by all parties. Payer concerns about the ability to generalize the results beyond the clinical trial can also be discussed at this time. Applicability then depends on the ability to enforce inclusion criteria similar to those used in the trials in the real world.

Evaluating the effects of variation in clinical practice: a risk adjusted cost-effectiveness (RAC-E) analysis of acute stroke services.

PubMed

Pham, Clarabelle; Caffrey, Orla; Ben-Tovim, David; Hakendorf, Paul; Crotty, Maria; Karnon, Jonathan

2012-08-21

Methods for the cost-effectiveness analysis of health technologies are now well established, but such methods may also have a useful role in the context of evaluating the effects of variation in applied clinical practice. This study illustrates a general methodology for the comparative analysis of applied clinical practice at alternative institutions--risk adjusted cost-effectiveness (RAC-E) analysis--with an application that compares acute hospital services for stroke patients admitted to the main public hospitals in South Australia. Using linked, routinely collected data on all South Australian hospital separations from July 2001 to June 2008, an analysis of the RAC-E of services provided at four metropolitan hospitals was undertaken using a decision analytic framework. Observed (plus extrapolated) and expected lifetime costs and survival were compared across patient populations, from which the relative cost-effectiveness of services provided at the different hospitals was estimated. Unadjusted results showed that at one hospital patients incurred fewer costs and gained more life years than at the other hospitals (i.e. it was the dominant hospital). After risk adjustment, the cost minimizing hospital incurred the lowest costs, but with fewer life-years gained than one other hospital. The mean incremental cost per life-year gained of services provided at the most effective hospital was under $20,000, with an associated 65% probability of being cost-effective at a $50,000 per life year monetary threshold. RAC-E analyses can be used to identify important variation in the costs and outcomes associated with clinical practice at alternative institutions. Such data provides an impetus for further investigation to identify specific areas of variation, which may then inform the dissemination of best practice service delivery and organisation.

Modified natural cycle versus controlled ovarian hyperstimulation IVF: a cost-effectiveness evaluation of three simulated treatment scenarios.

PubMed

Groen, Henk; Tonch, Nino; Simons, Arnold H M; van der Veen, Fulco; Hoek, Annemieke; Land, Jolande A

2013-12-01

Can modified natural cycle IVF or ICSI (MNC) be a cost-effective alternative for controlled ovarian hyperstimulation IVF or ICSI (COH)? The comparison of simulated scenarios indicates that a strategy of three to six cycles of MNC with minimized medication is a cost-effective alternative for one cycle of COH with strict application of single embryo transfer (SET). MNC is cheaper per cycle than COH but also less effective in terms of live birth rate (LBR). However, strict application of SET in COH cycles reduces effectiveness and up to three MNC cycles can be performed at the same costs as one COH cycle. The cost-effectiveness of MNC versus COH was evaluated in three simulated treatment scenarios: three cycles of MNC versus one cycle of COH with SET or double embryo transfer (DET) and subsequent transfer of cryopreserved embryos (Scenario 1); six cycles of MNC versus one cycle of COH with strictly SET and subsequent transfer of cryopreserved embryos (Scenario 2); six cycles of MNC with minimized medication (hCG ovulation trigger only) versus one cycle of COH with SET or DET and subsequent transfer of cryopreserved embryos (Scenario 3). We used baseline data obtained from two retrospective cohorts of consecutive patients (2005-2008) undergoing MNC in the University Medical Center Groningen (n = 499, maximum six cycles per patient) or their first COH cycle with subsequent transfer of cryopreserved embryos in the Academic Medical Center Amsterdam (n = 392). Data from 1994 MNC cycles (958 MNC-IVF and 1036 MNC-ICSI) and 392 fresh COH cycles (one per patient, 196 COH-IVF and 196 COH-ICSI) with subsequent transfer of cryopreserved embryos (n = 72 and n = 94 in MNC and COH cycles, respectively) in ovulatory, subfertile women <36 years of age served as baseline for the three simulated scenarios. To compare the scenarios, the incremental cost-effectiveness ratio (ICER) was calculated, defined as the ratio of the difference in IVF costs up to 6 weeks postpartum to the difference in LBR. Live birth was the primary outcome measure and was defined as the birth of at least one living child after a gestation of ≥25 weeks. In the baseline data, MNC was not cost-effective, as COH dominated MNC with a higher cumulative LBR (27.0 versus 24.0%) and lower cost per patient (€3694 versus €5254). The simulations showed that in scenario 1 three instead of six cycles lowered the costs of MNC to below the level of COH (€3390 versus €3694, respectively), but also lowered the LBR per patient (from 24.0 to 16.2%, respectively); Scenario 2: COH with strict SET was less effective than six cycles MNC (LBR 17.5 versus 24.0%, respectively), but also less expensive per patient (€2908) than MNC (€5254); Scenario 3: improved the cost-effectiveness of MNC but COH still dominated MNC when medication was minimized in terms of costs, i.e. €855 difference in favor of COH and 3% difference in LBR in favor of COH (ICER: €855/-3.0%). Owing to the retrospective nature of the study, the analyses required some assumptions, for example regarding the costs of pregnancy and delivery, which had to be based on the literature rather than on individual data. Furthermore, costs of IVF treatment were based on tariffs and not on actual costs. Although this may limit the external generalizability of the results, the limitations will influence both treatments equally, and would therefore not bias the comparison of MNC versus COH. The combined results suggest that MNC with minimized medication might be a cost-effective alternative for COH with strict SET. The scenarios reflect realistic alternatives for daily clinical practice. A preference for MNC depends on the willingness to trade off effectiveness in terms of LBR against the benefits of a milder stimulation regimen, including a very low rate of multiple pregnancies and hyperstimulation syndrome and ensuing lower costs per live birth. The study was supported by research grants from Merck Serono and Ferring Pharmaceuticals. The authors declare no conflicts of interest. Not applicable.

Electrification Beyond Light Duty: Class 2b-3 Commercial Vehicles

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

Birky, Alicia; Laughlin, Michael; Tartaglia, Katie

The class 2b-3 truck market covers a wide range of commercial truck applications across a half-million vehicle sales annually. This report collected public information and stakeholder input to assess the opportunity for electrification in this market. Although class 2b-3 pickup truck and van bodies are very similar to personal light vehicles, their functional requirements are quite different due to the demands of the commercial market. These demands vary by application and often vary from day to day for a single application. Fleet customers purchase these vehicles to perform a particular job for their business and are concerned about the overallmore » cost of doing that job. Therefore, the vehicles must meet the job requirements cost effectively. Customers also are sensitive to initial cost. Electrification offers the potential to reduce vehicle operating costs and possibly improve vehicle functionality. However, the current market for class 2b-3 electrified trucks is very small, and the trucks are costly. Increased production volumes are key to cost reductions and may be assisted by sharing components with larger or smaller truck classes. Expanding demand is also crucial and stakeholders identified several niche markets with duty cycles that are likely well-suited to electrified class 2b-3 trucks. To expand beyond these niches, class 2b-3 electric solutions must be robust, flexible, and adaptable in order to cover a wide range of vocations, applications, and duty cycles.« less

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

Ramachandran, N.

New technologies were used to cost-effectively remediate several hundred feet of radioactively contaminated subsurface drain pipes at the General Motors site in Adrian, Michigan, and to conduct post-remedial verification surveys. Supplemental cleanup criteria were applied to inaccessible areas of the project, and inexpensive treatment technology was used to treat wastewater generated. Application of these methods resulted in substantial cost savings.

48 CFR 231.205-18 - Independent research and development and bid and proposal costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... development of technologies identified as critical under 10 U.S.C. 2522. (6) Increase the development and promotion of efficient and effective applications of dual-use technologies. (7) Provide efficient and... and life-cycle costs of military systems. (3) Strengthen the defense industrial and technology base of...

48 CFR 231.205-18 - Independent research and development and bid and proposal costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... development of technologies identified as critical under 10 U.S.C. 2522. (6) Increase the development and promotion of efficient and effective applications of dual-use technologies. (7) Provide efficient and... and life-cycle costs of military systems. (3) Strengthen the defense industrial and technology base of...

48 CFR 231.205-18 - Independent research and development and bid and proposal costs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... development of technologies identified as critical under 10 U.S.C. 2522. (6) Increase the development and promotion of efficient and effective applications of dual-use technologies. (7) Provide efficient and... and life-cycle costs of military systems. (3) Strengthen the defense industrial and technology base of...

48 CFR 231.205-18 - Independent research and development and bid and proposal costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... development of technologies identified as critical under 10 U.S.C. 2522. (6) Increase the development and promotion of efficient and effective applications of dual-use technologies. (7) Provide efficient and... and life-cycle costs of military systems. (3) Strengthen the defense industrial and technology base of...

48 CFR 231.205-18 - Independent research and development and bid and proposal costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... development of technologies identified as critical under 10 U.S.C. 2522. (6) Increase the development and promotion of efficient and effective applications of dual-use technologies. (7) Provide efficient and... and life-cycle costs of military systems. (3) Strengthen the defense industrial and technology base of...

Assessment of microbial biomass carbon and nitrogen of native and non-native perennial pasture soils using hyperspectral data

USDA-ARS?s Scientific Manuscript database

Soil microbial biomass carbon (MBC) and nitrogen (MBN) are integral parts to soil organic matter. Increased production costs and chemical runoff can result from excessive application of fertilizer if these measurements are not used in total nutrient calculations. More timely and cost-effective me...

42 CFR 422.6 - Cost-sharing in enrollment-related costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... assistance program) and section 1860D-1(c) of the Act (relating to dissemination of enrollment information... which enrollment is effected or coordinated under section 1851 of the Act. (d) Collection of fees—(1... under title XVIII. (f) Assessment methodology. (1) The amount of the applicable portion of the user fee...

Metal-matrix composites: Status and prospects

NASA Technical Reports Server (NTRS)

1974-01-01

Applications of metal matrix composites for air frames and jet engine components are discussed. The current state of the art in primary and secondary fabrication is presented. The present and projected costs were analyzed to determine the cost effectiveness of metal matrix composites. The various types of metal matrix composites and their characteristics are described.

Results of FM-TV threshold reduction investigation for the ATS F trust experiment

NASA Technical Reports Server (NTRS)

Brown, J. P.

1972-01-01

An investigation of threshold effects in FM TV was initiated to determine if any simple, low cost techniques were available which can reduce the subjective video threshold, applicable to low cost community TV reception via satellite. Two methods of eliminating these effects were examined: the use of standard video pre-emphasis, and the use of an additional circuit to blank the picture tube during the retrace period.

NOSC Program Managers Handbook. Revision 1

DTIC Science & Technology

1988-02-01

cost. The effects of application of life-cycle cost analysis through the planning and RIDT&E phases of a program, and the " design to cost" concept on...is the plan for assuring the quality of the design , design documentation, and fabricated/assembled hardware and associated computer software. 13.5.3.2...listings and printouts, which document the n. requirements, design , or details of compute : software; explain the capabilities and limitations of the

Design and Field Test of a WSN Platform Prototype for Long-Term Environmental Monitoring

PubMed Central

Lazarescu, Mihai T.

2015-01-01

Long-term wildfire monitoring using distributed in situ temperature sensors is an accurate, yet demanding environmental monitoring application, which requires long-life, low-maintenance, low-cost sensors and a simple, fast, error-proof deployment procedure. We present in this paper the most important design considerations and optimizations of all elements of a low-cost WSN platform prototype for long-term, low-maintenance pervasive wildfire monitoring, its preparation for a nearly three-month field test, the analysis of the causes of failure during the test and the lessons learned for platform improvement. The main components of the total cost of the platform (nodes, deployment and maintenance) are carefully analyzed and optimized for this application. The gateways are designed to operate with resources that are generally used for sensor nodes, while the requirements and cost of the sensor nodes are significantly lower. We define and test in simulation and in the field experiment a simple, but effective communication protocol for this application. It helps to lower the cost of the nodes and field deployment procedure, while extending the theoretical lifetime of the sensor nodes to over 16 years on a single 1 Ah lithium battery. PMID:25912349

Dynamic adjustment in agricultural practices to economic incentives aiming to decrease fertilizer application.

PubMed

Sun, Shanxia; Delgado, Michael S; Sesmero, Juan P

2016-07-15

Input- and output-based economic policies designed to reduce water pollution from fertilizer runoff by adjusting management practices are theoretically justified and well-understood. Yet, in practice, adjustment in fertilizer application or land allocation may be sluggish. We provide practical guidance for policymakers regarding the relative magnitude and speed of adjustment of input- and output-based policies. Through a dynamic dual model of corn production that takes fertilizer as one of several production inputs, we measure the short- and long-term effects of policies that affect the relative prices of inputs and outputs through the short- and long-term price elasticities of fertilizer application, and also the total time required for different policies to affect fertilizer application through the adjustment rates of capital and land. These estimates allow us to compare input- and output-based policies based on their relative cost-effectiveness. Using data from Indiana and Illinois, we find that input-based policies are more cost-effective than their output-based counterparts in achieving a target reduction in fertilizer application. We show that input- and output-based policies yield adjustment in fertilizer application at the same speed, and that most of the adjustment takes place in the short-term. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Parameter of evidence-based medicine in health care economics].

PubMed

Wasem, J; Siebert, U

1999-08-01

In the view of scarcity of resources, economic evaluations in health care, in which not only effects but also costs related to a medical intervention are examined and a incremental cost-outcome-ratio is build, are an important supplement to the program of evidence based medicine. Outcomes of a medical intervention can be measured by clinical effectiveness, quality-adjusted life years, and monetary evaluation of benefits. As far as costs are concerned, direct medical costs, direct non-medical costs and indirect costs have to be considered in an economic evaluation. Data can be used from primary studies or secondary analysis; metaanalysis for synthesizing of data may be adequate. For calculation of incremental cost-benefit-ratios, models of decision analysis (decision tree models, Markov-models) often are necessary. Methodological and ethical limits for application of the results of economic evaluation in resource allocation decision in health care have to be regarded: Economic evaluations and the calculation of cost-outcome-rations should only support decision making but cannot replace it.

Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol.

PubMed

Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep

2016-01-01

An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. A pre-post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011) will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre-post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child services and on the cost of scaling up m-health technology for accredited social health activists in India.

Thermal spray for commercial shipbuilding

NASA Astrophysics Data System (ADS)

Rogers, F. S.

1997-09-01

Thermal spraying of steel with aluminum to protect it from corrosion is a technology that has been proven to work in the marine environment. The thermal spray coating system includes a paint sealer that is applied over the thermally sprayed aluminum. This extends the service life of the coating and provides color to the end product. The thermal spray system protects steel both through the principle of isolation (as in painting) and galvanizing. With this dual protection mechanism, steel is protected from corrosion even when the coating is damaged. The thermal- sprayed aluminum coating system has proved the most cost- effective corrosion protection system for the marine environment. Until recently, however, the initial cost of application has limited its use for general application. Arc spray technology has reduced the application cost of thermal spraying of aluminum to below that of painting. Commercial shipbuilders could use this technology to enhance their market position in the marine industry.

The Cost of Quality--Its Application to Libraries.

ERIC Educational Resources Information Center

Franklin, Brinley

1994-01-01

Examines the conceptual basis for the cost of quality and its application to libraries. The framework for analysis of this conceptual basis includes definitions of the cost of quality; a brief historical review of the cost of quality; and the application of quality cost to libraries, including an explanation of how quality costs respond to quality…

Cost Effectiveness Study of Wastewater Management Systems for Selected U.S. Coast Guard Vessels. Volume V. Characteristics and Cost Estimates of Selected Marine Sanitary Devices

DTIC Science & Technology

1977-02-01

emissions to meet Applicable standards for () disposal Of oJ~l-cOntAminated residues At sAG (A) MSD) suhsystem tias no potential for prr’ducing ail...odoriferous compounds are oxidized to mainly carbon dioxide and water vapor. The vapor treatment section (VTS) consists mainly of 1-1/2 inch piping...materials in black water stream. 61 Ability of MSD secondary emissions to moot applicable standards for tile discharge of air pollutants (a) No

Web-Enabled Systems for Student Access.

ERIC Educational Resources Information Center

Harris, Chad S.; Herring, Tom

1999-01-01

California State University, Fullerton is developing a suite of server-based, Web-enabled applications that distribute the functionality of its student information system software to external customers without modifying the mainframe applications or databases. The cost-effective, secure, and rapidly deployable business solution involves using the…

48 CFR 36.601-3 - Applicable contracting procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Services 36.601-3 Applicable contracting procedures. (a)(1) For facility design contracts, the statement of work shall require that the architect-engineer specify, in the construction design specifications, use..., availability, price reasonableness, and cost-effectiveness. Where appropriate, the statement of work also shall...

A Universal Nutrient Application Strategy For The Bioremediation Of Oil-Polluted Beaches

EPA Science Inventory

Biostimulation by nutrient application is a viable technology for restoring oil-contaminated beaches. Maximizing the nutrient residence time is key for achieving a rapid cost-effective cleanup. We considered the nutrient injection strategy through a perforated pipe at the high ti...

Energy Efficiency Improvement and Cost Saving Opportunities for the Dairy Processing Industry: An ENERGY STAR? Guide for Energy and Plant Managers

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

Brush, Adrian; Masanet, Eric; Worrell, Ernst

The U.S. dairy processing industry—defined in this Energy Guide as facilities engaged in the conversion of raw milk to consumable dairy products—consumes around $1.5 billion worth of purchased fuels and electricity per year. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. dairy processing industry to reduce energy consumption and greenhouse gas emissions in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented atmore » the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. dairy processing industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures applicable to dairy processing plants are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in dairy processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. Given the importance of water in dairy processing, a summary of basic, proven measures for improving water efficiency are also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. dairy processing industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures—as well as on their applicability to different production practices—is needed to assess their cost effectiveness at individual plants.« less

Energy Efficiency Improvement and Cost Saving Opportunities for the Fruit and Vegetable Processing Industry. An ENERGY STAR Guide for Energy and Plant Managers

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

Masanet, Eric; Masanet, Eric; Worrell, Ernst

2008-01-01

The U.S. fruit and vegetable processing industry--defined in this Energy Guide as facilities engaged in the canning, freezing, and drying or dehydrating of fruits and vegetables--consumes over $800 million worth of purchased fuels and electricity per year. Energy efficiency improvement isan important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. fruit and vegetable processing industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implementedmore » at the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. fruit and vegetable processing industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures applicable to fruit and vegetable processing plants are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in fruit and vegetable processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. Given the importance of water in fruit and vegetable processing, a summary of basic, proven measures for improving plant-level water efficiency are also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. fruit and vegetable processing industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures--as well as on their applicability to different production practices--is needed to assess their cost effectiveness at individual plants.« less

Cost-effectiveness analysis of online hemodiafiltration versus high-flux hemodialysis.

PubMed

Ramponi, Francesco; Ronco, Claudio; Mason, Giacomo; Rettore, Enrico; Marcelli, Daniele; Martino, Francesca; Neri, Mauro; Martin-Malo, Alejandro; Canaud, Bernard; Locatelli, Francesco

2016-01-01

Clinical studies suggest that hemodiafiltration (HDF) may lead to better clinical outcomes than high-flux hemodialysis (HF-HD), but concerns have been raised about the cost-effectiveness of HDF versus HF-HD. Aim of this study was to investigate whether clinical benefits, in terms of longer survival and better health-related quality of life, are worth the possibly higher costs of HDF compared to HF-HD. The analysis comprised a simulation based on the combined results of previous published studies, with the following steps: 1) estimation of the survival function of HF-HD patients from a clinical trial and of HDF patients using the risk reduction estimated in a meta-analysis; 2) simulation of the survival of the same sample of patients as if allocated to HF-HD or HDF using three-state Markov models; and 3) application of state-specific health-related quality of life coefficients and differential costs derived from the literature. Several Monte Carlo simulations were performed, including simulations for patients with different risk profiles, for example, by age (patients aged 40, 50, and 60 years), sex, and diabetic status. Scatter plots of simulations in the cost-effectiveness plane were produced, incremental cost-effectiveness ratios were estimated, and cost-effectiveness acceptability curves were computed. An incremental cost-effectiveness ratio of €6,982/quality-adjusted life years (QALY) was estimated for the baseline cohort of 50-year-old male patients. Given the commonly accepted threshold of €40,000/QALY, HDF is cost-effective. The probabilistic sensitivity analysis showed that HDF is cost-effective with a probability of ~81% at a threshold of €40,000/QALY. It is fundamental to measure the outcome also in terms of quality of life. HDF is more cost-effective for younger patients. HDF can be considered cost-effective compared to HF-HD.

Laparoscopic versus open liver segmentectomy: prospective, case-matched, intention-to-treat analysis of clinical outcomes and cost effectiveness.

PubMed

Polignano, Francesco M; Quyn, Aaron J; de Figueiredo, Rodrigo S M; Henderson, Nikola A; Kulli, Christoph; Tait, Iain S

2008-12-01

Reduction in hospital stay, blood loss, postoperative pain and complications are common findings after laparoscopic liver resection, suggesting that the laparoscopic approach may be a suitable alternative to open surgery. Some concerns have been raised regarding cost effectiveness of this procedure and potential implications of its large-scale application. Our aim has been to determine cost effectiveness of laparoscopic liver surgery by a case-matched, case-control, intention-to-treat analysis of its costs and short-term clinical outcomes compared with open surgery. Laparoscopic liver segmentectomies and bisegmentectomies performed at Ninewells Hospital and Medical School between 2005 and 2007 were considered. Resections involving more than two Couinaud segments, or involving any synchronous procedure, were excluded. An operation-magnitude-matched control group was identified amongst open liver resections performed between 2004 and 2007. Hospital costs were obtained from the Scottish Health Service Costs Book (ISD Scotland) and average national costs were calculated. Cost of theatre time, disposable surgical devices, hospital stay, and high-dependency unit (HDU) and intensive care unit (ICU) usage were the main endpoints for comparison. Secondary endpoints were morbidity and mortality. Statistical analysis was performed with Student's t-test, chi(2) and Fisher exact test as most appropriate. Twenty-five laparoscopic liver resections were considered, including atypical resection, segmentectomy and bisegmentectomy, and they were compared to 25 matching open resections. The two groups were homogeneous by age, sex, coexistent morbidity, magnitude of resection, prevalence of liver cirrhosis and indications. Operative time (p < 0.03), blood loss (p < 0.0001), Pringle manoeuvre (p < 0.03), hospital stay (p < 0.003) and postoperative complications (p < 0.002) were significantly reduced in the laparoscopic group. Overall hospital cost was significantly lower in the laparoscopic group by an average of 2,571 pounds sterling (p < 0.04). Laparoscopic liver segmentectomy and bisegmentectomy are feasible, safe and cost effective compared to similar open resections. Large-scale application of laparoscopic liver surgery could translate into significant savings to hospitals and health care programmes.

Improved cost-effectiveness of the block co-polymer anneal process for DSA

NASA Astrophysics Data System (ADS)

Pathangi, Hari; Stokhof, Maarten; Knaepen, Werner; Vaid, Varun; Mallik, Arindam; Chan, Boon Teik; Vandenbroeck, Nadia; Maes, Jan Willem; Gronheid, Roel

2016-04-01

This manuscript first presents a cost model to compare the cost of ownership of DSA and SAQP for a typical front end of line (FEoL) line patterning exercise. Then, we proceed to a feasibility study of using a vertical furnace to batch anneal the block co-polymer for DSA applications. We show that the defect performance of such a batch anneal process is comparable to the process of record anneal methods. This helps in increasing the cost benefit for DSA compared to the conventional multiple patterning approaches.

Long-term cost-effectiveness of medical, endoscopic and surgical management of gastroesophageal reflux disease.

PubMed

Funk, Luke M; Zhang, James Y; Drosdeck, Joseph M; Melvin, W Scott; Walker, John P; Perry, Kyle A

2015-01-01

The long-term cost effectiveness of medical, endoscopic, and operative treatments for adults with gastroesophageal reflux disease (GERD) remains unclear. We sought to estimate the cost effectiveness of medical, endoscopic, and operative treatments for adults with GERD who require daily proton pump inhibitor (PPI) therapy. A Markov model was generated from the payer's perspective using a 6-month cycle and 30-year time horizon. The base-case patient was a 45-year-old man with symptomatic GERD taking 20 mg of omeprazole twice daily. Four treatment strategies were analyzed: PPI therapy, transoral incisionless fundoplication (EsophyX), radiofrequency energy application to the lower esophageal sphincter (Stretta) and laparoscopic Nissen fundoplication. The model parameters were selected using the published literature and institutional billing data. The main outcome measure was the incremental cost-effectiveness ratio (cost per quality-adjusted life-year gained) for each therapy. In the base case analysis, which assumed a PPI cost of $234 over 6 months ($39 per month), Stretta and laparoscopic Nissen fundoplication were the most cost-effective options over a 30-year time period ($2,470.66 and $5,579.28 per QALY gained, respectively). If the cost of PPI therapy exceeded $90.63 per month over 30 years, laparoscopic Nissen fundoplication became the dominant treatment option. EsophyX was dominated by laparoscopic Nissen fundoplication at all points in time. Low-cost PPIs, Stretta, and laparoscopic Nissen fundoplication all represent cost-effective treatment strategies. In this model, when PPIs exceed $90 per month, medical therapy is no longer cost effective. Procedural GERD therapy should be considered for patients who require high-dose or expensive PPIs. Copyright © 2015 Elsevier Inc. All rights reserved.

Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives.

PubMed

Zempsky, William T; Zehrer, Cindy L; Lyle, Christopher T; Hedbloom, Edwin C

2005-09-01

Our objective was to review and assess the treatment of low-tension wounds and evaluate the cost-effectiveness of wound closure methods. We used a health economic model to estimate cost/closure of adhesive wound closure strips, tissue adhesives and sutures. The model incorporated cost-driving variables: application time, costs and the likelihood and costs of dehiscence and infection. The model was populated with variable estimates derived from the literature. Cost estimates and cosmetic results were compared. Parameter values were estimated using national healthcare and labour statistics. Sensitivity analyses were used to verify the results. Our analysis suggests that adhesive wound closure strips had the lowest average cost per laceration ($7.54), the lowest cost per infected laceration ($53.40) and the lowest cost per laceration with dehiscence ($25.40). The costs for sutures were $24.11, $69.91 and $41.91, respectively; the costs for tissue adhesives were $28.77, $74.68 and $46.68, respectively. The cosmetic outcome for all three treatments was equivalent. We conclude adhesive wound closure strips were both a cost-saving and a cost-effective alternative to sutures and tissue adhesives in the closure of low-tension lacerations.

Incremental cost of implementing residual insecticide treatment with delthametrine on top of intensive routine Aedes aegypti control.

PubMed

Baly, Alberto; Gonzalez, Karelia; Cabrera, Pedro; Popa, Julio C; Toledo, Maria E; Hernandez, Claudia; Montada, Domingo; Vanlerberghe, Veerle; Van der Stuyft, Patrick

2016-05-01

Information on the cost of implementing residual insecticide treatment (RIT) for Aedes control is scarce. We evaluated the incremental cost on top of intensive conventional routine activities of the Aedes control programme (ACP) in the city of Santiago de Cuba, Cuba. We conducted the cost analysis study in 2011-2012, from the perspective of the ACP. Data sources were bookkeeping records, activity registers of the Provincial ACP Centre and the accounts of an RIT implementation study in 21 clusters of on average four house blocks comprising 5180 premises. The annual cost of the routine ACP activities was 19.66 US$ per household. RIT applications in rounds at 4-month intervals covering, on average, 97.2% and using 8.5 g of delthametrine annually per household, cost 3.06 US$ per household per year. Delthametrine comprised 66.5% of this cost; the additional cost for deploying RIT comprised 15.6% of the total ACP routine cost and 27% of the cost related to routine adult stage Aedes control. The incremental cost of implementing RIT is high. It should be weighed against the incremental effect on the burden caused by the array of pathogens transmitted by Aedes. The cost could be reduced if the insecticide became cheaper, by limiting the number of yearly applications or by targeting transmission hot spots. © 2016 John Wiley & Sons Ltd.

Operating Room Time Savings with the Use of Splint Packs: A Randomized Controlled Trial

PubMed Central

Gonzalez, Tyler A.; Bluman, Eric M.; Palms, David; Smith, Jeremy T.; Chiodo, Christopher P.

2016-01-01

Background: The most expensive variable in the operating room (OR) is time. Lean Process Management is being used in the medical field to improve efficiency in the OR. Streamlining individual processes within the OR is crucial to a comprehensive time saving and cost-cutting health care strategy. At our institution, one hour of OR time costs approximately $500, exclusive of supply and personnel costs. Commercially prepared splint packs (SP) contain all components necessary for plaster-of-Paris short-leg splint application and have the potential to decrease splint application time and overall costs by making it a more lean process. We conducted a randomized controlled trial comparing OR time savings between SP use and bulk supply (BS) splint application. Methods: Fifty consecutive adult operative patients on whom post-operative short-leg splint immobilization was indicated were randomized to either a control group using BS or an experimental group using SP. One orthopaedic surgeon (EMB) prepared and applied all of the splints in a standardized fashion. Retrieval time, preparation time, splint application time, and total splinting time for both groups were measured and statistically analyzed. Results: The retrieval time, preparation time and total splinting time were significantly less (p<0.001) in the SP group compared with the BS group. There was no significant difference in application time between the SP group and BS group. Conclusion: The use of SP made the process of splinting more lean. This has resulted in an average of 2 minutes 52 seconds saved in total splinting time compared to BS, making it an effective cost-cutting and time saving technique. For high volume ORs, use of splint packs may contribute to substantial time and cost savings without impacting patient safety. PMID:26894212

Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

PubMed Central

Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

2016-01-01

Background: Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. Objective: This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran. Methods: This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS. Results: The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. Conclusion: By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department. PMID:26234974

Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital.

PubMed

Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

2015-05-17

Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran.‎ This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS.‎ The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department.

Cost-effectiveness of Competing Strategies for Management of Recurrent Clostridium difficile Infection: A Decision Analysis

PubMed Central

Konijeti, Gauree G.; Sauk, Jenny; Shrime, Mark G.; Gupta, Meera; Ananthakrishnan, Ashwin N.

2014-01-01

Background. Clostridium difficile infection (CDI) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. The cost-effectiveness of newer treatments for recurrent CDI has not been examined, yet would be important to inform clinical practice. The aim of this study was to analyze the cost effectiveness of competing strategies for recurrent CDI. Methods. We constructed a decision-analytic model comparing 4 treatment strategies for first-line treatment of recurrent CDI in a population with a median age of 65 years: metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplant (FMT). We modeled up to 2 additional recurrences following the initial recurrence. We assumed FMT delivery via colonoscopy as our base case, but conducted sensitivity analyses based on different modes of delivery. Willingness-to-pay threshold was set at $50 000 per quality-adjusted life-year. Results. At our base case estimates, initial treatment of recurrent CDI using FMT colonoscopy was the most cost-effective strategy, with an incremental cost-effectiveness ratio of $17 016 relative to oral vancomycin. Fidaxomicin and metronidazole were both dominated by FMT colonoscopy. On sensitivity analysis, FMT colonoscopy remained the most cost-effective strategy at cure rates >88.4% and CDI recurrence rates <14.9%. Fidaxomicin required a cost <$1359 to meet our cost-effectiveness threshold. In clinical settings where FMT is not available or applicable, the preferred strategy appears to be initial treatment with oral vancomycin. Conclusions. In this decision analysis examining treatment strategies for recurrent CDI, we demonstrate that FMT colonoscopy is the most cost-effective initial strategy for management of recurrent CDI. PMID:24692533

Cost-effectiveness of Project ADAM: a project to prevent sudden cardiac death in high school students.

PubMed

Berger, S; Whitstone, B N; Frisbee, S J; Miner, J T; Dhala, A; Pirrallo, R G; Utech, L M; Sachdeva, R C

2004-01-01

Public access defibrillation (PAD) in the adult population is thought to be both efficacious and cost-effective. Similar programs aimed at children and adolescents have not been evaluated for their cost-effectiveness. This study evaluates the potential cost-effectiveness of implementing Project ADAM, a program targeting children and adolescents in high schools in the Milwaukee Public School System. Project ADAM provides education about cardiopulmonary resuscitation (CPR) and the warning signs of sudden cardiac death (SCD) and training in the use and placement of automated external defibrillators (AEDs) in high schools. We developed decision analysis models to evaluate the cost-effectiveness of the decision to implement Project ADAM in public high schools in Milwaukee. We examined clinical model and public policy applications. Data on costs included estimates of hospital-based charges derived from a pediatric medical center where a series of patients were treated for SCD, educational programming, and the direct costs of one AED and training for 15 personnel per school. We performed sensitivity analyses to assess the variation in outputs with respect to changes to input data. The main outcome measures were Life years saved and incremental cost-effectiveness ratios. At an arbitrary societal willingness to pay $100,000 per life year saved, the policy to implement Project ADAM in schools is a cost-effective strategy at a threshold of approximately 5 patients over 5 years for the clinical model and approximately 8 patients over 5 years for the public policy model. Implementation of Project ADAM in high schools in the United States is potentially associated with an incremental cost-effectiveness ratio that is favorable.

Modelling the Cost Effectiveness of Disease-Modifying Treatments for Multiple Sclerosis

PubMed Central

Thompson, Joel P.; Abdolahi, Amir; Noyes, Katia

2013-01-01

Several cost-effectiveness models of disease-modifying treatments (DMTs) for multiple sclerosis (MS) have been developed for different populations and different countries. Vast differences in the approaches and discrepancies in the results give rise to heated discussions and limit the use of these models. Our main objective is to discuss the methodological challenges in modelling the cost effectiveness of treatments for MS. We conducted a review of published models to describe the approaches taken to date, to identify the key parameters that influence the cost effectiveness of DMTs, and to point out major areas of weakness and uncertainty. Thirty-six published models and analyses were identified. The greatest source of uncertainty is the absence of head-to-head randomized clinical trials. Modellers have used various techniques to compensate, including utilizing extension trials. The use of large observational cohorts in recent studies aids in identifying population-based, ‘real-world’ treatment effects. Major drivers of results include the time horizon modelled and DMT acquisition costs. Model endpoints must target either policy makers (using cost-utility analysis) or clinicians (conducting cost-effectiveness analyses). Lastly, the cost effectiveness of DMTs outside North America and Europe is currently unknown, with the lack of country-specific data as the major limiting factor. We suggest that limited data should not preclude analyses, as models may be built and updated in the future as data become available. Disclosure of modelling methods and assumptions could improve the transferability and applicability of models designed to reflect different healthcare systems. PMID:23640103

Space qualification of silicon carbide for mirror applications: progress and future objectives

NASA Astrophysics Data System (ADS)

Palusinski, Iwona A.; Ghozeil, Isaac

2006-09-01

Production of optical silicon carbide (SiC) for mirror applications continues to evolve and there are renewed plans to use this material in future space-based systems. While SiC has the potential for rapid and cost-effective manufacturing of large, lightweight, athermal optical systems, this material's use in mirror applications is relatively new and has limited flight heritage. This combination of drivers stresses the necessity for a space qualification program for this material. Successful space qualification will require independent collaboration to absorb the high cost of executing this program while taking advantage of each contributing group's laboratory expertise to develop a comprehensive SiC database. This paper provides an overview of the trends and progress in the production of SiC, and identifies future objectives such as non-destructive evaluation and space-effects modeling to ensure proper implementation of this material into future space-based systems.

Magnetic induction tomography of objects for security applications

NASA Astrophysics Data System (ADS)

Ward, Rob; Joseph, Max; Langley, Abbi; Taylor, Stuart; Watson, Joe C.

2017-10-01

A coil array imaging system has been further developed from previous investigations, focusing on designing its application for fast screening of small bags or parcels, with a view to the production of a compact instrument for security applications. In addition to reducing image acquisition times, work was directed toward exploring potential cost effective manufacturing routes. Based on magnetic induction tomography and eddy-current principles, the instrument captured images of conductive targets using a lock-in amplifier, individually multiplexing signals between a primary driver coil and a 20 by 21 imaging array of secondary passive coils constructed using a reproducible multiple tile design. The design was based on additive manufacturing techniques and provided 2 orthogonal imaging planes with an ability to reconstruct images in less than 10 seconds. An assessment of one of the imaging planes is presented. This technique potentially provides a cost effective threat evaluation technique that may compliment conventional radiographic approaches.

Study of selected tether applications in space, phase 3, volume 2

NASA Technical Reports Server (NTRS)

1986-01-01

The results of a Phase 3 study of two Selected Tether Applications in Space (STAIS); deorbit of a Shuttle and launch of an Orbital Transfer Vehicle (OTV), both from the space station using a tether were examined. The study objectives were to: perform a preliminary engineering design, define operational scenarios, develop a common cost model, perform cost benefits analyses, and develop a Work Breakdown Structure (WBS). Key features of the performance analysis were to identify the net increases in effective Shuttle cargo capability if tethers are used to assist in the deorbit of Shuttles and the launching of the OTVs from the space station and to define deployer system designs required to accomplish these tasks. Deployer concepts were designed and discussed. Operational scenarios, including timelines, for both tethered and nontethered Shuttle and OTV operations at the space station were evaluated. A summary discussion of the Selected Tether Applications Cost Model (STACOM) and the results of the cost benefits analysis are presented. Several critical technologies needed to implement tether assisted deployment of payloads are also discussed. Conclusions and recommendations are presented.

Cost-effectiveness of Store-and-Forward Teledermatology: A Systematic Review.

PubMed

Snoswell, Centaine; Finnane, Anna; Janda, Monika; Soyer, H Peter; Whitty, Jennifer A

2016-06-01

Teledermatology is a topical clinical approach being tested in Australia and elsewhere. With most dermatologists residing in metropolitan areas, teledermatology provides an apparent low-cost and convenient means of access for individuals living outside these areas. It is important that any proposed new addition to a health care system is assessed on the grounds of economic cost and effectiveness. To summarize and evaluate the current economic evidence comparing store-and-forward teledermatology (S&FTD) with conventional face-to-face care. Search terms with appropriate amendments were used to identify S&FTD articles that included economic analysis. Six databases were searched, and title, abstract and full-text reviews were conducted by 2 researchers. References of all unique returned articles were searched by hand. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to evaluate quality of the included articles. Eleven articles were selected for inclusion, including 1 cost analysis, 4 cost-minimization analyses, 4 cost-effectiveness analyses, and 2 cost-utility analyses. CHEERS scores ranged from 7 to 21 out of a possible 24 points, with a median score of 17. Current evidence is sparse but suggests that S&FTD can be cost-effective. It appears to be cost-effective when used as a triage mechanism to reduce face-to-face appointment requirements. The cost-effectiveness of S&FTD increases when patients are required to travel farther distances to access dermatology services. Further economic research is required for the emerging S&FTD, which uses dermoscopes in combination with smartphone applications, as well as regarding the possibility and consequences of patients self-capturing and transmitting images.

Performance-based, cost- and time-effective pcb analytical methodology.

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

Alvarado, J. S.

1998-06-11

Laboratory applications for the analysis of PCBs (polychlorinated biphenyls) in environmental matrices such as soil/sediment/sludge and oil/waste oil were evaluated for potential reduction in waste, source reduction, and alternative techniques for final determination. As a consequence, new procedures were studied for solvent substitution, miniaturization of extraction and cleanups, minimization of reagent consumption, reduction of cost per analysis, and reduction of time. These new procedures provide adequate data that meet all the performance requirements for the determination of PCBs. Use of the new procedures reduced costs for all sample preparation techniques. Time and cost were also reduced by combining the newmore » sample preparation procedures with the power of fast gas chromatography. Separation of Aroclor 1254 was achieved in less than 6 min by using DB-1 and SPB-608 columns. With the greatly shortened run times, reproducibility can be tested quickly and consequently with low cost. With performance-based methodology, the applications presented here can be applied now, without waiting for regulatory approval.« less

Experiences of Structured Elicitation for Model-Based Cost-Effectiveness Analyses.

PubMed

Soares, Marta O; Sharples, Linda; Morton, Alec; Claxton, Karl; Bojke, Laura

2018-06-01

Empirical evidence supporting the cost-effectiveness estimates of particular health care technologies may be limited, or it may even be missing entirely. In these situations, additional information, often in the form of expert judgments, is needed to reach a decision. There are formal methods to quantify experts' beliefs, termed as structured expert elicitation (SEE), but only limited research is available in support of methodological choices. Perhaps as a consequence, the use of SEE in the context of cost-effectiveness modelling is limited. This article reviews applications of SEE in cost-effectiveness modelling with the aim of summarizing the basis for methodological choices made in each application and recording the difficulties and challenges reported by the authors in the design, conduct, and analyses. The methods used in each application were extracted along with the criteria used to support methodological and practical choices and any issues or challenges discussed in the text. Issues and challenges were extracted using an open field, and then categorised and grouped for reporting. The review demonstrates considerable heterogeneity in methods used, and authors acknowledge great methodological uncertainty in justifying their choices. Specificities of the context area emerging as potentially important in determining further methodological research in elicitation are between- expert variation and its interpretation, the fact that substantive experts in the area may not be trained in quantitative subjects, that judgments are often needed on various parameter types, the need for some form of assessment of validity, and the need for more integration with behavioural research to devise relevant debiasing strategies. This review of experiences of SEE highlights a number of specificities/constraints that can shape the development of guidance and target future research efforts in this area. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

40 CFR 57.602 - Approval of proposal.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 57.603. The application shall also specify: (1) The design and substantive elements of the research...) The smelter owner's proposal. The smelter owner's NSO application shall include a proposed NSO... agency is that the planned work must yield the most cost effective technology possible. (c) Optional...

CICS Region Virtualization for Cost Effective Application Development

ERIC Educational Resources Information Center

Khan, Kamal Waris

2012-01-01

Mainframe is used for hosting large commercial databases, transaction servers and applications that require a greater degree of reliability, scalability and security. Customer Information Control System (CICS) is a mainframe software framework for implementing transaction services. It is designed for rapid, high-volume online processing. In order…

Space system operations and support cost analysis using Markov chains

NASA Technical Reports Server (NTRS)

Unal, Resit; Dean, Edwin B.; Moore, Arlene A.; Fairbairn, Robert E.

1990-01-01

This paper evaluates the use of Markov chain process in probabilistic life cycle cost analysis and suggests further uses of the process as a design aid tool. A methodology is developed for estimating operations and support cost and expected life for reusable space transportation systems. Application of the methodology is demonstrated for the case of a hypothetical space transportation vehicle. A sensitivity analysis is carried out to explore the effects of uncertainty in key model inputs.

Six Sigma in healthcare delivery.

PubMed

Liberatore, Matthew J

2013-01-01

The purpose of this paper is to conduct a comprehensive review and assessment of the extant Six Sigma healthcare literature, focusing on: application, process changes initiated and outcomes, including improvements in process metrics, cost and revenue. Data were obtained from an extensive literature search. Healthcare Six Sigma applications were categorized by functional area and department, key process metric, cost savings and revenue generation (if any) and other key implementation characteristics. Several inpatient care areas have seen most applications, including admission, discharge, medication administration, operating room (OR), cardiac and intensive care. About 42.1 percent of the applications have error rate as their driving metric, with the remainder focusing on process time (38 percent) and productivity (18.9 percent). While 67 percent had initial improvement in the key process metric, only 10 percent reported sustained improvement. Only 28 percent reported cost savings and 8 percent offered revenue enhancement. These results do not favorably assess Six Sigma's overall effectiveness and the value it offers healthcare. Results are based on reported applications. Future research can include directly surveying healthcare organizations to provide additional data for assessment. Future application should emphasize obtaining improvements that lead to significant and sustainable value. Healthcare staff can use the results to target promising areas. This article comprehensively assesses Six Sigma healthcare applications and impact.

Minimalist fault-tolerance techniques for mitigating single-event effects in non-radiation-hardened microcontrollers

NASA Astrophysics Data System (ADS)

Caldwell, Douglas Wyche

Commercial microcontrollers--monolithic integrated circuits containing microprocessor, memory and various peripheral functions--such as are used in industrial, automotive and military applications, present spacecraft avionics system designers an appealing mix of higher performance and lower power together with faster system-development time and lower unit costs. However, these parts are not radiation-hardened for application in the space environment and Single-Event Effects (SEE) caused by high-energy, ionizing radiation present a significant challenge. Mitigating these effects with techniques which require minimal additional support logic, and thereby preserve the high functional density of these devices, can allow their benefits to be realized. This dissertation uses fault-tolerance to mitigate the transient errors and occasional latchups that non-hardened microcontrollers can experience in the space radiation environment. Space systems requirements and the historical use of fault-tolerant computers in spacecraft provide context. Space radiation and its effects in semiconductors define the fault environment. A reference architecture is presented which uses two or three microcontrollers with a combination of hardware and software voting techniques to mitigate SEE. A prototypical spacecraft function (an inertial measurement unit) is used to illustrate the techniques and to explore how real application requirements impact the fault-tolerance approach. Low-cost approaches which leverage features of existing commercial microcontrollers are analyzed. A high-speed serial bus is used for voting among redundant devices and a novel wire-OR output voting scheme exploits the bidirectional controls of I/O pins. A hardware testbed and prototype software were constructed to evaluate two- and three-processor configurations. Simulated Single-Event Upsets (SEUs) were injected at high rates and the response of the system monitored. The resulting statistics were used to evaluate technical effectiveness. Fault-recovery probabilities (coverages) higher than 99.99% were experimentally demonstrated. The greater than thousand-fold reduction in observed effects provides performance comparable with SEE tolerance of tested, rad-hard devices. Technical results were combined with cost data to assess the cost-effectiveness of the techniques. It was found that a three-processor system was only marginally more effective than a two-device system at detecting and recovering from faults, but consumed substantially more resources, suggesting that simpler configurations are generally more cost-effective.

The Application and Evaluation of PLATO IV in AF Technical Training.

ERIC Educational Resources Information Center

Mockovak, William P.; And Others

The Air Force has been plagued with the rising cost of technical training and has increasingly turned to computer-assisted instruction (CAI) for better cost effectiveness. Toward this aim a trial of PLATO IV, a CAI system utilizing a graphic display and centered at the University of Illinois, was initiated at the Chanute and Sheppard training…

Economics of wildfire management: The development and application of suppression expenditure models

Treesearch

Michael S. Hand; Krista M. Gebert; Jingjing Liang; David E. Calkin; Matthew P. Thompson; Mo Zhou

2014-01-01

In the United States, increased wildland fire activity over the last 15 years has resulted in increased pressure to balance the cost, benefits, and risks of wildfire management. Amid increased public scrutiny and a highly variable wildland fire environment, a substantial body of research has developed to study factors affecting the cost-effectiveness of wildfire...

APPLICATION AND DEVELOPMENT OF APPROPRIATE TOOLS AND TECHNOLOGIES FOR COST-EFFECTIVE CARBON

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

Bill Stanley; Sandra Brown; Ellen Hawes

2003-09-01

The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects,more » providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas impacts. The research described in this report occurred between July 1, 2002 and June 30, 2003. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: advanced videography testing; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.« less

Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

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

Bill Stanley; Sandra Brown; Patrick Gonzalez

2004-07-10

The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects,more » providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas impacts. The research described in this report occurred between July 1, 2002 and June 30, 2003. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: remote sensing for carbon analysis; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.« less

Cost-effectiveness of alternative conservation strategies with application to the Pacific leatherback turtle.

PubMed

Gjertsen, Heidi; Squires, Dale; Dutton, Peter H; Eguchi, Tomoharu

2014-02-01

Although holistic conservation addressing all sources of mortality for endangered species or stocks is the preferred conservation strategy, limited budgets require a criterion to prioritize conservation investments. We compared the cost-effectiveness of nesting site and at-sea conservation strategies for Pacific leatherback turtles (Dermochelys coriacea). We sought to determine which conservation strategy or mix of strategies would produce the largest increase in population growth rate per dollar. Alternative strategies included protection of nesters and their eggs at nesting beaches in Indonesia, gear changes, effort restrictions, and caps on turtle takes in the Hawaiian (U.S.A.) longline swordfish fishery, and temporal and area closures in the California (U.S.A.) drift gill net fishery. We used a population model with a biological metric to measure the effects of conservation alternatives. We normalized all effects by cost to prioritize those strategies with the greatest biological effect relative to its economic cost. We used Monte Carlo simulation to address uncertainty in the main variables and to calculate probability distributions for cost-effectiveness measures. Nesting beach protection was the most cost-effective means of achieving increases in leatherback populations. This result creates the possibility of noncompensatory bycatch mitigation, where high-bycatch fisheries invest in protecting nesting beaches. An example of this practice is U.S. processors of longline tuna and California drift gill net fishers that tax themselves to finance low-cost nesting site protection. Under certain conditions, fisheries interventions, such as technologies that reduce leatherback bycatch without substantially decreasing target species catch, can be cost-effective. Reducing bycatch in coastal areas where bycatch is high, particularly adjacent to nesting beaches, may be cost-effective, particularly, if fisheries in the area are small and of little commercial value. © 2014 Society for Conservation Biology.

Feasibility and costs of phosphorus application limits on 39 U.S. swine operations.

PubMed

Lory, John A; Massey, Raymond E; Zulovich, Joseph M; Hoehne, John A; Schmidt, Amy M; Carlson, Marcia S; Fulhage, Charles D

2004-01-01

Concerns about manure P and water quality have prompted new regulations imposing P limits on land application of manure. Previous research established that P limits increase land needs for animal feeding operations. We evaluated the effect of N, annual P, and rotation P limits on the feasibility of manure management. A mechanistic model characterized manure management practices on 39 swine operations (20 unagitated lagoon and 19 slurry operations) in five states (Iowa, Missouri, North Carolina, Oklahoma, and Pennsylvania). Extensive information collected from each operation was used to determine effects of manure storage type, ownership structure, and application limits on attributes of manure management. Phosphorus limits had substantially greater effect on slurry operations, increasing land needs 250% (0.3 hectares per animal unit [AU]) and time for manure application 24% (2.5 min AU(-1)) for rotation P limits and 41% (4.4 min AU(-1)) for annual P limits. Annual P limits were infeasible for current land application equipment on two operations and had the greatest effect on time and costs because they required all but three slurry operations to reduce discharge rate. We recommend implementing rotation P limits (not to exceed crop N need) to minimize time effects, allow most farmers to use their current manure application methods, and allow manure to fulfill crop N and P needs in the year of application. Phosphorus limits increased potential manure value but would require slurry operations to recover at least 61% of manure value through manure sales. Phosphorus limits are likely to shape the U.S. swine industry through differential effects on the various sectors of the swine industry.

Economic Evaluation of a School-based Combined Program with a Targeted Pit and Fissure Sealant and Fluoride Mouth Rinse in Japan.

PubMed

Sakuma, Shihoko; Yoshihara, Akihiro; Miyazaki, Hideo; Kobayashi, Seigo

2010-01-01

In Niigata prefecture, Japan, a system has been developed based on a school-based fluoride mouth rinse program as follows; students with caries susceptible teeth are screened in a school dental examination, and encouraged to receive sealant placement in local dental clinics. However, the cost-effectiveness of sealant application in the public health has been questioned. The aim of this study was to estimate of the cost-effectiveness and cost-benefit ratio for a school-based combined program with fluoride mouth rinse and targeted fissure sealant in children residing in non-fluoridated areas in Japan. The analysis was based on comparing an intervention group with two cohorts in the 8-year-old (n=66) and 11-year-old (n=58) participating in the combined program for four and seven years, respectively, with a control group of the same grades (n=43 and n=54 respectively). The study measured mean differences in number of decayed and filled teeth (DFT) between the study groups and a combined program cost per child during study periods. The cost-effectiveness ratio was expressed as an individual annual program cost per DFT averted. In the cost-benefit ratio the mean difference in treatment cost between groups (program benefit) was compared to program cost. The mean reduced DFT differences between groups were 1.44 in 8-year-old and 3.17 in 11-year-old children. The cost-effectiveness ratio was ¥ 493 in the 8-year-old and ¥ 202 in the 11-year-old, respectively. The cost-benefit ratio was 1.84 in 8-year-old children and 2.42 in 11-year-old. This combined program indicated acceptable cost-effectiveness and cost -benefit ratio.

Cost-effective management alternatives for Snake River Chinook salmon: a biological-economic synthesis.

PubMed

Halsing, David L; Moore, Michael R

2008-04-01

The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can provide valuable tools for science-based policy and management.

Cost-effective management alternatives for Snake river chinook salmon: A biological-economic synthesis

USGS Publications Warehouse

Halsing, D.L.; Moore, M.R.

2008-01-01

The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can provide valuable tools for science-based policy and management.

5 CFR 1330.404 - Certification criteria.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., quantity, timeliness, and cost effectiveness, as applicable; and those technical, leadership and/or managerial competencies or behaviors that contribute to and are necessary to distinguish outstanding...

Energy Efficiency Improvement and Cost Saving Opportunities for the Baking Industry: An ENERGY STAR ® Guide for Plant and Energy Managers

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

Masanet, Eric; Therkelsen, Peter; Worrell, Ernst

The U.S. baking industry—defined in this Energy Guide as facilities engaged in the manufacture of commercial bakery products such as breads, rolls, frozen cakes, pies, pastries, and cookies and crackers—consumes over $800 million worth of purchased fuels and electricity per year. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component,more » process, facility, and organizational levels. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in food processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. A summary of basic, proven measures for improving plant-level water efficiency is also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. baking industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures—as well as on their applicability to different production practices—is needed to assess their cost effectiveness at individual plants.« less

Building America Case Study: Simple Retrofit High-Efficiency Natural Gas Water Heater Field Test, Minneapolis, Minnesota

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

High performance water heaters are typically more time consuming and costly to install in retrofit applications, making high performance water heaters difficult to justify economically. However, recent advancements in high performance water heaters have targeted the retrofit market, simplifying installations and reducing costs. Four high efficiency natural gas water heaters designed specifically for retrofit applications were installed in single-family homes along with detailed monitoring systems to characterize their savings potential, their installed efficiencies, and their ability to meet household demands. The water heaters tested for this project were designed to improve the cost-effectiveness and increase market penetration of high efficiencymore » water heaters in the residential retrofit market. The retrofit high efficiency water heaters achieved their goal of reducing costs, maintaining savings potential and installed efficiency of other high efficiency water heaters, and meeting the necessary capacity in order to improve cost-effectiveness. However, the improvements were not sufficient to achieve simple paybacks of less than ten years for the incremental cost compared to a minimum efficiency heater. Significant changes would be necessary to reduce the simple payback to six years or less. Annual energy savings in the range of $200 would also reduce paybacks to less than six years. These energy savings would require either significantly higher fuel costs (greater than $1.50 per therm) or very high usage (around 120 gallons per day). For current incremental costs, the water heater efficiency would need to be similar to that of a heat pump water heater to deliver a six year payback.« less

Simple Retrofit High-Efficiency Natural Gas Water Heater Field Test

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

Schoenbauer, Ben

High-performance water heaters are typically more time consuming and costly to install in retrofit applications, making high performance water heaters difficult to justify economically. However, recent advancements in high performance water heaters have targeted the retrofit market, simplifying installations and reducing costs. Four high efficiency natural gas water heaters designed specifically for retrofit applications were installed in single-family homes along with detailed monitoring systems to characterize their savings potential, their installed efficiencies, and their ability to meet household demands. The water heaters tested for this project were designed to improve the cost-effectiveness and increase market penetration of high efficiency watermore » heaters in the residential retrofit market. The retrofit high efficiency water heaters achieved their goal of reducing costs, maintaining savings potential and installed efficiency of other high efficiency water heaters, and meeting the necessary capacity in order to improve cost-effectiveness. However, the improvements were not sufficient to achieve simple paybacks of less than ten years for the incremental cost compared to a minimum efficiency heater. Significant changes would be necessary to reduce the simple payback to six years or less. Annual energy savings in the range of $200 would also reduce paybacks to less than six years. These energy savings would require either significantly higher fuel costs (greater than $1.50 per therm) or very high usage (around 120 gallons per day). For current incremental costs, the water heater efficiency would need to be similar to that of a heat pump water heater to deliver a six year payback.« less

Simple Retrofit High-Efficiency Natural Gas Water Heater Field Test

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

Schoenbauer, Ben

High performance water heaters are typically more time consuming and costly to install in retrofit applications, making high performance water heaters difficult to justify economically. However, recent advancements in high performance water heaters have targeted the retrofit market, simplifying installations and reducing costs. Four high efficiency natural gas water heaters designed specifically for retrofit applications were installed in single-family homes along with detailed monitoring systems to characterize their savings potential, their installed efficiencies, and their ability to meet household demands. The water heaters tested for this project were designed to improve the cost-effectiveness and increase market penetration of high efficiencymore » water heaters in the residential retrofit market. The retrofit high efficiency water heaters achieved their goal of reducing costs, maintaining savings potential and installed efficiency of other high efficiency water heaters, and meeting the necessary capacity in order to improve cost-effectiveness. However, the improvements were not sufficient to achieve simple paybacks of less than ten years for the incremental cost compared to a minimum efficiency heater. Significant changes would be necessary to reduce the simple payback to six years or less. Annual energy savings in the range of $200 would also reduce paybacks to less than six years. These energy savings would require either significantly higher fuel costs (greater than $1.50 per therm) or very high usage (around 120 gallons per day). For current incremental costs, the water heater efficiency would need to be similar to that of a heat pump water heater to deliver a six year payback.« less

Aquifer thermal-energy-storage costs with a seasonal-chill source

NASA Astrophysics Data System (ADS)

Brown, D. R.

1983-01-01

The cost of energy supplied by an aquifer thermal energy storage (ATES) ystem from a seasonal chill source was investigated. Costs were estimated for point demand and residential development ATES systems using the computer code AQUASTOR. AQUASTOR was developed at PNL specifically for the economic analysis of ATES systems. In this analysis the cost effect of varying a wide range of technical and economic parameters was examined. Those parameters exhibiting a substantial influence on the costs of ATES delivered chill were: system size; well flow rate; transmission distance; source temperature; well depth; and cost of capital. The effects of each parameter are discussed. Two primary constraints of ATES chill systems are the extremely low energy density of the storage fluid and the prohibitive costs of lengthly pipelines for delivering chill to residential users. This economic analysis concludes that ATES-delivered chill will not be competitive for residential cooling applications. The otherwise marginal attractiveness of ATES chill systems vanishes under the extremely low load factors characteristic of residential cooling systems. (LCL)

An Analysis of Failure Handling in Chameleon, A Framework for Supporting Cost-Effective Fault Tolerant Services

NASA Technical Reports Server (NTRS)

Haakensen, Erik Edward

1998-01-01

The desire for low-cost reliable computing is increasing. Most current fault tolerant computing solutions are not very flexible, i.e., they cannot adapt to reliability requirements of newly emerging applications in business, commerce, and manufacturing. It is important that users have a flexible, reliable platform to support both critical and noncritical applications. Chameleon, under development at the Center for Reliable and High-Performance Computing at the University of Illinois, is a software framework. for supporting cost-effective adaptable networked fault tolerant service. This thesis details a simulation of fault injection, detection, and recovery in Chameleon. The simulation was written in C++ using the DEPEND simulation library. The results obtained from the simulation included the amount of overhead incurred by the fault detection and recovery mechanisms supported by Chameleon. In addition, information about fault scenarios from which Chameleon cannot recover was gained. The results of the simulation showed that both critical and noncritical applications can be executed in the Chameleon environment with a fairly small amount of overhead. No single point of failure from which Chameleon could not recover was found. Chameleon was also found to be capable of recovering from several multiple failure scenarios.

Surgical Treatment of Pressure Ulcers with a Fibrin Sealant in Patients with Spinal Cord Injury: A Cost-Consequence Analysis.

PubMed

Velasco, Jose Manuel Arévalo; Lozano, Virginia; Oyagüez, Itziar; Casado, Miguel Angel

2015-11-01

A comparative study was performed to evaluate the effectiveness and costs of a fibrin sealant (Tissucol Duo [known as Tisseel in the United States], Baxter International, Deerfield, Illinois) to improve postoperative outcomes in patients with spinal cord injury undergoing surgical treatment for pressure ulcers (PrUs). Between January and June 2011, 27 patients underwent surgical treatment for PrUs with the direct application of Tissucol Duo sprayed before closure. The costs and outcomes obtained in this cohort were compared with those obtained in a previous retrospective study where 71 patients underwent conventional surgery. Lower rates of hematoma-seroma were observed in the study group (3.7% vs 33.8%; P < .05). Drain removal occurred earlier (10 vs 15 days; P < .05), and the average drain volume was also lower (155 vs 360 mL; P < .05) for this group. The mean length of hospital stay was significantly lower in the study group and was the main contributing factor to the overall costs. The application of Tissucol Duo during surgical treatment of PrUs in patients with spinal cord injury has been shown to be effective in reducing postoperative complications and in shortening the duration of the hospital stay with a consequent savings in costs.

Solair heater program: solair applications study. Final report

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

Not Available

1977-12-01

General Electric has designed and tested a low-cost solar system using a vacuum tube solar air heater under ERDA Contract E(11-1)-2705. This contract extension has been provided to evaluate various applications of this solar collector. The evaluation identified attractive applications, evaluated corresponding control procedures, estimated system performance, compared economically insolation and insulation, and evaluated the repackaging of off-the-shelf equipment for improved cost effectiveness. The results of this study prompted General Electric's marketing group to do a detailed commercialization study of a residential domestic water heating system using the Solair concept which has been selected as the most attractive application. Othermore » attractive applications are space/domestic water heating and a heat pump assisted solar system/domestic water heating where the heat pump and the solar system function in parallel. A prime advantage of heated air solar systems over liquid systems is cost and longer life which results in higher BTU's/dollar. Other air system advantages are no liquid leakage problems, no toxicity of freezing problems, and less complicated equipment. A hybrid solar system has been identified that can improve the market penetration of solar energy. This system would use the existing mass of the house for energy storage thereby reducing solar cost and complexity. Adequate performance can be obtained with house temperature swings comparable to those used in nighttime setback of the thermostat. Details of this system are provided.« less

3D-printing techniques in a medical setting: a systematic literature review.

PubMed

Tack, Philip; Victor, Jan; Gemmel, Paul; Annemans, Lieven

2016-10-21

Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis.

Can aging in place be cost effective? A systematic review.

PubMed

Graybill, Erin M; McMeekin, Peter; Wildman, John

2014-01-01

To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs) that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place. People aged 65+ and their live-in carers (where applicable), using an ALT to age in place at home opposed to a community-dwelling arrangement. Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style. Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered. The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.

Optimizing community case management strategies to achieve equitable reduction of childhood pneumonia mortality: An application of Equitable Impact Sensitive Tool (EQUIST) in five low- and middle-income countries.

PubMed

Waters, Donald; Theodoratou, Evropi; Campbell, Harry; Rudan, Igor; Chopra, Mickey

2012-12-01

The aim of this study was to populate the Equitable Impact Sensitive Tool (EQUIST) framework with all necessary data and conduct the first implementation of EQUIST in studying cost-effectiveness of community case management of childhood pneumonia in 5 low- and middle-income countries with relation to equity impact. Wealth quintile-specific data were gathered or modelled for all contributory determinants of the EQUIST framework, namely: under-five mortality rate, cost of intervention, intervention effectiveness, current coverage of intervention and relative disease distribution. These were then combined statistically to calculate the final outcome of the EQUIST model for community case management of childhood pneumonia: US$ per life saved, in several different approaches to scaling-up. The current 'mainstream' approach to scaling-up of interventions is never the most cost-effective. Community-case management appears to strongly support an 'equity-promoting' approach to scaling-up, displaying the highest levels of cost-effectiveness in interventions targeted at the poorest quintile of each study country, although absolute cost differences vary by context. The relationship between cost-effectiveness and equity impact is complex, with many determinants to consider. One important way to increase intervention cost-effectiveness in poorer quintiles is to improve the efficiency and quality of delivery. More data are needed in all areas to increase the accuracy of EQUIST-based estimates.

The cost-effectiveness of temozolomide in the adjuvant treatment of newly diagnosed glioblastoma in the United States

PubMed Central

Messali, Andrew; Hay, Joel W.; Villacorta, Reginald

2013-01-01

Background The objective of this work was to determine the cost-effectiveness of temozolomide compared with that of radiotherapy alone in the adjuvant treatment of newly diagnosed glioblastoma. Temozolomide is the only chemotherapeutic agent to have demonstrated a significant survival benefit in a randomized clinical trial. Our analysis builds on earlier work by incorporating caregiver time costs and generic temozolomide availability. It is also the first analysis applicable to the US context. Methods A systematic literature review was conducted to collect relevant data. Transition probabilities were calculated from randomized controlled trial data comparing temozolomide plus radiotherapy with radiotherapy alone. Direct costs were calculated from charges reported by the Mayo Clinic. Utilities were obtained from a previous cost-utility analysis. Using these data, a Markov model with a 1-month cycle length and 5-year time horizon was constructed. Results The addition of brand Temodar and generic temozolomide to the standard radiotherapy regimen was associated with base-case incremental cost-effectiveness ratios of $102 364 and $8875, respectively, per quality-adjusted life-year. The model was most sensitive to the progression-free survival associated with the use of only radiotherapy. Conclusions Both the brand and generic base-case estimates are cost-effective under a willingness-to-pay threshold of $150 000 per quality-adjusted life-year. All 1-way sensitivity analyses produced incremental cost-effectiveness ratios below this threshold. We conclude that both the brand Temodar and generic temozolomide are cost-effective treatments for newly diagnosed glioblastoma within the US context. However, assuming that the generic product produces equivalent quality of life and survival benefits, it would be significantly more cost-effective than the brand option. PMID:23935155

Economic implications of cardiovascular disease management programs: moving beyond one-off experiments.

PubMed

Maru, Shoko; Byrnes, Joshua; Carrington, Melinda J; Stewart, Simon; Scuffham, Paul A

2015-01-01

Substantial variation in economic analyses of cardiovascular disease management programs hinders not only the proper assessment of cost-effectiveness but also the identification of heterogeneity of interest such as patient characteristics. The authors discuss the impact of reporting and methodological variation on the cost-effectiveness of cardiovascular disease management programs by introducing issues that could lead to different policy or clinical decisions, followed by the challenges associated with net intervention effects and generalizability. The authors conclude with practical suggestions to mitigate the identified issues. Improved transparency through standardized reporting practice is the first step to advance beyond one-off experiments (limited applicability outside the study itself). Transparent reporting is a prerequisite for rigorous cost-effectiveness analyses that provide unambiguous implications for practice: what type of program works for whom and how.

A Practical Methodology for Disaggregating the Drivers of Drug Costs Using Administrative Data.

PubMed

Lungu, Elena R; Manti, Orlando J; Levine, Mitchell A H; Clark, Douglas A; Potashnik, Tanya M; McKinley, Carol I

2017-09-01

Prescription drug expenditures represent a significant component of health care costs in Canada, with estimates of $28.8 billion spent in 2014. Identifying the major cost drivers and the effect they have on prescription drug expenditures allows policy makers and researchers to interpret current cost pressures and anticipate future expenditure levels. To identify the major drivers of prescription drug costs and to develop a methodology to disaggregate the impact of each of the individual drivers. The methodology proposed in this study uses the Laspeyres approach for cost decomposition. This approach isolates the effect of the change in a specific factor (e.g., price) by holding the other factor(s) (e.g., quantity) constant at the base-period value. The Laspeyres approach is expanded to a multi-factorial framework to isolate and quantify several factors that drive prescription drug cost. Three broad categories of effects are considered: volume, price and drug-mix effects. For each category, important sub-effects are quantified. This study presents a new and comprehensive methodology for decomposing the change in prescription drug costs over time including step-by-step demonstrations of how the formulas were derived. This methodology has practical applications for health policy decision makers and can aid researchers in conducting cost driver analyses. The methodology can be adjusted depending on the purpose and analytical depth of the research and data availability. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

Application of Bayesian Approach to Cost-Effectiveness Analysis of Antiviral Treatments in Chronic Hepatitis B.

PubMed

Zhang, Hua; Huo, Mingdong; Chao, Jianqian; Liu, Pei

2016-01-01

Hepatitis B virus (HBV) infection is a major problem for public health; timely antiviral treatment can significantly prevent the progression of liver damage from HBV by slowing down or stopping the virus from reproducing. In the study we applied Bayesian approach to cost-effectiveness analysis, using Markov Chain Monte Carlo (MCMC) simulation methods for the relevant evidence input into the model to evaluate cost-effectiveness of entecavir (ETV) and lamivudine (LVD) therapy for chronic hepatitis B (CHB) in Jiangsu, China, thus providing information to the public health system in the CHB therapy. Eight-stage Markov model was developed, a hypothetical cohort of 35-year-old HBeAg-positive patients with CHB was entered into the model. Treatment regimens were LVD100mg daily and ETV 0.5 mg daily. The transition parameters were derived either from systematic reviews of the literature or from previous economic studies. The outcome measures were life-years, quality-adjusted lifeyears (QALYs), and expected costs associated with the treatments and disease progression. For the Bayesian models all the analysis was implemented by using WinBUGS version 1.4. Expected cost, life expectancy, QALYs decreased with age. Cost-effectiveness increased with age. Expected cost of ETV was less than LVD, while life expectancy and QALYs were higher than that of LVD, ETV strategy was more cost-effective. Costs and benefits of the Monte Carlo simulation were very close to the results of exact form among the group, but standard deviation of each group indicated there was a big difference between individual patients. Compared with lamivudine, entecavir is the more cost-effective option. CHB patients should accept antiviral treatment as soon as possible as the lower age the more cost-effective. Monte Carlo simulation obtained costs and effectiveness distribution, indicate our Markov model is of good robustness.

Decision science and cervical cancer.

PubMed

Cantor, Scott B; Fahs, Marianne C; Mandelblatt, Jeanne S; Myers, Evan R; Sanders, Gillian D

2003-11-01

Mathematical modeling is an effective tool for guiding cervical cancer screening, diagnosis, and treatment decisions for patients and policymakers. This article describes the use of mathematical modeling as outlined in five presentations from the Decision Science and Cervical Cancer session of the Second International Conference on Cervical Cancer held at The University of Texas M. D. Anderson Cancer Center, April 11-14, 2002. The authors provide an overview of mathematical modeling, especially decision analysis and cost-effectiveness analysis, and examples of how it can be used for clinical decision making regarding the prevention, diagnosis, and treatment of cervical cancer. Included are applications as well as theory regarding decision science and cervical cancer. Mathematical modeling can answer such questions as the optimal frequency for screening, the optimal age to stop screening, and the optimal way to diagnose cervical cancer. Results from one mathematical model demonstrated that a vaccine against high-risk strains of human papillomavirus was a cost-effective use of resources, and discussion of another model demonstrated the importance of collecting direct non-health care costs and time costs for cost-effectiveness analysis. Research presented indicated that care must be taken when applying the results of population-wide, cost-effectiveness analyses to reduce health disparities. Mathematical modeling can encompass a variety of theoretical and applied issues regarding decision science and cervical cancer. The ultimate objective of using decision-analytic and cost-effectiveness models is to identify ways to improve women's health at an economically reasonable cost. Copyright 2003 American Cancer Society.

NASA lithium cell applications

NASA Technical Reports Server (NTRS)

Juvinall, G. L.

1978-01-01

The advantages of lithium systems are described and a general summary of their application in present and future NASA programs is presented. Benefits of the lithium systems include an increased payload weight and an increased cost effectiveness to the customer. This also allows for more flexibility in the design of future space transportation systems.

25 CFR Appendix A to Part 276 - Principles for Determining Costs Applicable to Grants

Code of Federal Regulations, 2010 CFR

2010-04-01

... responsible for the efficient and effective administration of grant programs through the application of sound... government and is not allowable. 2. Advertising. Advertising media includes newspapers, magazines, radio and... or expenses for social security, employees' life and health insurance plans, unemployment insurance...

High-throughput single nucleotide polymorphism genotyping for breeding applications in rice using the BeadXpress platform

USDA-ARS?s Scientific Manuscript database

Multiplexed single nucleotide polymorphism (SNP) markers have the potential to increase the speed and cost-effectiveness of genotyping, provided that an optimal SNP density is used for each application. To test the efficiency of multiplexed SNP genotyping for diversity, mapping and breeding applicat...

High-throughput SNP genotyping for breeding applications in rice using the BeadXpress platform

USDA-ARS?s Scientific Manuscript database

Multiplexed single nucleotide polymorphism (SNP) markers have the potential to increase the speed and cost-effectiveness of genotyping, provided that an optimal SNP density is used for each application. To test the efficiency of multiplexed SNP genotyping for diversity, mapping and breeding applicat...

Study of small turbofan engines applicable to general-aviation aircraft

NASA Technical Reports Server (NTRS)

Merrill, G. L.; Burnett, G. A.; Alsworth, C. C.

1973-01-01

The applicability of small turbofan engines to general aviation aircraft is discussed. The engine and engine/airplane performance, weight, size, and cost interrelationships are examined. The effects of specific engine noise constraints are evaluated. The factors inhibiting the use of turbofan engines in general aviation aircraft are identified.

Web 2.0 and Nigerian Academic Librarians

ERIC Educational Resources Information Center

Adekunmisi, Sowemimo Ronke; Odunewu, Abiodun Olusegun

2016-01-01

Web 2.0 applications to library services are aimed at enhancing the provision of relevant and cost-effective information resources for quality education and research. Despite the richness of these web applications and their enormous impact on library and information services as recorded in the developed world, Nigerian academic libraries are yet…

Applications and Case Studies of the Next-Generation Sequencing Technologies in Food, Nutrition and Agriculture.

USDA-ARS?s Scientific Manuscript database

Next-generation sequencing technologies are able to produce high-throughput short sequence reads in a cost-effective fashion. The emergence of these technologies has not only facilitated genome sequencing but also changed the landscape of life sciences. Here I survey their major applications ranging...

Research and applications: Artificial intelligence

NASA Technical Reports Server (NTRS)

Chaitin, L. J.; Duda, R. O.; Johanson, P. A.; Raphael, B.; Rosen, C. A.; Yates, R. A.

1970-01-01

The program is reported for developing techniques in artificial intelligence and their application to the control of mobile automatons for carrying out tasks autonomously. Visual scene analysis, short-term problem solving, and long-term problem solving are discussed along with the PDP-15 simulator, LISP-FORTRAN-MACRO interface, resolution strategies, and cost effectiveness.

Capsules containing entomopathogenic nematodes as a Trojan horse approach to control the western corn rootworm

USDA-ARS?s Scientific Manuscript database

The use of entomopathogenic nematodes in the biological control of soil insect pests is hampered by the costly and inadequate application techniques. As a possible solution we evaluated an encapsulation approach that offers effective application and may possibly attract the pest by adding attractant...

Feasibility study of a solar domestic hot water system for Oliver Hall, the University of Kansas

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

Shen, J.C.W.

1985-01-01

Solar water heating represents a low-temperature use of solar energy. It has been proven cost effective in residential applications with renewable energy tax credits. However, tax credits for solar application are not available for state owned buildings, which incur higher system costs and may not economically justify solar energy. The purpose of this project was to design a site assembled solar hot water heating system to reduce system costs. Oliver Hall, a dormitory building at the University of Kansas, was chosen for this research project. The optimum size of the solar system was determined via several different methods to bemore » approximately 1800 square feet. The site chosen for the location of solar arrays was a ground-mounting on the west side of the dormitory due to the adjacency to the mechanical room, ease of maintenance, and lower initial cost. System components and equipment were chosen as the product of performance, cost, maintenance and product life. After completion of the system design, the unit cost data for each component was collected and the initial system cost was estimated to be $49,244 which translates into a payback period of 16 years.« less

Family Expense Manager Application in Android

NASA Astrophysics Data System (ADS)

Rajaprabha, M. N.

2017-11-01

FAMILY EXPENSES MANAGER is an android application. This monitors your own costs, family costs and incidental costs. This resembles a present day costs day book in your versatile. This application helps you to monitor your every day costs, settlement points of interest, general rundown, report in detail and periodic costs subtle elements. Every one of the information is put away in database and can be recovered by the client and their relatives.

The impact of using informative priors in a Bayesian cost-effectiveness analysis: an application of endovascular versus open surgical repair for abdominal aortic aneurysms in high-risk patients.

PubMed

McCarron, C Elizabeth; Pullenayegum, Eleanor M; Thabane, Lehana; Goeree, Ron; Tarride, Jean-Eric

2013-04-01

Bayesian methods have been proposed as a way of synthesizing all available evidence to inform decision making. However, few practical applications of the use of Bayesian methods for combining patient-level data (i.e., trial) with additional evidence (e.g., literature) exist in the cost-effectiveness literature. The objective of this study was to compare a Bayesian cost-effectiveness analysis using informative priors to a standard non-Bayesian nonparametric method to assess the impact of incorporating additional information into a cost-effectiveness analysis. Patient-level data from a previously published nonrandomized study were analyzed using traditional nonparametric bootstrap techniques and bivariate normal Bayesian models with vague and informative priors. Two different types of informative priors were considered to reflect different valuations of the additional evidence relative to the patient-level data (i.e., "face value" and "skeptical"). The impact of using different distributions and valuations was assessed in a sensitivity analysis. Models were compared in terms of incremental net monetary benefit (INMB) and cost-effectiveness acceptability frontiers (CEAFs). The bootstrapping and Bayesian analyses using vague priors provided similar results. The most pronounced impact of incorporating the informative priors was the increase in estimated life years in the control arm relative to what was observed in the patient-level data alone. Consequently, the incremental difference in life years originally observed in the patient-level data was reduced, and the INMB and CEAF changed accordingly. The results of this study demonstrate the potential impact and importance of incorporating additional information into an analysis of patient-level data, suggesting this could alter decisions as to whether a treatment should be adopted and whether more information should be acquired.

Novel Structured Metal Bipolar Plates for Low Cost Manufacturing

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

Wang, Conghua

2013-08-15

Bipolar plates are an important component in fuel cell stacks and accounts for more than 75% of stack weight and volume, and 20% of the stack cost. The technology development of metal bipolar plates can effectively reduce the fuel cells stack weight and volume over 50%. The challenge is to protect metal plate from corrosion at low cost for the broad commercial applications. While most of today’s PEM fuel cell metallic bipolar plate technologies use some precious metal, the focus of this SBIR project is to develop a low cost, novel nano-structured metal bipolar plate technology without using any preciousmore » metal. The technology will meet the performance and cost requirements for automobile applications. Through the Phase I project, TreadStone has identified the corrosion resistant and electrically conductive titanium oxide for the metal bipolar plate surface protection for automotive PEM fuel cell applications. TreadStone has overcome the manufacturing issues to apply the coating on metal substrate surface, and has demonstrated the feasibility of the coated stainless steel plates by ex-situ evaluation tests and the in-situ fuel cell long term durability test. The test results show the feasibility of the proposed nano-structured coating as the low cost metal bipolar plates of PEM fuel cells. The plan for further technology optimization is also outlined for the Phase II project.« less

SOLAR EFFECTS ON BUILDING DESIGN.

ERIC Educational Resources Information Center

Building Research Inst., Inc., Washington, DC.

A REPORT OF A PROGRAM HELD AS PART OF THE BUILDING RESEARCH INSTITUTE 1962 SPRING CONFERENCE ON THE SOLAR EFFECTS ON BUILDING DESIGN. TOPICS DISCUSSED ARE--(1) SOLAR ENERGY DATA APPLICABLE TO BUILDING DESIGN, (2) THERMAL EFFECTS OF SOLAR RADIATION ON MAN, (3) SOLAR EFFECTS ON ARCHITECTURE, (4) SOLAR EFFECTS ON BUILDING COSTS, (5) SELECTION OF…

The Impact of Big Data on Chronic Disease Management.

PubMed

Bhardwaj, Niharika; Wodajo, Bezawit; Spano, Anthony; Neal, Symaron; Coustasse, Alberto

Population health management and specifically chronic disease management depend on the ability of providers to prevent development of high-cost and high-risk conditions such as diabetes, heart failure, and chronic respiratory diseases and to control them. The advent of big data analytics has potential to empower health care providers to make timely and truly evidence-based informed decisions to provide more effective and personalized treatment while reducing the costs of this care to patients. The goal of this study was to identify real-world health care applications of big data analytics to determine its effectiveness in both patient outcomes and the relief of financial burdens. The methodology for this study was a literature review utilizing 49 articles. Evidence of big data analytics being largely beneficial in the areas of risk prediction, diagnostic accuracy and patient outcome improvement, hospital readmission reduction, treatment guidance, and cost reduction was noted. Initial applications of big data analytics have proved useful in various phases of chronic disease management and could help reduce the chronic disease burden.

Electrical Stimulation for Pressure Injuries: A Health Technology Assessment.

PubMed

2017-01-01

Pressure injuries (bedsores) are common and reduce quality of life. They are also costly and difficult to treat. This health technology assessment evaluates the effectiveness, cost-effectiveness, budget impact, and lived experience of adding electrical stimulation to standard wound care for pressure injuries. We conducted a systematic search for studies published to December 7, 2016, limited to randomized and non-randomized controlled trials examining the effectiveness of electrical stimulation plus standard wound care versus standard wound care alone for patients with pressure injuries. We assessed the quality of evidence through Grading of Recommendations Assessment, Development, and Evaluation (GRADE). In addition, we conducted an economic literature review and a budget impact analysis to assess the cost-effectiveness and affordability of electrical stimulation for treatment of pressure ulcers in Ontario. Given uncertainties in clinical evidence and resource use, we did not conduct a primary economic evaluation. Finally, we conducted qualitative interviews with patients and caregivers about their experiences with pressure injuries, currently available treatments, and (if applicable) electrical stimulation. Nine randomized controlled trials and two non-randomized controlled trials were found from the systematic search. There was no significant difference in complete pressure injury healing between adjunct electrical stimulation and standard wound care. There was a significant difference in wound surface area reduction favouring electrical stimulation compared with standard wound care.The only study on cost-effectiveness of electrical stimulation was partially applicable to the patient population of interest. Therefore, the cost-effectiveness of electrical stimulation cannot be determined. We estimate that the cost of publicly funding electrical stimulation for pressure injuries would be $0.77 to $3.85 million yearly for the next 5 years.Patients and caregivers reported that pressure injuries were burdensome and reduced their quality of life. Patients and caregivers also noted that electrical stimulation seemed to reduce the time it took the wounds to heal. While electrical stimulation is safe to use (GRADE quality of evidence: high) there is uncertainty about whether it improves wound healing (GRADE quality of evidence: low). In Ontario, publicly funding electrical stimulation for pressure injuries could result in extra costs of $0.77 to $3.85 million yearly for the next 5 years.

High-power direct-diode laser successes

NASA Astrophysics Data System (ADS)

Haake, John M.; Zediker, Mark S.

2004-06-01

Direct diode laser will become much more prevalent in the solar system of manufacturing due to their high efficiency, small portable size, unique beam profiles, and low ownership costs. There has been many novel applications described for high power direct diode laser [HPDDL] systems but few have been implemented in extreme production environments due to diode and diode system reliability. We discuss several novel applications in which the HPDDL have been implemented and proven reliable and cost-effective in production environments. These applications are laser hardening/surface modification, laser wire feed welding and laser paint stripping. Each of these applications uniquely tests the direct diode laser systems capabilities and confirms their reliability in production environments. A comparison of the advantages direct diode laser versus traditional industrial lasers such as CO2 and Nd:YAG and non-laser technologies such a RF induction, and MIG welders for each of these production applications is presented.

Using Parameter Constraints to Choose State Structures in Cost-Effectiveness Modelling.

PubMed

Thom, Howard; Jackson, Chris; Welton, Nicky; Sharples, Linda

2017-09-01

This article addresses the choice of state structure in a cost-effectiveness multi-state model. Key model outputs, such as treatment recommendations and prioritisation of future research, may be sensitive to state structure choice. For example, it may be uncertain whether to consider similar disease severities or similar clinical events as the same state or as separate states. Standard statistical methods for comparing models require a common reference dataset but merging states in a model aggregates the data, rendering these methods invalid. We propose a method that involves re-expressing a model with merged states as a model on the larger state space in which particular transition probabilities, costs and utilities are constrained to be equal between states. This produces a model that gives identical estimates of cost effectiveness to the model with merged states, while leaving the data unchanged. The comparison of state structures can be achieved by comparing maximised likelihoods or information criteria between constrained and unconstrained models. We can thus test whether the costs and/or health consequences for a patient in two states are the same, and hence if the states can be merged. We note that different structures can be used for rates, costs and utilities, as appropriate. We illustrate our method with applications to two recent models evaluating the cost effectiveness of prescribing anti-depressant medications by depression severity and the cost effectiveness of diagnostic tests for coronary artery disease. State structures in cost-effectiveness models can be compared using standard methods to compare constrained and unconstrained models.

Fault tolerant testbed evaluation, phase 1

NASA Technical Reports Server (NTRS)

Caluori, V., Jr.; Newberry, T.

1993-01-01

In recent years, avionics systems development costs have become the driving factor in the development of space systems, military aircraft, and commercial aircraft. A method of reducing avionics development costs is to utilize state-of-the-art software application generator (autocode) tools and methods. The recent maturity of application generator technology has the potential to dramatically reduce development costs by eliminating software development steps that have historically introduced errors and the need for re-work. Application generator tools have been demonstrated to be an effective method for autocoding non-redundant, relatively low-rate input/output (I/O) applications on the Space Station Freedom (SSF) program; however, they have not been demonstrated for fault tolerant, high-rate I/O, flight critical environments. This contract will evaluate the use of application generators in these harsh environments. Using Boeing's quad-redundant avionics system controller as the target system, Space Shuttle Guidance, Navigation, and Control (GN&C) software will be autocoded, tested, and evaluated in the Johnson (Space Center) Avionics Engineering Laboratory (JAEL). The response of the autocoded system will be shown to match the response of the existing Shuttle General Purpose Computers (GPC's), thereby demonstrating the viability of using autocode techniques in the development of future avionics systems.

Energy-efficient sensing in wireless sensor networks using compressed sensing.

PubMed

Razzaque, Mohammad Abdur; Dobson, Simon

2014-02-12

Sensing of the application environment is the main purpose of a wireless sensor network. Most existing energy management strategies and compression techniques assume that the sensing operation consumes significantly less energy than radio transmission and reception. This assumption does not hold in a number of practical applications. Sensing energy consumption in these applications may be comparable to, or even greater than, that of the radio. In this work, we support this claim by a quantitative analysis of the main operational energy costs of popular sensors, radios and sensor motes. In light of the importance of sensing level energy costs, especially for power hungry sensors, we consider compressed sensing and distributed compressed sensing as potential approaches to provide energy efficient sensing in wireless sensor networks. Numerical experiments investigating the effectiveness of compressed sensing and distributed compressed sensing using real datasets show their potential for efficient utilization of sensing and overall energy costs in wireless sensor networks. It is shown that, for some applications, compressed sensing and distributed compressed sensing can provide greater energy efficiency than transform coding and model-based adaptive sensing in wireless sensor networks.

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

NASA Astrophysics Data System (ADS)

King, Russel J.

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

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

The ECE application forecasts annual costs of preventive and corrective maintenance for budgeting purposes. Features within the application enable the user to change the specifications of the model to customize your forecast to best fit their needs and support “what if” analysis. Based on the user's selections, the ECE model forecasts annual maintenance costs. Preventive maintenance costs include the cost of labor to perform preventive maintenance activities at the specific frequency and labor rate. Corrective maintenance costs include the cost of labor and the cost of replacement parts. The application presents forecasted maintenance costs for the next five years inmore » two tables: costs by year and costs by site.« less

[What is an efficient health technology in Spain?].

PubMed

Sacristán, J A; Oliva, J; Del Llano, J; Prieto, L; Pinto, J L

2002-01-01

Despite the growing recognition of the potential applications of cost-effectiveness assessments, a criterion to establish what is an efficient health technology does not exist in Spain. The objective of this work is to describe the limits and the criteria used in Spain to recommend the adoption of health interventions. A review of the economic evaluations of health technologies published in Spain from 1990 to 2001 was conducted. Complete economic assessments in which the cost-effectiveness ratio was expressed as cost per life-year gained (LYG), cost per quality-adjusted-life-year (QALY) or cost per saved live were selected. Those interventions in which the authors established recommendations (adoption or rejection) and the criteria used were analyzed. Twenty (20%) of the 100 complete economic evaluations fulfilled the selection criteria. In16 studies, the results were expressed as cost per LYG, in 6 studies as cost per QALY and in 1 as cost per saved live. A total of 82 health interventions were assessed and some kind of recommendation was established in 44 of them. All technologies with a cost-effectiveness ratio lower than 30,000 euros (5 million pesetas) per LYG were recommended for adoption by the authors. Up to that limit there was no a clear tendency. Although the results must be interpreted with much precaution, given the limitations of the study, the limits of cost-effectiveness presented in this work could be a first reference to which would be an efficient health intervention in Spain.

Costs to physician offices of providing medications to medically indigent patients via pharmaceutical manufacturer prescription assistance programs.

PubMed

Clay, Patrick; Vaught, Eric; Glaros, Alan; Mangum, Stacy; Hansen, Daniel; Lindsey, Cameron

2007-01-01

Prescription assistance programs (PAPs) are offered by pharmaceutical manufacturers to provide medications at no out-of-pocket cost to various categories of medically indigent patients. some PAPs require only 1 application whereas others require as many as 4 applications per year per drug per patient, depending on the manufacturer's requirements. to measure the costs incurred by a medical clinic that provides chronic prescription medications via PAPs. this project was conducted in a free-standing, inner-city, Midwestern health clinic on the PAP application process for 1 representative drug for 32 pharmaceutical manufacturers that offered PAPs for drugs taken on a long-term basis for chronic conditions. time and motion studies were conducted using a medical assistant with the greatest amount of PAP experience. Assessment of time-to-access and time-to-complete forms was performed outside of normal clinic business hours to avoid interruptions. Personnel time costs also included receipt and delivery of drug to the patient (drug distribution time), which were assessed during normal business hours for actual medications received for 10 patients and included the time required to notify the patient of the arrival of the drug and to dispense the medication to the patient. supply costs for this PAP service included printing and copying costs. submission costs associated with mailing or faxing the documents were determined and calculated using the price of materials only. total application cost was calculated by adding the personnel time cost, supply cost, and submission cost. Annual PAP time was the time spent completing PAPs for 1 medication for 1 patient for 1 year. the time and resources required and the associated costs were aggregated separately for the pharmaceutical manufacturers that required 1, 2, or 4 applications per drug per patient per year. The total average application cost for all 32 companies was $25.18 [SD, $17.23]. Personnel time costs accounted for half or more of the total application cost, regardless of submission mode. the time to complete the form for any PAP was 0:06:20 [SD, 0:05:03] minutes with a range from 0:03:01 to 0:34:22 minutes. Printing costs were $0.20 [SD, $0.10] and copying costs were $1.96 [SD, $0.21]. Average supply costs were $2.16 [SD, $0.23]. Faxing versus mailing PAPs saved $17.90 per application. total annual clinic cost to assist patients in obtaining drugs through a PAP ranged from $10.42 per patient for a drug that requires 1 application per year (15 manufacturers, 47%) to $46.30 per patient for a drug in a PAP that requires 4 (re)applications per year (12 manufacturers, 38%). PAPs transmitted by mail required 0:49:18 [SD, 0:32:18] minutes, approximately 0:25:00 [SD, 0:21:00] minutes more than by fax (0:24:13 [SD, 0:11:32] minutes) or by Internet submissions (0:28:20 minutes), respectively. The number of PAP applications required per patient per medication annually has the greatest impact on clinic time and financial resources. Application submission method also influences the overall costs of providing this service in the clinical setting. Medical clinics should base their decision to provide a PAP application service to patients on the time and costs associated over the course of 1 year and not on the 1-time application cost.

Cost-Loss Analysis of Ensemble Solar Wind Forecasting: Space Weather Use of Terrestrial Weather Tools

NASA Astrophysics Data System (ADS)

Henley, E. M.; Pope, E. C. D.

2017-12-01

This commentary concerns recent work on solar wind forecasting by Owens and Riley (2017). The approach taken makes effective use of tools commonly used in terrestrial weather—notably, via use of a simple model—generation of an "ensemble" forecast, and application of a "cost-loss" analysis to the resulting probabilistic information, to explore the benefit of this forecast to users with different risk appetites. This commentary aims to highlight these useful techniques to the wider space weather audience and to briefly discuss the general context of application of terrestrial weather approaches to space weather.

Linkages from DOE's Solar Photovoltaic R&D to Commercial Renewable Power from Solar Energy

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

Ruegg, Rosalie; Thomas, Patrick

2011-04-01

DOE's Solar Photovoltaic R&D Subprogram promotes the development of cost-effective systems for directly converting solar energy into electricity for residential, commercial, and industrial applications. This study was commissioned to assess the extent to which the knowledge outputs of R&D funded by the DOE Solar PV subprogram are linked to downstream developments in commercial renewable power. A second purpose was to identify spillovers of the resulting knowledge to other areas of application. A third purpose was to lend support to a parallel benefit-cost study by contributing evidence of attribution of benefits to DOE.

Life expectancy and the value of early detection.

PubMed

Howard, David H

2005-09-01

This paper presents a model of the benefits and costs of early detection of asymptomatic disease as they vary by age. The benefits of early detection tend toward zero as the risk of death from competing causes increases. Costs per detected case also decline with age, assuming that disease incidence rises with age, but are always strictly positive. On balance, there is always an age limit beyond which the costs associated with early detection outweigh the benefits. Application of the model to prostate cancer screening suggests that early detection above age 70 or so is not cost-effective.

Geowall: Investigations into low-cost stereo display technologies

USGS Publications Warehouse

Steinwand, Daniel R.; Davis, Brian; Weeks, Nathan

2003-01-01

Recently, the combination of new projection technology, fast, low-cost graphics cards, and Linux-powered personal computers has made it possible to provide a stereoprojection and stereoviewing system that is much more affordable than previous commercial solutions. These Geowall systems are low-cost visualization systems built with commodity off-the-shelf components, run on open-source (and other) operating systems, and using open-source applications software. In short, they are ?Beowulf-class? visualization systems that provide a cost-effective way for the U. S. Geological Survey to broaden participation in the visualization community and view stereoimagery and three-dimensional models2.

Drivers and applications of integrated clean-up technologies for surfactant-enhanced remediation of environments contaminated with polycyclic aromatic hydrocarbons (PAHs).

PubMed

Liang, Xujun; Guo, Chuling; Liao, Changjun; Liu, Shasha; Wick, Lukas Y; Peng, Dan; Yi, Xiaoyun; Lu, Guining; Yin, Hua; Lin, Zhang; Dang, Zhi

2017-06-01

Surfactant-enhanced remediation (SER) is considered as a promising and efficient remediation approach. This review summarizes and discusses main drivers on the application of SER in removing polycyclic aromatic hydrocarbons (PAHs) from contaminated soil and water. The effect of PAH-PAH interactions on SER efficiency is, for the first time, illustrated in an SER review. Interactions between mixed PAHs could enhance, decrease, or have no impact on surfactants' solubilization power towards PAHs, thus affecting the optimal usage of surfactants for SER. Although SER can transfer PAHs from soil/non-aqueous phase liquids to the aqueous phase, the harmful impact of PAHs still exists. To decrease the level of PAHs in SER solutions, a series of SER-based integrated cleanup technologies have been developed including surfactant-enhanced bioremediation (SEBR), surfactant-enhanced phytoremediation (SEPR) and SER-advanced oxidation processes (SER-AOPs). In this review, the general considerations and corresponding applications of the integrated cleanup technologies are summarized and discussed. Compared with SER-AOPs, SEBR and SEPR need less operation cost, yet require more treatment time. To successfully achieve the field application of surfactant-based technologies, massive production of the cost-effective green surfactants (i.e. biosurfactants) and comprehensive evaluation of the drivers and the global cost of SER-based cleanup technologies need to be performed in the future. Copyright © 2017. Published by Elsevier Ltd.

Development of SnS2/RGO nanosheet composite for cost-effective aqueous hybrid supercapacitors.

PubMed

Chauhan, Himani; Singh, Manoj K; Kumar, Praveen; Hashmi, Safir Ahmad; Deka, Sasanka

2017-01-13

The development of low cost supercapacitor cells with unique capacitive properties is essential for many domestic and industrial purposes. Here we report the first ever application of SnS 2 -reduced graphene oxide (SnS 2 /RGO) layered nanocomposite as a superior electrode material for symmetric aqueous hybrid supercapacitors. We synthesized SnS 2 /RGO nanocomposite comprised of nanosheets of SnS 2 and graphene oxide via a one-pot hydrothermal approach. in situ as-synthesized SnS 2 /RGO is devised for the first time to give high specific capacitance 500 Fg -1 , energy density 16.67 Wh kg -1 and power density 488 W kg -1 . The cell retains 95% charge/discharge cycle stability up to 1000 cycles. In-short, the SnS 2 /RGO nanosheet composite presented is a novel and advanced material for application in high stability moderate value hybrid supercapacitors. All the currently available surveys in literature state the potential applicability of SnS 2 as the anode material for reversible lithium/sodium ion batteries (LIBs/NIBs) but there is a lack of equivalent studies on electrochemical capacitors. We filled up this knowledge gap by the use of the same material in a cost-effective, highly active hybrid supercapacitor application by utilizing its pseudocapacitance property combined with the layered capacitance property of graphene sheets.

Adverse outcome pathway networks: Development, analytics and applications

EPA Science Inventory

The US EPA is developing more cost effective and efficient ways to evaluate chemical safety using high throughput and computationally based testing strategies. An important component of this approach is the ability to translate chemical effects on fundamental biological processes...

Adverse outcome pathway networks I: Development and applications

EPA Science Inventory

The US EPA is developing more cost effective and efficient ways to evaluate chemical safety using high throughput and computationally based testing strategies. An important component of this approach is the ability to translate chemical effects on fundamental biological processes...

Adverse outcome pathway networks: Development, analytics, and applications

EPA Science Inventory

Product Description:The US EPA is developing more cost effective and efficient ways to evaluate chemical safety using high throughput and computationally based testing strategies. An important component of this approach is the ability to translate chemical effects on fundamental ...

Recovery, Reuse, and Recycle of Solvents.

DTIC Science & Technology

1985-12-01

Program ------------------------------------------------------ 1I In e t v s P o r m - - - - - - - - - - - - - - - - - - - - - - - - Soncentves Pr ogram...not known. . . ,o. .’* • . .~i 8 A M FIGURE 1 WORKSHEET FOR DETERMINING WASTE SOLVENT ECONOMIC ANALYSIS Activity/Complex: Preparer:_________ Location...annual f. operating cost of $890 18 V-7 C.6 M . SOLVENT RENTAL APPLICATIONS Solvent rental may be the most cost effective method for complying with both

Evaluating Willingness-to-Pay Thresholds for Dementia Caregiving Interventions: Application to the Tailored Activity Program

PubMed Central

Jutkowitz, Eric; Gitlin, Laura N.; Pizzi, Laura T.

2017-01-01

Objectives The study aims to apply willingness-to-pay (WTP) values derived from the literature to inform decision-makers of the cost-effectiveness of the Tailored Activity Program (TAP), an intervention proven to reduce caregiver burden. Methods TAP and other caregiver interventions employ an individual perspective and non–quality-adjusted life-year (QALY) outcome measure where the primary objective is to determine caregiver burden from an individual perspective. Therefore, standard cost/QALY thresholds are not appropriate. To identify relevant WTP values, we searched for studies that: 1) were published in the past 5 years and used contingent valuation methodology to identify WTP; 2) assessed WTP for a dementia-related intervention requiring out-of-pocket expenditure; and 3) asked caregivers their WTP for an outcome related to reducing caregiver burden. Three studies were identified utilizing four WTP values. We also assessed potential financial savings that caregivers could achieve from purchasing TAP. To assess the probability of TAP being cost-effective, we built a Monte Carlo simulation to test the four WTP values applied to two TAP outcome measures: reduction in caregiver hours “on duty;” and “doing things.” Results For outcome measure “on duty,” WTP varied between $1.06/hour and $4.58/hour. For outcome measure “doing things,” WTP varied between $2.21/hour and $9.57/hour. Applying the four identified WTP values from the literature to TAP outcomes resulted in TAP cost-effectiveness varying between 50% and 80% for both outcome measures. Conclusions When WTP data are not collected prospectively or conventional metrics cannot be applied, retrospectively assessing literature-derived WTP may be acceptable for informing decision-makers of potential cost-effectiveness of a proven program. Application of WTP to TAP shows potential cost-effectiveness that can be expected under the tested WTP scenarios. PMID:20561331

Oncology drugs for orphan indications: how are HTA processes evolving for this specific drug category?

PubMed

Adkins, Elizabeth M; Nicholson, Lindsay; Floyd, David; Ratcliffe, Mark; Chevrou-Severac, Helene

2017-01-01

Orphan drugs (ODs) are intended for the diagnosis, prevention, or treatment of rare diseases. Many cancer subtypes, including all childhood cancers, are defined as rare diseases, and over one-third of ODs are now intended to treat oncology indications. However, market access for oncology ODs is becoming increasingly challenging; ODs are prone to significant uncertainty around their cost-effectiveness, while payers must balance the need for these vital innovations with growing sensitivity to rising costs. The objective of this review was to evaluate different mechanisms that have been introduced to facilitate patient access to oncology ODs in five different countries (Australia, Canada, England, France, and Sweden), using eight oncology ODs and non-orphan oncology drugs as examples of their application. A targeted literature review of health technology assessment (HTA) agency websites was undertaken to identify country-specific guidance and HTA documentation for recently evaluated oncology ODs and non-orphan oncology drugs. None of these countries were found to have explicit HTA criteria for the assessment of ODs, and therefore, oncology ODs are assessed through the usual HTA process. However, distinct and additional processes are adopted to facilitate access to oncology ODs. Review of eight case-study drugs showed that these additional assessment processes were rarely used, and decisions were largely driven by proving cost-effectiveness using standard incremental cost-effectiveness ratio (ICER) thresholds. The predominant implication arising from this study is that application of standard HTA criteria to oncology ODs in many countries fails to take into account any uncertainties around their clinical- and cost-effectiveness, resulting in disparities in HTA reimbursement decisions based on differences in addressing or accepting uncertainty. In order to address this issue, HTA agencies should adopt a more flexible approach to cost-effectiveness, as typified by the Tandvårds-och Läkemedelsförmånsverket in Sweden, which takes into account the small patient numbers involved, limited budget impact, and high unmet medical needs.

Oncology drugs for orphan indications: how are HTA processes evolving for this specific drug category?

PubMed Central

Adkins, Elizabeth M; Nicholson, Lindsay; Floyd, David; Ratcliffe, Mark; Chevrou-Severac, Helene

2017-01-01

Orphan drugs (ODs) are intended for the diagnosis, prevention, or treatment of rare diseases. Many cancer subtypes, including all childhood cancers, are defined as rare diseases, and over one-third of ODs are now intended to treat oncology indications. However, market access for oncology ODs is becoming increasingly challenging; ODs are prone to significant uncertainty around their cost-effectiveness, while payers must balance the need for these vital innovations with growing sensitivity to rising costs. The objective of this review was to evaluate different mechanisms that have been introduced to facilitate patient access to oncology ODs in five different countries (Australia, Canada, England, France, and Sweden), using eight oncology ODs and non-orphan oncology drugs as examples of their application. A targeted literature review of health technology assessment (HTA) agency websites was undertaken to identify country-specific guidance and HTA documentation for recently evaluated oncology ODs and non-orphan oncology drugs. None of these countries were found to have explicit HTA criteria for the assessment of ODs, and therefore, oncology ODs are assessed through the usual HTA process. However, distinct and additional processes are adopted to facilitate access to oncology ODs. Review of eight case-study drugs showed that these additional assessment processes were rarely used, and decisions were largely driven by proving cost-effectiveness using standard incremental cost-effectiveness ratio (ICER) thresholds. The predominant implication arising from this study is that application of standard HTA criteria to oncology ODs in many countries fails to take into account any uncertainties around their clinical- and cost-effectiveness, resulting in disparities in HTA reimbursement decisions based on differences in addressing or accepting uncertainty. In order to address this issue, HTA agencies should adopt a more flexible approach to cost-effectiveness, as typified by the Tandvårds-och Läkemedelsförmånsverket in Sweden, which takes into account the small patient numbers involved, limited budget impact, and high unmet medical needs. PMID:28652787

Molecular Breeding to Create Optimized Crops: From Genetic Manipulation to Potential Applications in Plant Factories.

PubMed

Hiwasa-Tanase, Kyoko; Ezura, Hiroshi

2016-01-01

Crop cultivation in controlled environment plant factories offers great potential to stabilize the yield and quality of agricultural products. However, many crops are currently unsuited to these environments, particularly closed cultivation systems, due to space limitations, low light intensity, high implementation costs, and high energy requirements. A major barrier to closed system cultivation is the high running cost, which necessitates the use of high-margin crops for economic viability. High-value crops include those with enhanced nutritional value or containing additional functional components for pharmaceutical production or with the aim of providing health benefits. In addition, it is important to develop cultivars equipped with growth parameters that are suitable for closed cultivation. Small plant size is of particular importance due to the limited cultivation space. Other advantageous traits are short production cycle, the ability to grow under low light, and high nutriculture availability. Cost-effectiveness is improved from the use of cultivars that are specifically optimized for closed system cultivation. This review describes the features of closed cultivation systems and the potential application of molecular breeding to create crops that are optimized for cost-effectiveness and productivity in closed cultivation systems.

Molecular Breeding to Create Optimized Crops: From Genetic Manipulation to Potential Applications in Plant Factories

PubMed Central

Hiwasa-Tanase, Kyoko; Ezura, Hiroshi

2016-01-01

Crop cultivation in controlled environment plant factories offers great potential to stabilize the yield and quality of agricultural products. However, many crops are currently unsuited to these environments, particularly closed cultivation systems, due to space limitations, low light intensity, high implementation costs, and high energy requirements. A major barrier to closed system cultivation is the high running cost, which necessitates the use of high-margin crops for economic viability. High-value crops include those with enhanced nutritional value or containing additional functional components for pharmaceutical production or with the aim of providing health benefits. In addition, it is important to develop cultivars equipped with growth parameters that are suitable for closed cultivation. Small plant size is of particular importance due to the limited cultivation space. Other advantageous traits are short production cycle, the ability to grow under low light, and high nutriculture availability. Cost-effectiveness is improved from the use of cultivars that are specifically optimized for closed system cultivation. This review describes the features of closed cultivation systems and the potential application of molecular breeding to create crops that are optimized for cost-effectiveness and productivity in closed cultivation systems. PMID:27200016

A method to assess the potential effects of air pollution mitigation on healthcare costs.

PubMed

Sætterstrøm, Bjørn; Kruse, Marie; Brønnum-Hansen, Henrik; Bønløkke, Jakob Hjort; Flachs, Esben Meulengracht; Sørensen, Jan

2012-01-01

The aim of this study was to develop a method to assess the potential effects of air pollution mitigation on healthcare costs and to apply this method to assess the potential savings related to a reduction in fine particle matter in Denmark. The effects of air pollution on health were used to identify "exposed" individuals (i.e., cases). Coronary heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer were considered to be associated with air pollution. We used propensity score matching, two-part estimation, and Lin's method to estimate healthcare costs. Subsequently, we multiplied the number of saved cases due to mitigation with the healthcare costs to arrive to an expression for healthcare cost savings. The potential cost saving in the healthcare system arising from a modelled reduction in air pollution was estimated at €0.1-2.6 million per 100,000 inhabitants for the four diseases. We have illustrated an application of a method to assess the potential changes in healthcare costs due to a reduction in air pollution. The method relies on a large volume of administrative data and combines a number of established methods for epidemiological analysis.

Archival storage solutions for PACS

NASA Astrophysics Data System (ADS)

Chunn, Timothy

1997-05-01

While they are many, one of the inhibitors to the wide spread diffusion of PACS systems has been robust, cost effective digital archive storage solutions. Moreover, an automated Nearline solution is key to a central, sharable data repository, enabling many applications such as PACS, telemedicine and teleradiology, and information warehousing and data mining for research such as patient outcome analysis. Selecting the right solution depends on a number of factors: capacity requirements, write and retrieval performance requirements, scaleability in capacity and performance, configuration architecture and flexibility, subsystem availability and reliability, security requirements, system cost, achievable benefits and cost savings, investment protection, strategic fit and more.This paper addresses many of these issues. It compares and positions optical disk and magnetic tape technologies, which are the predominant archive mediums today. Price and performance comparisons will be made at different archive capacities, plus the effect of file size on storage system throughput will be analyzed. The concept of automated migration of images from high performance, high cost storage devices to high capacity, low cost storage devices will be introduced as a viable way to minimize overall storage costs for an archive. The concept of access density will also be introduced and applied to the selection of the most cost effective archive solution.

42 CFR 51c.501 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-10-01

... applicable to grants under section 330 of the Act for project costs which include the cost of acquisition and/or modernization of existing buildings (including the cost of amortizing the principal of, and paying the interest on, loans), except that, these regulations are not applicable to grants for project costs...

42 CFR 51c.501 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... applicable to grants under section 330 of the Act for project costs which include the cost of acquisition and/or modernization of existing buildings (including the cost of amortizing the principal of, and paying the interest on, loans), except that, these regulations are not applicable to grants for project costs...

Evaluating an Exterior Insulation and Finish System for Deep Energy Retrofits

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

Dentz, Jordan; Podorson, David

Exterior insulation and finish systems (EIFS) are proprietary synthetic formulations that are applied to the exterior walls of buildings to serve as insulation and exterior cladding. The insulation thickness can vary from less than one inch to a foot or more. In this project the applicability of EIFS for residential deep energy retrofits was investigated through modeling and a case study home. The home was retrofitted using a site-applied four-inch-thick EIFS. Site-specific details were developed as required for the residential retrofit application. Site work and the costs of the EIFS system were documented. The demonstration home was modeled using Buildingmore » Energy Optimization energy and cost analysis software to explore cost effectiveness of various EIFS insulation thicknesses in two climate locations.« less

The cost-effectiveness of rosacea treatments.

PubMed

Thomas, Kristen; Yelverton, Christopher B; Yentzer, Brad A; Balkrishnan, Rajesh; Fleischer, Alan B; Feldman, Steven R

2009-01-01

Topical and oral antibiotic/anti-inflammatory agents are mainstays of therapy for rosacea. However, costs and efficacies of these therapies vary widely. To determine relative cost-effectiveness of common therapeutic regimens using published data. Average daily costs (ADC) were determined based on treatment frequency and estimated gram usage for facial application of topical regimens of metronidazole (0.75%, 1%), azelaic acid (15%, 20%), sodium sulfacetamide and sulfur 10%/5%, and oral regimens of tetracycline, doxycycline, and isotretinoin. The ADC was compared with published efficacy rates from clinical trials, with efforts to standardize outcome measures. Based on these efficacy rates, costs per success were calculated and combined with office visit costs to estimate the total cost for each treatment for a 15-week period. The medication cost per treatment success of topical regimens ranged from $60.90 ($205.40, total, including office visits) for metronidazole 1% gel once daily, to $152.25 ($296.75, total) for azelaic acid 20% cream twice daily. Tetracycline 250 mg/day was the least costly oral agent at $6.30 per treatment success, or $150.80 total. Based on our best assessments of retrospective data from the literature, metronidazole 1% gel, once daily, was considerably less costly than several other branded and generic alternatives.

Influence of pharmacogenomic profiling prior to pharmaceutical treatment in metastatic colorectal cancer on cost effectiveness : a systematic review.

PubMed

Frank, Martin; Mittendorf, Thomas

2013-03-01

Metastatic colorectal cancer (mCRC) imposes a substantial health burden on individual patients and society. Furthermore, rising costs in oncology cause a growing concern about reimbursement for innovations in this sector. The promise of pharmacogenomic profiling and related stratified therapies in mCRC is to improve treatment efficacy and potentially save costs. Among other examples, the commonly used epidermal growth factor receptor (EGFR) antibodies cetuximab and panitumumab are only effective in patients with kirsten rat sarcoma viral oncogene homolog (KRAS) wild-type cancers. Hence, the adaptation of predictive biomarker testing might be a valid strategy for healthcare systems worldwide. This study aims to review the clinical and economic evidence supporting pharmacogenomic profiling prior to the administration of pharmaceutical treatment in mCRC. Moreover, key drivers and areas of uncertainty in cost-effectiveness evaluations are analysed. A systematic literature review was conducted to identify studies evaluating the cost effectiveness of predictive biomarkers and the result dependent usage of pharmaceutical agents in mCRC. The application of predictive biomarkers to detect KRAS mutations prior to the administration of EGFR antibodies saved treatment costs and was cost effective in all identified evaluations. However, because of the lack of data regarding cost-effectiveness analyses for predictive biomarker testing, e.g. for first-line treatment, definitive conclusions cannot be stated. Key drivers and areas of uncertainty in current cost-effectiveness analyses are, among others, the consideration of predictive biomarker costs, the characteristics of single predictive biomarkers and the availability of clinical data for the respective pharmaceutical intervention. Especially the cost effectiveness of uridine diphosphate-glucuronyl transferase 1A1 (UGT1A1) mutation analysis prior to irinotecan-based chemotherapy remains unclear. Pharmacogenomic profiling has the potential to improve the cost effectiveness of pharmaceutical treatment in mCRC. Hence, quantification of the economic impact of stratified medicine as well as cost-effectiveness analyses of pharmacogenomic profiling are becoming more important. Nevertheless, the methods applied in cost-effectiveness evaluations for the usage of predictive biomarkers for patient selection as well as the level of evidence required to determine clinical effectiveness are areas for further research. However, mCRC is one of the first indications in which stratified therapies are used in clinical practice. Thus, clinical and economic experiences could be helpful when adopting pharmacogenomic profiling into clinical practice for other indications.

Power and spectrally efficient M-ARY QAM schemes for future mobile satellite communications

NASA Technical Reports Server (NTRS)

Sreenath, K.; Feher, K.

1990-01-01

An effective method to compensate nonlinear phase distortion caused by the mobile amplifier is proposed. As a first step towards the future use of spectrally efficient modulation schemes for mobile satellite applications, we have investigated effects of nonlinearities and the phase compensation method on 16-QAM. The new method provides about 2 dB savings in power for 16-QAM operation with cost effective amplifiers near saturation and thereby promising use of spectrally efficient linear modulation schemes for future mobile satellite applications.

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

Soer, Wouter

LED luminaires have seen dramatic changes in cost breakdown over the past few years. The LED component cost, which until recently was the dominant portion of luminaire cost, has fallen to a level of the same order as the other luminaire components, such as the driver, housing, optics etc. With the current state of the technology, further luminaire performance improvement and cost reduction is realized most effectively by optimization of the whole system, rather than a single component. This project focuses on improving the integration between LEDs and drivers. Lumileds has developed a light engine platform based on low-cost high-powermore » LEDs and driver topologies optimized for integration with these LEDs on a single substrate. The integration of driver and LEDs enables an estimated luminaire cost reduction of about 25% for targeted applications, mostly due to significant reductions in driver and housing cost. The high-power LEDs are based on Lumileds’ patterned sapphire substrate flip-chip (PSS-FC) technology, affording reduced die fabrication and packaging cost compared to existing technology. Two general versions of PSS-FC die were developed in order to create the desired voltage and flux increments for driver integration: (i) small single-junction die (0.5 mm 2), optimal for distributed lighting applications, and (ii) larger multi-junction die (2 mm 2 and 4 mm 2) for high-power directional applications. Two driver topologies were developed: a tapped linear driver topology and a single-stage switch-mode topology, taking advantage of the flexible voltage configurations of the new PSS-FC die and the simplification opportunities enabled by integration of LEDs and driver on the same board. A prototype light engine was developed for an outdoor “core module” application based on the multi-junction PSS-FC die and the single-stage switch-mode driver. The light engine meets the project efficacy target of 128 lm/W at a luminous flux greater than 4100 lm, a correlated color temperature (CCT) of 4000K and a color rendering index (CRI) greater than 70.« less

Optimal periodic proof test based on cost-effective and reliability criteria

NASA Technical Reports Server (NTRS)

Yang, J.-N.

1976-01-01

An exploratory study for the optimization of periodic proof tests for fatigue-critical structures is presented. The optimal proof load level and the optimal number of periodic proof tests are determined by minimizing the total expected (statistical average) cost, while the constraint on the allowable level of structural reliability is satisfied. The total expected cost consists of the expected cost of proof tests, the expected cost of structures destroyed by proof tests, and the expected cost of structural failure in service. It is demonstrated by numerical examples that significant cost saving and reliability improvement for fatigue-critical structures can be achieved by the application of the optimal periodic proof test. The present study is relevant to the establishment of optimal maintenance procedures for fatigue-critical structures.

Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures.

PubMed

Neumann, Peter J; Anderson, Jordan E; Panzer, Ari D; Pope, Elle F; D'Cruz, Brittany N; Kim, David D; Cohen, Joshua T

2018-01-18

Background : We examined the similarities and differences between studies using two common metrics used in cost-effectiveness analyses (CEAs): cost per quality-adjusted life years (QALYs) gained and cost per disability-adjusted life year (DALY) averted. Methods : We used the Tufts Medical Center CEA Registry, which contains English-language cost-per-QALY gained studies, and  Global Cost-Effectiveness Analysis (GHCEA) Registry, which contains cost-per-DALY averted studies. We examined study characteristics including intervention type, sponsor, country, and primary disease, and also analysed the number of CEAs versus disease burden estimates for major diseases and conditions across three geographic regions. Results : We identified 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 and observed rapid growth in publication rates for both literatures. Cost-per-QALY studies were most likely to examine pharmaceuticals and interventions in high-income countries. Cost-per-DALY studies predominantly focused on infectious disease interventions and interventions in low and lower-middle income countries. We found discrepancies in the number of published CEAs for certain diseases and conditions in certain regions, suggesting "under-studied" areas (e.g., cardiovascular disease in Southeast Asia, East Asia, and Oceania and "overstudied" areas (e.g., HIV in Sub Saharan Africa) relative to disease burden in those regions. Conclusions : The number of cost-per QALY and cost-per-DALY analyses has grown rapidly with applications to diverse interventions and diseases.  Discrepancies between the number of published studies and disease burden suggest funding opportunities for future cost-effectiveness research.

Improvement Strategies, Cost Effective Production, and Potential Applications of Fungal Glucose Oxidase (GOD): Current Updates.

PubMed

Dubey, Manish K; Zehra, Andleeb; Aamir, Mohd; Meena, Mukesh; Ahirwal, Laxmi; Singh, Siddhartha; Shukla, Shruti; Upadhyay, Ram S; Bueno-Mari, Ruben; Bajpai, Vivek K

2017-01-01

Fungal glucose oxidase (GOD) is widely employed in the different sectors of food industries for use in baking products, dry egg powder, beverages, and gluconic acid production. GOD also has several other novel applications in chemical, pharmaceutical, textile, and other biotechnological industries. The electrochemical suitability of GOD catalyzed reactions has enabled its successful use in bioelectronic devices, particularly biofuel cells, and biosensors. Other crucial aspects of GOD such as improved feeding efficiency in response to GOD supplemental diet, roles in antimicrobial activities, and enhancing pathogen defense response, thereby providing induced resistance in plants have also been reported. Moreover, the medical science, another emerging branch where GOD was recently reported to induce several apoptosis characteristics as well as cellular senescence by downregulating Klotho gene expression. These widespread applications of GOD have led to increased demand for more extensive research to improve its production, characterization, and enhanced stability to enable long term usages. Currently, GOD is mainly produced and purified from Aspergillus niger and Penicillium species, but the yield is relatively low and the purification process is troublesome. It is practical to build an excellent GOD-producing strain. Therefore, the present review describes innovative methods of enhancing fungal GOD production by using genetic and non-genetic approaches in-depth along with purification techniques. The review also highlights current research progress in the cost effective production of GOD, including key advances, potential applications and limitations. Therefore, there is an extensive need to commercialize these processes by developing and optimizing novel strategies for cost effective GOD production.

Improvement Strategies, Cost Effective Production, and Potential Applications of Fungal Glucose Oxidase (GOD): Current Updates

PubMed Central

Dubey, Manish K.; Zehra, Andleeb; Aamir, Mohd; Meena, Mukesh; Ahirwal, Laxmi; Singh, Siddhartha; Shukla, Shruti; Upadhyay, Ram S.; Bueno-Mari, Ruben; Bajpai, Vivek K.

2017-01-01

Fungal glucose oxidase (GOD) is widely employed in the different sectors of food industries for use in baking products, dry egg powder, beverages, and gluconic acid production. GOD also has several other novel applications in chemical, pharmaceutical, textile, and other biotechnological industries. The electrochemical suitability of GOD catalyzed reactions has enabled its successful use in bioelectronic devices, particularly biofuel cells, and biosensors. Other crucial aspects of GOD such as improved feeding efficiency in response to GOD supplemental diet, roles in antimicrobial activities, and enhancing pathogen defense response, thereby providing induced resistance in plants have also been reported. Moreover, the medical science, another emerging branch where GOD was recently reported to induce several apoptosis characteristics as well as cellular senescence by downregulating Klotho gene expression. These widespread applications of GOD have led to increased demand for more extensive research to improve its production, characterization, and enhanced stability to enable long term usages. Currently, GOD is mainly produced and purified from Aspergillus niger and Penicillium species, but the yield is relatively low and the purification process is troublesome. It is practical to build an excellent GOD-producing strain. Therefore, the present review describes innovative methods of enhancing fungal GOD production by using genetic and non-genetic approaches in-depth along with purification techniques. The review also highlights current research progress in the cost effective production of GOD, including key advances, potential applications and limitations. Therefore, there is an extensive need to commercialize these processes by developing and optimizing novel strategies for cost effective GOD production. PMID:28659876

A low cost technique for synthesis of gold nanoparticles using microwave heating and its application in signal amplification for detecting Escherichia Coli O157:H7 bacteria

NASA Astrophysics Data System (ADS)

Thanh Ngo, Vo Ke; Giang Nguyen, Dang; Phat Huynh, Trong; Lam, Quang Vinh

2016-09-01

In the present work a low cost technique for preparation of gold nanoparticles (AuNPs) using microwave heating was developed. The effect of different elements (precursor reagents, irradiation time, and microwave radiation power) on the final morphology of AuNPs obtained through the microwave assisted technique has been investigated. The characterization of the samples has been carried out by transmission electron microscopy, UV-vis absorption spectroscopy, Fourier transform infrared spectroscopy, and powder x-ray diffraction. The results showed that to some extent the above-mentioned characterizations influenced the size of synthetized nanoparticles and application of microwave heating has many advantages such as low cost, rapid preparation and highly uniform particles. As an application in quartz crystal microbalance (QCM) immunosensor, AuNPs are conjugated with the Escherichia coli (E.coli) O157:H7 antibodies for signal amplification to detect E.coli O157:H7 bacteria residual in QCM system.

Real Time Optimal Control of Supercapacitor Operation for Frequency Response

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

Luo, Yusheng; Panwar, Mayank; Mohanpurkar, Manish

2016-07-01

Supercapacitors are gaining wider applications in power systems due to fast dynamic response. Utilizing supercapacitors by means of power electronics interfaces for power compensation is a proven effective technique. For applications such as requency restoration if the cost of supercapacitors maintenance as well as the energy loss on the power electronics interfaces are addressed. It is infeasible to use traditional optimization control methods to mitigate the impacts of frequent cycling. This paper proposes a Front End Controller (FEC) using Generalized Predictive Control featuring real time receding optimization. The optimization constraints are based on cost and thermal management to enhance tomore » the utilization efficiency of supercapacitors. A rigorous mathematical derivation is conducted and test results acquired from Digital Real Time Simulator are provided to demonstrate effectiveness.« less

Information Systems; Modern Health Care and Medical Information.

ERIC Educational Resources Information Center

Brandejs, J. F., And Others

1975-01-01

To effectively handle changes in health policy and health information, new designs and applications of automation are explored. Increased use of computer-based information systems in health care could serve as a means of control over the costs of developing more comprehensive health service, with applications increasing not only the automation of…

Application of Advanced Technology to Undergraduate Medical Education. Memorandum.

ERIC Educational Resources Information Center

Farquhar, J. A.; And Others

Advanced technology will have a great effect on medical education because it can speed up medical education and boost the quality of instruction without straining the capacity of medical schools to expand or driving costs to unreasonable levels. Six examples of an application of advanced technology to medical education are described in this…

ecoSmart landscapes: a versatile SaaS platform for green infrastructure applications in urban environments

Treesearch

Greg McPherson; Qingfu Xiao; Joe Purohit; Mark Dietenberger; Charles (C.R.) Boardman; Jim Simpson; Paula Peper

2014-01-01

The urban environment offers significant opportunities to improve sustainability and optimize water resources. Historically, research and software applications have been focused on the built environment (buildings). Cost-effective, practical tools that can assess the impact of different landscape configurations and their interactions with buildings have not been widely...

Research on the optimization of quota design in real estate

NASA Astrophysics Data System (ADS)

Sun, Chunling; Ma, Susu; Zhong, Weichao

2017-11-01

Quota design is one of the effective methods of cost control in real estate development project and widely used in the current real estate development project to control the engineering construction cost, but quota design have many deficiencies in design process. For this purpose, this paper put forward a method to achieve investment control of real estate development project, which combine quota design and value engineering(VE) at the stage of design. Specifically, it’s an optimizing for the structure of quota design. At first, determine the design limits by investment estimate value, then using VE to carry on initial allocation of design limits and gain the functional target cost, finally, consider the whole life cycle cost (LCC) and operational problem in practical application to finish complex correction for the functional target cost. The improved process can control the project cost more effectively. It not only can control investment in a certain range, but also make the project realize maximum value within investment.

A methodology for spacecraft technology insertion analysis balancing benefit, cost, and risk

NASA Astrophysics Data System (ADS)

Bearden, David Allen

Emerging technologies are changing the way space missions are developed and implemented. Technology development programs are proceeding with the goal of enhancing spacecraft performance and reducing mass and cost. However, it is often the case that technology insertion assessment activities, in the interest of maximizing performance and/or mass reduction, do not consider synergistic system-level effects. Furthermore, even though technical risks are often identified as a large cost and schedule driver, many design processes ignore effects of cost and schedule uncertainty. This research is based on the hypothesis that technology selection is a problem of balancing interrelated (and potentially competing) objectives. Current spacecraft technology selection approaches are summarized, and a Methodology for Evaluating and Ranking Insertion of Technology (MERIT) that expands on these practices to attack otherwise unsolved problems is demonstrated. MERIT combines the modern techniques of technology maturity measures, parametric models, genetic algorithms, and risk assessment (cost and schedule) in a unique manner to resolve very difficult issues including: user-generated uncertainty, relationships between cost/schedule and complexity, and technology "portfolio" management. While the methodology is sufficiently generic that it may in theory be applied to a number of technology insertion problems, this research focuses on application to the specific case of small (<500 kg) satellite design. Small satellite missions are of particular interest because they are often developed under rigid programmatic (cost and schedule) constraints and are motivated to introduce advanced technologies into the design. MERIT is demonstrated for programs procured under varying conditions and constraints such as stringent performance goals, not-to-exceed costs, or hard schedule requirements. MERIT'S contributions to the engineering community are its: unique coupling of the aspects of performance, cost, and schedule; assessment of system level impacts of technology insertion; procedures for estimating uncertainties (risks) associated with advanced technology; and application of heuristics to facilitate informed system-level technology utilization decisions earlier in the conceptual design phase. MERIT extends the state of the art in technology insertion assessment selection practice and, if adopted, may aid designers in determining the configuration of complex systems that meet essential requirements in a timely, cost-effective manner.

Development of a Cost-Effective Modular Pixelated NaI(Tl) Detector for Clinical SPECT Applications

PubMed Central

Rozler, Mike; Liang, Haoning; Chang, Wei

2013-01-01

A new pixelated detector for high-resolution clinical SPECT applications was designed and tested. The modular detector is based on a scintillator block comprised of 2.75×2.75×10 mm3 NaI(Tl) pixels and decoded by an array of 51 mm diameter single-anode PMTs. Several configurations, utilizing two types of PMTs, were evaluated using a collimated beam source to measure positioning accuracy directly. Good pixel separation was observed, with correct pixel identification ranging from 60 to 72% averaged over the entire area of the modules, depending on the PMT type and configuration. This translates to a significant improvement in positioning accuracy compared to continuous slab detectors of the same thickness, along with effective reduction of “dead” space at the edges. The observed 10% average energy resolution compares well to continuous slab detectors. The combined performance demonstrates the suitability of pixelated detectors decoded with a relatively small number of medium-sized PMTs as a cost-effective approach for high resolution clinical SPECT applications, in particular those involving curved detector geometries. PMID:24146436

24 CFR 242.43 - Application of cost savings.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Application of cost savings. 242.43... MORTGAGE INSURANCE FOR HOSPITALS Endorsement for Insurance § 242.43 Application of cost savings. At the sole discretion of HUD, any cost savings shall be used to: (a) Reduce the principal amount of the...

A cost-effectiveness analysis to illustrate the impact of cost definitions on results, interpretations and comparability of pharmacoeconomic studies in the US.

PubMed

Tunis, Sandra L

2009-01-01

There is a lack of a uniform proxy for defining direct medical costs in the US. This potentially important source of variation in modelling and other types of economic studies is often overlooked. The extent to which increased expenditures for an intervention can be offset by reductions in subsequent service costs can be directly related to the choice of cost definitions. To demonstrate how different cost definitions for direct medical costs can impact results and interpretations of a cost-effectiveness analysis. The IMS-CORE Diabetes Model was used to project the lifetime (35-year) cost effectiveness in the US of one pharmacological intervention 'medication A' compared with a second 'medication B' (both unspecified) for type 2 diabetes mellitus. The complications modelled included cardiovascular disease, renal disease, eye disease and neuropathy. The model had a Markov structure with Monte Carlo simulations. Utility values were derived from the published literature. Complication costs were obtained from a retrospective database study that extracted anonymous patient-level data from (primarily private payer) adjudicated medical and pharmaceutical claims. Costs for pharmacy services, outpatient services and inpatient hospitalizations were included. Cost definitions for complications included charged, allowed and paid amounts, and for medications included both wholesale acquisition cost (WAC) and average wholesale price (AWP). Costs were reported in year 2007 values. The cost-effectiveness results differed according to the particular combination of cost definitions employed. The use of charges greatly increased costs for complications. When the analysis incorporated WAC medication prices with charged amounts for complication costs, the incremental cost-effectiveness ratio (ICER) for medication A versus medication B was $US6337 per QALY. When AWP prices were used with charged amounts, medication A became a dominant treatment strategy, i.e. lower costs with greater effectiveness than medication B. For both allowed and paid scenarios, there was a difference in the ICER of over $US10,300 per QALY when medication prices were defined by WAC versus AWP. Ratios of medication costs to cardiovascular complication costs ranged from under 0.45 to over 1.7, depending upon the combination of costing definitions. Explicitly addressing the cost-definition issue can help provide meaningful cost-effectiveness data to payers for policy development and management of healthcare expenditures. It can also help move the pharmacoeconomics and outcomes research fields forward in terms of both methodology and practical application.

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.

Energy Storage on the Grid and the Short-term Variability of Wind

NASA Astrophysics Data System (ADS)

Hittinger, Eric Stephen

Wind generation presents variability on every time scale, which must be accommodated by the electric grid. Limited quantities of wind power can be successfully integrated by the current generation and demand-side response mix but, as deployment of variable resources increases, the resulting variability becomes increasingly difficult and costly to mitigate. In Chapter 2, we model a co-located power generation/energy storage block composed of wind generation, a gas turbine, and fast-ramping energy storage. A scenario analysis identifies system configurations that can generate power with 30% of energy from wind, a variability of less than 0.5% of the desired power level, and an average cost around $70/MWh. While energy storage technologies have existed for decades, fast-ramping grid-level storage is still an immature industry and is experiencing relatively rapid improvements in performance and cost across a variety of technologies. Decreased capital cost, increased power capability, and increased efficiency all would improve the value of an energy storage technology and each has cost implications that vary by application, but there has not yet been an investigation of the marginal rate of technical substitution between storage properties. The analysis in chapter 3 uses engineering-economic models of four emerging fast-ramping energy storage technologies to determine which storage properties have the greatest effect on cost-of-service. We find that capital cost of storage is consistently important, and identify applications for which power/energy limitations are important. In some systems with a large amount of wind power, the costs of wind integration have become significant and market rules have been slowly changing in order to internalize or control the variability of wind generation. Chapter 4 examines several potential market strategies for mitigating the effects of wind variability and estimate the effect that each strategy would have on the operation and profitability of wind farms. We find that market scenarios using existing price signals to motivate wind to reduce variability allow wind generators to participate in variability reduction when the market conditions are favorable, and can reduce short-term (30-minute) fluctuations while having little effect on wind farm revenue.

Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine.

PubMed

Sanders, Gillian D; Neumann, Peter J; Basu, Anirban; Brock, Dan W; Feeny, David; Krahn, Murray; Kuntz, Karen M; Meltzer, David O; Owens, Douglas K; Prosser, Lisa A; Salomon, Joshua A; Sculpher, Mark J; Trikalinos, Thomas A; Russell, Louise B; Siegel, Joanna E; Ganiats, Theodore G

2016-09-13

Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years. To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses. The intended audiences include researchers, government policy makers, public health officials, health care administrators, payers, businesses, clinicians, patients, and consumers. In 2012, the Second Panel on Cost-Effectiveness in Health and Medicine was formed and included 2 co-chairs, 13 members, and 3 additional members of a leadership group. These members were selected on the basis of their experience in the field to provide broad expertise in the design, conduct, and use of cost-effectiveness analyses. Over the next 3.5 years, the panel developed recommendations by consensus. These recommendations were then reviewed by invited external reviewers and through a public posting process. The concept of a "reference case" and a set of standard methodological practices that all cost-effectiveness analyses should follow to improve quality and comparability are recommended. All cost-effectiveness analyses should report 2 reference case analyses: one based on a health care sector perspective and another based on a societal perspective. The use of an "impact inventory," which is a structured table that contains consequences (both inside and outside the formal health care sector), intended to clarify the scope and boundaries of the 2 reference case analyses is also recommended. This special communication reviews these recommendations and others concerning the estimation of the consequences of interventions, the valuation of health outcomes, and the reporting of cost-effectiveness analyses. The Second Panel reviewed the current status of the field of cost-effectiveness analysis and developed a new set of recommendations. Major changes include the recommendation to perform analyses from 2 reference case perspectives and to provide an impact inventory to clarify included consequences.

Government conceptual estimating for contracting and management

NASA Technical Reports Server (NTRS)

Brown, J. A.

1986-01-01

The use of the Aerospace Price Book, a cost index, and conceptual cost estimating for cost-effective design and construction of space facilities is discussed. The price book consists of over 200 commonly used conceptual elements and 100 systems summaries of projects such as launch pads, processing facilities, and air locks. The cost index is composed of three divisions: (1) bid summaries of major Shuttle projects, (2) budget cost data sheets, and (3) cost management summaries; each of these divisions is described. Conceptual estimates of facilities and ground support equipment are required to provide the most probable project cost for budget, funding, and project approval purposes. Similar buildings, systems, and elements already designed are located in the cost index in order to make the best rough order of magnitude conceptual estimates for development of Space Shuttle facilities. An example displaying the applicability of the conceptual cost estimating procedure for the development of the KSC facilities is presented.

Cost effective technologies and renewable substrates for biosurfactants’ production

PubMed Central

Banat, Ibrahim M.; Satpute, Surekha K.; Cameotra, Swaranjit S.; Patil, Rajendra; Nyayanit, Narendra V.

2014-01-01

Diverse types of microbial surface active amphiphilic molecules are produced by a range of microbial communities. The extraordinary properties of biosurfactant/bioemulsifier (BS/BE) as surface active products allows them to have key roles in various field of applications such as bioremediation, biodegradation, enhanced oil recovery, pharmaceutics, food processing among many others. This leads to a vast number of potential applications of these BS/BE in different industrial sectors. Despite the huge number of reports and patents describing BS and BE applications and advantages, commercialization of these compounds remain difficult, costly and to a large extent irregular. This is mainly due to the usage of chemically synthesized media for growing producing microorganism and in turn the production of preferred quality products. It is important to note that although a number of developments have taken place in the field of BS industries, large scale production remains economically challenging for many types of these products. This is mainly due to the huge monetary difference between the investment and achievable productivity from the commercial point of view. This review discusses low cost, renewable raw substrates, and fermentation technology in BS/BE production processes and their role in reducing the production cost. PMID:25566213

[Decision analysis--a novel approach for calculating the cost-efficiency of medical tests].

PubMed

Becher, J

2008-09-01

Before issuing an insurance policy (e.g. life, disability, critical illness), insurers will usually carry out a medical risk assessment in order to prevent adverse selection. Often, the health questions in the application form will not be sufficient for this purpose since most applicants are not well-versed in medical science and terminology. If the insurer needs additional medical information such as a private medical attendant's report or current laboratory tests, however, costs will be incurred, which usually have to be paid by the insurer. What is the minimum sum insured which makes it worthwhile for the insurer to conduct certain screening tests, for example? Both the costs of medical screening and the associated savings are difficult to measure and involve a variety of different factors. Moreover, most parameters can only be estimated with limited accuracy. Therefore, we have developed a new calculation model using a decision-analysis approach. The new model makes it possible to analyse complex situations while taking into account the uncertainty of parameter estimation. Our findings show that in Germany, for instance, current sum thresholds for older applicants could in many cases be lowered and would still be cost-effective.

Evaluating the cost of one telehealth application connecting an acute and long-term care setting.

PubMed

Specht, J K; Wakefield, B; Flanagan, J

2001-01-01

This article describes a study of the costs of a pilot telemedicine chronic wound consultation clinic. Cost minimization analysis is the technique used to examine the costs of the clinic. The components of cost analysis include the fixed costs of personnel and equipment and the indirect costs of circuit and line charges. Cost avoidance is also examined. Cost avoidance evaluates what costs were avoided by the use of the telemedicine clinic. Additionally, the cost perspectives of the consulting agency, the referring agency, and the patient are examined. The average cost of a chronic wound consultation was $136.16 (acute care perspective). Costs of a traditional face-to-face consultation, if the residents were transported to the acute care facility would be $246.28. Fifteen telehealth consultations per month were used to determine per consultation costs for line charges and depreciation/maintenance costs. In this pilot study, a cost savings was realized and patients benefited. Increased volume will help to offset the cost of the equipment depreciation and maintenance and make telehealth chronic wound consultations more cost effective.

“Lost in translation”: accounting for between-country differences in the analysis of multinational cost-effectiveness data§

PubMed Central

Manca, Andrea; Willan, Andrew R.

2008-01-01

Background Cost-effectiveness analysis has gained status over the last 15 years as an important tool for assisting resource allocation decisions in a budged-limited environment such as healthcare. Randomised (multicentre) multinational controlled trials are often the main vehicle to collect primary patient-level information on resource use, cost and clinical effectiveness associated with alternative treatment strategies. However, trial-wide cost-effectiveness results may not be directly applicable to any one of the countries that participate in a multinational trial, requiring some form of additional modelling to customise the results to the country of interest. Objective The aim is to produce recommendations regarding methods that can be (currently) considered ‘good practice’ when exploring the geographical generalisability of cost-effectiveness data. The manuscript proposes an algorithm to assist with the choice of the appropriate analytical strategy when facing the task of adapting the study results from one country to another. The algorithm considers different scenarios characterised by whether or not (a) the country of interest participated in the trial, and (b) individual patient-level data (IPD) from the trial are available. Methods Structured review with description and discussion of case studies. Conclusions Methods to reflect between-country variability in cost-effectiveness data are available. It is important to be transparent regarding the assumptions made in the analysis and (where possible) assess their impact on the study results. PMID:17067195

Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

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

Bill Stanley; Patrick Gonzalez; Sandra Brown

2005-10-01

The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects,more » providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between April 1st , 2005 and June 30th, 2005. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.« less

Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration

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

Bill Stanley; Patrick Gonzalez; Sandra Brown

2006-01-01

The Nature Conservancy is participating in a Cooperative Agreement with the Department of Energy (DOE) National Energy Technology Laboratory (NETL) to explore the compatibility of carbon sequestration in terrestrial ecosystems and the conservation of biodiversity. The title of the research project is ''Application and Development of Appropriate Tools and Technologies for Cost-Effective Carbon Sequestration''. The objectives of the project are to: (1) improve carbon offset estimates produced in both the planning and implementation phases of projects; (2) build valid and standardized approaches to estimate project carbon benefits at a reasonable cost; and (3) lay the groundwork for implementing cost-effective projects,more » providing new testing ground for biodiversity protection and restoration projects that store additional atmospheric carbon. This Technical Progress Report discusses preliminary results of the six specific tasks that The Nature Conservancy is undertaking to answer research needs while facilitating the development of real projects with measurable greenhouse gas reductions. The research described in this report occurred between April 1st , 2005 and June 30th, 2005. The specific tasks discussed include: Task 1: carbon inventory advancements; Task 2: emerging technologies for remote sensing of terrestrial carbon; Task 3: baseline method development; Task 4: third-party technical advisory panel meetings; Task 5: new project feasibility studies; and Task 6: development of new project software screening tool.« less

Simultaneous Purification and Perforation of Low-Grade Si Sources for Lithium-Ion Battery Anode.

PubMed

Jin, Yan; Zhang, Su; Zhu, Bin; Tan, Yingling; Hu, Xiaozhen; Zong, Linqi; Zhu, Jia

2015-11-11

Silicon is regarded as one of the most promising candidates for lithium-ion battery anodes because of its abundance and high theoretical capacity. Various silicon nanostructures have been heavily investigated to improve electrochemical performance by addressing issues related to structure fracture and unstable solid-electrolyte interphase (SEI). However, to further enable widespread applications, scalable and cost-effective processes need to be developed to produce these nanostructures at large quantity with finely controlled structures and morphologies. In this study, we develop a scalable and low cost process to produce porous silicon directly from low grade silicon through ball-milling and modified metal-assisted chemical etching. The morphology of porous silicon can be drastically changed from porous-network to nanowire-array by adjusting the component in reaction solutions. Meanwhile, this perforation process can also effectively remove the impurities and, therefore, increase Si purity (up to 99.4%) significantly from low-grade and low-cost ferrosilicon (purity of 83.4%) sources. The electrochemical examinations indicate that these porous silicon structures with carbon treatment can deliver a stable capacity of 1287 mAh g(-1) over 100 cycles at a current density of 2 A g(-1). This type of purified porous silicon with finely controlled morphology, produced by a scalable and cost-effective fabrication process, can also serve as promising candidates for many other energy applications, such as thermoelectrics and solar energy conversion devices.

Setting the most robust effluent level under severe uncertainty: application of information-gap decision theory to chemical management.

PubMed

Yokomizo, Hiroyuki; Naito, Wataru; Tanaka, Yoshinari; Kamo, Masashi

2013-11-01

Decisions in ecological risk management for chemical substances must be made based on incomplete information due to uncertainties. To protect the ecosystems from the adverse effect of chemicals, a precautionary approach is often taken. The precautionary approach, which is based on conservative assumptions about the risks of chemical substances, can be applied selecting management models and data. This approach can lead to an adequate margin of safety for ecosystems by reducing exposure to harmful substances, either by reducing the use of target chemicals or putting in place strict water quality criteria. However, the reduction of chemical use or effluent concentrations typically entails a financial burden. The cost effectiveness of the precautionary approach may be small. Hence, we need to develop a formulaic methodology in chemical risk management that can sufficiently protect ecosystems in a cost-effective way, even when we do not have sufficient information for chemical management. Information-gap decision theory can provide the formulaic methodology. Information-gap decision theory determines which action is the most robust to uncertainty by guaranteeing an acceptable outcome under the largest degree of uncertainty without requiring information about the extent of parameter uncertainty at the outset. In this paper, we illustrate the application of information-gap decision theory to derive a framework for setting effluent limits of pollutants for point sources under uncertainty. Our application incorporates a cost for reduction in pollutant emission and a cost to wildlife species affected by the pollutant. Our framework enables us to settle upon actions to deal with severe uncertainty in ecological risk management of chemicals. Copyright © 2013 Elsevier Ltd. All rights reserved.

Commercial Smartphone-Based Devices and Smart Applications for Personalized Healthcare Monitoring and Management

PubMed Central

Vashist, Sandeep Kumar; Schneider, E. Marion; Luong, John H.T.

2014-01-01

Smartphone-based devices and applications (SBDAs) with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare). Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management. PMID:26852680

Commercial Smartphone-Based Devices and Smart Applications for Personalized Healthcare Monitoring and Management.

PubMed

Vashist, Sandeep Kumar; Schneider, E Marion; Luong, John H T

2014-08-18

Smartphone-based devices and applications (SBDAs) with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare). Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management.

Cost-Effective TiAl based Materials

NASA Technical Reports Server (NTRS)

Moxson, V. S.; Sun, Fusheng; Draper, Susan L.; Froes, F. H.; Duz, V.

2003-01-01

Because of their inherent low ductility, TiAl-based materials are difficult to fabricate, especially thin gage titanium gamma aluminide (TiAl) sheet and foil. In this paper, an innovative powder metallurgy approach for producing cost-effective thin gage TiAl sheets (with 356 mm long and 235 mm wide, and a thickness of 0.74, 1.09, 1.55, and 2.34 mm, respectively) is presented. The microstructures and tensile properties at room and elevated temperatures of the thin gage TiAl are studied. Results show that these TiAl sheets have a relatively homogenous chemistry, uniform microstructure, and acceptable mechanical properties. This work demonstrates a cost-effective method for producing both flat products (sheet/foil) and complex chunky parts of TiAl for various advanced applications including aerospace and automotive industries.

Payload analysis for space shuttle applications (study 2.2). Volume 3: Payload system operations analysis (task 2.2.1). [payload system operations analysis for shuttles and space tugs

NASA Technical Reports Server (NTRS)

1972-01-01

The technical and cost analysis that was performed for the payload system operations analysis is presented. The technical analysis consists of the operations for the payload/shuttle and payload/tug, and the spacecraft analysis which includes sortie, automated, and large observatory type payloads. The cost analysis includes the costing tradeoffs of the various payload design concepts and traffic models. The overall objectives of this effort were to identify payload design and operational concepts for the shuttle which will result in low cost design, and to examine the low cost design concepts to identify applicable design guidelines. The operations analysis examined several past and current NASA and DoD satellite programs to establish a shuttle operations model. From this model the analysis examined the payload/shuttle flow and determined facility concepts necessary for effective payload/shuttle ground operations. The study of the payload/tug operations was an examination of the various flight timelines for missions requiring the tug.

Value for money of changing healthcare services? Economic evaluation of quality improvement

PubMed Central

Severens, J

2003-01-01



 There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369

Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers.

PubMed

Yao, Guiqing Lily; Novielli, Nicola; Manaseki-Holland, Semira; Chen, Yen-Fu; van der Klink, Marcel; Barach, Paul; Chilton, Peter J; Lilford, Richard J

2012-12-01

We developed a method to estimate the expected cost-effectiveness of a service intervention at the design stage and 'road-tested' the method on an intervention to improve patient handover of care between hospital and community. The development of a nine-step evaluation framework: 1. Identification of multiple endpoints and arranging them into manageable groups; 2. Estimation of baseline overall and preventable risk; 3. Bayesian elicitation of expected effectiveness of the planned intervention; 4. Assigning utilities to groups of endpoints; 5. Costing the intervention; 6. Estimating health service costs associated with preventable adverse events; 7. Calculating health benefits; 8. Cost-effectiveness calculation; 9. Sensitivity and headroom analysis. Literature review suggested that adverse events follow 19% of patient discharges, and that one-third are preventable by improved handover (ie, 6.3% of all discharges). The intervention to improve handover would reduce the incidence of adverse events by 21% (ie, from 6.3% to 4.7%) according to the elicitation exercise. Potentially preventable adverse events were classified by severity and duration. Utilities were assigned to each category of adverse event. The costs associated with each category of event were obtained from the literature. The unit cost of the intervention was €16.6, which would yield a Quality Adjusted Life Year (QALY) gain per discharge of 0.010. The resulting cost saving was €14.3 per discharge. The intervention is cost-effective at approximately €214 per QALY under the base case, and remains cost-effective while the effectiveness is greater than 1.6%. We offer a usable framework to assist in ex ante health economic evaluations of health service interventions.

Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers

PubMed Central

Yao, Guiqing Lily; Novielli, Nicola; Manaseki-Holland, Semira; Chen, Yen-Fu; van der Klink, Marcel; Barach, Paul; Chilton, Peter J; Lilford, Richard J

2012-01-01

Background We developed a method to estimate the expected cost-effectiveness of a service intervention at the design stage and ‘road-tested’ the method on an intervention to improve patient handover of care between hospital and community. Method The development of a nine-step evaluation framework: 1. Identification of multiple endpoints and arranging them into manageable groups; 2. Estimation of baseline overall and preventable risk; 3. Bayesian elicitation of expected effectiveness of the planned intervention; 4. Assigning utilities to groups of endpoints; 5. Costing the intervention; 6. Estimating health service costs associated with preventable adverse events; 7. Calculating health benefits; 8. Cost-effectiveness calculation; 9. Sensitivity and headroom analysis. Results     Literature review suggested that adverse events follow 19% of patient discharges, and that one-third are preventable by improved handover (ie, 6.3% of all discharges). The intervention to improve handover would reduce the incidence of adverse events by 21% (ie, from 6.3% to 4.7%) according to the elicitation exercise. Potentially preventable adverse events were classified by severity and duration. Utilities were assigned to each category of adverse event. The costs associated with each category of event were obtained from the literature. The unit cost of the intervention was €16.6, which would yield a Quality Adjusted Life Year (QALY) gain per discharge of 0.010. The resulting cost saving was €14.3 per discharge. The intervention is cost-effective at approximately €214 per QALY under the base case, and remains cost-effective while the effectiveness is greater than 1.6%. Conclusions We offer a usable framework to assist in ex ante health economic evaluations of health service interventions. PMID:22976505

Enhancing a Low-Cost Virtual Reality Application through Constructivist Approach: The Case of Spatial Training of Middle Graders

ERIC Educational Resources Information Center

Samsudin, Khairulanuar; Rafi, Ahmad; Mohamad Ali, Ahmad Zamzuri; Abd. Rashid, Nazre

2014-01-01

The aim of this study is to develop and to test a low-cost virtual reality spatial trainer in terms of its effectiveness in spatial training. The researchers adopted three features deriving from the constructivist perspective to guide the design of the trainer, namely interaction, instruction, and support. The no control pre test post test…

Determining the Best-Fit FPGA for a Space Mission: An Analysis of Cost, SEU Sensitivity,and Reliability

NASA Technical Reports Server (NTRS)

Berg, Melanie; LaBel, Ken

2007-01-01

This viewgraph presentation reviews the selection of the optimum Field Programmable Gate Arrays (FPGA) for space missions. Included in this review is a discussion on differentiating amongst various FPGAs, cost analysis of the various options, the investigation of radiation effects, an expansion of the evaluation criteria, and the application of the evaluation criteria to the selection process.

High efficiency motor selection handbook

NASA Astrophysics Data System (ADS)

McCoy, Gilbert A.; Litman, Todd; Douglass, John G.

1990-10-01

Substantial reductions in energy and operational costs can be achieved through the use of energy-efficient electric motors. A handbook was compiled to help industry identify opportunities for cost-effective application of these motors. It covers the economic and operational factors to be considered when motor purchase decisions are being made. Its audience includes plant managers, plant engineers, and others interested in energy management or preventative maintenance programs.

Cost per responder of TNF-α therapies in Germany.

PubMed

Gissel, Christian; Repp, Holger

2013-12-01

Tumor necrosis factor α (TNF-α) inhibitors ranked highest in German pharmaceutical expenditure in 2011. Their most important application is the treatment of rheumatoid arthritis (RA). Our objective is to analyze cost per responder of TNF-α inhibitors for RA from the German Statutory Health Insurance funds' perspective. We aim to conduct the analysis based on randomized comparative effectiveness studies of the relevant treatments for the German setting. For inclusion of effectiveness studies, we require results in terms of response rates as defined by European League Against Rheumatism (EULAR) or American College of Rheumatology (ACR) criteria. We identify conventional triple therapy as the relevant comparator. We calculate cost per responder based on German direct medical costs. Direct clinical comparisons could be identified for both etanercept and infliximab compared to triple therapy. For infliximab, cost per responder was 216,392 euros for ACR50 and 432,784 euros for ACR70 responses. For etanercept, cost per ACR70 responder was 321,527 euros. Cost was lower for response defined by EULAR criteria, but data was only available for infliximab. Cost per responder is overestimated by 40% due to inclusion of taxes and mandatory rebates in German drugs' list prices. Our analysis shows specific requirements for cost-effectiveness analysis in Germany. Cost per responder for TNF-α treatment in the German setting is more than double the cost estimated in a similar analysis for the USA, which measured against placebo. The difference in results shows the critical role of the correct comparator for a specific setting.

Water Management Planning: A Case Study at Blue Grass Army Depot

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

Solana, Amy E.; Mcmordie, Katherine

2006-04-03

Executive Order 13123, Greening the Government Through Efficient Energy Management, mandates an aggressive policy for reducing potable water consumption at federal facilities. Implementation guid¬ance from the U.S. Department of Energy (DOE) set a requirement for each federal agency to “reduce potable water usage by implementing life cycle, cost-effective water efficiency programs that include a water management plan, and not less than four Federal Energy Management Program (FEMP) Best Manage¬ment Practices (BMPs).” The objective of this plan is to gain full compliance with Executive Order 13123 and associated DOE implementation guidance on behalf of Blue Grass Army Depot (BGAD), Richmond, Kentucky.more » In accordance with this plan, BGAD must: • Incorporate the plan as a component of the Installation energy conservation plan • Investigate the water savings potential and life-cycle cost effectiveness of the Operations and Maintenance (O&M) and retrofit/replacement options associated with the ten FEMP BMPs • Put into practice all applicable O&M options • Identify retrofit/replacement options appropriate for implementation (based upon calculation of the simple payback periods) • Establish a schedule for implementation of applicable and cost-effective retrofit/replacement options.« less

High Performance and Cost-Effective Direct Methanol Fuel Cells: Fe-N-C Methanol-Tolerant Oxygen Reduction Reaction Catalysts.

PubMed

Sebastián, David; Serov, Alexey; Artyushkova, Kateryna; Gordon, Jonathan; Atanassov, Plamen; Aricò, Antonino S; Baglio, Vincenzo

2016-08-09

Direct methanol fuel cells (DMFCs) offer great advantages for the supply of power with high efficiency and large energy density. The search for a cost-effective, active, stable and methanol-tolerant catalyst for the oxygen reduction reaction (ORR) is still a great challenge. In this work, platinum group metal-free (PGM-free) catalysts based on Fe-N-C are investigated in acidic medium. Post-treatment of the catalyst improves the ORR activity compared with previously published PGM-free formulations and shows an excellent tolerance to the presence of methanol. The feasibility for application in DMFC under a wide range of operating conditions is demonstrated, with a maximum power density of approximately 50 mW cm(-2) and a negligible methanol crossover effect on the performance. A review of the most recent PGM-free cathode formulations for DMFC indicates that this formulation leads to the highest performance at a low membrane-electrode assembly (MEA) cost. Moreover, a 100 h durability test in DMFC shows suitable applicability, with a similar performance-time behavior compared to common MEAs based on Pt cathodes. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Overview of innovative remediation of emerging contaminants

NASA Astrophysics Data System (ADS)

Keller, A. A.; Adeleye, A. S.; Huang, Y.; Garner, K.

2015-12-01

The application of nanotechnology in drinking water treatment and pollution cleanup is promising, as demonstrated by a number of field-based (pilot and full scale) and bench scale studies. A number of reviews exist for these nanotechnology-based applications; but to better illustrate its importance and guide its development, a direct comparison between traditional treatment technologies and emerging approaches using nanotechnology is needed. In this review, the performances of traditional technologies and nanotechnology for water treatment and environmental remediation were compared with the goal of providing an up-to-date reference on the state of treatment techniques for researchers, industry, and policy makers. Pollutants were categorized into broad classes, and the most cost-effective techniques (traditional and nanotechnology-based) in each category reported in the literature were compared. Where information was available, cost and environmental implications of both technologies were also compared. Traditional treatment technologies were found to currently offer the most cost-effective choices for removal of several common pollutants from drinking water and polluted sites. Nano-based techniques may however become important in complicated remediation conditions and meeting increasingly stringent water quality standards, especially in removal of emerging pollutants and low levels of contaminants. We also discuss challenges facing environmental application of nanotechnology were also discussed and potential solutions.

A Systems Biology Approach to Toxicology Research with Small Fish Models

EPA Science Inventory

Increasing use of mechanistically-based molecular and biochemical endpoints and in vitro assays is being advocated as a more efficient and cost-effective approach for generating chemical hazard data. However, development of effective assays and application of the resulting data i...

Validated Feasibility Study of Integrally Stiffened Metallic Fuselage Panels for Reducing Manufacturing Costs

NASA Technical Reports Server (NTRS)

Pettit, R. G.; Wang, J. J.; Toh, C.

2000-01-01

The continual need to reduce airframe cost and the emergence of high speed machining and other manufacturing technologies has brought about a renewed interest in large-scale integral structures for aircraft applications. Applications have been inhibited, however, because of the need to demonstrate damage tolerance, and by cost and manufacturing risks associated with the size and complexity of the parts. The Integral Airframe Structures (IAS) Program identified a feasible integrally stiffened fuselage concept and evaluated performance and manufacturing cost compared to conventional designs. An integral skin/stiffener concept was produced both by plate hog-out and near-net extrusion. Alloys evaluated included 7050-T7451 plate, 7050-T74511 extrusion, 6013-T6511 extrusion, and 7475-T7351 plate. Mechanical properties, structural details, and joint performance were evaluated as well as repair, static compression, and two-bay crack residual strength panels. Crack turning behavior was characterized through panel tests and improved methods for predicting crack turning were developed. Manufacturing cost was evaluated using COSTRAN. A hybrid design, made from high-speed machined extruded frames that are mechanically fastened to high-speed machined plate skin/stringer panels, was identified as the most cost-effective manufacturing solution. Recurring labor and material costs of the hybrid design are up to 61 percent less than the current technology baseline.

45 CFR 602.22 - Allowable costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CFR part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply.... (b) Applicable cost principles. For each kind of organization, there is a set of Federal principles... principles applicable to the organization incurring the costs. The following chart lists the kinds of...

A Practical Solution Using A New Approach To Robot Vision

NASA Astrophysics Data System (ADS)

Hudson, David L.

1984-01-01

Up to now, robot vision systems have been designed to serve both application development and operational needs in inspection, assembly and material handling. This universal approach to robot vision is too costly for many practical applications. A new industrial vision system separates the function of application program development from on-line operation. A Vision Development System (VDS) is equipped with facilities designed to simplify and accelerate the application program development process. A complimentary but lower cost Target Application System (TASK) runs the application program developed with the VDS. This concept is presented in the context of an actual robot vision application that improves inspection and assembly for a manufacturer of electronic terminal keyboards. Applications developed with a VDS experience lower development cost when compared with conventional vision systems. Since the TASK processor is not burdened with development tools, it can be installed at a lower cost than comparable "universal" vision systems that are intended to be used for both development and on-line operation. The VDS/TASK approach opens more industrial applications to robot vision that previously were not practical because of the high cost of vision systems. Although robot vision is a new technology, it has been applied successfully to a variety of industrial needs in inspection, manufacturing, and material handling. New developments in robot vision technology are creating practical, cost effective solutions for a variety of industrial needs. A year or two ago, researchers and robot manufacturers interested in implementing a robot vision application could take one of two approaches. The first approach was to purchase all the necessary vision components from various sources. That meant buying an image processor from one company, a camera from another and lens and light sources from yet others. The user then had to assemble the pieces, and in most instances he had to write all of his own software to test, analyze and process the vision application. The second and most common approach was to contract with the vision equipment vendor for the development and installation of a turnkey inspection or manufacturing system. The robot user and his company paid a premium for their vision system in an effort to assure the success of the system. Since 1981, emphasis on robotics has skyrocketed. New groups have been formed in many manufacturing companies with the charter to learn about, test and initially apply new robot and automation technologies. Machine vision is one of new technologies being tested and applied. This focused interest has created a need for a robot vision system that makes it easy for manufacturing engineers to learn about, test, and implement a robot vision application. A newly developed vision system addresses those needs. Vision Development System (VDS) is a complete hardware and software product for the development and testing of robot vision applications. A complimentary, low cost Target Application System (TASK) runs the application program developed with the VDS. An actual robot vision application that demonstrates inspection and pre-assembly for keyboard manufacturing is used to illustrate the VDS/TASK approach.

A cost-effective approach to the development of printed materials: a randomized controlled trial of three strategies.

PubMed

Paul, C L; Redman, S; Sanson-Fisher, R W

2004-12-01

Printed materials have been a primary mode of communication in public health education. Three major approaches to the development of these materials--the application of characteristics identified in the literature, behavioral strategies and marketing strategies--have major implications for both the effectiveness and cost of materials. However, little attention has been directed towards the cost-effectiveness of such approaches. In the present study, three pamphlets were developed using successive addition of each approach: first literature characteristics only ('C' pamphlet), then behavioral strategies ('C + B' pamphlet) and then marketing strategies ('C + B + M' pamphlet). Each pamphlet encouraged women to join a Pap Test Reminder Service (PTRS). Each pamphlet was mailed to a randomly selected sample of 2700 women aged 50-69 years. Registrations with the PTRS were monitored and 420 women in each pamphlet group were surveyed by telephone. It was reported that the 'C + B' and 'C + B + M' pamphlets were significantly more effective than the 'C' pamphlet. The 'C + B' pamphlet was the most cost-effective of the three pamphlets. There were no significant differences between any of the pamphlet groups on acceptability, knowledge or attitudes. It was suggested that the inclusion of behavioral strategies is likely to be a cost-effective approach to the development of printed health education materials.

Low-Cost Nested-MIMO Array for Large-Scale Wireless Sensor Applications.

PubMed

Zhang, Duo; Wu, Wen; Fang, Dagang; Wang, Wenqin; Cui, Can

2017-05-12

In modern communication and radar applications, large-scale sensor arrays have increasingly been used to improve the performance of a system. However, the hardware cost and circuit power consumption scale linearly with the number of sensors, which makes the whole system expensive and power-hungry. This paper presents a low-cost nested multiple-input multiple-output (MIMO) array, which is capable of providing O ( 2 N 2 ) degrees of freedom (DOF) with O ( N ) physical sensors. The sensor locations of the proposed array have closed-form expressions. Thus, the aperture size and number of DOF can be predicted as a function of the total number of sensors. Additionally, with the help of time-sequence-phase-weighting (TSPW) technology, only one receiver channel is required for sampling the signals received by all of the sensors, which is conducive to reducing the hardware cost and power consumption. Numerical simulation results demonstrate the effectiveness and superiority of the proposed array.

Low-Cost Nested-MIMO Array for Large-Scale Wireless Sensor Applications

PubMed Central

Zhang, Duo; Wu, Wen; Fang, Dagang; Wang, Wenqin; Cui, Can

2017-01-01

In modern communication and radar applications, large-scale sensor arrays have increasingly been used to improve the performance of a system. However, the hardware cost and circuit power consumption scale linearly with the number of sensors, which makes the whole system expensive and power-hungry. This paper presents a low-cost nested multiple-input multiple-output (MIMO) array, which is capable of providing O(2N2) degrees of freedom (DOF) with O(N) physical sensors. The sensor locations of the proposed array have closed-form expressions. Thus, the aperture size and number of DOF can be predicted as a function of the total number of sensors. Additionally, with the help of time-sequence-phase-weighting (TSPW) technology, only one receiver channel is required for sampling the signals received by all of the sensors, which is conducive to reducing the hardware cost and power consumption. Numerical simulation results demonstrate the effectiveness and superiority of the proposed array. PMID:28498329

Possibilities for mixed mode chip manufacturing in EUROPRACTICE

NASA Astrophysics Data System (ADS)

Das, C.

1997-02-01

EUROPRACTICE is an EC initiative under the ESPRIT programme which aims to stimulate the wider exploitation of state-of-the-art microelectronics technologies by European industry and to enhance European industrial competitiveness in the global market-place. Through EUROPRACTICE, the EC has created a range of Basic Services that offer users a cost-effective and flexible means of accessing three main microelectronics-based technologies: Application Specific Integrated Circuit (ASICs), Multi-Chip Modules (MCMs) and Microsystems. EUROPRACTICE Basic Services reduce the cost and risk for companies wishing to begin using these technologies. EUROPRACTICE offers a fully supported, low cost route for companies to design and fabricate ASICs for their individual applications. Low cost is achieved by consolidating designs from many users onto a single semiconductor wafer (MPW: Multi Project Wafer). The EUROPRACTICE IC Manufacturing Service (ICMS) offers a broad range of fabrication technologies including CMOS, BiCMOS and GaAs. The Service extends from enabling users to produce prototype ASICs for testing and evaluation, through to low-volume production runs.

Photovoltaics in the context of off-grid small power systems

NASA Astrophysics Data System (ADS)

Gabriel, A.; de Ruyter van Steveninck, A. W.

Practical criteria which determine the cost effectiveness in different applications of stand-alone off-grid continuous power systems up to 20 kW are examined. The analysis is limited to systems based on internal combustion engines and photovoltaic systems. It is shown that for nonmobile continuous power systems with offtakes above 20-25%, photovoltaic cost parity with 5 kW diesel systems is expected to occur in the second half of this decade or in the first half of the next decade, depending mainly on the fuel cost to the consumer. Larger diesel systems show improved costs due to scale benefits which are not available to photovoltaic systems.

Internal Roof and Attic Thermal Radiation Control Retrofit Strategies for Cooling-Dominated Climates

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

Fallahi, A.; Duraschlag, H.; Elliott, D.

2013-12-01

This project evaluates the cooling energy savings and cost effectiveness of radiation control retrofit strategies for residential attics in U.S. cooling-dominated climates. Usually, in residential applications, radiation control retrofit strategies are applied below the roof deck or on top of the attic floor insulation. They offer an alternative option to the addition of conventional bulk insulation such as fiberglass or cellulose insulation. Radiation control is a potentially low-cost energy efficiency retrofit strategy that does not require significant changes to existing homes. In this project, two groups of low-cost radiation control strategies were evaluated for southern U.S. applications. One uses amore » radiant barrier composed of two aluminum foils combined with an enclosed reflective air space and the second uses spray-applied interior radiation control coatings (IRCC).« less

Internal Roof and Attic Thermal Radiation Control Retrofit Strategies for Cooling-Dominated Climates

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

Fallahi, A.; Durschlag, H.; Elliott, D.

2013-12-01

This project evaluates the cooling energy savings and cost effectiveness of radiation control retrofit strategies for residential attics in U.S. cooling-dominated climates. Usually, in residential applications, radiation control retrofit strategies are applied below the roof deck or on top of the attic floor insulation. They offer an alternative option to the addition of conventional bulkinsulation such as fiberglass or cellulose insulation. Radiation control is a potentially low-cost energy efficiency retrofit strategy that does not require significant changes to existing homes. In this project, two groups of low-cost radiation control strategies were evaluated for southern U.S. applications. One uses a radiantmore » barrier composed of two aluminum foils combined with an enclosedreflective air space and the second uses spray-applied interior radiation control coatings (IRCC).« less

Application of hybrid propulsion systems to planetary missions

NASA Technical Reports Server (NTRS)

Don, J. P.; Phen, R. L.

1971-01-01

The feasibility and application of hybrid rocket propulsion to outer-planet orbiter missions is assessed in this study and guidelines regarding future development are provided. A Jupiter Orbiter Mission was selected for evaluation because it is the earliest planetary mission which may require advanced chemical propulsion. Mission and spacecraft characteristics which affect the selection and design of propulsion subsystems are presented. Alternative propulsion subsystems, including space-storable bipropellant liquids, a solid/monopropellant vernier, and a hybrid, are compared on the basis of performance, reliability, and cost. Cost-effectiveness comparisons are made for a range of assumptions including variation in (1) the level of need for spacecraft performance (determined in part by launch vehicle injected mass capability), and (2) achievable reliability at corresponding costs. The results indicated that the hybrid and space-storable bipropellant mechanizations are competitive.

Using a spreadsheet/table template for economic value added analysis.

PubMed

Cassey, Margaret

2008-01-01

Translating clinical research into practical applications that are cost effective has received significant attention as staff nurses attempt to expand new knowledge into an already complex daily workflow. spreadsheet/table template created in a word processing format can assist with setting up and carrying out the analysis of costs for comparing different approaches to routine activities. By encouraging nurses to take the initiative to examine parts of everyday nursing practice with an eye to cost analysis, significant contributions can be made to maximizing the bottom line.

Advanced energy system program

NASA Astrophysics Data System (ADS)

Trester, K.

1989-02-01

The objectives of the program are to design, develop and demonstrate a natural-gas-fueled, highly recuperated, 50 kW Brayton-cycle cogeneration system for commercial, institutional, and multifamily residential applications. Marketing studies have shown that this Advanced Energy System (AES), with its many unique and cost-effective features, has the potential to offer significant reductions in annual electrical and thermal energy costs to the consumer. Specific advantages of the system that result in low cost of ownership are high electrical efficiency (30 percent, HHV), low maintenance, high reliability and long life (20 years).

The High Rise Low Cost Housing : Sustainable Neighbourhood Elements (Green Elements) in Malaysia

NASA Astrophysics Data System (ADS)

Wahi, Noraziah; Mohamad, Ismail; Mohamad Zin, Rosli; Munikanan, Vikneswaran; Junaini, Syahrizan

2018-03-01

The sustainable development is a vital measure to alleviate the greenhouse gas effect, global warming and any other environment issues. The sustainable neighbourhood concept is not new in Malaysia, However, the concept still needs attention and awareness from the stakeholders. This paper discusses on the sustainable neighbourhood elements specifically green elements application on the high rise low cost housing in Malaysia. Malaysia should have focused sustainable neighbourhood planning and design especially on the high rise low cost housing therefore the future generation can be benefited from this type development.

Cost-effective optical switch matrix for microwave phased-array

NASA Technical Reports Server (NTRS)

Pan, J. J.; Chia, S. L.; Li, W. Z.; Grove, C. H.

1991-01-01

An all-fiber (6x6) optical shutter switch matrix with the control system for microwave phased array has been demonstrated. The device offers the advantages of integrated configuration, low cost, low power consumption, small size, and light weight. The maximum extinction ratio (among 36 individual pixel) of this switch matrix at 840 nm is 24.2 dB, and the switching time is less than 120 microsec. In addition to phased array application, this low cost switch matrix is extremely attractive for fiber optic switching networks.

Mobile Motion Capture--MiMiC.

PubMed

Harbert, Simeon D; Jaiswal, Tushar; Harley, Linda R; Vaughn, Tyler W; Baranak, Andrew S

2013-01-01

The low cost, simple, robust, mobile, and easy to use Mobile Motion Capture (MiMiC) system is presented and the constraints which guided the design of MiMiC are discussed. The MiMiC Android application allows motion data to be captured from kinematic modules such as Shimmer 2r sensors over Bluetooth. MiMiC is cost effective and can be used for an entire day in a person's daily routine without being intrusive. MiMiC is a flexible motion capture system which can be used for many applications including fall detection, detection of fatigue in industry workers, and analysis of individuals' work patterns in various environments.

Aircraft operability methods applied to space launch vehicles

NASA Astrophysics Data System (ADS)

Young, Douglas

1997-01-01

The commercial space launch market requirement for low vehicle operations costs necessitates the application of methods and technologies developed and proven for complex aircraft systems. The ``building in'' of reliability and maintainability, which is applied extensively in the aircraft industry, has yet to be applied to the maximum extent possible on launch vehicles. Use of vehicle system and structural health monitoring, automated ground systems and diagnostic design methods derived from aircraft applications support the goal of achieving low cost launch vehicle operations. Transforming these operability techniques to space applications where diagnostic effectiveness has significantly different metrics is critical to the success of future launch systems. These concepts will be discussed with reference to broad launch vehicle applicability. Lessons learned and techniques used in the adaptation of these methods will be outlined drawing from recent aircraft programs and implementation on phase 1 of the X-33/RLV technology development program.

Parametric evaluation of the cost effectiveness of Shuttle payload vibroacoustic test plans

NASA Technical Reports Server (NTRS)

Stahle, C. V.; Gongloff, H. R.; Keegan, W. B.; Young, J. P.

1978-01-01

Consideration is given to alternate vibroacoustic test plans for sortie and free flyer Shuttle payloads. Statistical decision models for nine test plans provide a viable method of evaluating the cost effectiveness of alternate vibroacoustic test plans and the associated test levels. The methodology is a major step toward the development of a useful tool for the quantitative tailoring of vibroacoustic test programs to sortie and free flyer payloads. A broader application of the methodology is now possible by the use of the OCTAVE computer code.

A Cost-Effectiveness Analysis of Alternative Guided Media for the Backbone Cable Plant Portion of the Base Information Transfer System

DTIC Science & Technology

1991-03-01

Applications, Garland STPM Press, 1979. 60 INITIAL DISTRIBUTION LIST 1 . Defense Technical Information Center 2 Cameron Station Alexandria, Virginia...AD-A242 688 V, III II lIlIIlI III I I NAVAL POSTGRADUATE SCHOOL Monterey, California D I; D ’C,ST...,, Z i 1 3 i THESIS A COST-EFFECTIVENESS...author and do not reflect the official policy or position of the Depart- ment of Defense or the US Government. 17 COSATI CODES 18 SUBJECT TERMS

Diatomite filtration of water for injection

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

Olmsted, B.C. Jr.; Bell, G.R.

1966-01-01

A discussion is presented of the capabilities, problems, and answers, in the performance of diatomite filters. The discussion includes a description of diatomite filtration, new developments, design criteria, and some case histories. Diatomite filters, when properly designed and installed, and when properly applied, can provide effective clarification of waters for injection at low capital and operating costs. Design, installation, and proper application, effectiveness, and capital and operating costs can be placed in the proper perspective in the light of general experience and recent pilot plant tests in the southern California area. (30 refs.)

Designing cost effective water demand management programs in Australia.

PubMed

White, S B; Fane, S A

2002-01-01

This paper describes recent experience with integrated resource planning (IRP) and the application of least cost planning (LCP) for the evaluation of demand management strategies in urban water. Two Australian case studies, Sydney and Northern New South Wales (NSW) are used in illustration. LCP can determine the most cost effective means of providing water services or alternatively the cheapest forms of water conservation. LCP contrasts to a traditional approach of evaluation which looks only at means of increasing supply. Detailed investigation of water usage, known as end-use analysis, is required for LCP. End-use analysis allows both rigorous demand forecasting, and the development and evaluation of conservation strategies. Strategies include education campaigns, increasing water use efficiency and promoting wastewater reuse or rainwater tanks. The optimal mix of conservation strategies and conventional capacity expansion is identified based on levelised unit cost. IRP uses LCP in the iterative process, evaluating and assessing options, investing in selected options, measuring the results, and then re-evaluating options. Key to this process is the design of cost effective demand management programs. IRP however includes a range of parameters beyond least economic cost in the planning process and program designs, including uncertainty, benefit partitioning and implementation considerations.

Lightweight Composite Materials for Heavy Duty Vehicles

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

Pruez, Jacky; Shoukry, Samir; Williams, Gergis

The main objective of this project is to develop, analyze and validate data, methodologies and tools that support widespread applications of automotive lightweighting technologies. Two underlying principles are guiding the research efforts towards this objective: • Seamless integration between the lightweight materials selected for certain vehicle systems, cost-effective methods for their design and manufacturing, and practical means to enhance their durability while reducing their Life-Cycle-Costs (LCC). • Smooth migration of the experience and findings accumulated so far at WVU in the areas of designing with lightweight materials, innovative joining concepts and durability predictions, from applications to the area of weightmore » savings for heavy vehicle systems and hydrogen storage tanks, to lightweighting applications of selected systems or assemblies in light–duty vehicles.« less

Cardiovascular Disease Screening By Community Health Workers Can Be Cost-Effective In Low-Resource Countries

PubMed Central

Gaziano, Thomas; Abrahams-Gessel, Shafika; Surka, Sam; Sy, Stephen; Pandya, Ankur; Denman, Catalina A.; Mendoza, Carlos; Puoane, Thandi; Levitt, Naomi S.

2016-01-01

In low-resource settings, a physician is not always available. We recently demonstrated that community health workers—instead of physicians or nurses—can efficiently screen adults for cardiovascular disease in South Africa, Mexico, and Guatemala. In this analysis we sought to determine the health and economic impacts of shifting this screening to community health workers equipped with either a paper-based or a mobile phone–based screening tool. We found that screening by community health workers was very cost-effective or even cost-saving in all three countries, compared to the usual clinic-based screening. The mobile application emerged as the most cost-effective strategy because it could save more lives than the paper tool at minimal extra cost. Our modeling indicated that screening by community health workers, combined with improved treatment rates, would increase the number of deaths averted from 15,000 to 110,000, compared to standard care. Policy makers should promote greater acceptance of community health workers by both national populations and health professionals and should increase their commitment to treating cardiovascular disease and making medications available. PMID:26355056

Design and Evaluation of a Health-Focused Personal Informatics Application with Support for Generalized Goal Management

ERIC Educational Resources Information Center

Medynskiy, Yevgeniy

2012-01-01

The practice of health self-management offers behavioral and problem-solving strategies that can effectively promote responsibility for one's own wellbeing, improve one's health outcomes, and decrease the cost of health services. Personal informatics applications support health self-management by allowing their users to easily track…

Clinical applications of breath testing

PubMed Central

Paschke, Kelly M; Mashir, Alquam

2010-01-01

Breath testing has the potential to benefit the medical field as a cost-effective, non-invasive diagnostic tool for diseases of the lung and beyond. With growing evidence of clinical worth, standardization of methods, and new sensor and detection technologies the stage is set for breath testing to gain considerable attention and wider application in upcoming years. PMID:21173863

75 FR 55318 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-10

... Numbers: ER10-1720-001. Applicants: Dry Lake Wind Power II LLC. Description: Dry Lake Wind Power II LLC... tariff filing per 35.12: Compliance filing for WR, NMST and Cost-Based Tariffs to be effective 3/30/2010... Time on Tuesday, September 21, 2010. Docket Numbers: ER10-2504-000. Applicants: Shiloh Wind Project 2...

Finite element analysis of helicopter structures

NASA Technical Reports Server (NTRS)

Rich, M. J.

1978-01-01

Application of the finite element analysis is now being expanded to three dimensional analysis of mechanical components. Examples are presented for airframe, mechanical components, and composite structure calculations. Data are detailed on the increase of model size, computer usage, and the effect on reducing stress analysis costs. Future applications for use of finite element analysis for helicopter structures are projected.

Survey of EPA facilities for solar thermal energy applications

NASA Technical Reports Server (NTRS)

Nelson, E. V.; Overly, P. T.; Bell, D. M.

1980-01-01

A study was done to assess the feasibility of applying solar thermal energy systems to EPA facilities. A survey was conducted to determine those EPA facilities where solar energy could best be used. These systems were optimized for each specific application and the system/facility combinations were ranked on the basis of greatest cost effectiveness.

76 FR 19063 - Applications for New Awards; Educational Opportunity Centers (EOC) Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... application meets this priority. This priority is: Projects that are designed to address the needs of military... other community resources in order to carry out projects that are cost-effective and best meet the needs....23). 3. Special Conditions: Under 34 CFR 74.14 and 80.12, the Secretary may impose special conditions...

Cost-Effectiveness Analysis of Tyrosine Kinase Inhibitors for Patients with Advanced Gastrointestinal Stromal Tumors.

PubMed

Nerich, Virginie; Fleck, Camille; Chaigneau, Loïc; Isambert, Nicolas; Borg, Christophe; Kalbacher, Elsa; Jary, Marine; Simon, Pauline; Pivot, Xavier; Blay, Jean-Yves; Limat, Samuel

2017-01-01

The management of advanced gastrointestinal stromal tumors (GISTs) has been modified considerably by the availability of costly tyrosine kinase inhibitors (TKIs); however, the best therapeutic sequence in terms of cost and effectiveness remains unknown. The aim of this study was to compare four potential strategies (reflecting the potential daily practice), each including imatinib 400 mg/day, as first-line treatment: S1 (imatinib 400 /best supportive care [BSC]); S2 (imatinib 400 /imatinib 800 /BSC); S3 (imatinib 400 /sunitinib/BSC); and S4 (imatinib 400 /imatinib 800 /sunitinib/BSC). A Markov model was developed with a hypothetical cohort of patients and a lifetime horizon. Transition probabilities were estimated from the results of clinical trials. The analysis was performed from the French payer perspective, and only direct medical costs were included. Clinical and economic parameters were discounted, and the robustness of results was assessed. The least costly and effective strategy was S1, at a cost of €65,744 for 32.9 life months (reference). S3 was the most cost-effective strategy, with an incremental cost-effectiveness ratio (ICER) of €48,277/life-year saved (LYS). S2 was dominated, and S4 yielded an ICER of €363,320/LYS compared with S3. Sensitivity analyses confirmed the robustness of these results; however, when taking into account a price reduction of 80 % for imatinib, S2 and S4 become the most cost-effective strategies. Our approach is innovative to the extent that our analysis takes into account the sequential application of TKIs. The results suggest that the S1 strategy is the best cost-effective strategy, but a price reduction of imatinib impacts on the results. This approach must continue, including new drugs and their impact on the quality of life of patients with advanced GISTs.

Microbial keratinases: industrial enzymes with waste management potential.

PubMed

Verma, Amit; Singh, Hukum; Anwar, Shahbaz; Chattopadhyay, Anirudha; Tiwari, Kapil K; Kaur, Surinder; Dhilon, Gurpreet Singh

2017-06-01

Proteases are ubiquitous enzymes that occur in various biological systems ranging from microorganisms to higher organisms. Microbial proteases are largely utilized in various established industrial processes. Despite their numerous industrial applications, they are not efficient in hydrolysis of recalcitrant, protein-rich keratinous wastes which result in environmental pollution and health hazards. This paved the way for the search of keratinolytic microorganisms having the ability to hydrolyze "hard to degrade" keratinous wastes. This new class of proteases is known as "keratinases". Due to their specificity, keratinases have an advantage over normal proteases and have replaced them in many industrial applications, such as nematicidal agents, nitrogenous fertilizer production from keratinous waste, animal feed and biofuel production. Keratinases have also replaced the normal proteases in the leather industry and detergent additive application due to their better performance. They have also been proved efficient in prion protein degradation. Above all, one of the major hurdles of enzyme industrial applications (cost effective production) can be achieved by using keratinous waste biomass, such as chicken feathers and hairs as fermentation substrate. Use of these low cost waste materials serves dual purposes: to reduce the fermentation cost for enzyme production as well as reducing the environmental waste load. The advent of keratinases has given new direction for waste management with industrial applications giving rise to green technology for sustainable development.

Mobile healthcare applications: system design review, critical issues and challenges.

PubMed

Baig, Mirza Mansoor; GholamHosseini, Hamid; Connolly, Martin J

2015-03-01

Mobile phones are becoming increasingly important in monitoring and delivery of healthcare interventions. They are often considered as pocket computers, due to their advanced computing features, enhanced preferences and diverse capabilities. Their sophisticated sensors and complex software applications make the mobile healthcare (m-health) based applications more feasible and innovative. In a number of scenarios user-friendliness, convenience and effectiveness of these systems have been acknowledged by both patients as well as healthcare providers. M-health technology employs advanced concepts and techniques from multidisciplinary fields of electrical engineering, computer science, biomedical engineering and medicine which benefit the innovations of these fields towards healthcare systems. This paper deals with two important aspects of current mobile phone based sensor applications in healthcare. Firstly, critical review of advanced applications such as; vital sign monitoring, blood glucose monitoring and in-built camera based smartphone sensor applications. Secondly, investigating challenges and critical issues related to the use of smartphones in healthcare including; reliability, efficiency, mobile phone platform variability, cost effectiveness, energy usage, user interface, quality of medical data, and security and privacy. It was found that the mobile based applications have been widely developed in recent years with fast growing deployment by healthcare professionals and patients. However, despite the advantages of smartphones in patient monitoring, education, and management there are some critical issues and challenges related to security and privacy of data, acceptability, reliability and cost that need to be addressed.

Methodology for conceptual remote sensing spacecraft technology: insertion analysis balancing performance, cost, and risk

NASA Astrophysics Data System (ADS)

Bearden, David A.; Duclos, Donald P.; Barrera, Mark J.; Mosher, Todd J.; Lao, Norman Y.

1997-12-01

Emerging technologies and micro-instrumentation are changing the way remote sensing spacecraft missions are developed and implemented. Government agencies responsible for procuring space systems are increasingly requesting analyses to estimate cost, performance and design impacts of advanced technology insertion for both state-of-the-art systems as well as systems to be built 5 to 10 years in the future. Numerous spacecraft technology development programs are being sponsored by Department of Defense (DoD) and National Aeronautics and Space Administration (NASA) agencies with the goal of enhancing spacecraft performance, reducing mass, and reducing cost. However, it is often the case that technology studies, in the interest of maximizing subsystem-level performance and/or mass reduction, do not anticipate synergistic system-level effects. Furthermore, even though technical risks are often identified as one of the largest cost drivers for space systems, many cost/design processes and models ignore effects of cost risk in the interest of quick estimates. To address these issues, the Aerospace Corporation developed a concept analysis methodology and associated software tools. These tools, collectively referred to as the concept analysis and design evaluation toolkit (CADET), facilitate system architecture studies and space system conceptual designs focusing on design heritage, technology selection, and associated effects on cost, risk and performance at the system and subsystem level. CADET allows: (1) quick response to technical design and cost questions; (2) assessment of the cost and performance impacts of existing and new designs/technologies; and (3) estimation of cost uncertainties and risks. These capabilities aid mission designers in determining the configuration of remote sensing missions that meet essential requirements in a cost- effective manner. This paper discuses the development of CADET modules and their application to several remote sensing satellite mission concepts.

VR Mobile Solutions For Chronic Stress Reduction in Young Adults.

PubMed

Gao, Kenneth; Boyd, Chelsie; Wiederhold, Mark D; Wiederhold, Brenda K

2014-01-01

Chronic stress in young adults has become a growing problem within recent decades and many are unable to find cost-effective and accessible treatment for psychological stress in their daily lives. We analyze the market of using a mobile application, Positive Technology, as a solution. Eleven participants, aged between 18 and 24, participated in the exercise. Self-reported stress reduction was measured via an online marketing survey, while physiological measurements were monitored via peripheral devices. Secondary goals assessed the app's ease-of-use, accessibility, and cost. Results indicate that participants enjoyed the availability of the mobile solution and found the app to be fun and easy to learn. Stress levels were reduced in 73% of the participants, with higher effects in females and in participants aged 18-24. We conclude that the mobile platform is an effective means of delivering psychological stress reduction, and could provide an accessible, cost-effective solution.

Advanced avionics concepts: Autonomous spacecraft control

NASA Technical Reports Server (NTRS)

1990-01-01

A large increase in space operations activities is expected because of Space Station Freedom (SSF) and long range Lunar base missions and Mars exploration. Space operations will also increase as a result of space commercialization (especially the increase in satellite networks). It is anticipated that the level of satellite servicing operations will grow tenfold from the current level within the next 20 years. This growth can be sustained only if the cost effectiveness of space operations is improved. Cost effectiveness is operational efficiency with proper effectiveness. A concept is presented of advanced avionics, autonomous spacecraft control, that will enable the desired growth, as well as maintain the cost effectiveness (operational efficiency) in satellite servicing operations. The concept of advanced avionics that allows autonomous spacecraft control is described along with a brief description of each component. Some of the benefits of autonomous operations are also described. A technology utilization breakdown is provided in terms of applications.

Implementation of computer-based patient records in primary care: the societal health economic effects.

PubMed Central

Arias-Vimárlund, V.; Ljunggren, M.; Timpka, T.

1996-01-01

OBJECTIVE: Exploration of the societal health economic effects occurring during the first year after implementation of Computerised Patient Records (CPRs) at Primary Health Care (PHC) centres. DESIGN: Comparative case studies of practice processes and their consequences one year after CPR implementation, using the constant comparison method. Application of transaction-cost analyses at a societal level on the results. SETTING: Two urban PHC centres under a managed care contract in Ostergötland county, Sweden. MAIN OUTCOME MEASURES: Central implementation issues. First-year societal direct normal costs, direct unexpected costs, and indirect costs. Societal benefits. RESULTS: The total societal effect of the CPR implementation was a cost of nearly 250,000 SEK (USD 37,000) per GP team. About 20% of the effect consisted of direct unexpected costs, accured from the reduction of practitioners' leisure time. The main issues in the implementation process were medical informatics knowledge and computer skills, adaptation of the human-computer interaction design to practice routines, and information access through the CPR. CONCLUSIONS: The societal costs exceed the benefits during the first year after CPR implementation at the observed PHC centres. Early investments in requirements engineering and staff training may increase the efficiency. Exploitation of the CPR for disease prevention and clinical quality improvement is necessary to defend the investment in societal terms. The exact calculation of societal costs requires further analysis of the affected groups' willingness to pay. PMID:8947717

Affordability of programmes to prevent spontaneous preterm birth in Austria: a budget impact analysis.

PubMed

Zechmeister-Koss, Ingrid; Piso, Brigitte

2014-02-01

Preterm birth is a rising health problem in Europe generally, and in Austria specifically. Decision makers require objective information on the effects and costs of measures to prevent preterm birth. We undertook a budget impact analysis from a public payer perspective and for a 1-year and 5-year time horizon for five prevention approaches to reduce preterm birth. These were cervix screening + progesterone application, progesterone injection, smoking cessation, fish oil supplementation and infection screening. We analysed affordability in terms of programme costs and potential cost savings. Programme costs range from below €50 000 (cervix screening in high-risk pregnancy) to €500 000 (universal infection screening). The lowest health effects have been shown for smoking cessation programmes (-10 preterm births per year), whereas infection screening demonstrated the largest effect (-230 preterm births per year). In the base-case analysis, all programmes are potentially cost saving (-€500 000 to -€13 million per year). In the sensitivity analyses, preterm birth costs, target group size and (partly) unit costs of programme components have an influence on potential cost savings. However, except for two programmes, the results are robust concerning an overall economic net benefit of the programmes analysed compared with no programme. The study is mainly limited by the quality of some cost data and choice of the reference scenario. When considering potential cost savings, the five prevention programmes analysed seem affordable, with cervix screening and infection screening likely being the most promising in Austria.

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

Ren, Hongbo; Qiao, Zemin; Liu, Xiao

Highlights: • Sol–gel route is combined with polymerization without using modifier. • Supercritical drying control is the key to obtain super-hydrophobic surfaces. • The whole fabrication is technologically controllable and with low costs. • The production rate is higher than 90%. • The method provides a cost-effective way for industry applications. - Abstract: We successfully synthesized one type of cheap super-hydrophobic hybrid porous materials in a sol–gel process. In this route, hydrophilic polymers and TEOS-base sol are used as precursors, the ultraviolet ray-initiated polymerization and supercritical fluid drying techniques are combined together to fulfill this task. All fabricated samples exhibitmore » lotus-leaf-like surface structures with super-hydrophobicity. The underlying mechanisms are carefully investigated using a field-emission scanning electron microscopy (FESEM) and an X-ray photoelectron spectroscopy (XPS). We found that a well-controlled drying process is crucial to the formation of such super-hydrophobic surfaces. As high as 90% production rate is obtained in our route and thus, it might provide a cost-effective way to produce super-hydrophobic hybrid materials for industry applications.« less

Bio-inspired silicon nanospikes fabricated by metal-assisted chemical etching for antibacterial surfaces

NASA Astrophysics Data System (ADS)

Hu, Huan; Siu, Vince S.; Gifford, Stacey M.; Kim, Sungcheol; Lu, Minhua; Meyer, Pablo; Stolovitzky, Gustavo A.

2017-12-01

The recently discovered bactericidal properties of nanostructures on wings of insects such as cicadas and dragonflies have inspired the development of similar nanostructured surfaces for antibacterial applications. Since most antibacterial applications require nanostructures covering a considerable amount of area, a practical fabrication method needs to be cost-effective and scalable. However, most reported nanofabrication methods require either expensive equipment or a high temperature process, limiting cost efficiency and scalability. Here, we report a simple, fast, low-cost, and scalable antibacterial surface nanofabrication methodology. Our method is based on metal-assisted chemical etching that only requires etching a single crystal silicon substrate in a mixture of silver nitrate and hydrofluoric acid for several minutes. We experimentally studied the effects of etching time on the morphology of the silicon nanospikes and the bactericidal properties of the resulting surface. We discovered that 6 minutes of etching results in a surface containing silicon nanospikes with optimal geometry. The bactericidal properties of the silicon nanospikes were supported by bacterial plating results, fluorescence images, and scanning electron microscopy images.

POwer WithOut Wire (POWOW): A SEP Concept for Space Exploration

NASA Technical Reports Server (NTRS)

Brandhorst, Henry W., Jr.; ONeill, Mark

2000-01-01

Electric propulsion has emerged as a cost-effective solution to a wide range of satellite applications. Deep Space 1 demonstrated electric propulsion as a primary propulsion source for a spacecraft. The POwer WithOut Wires (POWOW) concept has been developed as a solar electric propelled spacecraft that would travel to Mars, for example, enter selenosynchronous orbit and then use lasers to beam power to surface installations. This concept has been developed with industrial expertise in high efficiency solar cells, advanced concentrator modules, innovative arrays, and high power electric propulsion systems. The paper will present the latest version of the spacecraft, the technologies involved, possible missions and trip times to Mars and laser beaming options. The POWOW spacecraft is a general purpose solar electric propulsion system that includes technologies that are directly applicable to commercial and government spacecraft with power levels ranging from 4 kW in Low Earth Orbits (LEO) to about 1 MW. The system is modular and expandable. Learning curve costing methodologies are used to demonstrate cost effectiveness of a modular system.

Study of power management technology for orbital multi-100KWe applications. Volume 2: Study results

NASA Technical Reports Server (NTRS)

Mildice, J. W.

1980-01-01

The preliminary requirements and technology advances required for cost effective space power management systems for multi-100 kilowatt requirements were identified. System requirements were defined by establishing a baseline space platform in the 250 KE KWe range and examining typical user loads and interfaces. The most critical design parameters identified for detailed analysis include: increased distribution voltages and space plasma losses, the choice between ac and dc distribution systems, shuttle servicing effects on reliability, life cycle costs, and frequency impacts to power management system and payload systems for AC transmission. The first choice for a power management system for this kind of application and size range is a hybrid ac/dc combination with the following major features: modular design and construction-sized minimum weight/life cycle cost; high voltage transmission (100 Vac RMS); medium voltage array or = 440 Vdc); resonant inversion; transformer rotary joint; high frequency power transmission line or = 20 KHz); energy storage on array side or rotary joint; fully redundant; and 10 year life with minimal replacement and repair.

Fiber optic sensors for infrastructure applications

DOT National Transportation Integrated Search

1998-02-01

Fiber optic sensor technology offers the possibility of implementing "nervous systems" for infrastructure elements that allow high performance, cost effective health and damage assessment systems to be achieved. This is possible, largely due to syner...

A System to Create Training Systems

ERIC Educational Resources Information Center

Training in Business and Industry, 1971

1971-01-01

This article describes Kodak's procedure for analyzing, developing and pretesting training programs through its Marketing Education Center. Included is a case history of the application of the method which greatly affects cost effectiveness. (RR)

Epidemiological and Economic Evaluation of Alternative On-Farm Management Scenarios for Ovine Footrot in Switzerland

PubMed Central

Zingg, Dana; Steinbach, Sandro; Kuhlgatz, Christian; Rediger, Matthias; Schüpbach-Regula, Gertraud; Aepli, Matteo; Grøneng, Gry M.; Dürr, Salome

2017-01-01

Footrot is a multifactorial infectious disease mostly affecting sheep, caused by the bacteria Dichelobacter nodosus. It causes painful feet lesions resulting in animal welfare issues, weight loss, and reduced wool production, which leads to a considerable economic burden in animal production. In Switzerland, the disease is endemic and mandatory coordinated control programs exist only in some parts of the country. This study aimed to compare two nationwide control strategies and a no intervention scenario with the current situation, and to quantify their net economic effect. This was done by sequential application of a maximum entropy model (MEM), epidemiological simulation, and calculation of net economic effect using the net present value method. Building upon data from a questionnaire, the MEM revealed a nationwide footrot prevalence of 40.2%. Regional prevalence values were used as inputs for the epidemiological model. Under the application of the nationwide coordinated control program without (scenario B) and with (scenario C) improved diagnostics [polymerase chain reaction (PCR) test], the Swiss-wide prevalence decreased within 10 years to 14 and 5%, respectively. Contrary, an increase to 48% prevalence was observed when terminating the current control strategies (scenario D). Management costs included labor and material costs. Management benefits included reduction of fattening time and improved animal welfare, which is valued by Swiss consumers and therefore reduces societal costs. The net economic effect of the alternative scenarios B and C was positive, the one of scenario D was negative and over a period of 17 years quantified at CHF 422.3, 538.3, and −172.3 million (1 CHF = 1.040 US$), respectively. This implies that a systematic Swiss-wide management program under the application of the PCR diagnostic test is the most recommendable strategy for a cost-effective control of footrot in Switzerland. PMID:28560223

Mobile Health (mHealth) Technology for the Management of Hypertension and Hyperlipidemia: Slow Start but Loads of Potential.

PubMed

Rehman, Hasan; Kamal, Ayeesha K; Morris, Pamela B; Sayani, Saleem; Merchant, Anwar T; Virani, Salim S

2017-03-01

Hypertension and hyperlipidemia represent two major risk factors for atherosclerotic cardiovascular disease. Mobile health or mHealth is defined as the use of mobile phone and wireless technologies to support the achievement of health objectives. Management of hypertension, and to some extent hyperlipidemia, has often employed mHealth interventions given lower cost and greater patient engagement compared to traditional methods. These interventions include the use of text messaging, wireless devices, and mobile phone applications. This review considers recent studies evaluating the effectiveness of mHealth interventions in the management of hypertension and hyperlipidemia. Numerous studies have evaluated the role of mHealth interventions in the management of hypertension, while very few have evaluated their role in hyperlipidemia. Text messaging has been used most frequently. However, the trend is shifting towards the use of mobile phone applications and wireless devices. Interventions in developing countries have been modified for greater applicability to local settings. mHealth interventions were found to be frequently effective. However, studies comparing the relative efficacy of various mHealth strategies are scarce. Long-term cardiovascular outcomes data and analyses relating to cost effectiveness are also lacking. mHealth interventions may be effective in improving hypertension management. More studies are needed to evaluate the role of mHealth strategies in hyperlipidemia management, particularly in identifying high-risk individuals and improving medication adherence. Studies assessing the long-term impact of these interventions, comparing different interventions and analyzing their relative cost effectiveness, are also needed. Following recently published guidelines on reporting results of mHealth interventions will provide a more meaningful context for interpreting these promising early studies.

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

NASA Technical Reports Server (NTRS)

Wolf, M.

1979-01-01

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

Enhanced Deployment Strategy for Role-based Hierarchical Application Agents in Wireless Sensor Networks with Established Clusterheads

NASA Astrophysics Data System (ADS)

Gendreau, Audrey

Efficient self-organizing virtual clusterheads that supervise data collection based on their wireless connectivity, risk, and overhead costs, are an important element of Wireless Sensor Networks (WSNs). This function is especially critical during deployment when system resources are allocated to a subsequent application. In the presented research, a model used to deploy intrusion detection capability on a Local Area Network (LAN), in the literature, was extended to develop a role-based hierarchical agent deployment algorithm for a WSN. The resulting model took into consideration the monitoring capability, risk, deployment distribution cost, and monitoring cost associated with each node. Changing the original LAN methodology approach to model a cluster-based sensor network depended on the ability to duplicate a specific parameter that represented the monitoring capability. Furthermore, other parameters derived from a LAN can elevate costs and risk of deployment, as well as jeopardize the success of an application on a WSN. A key component of the approach presented in this research was to reduce the costs when established clusterheads in the network were found to be capable of hosting additional detection agents. In addition, another cost savings component of the study addressed the reduction of vulnerabilities associated with deployment of agents to high volume nodes. The effectiveness of the presented method was validated by comparing it against a type of a power-based scheme that used each node's remaining energy as the deployment value. While available energy is directly related to the model used in the presented method, the study deliberately sought out nodes that were identified with having superior monitoring capability, cost less to create and sustain, and are at low-risk of an attack. This work investigated improving the efficiency of an intrusion detection system (IDS) by using the proposed model to deploy monitoring agents after a temperature sensing application had established the network traffic flow to the sink. The same scenario was repeated using a power-based IDS to compare it against the proposed model. To identify a clusterhead's ability to host monitoring agents after the temperature sensing application terminated, the deployed IDS utilized the communication history and other network factors in order to rank the nodes. Similarly, using the node's communication history, the deployed power-based IDS ranked nodes based on their remaining power. For each individual scenario, and after the IDS application was deployed, the temperature sensing application was run for a second time. This time, to monitor the temperature sensing agents as the data flowed towards the sink, the network traffic was rerouted through the new intrusion detection clusterheads. Consequently, if the clusterheads were shared, the re-routing step was not preformed. Experimental results in this research demonstrated the effectiveness of applying a robust deployment metric to improve upon the energy efficiency of a deployed application in a multi-application WSN. It was found that in the scenarios with the intrusion detection application that utilized the proposed model resulted in more remaining energy than in the scenarios that implemented the power-based IDS. The algorithm especially had a positive impact on the small, dense, and more homogeneous networks. This finding was reinforced by the smaller percentage of new clusterheads that was selected. Essentially, the energy cost of the route to the sink was reduced because the network traffic was rerouted through fewer new clusterheads. Additionally, it was found that the intrusion detection topology that used the proposed approach formed smaller and more connected sets of clusterheads than the power-based IDS. As a consequence, this proposed approach essentially achieved the research objective for enhancing energy use in a multi-application WSN.

Clinical and economic evaluation of modulated electrohyperthermia concurrent to dose-dense temozolomide 21/28 days regimen in the treatment of recurrent glioblastoma: a retrospective analysis of a two-centre German cohort trial with systematic comparison and effect-to-treatment analysis

PubMed Central

2017-01-01

Objective To assess the efficacy and cost-effectiveness of modulated electrohyperthermia (mEHT) concurrent to dose-dense temozolomide (ddTMZ) 21/28 days regimen versus ddTMZ 21/28 days alone in patients with recurrent glioblastoma (GBM). Design A cohort of 54 patients with recurrent GBM treated with ddTMZ+mEHT in 2000–2005 was systematically retrospectively compared with five pooled ddTMZ 21/28 days cohorts (114 patients) enrolled in 2008–2013. Results The ddTMZ+mEHT cohort had a not significantly improved mean survival time (mST) versus the comparator (p=0.531) after a significantly less mean number of cycles (1.56 vs 3.98, p<0.001). Effect-to-treatment analysis (ETA) suggests that mEHT significantly enhances the efficacy of the ddTMZ 21/28 days regimen (p=0.011), with significantly less toxicity (no grade III–IV toxicity vs 45%–92%, p<0.0001). An estimated maximal attainable median survival time is 10.10 months (9.10–11.10). Cost-effectiveness analysis suggests that, unlike ddTMZ 21/28 days alone, ddTMZ+mEHT is cost-effective versus the applicable cost-effectiveness thresholds €US$25 000–50 000/quality-adjusted life year (QALY). Budget impact analysis suggests a significant saving of €8 577 947/$11 201 761 with 29.1–38.5 QALY gained per 1000 patients per year. Cost-benefit analysis suggests that mEHT is profitable and will generate revenues between €3 124 574 and $6 458 400, with a total economic effect (saving+revenues) of €5 700 034 to $8 237 432 per mEHT device over an 8-year period. Conclusions Our ETA suggests that mEHT significantly improves survival of patients receiving the ddTMZ 21/28 days regimen. Economic evaluation suggests that ddTMZ+mEHT is cost-effective, budget-saving and profitable. After confirmation of the results, mEHT could be recommended for the treatment of recurrent GBM as a cost-effective enhancer of ddTMZ regimens, and, probably, of the regular 5/28 days regimen. mEHT is applicable also as a single treatment if chemotherapy is impossible, and as a salvage treatment after the failure of chemotherapy. PMID:29102988

Current status of laser applications in urology

NASA Astrophysics Data System (ADS)

Knipper, Ansgar; Thomas, Stephen; Durek, C.; Jocham, Dieter

1993-05-01

The overall development of laser use in urology is recessing. The reasons are the refinement of methods of radical surgery and the continuing development of alternative technologies involving electric current. Taking the cost factor into account, are lasers still opportune in medicine? The answer is definitely yes. Cost reduction in medical practice without quality loss is only possible with effective methods of minimally invasive surgery. Continuing investigation of cutting, welding, coagulating and ablating instruments is justified. Competition of lasers to other technologies can only be beneficial to the cause. But where are the highlights of laser applications? The unsurpassed utilization of optical properties of lasers lie in the concept of photodynamic therapies and in optical feedback mechanisms for laser applications. The combination of lasers with three dimensional visualization of the treatment area by ultrasound (TULIP-procedure for benign prostatic hyperplasia) is a novel approach in laser application. The further development of these treatment modalities will reveal the true benefit of laser technology in urological applications.

The hand surgery fellowship application process: expectations, logistics, and costs.

PubMed

Meals, Clifton; Osterman, Meredith

2015-04-01

To investigate expectations, logistics, and costs relevant to the hand surgery fellowship application process. We sought to discover (1) what both applicants and program directors are seeking, (2) what both parties have to offer, (3) how both parties collect information about each other, and (4) the costs incurred in arranging each match. We conducted on-line surveys of hand surgery fellowship applicants for appointment in 2015 and of current fellowship program directors. Sixty-two applicants and 41 program directors completed the survey. Results revealed applicants' demographic characteristics, qualifications, method of ranking hand fellowship programs, costs incurred (both monetary and opportunity) during the application process, ultimate match status, and suggestions for change. Results also revealed program directors' program demographics, rationale for offering interviews and favorably ranking applicants, application-related logistical details, costs incurred (both monetary and opportunity) during the application process, and suggestions for change. Applicants for hand surgery fellowship training are primarily interested in a potential program's academic reputation, emphasis on orthopedic surgery, and location. The typical, successfully matched applicant was a 30-year-old male orthopedic resident with 3 publications to his credit. Applicants rely on peers and Web sites for information about fellowships. Fellowship directors are primarily seeking applicants recommended by other experienced surgeons and with positive personality traits. The typical fellowship director offers a single year of orthopedic-based fellowship training to 2 fellows per year and relies on a common application and in-person interviews to collect information about applicants. Applicants appear to be more concerned than directors about the current state of the match process. Applicants and directors alike incur heavy costs, in both dollars and opportunity, to arrange each match. A nuanced understanding of the match process suggests specific changes and may help reduce these costs. Economic and decision analysis V. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The small community solar thermal power experiment. Parabolic dish technology for industrial process heat application

NASA Technical Reports Server (NTRS)

Polzien, R. E.; Rodriguez, D.

1981-01-01

Aspects of incorporating a thermal energy transport system (ETS) into a field of parabolic dish collectors for industrial process heat (IPH) applications were investigated. Specific objectives are to: (1) verify the mathematical optimization of pipe diameters and insulation thicknesses calculated by a computer code; (2) verify the cost model for pipe network costs using conventional pipe network construction; (3) develop a design and the associated production costs for incorporating risers and downcomers on a low cost concentrator (LCC); (4) investigate the cost reduction of using unconventional pipe construction technology. The pipe network design and costs for a particular IPH application, specifically solar thermally enhanced oil recovery (STEOR) are analyzed. The application involves the hybrid operation of a solar powered steam generator in conjunction with a steam generator using fossil fuels to generate STEOR steam for wells. It is concluded that the STEOR application provides a baseline pipe network geometry used for optimization studies of pipe diameter and insulation thickness, and for development of comparative cost data, and operating parameters for the design of riser/downcomer modifications to the low cost concentrator.

Applications of polynomial optimization in financial risk investment

NASA Astrophysics Data System (ADS)

Zeng, Meilan; Fu, Hongwei

2017-09-01

Recently, polynomial optimization has many important applications in optimization, financial economics and eigenvalues of tensor, etc. This paper studies the applications of polynomial optimization in financial risk investment. We consider the standard mean-variance risk measurement model and the mean-variance risk measurement model with transaction costs. We use Lasserre's hierarchy of semidefinite programming (SDP) relaxations to solve the specific cases. The results show that polynomial optimization is effective for some financial optimization problems.

The automotive application of discontinuously reinforced TiB-Ti composites

NASA Astrophysics Data System (ADS)

Saito, Takashi

2004-05-01

In 1998, Toyota Motor Corporation adopted intake valves and exhaust valves made of titanium-based alloys for the engine of its Altezza. Both valves were manufactured via a newly developed cost-effective powder metallurgy process. The exhaust valve is made of a newly developed titanium metal-matrix composite (MMC). The valve has achieved sufficient durability and reliability with a manufacturing cost acceptable for the mass-produced automobile engine components.

Diazo processing of LANDSAT imagery: A low-cost instructional technique

NASA Technical Reports Server (NTRS)

Lusch, D. P.

1981-01-01

Diazo processing of LANDSAT imagery is a relatively simple and cost effective method of producing enhanced renditions of the visual LANDSAT products. This technique is capable of producing a variety of image enhancements which have value in a teaching laboratory environment. Additionally, with the appropriate equipment, applications research which relys on accurate and repeatable results is possible. Exposure and development equipment options, diazo materials, and enhancement routines are discussed.

Pseudo-Hall Effect in Graphite on Paper Based Four Terminal Devices for Stress Sensing Applications

NASA Astrophysics Data System (ADS)

Qamar, Afzaal; Sarwar, Tuba; Dinh, Toan; Foisal, A. R. M.; Phan, Hoang-Phuong; Viet Dao, Dzung

2017-04-01

A cost effective and easy to fabricate stress sensor based on pseudo-Hall effect in Graphite on Paper (GOP) has been presented in this article. The four terminal devices were developed by pencil drawing with hand on to the paper substrate. The stress was applied to the paper containing four terminal devices with the input current applied at two terminals and the offset voltage observed at other two terminals called pseudo-Hall effect. The GOP stress sensor showed significant response to the applied stress which was smooth and linear. These results showed that the pseudo-Hall effect in GOP based four terminal devices can be used for cost effective, flexible and easy to make stress, strain or force sensors.

Electrical Stimulation for Pressure Injuries: A Health Technology Assessment

PubMed Central

Lambrinos, Anna; Falk, Lindsey; Ali, Arshia; Holubowich, Corinne; Walter, Melissa

2017-01-01

Background Pressure injuries (bedsores) are common and reduce quality of life. They are also costly and difficult to treat. This health technology assessment evaluates the effectiveness, cost-effectiveness, budget impact, and lived experience of adding electrical stimulation to standard wound care for pressure injuries. Methods We conducted a systematic search for studies published to December 7, 2016, limited to randomized and non–randomized controlled trials examining the effectiveness of electrical stimulation plus standard wound care versus standard wound care alone for patients with pressure injuries. We assessed the quality of evidence through Grading of Recommendations Assessment, Development, and Evaluation (GRADE). In addition, we conducted an economic literature review and a budget impact analysis to assess the cost-effectiveness and affordability of electrical stimulation for treatment of pressure ulcers in Ontario. Given uncertainties in clinical evidence and resource use, we did not conduct a primary economic evaluation. Finally, we conducted qualitative interviews with patients and caregivers about their experiences with pressure injuries, currently available treatments, and (if applicable) electrical stimulation. Results Nine randomized controlled trials and two non–randomized controlled trials were found from the systematic search. There was no significant difference in complete pressure injury healing between adjunct electrical stimulation and standard wound care. There was a significant difference in wound surface area reduction favouring electrical stimulation compared with standard wound care. The only study on cost-effectiveness of electrical stimulation was partially applicable to the patient population of interest. Therefore, the cost-effectiveness of electrical stimulation cannot be determined. We estimate that the cost of publicly funding electrical stimulation for pressure injuries would be $0.77 to $3.85 million yearly for the next 5 years. Patients and caregivers reported that pressure injuries were burdensome and reduced their quality of life. Patients and caregivers also noted that electrical stimulation seemed to reduce the time it took the wounds to heal. Conclusions While electrical stimulation is safe to use (GRADE quality of evidence: high) there is uncertainty about whether it improves wound healing (GRADE quality of evidence: low). In Ontario, publicly funding electrical stimulation for pressure injuries could result in extra costs of $0.77 to $3.85 million yearly for the next 5 years. PMID:29201261

Development and Evaluation of A Novel and Cost-Effective Approach for Low-Cost NO₂ Sensor Drift Correction.

PubMed

Sun, Li; Westerdahl, Dane; Ning, Zhi

2017-08-19

Emerging low-cost gas sensor technologies have received increasing attention in recent years for air quality measurements due to their small size and convenient deployment. However, in the diverse applications these sensors face many technological challenges, including sensor drift over long-term deployment that cannot be easily addressed using mathematical correction algorithms or machine learning methods. This study aims to develop a novel approach to auto-correct the drift of commonly used electrochemical nitrogen dioxide (NO₂) sensor with comprehensive evaluation of its application. The impact of environmental factors on the NO₂ electrochemical sensor in low-ppb concentration level measurement was evaluated in laboratory and the temperature and relative humidity correction algorithm was evaluated. An automated zeroing protocol was developed and assessed using a chemical absorbent to remove NO₂ as a means to perform zero correction in varying ambient conditions. The sensor system was operated in three different environments in which data were compared to a reference NO₂ analyzer. The results showed that the zero-calibration protocol effectively corrected the observed drift of the sensor output. This technique offers the ability to enhance the performance of low-cost sensor based systems and these findings suggest extension of the approach to improve data quality from sensors measuring other gaseous pollutants in urban air.

Application of activity-based costing (ABC) for a Peruvian NGO healthcare provider.

PubMed

Waters, H; Abdallah, H; Santillán, D

2001-01-01

This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries.

Cost-effectiveness of MODY genetic testing: translating genomic advances into practical health applications.

PubMed

Naylor, Rochelle N; John, Priya M; Winn, Aaron N; Carmody, David; Greeley, Siri Atma W; Philipson, Louis H; Bell, Graeme I; Huang, Elbert S

2014-01-01

OBJECTIVE To evaluate the cost-effectiveness of a genetic testing policy for HNF1A-, HNF4A-, and GCK-MODY in a hypothetical cohort of type 2 diabetic patients 25-40 years old with a MODY prevalence of 2%. RESEARCH DESIGN AND METHODS We used a simulation model of type 2 diabetes complications based on UK Prospective Diabetes Study data, modified to account for the natural history of disease by genetic subtype to compare a policy of genetic testing at diabetes diagnosis versus a policy of no testing. Under the screening policy, successful sulfonylurea treatment of HNF1A-MODY and HNF4A-MODY was modeled to produce a glycosylated hemoglobin reduction of -1.5% compared with usual care. GCK-MODY received no therapy. Main outcome measures were costs and quality-adjusted life years (QALYs) based on lifetime risk of complications and treatments, expressed as the incremental cost-effectiveness ratio (ICER) (USD/QALY). RESULTS The testing policy yielded an average gain of 0.012 QALYs and resulted in an ICER of 205,000 USD. Sensitivity analysis showed that if the MODY prevalence was 6%, the ICER would be ~50,000 USD. If MODY prevalence was >30%, the testing policy was cost saving. Reducing genetic testing costs to 700 USD also resulted in an ICER of ~50,000 USD. CONCLUSIONS Our simulated model suggests that a policy of testing for MODY in selected populations is cost-effective for the U.S. based on contemporary ICER thresholds. Higher prevalence of MODY in the tested population or decreased testing costs would enhance cost-effectiveness. Our results make a compelling argument for routine coverage of genetic testing in patients with high clinical suspicion of MODY.

Cost-effectiveness of primary offer of IVF vs. primary offer of IUI followed by IVF (for IUI failures) in couples with unexplained or mild male factor subfertility.

PubMed

Pashayan, Nora; Lyratzopoulos, Georgios; Mathur, Raj

2006-06-23

In unexplained and mild male factor subfertility, both intrauterine insemination (IUI) and in-vitro fertilisation (IVF) are indicated as first line treatments. Because the success rate of IUI is low, many couples failing IUI subsequently require IVF treatment. In practice, it is therefore important to examine the comparative outcomes (live birth-producing pregnancy), costs, and cost-effectiveness of primary offer of IVF, compared with primary offer of IUI followed by IVF for couples failing IUI. Mathematical modelling was used to estimate comparative clinical and cost effectiveness of either primary offer of one full IVF cycle (including frozen cycles when applicable) or "IUI + IVF" (defined as primary IUI followed by IVF for IUI failures) to a hypothetical cohort of subfertile couples who are eligible for both treatment strategies. Data used in calculations were derived from the published peer-reviewed literature as well as activity data of local infertility units. Cost-effectiveness ratios for IVF, "unstimulated-IUI (U-IUI) + IVF", and "stimulated IUI (S-IUI) + IVF" were 12,600 pounds sterling, 13,100 pound sterling and 15,100 pound sterling per live birth-producing pregnancy respectively. For a hypothetical cohort of 100 couples with unexplained or mild male factor subfertility, compared with primary offer of IVF, 6 cycles of "U-IUI + IVF" or of "S-IUI + IVF" would cost an additional 174,200 pounds sterling and 438,000 pounds sterling, representing an opportunity cost of 54 and 136 additional IVF cycles and 14 to 35 live birth-producing pregnancies respectively. For couples with unexplained and mild male factor subfertility, primary offer of a full IVF cycle is less costly and more cost-effective than providing IUI (of any modality) followed by IVF.

Cost-effectiveness of primary offer of IVF vs. primary offer of IUI followed by IVF (for IUI failures) in couples with unexplained or mild male factor subfertility

PubMed Central

Pashayan, Nora; Lyratzopoulos, Georgios; Mathur, Raj

2006-01-01

Background In unexplained and mild male factor subfertility, both intrauterine insemination (IUI) and in-vitro fertilisation (IVF) are indicated as first line treatments. Because the success rate of IUI is low, many couples failing IUI subsequently require IVF treatment. In practice, it is therefore important to examine the comparative outcomes (live birth-producing pregnancy), costs, and cost-effectiveness of primary offer of IVF, compared with primary offer of IUI followed by IVF for couples failing IUI. Methods Mathematical modelling was used to estimate comparative clinical and cost effectiveness of either primary offer of one full IVF cycle (including frozen cycles when applicable) or "IUI + IVF" (defined as primary IUI followed by IVF for IUI failures) to a hypothetical cohort of subfertile couples who are eligible for both treatment strategies. Data used in calculations were derived from the published peer-reviewed literature as well as activity data of local infertility units. Results Cost-effectiveness ratios for IVF, "unstimulated-IUI (U-IUI) + IVF", and "stimulated IUI (S-IUI) + IVF" were £12,600, £13,100 and £15,100 per live birth-producing pregnancy respectively. For a hypothetical cohort of 100 couples with unexplained or mild male factor subfertility, compared with primary offer of IVF, 6 cycles of "U-IUI + IVF" or of "S-IUI + IVF" would cost an additional £174,200 and £438,000, representing an opportunity cost of 54 and 136 additional IVF cycles and 14 to 35 live birth-producing pregnancies respectively. Conclusion For couples with unexplained and mild male factor subfertility, primary offer of a full IVF cycle is less costly and more cost-effective than providing IUI (of any modality) followed by IVF. PMID:16796733

Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden

PubMed Central

Eckard, Nathalie; Janzon, Magnus; Levin, Lars-Åke

2014-01-01

Background: The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. Methods: A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. Results: This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Conclusion: Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit. PMID:25396208

Sensing properties of separative paper-based extended-gate ion-sensitive field-effect transistor for cost effective pH sensor applications

NASA Astrophysics Data System (ADS)

Cho, Won-Ju; Lim, Cheol-Min

2018-02-01

In this study, we developed a cost-effective ion-sensing field-effect transistor (FET) with an extended gate (EG) fabricated on a separative paper substrate. The pH sensing characteristics of the paper EG was compared with those of other EGs fabricated on silicon, glass, or polyimide substrates. The fabricated paper-based EGFET exhibited excellent sensitivity close to the Nernst response limit as well as to that of the other substrate-based EGFETs. In addition, we found that all EGFETs, regardless of the substrate, have similar non-ideal behavior, i.e., drift phenomenon and hysteresis width. To investigate the degradation and durability of the paper EG after prolonged use, aging-effect tests were carried out in terms of the hysteresis width and sensitivity over a course of 30 days. As a result, the paper EG maintained stable pH sensing characteristics after 30 days. Therefore, we expect that paper EGFETs can provide a cost-effective sensor platform.

What linear programming contributes: world food programme experience with the "cost of the diet" tool.

PubMed

Frega, Romeo; Lanfranco, Jose Guerra; De Greve, Sam; Bernardini, Sara; Geniez, Perrine; Grede, Nils; Bloem, Martin; de Pee, Saskia

2012-09-01

Linear programming has been used for analyzing children's complementary feeding diets, for optimizing nutrient adequacy of dietary recommendations for a population, and for estimating the economic value of fortified foods. To describe and apply a linear programming tool ("Cost of the Diet") with data from Mozambique to determine what could be cost-effective fortification strategies. Based on locally assessed average household dietary needs, seasonal market prices of available food products, and food composition data, the tool estimates the lowest-cost diet that meets almost all nutrient needs. The results were compared with expenditure data from Mozambique to establish the affordability of this diet by quintiles of the population. Three different applications were illustrated: identifying likely "limiting nutrients," comparing cost effectiveness of different fortification interventions at the household level, and assessing economic access to nutritious foods. The analysis identified iron, vitamin B2, and pantothenic acid as "limiting nutrients." Under the Mozambique conditions, vegetable oil was estimated as a more cost-efficient vehicle for vitamin A fortification than sugar; maize flour may also be an effective vehicle to provide other constraining micronutrients. Multiple micronutrient fortification of maize flour could reduce the cost of the "lowest-cost nutritious diet" by 18%, but even this diet can be afforded by only 20% of the Mozambican population. Within the context of fortification, linear programming can be a useful tool for identifying likely nutrient inadequacies, for comparing fortification options in terms of cost effectiveness, and for illustrating the potential benefit of fortification for improving household access to a nutritious diet.

Strategies to Improve Management of Acute Watery Diarrhea during a Military Deployment: A Cost Effectiveness Analysis.

PubMed

Schrader, Andrew J; Tribble, David R; Riddle, Mark S

2017-12-01

To inform policy and decision makers, a cost-effectiveness model was developed to predict the cost-effectiveness of implementing two hypothetical management strategies separately and concurrently on the mitigation of deployment-associated travelers' diarrhea (TD) burden. The first management strategy aimed to increase the likelihood that a deployed service member with TD will seek medical care earlier in the disease course compared with current patterns; the second strategy aimed to optimize provider treatment practices through the implementation of a Department of Defense Clinical Practice Guideline. Outcome measures selected to compare management strategies were duty days lost averted (DDL-averted) and a cost effectiveness ratio (CER) of cost per DDL-averted (USD/DDL-averted). Increasing health care and by seeking it more often and earlier in the disease course as a stand-alone management strategy produced more DDL (worse) than the base case (up to 8,898 DDL-gained per year) at an increased cost to the Department of Defense (CER $193). Increasing provider use of an optimal evidence-based treatment algorithm through Clinical Practice Guidelines prevented 5,299 DDL per year with overall cost savings (CER -$74). A combination of both strategies produced the greatest gain in DDL-averted (6,887) with a modest cost increase (CER $118). The application of this model demonstrates that changes in TD management during deployment can be implemented to reduce DDL with likely favorable impacts on mission capability and individual health readiness. The hypothetical combination strategy evaluated prevents the most DDL compared with current practice and is associated with a modest cost increase.

Strategies for the prevention of perinatal hepatitis B transmission in a marginalized population on the Thailand-Myanmar border: a cost-effectiveness analysis.

PubMed

Devine, Angela; Harvey, Rebecca; Min, Aung Myat; Gilder, Mary Ellen T; Paw, Moo Koh; Kang, Joy; Watts, Isabella; Hanboonkunupakarn, Borimas; Nosten, François; McGready, Rose

2017-08-09

Data on the cost effectiveness of hepatitis B virus (HBV) screening and vaccination strategies for prevention of vertical transmission of HBV in resource limited settings is sparse. A decision tree model of HBV prevention strategies utilised data from a cohort of 7071 pregnant women on the Thailand-Myanmar border using a provider perspective. All options included universal HBV vaccination for newborns in three strategies: (1) universal vaccination alone; (2) universal vaccination with screening of women during antenatal visits with rapid diagnostic test (RDT) plus HBV immune globulin (HBIG) administration to newborns of HBV surface antigen positive women; and (3) universal vaccination with screening of women during antenatal visits plus HBIG administration to newborns of women testing HBV e antigen positive by confirmatory test. At the time of the study, the HBIG after confirmatory test strategy was used. The costs in United States Dollars (US$), infections averted and incremental cost effectiveness ratios (ICERs) were calculated and sensitivity analyses were conducted. A willingness to pay threshold of US$1200 was used. The universal HBV vaccination was the least costly option at US$4.33 per woman attending the clinic. The HBIG after (RDT) strategy had an ICER of US$716.78 per infection averted. The HBIG after confirmatory test strategy was not cost-effective due to extended dominance. The one-way sensitivity analysis showed that while the transmission parameters and cost of HBIG had the biggest impact on outcomes, the HBIG after confirmatory test only became a cost-effective option when a low test cost was used or a high HBIG cost was used. The probabilistic sensitivity analysis showed that HBIG after RDT had an 87% likelihood of being cost-effective as compared to vaccination only at a willingness to pay threshold of US$1200. HBIG following confirmatory test is not a cost-effective strategy for preventing vertical transmission of HBV in the Thailand-Myanmar border population. By switching to HBIG following rapid diagnostic test, perinatal infections will be reduced by nearly one third. This strategy may be applicable to similar settings for marginalized populations where the confirmatory test is not logistically possible.

Cost review template and guidance for project officers grants Under 40 CFR Part 35 Subpart A

EPA Pesticide Factsheets

EPA will base its review of requested personnel costs on the previous application request. Costs within 10 of the previous application request will be deemed necessary and reasonable. Cost review template and Guidance.

Benefit design innovations: implications for consumer-directed health care.

PubMed

Tu, Ha T; Ginsburg, Paul B

2007-02-01

Current health insurance benefit designs that simply rely on higher, one-size-fits-all patient cost sharing have limited potential to curb rapidly rising costs, but innovations in benefit design can potentially make cost sharing a more effective tool, according to a new study by the Center for Studying Health System Change (HSC). Innovative benefit designs include incentives to encourage healthy behaviors; incentives that vary by service type, patient condition or enrollee income; and incentives to use efficient providers. But most applications of these innovative designs are not widespread, suggesting that any significant cost impact is many years off. Moreover, regulations governing high-deductible, consumer-directed health plans eligible for health savings accounts (HSAs) preclude some promising benefit design innovations and dilute the incentives in others. A movement away from a one-size-fits-all HSA benefit structure toward a more flexible design might broaden the appeal of HSA plans and enable them to incorporate features that promote cost-effective care.

Enabling chip-scale trace gas sensing systems with silicon photonics

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

Green, William

Tunable laser trace-gas spectroscopy has been effectively used in both environmental and medical applications, for its sensitivity and specificity. We’ll describe how contemporary silicon photonics manufacturing and assembly are leveraged for a cost-effective miniaturized spectroscopic sensor platform, and outline uses in fugitive methane emissions monitoring.

Steam disinfestation as a methyl bromide alternative in California cut flower nurseries

USDA-ARS?s Scientific Manuscript database

Steam may be an effective alternative to methyl bromide in cut flower production in California. Advantages of steam include broad spectrum pest control and a zero hour re-entry interval. The principle disadvantage of sheet steaming is cost effectiveness due to current energy prices and application...

77 FR 50903 - Food Distribution Program on Indian Reservations: Administrative Funding Allocations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... such entity. Because FNS Regional Offices received funding without regard to the effect of cost drivers... contains regulatory documents #0;having general applicability and legal effect, most of which are keyed #0... Distribution Program on Indian Reservations: Administrative Funding Allocations AGENCY: Food and Nutrition...

A Peltier-based variable temperature source

NASA Astrophysics Data System (ADS)

Molki, Arman; Roof Baba, Abdul

2014-11-01

In this paper we propose a simple and cost-effective variable temperature source based on the Peltier effect using a commercially purchased thermoelectric cooler. The proposed setup can be used to quickly establish relatively accurate dry temperature reference points, which are necessary for many temperature applications such as thermocouple calibration.

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2010 CFR

2010-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2014 CFR

2014-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2013 CFR

2013-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2011 CFR

2011-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

20 CFR 404.1599 - Work incentive experiments and rehabilitation demonstration projects in the disability program.

Code of Federal Regulations, 2012 CFR

2012-04-01

... and demonstration projects designed to provide more cost-effective ways of encouraging disabled beneficiaries to return to work and leave benefit rolls. These experiments and demonstration projects will test... to test their effect on the program. (c) Applicability and scope—(1) Participants and nonparticipants...

A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations.

PubMed

Achana, Felix; Petrou, Stavros; Khan, Kamran; Gaye, Amadou; Modi, Neena

2018-01-01

A new methodological framework for assessing agreement between cost-effectiveness endpoints generated using alternative sources of data on treatment costs and effects for trial-based economic evaluations is proposed. The framework can be used to validate cost-effectiveness endpoints generated from routine data sources when comparable data is available directly from trial case report forms or from another source. We illustrate application of the framework using data from a recent trial-based economic evaluation of the probiotic Bifidobacterium breve strain BBG administered to babies less than 31 weeks of gestation. Cost-effectiveness endpoints are compared using two sources of information; trial case report forms and data extracted from the National Neonatal Research Database (NNRD), a clinical database created through collaborative efforts of UK neonatal services. Focusing on mean incremental net benefits at £30,000 per episode of sepsis averted, the study revealed no evidence of discrepancy between the data sources (two-sided p values >0.4), low probability estimates of miscoverage (ranging from 0.039 to 0.060) and concordance correlation coefficients greater than 0.86. We conclude that the NNRD could potentially serve as a reliable source of data for future trial-based economic evaluations of neonatal interventions. We also discuss the potential implications of increasing opportunity to utilize routinely available data for the conduct of trial-based economic evaluations.