Space system production cost benefits from contemporary philosophies in management and manufacturing

NASA Technical Reports Server (NTRS)

Rosmait, Russell L.

1991-01-01

The cost of manufacturing space system hardware has always been expensive. The Engineering Cost Group of the Program Planning office at Marshall is attempting to account for cost savings that result from new technologies in manufacturing and management. The objective is to identify and define contemporary philosophies in manufacturing and management. The seven broad categories that make up the areas where technological advances can assist in reducing space system costs are illustrated. Included within these broad categories is a list of the processes or techniques that specifically provide the cost savings within todays design, test, production and operations environments. The processes and techniques listed achieve savings in the following manner: increased productivity; reduced down time; reduced scrap; reduced rework; reduced man hours; and reduced material costs. In addition, it should be noted that cost savings from production and processing improvements effect 20 to 40 pct. of production costs whereas savings from management improvements effects 60 to 80 of production cost. This is important because most efforts in reducing costs are spent trying to reduce cost in the production.

The Automated Array Assembly Task of the Low-cost Silicon Solar Array Project, Phase 2

NASA Technical Reports Server (NTRS)

Coleman, M. G.; Grenon, L.; Pastirik, E. M.; Pryor, R. A.; Sparks, T. G.

1978-01-01

An advanced process sequence for manufacturing high efficiency solar cells and modules in a cost-effective manner is discussed. Emphasis is on process simplicity and minimizing consumed materials. The process sequence incorporates texture etching, plasma processes for damage removal and patterning, ion implantation, low pressure silicon nitride deposition, and plated metal. A reliable module design is presented. Specific process step developments are given. A detailed cost analysis was performed to indicate future areas of fruitful cost reduction effort. Recommendations for advanced investigations are included.

Furniture rough mill costs evaluated by computer simulation

Treesearch

R. Bruce Anderson

1983-01-01

A crosscut-first furniture rough mill was simulated to evaluate processing and raw material costs on an individual part basis. Distributions representing the real-world characteristics of lumber, equipment feed speeds, and processing requirements are programed into the simulation. Costs of parts from a specific cutting bill are given, and effects of lumber input costs...

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.

Economic Evaluation of a Hybrid Desalination System Combining Forward and Reverse Osmosis

PubMed Central

Choi, Yongjun; Cho, Hyeongrak; Shin, Yonghyun; Jang, Yongsun; Lee, Sangho

2015-01-01

This study seeks to evaluate the performance and economic feasibility of the forward osmosis (FO)–reverse osmosis (RO) hybrid process; to propose a guideline by which this hybrid process might be more price-competitive in the field. A solution-diffusion model modified with film theory was applied to analyze the effects of concentration polarization, water, and salt transport coefficient on flux, recovery, seawater concentration, and treated wastewater of the FO process of an FO-RO hybrid system. A simple cost model was applied to analyze the effects of flux; recovery of the FO process; energy; and membrane cost on the FO-RO hybrid process. The simulation results showed that the water transport coefficient and internal concentration polarization resistance are very important factors that affect performance in the FO process; however; the effect of the salt transport coefficient does not seem to be large. It was also found that the flux and recovery of the FO process, the FO membrane, and the electricity cost are very important factors that influence the water cost of an FO-RO hybrid system. This hybrid system can be price-competitive with RO systems when its recovery rate is very high, the flux and the membrane cost of the FO are similar to those of the RO, and the electricity cost is expensive. The most important thing in commercializing the FO process is enhancing performance (e.g.; flux and the recovery of FO membranes). PMID:26729176

Costing bias in economic evaluations.

PubMed

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

2015-01-01

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

Process-based Cost Estimation for Ramjet/Scramjet Engines

NASA Technical Reports Server (NTRS)

Singh, Brijendra; Torres, Felix; Nesman, Miles; Reynolds, John

2003-01-01

Process-based cost estimation plays a key role in effecting cultural change that integrates distributed science, technology and engineering teams to rapidly create innovative and affordable products. Working together, NASA Glenn Research Center and Boeing Canoga Park have developed a methodology of process-based cost estimation bridging the methodologies of high-level parametric models and detailed bottoms-up estimation. The NASA GRC/Boeing CP process-based cost model provides a probabilistic structure of layered cost drivers. High-level inputs characterize mission requirements, system performance, and relevant economic factors. Design alternatives are extracted from a standard, product-specific work breakdown structure to pre-load lower-level cost driver inputs and generate the cost-risk analysis. As product design progresses and matures the lower level more detailed cost drivers can be re-accessed and the projected variation of input values narrowed, thereby generating a progressively more accurate estimate of cost-risk. Incorporated into the process-based cost model are techniques for decision analysis, specifically, the analytic hierarchy process (AHP) and functional utility analysis. Design alternatives may then be evaluated not just on cost-risk, but also user defined performance and schedule criteria. This implementation of full-trade study support contributes significantly to the realization of the integrated development environment. The process-based cost estimation model generates development and manufacturing cost estimates. The development team plans to expand the manufacturing process base from approximately 80 manufacturing processes to over 250 processes. Operation and support cost modeling is also envisioned. Process-based estimation considers the materials, resources, and processes in establishing cost-risk and rather depending on weight as an input, actually estimates weight along with cost and schedule.

Consolidation of graphite thermoplastic textile preforms for primary aircraft structure

NASA Technical Reports Server (NTRS)

Suarez, J.; Mahon, J.

1991-01-01

The use of innovative cost effective material forms and processes is being considered for fabrication of future primary aircraft structures. Processes that have been identified as meeting these goals are textile preforms that use resin transfer molding (RTM) and consolidation forming. The Novel Composites for Wing and Fuselage Applications (NCWFA) program has as its objective the integration of innovative design concepts with cost effective fabrication processes to develop damage-tolerant structures that can perform at a design ultimate strain level of 6000 micro-inch/inch. In this on-going effort, design trade studies were conducted to arrive at advanced wing designs that integrate new material forms with innovative structural concepts and cost effective fabrication methods. The focus has been on minimizing part count (mechanical fasteners, clips, number of stiffeners, etc.), by using cost effective textile reinforcement concepts that provide improved damage tolerance and out-of-plane load capability, low-cost resin transfer molding processing, and thermoplastic forming concepts. The fabrication of representative Y spars by consolidation methods will be described. The Y spars were fabricated using AS4 (6K)/PEEK 150g commingled angle interlock 0/90-degree woven preforms with +45-degree commingled plies stitched using high strength Toray carbon thread and processed by autoclave consolidation.

Differential Effects of Aging on Processes Underlying Task Switching

ERIC Educational Resources Information Center

West, Robert; Travers, Stephanie

2008-01-01

In this study, we used event-related brain potentials (ERPs) to examine the effects of aging on processes underlying task switching. The response time data revealed an age-related increase in mixing costs before controlling for general slowing and no effect of aging on switching costs. In the cue-locked epoch, the ERP data revealed little effect…

Cost-effectiveness of integrated analysis/design systems /IPAD/ An executive summary. II. [for aerospace vehicles

NASA Technical Reports Server (NTRS)

Miller, R. E., Jr.; Hansen, S. D.; Redhed, D. D.; Southall, J. W.; Kawaguchi, A. S.

1974-01-01

Evaluation of the cost-effectiveness of integrated analysis/design systems with particular attention to Integrated Program for Aerospace-Vehicle Design (IPAD) project. An analysis of all the ingredients of IPAD indicates the feasibility of a significant cost and flowtime reduction in the product design process involved. It is also concluded that an IPAD-supported design process will provide a framework for configuration control, whereby the engineering costs for design, analysis and testing can be controlled during the air vehicle development cycle.

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

PubMed

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

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

NREL, Abengoa Making Concentrating Solar Power System Manufacturing More

Science.gov Websites

Cost Effective | Energy Systems Integration Facility | NREL Abengoa NREL, Abengoa Making Concentrating Solar Power System Manufacturing More Cost Effective Abengoa is working with NREL researchers to develop a new and more cost-effective manufacturing process for critical components of concentrating solar

Social value and individual choice: The value of a choice-based decision-making process in a collectively funded health system.

PubMed

Espinoza, Manuel Antonio; Manca, Andrea; Claxton, Karl; Sculpher, Mark

2018-02-01

Evidence about cost-effectiveness is increasingly being used to inform decisions about the funding of new technologies that are usually implemented as guidelines from centralized decision-making bodies. However, there is also an increasing recognition for the role of patients in determining their preferred treatment option. This paper presents a method to estimate the value of implementing a choice-based decision process using the cost-effectiveness analysis toolbox. This value is estimated for 3 alternative scenarios. First, it compares centralized decisions, based on population average cost-effectiveness, against a decision process based on patient choice. Second, it compares centralized decision based on patients' subgroups versus an individual choice-based decision process. Third, it compares a centralized process based on average cost-effectiveness against a choice-based process where patients choose according to a different measure of outcome to that used by the centralized decision maker. The methods are applied to a case study for the management of acute coronary syndrome. It is concluded that implementing a choice-based process of treatment allocation may be an option in collectively funded health systems. However, its value will depend on the specific health problem and the social values considered relevant to the health system. Copyright © 2017 John Wiley & Sons, Ltd.

Print material as a public health education tool.

PubMed

Paul, C L; Redman, S; Sanson-Fisher, R W

1998-02-01

Despite the widespread use of print materials in public health education, little is known about the costs and processes involved in developing these materials and their effectiveness in practice. We examined a sample of printed health education materials, using interviews and checklists. The most cost-effective processes for developing materials were not being used and the effectiveness of materials was rarely evaluated.

Effects of a clinical pathway for video-assisted thoracoscopic surgery (VATS) on quality and cost of care.

PubMed

Schwarzbach, Matthias H M; Ronellenfitsch, Ulrich; Wang, Qian; Rössner, Eric D; Denz, Christof; Post, Stefan; Hohenberger, Peter

2010-04-01

The purpose of this study was to evaluate effects of a clinical pathway (CP) for video-assisted thoracoscopic surgery (VATS) on process quality, outcome quality, and hospital costs. We implemented a CP for VATS and compared 34 patients treated with CP to 77 patients treated without CP. Indicators for process quality were duration of catheter placement, pain intensity, respiratory exercising, and mobilization. Outcome quality was measured through morbidity, mortality, reoperations, and readmissions. Cost of hospital stay was calculated using an imputed daily rate. Foley catheters were removed significantly earlier after CP implementation. All patients on CP were mobilized and received pulmonary exercising on the operation day. Pain levels were low after CP implementation. Median hospital stay significantly reduced by 5 days. Perioperative outcome quality remained unchanged. Costs significantly diminished by 1,510 Euro per stay. CP implementation had positive effects on process quality. Specifically, catheter management was improved and a good pain control achieved. Patients benefited from shortened stay and were treated at lower cost. A clear effect on outcome quality was not found. CPs are a promising tool for quality improvement and cost containment in thoracic surgery.

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.

The economics of health information technology in medication management: a systematic review of economic evaluations.

PubMed

O'Reilly, Daria; Tarride, Jean-Eric; Goeree, Ron; Lokker, Cynthia; McKibbon, K Ann

2012-01-01

To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process. Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis. The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations. Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention. The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective.

Improving data collection processes for routine evaluation of treatment cost-effectiveness.

PubMed

Monto, Sari; Penttilä, Riku; Kärri, Timo; Puolakka, Kari; Valpas, Antti; Talonpoika, Anna-Maria

2016-04-01

The healthcare system in Finland has begun routine collection of health-related quality of life (HRQoL) information for patients in hospitals to support more systematic cost-effectiveness analysis (CEA). This article describes the systematic collection of HRQoL survey data, and addresses challenges in the implementation of patient surveys and acquisition of cost data in the case hospital. Challenges include problems with incomplete data and undefined management processes. In order to support CEA of hospital treatments, improvements are sought from the process management literature and in the observation of healthcare professionals. The article has been written from an information system and process management perspective, concluding that process ownership, automation of data collection and better staff training are keys to generating more reliable data.

A Guide to the Selection of Cost-Effective Wastewater Treatment Systems. Technical Report.

ERIC Educational Resources Information Center

Van Note, Robert H.; And Others

The data within this publication provide guidelines for planners, engineers and decision-makers at all governmental levels to evaluate cost-effectiveness of alternative wastewater treatment proposals. The processes described include conventional and advanced treatment units as well as most sludge handling and processing units. Flow sheets, cost…

Cost analysis of composite fan blade manufacturing processes

NASA Technical Reports Server (NTRS)

Stelson, T. S.; Barth, C. F.

1980-01-01

The relative manufacturing costs were estimated for large high technology fan blades prepared by advanced composite fabrication methods using seven candidate materials/process systems. These systems were identified as laminated resin matrix composite, filament wound resin matrix composite, superhybrid solid laminate, superhybrid spar/shell, metal matrix composite, metal matrix composite with a spar and shell, and hollow titanium. The costs were calculated utilizing analytical process models and all cost data are presented as normalized relative values where 100 was the cost of a conventionally forged solid titanium fan blade whose geometry corresponded to a size typical of 42 blades per disc. Four costs were calculated for each of the seven candidate systems to relate the variation of cost on blade size. Geometries typical of blade designs at 24, 30, 36 and 42 blades per disc were used. The impact of individual process yield factors on costs was also assessed as well as effects of process parameters, raw materials, labor rates and consumable items.

Investigation of test methods, material properties and processes for solar cell encapsulants

NASA Technical Reports Server (NTRS)

Willis, P. B.; Baum, B.

1983-01-01

The goal of the program is to identify, test, evaluate and recommend encapsulation materials and processes for the fabrication of cost-effective and long life solar modules. Of the $18 (1948 $) per square meter allocated for the encapsulation components approximately 50% of the cost ($9/sq m) may be taken by the load bearing component. Due to the proportionally high cost of this element, lower costing materials were investigated. Wood based products were found to be the lowest costing structural materials for module construction, however, they require protection from rainwater and humidity in order to acquire dimensional stability. The cost of a wood product based substrate must, therefore, include raw material costs plus the cost of additional processing to impart hygroscopic inertness. This protection is provided by a two step, or split process in which a flexible laminate containing the cell string is prepared, first in a vacuum process and then adhesively attached with a back cover film to the hardboard in a subsequent step.

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

A cost analysis comparing xeroradiography to film technics for intraoral radiography.

PubMed

Gratt, B M; Sickles, E A

1986-01-01

In the United States during 1978 $730 million was spent on dental radiographic services. Currently there are three alternatives for the processing of intraoral radiographs: manual wet-tanks, automatic film units, or xeroradiography. It was the intent of this study to determine which processing system is the most economical. Cost estimates were based on a usage rate of 750 patient images per month and included a calculation of the average cost per radiograph over a five-year period. Capital costs included initial processing equipment and site preparation. Operational costs included labor, supplies, utilities, darkroom rental, and breakdown costs. Clinical time trials were employed to measure examination times. Maintenance logs were employed to assess labor costs. Indirect costs of training were estimated. Results indicated that xeroradiography was the most cost effective ($0.81 per image) compared to either automatic film processing ($1.14 per image) or manual processing ($1.35 per image). Variations in projected costs indicated that if a dental practice performs primarily complete-mouth surveys, exposes less than 120 radiographs per month, and pays less than +6.50 per hour in wages, then manual (wet-tank) processing is the most economical method for producing intraoral radiographs.

Demonstration of wetland vegetation mapping in Florida from computer-processed satellite and aircraft multispectral scanner data

NASA Technical Reports Server (NTRS)

Butera, M. K.

1979-01-01

The success of remotely mapping wetland vegetation of the southwestern coast of Florida is examined. A computerized technique to process aircraft and LANDSAT multispectral scanner data into vegetation classification maps was used. The cost effectiveness of this mapping technique was evaluated in terms of user requirements, accuracy, and cost. Results indicate that mangrove communities are classified most cost effectively by the LANDSAT technique, with an accuracy of approximately 87 percent and with a cost of approximately 3 cent per hectare compared to $46.50 per hectare for conventional ground survey methods.

Allogeneic cell therapy bioprocess economics and optimization: downstream processing decisions.

PubMed

Hassan, Sally; Simaria, Ana S; Varadaraju, Hemanthram; Gupta, Siddharth; Warren, Kim; Farid, Suzanne S

2015-01-01

To develop a decisional tool to identify the most cost effective process flowsheets for allogeneic cell therapies across a range of production scales. A bioprocess economics and optimization tool was built to assess competing cell expansion and downstream processing (DSP) technologies. Tangential flow filtration was generally more cost-effective for the lower cells/lot achieved in planar technologies and fluidized bed centrifugation became the only feasible option for handling large bioreactor outputs. DSP bottlenecks were observed at large commercial lot sizes requiring multiple large bioreactors. The DSP contribution to the cost of goods/dose ranged between 20-55%, and 50-80% for planar and bioreactor flowsheets, respectively. This analysis can facilitate early decision-making during process development.

Using a value chain approach for effective decision making.

PubMed

Wilner, N A

1997-09-01

Effectively managing costs in a healthcare environment may require taking a new look at how those costs are evaluated. The price of a product is not necessarily the most effective or efficient way of determining the actual cost. Using a value chain approach takes into consideration the functional costs of using a product as well, including both the "process" and "downstream" costs to an organization. In this article, Associate Professor Neil A. Wilner examines the differences between price and cost using a typical purchase in a healthcare environment.

Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression

PubMed Central

Lindefors, Nils

2016-01-01

Background A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Methods Data was collected from 568 adult patients treated with ICBT for depression during 2013–2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Outcomes Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5) during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission after treatment during both 2013 and 2014; an additional 35% and 33% were in partial remission during 2013 and 2014, respectively. Confidence ellipses occupied the south-east (SE) and south-west (SW) quadrants of the incremental cost-effectiveness plane at both post-treatment and at follow-up, indicating that the ICBT treatment was less costly and equally effective after staff reallocation. Conclusion Treating patients to the target of full remission using psychologists instead of medical specialists for post-treatment assessment is cost-saving and consequently a more valuable use of limited resources. TDABC may be a useful tool for measuring resource costs, identifying quality improvement opportunities and evaluating the consequences of such initiatives. Combining TDABC with clinical outcome measures in CEA is potentially a useful approach in mental healthcare to estimate the value of process improvement initiatives. PMID:27798655

Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression.

PubMed

El Alaoui, Samir; Lindefors, Nils

2016-01-01

A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Data was collected from 568 adult patients treated with ICBT for depression during 2013-2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5) during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission after treatment during both 2013 and 2014; an additional 35% and 33% were in partial remission during 2013 and 2014, respectively. Confidence ellipses occupied the south-east (SE) and south-west (SW) quadrants of the incremental cost-effectiveness plane at both post-treatment and at follow-up, indicating that the ICBT treatment was less costly and equally effective after staff reallocation. Treating patients to the target of full remission using psychologists instead of medical specialists for post-treatment assessment is cost-saving and consequently a more valuable use of limited resources. TDABC may be a useful tool for measuring resource costs, identifying quality improvement opportunities and evaluating the consequences of such initiatives. Combining TDABC with clinical outcome measures in CEA is potentially a useful approach in mental healthcare to estimate the value of process improvement initiatives.

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.

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.

Economic analysis of fuel ethanol production from winter hulled barley by the EDGE (Enhanced Dry Grind Enzymatic) process.

PubMed

Nghiem, Nhuan P; Ramírez, Edna C; McAloon, Andrew J; Yee, Winnie; Johnston, David B; Hicks, Kevin B

2011-06-01

A process and cost model was developed for fuel ethanol production from winter barley based on the EDGE (Enhanced Dry Grind Enzymatic) process. In this process, in addition to β-glucanases, which are added to reduce the viscosity of the mash, β-glucosidase is also added to completely hydrolyze the oligomers obtained during the hydrolysis of β-glucans to glucose. The model allows determination of capital costs, operating costs, and ethanol production cost for a plant producing 40 million gallons of denatured fuel ethanol annually. A sensitivity study was also performed to examine the effects of β-glucosidase and barley costs on the final ethanol production cost. The results of this study clearly demonstrate the economic benefit of adding β-glucosidase. Lower ethanol production cost was obtained compared to that obtained without β-glucosidase addition in all cases except one where highest β-glucosidase cost allowance and lowest barley cost were used. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Science of and Advanced Technology for Cost-Effective Manufacture of High Precision Engineering Products. Volume 5. Automatic Generation of Process Outlines of Forming and Machining Processes.

DTIC Science & Technology

1986-08-01

THE SCIENCE OF AND ADVANCED TECHNOLOGY FOR COST-EFFECTIVE MANUFACTURE Lfl OF HIGH PRECISION ENGINEERING PRODUCTS N iA6/*N ONR Contract No. 83K0385...ADVANCED TECHNOLOGY FOR1 COST-EFFECTIVE MANUFACTURE OF1’ HIGH PRECISION ENGINEERING PRODUCTS ONR Contract No. 83K0385 Final Report Vol. 5 AUTOMATIC...Ck 53N Drawing #: 03116-6233 Raw Material: Iiz’ 500mm diameter and 3000mm length Ma, rial Alloy steel. high carbon content, quenched to Min 45Rc

The economics of health information technology in medication management: a systematic review of economic evaluations

PubMed Central

Tarride, Jean-Eric; Goeree, Ron; Lokker, Cynthia; McKibbon, K Ann

2011-01-01

Objective To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process. Materials and methods Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis. Results The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations. Discussion Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention. Conclusion The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective. PMID:21984590

Mechanical impedance measurements for improved cost-effective process monitoring

NASA Astrophysics Data System (ADS)

Clopet, Caroline R.; Pullen, Deborah A.; Badcock, Rodney A.; Ralph, Brian; Fernando, Gerard F.; Mahon, Steve W.

1999-06-01

The aerospace industry has seen a considerably growth in composite usage over the past ten years, especially with the development of cost effective manufacturing techniques such as Resin Transfer Molding and Resin Infusion under Flexible Tooling. The relatively high cost of raw material and conservative processing schedules has limited their growth further in non-aerospace technologies. In-situ process monitoring has been explored for some time as a means to improving the cost efficiency of manufacturing with dielectric spectroscopy and optical fiber sensors being the two primary techniques developed to date. A new emerging technique is discussed here making use of piezoelectric wafers with the ability to sense not only aspects of resin flow but also to detect the change in properties of the resin as it cures. Experimental investigations to date have shown a correlation between mechanical impedance measurements and the mechanical properties of cured epoxy systems with potential for full process monitoring.

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

EPA Science Inventory

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

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.

3D memory: etch is the new litho

NASA Astrophysics Data System (ADS)

Petti, Christopher

2018-03-01

This paper discusses the process challenges and limitations for 3D NAND processes, focusing on vertical 3D architectures. The effect of deep memory hole etches on die cost is calculated, with die cost showing a minimum at a given number of layers because of aspect-ratio dependent etch effects. Techniques to mitigate these etch effects are summarized, as are other etch issues, such as bowing and twisting. Metal replacement gate processes and their challenges are also described. Lastly, future directions of vertical 3D NAND technologies are explored.

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

Space processing economics

NASA Technical Reports Server (NTRS)

Bredt, J. H.

1974-01-01

Two types of space processing operations may be considered economically justified; they are manufacturing operations that make profits and experiment operations that provide needed applied research results at lower costs than those of alternative methods. Some examples from the Skylab experiments suggest that applied research should become cost effective soon after the space shuttle and Spacelab become operational. In space manufacturing, the total cost of space operations required to process materials must be repaid by the value added to the materials by the processing. Accurate estimates of profitability are not yet possible because shuttle operational costs are not firmly established and the markets for future products are difficult to estimate. However, approximate calculations show that semiconductor products and biological preparations may be processed on a scale consistent with market requirements and at costs that are at least compatible with profitability using the Shuttle/Spacelab system.

Cost-effectiveness analysis of TOC removal from slaughterhouse wastewater using combined anaerobic-aerobic and UV/H2O2 processes.

PubMed

Bustillo-Lecompte, Ciro Fernando; Mehrvar, Mehrab; Quiñones-Bolaños, Edgar

2014-02-15

The objective of this study is to evaluate the operating costs of treating slaughterhouse wastewater (SWW) using combined biological and advanced oxidation processes (AOPs). This study compares the performance and the treatment capability of an anaerobic baffled reactor (ABR), an aerated completely mixed activated sludge reactor (AS), and a UV/H2O2 process, as well as their combination for the removal of the total organic carbon (TOC). Overall efficiencies are found to be up to 75.22, 89.47, 94.53, 96.10, 96.36, and 99.98% for the UV/H2O2, ABR, AS, combined AS-ABR, combined ABR-AS, and combined ABR-AS-UV/H2O2 processes, respectively. Due to the consumption of electrical energy and reagents, operating costs are calculated at optimal conditions of each process. A cost-effectiveness analysis (CEA) is performed at optimal conditions for the SWW treatment by optimizing the total electricity cost, H2O2 consumption, and hydraulic retention time (HRT). The combined ABR-AS-UV/H2O2 processes have an optimal TOC removal of 92.46% at an HRT of 41 h, a cost of $1.25/kg of TOC removed, and $11.60/m(3) of treated SWW. This process reaches a maximum TOC removal of 99% in 76.5 h with an estimated cost of $2.19/kg TOC removal and $21.65/m(3) treated SWW, equivalent to $6.79/m(3) day. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cost Effective Recovery of Low-TDS Frac Flowback Water for Re-use

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

Claire Henderson; Harish Acharya; Hope Matis

2011-03-31

The project goal was to develop a cost-effective water recovery process to reduce the costs and envi-ronmental impact of shale gas production. This effort sought to develop both a flowback water pre-treatment process and a membrane-based partial demineralization process for the treatment of the low-Total Dissolved Solids (TDS) portion of the flowback water produced during hydrofracturing operations. The TDS cutoff for consideration in this project is < 35,000 {approx} 45,000 ppm, which is the typical limit for economic water recovery employing reverse osmosis (RO) type membrane desalination processes. The ultimate objective is the production of clean, reclaimed water suitable formore » re-use in hydrofracturing operations. The team successfully compiled data on flowback composition and other attributes across multiple shale plays, identified the likely applicability of membrane treatment processes in those shales, and expanded the proposed product portfolio to include four options suitable for various reuse or discharge applications. Pretreatment technologies were evaluated at the lab scale and down-selected based upon their efficacy in removing key contaminants. The chosen technologies were further validated by performing membrane fouling studies with treated flowback water to demonstrate the technical feasibility of flowback treatment with RO membranes. Process flow schemes were constructed for each of the four product options based on experimental performance data from actual flowback water treatment studies. For the products requiring membrane treatment, membrane system model-ing software was used to create designs for enhanced water recovery beyond the typical seawater desalination benchmark. System costs based upon vendor and internal cost information for all process flow schemes were generated and are below target and in line with customer expectations. Finally, to account for temporal and geographic variability in flowback characteristics as well as local disposal costs and regulations, a parametric value assessment tool was created to assess the economic attractiveness of a given flowback recovery process relative to conventional disposal for any combination of anticipated flowback TDS and local disposal cost. It is concluded that membrane systems in combination with appropriate pretreatment technologies can provide cost-effective recovery of low-TDS flow-back water for either beneficial reuse or safe surface discharge.« less

Cost-effectiveness of diabetes pay-for-performance incentive designs.

PubMed

Hsieh, Hui-Min; Tsai, Shu-Ling; Shin, Shyi-Jang; Mau, Lih-Wen; Chiu, Herng-Chia

2015-02-01

Taiwan's National Health Insurance (NHI) Program implemented a diabetes pay-for-performance program (P4P) based on process-of-care measures in 2001. In late 2006, that P4P program was revised to also include achievement of intermediate health outcomes. This study examined to what extent these 2 P4P incentive designs have been cost-effective and what the difference in effect may have been. Analyzing data using 3 population-based longitudinal databases (NHI's P4P dataset, NHI's claims database, and Taiwan's death registry), we compared costs and effectiveness between P4P and non-P4P diabetes patient groups in each phase. Propensity score matching was used to match comparable control groups for intervention groups. Outcomes included life-years, quality-adjusted life-years (QALYs), program intervention costs, cost-savings, and incremental cost-effectiveness ratios. QALYs for P4P patients and non-P4P patients were 2.08 and 1.99 in phase 1 and 2.08 and 2.02 in phase 2. The average incremental intervention costs per QALYs was TWD$335,546 in phase 1 and TWD$298,606 in phase 2. The average incremental all-cause medical costs saved by the P4P program per QALYs were TWD$602,167 in phase 1 and TWD$661,163 in phase 2. The findings indicated that both P4P programs were cost-effective and the resulting return on investment was 1.8:1 in phase 1 and 2.0:1 in phase 2. We conclude that the diabetes P4P program in both phases enabled the long-term cost-effective use of resources and cost-savings regardless of whether a bonus for intermediate outcome improvement was added to a process-based P4P incentive design.

Cost-Effectiveness of Reduced Waiting Time for Head and Neck Cancer Patients due to a Lean Process Redesign.

PubMed

Simons, Pascale A M; Ramaekers, Bram; Hoebers, Frank; Kross, Kenneth W; Marneffe, Wim; Pijls-Johannesma, Madelon; Vandijck, Dominique

2015-07-01

Compared with new technologies, the redesign of care processes is generally considered less attractive to improve patient outcomes. Nevertheless, it might result in better patient outcomes, without further increasing costs. Because early initiation of treatment is of vital importance for patients with head and neck cancer (HNC), these care processes were redesigned. This study aimed to assess patient outcomes and cost-effectiveness of this redesign. An economic (Markov) model was constructed to evaluate the biopsy process of suspicious lesion under local instead of general anesthesia, and combining computed tomography and positron emission tomography for diagnostics and radiotherapy planning. Patients treated for HNC were included in the model stratified by disease location (larynx, oropharynx, hypopharynx, and oral cavity) and stage (I-II and III-IV). Probabilistic sensitivity analyses were performed. Waiting time before treatment start reduced from 5 to 22 days for the included patient groups, resulting in 0.13 to 0.66 additional quality-adjusted life-years. The new workflow was cost-effective for all the included patient groups, using a ceiling ratio of €80,000 or €20,000. For patients treated for tumors located at the larynx and oral cavity, the new workflow resulted in additional quality-adjusted life-years, and costs decreased compared with the regular workflow. The health care payer benefited €14.1 million and €91.5 million, respectively, when individual net monetary benefits were extrapolated to an organizational level and a national level. The redesigned care process reduced the waiting time for the treatment of patients with HNC and proved cost-effective. Because care improved, implementation on a wider scale should be considered. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Does more mean less? The value of information for conservation planning under sea level rise.

PubMed

Runting, Rebecca K; Wilson, Kerrie A; Rhodes, Jonathan R

2013-02-01

Many studies have explored the benefits of adopting more sophisticated modelling techniques or spatial data in terms of our ability to accurately predict ecosystem responses to global change. However, we currently know little about whether the improved predictions will actually lead to better conservation outcomes once the costs of gaining improved models or data are accounted for. This severely limits our ability to make strategic decisions for adaptation to global pressures, particularly in landscapes subject to dynamic change such as the coastal zone. In such landscapes, the global phenomenon of sea level rise is a critical consideration for preserving biodiversity. Here, we address this issue in the context of making decisions about where to locate a reserve system to preserve coastal biodiversity with a limited budget. Specifically, we determined the cost-effectiveness of investing in high-resolution elevation data and process-based models for predicting wetland shifts in a coastal region of South East Queensland, Australia. We evaluated the resulting priority areas for reserve selection to quantify the cost-effectiveness of investment in better quantifying biological and physical processes. We show that, in this case, it is considerably more cost effective to use a process-based model and high-resolution elevation data, even if this requires a substantial proportion of the project budget to be expended (up to 99% in one instance). The less accurate model and data set failed to identify areas of high conservation value, reducing the cost-effectiveness of the resultant conservation plan. This suggests that when developing conservation plans in areas where sea level rise threatens biodiversity, investing in high-resolution elevation data and process-based models to predict shifts in coastal ecosystems may be highly cost effective. A future research priority is to determine how this cost-effectiveness varies among different regions across the globe. © 2012 Blackwell Publishing Ltd.

Energy, cost and design aspects of coarse- and fine-bubble aeration systems in the MBBR IFAS process.

PubMed

Sander, S; Behnisch, J; Wagner, M

2017-02-01

With the MBBR IFAS (moving bed biofilm reactor integrated fixed-film activated sludge) process, the biomass required for biological wastewater treatment is either suspended or fixed on free-moving plastic carriers in the reactor. Coarse- or fine-bubble aeration systems are used in the MBBR IFAS process. In this study, the oxygen transfer efficiency (OTE) of a coarse-bubble aeration system was improved significantly by the addition of the investigated carriers, even in-process (∼1% per vol-% of added carrier material). In a fine-bubble aeration system, the carriers had little or no effect on OTE. The effect of carriers on OTE strongly depends on the properties of the aeration system, the volumetric filling rate of the carriers, the properties of the carrier media, and the reactor geometry. This study shows that the effect of carriers on OTE is less pronounced in-process compared to clean water conditions. When designing new carriers in order to improve their effect on OTE further, suppliers should take this into account. Although the energy efficiency and cost effectiveness of coarse-bubble aeration systems can be improved significantly by the addition of carriers, fine-bubble aeration systems remain the more efficient and cost-effective alternative for aeration when applying the investigated MBBR IFAS process.

Process Research ON Semix Silicon Materials (PROSSM)

NASA Astrophysics Data System (ADS)

Wohlgemuth, J. H.; Warfield, D. B.

1982-02-01

A cost effective process sequence was identified, equipment was designed to implement a 6.6 MW per year automated production line, and a cost analysis projected a $0.56 per watt cell add-on cost for this line. Four process steps were developed for this program: glass beads back clean-up, hot spray antireflective coating, wave soldering of fronts, and ion milling for edging. While spray dopants were advertised as an off the shelf developed product, they were unreliable with shorter than advertised shelf life.

Process Research ON Semix Silicon Materials (PROSSM)

NASA Technical Reports Server (NTRS)

Wohlgemuth, J. H.; Warfield, D. B.

1982-01-01

A cost effective process sequence was identified, equipment was designed to implement a 6.6 MW per year automated production line, and a cost analysis projected a $0.56 per watt cell add-on cost for this line. Four process steps were developed for this program: glass beads back clean-up, hot spray antireflective coating, wave soldering of fronts, and ion milling for edging. While spray dopants were advertised as an off the shelf developed product, they were unreliable with shorter than advertised shelf life.

Cost-effectiveness analysis: problems and promise for evaluating medical technology

NASA Astrophysics Data System (ADS)

Juday, Timothy R.

1994-12-01

Although using limited financial resources in the most beneficial way, in principle, a laudable goal, actually developing standards for measuring the cost-effectiveness of medical technologies and incorporating them into the coverage process is a much more difficult proposition. Important methodological difficulties include determining how to compare a technology to its leading alternative, defining costs, incorporating patient preferences, and defining health outcomes. In addition, more practical questions must be addressed. These questions include: who does the analysis? who makes the decisions? which technologies to evaluate? what resources are required? what is the political and legal environment? how much is a health outcome worth? The ultimate question that must be answered is what is a health outcome worth? Cost-effectiveness analysis cannot answer this question; it only enables comparison of cost-effectiveness ratios across technologies. In order to determine whether a technology should be covered, society or individual insurers must determine how much they are willing to pay for the health benefits. Conducting cost-effectiveness analysis will not remove the need to make difficult resource allocation decisions; however, explicitly examining the tradeoffs involved in these decisions should help to improve the process.

An updated comprehensive techno-economic analysis of algae biodiesel.

PubMed

Nagarajan, Sanjay; Chou, Siaw Kiang; Cao, Shenyan; Wu, Chen; Zhou, Zhi

2013-10-01

Algae biodiesel is a promising but expensive alternative fuel to petro-diesel. To overcome cost barriers, detailed cost analyses are needed. A decade-old cost analysis by the U.S. National Renewable Energy Laboratory indicated that the costs of algae biodiesel were in the range of $0.53-0.85/L (2012 USD values). However, the cost of land and transesterification were just roughly estimated. In this study, an updated comprehensive techno-economic analysis was conducted with optimized processes and improved cost estimations. Latest process improvement, quotes from vendors, government databases, and other relevant data sources were used to calculate the updated algal biodiesel costs, and the final costs of biodiesel are in the range of $0.42-0.97/L. Additional improvements on cost-effective biodiesel production around the globe to cultivate algae was also recommended. Overall, the calculated costs seem promising, suggesting that a single step biodiesel production process is close to commercial reality. Copyright © 2012 Elsevier Ltd. All rights reserved.

Hot forming and quenching pilot process development for low cost and low environmental impact manufacturing.

NASA Astrophysics Data System (ADS)

Hall, Roger W.; Foster, Alistair; Herrmann Praturlon, Anja

2017-09-01

The Hot Forming and in-tool Quenching (HFQ®) process is a proven technique to enable complex shaped stampings to be manufactured from high strength aluminium. Its widespread uptake for high volume production will be maximised if it is able to wholly amortise the additional investment cost of this process compared to conventional deep drawing techniques. This paper discusses the use of three techniques to guide some of the development decisions taken during upscaling of the HFQ® process. Modelling of Process timing, Cost and Life-cycle impact were found to be effective tools to identify where development budget could be focused in order to be able to manufacture low cost panels of different sizes from many different alloys in a sustainable way. The results confirm that raw material cost, panel trimming, and artificial ageing were some of the highest contributing factors to final component cost. Additionally, heat treatment and lubricant removal stages played a significant role in the overall life-cycle assessment of the final products. These findings confirmed development priorities as novel furnace design, fast artificial ageing and low-cost alloy development.

Cost Models for MMC Manufacturing Processes

NASA Technical Reports Server (NTRS)

Elzey, Dana M.; Wadley, Haydn N. G.

1996-01-01

The quality cost modeling (QCM) tool is intended to be a relatively simple-to-use device for obtaining a first-order assessment of the quality-cost relationship for a given process-material combination. The QCM curve is a plot of cost versus quality (an index indicating microstructural quality), which is unique for a given process-material combination. The QCM curve indicates the tradeoff between cost and performance, thus enabling one to evaluate affordability. Additionally, the effect of changes in process design, raw materials, and process conditions on the cost-quality relationship can be evaluated. Such results might indicate the most efficient means to obtain improved quality at reduced cost by process design refinements, the implementation of sensors and models for closed loop process control, or improvement in the properties of raw materials being fed into the process. QCM also allows alternative processes for producing the same or similar material to be compared in terms of their potential for producing competitively priced, high quality material. Aside from demonstrating the usefulness of the QCM concept, this is one of the main foci of the present research program, namely to compare processes for making continuous fiber reinforced, metal matrix composites (MMC's). Two processes, low pressure plasma spray deposition and tape casting are considered for QCM development. This document consists of a detailed look at the design of the QCM approach, followed by discussion of the application of QCM to each of the selected MMC manufacturing processes along with results, comparison of processes, and finally, a summary of findings and recommendations.

Cost Effectiveness of Individual versus Group Cognitive Behavior Therapy for Problems of Depression and Anxiety in an HMO Population.

ERIC Educational Resources Information Center

Shapiro, Joan; And Others

1982-01-01

Compared the cost effectiveness of cognitive behavior group therapy, traditional process-oriented interpersonal group, and individual cognitive behavior therapy in dealing with depression and anxiety in a health maintenance organization population (N=44). Results suggest that cost considerations can become relatively important when decisions are…

Biosynthesis of indigo using recombinant E. coli: Development of a biological system for the cost-effective production of a large volume chemical

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

Berry, A.; Battist, S.; Chotani, G.

1995-11-01

Cost-effective production of any large-volume chemical by fermentation requires extensive manipulation of both the production organism and the fermentation and recovery processes. We have developed a recombinant E. coli system for the production of tryptophan and several other products derived from the aromatic amino acid pathway. By linking our technology for low-cost production of tryptophan from glucose with the enzyme naphthalene dioxygenase (NDO), we have achieved an overall process for the production of indigo dye from glucose. To successfully join these two technologies, both the tryptophan pathway and NDO were extensively modified via genetic engineering. In addition, systems were developedmore » to remove deleterious by-products generated during the chemical oxidations leading to indigo formation. Low-cost fermentation processes were developed that utilized minimal-salts media containing glucose as the sole carbon source. Finally, economical recovery processes were used that preserved the environmental friendliness of the biosynthetic route to indigo.« less

Analyzing the Effect of Multi-fuel and Practical Constraints on Realistic Economic Load Dispatch using Novel Two-stage PSO

NASA Astrophysics Data System (ADS)

Chintalapudi, V. S.; Sirigiri, Sivanagaraju

2017-04-01

In power system restructuring, pricing the electrical power plays a vital role in cost allocation between suppliers and consumers. In optimal power dispatch problem, not only the cost of active power generation but also the costs of reactive power generated by the generators should be considered to increase the effectiveness of the problem. As the characteristics of reactive power cost curve are similar to that of active power cost curve, a nonconvex reactive power cost function is formulated. In this paper, a more realistic multi-fuel total cost objective is formulated by considering active and reactive power costs of generators. The formulated cost function is optimized by satisfying equality, in-equality and practical constraints using the proposed uniform distributed two-stage particle swarm optimization. The proposed algorithm is a combination of uniform distribution of control variables (to start the iterative process with good initial value) and two-stage initialization processes (to obtain best final value in less number of iterations) can enhance the effectiveness of convergence characteristics. Obtained results for the considered standard test functions and electrical systems indicate the effectiveness of the proposed algorithm and can obtain efficient solution when compared to existing methods. Hence, the proposed method is a promising method and can be easily applied to optimize the power system objectives.

Analyzing the requirements for mass production of small wind turbine generators

NASA Astrophysics Data System (ADS)

Anuskiewicz, T.; Asmussen, J.; Frankenfield, O.

Mass producibility of small wind turbine generators to give manufacturers design and cost data for profitable production operations is discussed. A 15 kW wind turbine generator for production in annual volumes from 1,000 to 50,000 units is discussed. Methodology to cost the systems effectively is explained. The process estimate sequence followed is outlined with emphasis on the process estimate sheets compiled for each component and subsystem. These data enabled analysts to develop cost breakdown profiles crucial in manufacturing decision-making. The appraisal also led to various design recommendations including replacement of aluminum towers with cost effective carbon steel towers. Extensive cost information is supplied in tables covering subassemblies, capital requirements, and levelized energy costs. The physical layout of the plant is depicted to guide manufacturers in taking advantage of the growing business opportunity now offered in conjunction with the national need for energy development.

A workload model and measures for computer performance evaluation

NASA Technical Reports Server (NTRS)

Kerner, H.; Kuemmerle, K.

1972-01-01

A generalized workload definition is presented which constructs measurable workloads of unit size from workload elements, called elementary processes. An elementary process makes almost exclusive use of one of the processors, CPU, I/O processor, etc., and is measured by the cost of its execution. Various kinds of user programs can be simulated by quantitative composition of elementary processes into a type. The character of the type is defined by the weights of its elementary processes and its structure by the amount and sequence of transitions between its elementary processes. A set of types is batched to a mix. Mixes of identical cost are considered as equivalent amounts of workload. These formalized descriptions of workloads allow investigators to compare the results of different studies quantitatively. Since workloads of different composition are assigned a unit of cost, these descriptions enable determination of cost effectiveness of different workloads on a machine. Subsequently performance parameters such as throughput rate, gain factor, internal and external delay factors are defined and used to demonstrate the effects of various workload attributes on the performance of a selected large scale computer system.

Reducing Design Cycle Time and Cost Through Process Resequencing

NASA Technical Reports Server (NTRS)

Rogers, James L.

2004-01-01

In today's competitive environment, companies are under enormous pressure to reduce the time and cost of their design cycle. One method for reducing both time and cost is to develop an understanding of the flow of the design processes and the effects of the iterative subcycles that are found in complex design projects. Once these aspects are understood, the design manager can make decisions that take advantage of decomposition, concurrent engineering, and parallel processing techniques to reduce the total time and the total cost of the design cycle. One software tool that can aid in this decision-making process is the Design Manager's Aid for Intelligent Decomposition (DeMAID). The DeMAID software minimizes the feedback couplings that create iterative subcycles, groups processes into iterative subcycles, and decomposes the subcycles into a hierarchical structure. The real benefits of producing the best design in the least time and at a minimum cost are obtained from sequencing the processes in the subcycles.

Assessing Cost-Effectiveness in Obesity (ACE-Obesity): an overview of the ACE approach, economic methods and cost results

PubMed Central

2009-01-01

Background The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. Methods The Assessing Cost Effectiveness (ACE) approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. Results The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum) and when expressed as a 'cost per child' estimate (from

Improving environmental impact and cost assessment for supplier evaluation

NASA Astrophysics Data System (ADS)

Beucker, Severin; Lang, Claus

2004-02-01

Improving a company"s environmental and financial performance necessitates the evaluation of environmental impacts deriving from the production and cost effects of corporate actions. These effects have to be made transparent and concrete targets have to be developed. Such an evaluation has to be done on a regular basis but with limited expenses. To achieve this, different instruments of environmental controlling such as LCA and environmental performance indicators have to be combined with methods from cost accounting. Within the research project CARE (Computer Aided Resource Efficiency Accounting for Medium-Sized Enterprises), the method Resource Efficiency Accounting (REA) is used to give the participating companies new insights into hidden costs and environmental effects of their production and products. The method combines process based cost accounting with environmental impact assessment methodology and offers results that can be integrated into a company"s environmental controlling system and business processes like cost accounting, supplier assessment, etc. Much of the data necessary for the combined assessment can be available within a company"s IT system and therefore can be efficiently used for the assessment process. The project CARE puts a strong focus on the use of company data and information systems for the described assessment process and offers a methodological background for the evaluation and the structuring of such data. Besides the general approach of the project CARE the paper will present results from a case study in which the described approach is used for the evaluation of suppliers.

Clinical governance and operations management methodologies.

PubMed

Davies, C; Walley, P

2000-01-01

The clinical governance mechanism, introduced since 1998 in the UK National Health Service (NHS), aims to deliver high quality care with efficient, effective and cost-effective patient services. Scally and Donaldson recognised that new approaches are needed, and operations management techniques comprise potentially powerful methodologies in understanding the process of care, which can be applied both within and across professional boundaries. This paper summarises four studies in hospital Trusts which took approaches to improving process that were different from and less structured than business process re-engineering (BPR). The problems were then amenable to change at a relatively low cost and short timescale, producing significant improvement to patient care. This less structured approach to operations management avoided incurring overhead costs of large scale and costly change such as new information technology (IT) systems. The most successful changes were brought about by formal tools to control quantity, content and timing of changes.

Effect of an imaging-based streamlined electronic healthcare process on quality and costs.

PubMed

Bui, Alex A T; Taira, Ricky K; Goldman, Dana; Dionisio, John David N; Aberle, Denise R; El-Saden, Suzie; Sayre, James; Rice, Thomas; Kangarloo, Hooshang

2004-01-01

A streamlined process of care supported by technology and imaging may be effective in managing the overall healthcare process and costs. This study examined the effect of an imaging-based electronic process of care on costs and rates of hospitalization, emergency room (ER) visits, specialist diagnostic referrals, and patient satisfaction. A healthcare process was implemented for an employer group, highlighting improved patient access to primary care plus routine use of imaging and teleconsultation with diagnostic specialists. An electronic infrastructure supported patient access to physicians and communication among healthcare providers. The employer group, a self-insured company, manages a healthcare plan for its employees and their dependents: 4,072 employees were enrolled in the test group, and 7,639 in the control group. Outcome measures for expenses and frequency of hospitalizations, ER visits, traditional specialist referrals, primary care visits, and imaging utilization rates were measured using claims data over 1 year. Homogeneity tests of proportions were performed with a chi-square statistic, mean differences were tested by two-sample t-tests. Patient satisfaction with access to healthcare was gauged using results from an independent firm. Overall per member/per month costs post-implementation were lower in the enrolled population (126 dollars vs 160 dollars), even though occurrence of chronic/expensive diseases was higher in the enrolled group (18.8% vs 12.2%). Lower per member/per month costs were seen for inpatient (33.29 dollars vs 35.59 dollars); specialist referrals (21.36 dollars vs 26.84 dollars); and ER visits (3.68 dollars vs 5.22 dollars). Moreover, the utilization rate for hospital admissions, ER visits, and traditional specialist referrals were significantly lower in the enrolled group, although primary care and imaging utilization were higher. Comparison to similar employer groups showed that the company's costs were lower than national averages (119.24 dollars vs 146.32 dollars), indicating that the observed result was not attributable to normalization effects. Patient satisfaction with access to healthcare ranked in the top 21st percentile. A streamlined healthcare process supported by technology resulted in higher patient satisfaction and cost savings despite improved access to primary care and higher utilization of imaging.

Manufacturing of Smart Structures Using Fiber Placement Manufacturing Processes

NASA Technical Reports Server (NTRS)

Thomas, Matthew M.; Glowasky, Robert A.; McIlroy, Bruce E.; Story, Todd A.

1996-01-01

Smart structures research and development, with the ultimate aim of rapid commercial and military production of these structures, are at the forefront of the Synthesis and Processing of Intelligent Cost-Effective Structures (SPICES) program. As part of this ARPA-sponsored program, MDA-E is using fiber placement processes to manufacture integrated smart structure systems. These systems comprise advanced composite structures with embedded fiber optic sensors, shape memory alloys, piezoelectric actuators, and miniature accelerometers. Cost-effective approaches and solutions to smart material synthesis in the fiber-placement process, based upon integrated product development, are discussed herein.

Can the real opportunity cost stand up: displaced services, the straw man outside the room.

PubMed

Eckermann, Simon; Pekarsky, Brita

2014-04-01

In current literature, displaced services have been suggested to provide a basis for determining a threshold value for the effects of a new technology as part of a reimbursement process when budgets are fixed. We critically examine the conditions under which displaced services would represent an economically meaningful threshold value. We first show that if we assume that the least cost-effective services are displaced to finance a new technology, then the incremental cost-effectiveness ratio (ICER) of the displaced services (d) only coincides with that related to the opportunity cost of adopting that new technology, the ICER of the most cost-effective service in expansion (n), under highly restrictive conditions-namely, complete allocative efficiency in existing provision of health care interventions. More generally, reimbursement of new technology with a fixed budget comprises two actions; adoption and financing through displacement and the effect of reimbursement is the net effect of these two actions. In order for the reimbursement process to be a pathway to allocative efficiency within a fixed budget, the net effect of the strategy of reimbursement is compared with the most cost-effective alternative strategy for reimbursement: optimal reallocation, the health gain maximizing expansion of existing services financed by the health loss minimizing contraction. The shadow price of the health effects of a new technology, βc = (1/n + 1/d - 1/m)(-1), accounts for both imperfect displacement (the ICER of the displaced service, d < m, the ICER of the least cost-effective of the existing services in contraction) and the allocative inefficiency (n < m) characteristic of health systems.

Oil palm biomass as an adsorbent for heavy metals.

PubMed

Vakili, Mohammadtaghi; Rafatullah, Mohd; Ibrahim, Mahamad Hakimi; Abdullah, Ahmad Zuhairi; Salamatinia, Babak; Gholami, Zahra

2014-01-01

Many industries discharge untreated wastewater into the environment. Heavy metals from many industrial processes end up as hazardous pollutants of wastewaters.Heavy metal pollution has increased in recent decades and there is a growing concern for the public health risk they may pose. To remove heavy metal ions from polluted waste streams, adsorption processes are among the most common and effective treatment methods. The adsorbents that are used to remove heavy metal ions from aqueous media have both advantages and disadvantages. Cost and effectiveness are two of the most prominent criteria for choosing adsorbents. Because cost is so important, great effort has been extended to study and find effective lower cost adsorbents.One class of adsorbents that is gaining considerable attention is agricultural wastes. Among many alternatives, palm oil biomasses have shown promise as effective adsorbents for removing heavy metals from wastewater. The palm oil industry has rapidly expanded in recent years, and a large amount of palm oil biomass is available. This biomass is a low-cost agricultural waste that exhibits, either in its raw form or after being processed, the potential for eliminating heavy metal ions from wastewater. In this article, we provide background information on oil palm biomass and describe studies that indicate its potential as an alternative adsorbent for removing heavy metal ions from wastewater. From having reviewed the cogent literature on this topic we are encouraged that low-cost oil-palm-related adsorbents have already demonstrated outstanding removal capabilities for various pollutants.Because cost is so important to those who choose to clean waste streams by using adsorbents, the use of cheap sources of unconventional adsorbents is increasingly being investigated. An adsorbent is considered to be inexpensive when it is readily available, is environmentally friendly, is cost-effective and be effectively used in economical processes. The advantages that oil palm biomass has includes the following:available and exists in abundance, appears to be effective technically, and can be integrated into existing processes. Despite these advantages, oil palm biomasses have disadvantages such as low adsorption capacity, increased COD, BOD and TOC. These disadvantages can be overcome by modifying the biomass either chemically or thermally. Such modification creates a charged surface and increases the heavy metal ion binding capacity of the adsorbent.

Perceptual grouping does not affect multi-attribute decision making if no processing costs are involved.

PubMed

Ettlin, Florence; Bröder, Arndt

2015-05-01

Adaptive strategy selection implies that a decision strategy is chosen based on its fit to the task and situation. However, other aspects, such as the way information is presented, can determine information search behavior; especially when the application of certain strategies over others is facilitated. But are such display effects on multi-attribute decisions also at work when the manipulation does not entail differential costs for different decision strategies? Three Mouselab experiments with hidden information and one eye tracking experiment with an open information board revealed that decision behavior is unaffected by purely perceptual manipulations of the display based on Gestalt principles; that is, based on manipulations that induce no noteworthy processing costs for different information search patterns. We discuss our results in the context of previous findings on display effects; specifically, how the combination of these findings and our results reveal the crucial role of differential processing costs for different strategies for the emergence of display effects. This finding describes a boundary condition of the commonly acknowledged influence of information displays and is in line with the ideas of adaptive strategy selection and cost-benefit tradeoffs. Copyright © 2015. Published by Elsevier B.V.

Low cost solar array project production process and equipment task. A Module Experimental Process System Development Unit (MEPSDU)

NASA Technical Reports Server (NTRS)

1981-01-01

Technical readiness for the production of photovoltaic modules using single crystal silicon dendritic web sheet material is demonstrated by: (1) selection, design and implementation of solar cell and photovoltaic module process sequence in a Module Experimental Process System Development Unit; (2) demonstration runs; (3) passing of acceptance and qualification tests; and (4) achievement of a cost effective module.

Modeling the Downstream Processing of Monoclonal Antibodies Reveals Cost Advantages for Continuous Methods for a Broad Range of Manufacturing Scales.

PubMed

Hummel, Jonathan; Pagkaliwangan, Mark; Gjoka, Xhorxhi; Davidovits, Terence; Stock, Rick; Ransohoff, Thomas; Gantier, Rene; Schofield, Mark

2018-01-17

The biopharmaceutical industry is evolving in response to changing market conditions, including increasing competition and growing pressures to reduce costs. Single-use (SU) technologies and continuous bioprocessing have attracted attention as potential facilitators of cost-optimized manufacturing for monoclonal antibodies. While disposable bioprocessing has been adopted at many scales of manufacturing, continuous bioprocessing has yet to reach the same level of implementation. In this study, the cost of goods of Pall Life Science's integrated, continuous bioprocessing (ICB) platform is modeled, along with that of purification processes in stainless-steel and SU batch formats. All three models include costs associated with downstream processing only. Evaluation of the models across a broad range of clinical and commercial scenarios reveal that the cost savings gained by switching from stainless-steel to SU batch processing are often amplified by continuous operation. The continuous platform exhibits the lowest cost of goods across 78% of all scenarios modeled here, with the SU batch process having the lowest costs in the rest of the cases. The relative savings demonstrated by the continuous process are greatest at the highest feed titers and volumes. These findings indicate that existing and imminent continuous technologies and equipment can become key enablers for more cost effective manufacturing of biopharmaceuticals. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Process engineering economics of bioethanol production.

PubMed

Galbe, Mats; Sassner, Per; Wingren, Anders; Zacchi, Guido

2007-01-01

This work presents a review of studies on the process economics of ethanol production from lignocellulosic materials published since 1996. Our objective was to identify the most costly process steps and the impact of various parameters on the final production cost, e.g. plant capacity, raw material cost, and overall product yield, as well as process configuration. The variation in estimated ethanol production cost is considerable, ranging from about 0.13 to 0.81 US$ per liter ethanol. This can be explained to a large extent by actual process differences and variations in the assumptions underlying the techno-economic evaluations. The most important parameters for the economic outcome are the feedstock cost, which varied between 30 and 90 US$ per metric ton in the papers studied, and the plant capacity, which influences the capital cost. To reduce the ethanol production cost it is necessary to reach high ethanol yields, as well as a high ethanol concentration during fermentation, to be able to decrease the energy required for distillation and other downstream process steps. Improved pretreatment methods, enhanced enzymatic hydrolysis with cheaper and more effective enzymes, as well as improved fermentation systems present major research challenges if we are to make lignocellulose-based ethanol production competitive with sugar- and starch-based ethanol. Process integration, either internally or externally with other types of plants, e.g. heat and power plants, also offers a way of reducing the final ethanol production cost.

Machine learning-based method for personalized and cost-effective detection of Alzheimer's disease.

PubMed

Escudero, Javier; Ifeachor, Emmanuel; Zajicek, John P; Green, Colin; Shearer, James; Pearson, Stephen

2013-01-01

Diagnosis of Alzheimer's disease (AD) is often difficult, especially early in the disease process at the stage of mild cognitive impairment (MCI). Yet, it is at this stage that treatment is most likely to be effective, so there would be great advantages in improving the diagnosis process. We describe and test a machine learning approach for personalized and cost-effective diagnosis of AD. It uses locally weighted learning to tailor a classifier model to each patient and computes the sequence of biomarkers most informative or cost-effective to diagnose patients. Using ADNI data, we classified AD versus controls and MCI patients who progressed to AD within a year, against those who did not. The approach performed similarly to considering all data at once, while significantly reducing the number (and cost) of the biomarkers needed to achieve a confident diagnosis for each patient. Thus, it may contribute to a personalized and effective detection of AD, and may prove useful in clinical settings.

Cost-effectiveness of hospital pay-for-performance incentives.

PubMed

Nahra, Tammie A; Reiter, Kristin L; Hirth, Richard A; Shermer, Janet E; Wheeler, John R C

2006-02-01

One increasingly popular mechanism for stimulating quality improvements is pay-for-performance, or incentive, programs. This article examines the cost-effectiveness of a hospital incentive system for heart-related care, using a principal-agent model, where the insurer is the principal and hospitals are the agents. Four-year incentive system costsfor the payer were dollar 22,059,383, composed primarily of payments to the participating hospitals, with approximately 5 percent in administrative costs. Effectiveness is measured in stages, beginning with improvements in the processes of heart care. Care process improvements are converted into quality-adjusted life years (QALYs) gained, with reference to literatures on clinical effectiveness and survival. An estimated 24,418 patients received improved care, resulting in a range of QALYs from 733 to 1,701, depending on assumptions about clinical effectiveness. Cost per QALY was found to be between dollar 12,967 and dollar 30,081, a level well under consensus measures of the value of a QALY.

Principles of operating room organization.

PubMed

Watkins, W D

1997-01-01

The importance of the changing health care climate has triggered important changes in the management of high-cost components of acute care facilities. By integrating and better managing various elements of the surgical process, health care institutions are able to rationally trim costs while maintaining high-quality services. The leadership that physicians can provide is crucial to the success of this undertaking (1). The importance of the use of primary data related to patient throughput and related resources should be strongly emphasized, for only when such data are converted to INFORMATION of functional value can participating healthcare personnel be reasonably expected to anticipate and respond to varying clinical demands with ever-limited resources. Despite the claims of specific commercial vendors, no single product will likely be sufficient to significantly change the perioperative process to the degree or for the duration demanded by healthcare reform. The most effective approach to achieving safety, cost-effectiveness, and predictable process in the realm of Surgical Services will occur by appropriate application of the "best of breed" contributions of: (a) medical/patient safety practice/oversight; (b) information technology; (c) contemporary management; and (d) innovative and functional cost-accounting methodology. S "modified activity-based cost accounting method" can serve as the basis for acquiring true direct-cost information related to the perioperative process. The proposed overall management strategy emphasizes process and feedback, rather than specific product, and although imposing initial demands and change on the traditional hospital setting, can advance the strongest competitive position in perioperative services. This comprehensive approach comprises a functional basis for important bench-marking activities among multiple surgical services. An active, comparative process of this type is of paramount importance in emphasizing patient care and safety as the highest priority while changing the process and cost of perioperative care. Additionally, this approach objectively defines the surgical process in terms by which the impact of new treatments, drugs, devices and process changes can be assessed rationally.

Cost-effective strategy to mitigate transportation disruptions in supply chain

NASA Astrophysics Data System (ADS)

Albertzeth, G.; Pujawan, I. N.

2018-04-01

Supply chain disruptions have gained significant attention by scholars. But, even though transportation plays a central role in supply chain, only few studies address transportation disruptions. This research demonstrates a real case of an order delivery process from a focal company (FC) to a single distributor, where transportation disruptions stochastically occurs. Considering the possibility of sales loss during the disruption duration, we proposed a redundant stock, flexible route, and combined flexibility-redundancy (ReFlex) as mitigation strategies and a base case as a risk acceptance strategy. The objective is to find out the best strategy that promotes cost-effectiveness against transportation disruptions. To fulfill this objective, we use simulation modeling and cost-effectiveness analysis (CEA) as our research method. We simulate the delivery process of 5 brands using each strategy to produce two different responses: loss of sales percentage and the incurred costs. Next, using these responses, we evaluate and compare the cost-effectiveness ratio of each strategy using CEA. We found that redundant stock gave the best effectiveness on all brands, ReFlex as the second best, while flexible route gave the least effectiveness. Finally, we recommend which strategy should be applied based on the decision maker willingness to pay.

Automated aray assembly, phase 2

NASA Technical Reports Server (NTRS)

Daiello, R. V.

1979-01-01

A manufacturing process suitable for the large-scale production of silicon solar array modules at a cost of less than $500/peak kW is described. Factors which control the efficiency of ion implanted silicon solar cells, screen-printed thick film metallization, spray-on antireflection coating process, and panel assembly are discussed. Conclusions regarding technological readiness or cost effectiveness of individual process steps are presented.

Cost analysis of colorectal cancer screening with CT colonography in Italy.

PubMed

Mantellini, Paola; Lippi, Giuseppe; Sali, Lapo; Grazzini, Grazia; Delsanto, Silvia; Mallardi, Beatrice; Falchini, Massimo; Castiglione, Guido; Carozzi, Francesca Maria; Mascalchi, Mario; Milani, Stefano; Ventura, Leonardo; Zappa, Marco

2018-06-01

Unit costs of screening CT colonography (CTC) can be useful for cost-effectiveness analyses and for health care decision-making. We evaluated the unit costs of CTC as a primary screening test for colorectal cancer in the setting of a randomized trial in Italy. Data were collected within the randomized SAVE trial. Subjects were invited to screening CTC by mail and requested to have a pre-examination consultation. CTCs were performed with 64- and 128-slice CT scanners after reduced or full bowel preparation. Activity-based costing was used to determine unit costs per-process, per-participant to screening CTC, and per-subject with advanced neoplasia. Among 5242 subjects invited to undergo screening CTC, 1312 had pre-examination consultation and 1286 ultimately underwent CTC. Among 129 subjects with a positive CTC, 126 underwent assessment colonoscopy and 67 were ultimately diagnosed with advanced neoplasia (i.e., cancer or advanced adenoma). Cost per-participant of the entire screening CTC pathway was €196.80. Average cost per-participant for the screening invitation process was €17.04 and €9.45 for the pre-examination consultation process. Average cost per-participant of the CTC execution and reading process was €146.08 and of the diagnostic assessment colonoscopy process was €24.23. Average cost per-subject with advanced neoplasia was €3777.30. Cost of screening CTC was €196.80 per-participant. Our data suggest that the more relevant cost of screening CTC, amenable of intervention, is related to CTC execution and reading process.

An experimental strategy validated to design cost-effective culture media based on response surface methodology.

PubMed

Navarrete-Bolaños, J L; Téllez-Martínez, M G; Miranda-López, R; Jiménez-Islas, H

2017-07-03

For any fermentation process, the production cost depends on several factors, such as the genetics of the microorganism, the process condition, and the culture medium composition. In this work, a guideline for the design of cost-efficient culture media using a sequential approach based on response surface methodology is described. The procedure was applied to analyze and optimize a culture medium of registered trademark and a base culture medium obtained as a result of the screening analysis from different culture media used to grow the same strain according to the literature. During the experiments, the procedure quantitatively identified an appropriate array of micronutrients to obtain a significant yield and find a minimum number of culture medium ingredients without limiting the process efficiency. The resultant culture medium showed an efficiency that compares favorably with the registered trademark medium at a 95% lower cost as well as reduced the number of ingredients in the base culture medium by 60% without limiting the process efficiency. These results demonstrated that, aside from satisfying the qualitative requirements, an optimum quantity of each constituent is needed to obtain a cost-effective culture medium. Study process variables for optimized culture medium and scaling-up production for the optimal values are desirable.

Further Evidence on the Effect of Acquisition Policy and Process on Cost Growth

DTIC Science & Technology

2016-04-30

bust periods. A complete summary also would need to take into account parallel analyses for the boom periods and the comparisons of cost growth in...qÜáêíÉÉåíÜ=^ååì~ä= ^Åèìáëáíáçå=oÉëÉ~êÅÜ= póãéçëáìã= tÉÇåÉëÇ~ó=pÉëëáçåë= sçäìãÉ=f= = Further Evidence on the Effect of Acquisition Policy and Process on Cost ...Goeller, Defense Acquisition Analyst, Institute for Defense Analyses Stanley Horowitz, Assistant Director, Cost Analysis and Research Division

How do we evaluate the cost of healthcare technology?

NASA Astrophysics Data System (ADS)

Nobel, Joel J.

1994-12-01

Five critical questions apply when evaluating the cost of healthcare technology: Who is asking the question (of how to evaluate healthcare costs)? For what purpose? What is the nature of the decision that must be made? At what state of a technology's development and diffusion are the questions being posed? What type of technology is stimulating the questions? A large number of organizations, both national and international, are engaged in technology assessment, and constructive disagreement improves the overall quality of those assessments. Current cost measurements tools such as cost-utility analysis, cost-benefit analysis, cost- effectiveness analysis, and outcomes research are weak and ineffective. Recently, pharmaceutical manufacturers have adopted more global cost-effectiveness studies. Technology assessments will ultimately focus on examining the relative cost-effectiveness of alternative technologies for a specific pathology or examining the relative cost-effectiveness of alternative technologies for a specific pathology or DRG. In addition to the traditional healthcare facility--hospital, outpatient facility, or group practice, group purchasing organizations are also asking about cost-effectiveness of healthcare. ECRI's SELECTTM process, unlike less effective technology assessments, takes into account real-world user experience data and life-cycle cost analysis in addition to detailed comparisons of technical features and performance.

Extending Beowulf Clusters

USGS Publications Warehouse

Steinwand, Daniel R.; Maddox, Brian; Beckmann, Tim; Hamer, George

2003-01-01

Beowulf clusters can provide a cost-effective way to compute numerical models and process large amounts of remote sensing image data. Usually a Beowulf cluster is designed to accomplish a specific set of processing goals, and processing is very efficient when the problem remains inside the constraints of the original design. There are cases, however, when one might wish to compute a problem that is beyond the capacity of the local Beowulf system. In these cases, spreading the problem to multiple clusters or to other machines on the network may provide a cost-effective solution.

Costing improvement of remanufacturing crankshaft by integrating Mahalanobis-Taguchi System and Activity based Costing

NASA Astrophysics Data System (ADS)

Abu, M. Y.; Nor, E. E. Mohd; Rahman, M. S. Abd

2018-04-01

Integration between quality and costing system is very crucial in order to achieve an accurate product cost and profit. Current practice by most of remanufacturers, there are still lacking on optimization during the remanufacturing process which contributed to incorrect variables consideration to the costing system. Meanwhile, traditional costing accounting being practice has distortion in the cost unit which lead to inaccurate cost of product. The aim of this work is to identify the critical and non-critical variables during remanufacturing process using Mahalanobis-Taguchi System and simultaneously estimate the cost using Activity Based Costing method. The orthogonal array was applied to indicate the contribution of variables in the factorial effect graph and the critical variables were considered with overhead costs that are actually demanding the activities. This work improved the quality inspection together with costing system to produce an accurate profitability information. As a result, the cost per unit of remanufactured crankshaft of MAN engine model with 5 critical crankpins is MYR609.50 while Detroit engine model with 4 critical crankpins is MYR1254.80. The significant of output demonstrated through promoting green by reducing re-melting process of damaged parts to ensure consistent benefit of return cores.

Process, cost, and clinical quality: the initial oral contraceptive visit.

PubMed

McMullen, Michael J; Woolford, Samuel W; Moore, Charles L; Berger, Barry M

2013-01-01

To demonstrate how the analysis of clinical process, cost, and outcomes can identify healthcare improvements that reduce cost without sacrificing quality, using the example of the initial visit associated with oral contraceptive pill use. Cross-sectional study using data collected by HealthMETRICS between 1996 and 2009. Using data collected from 106 sites in 24 states, the unintended pregnancy (UIP) rate, effectiveness of patient education, and unit visit cost were calculated. Staff type providing education and placement of education were recorded. Two-way analysis of variance models were created and tested for significance to identify differences between groups. Sites using nonclinical staff to provide education outside the exam were associated with lower cost, higher education scores, and a UIP rate no different from that of sites using clinical staff. Sites also providing patient education during the physical examination were associated with higher cost, lower education scores, and a UIP rate no lower than that of sites providing education outside of the exam. Through analyzing process, cost, and quality, lower-cost processes that did not reduce clinical quality were identified. This methodology is applicable to other clinical services for identifying low-cost processes that do not result in lower clinical quality. By using nonclinical staff educators to provide education outside of the physical examination, sites could save an average of 32% of the total cost of the visit.

[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…

A Decision Tool that Combines Discrete Event Software Process Models with System Dynamics Pieces for Software Development Cost Estimation and Analysis

NASA Technical Reports Server (NTRS)

Mizell, Carolyn Barrett; Malone, Linda

2007-01-01

The development process for a large software development project is very complex and dependent on many variables that are dynamic and interrelated. Factors such as size, productivity and defect injection rates will have substantial impact on the project in terms of cost and schedule. These factors can be affected by the intricacies of the process itself as well as human behavior because the process is very labor intensive. The complex nature of the development process can be investigated with software development process models that utilize discrete event simulation to analyze the effects of process changes. The organizational environment and its effects on the workforce can be analyzed with system dynamics that utilizes continuous simulation. Each has unique strengths and the benefits of both types can be exploited by combining a system dynamics model and a discrete event process model. This paper will demonstrate how the two types of models can be combined to investigate the impacts of human resource interactions on productivity and ultimately on cost and schedule.

Array automated assembly task low cost silicon solar array project, phase 2

NASA Technical Reports Server (NTRS)

Olson, C.

1980-01-01

Analyses of solar cell and module process steps for throughput rate, cost effectiveness, and reproductibility are reported. In addition to the concentration on cell and module processing sequences, an investigation was made into the capability of using microwave energy in the diffusion, sintering, and thick film firing steps of cell processing. Although the entire process sequence was integrated, the steps are treated individually with test and experimental data, conclusions, and recommendations.

Process development and exergy cost sensitivity analysis of a hybrid molten carbonate fuel cell power plant and carbon dioxide capturing process

NASA Astrophysics Data System (ADS)

Mehrpooya, Mehdi; Ansarinasab, Hojat; Moftakhari Sharifzadeh, Mohammad Mehdi; Rosen, Marc A.

2017-10-01

An integrated power plant with a net electrical power output of 3.71 × 105 kW is developed and investigated. The electrical efficiency of the process is found to be 60.1%. The process includes three main sub-systems: molten carbonate fuel cell system, heat recovery section and cryogenic carbon dioxide capturing process. Conventional and advanced exergoeconomic methods are used for analyzing the process. Advanced exergoeconomic analysis is a comprehensive evaluation tool which combines an exergetic approach with economic analysis procedures. With this method, investment and exergy destruction costs of the process components are divided into endogenous/exogenous and avoidable/unavoidable parts. Results of the conventional exergoeconomic analyses demonstrate that the combustion chamber has the largest exergy destruction rate (182 MW) and cost rate (13,100 /h). Also, the total process cost rate can be decreased by reducing the cost rate of the fuel cell and improving the efficiency of the combustion chamber and heat recovery steam generator. Based on the total avoidable endogenous cost rate, the priority for modification is the heat recovery steam generator, a compressor and a turbine of the power plant, in rank order. A sensitivity analysis is done to investigate the exergoeconomic factor parameters through changing the effective parameter variations.

Economics of polysilicon processes

NASA Technical Reports Server (NTRS)

Yaws, C. L.; Li, K. Y.; Chou, S. M.

1986-01-01

Techniques are being developed to provide lower cost polysilicon material for solar cells. Existing technology which normally provides semiconductor industry polysilicon material is undergoing changes and also being used to provide polysilicon material for solar cells. Economics of new and existing technologies are presented for producing polysilicon. The economics are primarily based on the preliminary process design of a plant producing 1,000 metric tons/year of silicon. The polysilicon processes include: Siemen's process (hydrogen reduction of trichlorosilane); Union Carbide process (silane decomposition); and Hemlock Semiconductor process (hydrogen reduction of dichlorosilane). The economics include cost estimates of capital investment and product cost to produce polysilicon via the technology. Sensitivity analysis results are also presented to disclose the effect of major paramentes such as utilities, labor, raw materials and capital investment.

Development of hybrid lifecycle cost estimating tool (HLCET) for manufacturing influenced design tradeoff

NASA Astrophysics Data System (ADS)

Sirirojvisuth, Apinut

In complex aerospace system design, making an effective design decision requires multidisciplinary knowledge from both product and process perspectives. Integrating manufacturing considerations into the design process is most valuable during the early design stages since designers have more freedom to integrate new ideas when changes are relatively inexpensive in terms of time and effort. Several metrics related to manufacturability are cost, time, and manufacturing readiness level (MRL). Yet, there is a lack of structured methodology that quantifies how changes in the design decisions impact these metrics. As a result, a new set of integrated cost analysis tools are proposed in this study to quantify the impacts. Equally important is the capability to integrate this new cost tool into the existing design methodologies without sacrificing agility and flexibility required during the early design phases. To demonstrate the applicability of this concept, a ModelCenter environment is used to develop software architecture that represents Integrated Product and Process Development (IPPD) methodology used in several aerospace systems designs. The environment seamlessly integrates product and process analysis tools and makes effective transition from one design phase to the other while retaining knowledge gained a priori. Then, an advanced cost estimating tool called Hybrid Lifecycle Cost Estimating Tool (HLCET), a hybrid combination of weight-, process-, and activity-based estimating techniques, is integrated with the design framework. A new weight-based lifecycle cost model is created based on Tailored Cost Model (TCM) equations [3]. This lifecycle cost tool estimates the program cost based on vehicle component weights and programmatic assumptions. Additional high fidelity cost tools like process-based and activity-based cost analysis methods can be used to modify the baseline TCM result as more knowledge is accumulated over design iterations. Therefore, with this concept, the additional manufacturing knowledge can be used to identify a more accurate lifecycle cost and facilitate higher fidelity tradeoffs during conceptual and preliminary design. Advanced Composite Cost Estimating Model (ACCEM) is employed as a process-based cost component to replace the original TCM result of the composite part production cost. The reason for the replacement is that TCM estimates production costs from part weights as a result of subtractive manufacturing of metallic origin such as casting, forging, and machining processes. A complexity factor can sometimes be adjusted to reflect different types of metal and machine settings. The TCM assumption, however, gives erroneous results when applied to additive processes like those of composite manufacturing. Another innovative aspect of this research is the introduction of a work measurement technique called Maynard Operation Sequence Technique (MOST) to be used, similarly to Activity-Based Costing (ABC) approach, to estimate manufacturing time of a part by virtue of breaking down the operations occurred during its production. ABC allows a realistic determination of cost incurred in each activity, as opposed to using a traditional method of time estimation by analogy or using response surface equations from historical process data. The MOST concept provides a tailored study of an individual process typically required for a new, innovative design. Nevertheless, the MOST idea has some challenges, one of which is its requirement to build a new process from ground up. The process development requires a Subject Matter Expertise (SME) in manufacturing method of the particular design. The SME must have also a comprehensive understanding of the MOST system so that the correct parameters are chosen. In practice, these knowledge requirements may demand people from outside of the design discipline and a priori training of MOST. To relieve the constraint, this study includes an entirely new sub-system architecture that comprises 1) a knowledge-based system to provide the required knowledge during the process selection; and 2) a new user-interface to guide the parameter selection when building the process using MOST. Also included in this study is the demonstration of how the HLCET and its constituents can be integrated with a Georgia Tech' Integrated Product and Process Development (IPPD) methodology. The applicability of this work will be shown through a complex aerospace design example to gain insights into how manufacturing knowledge helps make better design decisions during the early stages. The setup process is explained with an example of its utility demonstrated in a hypothetical fighter aircraft wing redesign. The evaluation of the system effectiveness against existing methodologies is illustrated to conclude the thesis.

Verifying different-modality properties for concepts produces switching costs.

PubMed

Pecher, Diane; Zeelenberg, René; Barsalou, Lawrence W

2003-03-01

According to perceptual symbol systems, sensorimotor simulations underlie the representation of concepts. It follows that sensorimotor phenomena should arise in conceptual processing. Previous studies have shown that switching from one modality to another during perceptual processing incurs a processing cost. If perceptual simulation underlies conceptual processing, then verifying the properties of concepts should exhibit a switching cost as well. For example, verifying a property in the auditory modality (e.g., BLENDER-loud) should be slower after verifying a property in a different modality (e.g., CRANBERRIES-tart) than after verifying a property in the same modality (e.g., LEAVES-rustling). Only words were presented to subjects, and there were no instructions to use imagery. Nevertheless, switching modalities incurred a cost, analogous to the cost of switching modalities in perception. A second experiment showed that this effect was not due to associative priming between properties in the same modality. These results support the hypothesis that perceptual simulation underlies conceptual processing.

Cognitive Constraints and Island Effects

PubMed Central

Hofmeister, Philip; Sag, Ivan A.

2012-01-01

Competence-based theories of island effects play a central role in generative grammar, yet the graded nature of many syntactic islands has never been properly accounted for. Categorical syntactic accounts of island effects have persisted in spite of a wealth of data suggesting that island effects are not categorical in nature and that non-structural manipulations that leave island structures intact can radically alter judgments of island violations. We argue here, building on work by Deane, Kluender, and others, that processing factors have the potential to account for this otherwise unexplained variation in acceptability judgments. We report the results of self-paced reading experiments and controlled acceptability studies which explore the relationship between processing costs and judgments of acceptability. In each of the three self-paced reading studies, the data indicate that the processing cost of different types of island violations can be significantly reduced to a degree comparable to that of non-island filler-gap constructions by manipulating a single non-structural factor. Moreover, this reduction in processing cost is accompanied by significant improvements in acceptability. This evidence favors the hypothesis that island-violating constructions involve numerous processing pressures that aggregate to drive processing difficulty above a threshold so that a perception of unacceptability ensues. We examine the implications of these findings for the grammar of filler-gap dependencies.* PMID:22661792

Quality Function Deployment for Large Systems

NASA Technical Reports Server (NTRS)

Dean, Edwin B.

1992-01-01

Quality Function Deployment (QFD) is typically applied to small subsystems. This paper describes efforts to extend QFD to large scale systems. It links QFD to the system engineering process, the concurrent engineering process, the robust design process, and the costing process. The effect is to generate a tightly linked project management process of high dimensionality which flushes out issues early to provide a high quality, low cost, and, hence, competitive product. A pre-QFD matrix linking customers to customer desires is described.

Producing High-Quality Titanium Alloy by a Cost-Effective Route Combining Fast Heating and Hot Processing

NASA Astrophysics Data System (ADS)

Yang, Fei; Raynova, Stella; Singh, Ajit; Zhao, Qinyang; Romero, Carlos; Bolzoni, Leandro

2018-02-01

Powder metallurgy is a very attractive method for producing titanium alloys, which can be near-net-shape formed and have freedom in composition selection. However, applications are still limited due to product affordability. In this paper, we will discuss a possible cost-effective route, combining fast heating and hot processing, to produce titanium alloys with similar or even better mechanical properties than that of ingot metallurgy titanium alloys. Two titanium alloys, Ti-5Al-5V-5Mo-3Cr (Ti-5553) and Ti-5Fe, were successfully produced from HDH titanium powder and other master alloy powders using the proposed processing route. The effect of the processing route on microstructural variation and mechanical properties have been discussed.

A Process Management System for Networked Manufacturing

NASA Astrophysics Data System (ADS)

Liu, Tingting; Wang, Huifen; Liu, Linyan

With the development of computer, communication and network, networked manufacturing has become one of the main manufacturing paradigms in the 21st century. Under the networked manufacturing environment, there exist a large number of cooperative tasks susceptible to alterations, conflicts caused by resources and problems of cost and quality. This increases the complexity of administration. Process management is a technology used to design, enact, control, and analyze networked manufacturing processes. It supports efficient execution, effective management, conflict resolution, cost containment and quality control. In this paper we propose an integrated process management system for networked manufacturing. Requirements of process management are analyzed and architecture of the system is presented. And a process model considering process cost and quality is developed. Finally a case study is provided to explain how the system runs efficiently.

Process for purification of solids

NASA Technical Reports Server (NTRS)

Herzer, H.; Rath, H. J.; Schmidt, D.

1981-01-01

A process for purifying solids, especially silicon, by melting and subsequent resolidification, is described. Silicon used in solar cell manufacturing is processed more efficiently and cost effectively.

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.

Effects of noise upon human information processing

NASA Technical Reports Server (NTRS)

Cohen, H. H.; Conrad, D. W.; Obrien, J. F.; Pearson, R. G.

1974-01-01

Studies of noise effects upon human information processing are described which investigated whether or not effects of noise upon performance are dependent upon specific characteristics of noise stimulation and their interaction with task conditions. The difficulty of predicting noise effects was emphasized. Arousal theory was considered to have explanatory value in interpreting the findings of all the studies. Performance under noise was found to involve a psychophysiological cost, measured by vasoconstriction response, with the degree of response cost being related to scores on a noise annoyance sensitivity scale. Noise sensitive subjects showed a greater autonomic response under noise stimulation.

[Calculation of workers' health care costs].

PubMed

Rydlewska-Liszkowska, Izabela

2006-01-01

In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference subjects as cost objects and taking account of all their interrelations. Final products, specific assignments, resources and activities may all be regarded as cost objects. The ABC method is characterized by a very high informative value in terms of setting prices of products in the area of workers' health care. It also facilitates the assessment of costs of individual activities under a multidisciplinary approach to health care and the setting costs of varied products. The ABC method provides precise data on the consumption of resources, such as human labor or various materials.

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.

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.

Scenario drafting to anticipate future developments in technology assessment.

PubMed

Retèl, Valesca P; Joore, Manuela A; Linn, Sabine C; Rutgers, Emiel J T; van Harten, Wim H

2012-08-16

Health Technology Assessment (HTA) information, and in particular cost-effectiveness data is needed to guide decisions, preferably already in early stages of technological development. However, at that moment there is usually a high degree of uncertainty, because evidence is limited and different development paths are still possible. We developed a multi-parameter framework to assess dynamic aspects of a technology -still in development-, by means of scenario drafting to determine the effects, costs and cost-effectiveness of possible future diffusion patterns. Secondly, we explored the value of this method on the case of the clinical implementation of the 70-gene signature for breast cancer, a gene expression profile for selecting patients who will benefit most from chemotherapy. To incorporate process-uncertainty, ten possible scenarios regarding the introduction of the 70-gene signature were drafted with European experts. Out of 5 most likely scenarios, 3 drivers of diffusion (non-compliance, technical failure, and uptake) were quantitatively integrated in a decision-analytical model. For these scenarios, the cost-effectiveness of the 70-gene signature expressed in Incremental Cost-Effectiveness Ratios (ICERs) was compared to clinical guidelines, calculated from the past (2005) until the future (2020). In 2005 the ICER was €1,9 million/quality-adjusted-life-year (QALY), meaning that the 70-gene signature was not yet cost-effective compared to the current clinical guideline. The ICER for the 70-gene signature improved over time with a range of €1,9 million to €26,145 in 2010 and €1,9 million to €11,123/QALY in 2020 depending on the separate scenario used. From 2010, the 70-gene signature should be cost-effective, based on the combined scenario. The uptake-scenario had strongest influence on the cost-effectiveness. When optimal diffusion of a technology is sought, incorporating process-uncertainty by means of scenario drafting into a decision model may reveal unanticipated developments and can demonstrate a range of possible cost-effectiveness outcomes. The effect of scenarios give additional information on the speed with cost effectiveness might be reached and thus provide a more realistic picture for policy makers, opinion leaders and manufacturers.

Scenario drafting to anticipate future developments in technology assessment

PubMed Central

2012-01-01

Background Health Technology Assessment (HTA) information, and in particular cost-effectiveness data is needed to guide decisions, preferably already in early stages of technological development. However, at that moment there is usually a high degree of uncertainty, because evidence is limited and different development paths are still possible. We developed a multi-parameter framework to assess dynamic aspects of a technology -still in development-, by means of scenario drafting to determine the effects, costs and cost-effectiveness of possible future diffusion patterns. Secondly, we explored the value of this method on the case of the clinical implementation of the 70-gene signature for breast cancer, a gene expression profile for selecting patients who will benefit most from chemotherapy. Methods To incorporate process-uncertainty, ten possible scenarios regarding the introduction of the 70-gene signature were drafted with European experts. Out of 5 most likely scenarios, 3 drivers of diffusion (non-compliance, technical failure, and uptake) were quantitatively integrated in a decision-analytical model. For these scenarios, the cost-effectiveness of the 70-gene signature expressed in Incremental Cost-Effectiveness Ratios (ICERs) was compared to clinical guidelines, calculated from the past (2005) until the future (2020). Results In 2005 the ICER was €1,9 million/quality-adjusted-life-year (QALY), meaning that the 70-gene signature was not yet cost-effective compared to the current clinical guideline. The ICER for the 70-gene signature improved over time with a range of €1,9 million to €26,145 in 2010 and €1,9 million to €11,123/QALY in 2020 depending on the separate scenario used. From 2010, the 70-gene signature should be cost-effective, based on the combined scenario. The uptake-scenario had strongest influence on the cost-effectiveness. Conclusions When optimal diffusion of a technology is sought, incorporating process-uncertainty by means of scenario drafting into a decision model may reveal unanticipated developments and can demonstrate a range of possible cost-effectiveness outcomes. The effect of scenarios give additional information on the speed with cost effectiveness might be reached and thus provide a more realistic picture for policy makers, opinion leaders and manufacturers. PMID:22894140

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

PubMed

Peltokorpi, Antti; Kujala, Jaakko

2006-01-01

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

A cost-effective method for femoral head allograft procurement for spinal arthrodesis: an alternative to commercially available allograft.

PubMed

Brown, Desmond A; Mallory, Grant W; Higgins, Dominique M; Abdulaziz, Mohammed; Huddleston, Paul M; Nassr, Ahmad; Fogelson, Jeremy L; Clarke, Michelle J

2014-07-01

A cost-effective procurement process for harvesting, storing, and using femoral head allografts is described. A brief review of the literature on the use of these allografts and a discussion of costs are provided. To describe a cost-effective method for the harvesting, storage, and use of femoral heads from patients undergoing total hip arthroplasty at our institution as a source of allograft bone. Spine fusion surgery uses a large proportion of commercially available bone grafts and bone substitutes. As the number of such surgical procedures performed in the United States continues to rise, these materials are at a historically high level of demand, which is projected to continue. Iliac crest bone autograft has historically been the standard of care, although this may be losing favor due to potential donor site morbidity. Although many substitutes are effective in promoting arthrodesis, their use is limited because of cost. Femoral heads are harvested under sterile conditions during total hip arthroplasty. The patient is tested per Food and Drug Administration regulations, and the tissue sample is cultured. The tissue is frozen and quarantined for a 6-month minimum pending repeat testing of donors and subsequently released for use. The relative cost-effectiveness of this tissue as a source of allograft bone is discussed. The average femoral head allograft is 54 to 56 mm in diameter and yields 50 cm of bone graft, with an average cost of US $435 for processing of the tissue resulting in a cost of US $8.70 per cm of allograft produced. Average production costs are significantly lower than those for other commonly available commercial bone grafts and substitutes. Femoral head allograft is a cost-effective alternative to commercially available allografts and bone substitutes. The method of procurement, storage, and use described could be adopted by other institutions in an effort to mitigate cost and increase supply. N/A.

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

RTM: Cost-effective processing of composite structures

NASA Technical Reports Server (NTRS)

Hasko, Greg; Dexter, H. Benson

1991-01-01

Resin transfer molding (RTM) is a promising method for cost effective fabrication of high strength, low weight composite structures from textile preforms. In this process, dry fibers are placed in a mold, resin is introduced either by vacuum infusion or pressure, and the part is cured. RTM has been used in many industries, including automotive, recreation, and aerospace. Each of the industries has different requirements of material strength, weight, reliability, environmental resistance, cost, and production rate. These requirements drive the selection of fibers and resins, fiber volume fractions, fiber orientations, mold design, and processing equipment. Research is made into applying RTM to primary aircraft structures which require high strength and stiffness at low density. The material requirements are discussed of various industries, along with methods of orienting and distributing fibers, mold configurations, and processing parameters. Processing and material parameters such as resin viscosity, perform compaction and permeability, and tool design concepts are discussed. Experimental methods to measure preform compaction and permeability are presented.

A quality-based cost model for new electronic systems and products

NASA Astrophysics Data System (ADS)

Shina, Sammy G.; Saigal, Anil

1998-04-01

This article outlines a method for developing a quality-based cost model for the design of new electronic systems and products. The model incorporates a methodology for determining a cost-effective design margin allocation for electronic products and systems and its impact on manufacturing quality and cost. A spreadsheet-based cost estimating tool was developed to help implement this methodology in order for the system design engineers to quickly estimate the effect of design decisions and tradeoffs on the quality and cost of new products. The tool was developed with automatic spreadsheet connectivity to current process capability and with provisions to consider the impact of capital equipment and tooling purchases to reduce the product cost.

Integrating Efficiency of Industry Processes and Practices Alongside Technology Effectiveness in Space Transportation Cost Modeling and Analysis

NASA Technical Reports Server (NTRS)

Zapata, Edgar

2012-01-01

This paper presents past and current work in dealing with indirect industry and NASA costs when providing cost estimation or analysis for NASA projects and programs. Indirect costs, when defined as those costs in a project removed from the actual hardware or software hands-on labor; makes up most of the costs of today's complex large scale NASA space/industry projects. This appears to be the case across phases from research into development into production and into the operation of the system. Space transportation is the case of interest here. Modeling and cost estimation as a process rather than a product will be emphasized. Analysis as a series of belief systems in play among decision makers and decision factors will also be emphasized to provide context.

Commercialization of Kennedy Space Center Instrumentation Developed to Improve Safety, Reliability, Cost Effectiveness of Space Shuttle Processing, Launch, and Landing

NASA Technical Reports Server (NTRS)

Helms, William R.; Starr, Stanley O.

1997-01-01

Priorities and achievements of the Kennedy Space Center (KSF) Instrumentation Laboratories in improving operational safety and decreasing processing costs associated with the Shuttle vehicle are addressed. Technologies that have been or are in the process of technology transfer are reviewed, and routes by which commercial concerns can obtain licenses to other KSF Instrumentation Laboratory technologies are discussed.

Steam sterilization costs: a guide for the central service manager.

PubMed

O'Shaughnessy, K L

1993-07-01

The Nassau County Medical Center CS department, East Meadow, New York, was faced with a staff layoff and an increased workload. With some hard thinking and strong staff support, new processes/systems were designed to save time and money. These included outsourcing the sterilization of "easy" trays, instituting a case cart program and developing custom packs. In order to determine where savings could be had, it was first important to examine current costs. By breaking the costs of sterilization processing down into an average cost per load, a formula was developed that helped determine many additional cost comparisons for the department. For example, the cost analysis formula could be used by CS departments to determine the cost-effectiveness of off-site sterilization, to compare using disposable vs. reusable items and to determine costs for EtO sterilization and aeration.

Local health care expenditure plans and their opportunity costs.

PubMed

Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew

2015-09-01

In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Treatment of concentrated industrial wastewaters originating from oil shale and the like by electrolysis polyurethane foam interaction

DOEpatents

Tiernan, Joan E.

1990-01-01

Highly concentrated and toxic petroleum-based and synthetic fuels wastewaters such as oil shale retort water are treated in a unit treatment process by electrolysis in a reactor containing oleophilic, ionized, open-celled polyurethane foams and subjected to mixing and laminar flow conditions at an average detention time of six hours. Both the polyurethane foams and the foam regenerate solution are re-used. The treatment is a cost-effective process for waste-waters which are not treatable, or are not cost-effectively treatable, by conventional process series.

Boiler MACT Technical Assistance (Fact Sheet)

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

Not Available

2012-03-01

Fact sheet describing the changes to Environmental Protection Act process standards. The DOE will offer technical assistance to ensure that major sources burning coal and oil have information on cost-effective, clean energy strategies for compliance, and to promote cleaner, more efficient boiler burning to cut harmful pollution and reduce operational costs. The U.S. Environmental Protection Agency (EPA) is expected to finalize the reconsideration process for its Clean Air Act pollution standards National Emissions Standards for Hazardous Air Pollutants for Major Sources: Industrial, Commercial, and Institutional Boilers and Process Heaters (known as Boiler Maximum Achievable Control Technology (MACT)), in Spring 2012.more » This rule applies to large and small boilers in a wide range of industrial facilities and institutions. The U.S. Department of Energy (DOE) will offer technical assistance to ensure that major sources burning coal or oil have information on cost-effective clean energy strategies for compliance, including combined heat and power, and to promote cleaner, more efficient boilers to cut harmful pollution and reduce operational costs.« less

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

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

From A to Z: Medication Cost-Management Strategies for Disproportionate Share Hospitals

PubMed Central

Henry, Andrea; Erowele, Goldina Ikezuagu; Ndefo, Uche Anadu; Milton-Brown, Jackie; Anassi, Enock; Green, Wendy; Alvidrez, Adriana; Okpara, Alphonsus U.

2011-01-01

Background Harris County Hospital District, Houston, TX, is a publicly funded hospital system that provides care to residents of Harris County with a need-based payment system. The Harris County Hospital District pharmacy department, with a drug budget of more than $75 million in fiscal year 2010, utilizes a closed formulary system that is managed by the Formulary Management and Pharmacoeconomics Service, along with the medical staff. This service is comprised of clinical pharmacists whose goal is to provide a comprehensive, safe, and cost-effective formulary. Objective To describe the unique formulary management process at a county hospital system and what makes this process cost-effective, which may benefit pharmacy departments in institutions serving an indigent patient population. Summary The Harris County Hospital District drug formulary is overseen by the Pharmacy & Therapeutics committee, which is supported by 5 therapeutic subcommittees, including antimicrobials, cardiovascular, general formulary, central nervous system, and oncology. The Pharmacy & Therapeutics Committee consists of a medical staff committee that is supported by clinical pharmacists, who serve as the facilitators of these 5 subcommittees. Their responsibilities include the provision of drug information for formulary decisions, providing parameters to govern the use of certain medications, communicating changes to the formulary, conducting class reviews and medication utilization evaluations, coordinating annual pharmaceutical bids, reviewing and writing medication use policies and procedures, facilitating the use of cost-effective medications, and monitoring the use of medications in the hospital system. Conclusion The processes incorporated by Harris County Hospital District in its formulary management are cost-effective and may be beneficial to other pharmacy departments, especially those institutions that serve an indigent patient population and are interested in cost-effective management strategies. PMID:25126349

The role of cost-effectiveness analysis in developing nutrition policy.

PubMed

Cobiac, Linda J; Veerman, Lennert; Vos, Theo

2013-01-01

Concern about the overconsumption of unhealthy foods is growing worldwide. With high global rates of noncommunicable diseases related to poor nutrition and projections of more rapid increases of rates in low- and middle-income countries, it is vital to identify effective but low-cost interventions. Cost-effectiveness studies show that individually targeted dietary interventions can be effective and cost-effective, but a growing number of modeling studies suggest that population-wide approaches may bring larger and more sustained benefits for population health at a lower cost to society. Mandatory regulation of salt in processed foods, in particular, is highly recommended. Future research should focus on lacunae in the current evidence base: effectiveness of interventions addressing the marketing, availability, and price of healthy and unhealthy foods; modeling health impacts of complex dietary changes and multi-intervention strategies; and modeling health implications in diverse subpopulations to identify interventions that will most efficiently and effectively reduce health inequalities.

Novel cost controlled materials and processing for primary structures

NASA Technical Reports Server (NTRS)

Dastin, S. J.

1993-01-01

Textile laminates, developed a number of years ago, have recently been shown to be applicable to primary aircraft structures for both small and large components. Such structures have the potential to reduce acquisition costs but require advanced automated processing to keep costs controlled while verifying product reliability and assuring structural integrity, durability and affordable life-cycle costs. Recently, resin systems and graphite-reinforced woven shapes have been developed that have the potential for improved RTM processes for aircraft structures. Ciba-Geigy, Brochier Division has registered an RTM prepreg reinforcement called 'Injectex' that has shown effectivity for aircraft components. Other novel approaches discussed are thermotropic resins producing components by injection molding and ceramic polymers for long-duration hot structures. The potential of such materials and processing will be reviewed along with initial information/data available to date.

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.

A Module Experimental Process System Development Unit (MEPSDU). [flat plate solar arrays

NASA Technical Reports Server (NTRS)

1981-01-01

The development of a cost effective process sequence that has the potential for the production of flat plate photovoltaic modules which meet the price goal in 1986 of 70 cents or less per Watt peak is described. The major accomplishments include (1) an improved AR coating technique; (2) the use of sand blast back clean-up to reduce clean up costs and to allow much of the Al paste to serve as a back conductor; and (3) the development of wave soldering for use with solar cells. Cells were processed to evaluate different process steps, a cell and minimodule test plan was prepared and data were collected for preliminary Samics cost analysis.

Cost-effective conservation planning: lessons from economics.

PubMed

Duke, Joshua M; Dundas, Steven J; Messer, Kent D

2013-08-15

Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Software Development Simulation Model of a Spiral Process

NASA Technical Reports Server (NTRS)

Mizell, Carolyn; Malone, Linda

2007-01-01

There is a need for simulation models of software development processes other than the waterfall because processes such as spiral development are becoming more and more popular. The use of a spiral process can make the inherently difficult job of cost and schedule estimation even more challenging due to its evolutionary nature, but this allows for a more flexible process that can better meet customers' needs. This paper will present a discrete event simulation model of spiral development that can be used to analyze cost and schedule effects of using such a process in comparison to a waterfall process.

An Analytical Framework for Evaluating E-Commerce Business Models and Strategies.

ERIC Educational Resources Information Center

Lee, Chung-Shing

2001-01-01

Considers electronic commerce as a paradigm shift, or a disruptive innovation, and presents an analytical framework based on the theories of transaction costs and switching costs. Topics include business transformation process; scale effect; scope effect; new sources of revenue; and e-commerce value creation model and strategy. (LRW)

The Cost and Effectiveness of Solids Thickening Technologies for Treating Backwash and Recovering Nutrients from Intensive Aquaculture Systems

USDA-ARS?s Scientific Manuscript database

The cost and effectiveness of three solids thickening processes, i.e., gravity thickening settlers (GTS), inclined belt filters (IBF), geotextile bag filters (GBF), were individually evaluated with the biosolids backwash produced in intensive aquaculture systems equipped with microscreen drum filter...

The Manuscript That We Finished: Structural Separation Reduces the Cost of Complement Coercion

ERIC Educational Resources Information Center

Lowder, Matthew W.; Gordon, Peter C.

2015-01-01

Two eye-tracking experiments examined the effects of sentence structure on the processing of complement coercion, in which an event-selecting verb combines with a complement that represents an entity (e.g., "began the memo"). Previous work has demonstrated that these expressions impose a processing cost, which has been attributed to the…

[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.

Health services research in urology.

PubMed

Yu, Hua-Yin; Ulmer, William; Kowalczyk, Keith J; Hu, Jim C

2011-06-01

Health services research (HSR) is increasingly important given the focus on patient-centered, cost-effective, high-quality health care. We examine how HSR affects contemporary evidence-based urologic practice and its role in shaping future urologic research and care. PubMed, urologic texts, and lay literature were reviewed for terms pertaining to HSR/outcomes research and urologic disease processes. HSR is a broad discipline that focuses on access, cost, and outcomes of Health care. Its use has been applied to a myriad of urologic conditions to identify deficiencies in access, to evaluate cost-effectiveness of therapies, and to evaluate structural, process, and outcome quality measures. HSR utilizes an evidence-based approach to identify the most effective ways to organize/manage, finance, and deliver high-quality urologic care and to tailor care optimized to individuals.

Simulation Based Low-Cost Composite Process Development at the US Air Force Research Laboratory

NASA Technical Reports Server (NTRS)

Rice, Brian P.; Lee, C. William; Curliss, David B.

2003-01-01

Low-cost composite research in the US Air Force Research Laboratory, Materials and Manufacturing Directorate, Organic Matrix Composites Branch has focused on the theme of affordable performance. Practically, this means that we use a very broad view when considering the affordability of composites. Factors such as material costs, labor costs, recurring and nonrecurring manufacturing costs are balanced against performance to arrive at the relative affordability vs. performance measure of merit. The research efforts discussed here are two projects focused on affordable processing of composites. The first topic is the use of a neural network scheme to model cure reaction kinetics, then utilize the kinetics coupled with simple heat transport models to predict, in real-time, future exotherms and control them. The neural network scheme is demonstrated to be very robust and a much more efficient method that mechanistic cure modeling approach. This enables very practical low-cost processing of thick composite parts. The second project is liquid composite molding (LCM) process simulation. LCM processing of large 3D integrated composite parts has been demonstrated to be a very cost effective way to produce large integrated aerospace components specific examples of LCM processes are resin transfer molding (RTM), vacuum assisted resin transfer molding (VARTM), and other similar approaches. LCM process simulation is a critical part of developing an LCM process approach. Flow simulation enables the development of the most robust approach to introducing resin into complex preforms. Furthermore, LCM simulation can be used in conjunction with flow front sensors to control the LCM process in real-time to account for preform or resin variability.

Shared visions: Partnership of Rockwell International and NASA Cost Effectiveness Enhancements (CEE) for the space shuttle system integration program

NASA Technical Reports Server (NTRS)

Bejmuk, Bohdan I.; Williams, Larry

1992-01-01

As a result of limited resources and tight fiscal constraints over the past several years, the defense and aerospace industries have experienced a downturn in business activity. The impact of fewer contracts being awarded has placed a greater emphasis for effectiveness and efficiency on industry contractors. It is clear that a reallocation of resources is required for America to continue to lead the world in space and technology. The key to technological and economic survival is the transforming of existing programs, such as the Space Shuttle Program, into more cost efficient programs so as to divert the savings to other NASA programs. The partnership between Rockwell International and NASA and their joint improvement efforts that resulted in significant streamlining and cost reduction measures to Rockwell International Space System Division's work on the Space Shuttle System Integration Contract is described. This work was a result of an established Cost Effectiveness Enhancement (CEE) Team formed initially in Fiscal Year 1991, and more recently expanded to a larger scale CEE Initiative in 1992. By working closely with the customer in agreeing to contract content, obtaining management endorsement and commitment, and involving the employees in total quality management (TQM) and continuous improvement 'teams,' the initial annual cost reduction target was exceeded significantly. The CEE Initiative helped reduce the cost of the Shuttle Systems Integration contract while establishing a stronger program based upon customer needs, teamwork, quality enhancements, and cost effectiveness. This was accomplished by systematically analyzing, challenging, and changing the established processes, practices, and systems. This examination, in nature, was work intensive due to the depth and breadth of the activity. The CEE Initiative has provided opportunities to make a difference in the way Rockwell and NASA work together - to update the methods and processes of the organizations. The future success of NASA space programs and Rockwell hinges upon the ability to adopt new, more efficient and effective work processes. Efficiency, proficiency, cost effectiveness, and teamwork are a necessity for economic survival. Continuous improvement initiatives like the CEE are, and will continue to be, vehicles by which the road can be traveled with a vision to the future.

Shared visions: Partnership of Rockwell International and NASA Cost Effectiveness Enhancements (CEE) for the space shuttle system integration program

NASA Astrophysics Data System (ADS)

Bejmuk, Bohdan I.; Williams, Larry

As a result of limited resources and tight fiscal constraints over the past several years, the defense and aerospace industries have experienced a downturn in business activity. The impact of fewer contracts being awarded has placed a greater emphasis for effectiveness and efficiency on industry contractors. It is clear that a reallocation of resources is required for America to continue to lead the world in space and technology. The key to technological and economic survival is the transforming of existing programs, such as the Space Shuttle Program, into more cost efficient programs so as to divert the savings to other NASA programs. The partnership between Rockwell International and NASA and their joint improvement efforts that resulted in significant streamlining and cost reduction measures to Rockwell International Space System Division's work on the Space Shuttle System Integration Contract is described. This work was a result of an established Cost Effectiveness Enhancement (CEE) Team formed initially in Fiscal Year 1991, and more recently expanded to a larger scale CEE Initiative in 1992. By working closely with the customer in agreeing to contract content, obtaining management endorsement and commitment, and involving the employees in total quality management (TQM) and continuous improvement 'teams,' the initial annual cost reduction target was exceeded significantly. The CEE Initiative helped reduce the cost of the Shuttle Systems Integration contract while establishing a stronger program based upon customer needs, teamwork, quality enhancements, and cost effectiveness. This was accomplished by systematically analyzing, challenging, and changing the established processes, practices, and systems. This examination, in nature, was work intensive due to the depth and breadth of the activity. The CEE Initiative has provided opportunities to make a difference in the way Rockwell and NASA work together - to update the methods and processes of the organizations. The future success of NASA space programs and Rockwell hinges upon the ability to adopt new, more efficient and effective work processes. Efficiency, proficiency, cost effectiveness, and teamwork are a necessity for economic survival. Continuous improvement initiatives like the CEE are, and will continue to be, vehicles by which the road can be traveled with a vision to the future.

The RCM as a Decision Making Process.

ERIC Educational Resources Information Center

Chambers, Jay G.; And Others

In most educational literature, the subject of costs has been isolated from curriculum, personnel, and program effectiveness. A dichotomy has existed between fiscal and curricular decision-making. The Resource Cost Model (RCM) was designed to help policymakers measure to what extent differences in the costs of educational services are attributable…

Sequential Effects in Deduction: Cost of Inference Switch

ERIC Educational Resources Information Center

Milan, Emilio G.; Moreno-Rios, Sergio; Espino, Orlando; Santamaria, Carlos; Gonzalez-Hernandez, Antonio

2010-01-01

The task-switch paradigm has helped psychologists gain insight into the processes involved in changing from one activity to another. The literature has yielded consistent results about switch cost reconfiguration (abrupt offset in regular task-switch vs. gradual reduction in random task-switch; endogenous and exogenous components of switch cost;…

Phase 1 of the automated array assembly task of the low cost silicon solar array project

NASA Technical Reports Server (NTRS)

Pryor, R. A.; Grenon, L. A.; Coleman, M. G.

1978-01-01

The results of a study of process variables and solar cell variables are presented. Interactions between variables and their effects upon control ranges of the variables are identified. The results of a cost analysis for manufacturing solar cells are discussed. The cost analysis includes a sensitivity analysis of a number of cost factors.

Stochastic model for fatigue crack size and cost effective design decisions. [for aerospace structures

NASA Technical Reports Server (NTRS)

Hanagud, S.; Uppaluri, B.

1975-01-01

This paper describes a methodology for making cost effective fatigue design decisions. The methodology is based on a probabilistic model for the stochastic process of fatigue crack growth with time. The development of a particular model for the stochastic process is also discussed in the paper. The model is based on the assumption of continuous time and discrete space of crack lengths. Statistical decision theory and the developed probabilistic model are used to develop the procedure for making fatigue design decisions on the basis of minimum expected cost or risk function and reliability bounds. Selections of initial flaw size distribution, NDT, repair threshold crack lengths, and inspection intervals are discussed.

Identification and verification of critical performance dimensions. Phase 1 of the systematic process redesign of drug distribution.

PubMed

Colen, Hadewig B; Neef, Cees; Schuring, Roel W

2003-06-01

Worldwide patient safety has become a major social policy problem for healthcare organisations. As in other organisations, the patients in our hospital also suffer from an inadequate distribution process, as becomes clear from incident reports involving medication errors. Medisch Spectrum Twente is a top primary-care, clinical, teaching hospital. The hospital pharmacy takes care of 1070 internal beds and 1120 beds in an affiliated psychiatric hospital and nursing homes. In the beginning of 1999, our pharmacy group started a large interdisciplinary research project to develop a safe, effective and efficient drug distribution system by using systematic process redesign. The process redesign includes both organisational and technological components. This article describes the identification and verification of critical performance dimensions for the design of drug distribution processes in hospitals (phase 1 of the systematic process redesign of drug distribution). Based on reported errors and related causes, we suggested six generic performance domains. To assess the role of the performance dimensions, we used three approaches: flowcharts, interviews with stakeholders and review of the existing performance using time studies and medication error studies. We were able to set targets for costs, quality of information, responsiveness, employee satisfaction, and degree of innovation. We still have to establish what drug distribution system, in respect of quality and cost-effectiveness, represents the best and most cost-effective way of preventing medication errors. We intend to develop an evaluation model, using the critical performance dimensions as a starting point. This model can be used as a simulation template to compare different drug distribution concepts in order to define the differences in quality and cost-effectiveness.

[Profitability of a day hospital: analysis of activity, cost and effectiveness].

PubMed

Hernando Ortiz, Lili; Hinojosa Mena-Bernal, Carmen; González Sarmiento, Enrique; González Guilabert, Isabel; Arana Ruiz, Jorge; Muñoz Moreno, M Fe

2012-01-01

Day hospitals are an alternative to conventional hospital care. We analyzed the functioning and profitability of the day hospital of Hospital Clínico de Valladolid, Spain, in 2009. Profitability is expressed as the provision of identical health coverage at a lower cost than that generated by conventional hospital care and with adequate quality indicators. We performed a retrospective, observational and descriptive study of the information obtained on each patient attended in the day hospital from January 1 to December 31, 2009. We studied four quality indicators: cancellation of meetings, the rate of transfusion reactions, the out-patient rate and the satisfaction index. The estimated savings for each process was calculated as the difference in the average cost of hospitalization minus the average cost of the process in the day hospital. The most frequent diseases were systemic and connective tissue diseases, accounting for 25.4% of the processes treated; of these, 17.1% corresponded to rheumatoid arthritis. Patient satisfaction was 93%. Meetings cancellations and the rate of transfusion reactions were 0%. The out-patient rate was 26%. Day hospital costs were 8.6% of conventional hospital costs, with savings of 78,390.69 euros. The day hospital is cost effective due to savings compared with conventional hospitalization and has a satisfactory quality index. Copyright © 2011 SESPAS. Published by Elsevier España, S.L. All rights reserved.

Lean principles optimize on-time vascular surgery operating room starts and decrease resident work hours.

PubMed

Warner, Courtney J; Walsh, Daniel B; Horvath, Alexander J; Walsh, Teri R; Herrick, Daniel P; Prentiss, Steven J; Powell, Richard J

2013-11-01

Lean process improvement techniques are used in industry to improve efficiency and quality while controlling costs. These techniques are less commonly applied in health care. This study assessed the effectiveness of Lean principles on first case on-time operating room starts and quantified effects on resident work hours. Standard process improvement techniques (DMAIC methodology: define, measure, analyze, improve, control) were used to identify causes of delayed vascular surgery first case starts. Value stream maps and process flow diagrams were created. Process data were analyzed with Pareto and control charts. High-yield changes were identified and simulated in computer and live settings prior to implementation. The primary outcome measure was the proportion of on-time first case starts; secondary outcomes included hospital costs, resident rounding time, and work hours. Data were compared with existing benchmarks. Prior to implementation, 39% of first cases started on time. Process mapping identified late resident arrival in preoperative holding as a cause of delayed first case starts. Resident rounding process inefficiencies were identified and changed through the use of checklists, standardization, and elimination of nonvalue-added activity. Following implementation of process improvements, first case on-time starts improved to 71% at 6 weeks (P = .002). Improvement was sustained with an 86% on-time rate at 1 year (P < .001). Resident rounding time was reduced by 33% (from 70 to 47 minutes). At 9 weeks following implementation, these changes generated an opportunity cost potential of $12,582. Use of Lean principles allowed rapid identification and implementation of perioperative process changes that improved efficiency and resulted in significant cost savings. This improvement was sustained at 1 year. Downstream effects included improved resident efficiency with decreased work hours. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Regenerating an Arsenic Removal Iron-Based Adsorptive ...

EPA Pesticide Factsheets

Adsorptive media technology is a frequently used method of removing arsenic by small water systems because of its simplicity and efficiency. Current practice is to replace the media when it no longer reduces arsenic below the USEPA drinking water maximum contaminant level (MCL) of 10 µg/L. Media replacement typically accounts for approximately 80% of the total operational and maintenance (O/M) costs. This cost can be substantial and cost prohibitive for many small systems. One potential option to reduce the cost is on-site regeneration and reuse of the media. To evaluate the regeneration option, three consecutive regeneration studies were conducted on a full scale 295 gpm arsenic removal adsorptive media system. This paper, of a two part series, describes the regeneration process and its effectiveness to strip the arsenic and other contaminants from an exhausted media. The results of the regeneration studies found that a three step regeneration process of media backwash, caustic regeneration and acid neutralization/conditioning is very effective for stripping arsenic and other contaminants from the exhaustive media of a full scale arsenic removal system This paper, of a two part series, describes the regeneration process and its effectiveness to strip the arsenic and other contaminants from an exhausted media

A cost-effectiveness analysis of self-debriefing versus instructor debriefing for simulated crises in perioperative medicine in Canada.

PubMed

Isaranuwatchai, Wanrudee; Alam, Fahad; Hoch, Jeffrey; Boet, Sylvain

2017-01-01

High-fidelity simulation training is effective for learning crisis resource management (CRM) skills, but cost is a major barrier to implementing high-fidelity simulation training into the curriculum. The aim of this study was to examine the cost-effectiveness of self-debriefing and traditional instructor debriefing in CRM training programs and to calculate the minimum willingness-to-pay (WTP) value when one debriefing type becomes more cost-effective than the other. This study used previous data from a randomized controlled trial involving 50 anesthesiology residents in Canada. Each participant managed a pretest crisis scenario. Participants who were randomized to self-debrief used the video of their pretest scenario with no instructor present during their debriefing. Participants from the control group were debriefed by a trained instructor using the video of their pretest scenario. Participants individually managed a post-test simulated crisis scenario. We compared the cost and effectiveness of self-debriefing versus instructor debriefing using net benefit regression. The cost-effectiveness estimate was reported as the incremental net benefit and the uncertainty was presented using a cost-effectiveness acceptability curve. Self-debriefing costs less than instructor debriefing. As the WTP increased, the probability that self-debriefing would be cost-effective decreased. With a WTP ≤Can$200, the self-debriefing program was cost-effective. However, when effectiveness was priced higher than cost-savings and with a WTP >Can$300, instructor debriefing was the preferred alternative. With a lower WTP (≤Can$200), self-debriefing was cost-effective in CRM simulation training when compared to instructor debriefing. This study provides evidence regarding cost-effectiveness that will inform decision-makers and clinical educators in their decision-making process, and may help to optimize resource allocation in education.

Improving cost-effectiveness of and outcomes from drug therapy in patients with atrial fibrillation in managed care: role of the pharmacist.

PubMed

Johnson, Samuel G

2009-08-01

The medical care costs for procedures, medications, and testing associated with atrial fibrillation (AF) in the United States are high and projected to increase markedly in the future as the number of Americans affected grows. The burden on patient quality of life, the health care system, and society are pharmacoeconomic considerations in managing AF. To identify key pharmacoeconomic considerations in managing AF and describe ways in which managed care pharmacists can improve the cost-effectiveness of and outcomes from drug therapy for AF. The high medical care costs of AF are largely the result of the high cost of hospitalization and inpatient procedures. Recurrence of AF dramatically increases costs, especially for hospital care. Managed care pharmacists have many opportunities to provide cost-effective care to and improve outcomes in patients with AF. Policy and process review, population management, and case management are key strategies for improving outcomes in patients with AF. Pharmacist input into policy and process review, including pharmacy benefits design, formulary management, and the use of information technology, can help ensure that the use of drug therapy for AF is cost-effective. Population management strategies, such as development of clinical pathways and patient registries, seek to improve the quality, consistency, and cost-effectiveness of care and the likelihood that desired therapeutic outcomes are achieved through targeted interventions. Case management strategies focus on longitudinal care for individuals in order to improve quality. Pharmacist-managed anticoagulation services and antiarrhythmic drug monitoring are the 2 most widely known case management strategies for patients with AF. Managed care pharmacists can screen patients with AF for the use of anticoagulation, which is needed to prevent embolic stroke but is under-used, even though recommended by evidence-based guidelines. The clinical efficacy and cost-effectiveness of pharmacist-managed anticoagulation services for patients with AF are well documented. Pharmacist-managed antiarrhythmic drug monitoring is a less well-known case management strategy that facilitates early detection and intervention to minimize toxicity. Managed care pharmacists can play an instrumental role in implementing strategies to improve the cost-effectiveness of and outcomes from drug therapy for AF.

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.

An optimal policy for a single-vendor and a single-buyer integrated system with setup cost reduction and process-quality improvement

NASA Astrophysics Data System (ADS)

Shu, Hui; Zhou, Xideng

2014-05-01

The single-vendor single-buyer integrated production inventory system has been an object of study for a long time, but little is known about the effect of investing in reducing setup cost reduction and process-quality improvement for an integrated inventory system in which the products are sold with free minimal repair warranty. The purpose of this article is to minimise the integrated cost by optimising simultaneously the number of shipments and the shipment quantity, the setup cost, and the process quality. An efficient algorithm procedure is proposed for determining the optimal decision variables. A numerical example is presented to illustrate the results of the proposed models graphically. Sensitivity analysis of the model with respect to key parameters of the system is carried out. The paper shows that the proposed integrated model can result in significant savings in the integrated cost.

Effects of illness and disability on job separation.

PubMed

Magee, William

2004-03-01

Effects of illness and disability on job separation result from both voluntary and involuntary processes. Voluntary processes range from the reasoned actions of workers who weigh illness and disability in their decision-making, to reactive stress-avoidance responses. Involuntary processes include employer discrimination against ill or disabled workers. Analyses of the effects of illness and disability that differentiate reasons for job separation can illuminate the processes involved. This paper reports on an evaluation of effects of illness and disability on job separation predicted by theories of reasoned action, stress, and employer discrimination against ill and disabled workers. Effects of four illness/disability conditions on the rate of job separation for 12 reasons are estimated using data from a longitudinal study of a representative sample of the Canadian population-the Survey of Labour and Income Dynamics (SLID). Two of the four effects that are statistically significant (under conservative Bayesian criteria for statistical significance) are consistent with the idea that workers weigh illness and disability as costs, and calculate the costs and benefits of continuing to work with an illness or disability: (1) disabling illness increases the hazard of leaving a job in order to engage in caregiving, and (2) work-related disability increases the hazard of leaving a job due to poor pay. The other two significant effects indicate that: (3) disabling illness decreases the hazard of layoff, and (4) non-work disability increases the hazard of leaving one job to take a different job. This last effect is consistent with a stress-interruption process. Other effects are statistically significant under conventional criteria for statistical significance, and most of these effects are also consistent with cost-benefit and stress theories. Some effects of illness and disability are sex and age-specific, and reasons for the specificity of these effects are discussed.

New decision-making processes for the pricing of health technologies in Japan: The FY 2016/2017 pilot phase for the introduction of economic evaluations.

PubMed

Shiroiwa, Takeru; Fukuda, Takashi; Ikeda, Shunya; Takura, Tomoyuki

2017-08-01

Economic evaluation is used for decision-making processes in healthcare technologies in many developed countries. In Japan, no health economic data have been requested for drugs, medical devices, and interventions till date. However, economic evaluation is gradually gaining importance, and a trial implementation of the cost-effectiveness evaluation of drugs and medical devices has begun. Discussions on economic evaluation began in May 2012 within a newly established sub-committee of the Chuikyo, referred to as the "Special Committee on Cost Effectiveness." After four years of discussions, this committee determined that during the trial implementation, the results of the cost-effectiveness evaluation would be used for the re-pricing of drugs and medical devices at the end of fiscal year (FY) 2017. Chuikyo selected 13 products (7 drugs and 6 medical devices) as targets for this evaluation. These products will be evaluated until the end of FY 2017 based on the following process: manufacturers will submit the data of economic evaluation; the National Institute of Public Health will coordinate the review process; academic groups will perform the actual review of the submitted data, and the expert committee will appraise these data. This represents the first step to introducing cost-effectiveness analysis in the Japanese healthcare system. We believe that these efforts will contribute to the efficiency and sustainability of the Japanese healthcare system. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

ACE: A distributed system to manage large data archives

NASA Technical Reports Server (NTRS)

Daily, Mike I.; Allen, Frank W.

1993-01-01

Competitive pressures in the oil and gas industry are requiring a much tighter integration of technical data into E and P business processes. The development of new systems to accommodate this business need must comprehend the significant numbers of large, complex data objects which the industry generates. The life cycle of the data objects is a four phase progression from data acquisition, to data processing, through data interpretation, and ending finally with data archival. In order to implement a cost effect system which provides an efficient conversion from data to information and allows effective use of this information, an organization must consider the technical data management requirements in all four phases. A set of technical issues which may differ in each phase must be addressed to insure an overall successful development strategy. The technical issues include standardized data formats and media for data acquisition, data management during processing, plus networks, applications software, and GUI's for interpretation of the processed data. Mass storage hardware and software is required to provide cost effective storage and retrieval during the latter three stages as well as long term archival. Mobil Oil Corporation's Exploration and Producing Technical Center (MEPTEC) has addressed the technical and cost issues of designing, building, and implementing an Advanced Computing Environment (ACE) to support the petroleum E and P function, which is critical to the corporation's continued success. Mobile views ACE as a cost effective solution which can give Mobile a competitive edge as well as a viable technical solution.

Excimer laser annealing to fabricate low cost solar cells

NASA Technical Reports Server (NTRS)

1984-01-01

The objective is to show whether or not pulsed excimer laser annealing (PELA) of ion-implanted junctions is a cost effective replacement for diffused junctions in fabricating crystalline silicon solar cells. The preliminary economic analysis completed shows that the use of PELA to fabricate both the front junction and back surface field (BSF) would cost approximately 35 cents per peak watt (Wp), compared to a cost of 15 cents/Wp for diffusion, aluminum BSF and an extra cleaning step in the baseline process. The cost advantage of the PELA process depends on improving the average cell efficiency from 14% to 16%, which would lower the overall cost of the module by about 15 cents/Wp. An optimized PELA process compatible with commercial production is to be developed, and increased cell efficiency with sufficient product for adequate statistical analysis demonstrated. An excimer laser annealing station was set-up and made operational. The first experiment used 248 nm radiation to anneal phosphorus implants in polished and texture-etched silicon.

SOME QUANTITATIVE ASPECTS OF THE INSTRUCTIONAL PROCESS.

ERIC Educational Resources Information Center

GAVIN, WILLIAM J.; SPITZER, MURRAY

THE DATA FROM THE SEVERAL STUDIES ANALYZED IN THIS REPORT HAVE BEEN COLLECTED AS PART OF AN ON-GOING EFFORT TO IMPLEMENT THE ABT ASSOCIATES' EDUCATION COST EFFECTIVENESS INSTRUCTIONAL PROCESS SUBMODEL, WHICH IS DEVELOPING TECHNIQUES TO EVALUATE THE QUANTITATIVE, CAUSE-AND-EFFECT RELATIONSHIP BETWEEN THE INSTRUCTIONAL PROCESS AND SCHOLASTIC…

The Effects of the Use of Activity-Based Costing Software in the Learning Process: An Empirical Analysis

ERIC Educational Resources Information Center

Tan, Andrea; Ferreira, Aldónio

2012-01-01

This study investigates the influence of the use of accounting software in teaching activity-based costing (ABC) on the learning process. It draws upon the Theory of Planned Behaviour and uses the end-user computer satisfaction (EUCS) framework to examine students' satisfaction with the ABC software. The study examines students' satisfaction with…

Gene recovery microdissection (GRM) a process for producing chromosome region-specific libraries of expressed genes

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

Christian, A T; Coleman, M A; Tucker, J D

2001-02-08

Gene Recovery Microdissection (GRM) is a unique and cost-effective process for producing chromosome region-specific libraries of expressed genes. It accelerates the pace, reduces the cost, and extends the capabilities of functional genomic research, the means by which scientists will put to life-saving, life-enhancing use their knowledge of any plant or animal genome.

Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

PubMed

Rosenberg, Christian; Kroos, Kristin; Rosenberg, Britta; Hosten, Norbert; Flessa, Steffen

2013-08-01

Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.

Priority setting for orphan drugs: an international comparison.

PubMed

Rosenberg-Yunger, Zahava R S; Daar, Abdallah S; Thorsteinsdóttir, Halla; Martin, Douglas K

2011-04-01

To describe the process of priority setting for two orphan drugs - Cerezyme and Fabrazyme - in Canada, Australia and Israel, in order to understand and improve the process based on stakeholder perspectives. We conducted qualitative case studies of how three independent drug advisory committees made decisions relating to the funding of Cerezyme and Fabrazyme. Interviews were conducted with 22 informants, including committee members, patient groups and industry representatives. (1) DESCRIPTION: Orphan drugs reimbursement recommendations by expert panels were based on clinical evidence, cost and cost-effectiveness analysis. (2) EVALUATION: Committee members expressed an overall preference for the current drug review process used by their own committee, but were concerned with the fairness of the process particularly for orphan drugs. Other informants suggested the inclusion of other relevant values (e.g. lack of alternative treatments) in order to improve the priority setting process. Some patient groups suggested the use of an alternative funding mechanism for orphan drugs. Priority setting for drugs is not solely a technical process (involving cost-effective analysis, evidence-based medicine, etc.). Understanding the process by which reimbursement decisions are made for orphan drugs may help improve the system for future orphan drugs. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The effect of hillslope angle on pocket gopher (Thomomys bottae) burrow geometry.

PubMed

Seabloom, E W; Reichman, O J; Gabet, E J

2000-10-01

One way for animals to decrease energy expenditures is to minimize the cost of movement. For animals dwelling on slopes, gravity can impart a large energetic cost to movement. For this reason, animals traveling aboveground alter their movement patterns in response to the steepness of terrain (specifically hillslope angle) so as to minimize their energetic costs. Subterranean animals should also benefit from choosing optimum movement paths in relation to hillslopes but concurrently must factor the cost of excavation into their movement decisions. In cases where the excavation costs are much higher than the costs of working against gravity, excavation costs may override the consideration of gravitational costs and movement of subterranean animals may be independent of hillslope angle. To determine the response of a subterranean animal to hillslope angle, we excavated tunnels in the burrow systems of 19 pocket gophers in southern California that occupied hillslopes ranging from 2 to 30°. At each excavation we measured several characteristics of burrow geometry and used these data in a model of pocket gopher energetics to calculate the cost of tunnel construction at the various hillslope angles. We found that the cost of tunnel construction was independent of hillslope angle, and that the costs of shearing soil and pushing soil horizontally through the tunnels were 3 orders of magnitude greater than the costs of lifting the soil against the force of gravity. Accordingly, pocket gopher foraging tunnels were oriented independently of the hillslope. The decoupling of the movement patterns of subterranean animals from the effects of gravity is a distinctive feature of the subterranean habit compared to the movement of aboveground animals. Because of the important effects of tunnel construction on soil processes, this unique biological feature of subterranean animals has implications for basic physical processes, such as soil erosion. We found that the rate of soil flux generated by pocket gopher activity was invariant to hillslope. This relationship is in contrast to the most common model of soil movement generated by purely physical processes.

Pyrimethanil degradation by photo-Fenton process: Influence of iron and irradiance level on treatment cost.

PubMed

Cabrera Reina, A; Miralles-Cuevas, S; Casas López, J L; Sánchez Pérez, J A

2017-12-15

This study evaluates the combined effect of photo-catalyst concentration and irradiance level on photo-Fenton efficiency when this treatment is applied to industrial wastewater decontamination. Three levels of irradiance (18, 32 and 46W/m 2 ) and three iron concentrations (8, 20 and 32mg/L) were selected and their influence over the process studied using a raceway pond reactor placed inside a solar box. For 8mg/L, it was found that there was a lack of catalyst to make use of all the available photons. For 20mg/L, the treatment always improved with irradiance indicating that the process was photo-limited. For 32mg/L, the excess of iron caused an excess of radicals production which proved to be counter-productive for the overall process efficiency. The economic assessment showed that acquisition and maintenance costs represent the lowest relative values. The highest cost was found to be the cost of the reagents consumed. Both sulfuric acid and sodium hydroxide are negligible in terms of costs. Iron cost percentages were also very low and never higher than 10.5% while the highest cost was always that of hydrogen peroxide, representing at least 85% of the reagent costs. Thus, the total costs were between 0.76 and 1.39€/m 3 . Copyright © 2017 Elsevier B.V. All rights reserved.

Toward zero waste to landfill: an effective method for recycling zeolite waste from refinery industry

NASA Astrophysics Data System (ADS)

Homchuen, K.; Anuwattana, R.; Limphitakphong, N.; Chavalparit, O.

2017-07-01

One-third of landfill waste of refinery plant in Thailand was spent chloride zeolite, which wastes a huge of land, cost and time for handling. Toward zero waste to landfill, this study was aimed at determining an effective method for recycling zeolite waste by comparing the chemical process with the electrochemical process. To investigate the optimum conditions of both processes, concentration of chemical solution and reaction time were carried out for the former, while the latter varied in term of current density, initial pH of water, and reaction time. The results stated that regenerating zeolite waste from refinery industry in Thailand should be done through the chemical process with alkaline solution because it provided the best chloride adsorption efficiency with cost the least. A successful recycling will be beneficial not only in reducing the amount of landfill waste but also in reducing material and disposal costs and consumption of natural resources as well.

Cost of Purchased Versus Produced Plasma from Donor Recruitment Through Transfusion.

PubMed

Prioli, Katherine M; Pizzi, Laura T; Karp, Julie Katz; Galanis, Taki; Herman, Jay H

2016-10-01

Plasma is used to treat acquired coagulopathy or thrombotic thrombocytopenic purpura, or to reverse warfarin effect. Scant data are available, however, about its costs. To estimate total costs of plasma from production through administration, from the perspective of a US hospital blood donor center (BDC). Six sequential decision analytic models were constructed and informed by primary and secondary data on time, tasks, personnel, and supplies for donation, processing, and administration. Expected values of the models were summed to yield the BDC's total cost of producing, preparing, and transfusing plasma. Costs ($US 2015) are reported for a typical patient using three units of plasma. Models assume plasma was obtained from whole blood donation and transfused in an inpatient setting. Univariate sensitivity analyses were performed to test the impact of changing inputs for personnel costs and adverse event (AE) rates and costs. BDC production cost of plasma was $91.24/patient ($30.41/unit), a $30.16/patient savings versus purchased plasma. Administration and monitoring costs totaled $194.64/patient. Sensitivity analyses indicated that modifying BDC personnel costs during donation and processing has little impact on total plasma costs. However, the probability and cost of transfusion-associated circulatory overload (TACO) have a significant impact on costs. Plasma produced by our BDC may be less costly than purchased plasma. Though plasma processes have multiple tasks involving staff time, these are not the largest cost driver. Major plasma-related AEs are uncommon, but are the biggest driver of total plasma costs.

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

The economics of screening infants at risk of hearing impairment: an international analysis.

PubMed

Burke, Martyn J; Shenton, Ruth C; Taylor, Matthew J

2012-02-01

Hearing impairment in children across the world constitutes a particularly serious obstacle to their optimal development and education, including language acquisition. Around 0.5-6 in every 1000 neonates and infants have congenital or early childhood onset sensorineural deafness or severe-to-profound hearing impairment, with significant consequences. Therefore, early detection is a vitally important element in providing appropriate support for deaf and hearing-impaired babies that will help them enjoy equal opportunities in society alongside all other children. This analysis estimates the costs and effectiveness of various interventions to screen infants at risk of hearing impairment. The economic analysis used a decision tree approach to determine the cost-effectiveness of newborn hearing screening strategies. Two unique models were built to capture different strategic screening decisions. Firstly, the cost-effectiveness of universal newborn hearing screening (UNHS) was compared to selective screening of newborns with risk factors. Secondly, the cost-effectiveness of providing a one-stage screening process vs. a two-stage screening process was investigated. Two countries, the United Kingdom and India, were used as case studies to illustrate the likely cost outcomes associated with the various strategies to diagnose hearing loss in infants. In the UK, the universal strategy incurs a further cost of approximately £2.3 million but detected an extra 63 cases. An incremental cost per case detected of £36,181 was estimated. The estimated economic burden was substantially higher in India when adopting a universal strategy due to the higher baseline prevalence of hearing loss. The one-stage screening strategy accumulated an additional 13,480 and 13,432 extra cases of false-positives, in the UK and India respectively when compared to a two-stage screening strategy. This represented increased costs by approximately £1.3 million and INR 34.6 million. The cost-effectiveness of a screening intervention was largely dependent upon two key factors. As would be expected, the cost (per patient) of the intervention drives the model substantially, with higher costs leading to higher cost-effectiveness ratios. Likewise, the baseline prevalence (risk) of hearing impairment also affected the results. In scenarios where the baseline risk was low, the intervention was less likely to be cost-effective compared to when the baseline risk was high. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Array automated assembly task, phase 2. Low cost silicon solar array project

NASA Technical Reports Server (NTRS)

Rhee, S. S.; Jones, G. T.; Allison, K. T.

1978-01-01

Several modifications instituted in the wafer surface preparation process served to significantly reduce the process cost to 1.55 cents per peak watt in 1975 cents. Performance verification tests of a laser scanning system showed a limited capability to detect hidden cracks or defects, but with potential equipment modifications this cost effective system could be rendered suitable for applications. Installation of electroless nickel plating system was completed along with an optimization of the wafer plating process. The solder coating and flux removal process verification test was completed. An optimum temperature range of 500-550 C was found to produce uniform solder coating with the restriction that a modified dipping procedure is utilized. Finally, the construction of the spray-on dopant equipment was completed.

Cost-effectiveness analysis of sandhill crane habitat management

USGS Publications Warehouse

Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.

2013-01-01

Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

Comparative Cost-Effectiveness Analysis of Three Different Automated Medication Systems Implemented in a Danish Hospital Setting.

PubMed

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

2018-02-01

Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice. The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS). The economic evaluation used original effect and cost data from prospective, controlled, before-and-after studies of medication systems implemented at a Danish hematological ward and an acute medical unit. Effectiveness was described as the proportion of clinical and procedural error opportunities that were associated with one or more errors. An error was defined as a deviation from the electronic prescription, from standard hospital policy, or from written procedures. The cost assessment was based on 6-month standardization of observed cost data. The model-based comparative cost-effectiveness analyses were conducted with system-specific assumptions of the effect size and costs in scenarios with consumptions of 15,000, 30,000, and 45,000 doses per 6-month period. With 30,000 doses the cost-effectiveness model showed that the cost-effectiveness ratio expressed as the cost per avoided clinical error was €24 for the psAMS, €26 for the npsAMS, and €386 for the cAMS. Comparison of the cost-effectiveness of the three systems in relation to different valuations of an avoided error showed that the psAMS was the most cost-effective system regardless of error type or valuation. The model-based indirect comparison against the conventional practice showed that psAMS and npsAMS were more cost-effective than the cAMS alternative, and that psAMS was more cost-effective than npsAMS.

[Research progress of ecosystem service flow.

PubMed

Liu, Hui Min; Fan, Yu Long; Ding, Sheng Yan

2016-07-01

With the development of social economy, human disturbance has resulted in a variety of ecosystem service degradation or disappearance. Ecosystem services flow plays an important role in delivery, transformation and maintenance of ecosystem services, and becomes one of the new research directions. In this paper, based on the classification of ecosystem services flow, we analyzed ecosystem service delivery carrier, and investigated the mechanism of ecosystem service flow, including the information, property, scale features, quantification and cartography. Moreover, a tentative analysis on cost-effective of ecosystem services flow (such as transportation costs, conversion costs, usage costs and cost of relativity) was made to analyze the consumption cost in ecosystem services flow process. It aimed to analyze dissipation cost in ecosystem services flow process. To a certain extent, the study of ecosystem service flow solved the problem of "double counting" in ecosystem services valuation, which could make a contribution for the sake of recognizing hot supply and consumption spots of ecosystem services. In addition, it would be conducive to maximizing the ecosystem service benefits in the transmission process and putting forward scientific and reasonable ecological compensation.

Product pricing in the Solar Array Manufacturing Industry - An executive summary of SAMICS

NASA Technical Reports Server (NTRS)

Chamberlain, R. G.

1978-01-01

Capabilities, methodology, and a description of input data to the Solar Array Manufacturing Industry Costing Standards (SAMICS) are presented. SAMICS were developed to provide a standardized procedure and data base for comparing manufacturing processes of Low-cost Solar Array (LSA) subcontractors, guide the setting of research priorities, and assess the progress of LSA toward its hundred-fold cost reduction goal. SAMICS can be used to estimate the manufacturing costs and product prices and determine the impact of inflation, taxes, and interest rates, but it is limited by its ignoring the effects of the market supply and demand and an assumption that all factories operate in a production line mode. The SAMICS methodology defines the industry structure, hypothetical supplier companies, and manufacturing processes and maintains a body of standardized data which is used to compute the final product price. The input data includes the product description, the process characteristics, the equipment cost factors, and production data for the preparation of detailed cost estimates. Activities validating that SAMICS produced realistic price estimates and cost breakdowns are described.

STAR--people-powered prioritization: a 21st-century solution to allocation headaches.

PubMed

Airoldi, Mara; Morton, Alec; Smith, Jenifer A E; Bevan, Gwyn

2014-11-01

The aim of cost effectiveness analysis (CEA) is to inform the allocation of scarce resources. CEA is routinely used in assessing the cost-effectiveness of specific health technologies by agencies such as the National Institute for Health and Clinical Excellence (NICE) in England and Wales. But there is extensive evidence that because of barriers of accessibility and acceptability, CEA has not been used by local health planners in their annual task of allocating fixed budgets to a wide range of types of health care. This paper argues that these planners can use Socio Technical Allocation of Resources (STAR) for that task. STAR builds on the principles of CEA and the practice of program budgeting and marginal analysis. STAR uses requisite models to assess the cost-effectiveness of all interventions considered for resource reallocation by explicitly applying the theory of health economics to evidence of scale, costs, and benefits, with deliberation facilitated through an interactive social process of engaging key stakeholders. In that social process, the stakeholders generate missing estimates of scale, costs, and benefits of the interventions; develop visual models of their relative cost-effectiveness; and interpret the results. We demonstrate the feasibility of STAR by showing how it was used by a local health planning agency of the English National Health Service, the Isle of Wight Primary Care Trust, to allocate a fixed budget in 2008 and 2009. © The Author(s) 2014.

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.

A holistic framework for design of cost-effective minimum water utilization network.

PubMed

Wan Alwi, S R; Manan, Z A; Samingin, M H; Misran, N

2008-07-01

Water pinch analysis (WPA) is a well-established tool for the design of a maximum water recovery (MWR) network. MWR, which is primarily concerned with water recovery and regeneration, only partly addresses water minimization problem. Strictly speaking, WPA can only lead to maximum water recovery targets as opposed to the minimum water targets as widely claimed by researchers over the years. The minimum water targets can be achieved when all water minimization options including elimination, reduction, reuse/recycling, outsourcing and regeneration have been holistically applied. Even though WPA has been well established for synthesis of MWR network, research towards holistic water minimization has lagged behind. This paper describes a new holistic framework for designing a cost-effective minimum water network (CEMWN) for industry and urban systems. The framework consists of five key steps, i.e. (1) Specify the limiting water data, (2) Determine MWR targets, (3) Screen process changes using water management hierarchy (WMH), (4) Apply Systematic Hierarchical Approach for Resilient Process Screening (SHARPS) strategy, and (5) Design water network. Three key contributions have emerged from this work. First is a hierarchical approach for systematic screening of process changes guided by the WMH. Second is a set of four new heuristics for implementing process changes that considers the interactions among process changes options as well as among equipment and the implications of applying each process change on utility targets. Third is the SHARPS cost-screening technique to customize process changes and ultimately generate a minimum water utilization network that is cost-effective and affordable. The CEMWN holistic framework has been successfully implemented on semiconductor and mosque case studies and yielded results within the designer payback period criterion.

Aeration control of thermophilic aerobic digestion using fluorescence monitoring.

PubMed

Kim, Young-Kee; Oh, Byung-Keun

2009-01-01

The thermophilic aerobic digestion (TAD) process is recognized as an effective method for rapid waste activated sludge (WAS) degradation and the deactivation of pathogenic microorganisms. Yet, high energy costs due to heating and aeration have limited the commercialization of economical TAD processes. Previous research on autothermal thermophilic aerobic digestion (ATAD) has already reduced the heating cost. However, only a few studies have focused on reducing the aeration cost. Therefore, this study applied a two-step aeration control strategy to a fill-and-draw mode semicontinuous TAD process. The NADH-dependent fluorescence was monitored throughout the TAD experiment, and the aeration rate shifted according to the fluorescence intensity. As a result, the simple two-step aeration control operation achieved a 20.3% reduction in the total aeration, while maintaining an effective and stable operation. It is also expected that more savings can be achieved with a further reduction of the lower aeration rate or multisegmentation of the aeration rate.

Upgrade Recycling of Cast Iron Scrap Chips towards β-FeSi₂ Thermoelectric Materials.

PubMed

Laila, Assayidatul; Nanko, Makoto; Takeda, Masatoshi

2014-09-04

The upgrade recycling of cast-iron scrap chips towards β-FeSi₂ thermoelectric materials is proposed as an eco-friendly and cost-effective production process. By using scrap waste from the machining process of cast-iron components, the material cost to fabricate β-FeSi₂ is reduced and the industrial waste is recycled. In this study, β-FeSi₂ specimens obtained from cast iron scrap chips were prepared both in the undoped form and doped with Al and Co elements. The maximum figure of merit ( ZT ) indicated a thermoelectric performance of approximately 70% in p-type samples and nearly 90% in n-type samples compared to β-FeSi₂ prepared from pure Fe and other published studies. The use of cast iron scrap chips to produce β-FeSi₂ shows promise as an eco-friendly and cost-effective production process for thermoelectric materials.

Engineered yeast for enhanced CO2 mineralization†

PubMed Central

Barbero, Roberto; Carnelli, Lino; Simon, Anna; Kao, Albert; Monforte, Alessandra d’Arminio; Riccò, Moreno; Bianchi, Daniele; Belcher, Angela

2014-01-01

In this work, a biologically catalyzed CO2 mineralization process for the capture of CO2 from point sources was designed, constructed at a laboratory scale, and, using standard chemical process scale-up protocols, was modeled and evaluated at an industrial scale. A yeast display system in Saccharomyces cerevisae was used to screen several carbonic anhydrase isoforms and mineralization peptides for their impact on CO2 hydration, CaCO3 mineralization, and particle settling rate. Enhanced rates for each of these steps in the CaCO3 mineralization process were confirmed using quantitative techniques in lab-scale measurements. The effect of these enhanced rates on the CO2 capture cost in an industrial scale CO2 mineralization process using coal fly ash as the CaO source was evaluated. The model predicts a process using bCA2- yeast and fly ash is ~10% more cost effective per ton of CO2 captured than a process with no biological molecules, a savings not realized by wild-type yeast and high-temperature stable recombinant CA2 alone or in combination. The levelized cost of electricity for a power plant using this process was calculated and scenarios in which this process compares favorably to CO2 capture by MEA absorption process are presented. PMID:25289021

Proliferation resistance design of a plutonium cycle (Proliferation Resistance Engineering Program: PREP)

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

Sorenson, R.J.; Roberts, F.P.; Clark, R.G.

1979-01-19

This document describes the proliferation resistance engineering concepts developed to counter the threat of proliferation of nuclear weapons in an International Fuel Service Center (IFSC). The basic elements of an International Fuel Service Center are described. Possible methods for resisting proliferation such as processing alternatives, close-coupling of facilities, process equipment layout, maintenance philosophy, process control, and process monitoring are discussed. Political and institutional issues in providing proliferation resistance for an International Fuel Service Center are analyzed. The conclusions drawn are (1) use-denial can provide time for international response in the event of a host nation takeover. Passive use-denial is moremore » acceptable than active use-denial, and acceptability of active-denial concepts is highly dependent on sovereignty, energy dependence and economic considerations; (2) multinational presence can enhance proliferation resistance; and (3) use-denial must be nonprejudicial with balanced interests for governments and/or private corporations being served. Comparisons between an IFSC as a national facility, an IFSC with minimum multinational effect, and an IFSC with maximum multinational effect show incremental design costs to be less than 2% of total cost of the baseline non-PRE concept facility. The total equipment acquisition cost increment is estimated to be less than 2% of total baseline facility costs. Personnel costs are estimated to increase by less than 10% due to maximum international presence. 46 figures, 9 tables.« less

Full depth reclamation with cement, fourth interim, December 2009.

DOT National Transportation Integrated Search

2009-12-01

Due to the rising cost of virgin aggregate and asphalt products the Maine Department of Transportation : (MaineDOT) utilizes a number of reconstruction and rehabilitation processes to cost effectively maintain : Maines highway system. One rehabili...

The choice: Welding with CO2 or Nd:YAG lasers

NASA Astrophysics Data System (ADS)

Leong, Keng H.

The recent commercial availability of multi-kilowatt Nd:YAG lasers has opened new avenues for rapid laser processing as well as intensified the competition (cost effectiveness) between CO2 and Nd:YAG laser systems. Vendors offering Nd:YAG laser systems may claim lower operating costs (than CO2) and fiberoptic beam delivery flexibility while CO2 systems vendors may emphasize lower capital cost and well established processing requirements and experience. The capital and operating costs of a laser system are impacted by demand and supply economics and technological advances. Frequently the total cost of a workcell using a laser for processing has to be considered rather than the laser system alone. Consequently it is not very practical to approach the selection of a laser system based on its capital cost and estimated operating cost only. This presentation describes a more pragmatic approach to aid the user in the selection of the optimal multi-kilowatt laser system for a particular processing requirement with emphasis on welding. CO2 laser systems are well established on the factory floor. Consequently, emphasis is given to the comparative application of Nd:YAG lasers, process requirements and performance. Requirements for the laser welding of different metals are examined in the context of hardware (laser system and beam delivery) selection and examples of welding speeds that can be achieved using CO2 and Nd:YAG lasers are examined.

Investigation of test methods, material properties, and processes for solar cell encapsulants

NASA Technical Reports Server (NTRS)

Willis, P. B.

1983-01-01

A study of potentially useful low cost encapsulation materials for the Flat-Plate Solar Array project is discussed. The goal is to identify, evaluate, test and recommend encapsulant materials and processes for the production of cost-effective, long life solar cell modules. Technical investigations included studies of aging and degradation of candidate encapsulation materials, continued identification of primers for durable bonding of module interfaces, continued evaluation of soil resistant treatments for the sunlit surface of the module and testing of corrosion protective coatings for use low cost mild steel substrates.

An effective and optimal quality control approach for green energy manufacturing using design of experiments framework and evolutionary algorithm

NASA Astrophysics Data System (ADS)

Saavedra, Juan Alejandro

Quality Control (QC) and Quality Assurance (QA) strategies vary significantly across industries in the manufacturing sector depending on the product being built. Such strategies range from simple statistical analysis and process controls, decision-making process of reworking, repairing, or scraping defective product. This study proposes an optimal QC methodology in order to include rework stations during the manufacturing process by identifying the amount and location of these workstations. The factors that are considered to optimize these stations are cost, cycle time, reworkability and rework benefit. The goal is to minimize the cost and cycle time of the process, but increase the reworkability and rework benefit. The specific objectives of this study are: (1) to propose a cost estimation model that includes energy consumption, and (2) to propose an optimal QC methodology to identify quantity and location of rework workstations. The cost estimation model includes energy consumption as part of the product direct cost. The cost estimation model developed allows the user to calculate product direct cost as the quality sigma level of the process changes. This provides a benefit because a complete cost estimation calculation does not need to be performed every time the processes yield changes. This cost estimation model is then used for the QC strategy optimization process. In order to propose a methodology that provides an optimal QC strategy, the possible factors that affect QC were evaluated. A screening Design of Experiments (DOE) was performed on seven initial factors and identified 3 significant factors. It reflected that one response variable was not required for the optimization process. A full factorial DOE was estimated in order to verify the significant factors obtained previously. The QC strategy optimization is performed through a Genetic Algorithm (GA) which allows the evaluation of several solutions in order to obtain feasible optimal solutions. The GA evaluates possible solutions based on cost, cycle time, reworkability and rework benefit. Finally it provides several possible solutions because this is a multi-objective optimization problem. The solutions are presented as chromosomes that clearly state the amount and location of the rework stations. The user analyzes these solutions in order to select one by deciding which of the four factors considered is most important depending on the product being manufactured or the company's objective. The major contribution of this study is to provide the user with a methodology used to identify an effective and optimal QC strategy that incorporates the number and location of rework substations in order to minimize direct product cost, and cycle time, and maximize reworkability, and rework benefit.

Standardized Review and Approval Process for High-Cost Medication Use Promotes Value-Based Care in a Large Academic Medical System.

PubMed

Durvasula, Raghu; Kelly, Janet; Schleyer, Anneliese; Anawalt, Bradley D; Somani, Shabir; Dellit, Timothy H

2018-04-01

As healthcare costs rise and reimbursements decrease, healthcare organization leadership and clinical providers must collaborate to provide high-value healthcare. Medications are a key driver of the increasing cost of healthcare, largely as a result of the proliferation of expensive specialty drugs, including biologic agents. Such medications contribute significantly to the inpatient diagnosis-related group payment system, often with minimal or unproved benefit over less-expensive therapies. To describe a systematic review process to reduce non-evidence-based inpatient use of high-cost medications across a large multihospital academic health system. We created a Pharmacy & Therapeutics subcommittee consisting of clinicians, pharmacists, and an ethics representative. This committee developed a standardized process for a timely review (<48 hours) and approval of high-cost medications based on their clinical effectiveness, safety, and appropriateness. The engagement of clinical experts in the development of the consensus-based guidelines for the use of specific medications facilitated the clinicians' acceptance of the review process. Over a 2-year period, a total of 85 patient-specific requests underwent formal review. All reviews were conducted within 48 hours. This review process has reduced the non-evidence-based use of specialty medications and has resulted in a pharmacy savings of $491,000 in fiscal year 2016, with almost 80% of the savings occurring in the last 2 quarters, because our process has matured. The creation of a collaborative review process to ensure consistent, evidence-based utilization of high-cost medications provides value-based care, while minimizing unnecessary practice variation and reducing the cost of inpatient care.

Increasing value in plagiocephaly care: a time-driven activity-based costing pilot study.

PubMed

Inverso, Gino; Lappi, Michael D; Flath-Sporn, Susan J; Heald, Ronald; Kim, David C; Meara, John G

2015-06-01

Process management within a health care setting is poorly understood and often leads to an incomplete understanding of the true costs of patient care. Using time-driven activity-based costing methods, we evaluated the high-volume, low-complexity diagnosis of plagiocephaly to increase value within our clinic. A total of 59 plagiocephaly patients were evaluated in phase 1 (n = 31) and phase 2 (n = 28) of this study. During phase 1, a process map was created, encompassing each of the 5 clinicians and administrative personnel delivering 23 unique activities. After analysis of the phase 1 process maps, average times as well as costs of these activities were evaluated for potential modifications in workflow. These modifications were implemented in phase 2 to determine overall impact on visit-time and costs of care. Improvements in patient education, workflow coordination, and examination room allocation were implemented during phase 2, resulting in a reduced patient visit-time of 13:25 (19.9% improvement) and an increased cost of $8.22 per patient (7.7% increase) due to changes in physician process times. However, this increased cost was directly offset by the availability of 2 additional appointments per day, potentially generating $7904 of additional annual revenue. Quantifying the impact of a 19.9% reduction in patient visit-time at an increased cost of 7.7% resulted in an increased value ratio of 1.113. This pilot study effectively demonstrates the novel use of time-driven activity-based costing in combination with the value equation as a metric for continuous process improvement programs within the health care setting.

Processing of basalt fiber production waste

NASA Astrophysics Data System (ADS)

Sevostyanov, V. S.; Shatalov, A. V.; Shatalov, V. A.; Golubeva, U. V.

2018-03-01

The production of mineral rock wool forms a large proportion of off-test waste products. In addition to the cost of their production, there are costs for processing and utilization, such as transportation, disposal and preservation. Besides, wastes have harmful effect on the environment. This necessitates research aimed to study the stress-related characteristics of materials, their recyclability and use in the production of heat-saving products.

National Biofuels Action Plan

DTIC Science & Technology

2008-10-01

edge biofuel production processes . In early 2007 President Bush announced the “Twenty-in-Ten” initiative, a plan to reduce gasoline consumption by 20...Feedstock Logistics consists of harvesting or collecting feedstock from the area of production , processing it for use in biorefi neries, storing it... production targets are too costly to compete effectively in the marketplace. Because the pace of technological breakthroughs required to lower costs is

A review of the methodological challenges in assessing the cost effectiveness of pharmacist interventions.

PubMed

Elliott, Rachel A; Putman, Koen; Davies, James; Annemans, Lieven

2014-12-01

Pharmacists' roles are shifting away from medicines supply and the provision of patient education involving acute medications towards consultation-type services for chronic medications. Determining the cost effectiveness of pharmacist interventions has been complicated by methodological challenges. A critique of 31 economic evaluations carried out alongside comparative studies of pharmacist interventions published between 2003 and 2013 (12 from the UK, six from the USA) found a range of disease-specific and cross-therapeutic interventions targeting both patients and prescribers in a range of settings evaluated through a variety of study designs. Only ten were full economic evaluations, five of which were based on randomized controlled trials (RCTs). The intervention was usually quite well described, but the comparator was not always clearly described, and some interventions are very context specific due to the variability in pharmacist services available in different countries and practice settings. Complex multidirectional aims of most pharmacist interventions have led to many process, intermediate and longer-term outcomes being included in any one study. Quality of resource use and cost data varied. Most incremental cost-effectiveness ratios (ICERs) were generated from process indicators such as errors and adherence, with only four studies reporting cost per quality-adjusted life-year (QALY). Very few studies examined the effect of uncertainty, and methods used were not very clear in some cases. The principal finding from our critique is that poor RCT study design or analysis precludes many studies from finding pharmacist interventions effective or cost effective. We conclude with a set of recommendations for future study design.

Process cost and facility considerations in the selection of primary cell culture clarification technology.

PubMed

Felo, Michael; Christensen, Brandon; Higgins, John

2013-01-01

The bioreactor volume delineating the selection of primary clarification technology is not always easily defined. Development of a commercial scale process for the manufacture of therapeutic proteins requires scale-up from a few liters to thousands of liters. While the separation techniques used for protein purification are largely conserved across scales, the separation techniques for primary cell culture clarification vary with scale. Process models were developed to compare monoclonal antibody production costs using two cell culture clarification technologies. One process model was created for cell culture clarification by disc stack centrifugation with depth filtration. A second process model was created for clarification by multi-stage depth filtration. Analyses were performed to examine the influence of bioreactor volume, product titer, depth filter capacity, and facility utilization on overall operating costs. At bioreactor volumes <1,000 L, clarification using multi-stage depth filtration offers cost savings compared to clarification using centrifugation. For bioreactor volumes >5,000 L, clarification using centrifugation followed by depth filtration offers significant cost savings. For bioreactor volumes of ∼ 2,000 L, clarification costs are similar between depth filtration and centrifugation. At this scale, factors including facility utilization, available capital, ease of process development, implementation timelines, and process performance characterization play an important role in clarification technology selection. In the case study presented, a multi-product facility selected multi-stage depth filtration for cell culture clarification at the 500 and 2,000 L scales of operation. Facility implementation timelines, process development activities, equipment commissioning and validation, scale-up effects, and process robustness are examined. © 2013 American Institute of Chemical Engineers.

Advanced in-duct sorbent injection for SO{sub 2} control. Topical report No. 2, Subtask 2.2: Design optimization

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

Rosenhoover, W.A.; Stouffer, M.R.; Withum, J.A.

1994-12-01

The objective of this research project is to develop second-generation duct injection technology as a cost-effective SO{sub 2} control option for the 1990 Clean Air Act Amendments. Research is focused on the Advanced Coolside process, which has shown the potential for achieving the performance targets of 90% SO{sub 2} removal and 60% sorbent utilization. In Subtask 2.2, Design Optimization, process improvement was sought by optimizing sorbent recycle and by optimizing process equipment for reduced cost. The pilot plant recycle testing showed that 90% SO{sub 2} removal could be achieved at sorbent utilizations up to 75%. This testing also showed thatmore » the Advanced Coolside process has the potential to achieve very high removal efficiency (90 to greater than 99%). Two alternative contactor designs were developed, tested and optimized through pilot plant testing; the improved designs will reduce process costs significantly, while maintaining operability and performance essential to the process. Also, sorbent recycle handling equipment was optimized to reduce cost.« less

Cost effective technology

NASA Astrophysics Data System (ADS)

Miller, S. C.

1989-09-01

With relation to advanced technology for gas turbines, the overall process of product definition and development, concentrating particularly on the integration of activities between engineering design and manufacturing, is surveyed. The development of new philosophies in each of these spheres of activity is concluded to be cost effective technology and to make a highly significant contribution to the competitiveness and profitability of the industry.

Cost assessment of natural hazards in Europe - state-of-the-art, knowledge gaps and recommendations

NASA Astrophysics Data System (ADS)

Meyer, V.; Becker, N.; Markantonis, V.; Schwarze, R.; van den Bergh, J. C. J. M.; Bouwer, L. M.; Bubeck, P.; Ciavola, P.; Thieken, A. H.; Genovese, E.; Green, C.; Hallegatte, S.; Kreibich, H.; Lequeux, Q.; Viavattenne, C.; Logar, I.; Papyrakis, E.; Pfurtscheller, C.; Poussin, J.; Przyluski, V.

2012-04-01

Effective and efficient reduction of natural hazard risks requires a thorough understanding of the costs of natural hazards in order to develop sustainable risk management strategies. The current methods that assess the costs of different natural hazards employ a diversity of terminologies and approaches for different hazards and impacted sectors. This makes it difficult to arrive at robust, comprehensive and comparable cost figures. The CONHAZ (Costs of Natural Hazards) project aimed to compile and synthesise current knowledge on cost assessment methods in order to strengthen the role of cost assessments in the development of integrated natural hazard management and adaptation planning. In order to achieve this, CONHAZ has adopted a comprehensive approach, considering natural hazards ranging from droughts, floods and coastal hazards to Alpine hazards, as well as different impacted sectors and cost types. Its specific objectives have been 1) to compile the state-of-the-art methods for cost assessment; 2) to analyse and assess these methods in terms of technical aspects, as well as terminology, data quality and availability, and research gaps; and 3) to synthesise resulting knowledge into recommendations and to identify further research needs. This presentation summarises the main results of CONHAZ. CONHAZ differentiates between direct tangible damages, losses due to business interruption, indirect damages, intangible effects, and costs of risk mitigation. It is shown that the main focus of cost assessment methods and their application in practice is on direct costs, while existing methods for assessing intangible and indirect effects are rather rarely applied and methods for assessing indirect effects often cannot be used on the scale of interest (e.g. the regional scale). Furthermore, methods often focus on single sectors and/or hazards, and only very few are able to reflect several sectors or multiple hazards. Process understanding and its use in cost assessment is poor, leading to highly uncertain results. However, sensitivity and uncertainty analyses as well as validations are hardly undertaken. Important recommendations are that cost assessment can be made more comprehensive by including indirect and intangible effects. Furthermore, the importance is highlighted of identifying sources of uncertainties, of reducing them effectively and of documenting remaining ones. One source of uncertainty concerns data sources. A framework for supporting data collection on the European level ensuring minimum data quality standards would facilitate the development and consistency of European and national databases. Furthermore, an improvement of methods is needed with regard to a better understanding and modelling of the damaging processes. In particular, there is a need for a better understanding of the economic response to external shocks and to improve models for indirect cost assessment based on this. Also models to estimate direct economic damage need to be based on more knowledge about the complex processes leading to damages. Moreover, the dynamics of risk due to climate and socio-economic change have to be better considered in the models in order to unveil uncertainties about future developments in the costs of natural hazards. Finally, there is a need for appropriate and transparent tools and guidance to support decision makers in the integration of uncertain cost assessment figures into decision making.

Portable brine evaporator unit, process, and system

DOEpatents

Hart, Paul John; Miller, Bruce G.; Wincek, Ronald T.; Decker, Glenn E.; Johnson, David K.

2009-04-07

The present invention discloses a comprehensive, efficient, and cost effective portable evaporator unit, method, and system for the treatment of brine. The evaporator unit, method, and system require a pretreatment process that removes heavy metals, crude oil, and other contaminates in preparation for the evaporator unit. The pretreatment and the evaporator unit, method, and system process metals and brine at the site where they are generated (the well site). Thus, saving significant money to producers who can avoid present and future increases in transportation costs.

Decision Making Methods in Space Economics and Systems Engineering

NASA Technical Reports Server (NTRS)

Shishko, Robert

2006-01-01

This viewgraph presentation reviews various methods of decision making and the impact that they have on space economics and systems engineering. Some of the methods discussed are: Present Value and Internal Rate of Return (IRR); Cost-Benefit Analysis; Real Options; Cost-Effectiveness Analysis; Cost-Utility Analysis; Multi-Attribute Utility Theory (MAUT); and Analytic Hierarchy Process (AHP).

Controlling healthcare costs by removing waste: what American doctors can do now.

PubMed

Swensen, Stephen J; Kaplan, Gary S; Meyer, Gregg S; Nelson, Eugene C; Hunt, Gordon C; Pryor, David B; Weissberg, Jed I; Daley, Jennifer; Yates, Gary R; Chassin, Mark R

2011-06-01

Healthcare costs are unsustainable. The authors propose a solution to control costs without rationing (deliberate withholding of effective care) or payment reductions to doctors and hospitals. Three physician-led strategies comprise this solution: reduce (1) overuse of health services, (2) preventable complications and (3) waste within healthcare processes. These challenges know no borders.

Full depth reclamation with cement, second and third interim, December, 2008.

DOT National Transportation Integrated Search

2008-12-01

Due to the rising cost of virgin aggregate and asphalt products the Maine Department of Transportation : (MaineDOT) utilizes a number of reconstruction and rehabilitation processes to cost effectively maintain : Maines highway system. One rehabili...

Hospital pharmacy decisions, cost containment, and the use of cost-effectiveness analysis.

PubMed

Sloan, F A; Whetten-Goldstein, K; Wilson, A

1997-08-01

The key hypothesis of the study was that hospital pharmacies under the pressure of managed care would be more likely to adopt process innovations to assure less costly and more cost-effective provision of care. We conducted a survey of 103 hospitals and analyzed secondary data on cost and staffing. Compared to the size of the reduction in length of stay, changes in the way that a day of care is delivered appear to be minor, even in areas with substantial managed care share. The vast majority of hospitals surveyed had implemented some form of therapeutic interchange and generic substitution. Most hospitals used some drug utilization guidelines, but as of mid 1995 these were not yet important management tools for hospital pharmacies. To our knowledge, ours was the first survey to investigate the link between hospital formularies and use of cost-effectiveness analysis. At most cost-effectiveness was a minor tool in pharmaceutical decision making in hospitals at present. We could determine no differences in use of such analyses by managed care market share in the hospital's market share. One impediment to the use of cost-effectiveness studies was the lack of timeliness of studies. Other stated reasons for not using cost-effectiveness analysis more often were: lack of information on hospitalized patients and hence on the potential cost offsets accruing to the hospital: lack of independent sponsorship, and inadequate expertise in economic evaluation.

Assessing the quality of cost management

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

Fayne, V.; McAllister, A.; Weiner, S.B.

1995-12-31

Managing environmental programs can be effective only when good cost and cost-related management practices are developed and implemented. The Department of Energy`s Office of Environmental Management (EM), recognizing this key role of cost management, initiated several cost and cost-related management activities including the Cost Quality Management (CQM) Program. The CQM Program includes an assessment activity, Cost Quality Management Assessments (CQMAs), and a technical assistance effort to improve program/project cost effectiveness. CQMAs provide a tool for establishing a baseline of cost-management practices and for measuring improvement in those practices. The result of the CQMA program is an organization that has anmore » increasing cost-consciousness, improved cost-management skills and abilities, and a commitment to respond to the public`s concerns for both a safe environment and prudent budget outlays. The CQMA program is part of the foundation of quality management practices in DOE. The CQMA process has contributed to better cost and cost-related management practices by providing measurements and feedback; defining the components of a quality cost-management system; and helping sites develop/improve specific cost-management techniques and methods.« less

Digitizing dissertations for an institutional repository: a process and cost analysis.

PubMed

Piorun, Mary; Palmer, Lisa A

2008-07-01

This paper describes the Lamar Soutter Library's process and costs associated with digitizing 300 doctoral dissertations for a newly implemented institutional repository at the University of Massachusetts Medical School. Project tasks included identifying metadata elements, obtaining and tracking permissions, converting the dissertations to an electronic format, and coordinating workflow between library departments. Each dissertation was scanned, reviewed for quality control, enhanced with a table of contents, processed through an optical character recognition function, and added to the institutional repository. Three hundred and twenty dissertations were digitized and added to the repository for a cost of $23,562, or $0.28 per page. Seventy-four percent of the authors who were contacted (n = 282) granted permission to digitize their dissertations. Processing time per title was 170 minutes, for a total processing time of 906 hours. In the first 17 months, full-text dissertations in the collection were downloaded 17,555 times. Locally digitizing dissertations or other scholarly works for inclusion in institutional repositories can be cost effective, especially if small, defined projects are chosen. A successful project serves as an excellent recruitment strategy for the institutional repository and helps libraries build new relationships. Challenges include workflow, cost, policy development, and copyright permissions.

Progress and challenges for cost effective kerfless Silicon crystal growth for PV application

NASA Astrophysics Data System (ADS)

Serra, J. M.; Alves, J. Maia; Vallera, A. M.

2017-06-01

The major barrier for PV penetration is cost. And the single most important cost factor in silicon technology is the wafer (≈35% of the module cost). Although tremendous progress on cell processing has been reported in recent years, a much smaller evolution is seen on what should be the key point to address - the wafer. The ingot-slicing process is reaching its limits as the wafer thickness is reduced in an effort to lower material costs. Kerf losses of ≈50% and an increase in breakage of a high value added material are putting a lower bound to this approach. New ideas are therefore needed for producing wafers in a way to overcome these limitations. In this paper we present three new concepts being developed in our laboratory that have one thing in common: they all are zero kerf loss processes, aiming at significant reductions in material loss. One explores the concept of exfoliation, the other two aim at the growth of silicon directly into ribbons. These were conceived as continuous processes, based on a floating molten zone concept, to avoid impurity contamination during crystallization.

IT investments can add business value.

PubMed

Williams, Terry G

2002-05-01

Investment in information technology (IT) is costly, but necessary to enable healthcare organizations to improve their infrastructure and achieve other improvement initiatives. Such an investment is even more costly, however, if the technology does not appropriately enable organizations to perform business processes that help them accomplish their mission of providing safe, high-quality care cost-effectively. Before committing to a costly IT investment, healthcare organizations should implement a decision-making process that can help them choose, implement, and use technology that will provide sustained business value. A seven-step decision-making process that can help healthcare organizations achieve this result involves performing a gap analysis, assessing and aligning organizational goals, establishing distributed accountability, identifying linked organizational-change initiatives, determining measurement methods, establishing appropriate teams to ensure systems are integrated with multidisciplinary improvement methods, and developing a plan to accelerate adoption of the IT product.

Cost-effectiveness and Pricing of Antibacterial Drugs

PubMed Central

Verhoef, Talitha I; Morris, Stephen

2015-01-01

Growing resistance to antibacterial agents has increased the need for the development of new drugs to treat bacterial infections. Given increasing pressure on limited health budgets, it is important to study the cost-effectiveness of these drugs, as well as their safety and efficacy, to find out whether or not they provide value for money and should be reimbursed. In this article, we systematically reviewed 38 cost-effectiveness analyses of new antibacterial agents. Most studies showed the new antibacterial drugs were cost-effective compared to older generation drugs. Drug pricing is a complicated process, involving different stakeholders, and has a large influence on cost-effectiveness. Value-based pricing is a method to determine the price of a drug at which it can be cost-effective. It is currently unclear what the influence of value-based pricing will be on the prices of new antibacterial agents, but an important factor will be the definition of ‘value’, which as well as the impact of the drug on patient health might also include other factors such as wider social impact and the health impact of disease. PMID:25521641

Further Evidence on the Effect of Acquisition Policy and Process on Cost Growth of Major Defense Acquisition Programs

DTIC Science & Technology

2016-06-01

Total Package Procurement (TPP) when it was judged to be practicable and, when not, Fixed Price Incentive Fee (FPIF) or Cost Plus Incentive Fee (CPIF...development contracts in favor of CPIF. ( Cost Plus Award Fee may not have been included in the contracting play book yet.) As a general matter, Packard’s...Group CAPE Cost Assessment and Program Evaluation CD Compact Disc CE Current Estimate CLC Calibrated Learning Curve CPIF Cost Plus Incentive Fee

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.

Economic evaluation of the Good School Toolkit: an intervention for reducing violence in primary schools in Uganda.

PubMed

Greco, Giulia; Knight, Louise; Ssekadde, Willington; Namy, Sophie; Naker, Dipak; Devries, Karen

2018-01-01

This paper presents the cost and cost-effectiveness of the Good School Toolkit (GST), a programme aimed at reducing physical violence perpetrated by school staff to students in Uganda. The effectiveness of the Toolkit was tested with a cluster randomised controlled trial in 42 primary schools in Luwero District, Uganda. A full economic costing evaluation and cost-effectiveness analysis were conducted alongside the trial. Both financial and economic costs were collected retrospectively from the provider's perspective to estimate total and unit costs. The total cost of setting up and running the Toolkit over the 18-month trial period is estimated at US$397 233, excluding process monitor (M&E) activities. The cost to run the intervention is US$7429 per school annually, or US$15 per primary school pupil annually, in the trial intervention schools. It is estimated that the intervention has averted 1620 cases of past-week physical violence during the 18-month implementation period. The total cost per case of violence averted is US$244, and the annual implementation cost is US$96 per case averted during the trial. The GST is a cost-effective intervention for reducing violence against pupils in primary schools in Uganda. It compares favourably against other violence reduction interventions in the region.

Improvement in current density of nano- and micro-structured Si solar cells by cost-effective elastomeric stamp process

NASA Astrophysics Data System (ADS)

Jeon, Kiseok; Jee, Hongsub; Lim, Sangwoo; Park, Min Joon; Jeong, Chaehwan

2018-03-01

Effective incident light should be controlled for improving the current density of solar cells by employing nano- and micro-structures on silicon surface. The elastomeric stamp process, which is more cost effective and simpler than conventional photolithography, was proposed for the fabrication of nano- and micro-structures. Polydimethylsiloxane (PDMS) was poured on a mother pattern with a diameter of 6 μm and a spacing of 2 μm; then, curing was performed to create a PDMS mold. The regular micropattern was stamped on a low-viscosity resin-coated silicon surface, followed by the simple reactive ion etching process. Nano-structures were formed using the Ag-based electroless etching process. As etching time was increased to 6 min, reflectance decreased to 4.53% and current density improved from 22.35 to 34.72 mA/cm2.

Cost-effectiveness of midwifery services vs. medical services in Quebec. LEquipe dEvaluation des Projets-Pilotes Sages-Femmes.

PubMed

Reinharz, D; Blais, R; Fraser, W D; Contandriopoulos, A P

2000-01-01

This study compared the cost-effectiveness of midwife services provided in birth centres operating as pilot projects with current hospital-based medical services in the province of Quebec. One thousand midwives' clients were matched with 1,000 physicians' clients on the basis of socio-demographic characteristics and obstetrical risk. Direct costs for the prenatal, intrapartum and postpartum periods were estimated. Effectiveness was assessed on the basis of three clinical indicators and four indices related to the individualization of care as assessed by women. Results show that the costs of midwife services were barely lower than or equal to those of physician services, but cost-effectiveness ratios were to the advantage of the midwife group, except for one clinical indicator (neonatal ventilation). Overall, this study provides rational support for the process of legalizing midwifery in the province.

Inefficiencies and high-value improvements in U.S. cervical cancer screening practice: A cost-effectiveness analysis

PubMed Central

Kim, Jane J.; Campos, Nicole G.; Sy, Stephen; Burger, Emily A.; Cuzick, Jack; Castle, Philip E.; Hunt, William C.; Waxman, Alan; Wheeler, Cosette M.

2016-01-01

Background Studies suggest that cervical cancer screening practice in the United States is inefficient. The cost and health implications of non-compliance in the screening process compared to recommended guidelines are uncertain. Objective To estimate the benefits, costs, and cost-effectiveness of current cervical cancer screening practice and assess the value of screening improvements. Design Model-based cost-effectiveness analysis. Data Sources New Mexico HPV Pap Registry; medical literature. Target Population Cohort of women eligible for routine screening. Time Horizon Lifetime. Perspective Societal. Interventions Current cervical cancer screening practice; improved compliance to guidelines-based screening interval, triage testing, diagnostic referrals, and precancer treatment referrals. Outcome Measures Reductions in lifetime cervical cancer risk, quality-adjusted life-years (QALYs), lifetime costs, incremental cost-effectiveness ratios (ICERs), incremental net monetary benefits (INMBs Results of Base-Case Analysis Current screening practice was associated with lower health benefit and was not cost-effective relative to guidelines-based strategies. Improvements in the screening process were associated with higher QALYs and small changes in costs. Perfect c4mpliance to a 3-yearly screening interval and to colposcopy/biopsy referrals were associated with the highest INMBs ($759 and $741, respectively, at a willingness-to-pay threshold of $100,000 per QALY gained); together, the INMB increased to $1,645. Results of Sensitivity Analysis Current screening practice was inefficient in 100% of simulations. The rank ordering of screening improvements according to INMBs was stable over a range of screening inputs and willingness-to-pay thresholds. Limitations The impact of HPV vaccination was not considered. Conclusions The added health benefit of improving compliance to guidelines, especially the 3-yearly interval for cytology screening and diagnostic follow-up, may justify additional investments in interventions to improve U.S. cervical cancer screening practice. Funding Source U.S. National Cancer Institute. PMID:26414147

[Cost-effectiveness and cost-benefit analysis on strategy for preventing mother-to-child transmission of hepatitis B virus].

PubMed

Cai, Y L; Zhang, S X; Yang, P C; Lin, Y

2016-06-01

Through cost-benefit analysis (CBA), cost-effectiveness analysis (CEA) and quantitative optimization analysis to understand the economic benefit and outcomes of strategy regarding preventing mother-to-child transmission (PMTCT) on hepatitis B virus. Based on the principle of Hepatitis B immunization decision analytic-Markov model, strategies on PMTCT and universal vaccination were compared. Related parameters of Shenzhen were introduced to the model, a birth cohort was set up as the study population in 2013. The net present value (NPV), benefit-cost ratio (BCR), incremental cost-effectiveness ratio (ICER) were calculated and the differences between CBA and CEA were compared. A decision tree was built as the decision analysis model for hepatitis B immunization. Three kinds of Markov models were used to simulate the outcomes after the implementation of vaccination program. The PMTCT strategy of Shenzhen showed a net-gain as 38 097.51 Yuan/per person in 2013, with BCR as 14.37. The universal vaccination strategy showed a net-gain as 37 083.03 Yuan/per person, with BCR as 12.07. Data showed that the PMTCT strategy was better than the universal vaccination one and would end with gaining more economic benefit. When comparing with the universal vaccination program, the PMTCT strategy would save 85 100.00 Yuan more on QALY gains for every person. The PMTCT strategy seemed more cost-effective compared with the one under universal vaccination program. In the CBA and CEA hepatitis B immunization programs, the immunization coverage rate and costs of hepatitis B related diseases were the most important influencing factors. Outcomes of joint-changes of all the parameters in CEA showed that PMTCT strategy was a more cost-effective. The PMTCT strategy gained more economic benefit and effects on health. However, the cost of PMTCT strategy was more than the universal vaccination program, thus it is important to pay attention to the process of PMTCT strategy and the universal vaccination program. CBA seemed suitable for strategy optimization while CEA was better for strategy evaluation. Hopefully, programs as combination of the above said two methods would facilitate the process of economic evaluation.

Teasing apart coercion and surprisal: Evidence from eye-movements and ERPs.

PubMed

Delogu, Francesca; Crocker, Matthew W; Drenhaus, Heiner

2017-04-01

Previous behavioral and electrophysiological studies have presented evidence suggesting that coercion expressions (e.g., began the book) are more difficult to process than control expressions like read the book. While this processing cost has been attributed to a specific coercion operation for recovering an event-sense of the complement (e.g., began reading the book), an alternative view based on the Surprisal Theory of language processing would attribute the cost to the relative unpredictability of the complement noun in the coercion compared to the control condition, with no need to postulate coercion-specific mechanisms. In two experiments, monitoring eye-tracking and event-related potentials (ERPs), respectively, we sought to determine whether there is any evidence for coercion-specific processing cost above-and-beyond the difficulty predicted by surprisal, by contrasting coercing and control expressions with a further control condition in which the predictability of the complement noun was similar to that in the coercion condition (e.g., bought the book). While the eye-tracking study showed significant effects of surprisal and a marginal effect of coercion on late reading measures, the ERP study clearly supported the surprisal account. Overall, our findings suggest that the coercion cost largely reflects the surprisal of the complement noun with coercion specific operations possibly influencing later processing stages. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

48 CFR 48.102 - Policies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... cost-effective value engineering procedures and processes. Agencies shall provide contractors a... services must require a mandatory value engineering program to reduce total ownership cost in accordance... VALUE ENGINEERING Policies and Procedures 48.102 Policies. (a) As required by Section 36 of the Office...

48 CFR 48.102 - Policies.

Code of Federal Regulations, 2013 CFR

2013-10-01

... cost-effective value engineering procedures and processes. Agencies shall provide contractors a... services must require a mandatory value engineering program to reduce total ownership cost in accordance... VALUE ENGINEERING Policies and Procedures 48.102 Policies. (a) As required by Section 36 of the Office...

A process model to estimate biodiesel production costs.

PubMed

Haas, Michael J; McAloon, Andrew J; Yee, Winnie C; Foglia, Thomas A

2006-03-01

'Biodiesel' is the name given to a renewable diesel fuel that is produced from fats and oils. It consists of the simple alkyl esters of fatty acids, most typically the methyl esters. We have developed a computer model to estimate the capital and operating costs of a moderately-sized industrial biodiesel production facility. The major process operations in the plant were continuous-process vegetable oil transesterification, and ester and glycerol recovery. The model was designed using contemporary process simulation software, and current reagent, equipment and supply costs, following current production practices. Crude, degummed soybean oil was specified as the feedstock. Annual production capacity of the plant was set at 37,854,118 l (10 x 10(6)gal). Facility construction costs were calculated to be US dollar 11.3 million. The largest contributors to the equipment cost, accounting for nearly one third of expenditures, were storage tanks to contain a 25 day capacity of feedstock and product. At a value of US dollar 0.52/kg (dollar 0.236/lb) for feedstock soybean oil, a biodiesel production cost of US dollar 0.53/l (dollar 2.00/gal) was predicted. The single greatest contributor to this value was the cost of the oil feedstock, which accounted for 88% of total estimated production costs. An analysis of the dependence of production costs on the cost of the feedstock indicated a direct linear relationship between the two, with a change of US dollar 0.020/l (dollar 0.075/gal) in product cost per US dollar 0.022/kg (dollar 0.01/lb) change in oil cost. Process economics included the recovery of coproduct glycerol generated during biodiesel production, and its sale into the commercial glycerol market as an 80% w/w aqueous solution, which reduced production costs by approximately 6%. The production cost of biodiesel was found to vary inversely and linearly with variations in the market value of glycerol, increasing by US dollar 0.0022/l (dollar 0.0085/gal) for every US dollar 0.022/kg (dollar 0.01/lb) reduction in glycerol value. The model is flexible in that it can be modified to calculate the effects on capital and production costs of changes in feedstock cost, changes in the type of feedstock employed, changes in the value of the glycerol coproduct, and changes in process chemistry and technology.

Using cost-effectiveness analysis to sharpen formulary decision-making: the example of tiotropium at the Veterans Affairs health care system.

PubMed

Onukwugha, Ebere; Mullins, C Daniel; DeLisle, Sylvain

2008-01-01

To identify a cost-saving subset of criteria for the use of tiotropium at a Veterans Affairs Medical Center based on a cost-effectiveness analysis with ipratropium as the comparator. Retrospective analysis of electronic medical records for the calendar year 2004 was conducted. The sample was drawn from a population at the Baltimore Veterans Affairs Medical Center that had a confirmed diagnosis of chronic obstructive pulmonary disease (COPD) and had filled prescriptions for ipratropium. The tiotropium sample was based on a modeled cohort of COPD patients who had received tiotropium. The analysis was conducted from the perspective of the Veterans Affairs Health Care System. The outcome was the incremental cost-effectiveness of tiotropium versus ipratropium. The incremental cost-effectiveness ratio (ICER) was $2360 per avoided exacerbation. Tiotropium cost-effectiveness increased with COPD severity and was cost-saving in patients with very severe disease (ICER = $-1818) and in patients with a previous COPD-related hospitalization (ICER = $-4472). The ICER was most sensitive to the relative effectiveness and price of tiotropium. Results identified the levels of treatment effectiveness and price beyond which tiotropium would become cost-saving relative to ipratropium. The results support the existing Veterans Affairs practice of offering tiotropium to patients with COPD-related hospitalizations. Periodic review of the effectiveness data to determine whether tiotropium would be cost-saving in patients with very severe COPD is suggested. Cost-effectiveness analyses that identify practical criteria-for-use should become an integral part of the formulary process.

Cost-effective solutions for sewage treatment in developing countries--the case of Brazil.

PubMed

Jordão, E P; Volschan, I

2004-01-01

Cost-effective solutions are a must in developing countries, not only regarding investment costs, but also in respect to technology and operating practices. With these two goals in mind, in Brazil a particular effort has been directed for the development and application of the Chemical Enhanced Primary Treatment (CEPT) process and of the Upflow Anaerobic Sludge Blanket (UASB) process, both followed by complementary secondary treatment. Both technologies are under current expansion in Brazil. Large CEPT plants have been designed and built, up to 3.7 m3/s average design flow, as well as large UASB reactors, up to 3.0 m3/s average design flow. The applied technologies are cost-effective: they present low investment and efficiencies of BOD removal of up to 50% to 70%. They allow the plant construction in steps, an initial phase with efficiency over the usual primary treatment, and in order to achieve best effluent quality and meet legal water quality standards, a logic upgrade post-treatment can later on be implemented. The higher initial reduction of BOD and TSS also permits savings in construction and operational costs of secondary treatment, due to lower organic load and lower energy consumption. Sludge represents a particular point of attention: in the cases when the CEPT was used, Chemical Stabilisation of the Sludge (CSS) has also been practiced, eliminating the high construction costs of the digesters, all the plant staying chemically operated. In the cases when the UASB is used preceding secondary treatment, sludge can easily return to the anaerobic vessel, the costly sludge digestion unit being avoided. UASB reactors have practically no equipment in the anaerobic vessel, no energy consumption, low sludge production, and when applied in hot climates as in Brazil, heating devices are not required. The Brazilian experience, some particular cases, special comments on design and different secondary treatment processes are presented in this paper, as a contribution to the discussion of cost and benefits, a prime point to be considered.

LanzaTech- Capturing Carbon. Fueling Growth.

ScienceCinema

NONE

2018-01-16

LanzaTech will design a gas fermentation system that will significantly improve the rate at which methane gas is delivered to a biocatalyst. Current gas fermentation processes are not cost effective compared to other gas-to-liquid technologies because they are too slow for large-scale production. If successful, LanzaTech's system will process large amounts of methane at a high rate, reducing the energy inputs and costs associated with methane conversion.

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.

Reduce on the Cost of Photovoltaic Power Generation for Polycrystalline Silicon Solar Cells by Double Printing of Ag/Cu Front Contact Layer

NASA Astrophysics Data System (ADS)

Peng, Zhuoyin; Liu, Zhou; Chen, Jianlin; Liao, Lida; Chen, Jian; Li, Cong; Li, Wei

2018-06-01

With the development of photovoltaic industry, the cost of photovoltaic power generation has become the significant issue. And the metallization process has decided the cost of original materials and photovoltaic efficiency of the solar cells. Nowadays, double printing process has been introduced instead of one-step printing process for front contact of polycrystalline silicon solar cells, which can effectively improve the photovoltaic conversion efficiency of silicon solar cells. Here, the relative cheap Cu paste has replaced the expensive Ag paste to form Ag/Cu composite front contact of silicon solar cells. The photovoltaic performance and the cost of photovoltaic power generation have been investigated. With the optimization on structure and height of Cu finger layer for Ag/Cu composite double-printed front contact, the silicon solar cells have exhibited a photovoltaic conversion efficiency of 18.41%, which has reduced 3.42 cent per Watt for the cost of photovoltaic power generation.

Semisolid forming of 44MnSiV6 microalloyed steel

NASA Astrophysics Data System (ADS)

Plata, Gorka; Lozares, Jokin; Hurtado, Iñaki; Azpilgain, Zigor; Idoyaga, Zuriñe

2018-05-01

Globalisation is forcing many sectors to be more cost-effective due to the low manpower cost of developing countries. This, in combination with European trends of green production and reduction of emissions, enhances the necessity of advanced technologies to remain at the forefront of the market. It is precisely in this field where the Semisolid forming (SSF) exhibits a great potential. In Mondragon Unibertsitatea, it has been demonstrated the capability of producing sound components of 42CrMo4 and S48C steels by saving material, energy and attaining as hot forged properties. To make the process even more cost-effective, it has also been proved the capacity of SSF 44MnSiV6 microalloyed steel that enables the striking of the post processing heat treatment.

Cost Effectiveness of Monoclonal Antibody Therapy for Rare Diseases: A Systematic Review.

PubMed

Park, Taehwan; Griggs, Scott K; Suh, Dong-Churl

2015-08-01

Monoclonal antibody (mAb)-based orphan drugs have led to advances in the treatment of diseases by selectively targeting molecule functions. However, their high treatment costs impose a substantial cost burden on patients and society. The study aimed to systematically review cost-effectiveness evidence of mAb orphan drugs. Ovid MEDLINE(®), EMBASE(®), and PsycINFO(®) were searched in June 2014 and articles were selected if they conducted economic evaluations of the mAb orphan drugs that had received marketing approval in the USA. The quality of the selected studies was assessed using the Quality of Health Economic Studies (QHES) instrument. We reviewed 16 articles that included 24 economic evaluations of nine mAb orphan drugs. Six of these nine drugs were included in cost-utility analysis studies, whereas three drugs were included in cost-effectiveness analysis studies. Previous cost-utility analysis studies revealed that four mAb orphan drugs (cetuximab, ipilimumab, rituximab, and trastuzumab) were found to be cost effective; one drug (bevacizumab) was not cost effective; and one drug (infliximab) was not consistent across the studies. Prior cost-effectiveness analysis studies which included three mAb orphan drugs (adalimumab, alemtuzumab, and basiliximab) showed that the incremental cost per effectiveness gained for these drugs ranged from $US4669 to $Can52,536 Canadian dollars. The quality of the included studies was good or fair with the exception of one study. Some mAb orphan drugs were reported as cost effective under the current decision-making processes. Use of these expensive drugs, however, can raise an equity issue which concerns fairness in access to treatment. The issue of equal access to drugs needs to be considered alongside other societal values in making the final health policy decisions.

Routine magnetic resonance imaging for idiopathic olfactory loss: a modeling-based economic evaluation.

PubMed

Rudmik, Luke; Smith, Kristine A; Soler, Zachary M; Schlosser, Rodney J; Smith, Timothy L

2014-10-01

Idiopathic olfactory loss is a common clinical scenario encountered by otolaryngologists. While trying to allocate limited health care resources appropriately, the decision to obtain a magnetic resonance imaging (MRI) scan to investigate for a rare intracranial abnormality can be difficult. To evaluate the cost-effectiveness of ordering routine MRI in patients with idiopathic olfactory loss. We performed a modeling-based economic evaluation with a time horizon of less than 1 year. Patients included in the analysis had idiopathic olfactory loss defined by no preceding viral illness or head trauma and negative findings of a physical examination and nasal endoscopy. Routine MRI vs no-imaging strategies. We developed a decision tree economic model from the societal perspective. Effectiveness, probability, and cost data were obtained from the published literature. Litigation rates and costs related to a missed diagnosis were obtained from the Physicians Insurers Association of America. A univariate threshold analysis and multivariate probabilistic sensitivity analysis were performed to quantify the degree of certainty in the economic conclusion of the reference case. The comparative groups included those who underwent routine MRI of the brain with contrast alone and those who underwent no brain imaging. The primary outcome was the cost per correct diagnosis of idiopathic olfactory loss. The mean (SD) cost for the MRI strategy totaled $2400.00 ($1717.54) and was effective 100% of the time, whereas the mean (SD) cost for the no-imaging strategy totaled $86.61 ($107.40) and was effective 98% of the time. The incremental cost-effectiveness ratio for the MRI strategy compared with the no-imaging strategy was $115 669.50, which is higher than most acceptable willingness-to-pay thresholds. The threshold analysis demonstrated that when the probability of having a treatable intracranial disease process reached 7.9%, the incremental cost-effectiveness ratio for MRI vs no imaging was $24 654.38. The probabilistic sensitivity analysis demonstrated that the no-imaging strategy was the cost-effective decision with 81% certainty at a willingness-to-pay threshold of $50 000. This economic evaluation suggests that the most cost-effective decision is to not obtain a routine MRI scan of the brain in patients with idiopathic olfactory loss. Outcomes from this study may be used to counsel patients and aid in the decision-making process.

Effects of distinctive encoding on correct and false memory: a meta-analytic review of costs and benefits and their origins in the DRM paradigm.

PubMed

Huff, Mark J; Bodner, Glen E; Fawcett, Jonathan M

2015-04-01

We review and meta-analyze how distinctive encoding alters encoding and retrieval processes and, thus, affects correct and false recognition in the Deese-Roediger-McDermott (DRM) paradigm. Reductions in false recognition following distinctive encoding (e.g., generation), relative to a nondistinctive read-only control condition, reflected both impoverished relational encoding and use of a retrieval-based distinctiveness heuristic. Additional analyses evaluated the costs and benefits of distinctive encoding in within-subjects designs relative to between-group designs. Correct recognition was design independent, but in a within design, distinctive encoding was less effective at reducing false recognition for distinctively encoded lists but more effective for nondistinctively encoded lists. Thus, distinctive encoding is not entirely "cost free" in a within design. In addition to delineating the conditions that modulate the effects of distinctive encoding on recognition accuracy, we discuss the utility of using signal detection indices of memory information and memory monitoring at test to separate encoding and retrieval processes.

Low-cost manufacturing of the point focus concentrating module and its key component, the Fresnel lens. Final subcontract report, 31 January 1991--6 May 1991

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

Saifee, T.; Konnerth, A. III

1991-11-01

Solar Kinetics, Inc. (SKI) has been developing point-focus concentrating PV modules since 1986. SKI is currently in position to manufacture between 200 to 600 kilowatts annually of the current design by a combination of manual and semi-automated methods. This report reviews the current status of module manufacture and specifies the required approach to achieve a high-volume manufacturing capability and low cost. The approach taken will include process development concurrent with module design for automated manufacturing. The current effort reviews the major manufacturing costs and identifies components and processes whose improvements would produce the greatest effect on manufacturability and cost reduction.more » The Fresnel lens is one such key component. Investigating specific alternative manufacturing methods and sources has substantially reduced the lens costs and has exceeded the DOE cost-reduction goals. 15 refs.« less

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.

RFID in healthcare: a Six Sigma DMAIC and simulation case study.

PubMed

Southard, Peter B; Chandra, Charu; Kumar, Sameer

2012-01-01

The purpose of this paper is to develop a business model to generate quantitative evidence of the benefits of implementing radio frequency identification (RFID) technology, limiting the scope to outpatient surgical processes in hospitals. The study primarily uses the define-measure-analyze-improve-control (DMAIC) approach, and draws on various analytical tools such as work flow diagrams, value stream mapping, and discrete event simulation to examine the effect of implementing RFID technology on improving effectiveness (quality and timeliness) and efficiency (cost reduction) of outpatient surgical processes. The analysis showed significant estimated annual cost and time savings in carrying out patients' surgical procedures with RFID technology implementation for the outpatient surgery processes in a hospital. This is largely due to the elimination of both non-value added activities of locating supplies and equipment and also the elimination of the "return" loop created by preventable post operative infections. Several poka-yokes developed using RFID technology were identified to eliminate those two issues. Several poka-yokes developed using RFID technology were identified for improving the safety of the patient and cost effectiveness of the operation to ensure the success of the outpatient surgical process. Many stakeholders in the hospital environment will be impacted including patients, physicians, nurses, technicians, administrators and other hospital personnel. Different levels of training of hospital personnel will be required, based on the degree of interaction with the RFID system. Computations of costs and savings will help decision makers understand the benefits and implications of the technology in the hospital environment.

How drugs are developed and approved by the FDA: current process and future directions.

PubMed

Ciociola, Arthur A; Cohen, Lawrence B; Kulkarni, Prasad

2014-05-01

This article provides an overview of FDA's regulatory processes for drug development and approval, and the estimated costs associated with the development of a drug, and also examines the issues and challenges facing the FDA in the near future. A literature search was performed using MEDLINE to summarize the current FDA drug approval processes and future directions. MEDLINE was further utilized to search for all cost analysis studies performed to evaluate the pharmaceutical industry R&D productivity and drug development cost estimates. While the drug approval process remains at high risk and spans over multiple years, the FDA drug review and approval process has improved, with the median approval time for new molecular drugs been reduced from 19 months to 10 months. The overall cost to development of a drug remains quite high and has been estimated to range from $868M to $1,241M USD. Several new laws have been enacted, including the FDA Safety and Innovation Act (FDASIA) of 2013, which is designed to improve the drug approval process and enhance access to new medicines. The FDA's improved processes for drug approval and post-market surveillance have achieved the goal of providing patients with timely access to effective drugs while minimizing the risk of drug-related harm. The FDA drug approval process is not without controversy, as a number of well-known gastroenterology drugs have been withdrawn from the US market over the past few years. With the approval of the new FDASIA law, the FDA will continue to improve their processes and, working together with the ACG through the FDA-Related Matters Committee, continue to develop safe and effective drugs for our patients.

Reactive control processes contributing to residual switch cost and mixing cost across the adult lifespan.

PubMed

Whitson, Lisa R; Karayanidis, Frini; Fulham, Ross; Provost, Alexander; Michie, Patricia T; Heathcote, Andrew; Hsieh, Shulan

2014-01-01

In task-switching paradigms, performance is better when repeating the same task than when alternating between tasks (switch cost) and when repeating a task alone rather than intermixed with another task (mixing cost). These costs remain even after extensive practice and when task cues enable advanced preparation (residual costs). Moreover, residual reaction time mixing cost has been consistently shown to increase with age. Residual switch and mixing costs modulate the amplitude of the stimulus-locked P3b. This mixing effect is disproportionately larger in older adults who also prepare more for and respond more cautiously on these "mixed" repeat trials (Karayanidis et al., 2011). In this paper, we analyze stimulus-locked and response-locked P3 and lateralized readiness potentials to identify whether residual switch and mixing cost arise from the need to control interference at the level of stimulus processing or response processing. Residual mixing cost was associated with control of stimulus-level interference, whereas residual switch cost was also associated with a delay in response selection. In older adults, the disproportionate increase in mixing cost was associated with greater interference at the level of decision-response mapping and response programming for repeat trials in mixed-task blocks. These findings suggest that older adults strategically recruit greater proactive and reactive control to overcome increased susceptibility to post-stimulus interference. This interpretation is consistent with recruitment of compensatory strategies to compensate for reduced repetition benefit rather than an overall decline on cognitive flexibility.

Reactive control processes contributing to residual switch cost and mixing cost across the adult lifespan

PubMed Central

Whitson, Lisa R.; Karayanidis, Frini; Fulham, Ross; Provost, Alexander; Michie, Patricia T.; Heathcote, Andrew; Hsieh, Shulan

2014-01-01

In task-switching paradigms, performance is better when repeating the same task than when alternating between tasks (switch cost) and when repeating a task alone rather than intermixed with another task (mixing cost). These costs remain even after extensive practice and when task cues enable advanced preparation (residual costs). Moreover, residual reaction time mixing cost has been consistently shown to increase with age. Residual switch and mixing costs modulate the amplitude of the stimulus-locked P3b. This mixing effect is disproportionately larger in older adults who also prepare more for and respond more cautiously on these “mixed” repeat trials (Karayanidis et al., 2011). In this paper, we analyze stimulus-locked and response-locked P3 and lateralized readiness potentials to identify whether residual switch and mixing cost arise from the need to control interference at the level of stimulus processing or response processing. Residual mixing cost was associated with control of stimulus-level interference, whereas residual switch cost was also associated with a delay in response selection. In older adults, the disproportionate increase in mixing cost was associated with greater interference at the level of decision-response mapping and response programming for repeat trials in mixed-task blocks. These findings suggest that older adults strategically recruit greater proactive and reactive control to overcome increased susceptibility to post-stimulus interference. This interpretation is consistent with recruitment of compensatory strategies to compensate for reduced repetition benefit rather than an overall decline on cognitive flexibility. PMID:24817859

Standardized Review and Approval Process for High-Cost Medication Use Promotes Value-Based Care in a Large Academic Medical System

PubMed Central

Durvasula, Raghu; Kelly, Janet; Schleyer, Anneliese; Anawalt, Bradley D.; Somani, Shabir; Dellit, Timothy H.

2018-01-01

Background As healthcare costs rise and reimbursements decrease, healthcare organization leadership and clinical providers must collaborate to provide high-value healthcare. Medications are a key driver of the increasing cost of healthcare, largely as a result of the proliferation of expensive specialty drugs, including biologic agents. Such medications contribute significantly to the inpatient diagnosis-related group payment system, often with minimal or unproved benefit over less-expensive therapies. Objective To describe a systematic review process to reduce non–evidence-based inpatient use of high-cost medications across a large multihospital academic health system. Methods We created a Pharmacy & Therapeutics subcommittee consisting of clinicians, pharmacists, and an ethics representative. This committee developed a standardized process for a timely review (<48 hours) and approval of high-cost medications based on their clinical effectiveness, safety, and appropriateness. The engagement of clinical experts in the development of the consensus-based guidelines for the use of specific medications facilitated the clinicians' acceptance of the review process. Results Over a 2-year period, a total of 85 patient-specific requests underwent formal review. All reviews were conducted within 48 hours. This review process has reduced the non–evidence-based use of specialty medications and has resulted in a pharmacy savings of $491,000 in fiscal year 2016, with almost 80% of the savings occurring in the last 2 quarters, because our process has matured. Conclusion The creation of a collaborative review process to ensure consistent, evidence-based utilization of high-cost medications provides value-based care, while minimizing unnecessary practice variation and reducing the cost of inpatient care.

"N"-2 Repetition Costs Depend on Preparation in Trials "n"-1 and "n"-2

ERIC Educational Resources Information Center

Scheil, Juliane; Kleinsorge, Thomas

2014-01-01

In task switching, a common result supporting the notion of inhibitory processes as a determinant of switch costs is the occurrence of "n"-2 repetition costs. Evidence suggests that this effect is not affected by preparation. However, the role of preparation on preceding trials has been neglected so far. In this study, evidence for an…

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...

Rand Arroyo Center 2014

DTIC Science & Technology

2015-01-01

field effective command and control sys- tems within the framework of current policies and processes. Cost Considerations in Cloud Computing ...www.rand.org/t/PE113 Finds that cloud provider costs can vary compared with tradi- tional information system alternatives because of different cost structures...for analysts evaluating new cloud investments. U.S. Army photo by Staff Sgt. Christopher Calvert FOCUS ON Capabilities Development and Acquisition

Use of a multimission system for cost effective support of planetary science data processing

NASA Technical Reports Server (NTRS)

Green, William B.

1994-01-01

JPL's Multimission Operations Systems Office (MOSO) provides a multimission facility at JPL for processing science instrument data from NASA's planetary missions. This facility, the Multimission Image Processing System (MIPS), is developed and maintained by MOSO to meet requirements that span the NASA family of planetary missions. Although the word 'image' appears in the title, MIPS is used to process instrument data from a variety of science instruments. This paper describes the design of a new system architecture now being implemented within the MIPS to support future planetary mission activities at significantly reduced operations and maintenance cost.

Stimulating learning-by-doing in advanced biofuels: effectiveness of alternative policies

NASA Astrophysics Data System (ADS)

Chen, Xiaoguang; Khanna, Madhu; Yeh, Sonia

2012-12-01

This letter examines the effectiveness of various biofuel and climate policies in reducing future processing costs of cellulosic biofuels due to learning-by-doing. These policies include a biofuel production mandate alone and supplementing the biofuel mandate with other policies, namely a national low carbon fuel standard, a cellulosic biofuel production tax credit or a carbon price policy. We find that the binding biofuel targets considered here can reduce the unit processing cost of cellulosic ethanol by about 30% to 70% between 2015 and 2035 depending on the assumptions about learning rates and initial costs of biofuel production. The cost in 2035 is more sensitive to the speed with which learning occurs and less sensitive to uncertainty in the initial production cost. With learning rates of 5-10%, cellulosic biofuels will still be at least 40% more expensive than liquid fossil fuels in 2035. The addition of supplementary low carbon/tax credit policies to the mandate that enhance incentives for cellulosic biofuels can achieve similar reductions in these costs several years earlier than the mandate alone; the extent of these incentives differs across policies and different kinds of cellulosic biofuels.

Computer simulation of energy use, greenhouse gas emissions, and process economics of the fluid milk process.

PubMed

Tomasula, P M; Yee, W C F; McAloon, A J; Nutter, D W; Bonnaillie, L M

2013-05-01

Energy-savings measures have been implemented in fluid milk plants to lower energy costs and the energy-related carbon dioxide (CO2) emissions. Although these measures have resulted in reductions in steam, electricity, compressed air, and refrigeration use of up to 30%, a benchmarking framework is necessary to examine the implementation of process-specific measures that would lower energy use, costs, and CO2 emissions even further. In this study, using information provided by the dairy industry and equipment vendors, a customizable model of the fluid milk process was developed for use in process design software to benchmark the electrical and fuel energy consumption and CO2 emissions of current processes. It may also be used to test the feasibility of new processing concepts to lower energy and CO2 emissions with calculation of new capital and operating costs. The accuracy of the model in predicting total energy usage of the entire fluid milk process and the pasteurization step was validated using available literature and industry energy data. Computer simulation of small (40.0 million L/yr), medium (113.6 million L/yr), and large (227.1 million L/yr) processing plants predicted the carbon footprint of milk, defined as grams of CO2 equivalents (CO2e) per kilogram of packaged milk, to within 5% of the value of 96 g of CO 2e/kg of packaged milk obtained in an industry-conducted life cycle assessment and also showed, in agreement with the same study, that plant size had no effect on the carbon footprint of milk but that larger plants were more cost effective in producing milk. Analysis of the pasteurization step showed that increasing the percentage regeneration of the pasteurizer from 90 to 96% would lower its thermal energy use by almost 60% and that implementation of partial homogenization would lower electrical energy use and CO2e emissions of homogenization by 82 and 5.4%, respectively. It was also demonstrated that implementation of steps to lower non-process-related electrical energy in the plant would be more effective in lowering energy use and CO2e emissions than fuel-related energy reductions. The model also predicts process-related water usage, but this portion of the model was not validated due to a lack of data. The simulator model can serve as a benchmarking framework for current plant operations and a tool to test cost-effective process upgrades or evaluate new technologies that improve the energy efficiency and lower the carbon footprint of milk processing plants. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Good Manufacturing Practices (GMP) manufacturing of advanced therapy medicinal products: a novel tailored model for optimizing performance and estimating costs.

PubMed

Abou-El-Enein, Mohamed; Römhild, Andy; Kaiser, Daniel; Beier, Carola; Bauer, Gerhard; Volk, Hans-Dieter; Reinke, Petra

2013-03-01

Advanced therapy medicinal products (ATMP) have gained considerable attention in academia due to their therapeutic potential. Good Manufacturing Practice (GMP) principles ensure the quality and sterility of manufacturing these products. We developed a model for estimating the manufacturing costs of cell therapy products and optimizing the performance of academic GMP-facilities. The "Clean-Room Technology Assessment Technique" (CTAT) was tested prospectively in the GMP facility of BCRT, Berlin, Germany, then retrospectively in the GMP facility of the University of California-Davis, California, USA. CTAT is a two-level model: level one identifies operational (core) processes and measures their fixed costs; level two identifies production (supporting) processes and measures their variable costs. The model comprises several tools to measure and optimize performance of these processes. Manufacturing costs were itemized using adjusted micro-costing system. CTAT identified GMP activities with strong correlation to the manufacturing process of cell-based products. Building best practice standards allowed for performance improvement and elimination of human errors. The model also demonstrated the unidirectional dependencies that may exist among the core GMP activities. When compared to traditional business models, the CTAT assessment resulted in a more accurate allocation of annual expenses. The estimated expenses were used to set a fee structure for both GMP facilities. A mathematical equation was also developed to provide the final product cost. CTAT can be a useful tool in estimating accurate costs for the ATMPs manufactured in an optimized GMP process. These estimates are useful when analyzing the cost-effectiveness of these novel interventions. Copyright © 2013 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Carbon black dispersion pre-plating technology for printed wire board manufacturing. Final technology evaluation report

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

Folsom, D.W.; Gavaskar, A.R.; Jones, J.A.

1993-10-01

The project compared chemical use, waste generation, cost, and product quality between electroless copper and carbon-black-based preplating technologies at the printed wire board (PWB) manufacturing facility of McCurdy Circuits in Orange, CA. The carbon-black based preplating technology evaluated is used as an alternative process for electroless copper (EC) plating of through-holes before electrolytic copper plating. The specific process used at McCurdy is the BlackHole (BH) technology process, which uses a dispersion of carbon black in an aqueous solution to provide a conductive surface for subsequent electrolytic copper plating. The carbon-black dispersion technology provided effective waste reduction and long-term cost savings.more » The economic analysis determined that the new process was cost efficient because chemical use was reduced and the process proved more efficient; the payback period was less than 4 yrs.« less

The Impact of City-level Permitting Processes on Residential Photovoltaic Installation Prices and Development Times: An Empirical Analysis of Solar Systems in California Cities

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

Wiser, Ryan; Dong, Changgui

Business process or “soft” costs account for well over 50% of the installed price of residential photovoltaic (PV) systems in the United States, so understanding these costs is crucial for identifying PV cost-reduction opportunities. Among these costs are those imposed by city-level permitting processes, which may add both expense and time to the PV development process. Building on previous research, this study evaluates the effect of city-level permitting processes on the installed price of residential PV systems and on the time required to develop and install those systems. The study uses a unique dataset from the U.S. Department of Energy’smore » Rooftop Solar Challenge Program, which includes city-level permitting process “scores,” plus data from the California Solar Initiative and the U.S. Census. Econometric methods are used to quantify the price and development-time effects of city-level permitting processes on more than 3,000 PV installations across 44 California cities in 2011. Results indicate that city-level permitting processes have a substantial and statistically significant effect on average installation prices and project development times. The results suggest that cities with the most favorable (i.e., highest-scoring) permitting practices can reduce average residential PV prices by $0.27–$0.77/W (4%–12% of median PV prices in California) compared with cities with the most onerous (i.e., lowest-scoring) permitting practices, depending on the regression model used. Though the empirical models for development times are less robust, results suggest that the most streamlined permitting practices may shorten development times by around 24 days on average (25% of the median development time). These findings illustrate the potential price and development-time benefits of streamlining local permitting procedures for PV systems.« less

Cancer care, money, and the value of life: whose justice? Which rationality?

PubMed

Sulmasy, Daniel P

2007-01-10

Cost-containment in oncology is a moral issue. While economists use the word "rationing" to describe all limitations on resource utilization that result from human choice, the ordinary language distinction between allocation and rationing is morally meaningful and can help oncologists to determine their proper moral role in cost-containment. It is argued that oncologists should not be required to ration at the bedside, nor should they be given financial incentives to practice frugally, nor should they be subjected to a variety of bureaucratic mechanisms to control costs indirectly. In addition, it is argued that the fact that treatments have a price does not logically imply that patients have a price. Cost-effectiveness analysis is often suggested as a means of deciding how best to allocate resources, but some of its many ethical limitations are discussed. The alternative is an open, public, participatory process about how to ration care, abandoning the formulaic pretenses of cost-effectiveness analysis, but with a commitment to reason, good will, and common sense. Oncologists would then be free to advocate for their patients within the constraints imposed by this public process.

Fixing the game: are between-silo differences in funding arrangements handicapping some interventions and giving others a head-start?

PubMed

Segal, Leonie; Dalziel, Kim; Mortimer, Duncan

2010-04-01

Given resource scarcity, not all potentially beneficial health services can be funded. Choices are made, if not explicitly, implicitly as some health services are funded and others are not. But what are the primary influences on those choices? We sought to test whether funding decisions are linked to cost effectiveness and to quantify the influence of funding arrangements and community values arguments. We tested this via empirical analysis of 245 Australian health-care interventions for which cost-effectiveness estimates had been published. The likelihood of government funding was modelled as a function of cost effectiveness, patient/target group characteristics, intervention characteristics and publication characteristics, using multiple regression analysis. We found that higher cost effectiveness ratios were a significant predictor of funding rejection, but that cost effectiveness was not related to the level of funding. Intervention characteristics linked to funding and delivery arrangements and community values arguments were significant predictors of funding outcomes. Our analysis supports the hypothesis that funding and delivery arrangements influence both whether an intervention is funded and funding level; even after controlling for community values and cost effectiveness. It suggests that adopting partial priority setting processes without regard to opportunity cost can have the perverse effect of compounding allocative inefficiencies. Copyright (c) 2009 John Wiley & Sons, Ltd.

Low Cost Processing of Commingled Thermoplastic Composites

NASA Astrophysics Data System (ADS)

Chiasson, Matthew Lee

A low cost vacuum consolidation process has been investigated for use with commingled thermoplastic matrix composites. In particular, the vacuum consolidation behaviour of commingled polypropylene/glass fibre and commingled nylon/carbon fibre precursors were studied. Laminates were consolidated in a convection oven under vacuum pressure. During processing, the consolidation of the laminate packs was measured by use of non-contact eddy current sensors. The consolidation curves are then used to tune an empirical consolidation model. The overall quality of the resulting laminates is also discussed. Dynamic mechanical analysis, differential scanning calorimetry and mechanical tensile testing were also performed in order to determine the effects of varying processing parameters on the physical and mechanical properties of the laminates. Through this analysis, it was determined that the nylon/carbon fibre blend was not suitable for vacuum consolidation, while the polypropylene/glass fibre blend is a viable option for vacuum consolidation. The ultimate goal of this work is to provide a foundation from which low cost unmanned aerial vehicle (UAV) components can be designed and manufactured from thermoplastic matrix composites using a low cost processing technique as an alternative to traditional thermoset composite materials.

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.

Systematic process synthesis and design methods for cost effective waste minimization

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

Biegler, L.T.; Grossman, I.E.; Westerberg, A.W.

We present progress on our work to develop synthesis methods to aid in the design of cost effective approaches to waste minimization. Work continues to combine the approaches of Douglas and coworkers and of Grossmann and coworkers on a hierarchical approach where bounding information allows it to fit within a mixed integer programming approach. We continue work on the synthesis of reactors and of flexible separation processes. In the first instance, we strive for methods we can use to reduce the production of potential pollutants, while in the second we look for ways to recover and recycle solvents.

Continuous processing and the applications of online tools in pharmaceutical product manufacture: developments and examples.

PubMed

Ooi, Shing Ming; Sarkar, Srimanta; van Varenbergh, Griet; Schoeters, Kris; Heng, Paul Wan Sia

2013-04-01

Continuous processing and production in pharmaceutical manufacturing has received increased attention in recent years mainly due to the industries' pressing needs for more efficient, cost-effective processes and production, as well as regulatory facilitation. To achieve optimum product quality, the traditional trial-and-error method for the optimization of different process and formulation parameters is expensive and time consuming. Real-time evaluation and the control of product quality using an online process analyzer in continuous processing can provide high-quality production with very high-throughput at low unit cost. This review focuses on continuous processing and the application of different real-time monitoring tools used in the pharmaceutical industry for continuous processing from powder to tablets.

Low-Cost alpha Alane for Hydrogen Storage

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

Fabian, Tibor; Petrie, Mark; Crouch-Baker, Steven

This project was directed towards the further development of the Savannah River National Laboratory (SRNL) lab-scale electrochemical synthesis of the hydrogen storage material alpha-alane and Ardica Technologies-SRI International (SRI) chemical downstream processes that are necessary to meet DoE cost metrics and transition alpha-alane synthesis to an industrial scale. Ardica has demonstrated the use of alpha-alane in a fuel-cell system for the U.S. Army WFC20 20W soldier power system that has successfully passed initial field trials with individual soldiers. While alpha-alane has been clearly identified as a desirable hydrogen storage material, cost-effective means for its production and regeneration on a scalemore » of use applicable to the industry have yet to be established. We focused on three, principal development areas: 1. The construction of a comprehensive engineering techno-economic model to establish the production costs of alpha-alane by both electrochemical and chemical routes at scale. 2. The identification of critical, cost-saving design elements of the electrochemical cell and the quantification of the product yields of the primary electrochemical process. A moving particle-bed reactor design was constructed and operated. 3. The experimental quantification of the product yields of candidate downstream chemical processes necessary to produce alpha-alane to complete the most cost-effective overall manufacturing process. Our techno-economic model shows that under key assumptions most 2015 and 2020 DOE hydrogen storage system cost targets for low and medium power can be achieved using the electrochemical alane synthesis process. To meet the most aggressive 2020 storage system cost target, $1/g, our model indicates that 420 metric tons per year (MT/y) production of alpha-alane is required. Laboratory-scale experimental work demonstrated that the yields of two of the three critical component steps within the overall “electrochemical process” were sufficiently high to meet this production target. In the case of the yield of the third step, the crystallization of alpha-alane from the primary alane-related product of the electrochemical reaction, further development is required.« less

A Single-use Strategy to Enable Manufacturing of Affordable Biologics.

PubMed

Jacquemart, Renaud; Vandersluis, Melissa; Zhao, Mochao; Sukhija, Karan; Sidhu, Navneet; Stout, Jim

2016-01-01

The current processing paradigm of large manufacturing facilities dedicated to single product production is no longer an effective approach for best manufacturing practices. Increasing competition for new indications and the launch of biosimilars for the monoclonal antibody market have put pressure on manufacturers to produce at lower cost. Single-use technologies and continuous upstream processes have proven to be cost-efficient options to increase biomass production but as of today the adoption has been only minimal for the purification operations, partly due to concerns related to cost and scale-up. This review summarizes how a single-use holistic process and facility strategy can overcome scale limitations and enable cost-efficient manufacturing to support the growing demand for affordable biologics. Technologies enabling high productivity, right-sized, small footprint, continuous, and automated upstream and downstream operations are evaluated in order to propose a concept for the flexible facility of the future.

Investigation of test methods, material properties, and processes for solar cell encapsulants. Fourteenth quarterly progress report, August 12, 1978-November 12, 1979. [EVA, EPDM, aliphatic urethane, PVC plastisol, and butyl acrylate

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

Willis, P. B.; Baum, B.; Schnitzer, H. S.

1979-12-01

Springborn Laboratories is engaged in a study of evaluating potentially useful encapsulating materials for Task 3 of the Low-Cost Silicon Solar Array project (LSA) funded by DOE. The goal of this program is to identify, evaluate, and recommend encapsulant materials and processes for the production of cost-effective, long-life solar cell modules. This report presents the results of a cost analysis of candidate potting compounds for long life solar module encapsulation. Additionally, the two major encapsulation processes, sheet lamination and liquid casting, are costed on the basis of a large scale production facility. Potting compounds studied include EVA, sheet, clear; EVA,more » sheet, pigmented; EPDM, sheet, clear; Aliphatic urethane, syrup; PVC Plastisol; Butyl acrylate, syrup; and Butyl acrylate, sheet.« less

The influence of cue-task association and location on switch cost and alternating-switch cost.

PubMed

Arbuthnott, Katherine D; Woodward, Todd S

2002-03-01

Task-switching performance is strongly influenced by whether the imperative stimulus uniquely specifies which task to perform: Switch cost is substantial with bivalent stimuli but is greatly reduced with univalent stimuli, suggesting that available contextual information influences processing in task-switching situations. The present study examined whether task-relevant information provided by task cues influences the magnitude of switch cost in a parallel manner. Cues presented 500 ms prior to a trivalent stimulus indicated which of three tasks to perform. These cues either had a preexisting association with the to-be-performed task (verbal cues), or a recently learned association with the task (spatial and shape cues). The results paralleled the effects of stimulus bivalence: substantial switch cost with recently learned cue-task associations and greatly reduced switch cost with preexisting cue-task associations. This suggests that both stimulus-based and cue-based information can activate the relevant task set, possibly providing external support to endogenous control processes. Alternating-switch cost, a greater cost for switching back to a recently abandoned task, was also observed with both preexisting and recently learned cue-task associations, but only when all tasks were presented in a consistent spatial location. When spatial location was used to cue the to-be-performed tasks, no alternating-switch cost was observed, suggesting that different processes may be involved when tasks are uniquely located in space. Specification of the nature of these processes may prove to be complex, as post-hoc inspection of the data suggested that for the spatial cue condition, the alternating-switch cost may oscillate between cost and benefit, depending on the relevant task.

Self-Disclosure as an Exchange Process: Reinforcement Effects.

ERIC Educational Resources Information Center

Taylor, Dalmas A.

In association with an extensive examination of the disclosure literature, this paper describes two laboratory studies designed to yield information regarding the effects of reinforcement on self-disclosing behaviors in an exchange process. In one series, the experimenters manipulated the patterns of personal reward/cost experiences, hypothesizing…

Evaluation of a Stratified National Breast Screening Program in the United Kingdom: An Early Model-Based Cost-Effectiveness Analysis.

PubMed

Gray, Ewan; Donten, Anna; Karssemeijer, Nico; van Gils, Carla; Evans, D Gareth; Astley, Sue; Payne, Katherine

2017-09-01

To identify the incremental costs and consequences of stratified national breast screening programs (stratified NBSPs) and drivers of relative cost-effectiveness. A decision-analytic model (discrete event simulation) was conceptualized to represent four stratified NBSPs (risk 1, risk 2, masking [supplemental screening for women with higher breast density], and masking and risk 1) compared with the current UK NBSP and no screening. The model assumed a lifetime horizon, the health service perspective to identify costs (£, 2015), and measured consequences in quality-adjusted life-years (QALYs). Multiple data sources were used: systematic reviews of effectiveness and utility, published studies reporting costs, and cohort studies embedded in existing NBSPs. Model parameter uncertainty was assessed using probabilistic sensitivity analysis and one-way sensitivity analysis. The base-case analysis, supported by probabilistic sensitivity analysis, suggested that the risk stratified NBSPs (risk 1 and risk-2) were relatively cost-effective when compared with the current UK NBSP, with incremental cost-effectiveness ratios of £16,689 per QALY and £23,924 per QALY, respectively. Stratified NBSP including masking approaches (supplemental screening for women with higher breast density) was not a cost-effective alternative, with incremental cost-effectiveness ratios of £212,947 per QALY (masking) and £75,254 per QALY (risk 1 and masking). When compared with no screening, all stratified NBSPs could be considered cost-effective. Key drivers of cost-effectiveness were discount rate, natural history model parameters, mammographic sensitivity, and biopsy rates for recalled cases. A key assumption was that the risk model used in the stratification process was perfectly calibrated to the population. This early model-based cost-effectiveness analysis provides indicative evidence for decision makers to understand the key drivers of costs and QALYs for exemplar stratified NBSP. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Inhibition in task switching: The reliability of the n - 2 repetition cost.

PubMed

Kowalczyk, Agnieszka W; Grange, James A

2017-12-01

The n - 2 repetition cost seen in task switching is the effect of slower response times performing a recently completed task (e.g. an ABA sequence) compared to performing a task that was not recently completed (e.g. a CBA sequence). This cost is thought to reflect cognitive inhibition of task representations and as such, the n - 2 repetition cost has begun to be used as an assessment of individual differences in inhibitory control; however, the reliability of this measure has not been investigated in a systematic manner. The current study addressed this important issue. Seventy-two participants performed three task switching paradigms; participants were also assessed on rumination traits and processing speed-measures of individual differences potentially modulating the n - 2 repetition cost. We found significant n - 2 repetition costs for each paradigm. However, split-half reliability tests revealed that this cost was not reliable at the individual-difference level. Neither rumination tendencies nor processing speed predicted this cost. We conclude that the n - 2 repetition cost is not reliable as a measure of individual differences in inhibitory control.

Analogous selection processes in declarative and procedural working memory: N-2 list-repetition and task-repetition costs.

PubMed

Gade, Miriam; Souza, Alessandra S; Druey, Michel D; Oberauer, Klaus

2017-01-01

Working memory (WM) holds and manipulates representations for ongoing cognition. Oberauer (Psychology of Learning and Motivation, 51, 45-100, 2009) distinguishes between two analogous WM sub-systems: a declarative WM which handles the objects of thought, and a procedural WM which handles the representations of (cognitive) actions. Here, we assessed whether analogous effects are observed when participants switch between memory sets (declarative representations) and when they switch between task sets (procedural representations). One mechanism assumed to facilitate switching in procedural WM is the inhibition of previously used, but currently irrelevant task sets, as indexed by n-2 task-repetition costs (Mayr & Keele, Journal of Experimental Psychology: General, 129(1), 4-26, 2000). In this study we tested for an analogous effect in declarative WM. We assessed the evidence for n-2 list-repetition costs across eight experiments in which participants switched between memory lists to perform speeded classifications, mental arithmetic, or a local recognition test. N-2 list-repetition costs were obtained consistently in conditions assumed to increase interference between memory lists, and when lists formed chunks in long-term memory. Further analyses across experiments revealed a substantial contribution of episodic memory to n-2 list-repetition costs, thereby questioning the interpretation of n-2 repetition costs as reflecting inhibition. We reanalyzed the data of eight task-switching experiments, and observed that episodic memory also contributes to n-2 task-repetition costs. Taken together, these results show analogous processing principles in declarative and procedural WM, and question the relevance of inhibitory processes for efficient switching between mental sets.

Strategies for Sustainable Cancer Care.

PubMed

Kerr, David J; Jani, Anant; Gray, Sir Muir

2016-01-01

There is an increasing focus on the relative cost-effectiveness and sustainability of delivering high-quality cancer care, with most emphasis, debatably, given to cost control of innovative treatments. It is difficult to calculate all the direct and indirect contributors to the total cost of cancer treatment, but it is estimated that cancer drugs constitute 10% to 30% of the total cost of cancer care. A 2007 study in France showed the contribution of drug costs was less than 20%, with approximately 70% of the total expenditure on cancer accounted for by health care resource use, such as hospitalization. The U.K. government established the National Institute for Health and Care Excellence (NICE)-the dominant function of which is technology appraisal-to assess the clinical and cost-effectiveness of new pharmaceutical and biopharmaceutical products. This is to ensure that all National Health Service (NHS) patients have equitable access to the most clinically effective and cost-effective treatments that are viable. NICE has developed a transparent, public process to judge incremental cost-effectiveness using the quality-adjusted life year (QALY), which allows comparisons of cost-effectiveness across medical specialties. NICE has been both lauded and criticized-especially when it passes judgment on marginally effective but expensive anticancer drugs-but it provides a route to "rational rationing" and, therefore, may contribute to sustainable cancer care by highlighting the issue of affordable medicine. This implies a challenge to the wider oncology community as to how we might cooperate to introduce the concept of value-driven cancer care.

Costs and Effectiveness of Treatment Alternatives for Proximal Caries Lesions

PubMed Central

Schwendicke, Falk; Meyer-Lueckel, Hendrik; Stolpe, Michael; Dörfer, Christof Edmund; Paris, Sebastian

2014-01-01

Objectives Invasive therapy of proximal caries lesions initiates a cascade of re-treatment cycles with increasing loss of dental hard tissue. Non- and micro-invasive treatment aim at delaying this cascade and may thus reduce both the health and economic burden of such lesions. This study compared the costs and effectiveness of alternative treatments of proximal caries lesions. Methods A Markov-process model was used to simulate the events following the treatment of a proximal posterior lesion (E2/D1) in a 20-year-old patient in Germany. We compared three interventions (non-invasive; micro-invasive using resin infiltration; invasive using composite restoration). We calculated the risk of complications of initial and possible follow-up treatments and modelled time-dependent non-linear transition probabilities. Costs were calculated based on item-fee catalogues in Germany. Monte-Carlo-microsimulations were performed to compare cost-effectiveness of non- versus micro-invasive treatment and to analyse lifetime costs of all three treatments. Results Micro-invasive treatment was both more costly and more effective than non-invasive therapy, with ceiling-value-thresholds for willingness-to-pay between 16.73 € for E2 and 1.57 € for D1 lesions. Invasive treatment was the most costly strategy. Calculated costs and effectiveness were sensitive to lesion stage, patient’s age, discounting rate and assumed initial treatment costs. Conclusions Non- and micro-invasive treatments have lower long-term costs than invasive therapy of proximal lesions. Micro-invasive therapy had the highest cost-effectiveness for treating D1 lesions in young patients. Decision makers with a willingness-to-pay over 16.73 € and 1.57 € for E2 and D1 lesions, respectively, will find micro-invasive treatment more cost-effective than non-invasive therapy. PMID:24475208

Producing optical (contact) lenses by a novel low cost process

NASA Astrophysics Data System (ADS)

Skipper, Richard S.; Spencer, Ian D.

2005-09-01

The rapid and impressive growth of China has been achieved on the back of highly labour intensive industries, often in manufacturing, and at the cost of companies and jobs in Europe and America. Approaches that worked well in the 1990's to reduce production costs in the developed countries are no longer effective when confronted with the low labour costs of China and India. We have looked at contact lenses as a product that has become highly available to consumers here but as an industry that has reduced costs by moving to low labour cost countries. The question to be answered was, "Do we have the skill to still make the product in the UK, and can we make it cheap enough to export to China?" if we do not, then contact lens manufacture will move to China sooner or later. The challenge to enter the markets of the BRIC (Brazil, Russia, India and China) countries is extremely exciting as here is the new money, high growth and here is a product that sells to those with disposable incomes. To succeed we knew we had to be radical in our approach; the radical step was very simple: to devise a process in which each step added value to the customer and not cost to the product. The presentation examines the processes used by the major producers and how, by applying good manufacturing practice sound scientific principles to them, the opportunity to design a new low cost patented process was identified.

On the costs of parallel processing in dual-task performance: The case of lexical processing in word production.

PubMed

Paucke, Madlen; Oppermann, Frank; Koch, Iring; Jescheniak, Jörg D

2015-12-01

Previous dual-task picture-naming studies suggest that lexical processes require capacity-limited processes and prevent other tasks to be carried out in parallel. However, studies involving the processing of multiple pictures suggest that parallel lexical processing is possible. The present study investigated the specific costs that may arise when such parallel processing occurs. We used a novel dual-task paradigm by presenting 2 visual objects associated with different tasks and manipulating between-task similarity. With high similarity, a picture-naming task (T1) was combined with a phoneme-decision task (T2), so that lexical processes were shared across tasks. With low similarity, picture-naming was combined with a size-decision T2 (nonshared lexical processes). In Experiment 1, we found that a manipulation of lexical processes (lexical frequency of T1 object name) showed an additive propagation with low between-task similarity and an overadditive propagation with high between-task similarity. Experiment 2 replicated this differential forward propagation of the lexical effect and showed that it disappeared with longer stimulus onset asynchronies. Moreover, both experiments showed backward crosstalk, indexed as worse T1 performance with high between-task similarity compared with low similarity. Together, these findings suggest that conditions of high between-task similarity can lead to parallel lexical processing in both tasks, which, however, does not result in benefits but rather in extra performance costs. These costs can be attributed to crosstalk based on the dual-task binding problem arising from parallel processing. Hence, the present study reveals that capacity-limited lexical processing can run in parallel across dual tasks but only at the expense of extraordinary high costs. (c) 2015 APA, all rights reserved).

Operations and support cost modeling using Markov chains

NASA Technical Reports Server (NTRS)

Unal, Resit

1989-01-01

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

Applying Costs, Risks and Values Evaluation (CRAVE) methodology to Engineering Support Request (ESR) prioritization

NASA Technical Reports Server (NTRS)

Joglekar, Prafulla N.

1994-01-01

Given limited budget, the problem of prioritization among Engineering Support Requests (ESR's) with varied sizes, shapes, and colors is a difficult one. At the Kennedy Space Center (KSC), the recently developed 4-Matrix (4-M) method represents a step in the right direction as it attempts to combine the traditional criteria of technical merits only with the new concern for cost-effectiveness. However, the 4-M method was not adequately successful in the actual prioritization of ESRs for the fiscal year 1995 (FY95). This research identifies a number of design issues that should help us to develop better methods. It emphasizes that given the variety and diversity of ESR's one should not expect that a single method could help in the assessment of all ESR's. One conclusion is that a methodology such as Costs, Risks, and Values Evaluation (CRAVE) should be adopted. It also is clear that the development of methods such as 4-M requires input not only from engineers with technical expertise in ESR's but also from personnel with adequate background in the theory and practice of cost-effectiveness analysis. At KSC, ESR prioritization is one part of the Ground Support Working Teams (GSWT) Integration Process. It was discovered that the more important barriers to the incorporation of cost-effectiveness considerations in ESR prioritization lie in this process. The culture of integration, and the corresponding structure of review by a committee of peers, is not conducive to the analysis and confrontation necessary in the assessment and prioritization of ESR's. Without assistance from appropriately trained analysts charged with the responsibility to analyze and be confrontational about each ESR, the GSWT steering committee will continue to make its decisions based on incomplete understanding, inconsistent numbers, and at times, colored facts. The current organizational separation of the prioritization and the funding processes is also identified as an important barrier to the pursuit of cost-effectiveness. Perhaps the greatest barrier is that, at the working level, KSC's culture is so preoccupied with technical concerns that it seems almost oblivious to any cost concerns, let alone cost-effectiveness concerns. It is recommended that we must urgently begin to change that culture and seek a better balance between these two concerns.

47 CFR 54.642 - Competitive bidding requirement and exemptions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Healthcare... process. (1) All entities participating in the Healthcare Connect Fund must conduct a fair and open... local requirements. (c) Cost-effective. For purposes of the Healthcare Connect Fund, “cost-effective” is...

47 CFR 54.642 - Competitive bidding requirement and exemptions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Healthcare... process. (1) All entities participating in the Healthcare Connect Fund must conduct a fair and open... local requirements. (c) Cost-effective. For purposes of the Healthcare Connect Fund, “cost-effective” is...

Integration of aerobic granular sludge and mesh filter membrane bioreactor for cost-effective wastewater treatment.

PubMed

Li, Wen-Wei; Wang, Yun-Kun; Sheng, Guo-Ping; Gui, Yong-Xin; Yu, Lei; Xie, Tong-Qing; Yu, Han-Qing

2012-10-01

Conventional MBR has been mostly based on floc sludge and the use of costly microfiltration membranes. Here, a novel aerobic granule (AG)-mesh filter MBR (MMBR) process was developed for cost-effective wastewater treatment. During 32-day continuous operation, a predominance of granules was maintained in the system, and good filtration performance was achieved at a low trans-membrane pressure (TMP) of below 0.025 m. The granules showed a lower fouling propensity than sludge flocs, attributed to the formation of more porous biocake layer at mesh surface. A low-flux and low-TMP filtration favored a stable system operation. In addition, the reactor had high pollutant removal efficiencies, with a 91.4% chemical oxygen demand removal, 95.7% NH(4)(+) removal, and a low effluent turbidity of 4.1 NTU at the stable stage. This AG-MMBR process offers a promising technology for low-cost and efficient treatment of wastewaters. Copyright © 2012 Elsevier Ltd. All rights reserved.

Probabilistic cost-benefit analysis of disaster risk management in a development context.

PubMed

Kull, Daniel; Mechler, Reinhard; Hochrainer-Stigler, Stefan

2013-07-01

Limited studies have shown that disaster risk management (DRM) can be cost-efficient in a development context. Cost-benefit analysis (CBA) is an evaluation tool to analyse economic efficiency. This research introduces quantitative, stochastic CBA frameworks and applies them in case studies of flood and drought risk reduction in India and Pakistan, while also incorporating projected climate change impacts. DRM interventions are shown to be economically efficient, with integrated approaches more cost-effective and robust than singular interventions. The paper highlights that CBA can be a useful tool if certain issues are considered properly, including: complexities in estimating risk; data dependency of results; negative effects of interventions; and distributional aspects. The design and process of CBA must take into account specific objectives, available information, resources, and the perceptions and needs of stakeholders as transparently as possible. Intervention design and uncertainties should be qualified through dialogue, indicating that process is as important as numerical results. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Economic evaluation of the Good School Toolkit: an intervention for reducing violence in primary schools in Uganda

PubMed Central

Knight, Louise; Ssekadde, Willington; Namy, Sophie; Naker, Dipak; Devries, Karen

2018-01-01

Introduction This paper presents the cost and cost-effectiveness of the Good School Toolkit (GST), a programme aimed at reducing physical violence perpetrated by school staff to students in Uganda. Methods The effectiveness of the Toolkit was tested with a cluster randomised controlled trial in 42 primary schools in Luwero District, Uganda. A full economic costing evaluation and cost-effectiveness analysis were conducted alongside the trial. Both financial and economic costs were collected retrospectively from the provider’s perspective to estimate total and unit costs. Results The total cost of setting up and running the Toolkit over the 18-month trial period is estimated at US$397 233, excluding process monitor (M&E) activities. The cost to run the intervention is US$7429 per school annually, or US$15 per primary school pupil annually, in the trial intervention schools. It is estimated that the intervention has averted 1620 cases of past-week physical violence during the 18-month implementation period. The total cost per case of violence averted is US$244, and the annual implementation cost is US$96 per case averted during the trial. Conclusions The GST is a cost-effective intervention for reducing violence against pupils in primary schools in Uganda. It compares favourably against other violence reduction interventions in the region. PMID:29707243

Optimizing The DSSC Fabrication Process Using Lean Six Sigma

NASA Astrophysics Data System (ADS)

Fauss, Brian

Alternative energy technologies must become more cost effective to achieve grid parity with fossil fuels. Dye sensitized solar cells (DSSCs) are an innovative third generation photovoltaic technology, which is demonstrating tremendous potential to become a revolutionary technology due to recent breakthroughs in cost of fabrication. The study here focused on quality improvement measures undertaken to improve fabrication of DSSCs and enhance process efficiency and effectiveness. Several quality improvement methods were implemented to optimize the seven step individual DSSC fabrication processes. Lean Manufacturing's 5S method successfully increased efficiency in all of the processes. Six Sigma's DMAIC methodology was used to identify and eliminate each of the root causes of defects in the critical titanium dioxide deposition process. These optimizations resulted with the following significant improvements in the production process: 1. fabrication time of the DSSCs was reduced by 54 %; 2. fabrication procedures were improved to the extent that all critical defects in the process were eliminated; 3. the quantity of functioning DSSCs fabricated was increased from 17 % to 90 %.

Applying activity-based costing in long-term care.

PubMed

Wodchis, W P

1998-01-01

As greater numbers of the elderly use health services, and as health care costs climb, effective financial tracking is essential. Cost management in health care can benefit if costs are linked to the care activities where they are incurred. Activity-based costing (ABC) provides a useful approach. The framework aligns costs (inputs), through activities (process), to outputs and outcomes. It allocates costs based on client care needs rather than management structure. The ABC framework was tested in a residential care facility and in supportive housing apartments. The results demonstrate the feasibility and advantages of ABC for long term care agencies, including community-based care.

Economic evaluation of emergency obstetric care training: a systematic review.

PubMed

Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

2017-12-04

Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a need to scale-up and standardise processes that capture both cost and effectiveness of training and to agree on suitable economic evaluation models that allow for comparability across settings. PROSPERO_CRD42016041911 .

Nonlinear relative-proportion-based route adjustment process for day-to-day traffic dynamics: modeling, equilibrium and stability analysis

NASA Astrophysics Data System (ADS)

Zhu, Wenlong; Ma, Shoufeng; Tian, Junfang; Li, Geng

2016-11-01

Travelers' route adjustment behaviors in a congested road traffic network are acknowledged as a dynamic game process between them. Existing Proportional-Switch Adjustment Process (PSAP) models have been extensively investigated to characterize travelers' route choice behaviors; PSAP has concise structure and intuitive behavior rule. Unfortunately most of which have some limitations, i.e., the flow over adjustment problem for the discrete PSAP model, the absolute cost differences route adjustment problem, etc. This paper proposes a relative-Proportion-based Route Adjustment Process (rePRAP) maintains the advantages of PSAP and overcomes these limitations. The rePRAP describes the situation that travelers on higher cost route switch to those with lower cost at the rate that is unilaterally depended on the relative cost differences between higher cost route and its alternatives. It is verified to be consistent with the principle of the rational behavior adjustment process. The equivalence among user equilibrium, stationary path flow pattern and stationary link flow pattern is established, which can be applied to judge whether a given network traffic flow has reached UE or not by detecting the stationary or non-stationary state of link flow pattern. The stability theorem is proved by the Lyapunov function approach. A simple example is tested to demonstrate the effectiveness of the rePRAP model.

Digitizing Dissertations for an Institutional Repository: A Process and Cost Analysis*

PubMed Central

Piorun, Mary; Palmer, Lisa A.

2008-01-01

Objective: This paper describes the Lamar Soutter Library's process and costs associated with digitizing 300 doctoral dissertations for a newly implemented institutional repository at the University of Massachusetts Medical School. Methodology: Project tasks included identifying metadata elements, obtaining and tracking permissions, converting the dissertations to an electronic format, and coordinating workflow between library departments. Each dissertation was scanned, reviewed for quality control, enhanced with a table of contents, processed through an optical character recognition function, and added to the institutional repository. Results: Three hundred and twenty dissertations were digitized and added to the repository for a cost of $23,562, or $0.28 per page. Seventy-four percent of the authors who were contacted (n = 282) granted permission to digitize their dissertations. Processing time per title was 170 minutes, for a total processing time of 906 hours. In the first 17 months, full-text dissertations in the collection were downloaded 17,555 times. Conclusion: Locally digitizing dissertations or other scholarly works for inclusion in institutional repositories can be cost effective, especially if small, defined projects are chosen. A successful project serves as an excellent recruitment strategy for the institutional repository and helps libraries build new relationships. Challenges include workflow, cost, policy development, and copyright permissions. PMID:18654648

Costing behavioral interventions: a practical guide to enhance translation.

PubMed

Ritzwoller, Debra P; Sukhanova, Anna; Gaglio, Bridget; Glasgow, Russell E

2009-04-01

Cost and cost effectiveness of behavioral interventions are critical parts of dissemination and implementation into non-academic settings. Due to the lack of indicative data and policy makers' increasing demands for both program effectiveness and efficiency, cost analyses can serve as valuable tools in the evaluation process. To stimulate and promote broader use of practical techniques that can be used to efficiently estimate the implementation costs of behavioral interventions, we propose a set of analytic steps that can be employed across a broad range of interventions. Intervention costs must be distinguished from research, development, and recruitment costs. The inclusion of sensitivity analyses is recommended to understand the implications of implementation of the intervention into different settings using different intervention resources. To illustrate these procedures, we use data from a smoking reduction practical clinical trial to describe the techniques and methods used to estimate and evaluate the costs associated with the intervention. Estimated intervention costs per participant were $419, with a range of $276 to $703, depending on the number of participants.

Protocol for process evaluation of a randomised controlled trial of family-led rehabilitation post stroke (ATTEND) in India

PubMed Central

Liu, Hueiming; Lindley, Richard; Alim, Mohammed; Felix, Cynthia; Gandhi, Dorcas B C; Verma, Shweta J; Tugnawat, Deepak Kumar; Syrigapu, Anuradha; Ramamurthy, Ramaprabhu Krishnappa; Pandian, Jeyaraj D; Walker, Marion; Forster, Anne; Anderson, Craig S; Langhorne, Peter; Murthy, Gudlavalleti Venkata Satyanarayana; Shamanna, Bindiganavale Ramaswamy; Hackett, Maree L; Maulik, Pallab K; Harvey, Lisa A; Jan, Stephen

2016-01-01

Introduction We are undertaking a randomised controlled trial (fAmily led rehabiliTaTion aftEr stroke in INDia, ATTEND) evaluating training a family carer to enable maximal rehabilitation of patients with stroke-related disability; as a potentially affordable, culturally acceptable and effective intervention for use in India. A process evaluation is needed to understand how and why this complex intervention may be effective, and to capture important barriers and facilitators to its implementation. We describe the protocol for our process evaluation to encourage the development of in-process evaluation methodology and transparency in reporting. Methods and analysis The realist and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) frameworks informed the design. Mixed methods include semistructured interviews with health providers, patients and their carers, analysis of quantitative process data describing fidelity and dose of intervention, observations of trial set up and implementation, and the analysis of the cost data from the patients and their families perspective and programme budgets. These qualitative and quantitative data will be analysed iteratively prior to knowing the quantitative outcomes of the trial, and then triangulated with the results from the primary outcome evaluation. Ethics and dissemination The process evaluation has received ethical approval for all sites in India. In low-income and middle-income countries, the available human capital can form an approach to reducing the evidence practice gap, compared with the high cost alternatives available in established market economies. This process evaluation will provide insights into how such a programme can be implemented in practice and brought to scale. Through local stakeholder engagement and dissemination of findings globally we hope to build on patient-centred, cost-effective and sustainable models of stroke rehabilitation. Trial registration number CTRI/2013/04/003557. PMID:27633636

The impact of including passive benefits in cost-effectiveness analysis: the case of automated external defibrillators on commercial aircraft.

PubMed

Cram, Peter; Vijan, Sandeep; Wolbrink, Alex; Fendrick, A Mark

2003-01-01

Traditional cost-utility analysis assumes that all benefits from health-related interventions are captured by the quality-adjusted life-years (QALYs) gained by the few individuals whose outcome is improved by the intervention. However, it is possible that many individuals who do not directly benefit from an intervention receive utility, and therefore QALYs, because of the passive benefit (aka sense of security) provided by the existence of the intervention. The objective of this study was to evaluate the impact that varying quantities of passive benefit have on the cost-effectiveness of airline defibrillator programs. A decision analytic model with Markov processes was constructed to evaluate the cost-effectiveness of defibrillator deployment on domestic commercial passenger aircraft over 1 year. Airline passengers were assigned small incremental utility gains (.001-.01) during an estimated 3-hour flight to evaluate the impact of passive benefit on overall cost-effectiveness. In the base case analysis with no allowance for passive benefit, the cost-effectiveness of airline automated external defibrillator deployment was US dollars 34000 per QALY gained. If 1% of all passengers received utility gain of.01, the cost-effectiveness declined to US dollars 30000. Cost-effectiveness was enhanced when the quantity of passive benefit was raised or the percentage of individuals receiving passive benefit increased. Automated external defibrillator deployment on passenger aircraft is likely to be cost-effective. If a small percentage of airline passengers receive incremental utility gains from passive benefit of automated external defibrillator availability, the impact on overall cost-effectiveness may be substantial. Further research should attempt to clarify the magnitude and percentage of patients who receive passive benefit.

Cost-effectiveness and pricing of antibacterial drugs.

PubMed

Verhoef, Talitha I; Morris, Stephen

2015-01-01

Growing resistance to antibacterial agents has increased the need for the development of new drugs to treat bacterial infections. Given increasing pressure on limited health budgets, it is important to study the cost-effectiveness of these drugs, as well as their safety and efficacy, to find out whether or not they provide value for money and should be reimbursed. In this article, we systematically reviewed 38 cost-effectiveness analyses of new antibacterial agents. Most studies showed the new antibacterial drugs were cost-effective compared to older generation drugs. Drug pricing is a complicated process, involving different stakeholders, and has a large influence on cost-effectiveness. Value-based pricing is a method to determine the price of a drug at which it can be cost-effective. It is currently unclear what the influence of value-based pricing will be on the prices of new antibacterial agents, but an important factor will be the definition of 'value', which as well as the impact of the drug on patient health might also include other factors such as wider social impact and the health impact of disease. © 2015 The Authors. Chemical Biology & Drug Design Published by John Wiley & Sons Ltd.

Costs of early detection systems for epidemic malaria in highland areas of Kenya and Uganda

PubMed Central

Mueller, Dirk H; Abeku, Tarekegn A; Okia, Michael; Rapuoda, Beth; Cox, Jonathan

2009-01-01

Background Malaria epidemics cause substantial morbidity and mortality in highland areas of Africa. The costs of detecting and controlling these epidemics have not been explored adequately in the past. This study presents the costs of establishing and running an early detection system (EDS) for epidemic malaria in four districts in the highlands of Kenya and Uganda. Methods An economic costing was carried out from the health service provider's perspective in both countries. Staff time for data entry and processing, as well as supervising and coordinating EDS activities at district and national levels was recorded and associated opportunity costs estimated. A threshold analysis was carried out to determine the number of DALYs or deaths that would need to be averted in order for the EDS to be considered cost-effective. Results The total costs of the EDS per district per year ranged between US$ 14,439 and 15,512. Salaries were identified as major cost-drivers, although their relative contribution to overall costs varied by country. Costs of relaying surveillance data between facilities and district offices (typically by hand) were also substantial. Data from Uganda indicated that 4% or more of overall costs could potentially be saved by switching to data transfer via mobile phones. Based on commonly used thresholds, 96 DALYs in Uganda and 103 DALYs in Kenya would need to be averted annually in each district for the EDS to be considered cost-effective. Conclusion Results from this analysis suggest that EDS are likely to be cost-effective. Further studies that include the costs and effects of the health systems' reaction prompted by EDS will need to be undertaken in order to obtain comprehensive cost-effectiveness estimates. PMID:19149878

Costs of early detection systems for epidemic malaria in highland areas of Kenya and Uganda.

PubMed

Mueller, Dirk H; Abeku, Tarekegn A; Okia, Michael; Rapuoda, Beth; Cox, Jonathan

2009-01-16

Malaria epidemics cause substantial morbidity and mortality in highland areas of Africa. The costs of detecting and controlling these epidemics have not been explored adequately in the past. This study presents the costs of establishing and running an early detection system (EDS) for epidemic malaria in four districts in the highlands of Kenya and Uganda. An economic costing was carried out from the health service provider's perspective in both countries. Staff time for data entry and processing, as well as supervising and coordinating EDS activities at district and national levels was recorded and associated opportunity costs estimated. A threshold analysis was carried out to determine the number of DALYs or deaths that would need to be averted in order for the EDS to be considered cost-effective. The total costs of the EDS per district per year ranged between US$ 14,439 and 15,512. Salaries were identified as major cost-drivers, although their relative contribution to overall costs varied by country. Costs of relaying surveillance data between facilities and district offices (typically by hand) were also substantial. Data from Uganda indicated that 4% or more of overall costs could potentially be saved by switching to data transfer via mobile phones. Based on commonly used thresholds, 96 DALYs in Uganda and 103 DALYs in Kenya would need to be averted annually in each district for the EDS to be considered cost-effective. Results from this analysis suggest that EDS are likely to be cost-effective. Further studies that include the costs and effects of the health systems' reaction prompted by EDS will need to be undertaken in order to obtain comprehensive cost-effectiveness estimates.

D-malate production by permeabilized Pseudomonas pseudoalcaligenes; optimization of conversion and biocatalyst productivity.

PubMed

Michielsen, M J; Frielink, C; Wijffels, R H; Tramper, J; Beeftink, H H

2000-04-14

For the development of a continuous process for the production of solid D-malate from a Ca-maleate suspension by permeabilized Pseudomonas pseudoalcaligenes, it is important to understand the effect of appropriate process parameters on the stability and activity of the biocatalyst. Previously, we quantified the effect of product (D-malate2 -) concentration on both the first-order biocatalyst inactivation rate and on the biocatalytic conversion rate. The effects of the remaining process parameters (ionic strength, and substrate and Ca2 + concentration) on biocatalyst activity are reported here. At (common) ionic strengths below 2 M, biocatalyst activity was unaffected. At high substrate concentrations, inhibition occurred. Ca2+ concentration did not affect biocatalyst activity. The kinetic parameters (both for conversion and inactivation) were determined as a function of temperature by fitting the complete kinetic model, featuring substrate inhibition, competitive product inhibition and first-order irreversible biocatalyst inactivation, at different temperatures simultaneously through three extended data sets of substrate concentration versus time. Temperature affected both the conversion and inactivation parameters. The final model was used to calculate the substrate and biocatalyst costs per mmol of product in a continuous system with biocatalyst replenishment and biocatalyst recycling. Despite the effect of temperature on each kinetic parameter separately, the overall effect of temperature on the costs was found to be negligible (between 293 and 308 K). Within pertinent ranges, the sum of the substrate and biocatalyst costs per mmol of product was calculated to decrease with the influent substrate concentration and the residence time. The sum of the costs showed a minimum as a function of the influent biocatalyst concentration.

Health economics of market access for biopharmaceuticals and biosimilars.

PubMed

Simoens, Steven

2009-09-01

This article discusses health economic challenges of research and development, registration, pricing and reimbursement of biopharmaceuticals and biosimilars. A literature search was carried out of PubMed, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews and EconLit up to March 2009. The development process of biopharmaceuticals is risky, lengthy, complex and expensive. Registration is complicated by the inherent variation between biopharmaceuticals. Also, as biopharmaceuticals are likely to be efficacious in a subgroup of the patient population, there is a need to select the most responsive target population and to identify biomarkers. To inform pricing and reimbursement decisions, the development process needs to collect comparative data to calculate the incremental cost effectiveness and budget impact of biopharmaceuticals. There is a role for innovative mechanisms such as risk-sharing arrangements to reimburse biopharmaceuticals. Given that biosimilars are similar, but not identical to the reference biopharmaceutical, the development process needs to generate clinical trial data in order to gain marketing authorisation. From a health economic perspective, the question arises whether inherent differences between biopharmaceuticals and biosimilars produce differences in safety, effectiveness and costs: to date, this question is unresolved. The early inclusion of health economics in the process of developing biopharmaceuticals and biosimilars is imperative with a view to demonstrating their relative (cost) effectiveness and informing registration, pricing and reimbursement decisions.

Depth treatment of coal-chemical engineering wastewater by a cost-effective sequential heterogeneous Fenton and biodegradation process.

PubMed

Fang, Yili; Yin, Weizhao; Jiang, Yanbin; Ge, Hengjun; Li, Ping; Wu, Jinhua

2018-05-01

In this study, a sequential Fe 0 /H 2 O 2 reaction and biological process was employed as a low-cost depth treatment method to remove recalcitrant compounds from coal-chemical engineering wastewater after regular biological treatment. First of all, a chemical oxygen demand (COD) and color removal efficiency of 66 and 63% was achieved at initial pH of 6.8, 25 mmol L -1 of H 2 O 2 , and 2 g L -1 of Fe 0 in the Fe 0 /H 2 O 2 reaction. According to the gas chromatography-mass spectrometer (GC-MS) and gas chromatography-flame ionization detector (GC-FID) analysis, the recalcitrant compounds were effectively decomposed into short-chain organic acids such as acetic, propionic, and butyric acids. Although these acids were resistant to the Fe 0 /H 2 O 2 reaction, they were effectively eliminated in the sequential air lift reactor (ALR) at a hydraulic retention time (HRT) of 2 h, resulting in a further decrease of COD and color from 120 to 51 mg L -1 and from 70 to 38 times, respectively. A low operational cost of 0.35 $ m -3 was achieved because pH adjustment and iron-containing sludge disposal could be avoided since a total COD and color removal efficiency of 85 and 79% could be achieved at an original pH of 6.8 by the above sequential process with a ferric ion concentration below 0.8 mg L -1 after the Fe 0 /H 2 O 2 reaction. It indicated that the above sequential process is a promising and cost-effective method for the depth treatment of coal-chemical engineering wastewaters to satisfy discharge requirements.

Cost-effective and rapid concrete repair techniques.

DOT National Transportation Integrated Search

2016-02-08

Concrete is a principal component of many transportation structures. While highly durable, a : variety of processes degrade and damage concrete. Replacement is expensive. Many cases : warrant repair instead of replacement. Since many damage processes...

Activity-based costing in radiology. Application in a pediatric radiological unit.

PubMed

Laurila, J; Suramo, I; Brommels, M; Tolppanen, E M; Koivukangas, P; Lanning, P; Standertskjöld-Nordenstam, G

2000-03-01

To get an informative and detailed picture of the resource utilization in a radiology department in order to support its pricing and management. A system based mainly on the theoretical foundations of activity-based costing (ABC) was designed, tested and compared with conventional costing. The study was performed at the Pediatric Unit of the Department of Radiology, Oulu University Hospital. The material consisted of all the 7,452 radiological procedures done in the unit during the first half of 1994, when both methods of costing where in use. Detailed cost data were obtained from the hospital financial and personnel systems and then related to activity data captured in the radiology information system. The allocation of overhead costs was greatly reduced by the introduction of ABC compared to conventional costing. The overhead cost as a percentage of total costs dropped to one-fourth of total costs, from 57% to 16%. The change of unit costs of radiological procedures varied from -42% to +82%. Costing is much more detailed and precise, and the percentage of unspecified allocated overhead costs diminishes drastically when ABC is used. The new information enhances effective departmental management, as the whole process of radiological procedures is identifiable by single activities, amenable to corrective actions and process improvement.

Defense Remote Handled Transuranic Waste Cost/Schedule Optimization Study

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

Pierce, G.D.; Beaulieu, D.H.; Wolaver, R.W.

1986-11-01

The purpose of this study is to provide the DOE information with which it can establish the most efficient program for the long management and disposal, in the Waste Isolation Pilot Plant (WIPP), of remote handled (RH) transuranic (TRU) waste. To fulfill this purpose, a comprehensive review of waste characteristics, existing and projected waste inventories, processing and transportation options, and WIPP requirements was made. Cost differences between waste management alternatives were analyzed and compared to an established baseline. The result of this study is an information package that DOE can use as the basis for policy decisions. As part ofmore » this study, a comprehensive list of alternatives for each element of the baseline was developed and reviewed with the sites. The principle conclusions of the study follow. A single processing facility for RH TRU waste is both necessary and sufficient. The RH TRU processing facility should be located at Oak Ridge National Laboratory (ORNL). Shielding of RH TRU to contact handled levels is not an economic alternative in general, but is an acceptable alternative for specific waste streams. Compaction is only cost effective at the ORNL processing facility, with a possible exception at Hanford for small compaction of paint cans of newly generated glovebox waste. It is more cost effective to ship certified waste to WIPP in 55-gal drums than in canisters, assuming a suitable drum cask becomes available. Some waste forms cannot be packaged in drums, a canister/shielded cask capability is also required. To achieve the desired disposal rate, the ORNL processing facility must be operational by 1996. Implementing the conclusions of this study can save approximately $110 million, compared to the baseline, in facility, transportation, and interim storage costs through the year 2013. 10 figs., 28 tabs.« less

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.

Cost-effective smoke-free multiunit housing media campaigns: connecting with local communities.

PubMed

Modayil, Mary V; Consolacion, Theodora B; Isler, Jonathan; Soria, Sandra; Stevens, Colleen

2011-11-01

Presented are cost-effective paid media strategies to educate Californians to advocate for stronger smoke-free multiunit housing (SF-MUH) policies between 2006 and 2008. Included is a summary of general market and specific ethnic market costs that correspond to SF-MUH attitudes and home smoking bans. Statewide questionnaires indicated that half of the intended general market saw an antitobacco TV ad and half of the intended ethnic markets heard radio ads. Analyses indicated that it cost $0.67 and $0.78 per person to see Caution Tape and Apartment TV ads, respectively. Slightly higher per capita costs corresponded with positive attitudes toward SF-MUH: $0.87 for Caution Tape and $1.00 for Apartment. Lessons learned from this campaign included effectiveness of specific ads in ethnic markets, impact on SF-MUH work plan policy objectives, and the need for collaborations among state and local partners throughout the message development process.

Process-based costing.

PubMed

Lee, Robert H; Bott, Marjorie J; Forbes, Sarah; Redford, Linda; Swagerty, Daniel L; Taunton, Roma Lee

2003-01-01

Understanding how quality improvement affects costs is important. Unfortunately, low-cost, reliable ways of measuring direct costs are scarce. This article builds on the principles of process improvement to develop a costing strategy that meets both criteria. Process-based costing has 4 steps: developing a flowchart, estimating resource use, valuing resources, and calculating direct costs. To illustrate the technique, this article uses it to cost the care planning process in 3 long-term care facilities. We conclude that process-based costing is easy to implement; generates reliable, valid data; and allows nursing managers to assess the costs of new or modified processes.

Enhanced ABC costing for hospitals: directed expense costing.

PubMed

Ryan, J

1997-10-01

Space limitations do not allow a complete discussion of all the topics and many of the obvious questions that the preceding brief introduction to directed expense costing probably raised in the reader's mind. These include how errors in accounting practices like posting expenses to the wrong period are handled; and how the system automatically adjusts costs for expenses benefiting several periods but posted to the acquisition month. As was mentioned above, underlying this overtly simple costing method are a number of sophisticated and sometimes complex processes that are hidden from the normal user and designed to automatically protect the integrity and accuracy of the costing process. From a user's viewpoint, the system is straightforward, understandable, and easy to use and audit. From a software development perspective, it is not quite that effortless. By using a system that is understood by all users at all levels, these users can now communicate with each other in a new and effective way. This new communication channel only occurs after each user is satisfied as to the overall costing quality achieved by the process. However, not all managers or physicians are always happy that the institution is using this "understandable" cost accounting system. During one of the weekly meetings of a hospital's administrative council, complaints from several powerful department heads concerning the impact that the use of cost data was having on them were brought up for discussion. In defending the continued use of the system, one vice president stated to the group that cost accounting does not get any easier than this, or any less expensive, or any more accurate. The directed expense process works and works very well. Our department heads and physicians will have to come to grips with the accountably it provides us to assess their value to the hospital.

Cost-Effectiveness Analysis of Interventions to Reduce Risk of Aspiration in Elderly Cancer Survivors Residing in Skilled Nursing Facilities.

PubMed

Mantravadi, S

2017-04-01

Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death. Analyses of cost, decision-tree modeling, and cost effectiveness were performed to compare a hypothetical, interventional model based on best practices with usual (standard) care. A societal perspective was used as the economic view point. Direct costs, caregiver time, and market values for wages were estimated for the 2 interventions. Effectiveness values for the cost-effectiveness and decision-tree analyses were obtained from the literature. The incremental-cost-effectiveness ratio was calculated and used to compare the intervention with usual care. The interventional method was more costly but more effective than usual care. A sensitivity analysis considered the uncertainty of event probability (aspiration vs no aspiration). The interventional protocol for aspiration reduction continued to be more cost effective than usual care. Aspiration takes a financial toll on all facets of health care, including on nurses, skilled nursing facilities, patients, their families, and insurers, among others. Implementing guidelines that describe best practices for aspiration appears to be a cost-effective strategy for reducing aspirations among cancer survivors - especially elderly patients - who live in skilled nursing facilities.

Development of a Two-Stage Microalgae Dewatering Process – A Life Cycle Assessment Approach

PubMed Central

Soomro, Rizwan R.; Zeng, Xianhai; Lu, Yinghua; Lin, Lu; Danquah, Michael K.

2016-01-01

Even though microalgal biomass is leading the third generation biofuel research, significant effort is required to establish an economically viable commercial-scale microalgal biofuel production system. Whilst a significant amount of work has been reported on large-scale cultivation of microalgae using photo-bioreactors and pond systems, research focus on establishing high performance downstream dewatering operations for large-scale processing under optimal economy is limited. The enormous amount of energy and associated cost required for dewatering large-volume microalgal cultures has been the primary hindrance to the development of the needed biomass quantity for industrial-scale microalgal biofuels production. The extremely dilute nature of large-volume microalgal suspension and the small size of microalgae cells in suspension create a significant processing cost during dewatering and this has raised major concerns towards the economic success of commercial-scale microalgal biofuel production as an alternative to conventional petroleum fuels. This article reports an effective framework to assess the performance of different dewatering technologies as the basis to establish an effective two-stage dewatering system. Bioflocculation coupled with tangential flow filtration (TFF) emerged a promising technique with total energy input of 0.041 kWh, 0.05 kg CO2 emissions and a cost of $ 0.0043 for producing 1 kg of microalgae biomass. A streamlined process for operational analysis of two-stage microalgae dewatering technique, encompassing energy input, carbon dioxide emission, and process cost, is presented. PMID:26904075

Cost-engineering modeling to support rapid concept development of an advanced infrared satellite system

NASA Astrophysics Data System (ADS)

Bell, Kevin D.; Dafesh, Philip A.; Hsu, L. A.; Tsuda, A. S.

1995-12-01

Current architectural and design trade techniques often carry unaffordable alternatives late into the decision process. Early decisions made during the concept exploration and development (CE&D) phase will drive the cost of a program more than any other phase of development; thus, designers must be able to assess both the performance and cost impacts of their early choices. The Space Based Infrared System (SBIRS) cost engineering model (CEM) described in this paper is an end-to-end process integrating engineering and cost expertise through commonly available spreadsheet software, allowing for concurrent design engineering and cost estimation to identify and balance system drives to reduce acquisition costs. The automated interconnectivity between subsystem models using spreadsheet software allows for the quick and consistent assessment of the system design impacts and relative cost impacts due to requirement changes. It is different from most CEM efforts attempted in the past as it incorporates more detailed spacecraft and sensor payload models, and has been applied to determine the cost drivers for an advanced infrared satellite system acquisition. The CEM is comprised of integrated detailed engineering and cost estimating relationships describing performance, design, and cost parameters. Detailed models have been developed to evaluate design parameters for the spacecraft bus and sensor; both step-starer and scanner sensor types incorporate models of focal plane array, optics, processing, thermal, communications, and mission performance. The current CEM effort has provided visibility to requirements, design, and cost drivers for system architects and decision makers to determine the configuration of an infrared satellite architecture that meets essential requirements cost effectively. In general, the methodology described in this paper consists of process building blocks that can be tailored to the needs of many applications. Descriptions of the spacecraft and payload subsystem models provide insight into The Aerospace Corporation expertise and scope of the SBIRS concept development effort.

48 CFR 48.102 - Policies.

Code of Federal Regulations, 2014 CFR

2014-10-01

... VALUE ENGINEERING Policies and Procedures 48.102 Policies. (a) As required by 41 U.S.C. 1711, agencies shall establish and maintain cost-effective value engineering procedures and processes. Agencies shall... cost in accordance with 48.101(b)(2). However, there must be no sharing of value engineering savings in...

Screening blood donors for human immunodeficiency virus antibody: cost-benefit analysis.

PubMed Central

Eisenstaedt, R S; Getzen, T E

1988-01-01

The costs and benefits of screening blood donors for antibody to human immunodeficiency virus (HIV) are assessed. Total costs, including testing, discarding processed blood, marginal donor recruiting, notifying and evaluating positive donors, are $36,234,000 annually for 10 million donors in 1986. Screening these donors will prevent 292 cases of transfusion-transmitted acquired immune deficiency syndrome (TT-AIDS), saving the costs of therapy and loss of earnings for total benefits of $43,490,480, a benefit:cost ratio of 1.2:1. Net economic benefits of $0.73 per donor will arise from the program. Calculated benefits will rise as increased numbers of infected recipients are diagnosed with longer follow-up or as partially effective therapy increases the cost of caring for patients with AIDS. Changes in test sensitivity, follow-up procedures, estimated value of life, and testing costs will also alter these projections, but none as dramatically as a change in the overall specificity of the screening process. The cost per case of TT-AIDS prevented, $124,089, and cost per year of life extended, $10,885, are comparable to costs of other screening programs. PMID:3126676

Autism: Hard to Switch from Details to the Whole.

PubMed

Soriano, María Felipa; Ibáñez-Molina, Antonio J; Paredes, Natalia; Macizo, Pedro

2017-12-18

It has long been proposed that individuals with autism exhibit a superior processing of details at the expense of an impaired global processing. This theory has received some empirical support, but results are mixed. In this research we have studied local and global processing in ASD and Typically Developing children, with an adaptation of the Navon task, designed to measure congruency effects between local and global stimuli and switching cost between local and global tasks. ASD children showed preserved global processing; however, compared to Typically Developing children, they exhibited more facilitation from congruent local stimuli when they performed the global task. In addition, children with ASD had more switching cost than Typically Developing children only when they switched from the local to the global task, reflecting a specific difficulty to disengage from local stimuli. Together, results suggest that ASD is characterized by a tendency to process local details, they benefit from the processing of local stimuli at the expense of increasing cost to disengage from local stimuli when global processing is needed. Thus, this work demonstrates experimentally the advantages and disadvantages of the increased local processing in children with ASD.

[Cost-effectiveness of breast cancer screening policies in Mexico].

PubMed

Valencia-Mendoza, Atanacio; Sánchez-González, Gilberto; Bautista-Arredondo, Sergio; Torres-Mejía, Gabriela; Bertozzi, Stefano M

2009-01-01

Generate cost-effectiveness information to allow policy makers optimize breast cancer (BC) policy in Mexico. We constructed a Markov model that incorporates four interrelated processes of the disease: the natural history; detection using mammography; treatment; and other competing-causes mortality, according to which 13 different strategies were modeled. Strategies (starting age, % of coverage, frequency in years)= (48, 25, 2), (40, 50, 2) and (40, 50, 1) constituted the optimal method for expanding the BC program, yielding 75.3, 116.4 and 171.1 thousand pesos per life-year saved, respectively. The strategies included in the optimal method for expanding the program produce a cost per life-year saved of less than two times the GNP per capita and hence are cost-effective according to WHO Commission on Macroeconomics and Health criteria.

Forward osmosis niches in seawater desalination and wastewater reuse.

PubMed

Valladares Linares, R; Li, Z; Sarp, S; Bucs, Sz S; Amy, G; Vrouwenvelder, J S

2014-12-01

This review focuses on the present status of forward osmosis (FO) niches in two main areas: seawater desalination and wastewater reuse. Specific applications for desalination and impaired-quality water treatment and reuse are described, as well as the benefits, advantages, challenges, costs and knowledge gaps on FO hybrid systems are discussed. FO can play a role as a bridge to integrate upstream and downstream water treatment processes, to reduce the energy consumption of the entire desalination or water recovery and reuse processes, thus achieving a sustainable solution for the water-energy nexus. FO hybrid membrane systems showed to have advantages over traditional membrane process like high pressure reverse osmosis and nanofiltration for desalination and wastewater treatment: (i) chemical storage and feed water systems may be reduced for capital, operational and maintenance cost, (ii) water quality is improved, (iii) reduced process piping costs, (iv) more flexible treatment units, and (v) higher overall sustainability of the desalination and wastewater treatment process. Nevertheless, major challenges make FO systems not yet a commercially viable technology, the most critical being the development of a high flux membrane, capable of maintaining an elevated salt rejection and a reduced internal concentration polarization effect, and the availability of appropriate draw solutions (cost effective and non-toxic), which can be recirculated via an efficient recovery process. This review article highlights the features of hybrid FO systems and specifically provides the state-of-the-art applications in the water industry in a novel classification and based on the latest developments toward scaling up these systems. Copyright © 2014 Elsevier Ltd. All rights reserved.

Enzymatic cell disruption of microalgae biomass in biorefinery processes.

PubMed

Demuez, Marie; Mahdy, Ahmed; Tomás-Pejó, Elia; González-Fernández, Cristina; Ballesteros, Mercedes

2015-10-01

When employing biotechnological processes for the procurement of biofuels and bio-products from microalgae, one of the most critical steps affecting economy and yields is the "cell disruption" stage. Currently, enzymatic cell disruption has delivered effective and cost competitive results when compared to mechanical and chemical cell disruption methods. However, the introduction of enzymes implies additional associated cost within the overall process. In order to reduce this cost, autolysis of microalgae is proposed as alternative enzymatic cell disruption method. This review aims to provide the state of the art of enzymatic cell disruption treatments employed in biorefinery processes and highlights the use of endopeptidases. During the enzymatic processes of microalgae life cycle, some lytic enzymes involved in cell division and programmed cell death have been proven useful in performing cell lysis. In this context, the role of endopeptidases is emphasized. Mirroring these natural events, an alternative cell disruption approach is proposed and described with the potential to induce the autolysis process using intrinsic cell enzymes. Integrating induced autolysis within biofuel production processes offers a promising approach to reduce overall global costs and energetic input associated with those of current cell disruption methods. A number of options for further inquiry are also discussed. © 2015 Wiley Periodicals, Inc.

ESTIMATING TREATMENT EFFECTS ON HEALTHCARE COSTS UNDER EXOGENEITY: IS THERE A ‘MAGIC BULLET’?

PubMed Central

Polsky, Daniel; Manning, Willard G.

2011-01-01

Methods for estimating average treatment effects, under the assumption of no unmeasured confounders, include regression models; propensity score adjustments using stratification, weighting, or matching; and doubly robust estimators (a combination of both). Researchers continue to debate about the best estimator for outcomes such as health care cost data, as they are usually characterized by an asymmetric distribution and heterogeneous treatment effects,. Challenges in finding the right specifications for regression models are well documented in the literature. Propensity score estimators are proposed as alternatives to overcoming these challenges. Using simulations, we find that in moderate size samples (n= 5000), balancing on propensity scores that are estimated from saturated specifications can balance the covariate means across treatment arms but fails to balance higher-order moments and covariances amongst covariates. Therefore, unlike regression model, even if a formal model for outcomes is not required, propensity score estimators can be inefficient at best and biased at worst for health care cost data. Our simulation study, designed to take a ‘proof by contradiction’ approach, proves that no one estimator can be considered the best under all data generating processes for outcomes such as costs. The inverse-propensity weighted estimator is most likely to be unbiased under alternate data generating processes but is prone to bias under misspecification of the propensity score model and is inefficient compared to an unbiased regression estimator. Our results show that there are no ‘magic bullets’ when it comes to estimating treatment effects in health care costs. Care should be taken before naively applying any one estimator to estimate average treatment effects in these data. We illustrate the performance of alternative methods in a cost dataset on breast cancer treatment. PMID:22199462

Methodological quality of economic evaluations of new pharmaceuticals in The Netherlands.

PubMed

Hoomans, Ties; Severens, Johan L; van der Roer, Nicole; Delwel, Gepke O

2012-03-01

In the Netherlands, decisions about the reimbursement of new pharmaceuticals are based on cost effectiveness, as well as therapeutic value and budget impact. Since 1 January 2005, drug manufacturers are formally required to substantiate the cost effectiveness of drugs that have therapeutic added value in comparison with existing ones through pharmacoeconomic evaluations. Dutch guidelines for pharmacoeconomic research provide methods guidance, ensuring consistency in both the evidence and the decision-making process about drug reimbursement. This study reviewed the methodological quality of all 21 formally required pharmacoeconomic evaluations of new pharmaceuticals between 1 January 2005 and 1 October 2008, and verified whether these evaluations complied with pharmacoeconomic guidelines. Data on the quality of the pharmacoeconomic evaluations were extracted from the pharmacoeconomic reports published by the Dutch Health Care Insurance Board (CVZ). The Board's newsletters provided information on the advice to, and reimbursement decisions made by, the Dutch Minister of Health. All data extraction was carried out by two independent reviewers, and descriptive analyses were conducted. The methodological quality was sound in only 8 of the 21 pharmacoeconomic evaluations. In most cases, the perspective of analysis, the comparator drugs, and the reporting of both total and incremental costs and effects were correct. However, drug indication, form (i.e. cost utility/cost effectiveness) and time horizon of the evaluations were frequently flawed. Moreover, the costs and effects of the pharmaceuticals were not always analysed correctly, and modelling studies were often non-transparent. Twelve drugs were reimbursed, and nine were not. The compliance with pharmacoeconomic guidelines in economic evaluations of new pharmaceuticals can be improved. This would improve the methodological quality of the pharmacoeconomic evaluations and ensure consistency in the evidence and the decision-making process for drug reimbursement in the Netherlands.

Patrick Air Force Base integrated resource assessment. Volume 1, Executive summary

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

Sandusky, W.F.; Wahlstrom, R.R.

1994-03-01

Some of the most difficult problems encountered at federal sites in reducing energy consumption in a cost-effective manner revolve around understanding where energy is being used and what technologies can be employed to decrease energy use. Many large federal sites have one or two meters to track electric energy use for several thousand buildings and numerous industrial processes. Even where meters are available on individual buildings or family housing units, the meters are not consistently read. When the federal energy manager has been able to identify high energy users, the energy manager may not have the background, training, or resourcesmore » to determine the most cost-effective options for reducing this energy use. This limitation can lead to selection of suboptimal projects that prevent the site from achieving full life-cycle cost savings. The USDOE Federal Energy Management Program has been tasked by the US Air Force Space Command to identify, evaluate, and acquire all cost-effective energy projects at selected federal facilities. This is part of a model program developed to provide a systematic approach to evaluating energy opportunities. The program (1) identifies the building groups and end uses using the most energy (not just having the greatest energy-use intensity) and (2) evaluates the numerous options for retrofit or installation of new technology that will result in the selection of the most cost-effective technologies. This model program provides the federal energy manager with a road map to significantly reduce energy use in a planned, rational, cost-effective fashion that is not biased by the constraints of the typical funding sources available to federal sites. The results from this assessment process can easily be turned into a 5- to 10-year energy management plan.« less

Protocol for evaluation of the cost-effectiveness of ePrescribing systems and candidate prototype for other related health information technologies

PubMed Central

2014-01-01

Background This protocol concerns the assessment of cost-effectiveness of hospital health information technology (HIT) in four hospitals. Two of these hospitals are acquiring ePrescribing systems incorporating extensive decision support, while the other two will implement systems incorporating more basic clinical algorithms. Implementation of an ePrescribing system will have diffuse effects over myriad clinical processes, so the protocol has to deal with a large amount of information collected at various ‘levels’ across the system. Methods/Design The method we propose is use of Bayesian ideas as a philosophical guide. Assessment of cost-effectiveness requires a number of parameters in order to measure incremental cost utility or benefit – the effectiveness of the intervention in reducing frequency of preventable adverse events; utilities for these adverse events; costs of HIT systems; and cost consequences of adverse events averted. There is no single end-point that adequately and unproblematically captures the effectiveness of the intervention; we therefore plan to observe changes in error rates and adverse events in four error categories (death, permanent disability, moderate disability, minimal effect). For each category we will elicit and pool subjective probability densities from experts for reductions in adverse events, resulting from deployment of the intervention in a hospital with extensive decision support. The experts will have been briefed with quantitative and qualitative data from the study and external data sources prior to elicitation. Following this, there will be a process of deliberative dialogues so that experts can “re-calibrate” their subjective probability estimates. The consolidated densities assembled from the repeat elicitation exercise will then be used to populate a health economic model, along with salient utilities. The credible limits from these densities can define thresholds for sensitivity analyses. Discussion The protocol we present here was designed for evaluation of ePrescribing systems. However, the methodology we propose could be used whenever research cannot provide a direct and unbiased measure of comparative effectiveness. PMID:25038609

A Module Experimental Process System Development Unit (MEPSDU). [development of low cost solar arrays

NASA Technical Reports Server (NTRS)

1981-01-01

The technical readiness of a cost effective process sequence that has the potential for the production of flat plate photovoltaic modules which met the price goal in 1986 of $.70 or less per Watt peak was demonstrated. The proposed process sequence was reviewed and laboratory verification experiments were conducted. The preliminary process includes the following features: semicrystalline silicon (10 cm by 10 cm) as the silicon input material; spray on dopant diffusion source; Al paste BSF formation; spray on AR coating; electroless Ni plate solder dip metallization; laser scribe edges; K & S tabbing and stringing machine; and laminated EVA modules.

Integrated Glass Coating Manufacturing Line

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

Brophy, Brenor

2015-09-30

This project aims to enable US module manufacturers to coat glass with Enki’s state of the art tunable functionalized AR coatings at the lowest possible cost and highest possible performance by encapsulating Enki’s coating process in an integrated tool that facilitates effective process improvement through metrology and data analysis for greater quality and performance while reducing footprint, operating and capital costs. The Phase 1 objective was a fully designed manufacturing line, including fully specified equipment ready for issue of purchase requisitions; a detailed economic justification based on market prices at the end of Phase 1 and projected manufacturing costs andmore » a detailed deployment plan for the equipment.« less

Cost Effectiveness of the Angiotensin Receptor Neprilysin Inhibitor Sacubitril/Valsartan for Patients with Chronic Heart Failure and Reduced Ejection Fraction in the Netherlands: A Country Adaptation Analysis Under the Former and Current Dutch Pharmacoeconomic Guidelines.

PubMed

Ramos, Isaac Corro; Versteegh, Matthijs M; de Boer, Rudolf A; Koenders, Jolanda M A; Linssen, Gerard C M; Meeder, Joan G; Rutten-van Mölken, Maureen P M H

2017-12-01

To describe the adaptation of a global health economic model to determine whether treatment with the angiotensin receptor neprilysin inhibitor LCZ696 is cost effective compared with the angiotensin-converting enzyme inhibitor enalapril in adult patients with chronic heart failure with reduced left ventricular ejection fraction in the Netherlands; and to explore the effect of performing the cost-effectiveness analyses according to the new pharmacoeconomic Dutch guidelines (updated during the submission process of LCZ696), which require a value-of-information analysis and the inclusion of indirect medical costs of life-years gained. We adapted a UK model to reflect the societal perspective in the Netherlands by including travel expenses, productivity loss, informal care costs, and indirect medical costs during the life-years gained and performed a preliminary value-of-information analysis. The incremental cost-effectiveness ratio obtained was €17,600 per quality-adjusted life-year (QALY) gained. This was robust to changes in most structural assumptions and across different subgroups of patients. Probability sensitivity analysis results showed that the probability that LCZ696 is cost-effective at a €50,000 per QALY threshold is 99.8%, with a population expected value of perfect information of €297,128. On including indirect medical costs of life-years gained, the incremental cost-effectiveness ratio was €26,491 per QALY gained, and LCZ696 was 99.46% cost effective at €50,000 per QALY, with a population expected value of perfect information of €2,849,647. LCZ696 is cost effective compared with enalapril under the former and current Dutch guidelines. However, the (monetary) consequences of making a wrong decision were considerably different in both scenarios. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Organizational change through Lean Thinking.

PubMed

Tsasis, Peter; Bruce-Barrett, Cindy

2008-08-01

In production and manufacturing plants, Lean Thinking has been used to improve processes by eliminating waste and thus enhancing efficiency. In health care, Lean Thinking has emerged as a comprehensive approach towards improving processes embedded in the diagnostic, treatment and care activities of health-care organizations with cost containment results. This paper provides a case study example where Lean Thinking is not only used to improve efficiency and cost containment, but also as an approach to effective organizational change.

Cost-Effectiveness Research in Neurosurgery: We Can and We Must.

PubMed

Stein, Sherman C

2018-01-05

Rapid advancement of medical and surgical therapies, coupled with the recent preoccupation with limiting healthcare costs, makes a collision of the 2 objectives imminent. This article explains the value of cost-effectiveness analysis (CEA) in reconciling the 2 competing goals, and provides a brief introduction to evidence-based CEA techniques. The historical role of CEA in determining whether new neurosurgical strategies provide value for cost is summarized briefly, as are the limitations of the technique. Finally, the unique ability of the neurosurgical community to provide input to the CEA process is emphasized, as are the potential risks of leaving these important decisions in the hands of others. Copyright © 2018 by the Congress of Neurological Surgeons.

Optimal control of malaria: combining vector interventions and drug therapies.

PubMed

Khamis, Doran; El Mouden, Claire; Kura, Klodeta; Bonsall, Michael B

2018-04-24

The sterile insect technique and transgenic equivalents are considered promising tools for controlling vector-borne disease in an age of increasing insecticide and drug-resistance. Combining vector interventions with artemisinin-based therapies may achieve the twin goals of suppressing malaria endemicity while managing artemisinin resistance. While the cost-effectiveness of these controls has been investigated independently, their combined usage has not been dynamically optimized in response to ecological and epidemiological processes. An optimal control framework based on coupled models of mosquito population dynamics and malaria epidemiology is used to investigate the cost-effectiveness of combining vector control with drug therapies in homogeneous environments with and without vector migration. The costs of endemic malaria are weighed against the costs of administering artemisinin therapies and releasing modified mosquitoes using various cost structures. Larval density dependence is shown to reduce the cost-effectiveness of conventional sterile insect releases compared with transgenic mosquitoes with a late-acting lethal gene. Using drug treatments can reduce the critical vector control release ratio necessary to cause disease fadeout. Combining vector control and drug therapies is the most effective and efficient use of resources, and using optimized implementation strategies can substantially reduce costs.

Cost-effectiveness analysis of policy instruments for greenhouse gas emission mitigation in the agricultural sector.

PubMed

Bakam, Innocent; Balana, Bedru Babulo; Matthews, Robin

2012-12-15

Market-based policy instruments to reduce greenhouse gas (GHG) emissions are generally considered more appropriate than command and control tools. However, the omission of transaction costs from policy evaluations and decision-making processes may result in inefficiency in public resource allocation and sub-optimal policy choices and outcomes. This paper aims to assess the relative cost-effectiveness of market-based GHG mitigation policy instruments in the agricultural sector by incorporating transaction costs. Assuming that farmers' responses to mitigation policies are economically rationale, an individual-based model is developed to study the relative performances of an emission tax, a nitrogen fertilizer tax, and a carbon trading scheme using farm data from the Scottish farm account survey (FAS) and emissions and transaction cost data from literature metadata survey. Model simulations show that none of the three schemes could be considered the most cost effective in all circumstances. The cost effectiveness depends both on the tax rate and the amount of free permits allocated to farmers. However, the emissions trading scheme appears to outperform both other policies in realistic scenarios. Copyright © 2012 Elsevier Ltd. All rights reserved.

A novel methodology for estimating upper limits of major cost drivers for profitable conceptual launch system architectures

NASA Astrophysics Data System (ADS)

Rhodes, Russel E.; Byrd, Raymond J.

1998-01-01

This paper presents a ``back of the envelope'' technique for fast, timely, on-the-spot, assessment of affordability (profitability) of commercial space transportation architectural concepts. The tool presented here is not intended to replace conventional, detailed costing methodology. The process described enables ``quick look'' estimations and assumptions to effectively determine whether an initial concept (with its attendant cost estimating line items) provides focus for major leapfrog improvement. The Cost Charts Users Guide provides a generic sample tutorial, building an approximate understanding of the basic launch system cost factors and their representative magnitudes. This process will enable the user to develop a net ``cost (and price) per payload-mass unit to orbit'' incorporating a variety of significant cost drivers, supplemental to basic vehicle cost estimates. If acquisition cost and recurring cost factors (as a function of cost per payload-mass unit to orbit) do not meet the predetermined system-profitability goal, the concept in question will be clearly seen as non-competitive. Multiple analytical approaches, and applications of a variety of interrelated assumptions, can be examined in a quick, (on-the-spot) cost approximation analysis as this tool has inherent flexibility. The technique will allow determination of concept conformance to system objectives.

A cost-effective line-based light-balancing technique using adaptive processing.

PubMed

Hsia, Shih-Chang; Chen, Ming-Huei; Chen, Yu-Min

2006-09-01

The camera imaging system has been widely used; however, the displaying image appears to have an unequal light distribution. This paper presents novel light-balancing techniques to compensate uneven illumination based on adaptive signal processing. For text image processing, first, we estimate the background level and then process each pixel with nonuniform gain. This algorithm can balance the light distribution while keeping a high contrast in the image. For graph image processing, the adaptive section control using piecewise nonlinear gain is proposed to equalize the histogram. Simulations show that the performance of light balance is better than the other methods. Moreover, we employ line-based processing to efficiently reduce the memory requirement and the computational cost to make it applicable in real-time systems.

Effect of structural changes of lignocelluloses material upon pre-treatment using green solvents

NASA Astrophysics Data System (ADS)

Gunny, Ahmad Anas Nagoor; Arbain, Dachyar; Jamal, Parveen

2017-04-01

The Malaysia Biomass strategy 2020 stated that the key step of biofuel production from biomass lies on the pretreatment process. Conventional `pre-treatment' methods are `non-green" and costly. The recent green and cost-effective biomass pretreatment is using new generation of Ionic Liquids also known as Deep Eutectic Solvents (DESs). DESs are made of renewable components are cheaper, greener and the process synthesis are easier. Thus, the present paper concerns with the preparation of various combination of DES and to study the effect of DESs pretreatment process on microcrystalline cellulose (MCC), a model substrate. The crystalline structural changes were studied using using X-ray Diffraction Methods, Fourier Transformed Infrared Spectroscopy (FTIR) and surface area and pore size analysis. Results showed reduction of crystalline structure of MCC treated with the DESs and increment of surface area and pore size of MCC after pre-treatment process. These results indicated the DES has successfully converted the lignocelluloses material in the form suitable for hydrolysis and conversion to simple sugar.

Chemical activation of gasification carbon residue for phosphate removal

NASA Astrophysics Data System (ADS)

Kilpimaa, Sari; Runtti, Hanna; Lassi, Ulla; Kuokkanen, Toivo

2012-05-01

Recycling of waste materials provides an economical and environmentally significant method to reduce the amount of waste. Bioash formed in the gasification process possesses a notable amount of unburned carbon and therefore it can be called a carbon residue. After chemical activation carbon residue could be use to replace activated carbon for example in wastewater purification processes. The effect of chemical activation process variables such as chemical agents and contact time in the chemical activation process were investigated. This study also explored the effectiveness of the chemically activated carbon residue for the removal of phosphate from an aqueous solution. The experimental adsorption study was performed in a batch reactor and the influence of adsorption time, initial phosphate concentration and pH was studied. Due to the carbon residue's low cost and high adsorption capacity, this type of waste has the potential to be utilised for the cost-effective removal of phosphate from wastewaters. Potential adsorbents could be prepared from these carbonaceous by-products and used as an adsorbent for phosphate removal.

Terrestrial solar cell module automated array assembly, task 4

NASA Technical Reports Server (NTRS)

1978-01-01

A cost effective design and manufacturing process which would produce solar cell modules capable of meeting qualification test criteria was developed. Emphasis was placed on the development of an aluminum paste back contact process.

Assessment of hospital processes using a process mining technique: Outpatient process analysis at a tertiary hospital.

PubMed

Yoo, Sooyoung; Cho, Minsu; Kim, Eunhye; Kim, Seok; Sim, Yerim; Yoo, Donghyun; Hwang, Hee; Song, Minseok

2016-04-01

Many hospitals are increasing their efforts to improve processes because processes play an important role in enhancing work efficiency and reducing costs. However, to date, a quantitative tool has not been available to examine the before and after effects of processes and environmental changes, other than the use of indirect indicators, such as mortality rate and readmission rate. This study used process mining technology to analyze process changes based on changes in the hospital environment, such as the construction of a new building, and to measure the effects of environmental changes in terms of consultation wait time, time spent per task, and outpatient care processes. Using process mining technology, electronic health record (EHR) log data of outpatient care before and after constructing a new building were analyzed, and the effectiveness of the technology in terms of the process was evaluated. Using the process mining technique, we found that the total time spent in outpatient care did not increase significantly compared to that before the construction of a new building, considering that the number of outpatients increased, and the consultation wait time decreased. These results suggest that the operation of the outpatient clinic was effective after changes were implemented in the hospital environment. We further identified improvements in processes using the process mining technique, thereby demonstrating the usefulness of this technique for analyzing complex hospital processes at a low cost. This study confirmed the effectiveness of process mining technology at an actual hospital site. In future studies, the use of process mining technology will be expanded by applying this approach to a larger variety of process change situations. Copyright © 2016. Published by Elsevier Ireland Ltd.

A novel eco-friendly technique for efficient control of lime water softening process.

PubMed

Ostovar, Mohamad; Amiri, Mohamad

2013-12-01

Lime softening is an established type of water treatment used for water softening. The performance of this process is highly dependent on lime dosage. Currently, lime dosage is adjusted manually based on chemical tests, aimed at maintaining the phenolphthalein (P) and total (M) alkalinities within a certain range (2 P - M > or = 5). In this paper, a critical study of the softening process has been presented. It has been shown that the current method is frequently incorrect. Furthermore, electrical conductivity (EC) has been introduced as a novel indicator for effectively characterizing the lime softening process.This novel technique has several advantages over the current alkalinities method. Because no chemical reagents are needed for titration, which is a simple test, there is a considerable reduction in test costs. Additionally, there is a reduction in the treated water hardness and generated sludge during the lime softening process. Therefore, it is highly eco-friendly, and is a very cost effective alternative technique for efficient control of the lime softening process.

A Portable Computer System for Auditing Quality of Ambulatory Care

PubMed Central

McCoy, J. Michael; Dunn, Earl V.; Borgiel, Alexander E.

1987-01-01

Prior efforts to effectively and efficiently audit quality of ambulatory care based on comprehensive process criteria have been limited largely by the complexity and cost of data abstraction and management. Over the years, several demonstration projects have generated large sets of process criteria and mapping systems for evaluating quality of care, but these paper-based approaches have been impractical to implement on a routine basis. Recognizing that portable microcomputers could solve many of the technical problems in abstracting data from medical records, we built upon previously described criteria and developed a microcomputer-based abstracting system that facilitates reliable and cost-effective data abstraction.

Development of a cost-effective production process for Halomonas levan.

PubMed

Erkorkmaz, Burak Adnan; Kırtel, Onur; Ateş Duru, Özlem; Toksoy Öner, Ebru

2018-05-17

Levan polysaccharide is an industrially important natural polymer with unique properties and diverse high-value applications. However, current bottlenecks associated with its large-scale production need to be overcome by innovative approaches leading to economically viable processes. Besides many mesophilic levan producers, halophilic Halomonas smyrnensis cultures hold distinctive industrial potential and, for the first time with this study, the advantage of halophilicity is used and conditions for non-sterile levan production were optimized. Levan productivity of Halomonas cultures in medium containing industrial sucrose from sugar beet and food industry by-product syrup, a total of ten sea, lake and rock salt samples from four natural salterns, as well as three different industrial-grade boron compounds were compared and the most suitable low-cost substitutes for sucrose, salt and boron were specified. Then, the effects of pH control, non-sterile conditions and different bioreactor modes (batch and fed-batch) were investigated. The development of a cost-effective production process was achieved with the highest yield (18.06 g/L) reported so far on this microbial system, as well as the highest theoretical bioconversion efficiency ever reported for levan-producing suspension cultures. Structural integrity and biocompatibility of the final product were also verified in vitro.

Linking Internet strategy to high-quality, cost-effective managed care.

PubMed

Beauregard, T R

2000-01-01

This article describes an experimental pilot project incorporating e-commerce and the Internet into the traditional process of health benefit negotiations through the utilization of an HMO Internet auction. The timeline and process of the auction are described, with the final auction taking place during the last week of negotiations. The results reveal an efficient and effective system to augment the traditional benefit negotiation process.

Perceptions and Cost-Analysis of a Multiple Mini-Interview in a Pharmacy School Admissions Process.

PubMed

Corelli, Robin L; Muchnik, Michael A; Beechinor, Ryan J; Fong, Gary; Vogt, Eleanor M; Cocohoba, Jennifer M; Tsourounis, Candy; Hudmon, Karen Suchanek

2015-11-25

To improve the quality of admissions interviews for a doctor of pharmacy program, using a multiple mini-interview (MMI) in place of the standard interview. Stakeholders completed an anonymous web-based survey. This study characterized perceptions of the MMI format across 3 major stakeholders (candidates, interviewers, admissions committee members) and included comparative cost estimates.Costs were estimated using human and facility resources from the 2012 cycle (standard format) and the 2013 cycle (MMI format). Most candidates (65%), interviewers (86%), and admissions committee members (79%) perceived the MMI format as effective for evaluating applicants, and most (59% of candidates, 84% of interviewers, 77% of committee members) agreed that the MMI format should be continued. Cost per candidate interviewed was $136.34 (standard interview) vs $75.30 (MMI). Perceptions of the MMI process were favorable across stakeholder groups, and this format was less costly per candidate interviewed.

Silicon materials task of the Low Cost Solar Array Project: Effect of impurities and processing on silicon solar cells

NASA Technical Reports Server (NTRS)

Hopkins, R. H.; Davis, J. R.; Rohatgi, A.; Hanes, M. H.; Rai-Choudhury, P.; Mollenkopf, H. C.

1982-01-01

The effects of impurities and processing on the characteristics of silicon and terrestrial silicon solar cells were defined in order to develop cost benefit relationships for the use of cheaper, less pure solar grades of silicon. The amount of concentrations of commonly encountered impurities that can be tolerated in typical p or n base solar cells was established, then a preliminary analytical model from which the cell performance could be projected depending on the kinds and amounts of contaminants in the silicon base material was developed. The impurity data base was expanded to include construction materials, and the impurity performace model was refined to account for additional effects such as base resistivity, grain boundary interactions, thermal processing, synergic behavior, and nonuniform impurity distributions. A preliminary assessment of long term (aging) behavior of impurities was also undertaken.

Health Benefits 101: The University of Kentucky's Effort to Improve Lives, Control Costs and Offer a Sustainable Benefits Package

ERIC Educational Resources Information Center

Payne, Joey

2008-01-01

A few years ago, the University of Kentucky found itself faced with unsustainable trends in retiree health care costs, as well as the rising cost of health care in general. This article provides an overview of the process and decisions made by the University of Kentucky to effect positive change in its health benefits for employees, retirees and…

Multi-criteria analysis for PM10 planning

NASA Astrophysics Data System (ADS)

Pisoni, Enrico; Carnevale, Claudio; Volta, Marialuisa

To implement sound air quality policies, Regulatory Agencies require tools to evaluate outcomes and costs associated to different emission reduction strategies. These tools are even more useful when considering atmospheric PM10 concentrations due to the complex nonlinear processes that affect production and accumulation of the secondary fraction of this pollutant. The approaches presented in the literature (Integrated Assessment Modeling) are mainly cost-benefit and cost-effective analysis. In this work, the formulation of a multi-objective problem to control particulate matter is proposed. The methodology defines: (a) the control objectives (the air quality indicator and the emission reduction cost functions); (b) the decision variables (precursor emission reductions); (c) the problem constraints (maximum feasible technology reductions). The cause-effect relations between air quality indicators and decision variables are identified tuning nonlinear source-receptor models. The multi-objective problem solution provides to the decision maker a set of not-dominated scenarios representing the efficient trade-off between the air quality benefit and the internal costs (emission reduction technology costs). The methodology has been implemented for Northern Italy, often affected by high long-term exposure to PM10. The source-receptor models used in the multi-objective analysis are identified processing long-term simulations of GAMES multiphase modeling system, performed in the framework of CAFE-Citydelta project.

Changing the way employee benefit communications are produced: outsourcing, a more efficient, less costly process.

PubMed

Herren, K

1995-12-01

Outsourcing may offer employers an efficient, cost-effective way to produce employee benefit communications. It offers a way to utilize the latest technology to produce personalized benefit statements or to target an announcement of benefit changes to a specific group of employees.

Cost/Benefits of Solid Waste Reuse

ERIC Educational Resources Information Center

Schulz, Helmut W.

1975-01-01

Municipalities and industry are being forced to seek alternatives to sanitary landfills and incineration as means of eliminating solid wastes. Based on the Columbia study, the two most cost-effective, environmentally acceptable alternatives are the high temperature, oxygen-fed pyrolysis process and the co-combustion of refuse-derived fuel in…

Assessment of Energy Efficiency Improvement in the United States Petroleum Refining Industry

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

Morrow, William R.; Marano, John; Sathaye, Jayant

2013-02-01

Adoption of efficient process technologies is an important approach to reducing CO 2 emissions, in particular those associated with combustion. In many cases, implementing energy efficiency measures is among the most cost-effective approaches that any refiner can take, improving productivity while reducing emissions. Therefore, careful analysis of the options and costs associated with efficiency measures is required to establish sound carbon policies addressing global climate change, and is the primary focus of LBNL’s current petroleum refining sector analysis for the U.S. Environmental Protection Agency. The analysis is aimed at identifying energy efficiency-related measures and developing energy abatement supply curves andmore » CO 2 emissions reduction potential for the U.S. refining industry. A refinery model has been developed for this purpose that is a notional aggregation of the U.S. petroleum refining sector. It consists of twelve processing units and account s for the additional energy requirements from steam generation, hydrogen production and water utilities required by each of the twelve processing units. The model is carbon and energy balanced such that crud e oil inputs and major refinery sector outputs (fuels) are benchmarked to 2010 data. Estimates of the current penetration for the identified energy efficiency measures benchmark the energy requirements to those reported in U.S. DOE 2010 data. The remaining energy efficiency potential for each of the measures is estimated and compared to U.S. DOE fuel prices resulting in estimates of cost- effective energy efficiency opportunities for each of the twelve major processes. A combined cost of conserved energy supply curve is also presented along with the CO 2 emissions abatement opportunities that exist in the U.S. petroleum refinery sector. Roughly 1,200 PJ per year of primary fuels savings and close to 500 GWh per y ear of electricity savings are potentially cost-effective given U.S. DOE fuel price forecasts. This represents roughly 70 million metric tonnes of CO 2 emission reductions assuming 2010 emissions factor for grid electricity. Energy efficiency measures resulting in an additional 400 PJ per year of primary fuels savings and close to 1,700 GWh per year of electricity savings, and an associated 24 million metric tonnes of CO 2 emission reductions are not cost-effective given the same assumption with respect to fuel prices and electricity emissions factors. Compared to the modeled energy requirements for the U.S. petroleum refining sector, the cost effective potential represents a 40% reduction in fuel consumption and a 2% reduction in electricity consumption. The non-cost-effective potential represents an additional 13% reduction in fuel consumption and an additional 7% reduction in electricity consumption. The relative energy reduction potentials are mu ch higher for fuel consumption than electricity consumption largely in part because fuel is the primary energy consumption type in the refineries. Moreover, many cost effective fuel savings measures would increase electricity consumption. The model also has the potential to be used to examine the costs and benefits of the other CO 2 mitigation options, such as combined heat and power (CHP), carbon capture, and the potential introduction of biomass feedstocks. However, these options are not addressed in this report as this report is focused on developing the modeling methodology and assessing fuels savings measures. These opportunities to further reduce refinery sector CO 2 emissions and are recommended for further research and analysis.« less

Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients.

PubMed

Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

2017-04-01

Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions.

Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial

PubMed Central

Crawley, Esther M; Gaunt, Daisy M; Garfield, Kirsty; Hollingworth, William; Sterne, Jonathan A C; Beasant, Lucy; Collin, Simon M; Mills, Nicola; Montgomery, Alan A

2018-01-01

Objective Investigate the effectiveness and cost-effectiveness of the Lightning Process (LP) in addition to specialist medical care (SMC) compared with SMC alone, for children with chronic fatigue syndrome (CFS)/myalgic encephalitis (ME). Design Pragmatic randomised controlled open trial. Participants were randomly assigned to SMC or SMC+LP. Randomisation was minimised by age and gender. Setting Specialist paediatric CFS/ME service. Patients 12–18 year olds with mild/moderate CFS/ME. Main outcome measures The primary outcome was the the 36-Item Short-Form Health Survey Physical Function Subscale (SF-36-PFS) at 6 months. Secondary outcomes included pain, anxiety, depression, school attendance and cost-effectiveness from a health service perspective at 3, 6 and 12 months. Results We recruited 100 participants, of whom 51 were randomised to SMC+LP. Data from 81 participants were analysed at 6 months. Physical function (SF-36-PFS) was better in those allocated SMC+LP (adjusted difference in means 12.5(95% CI 4.5 to 20.5), p=0.003) and this improved further at 12 months (15.1 (5.8 to 24.4), p=0.002). At 6 months, fatigue and anxiety were reduced, and at 12 months, fatigue, anxiety, depression and school attendance had improved in the SMC+LP arm. Results were similar following multiple imputation. SMC+LP was probably more cost-effective in the multiple imputation dataset (difference in means in net monetary benefit at 12 months £1474(95% CI £111 to £2836), p=0.034) but not for complete cases. Conclusion The LP is effective and is probably cost-effective when provided in addition to SMC for mild/moderately affected adolescents with CFS/ME. Trial registration number ISRCTN81456207. PMID:28931531

Solution-Processed Donor-Acceptor Polymer Nanowire Network Semiconductors For High-Performance Field-Effect Transistors

PubMed Central

Lei, Yanlian; Deng, Ping; Li, Jun; Lin, Ming; Zhu, Furong; Ng, Tsz-Wai; Lee, Chun-Sing; Ong, Beng S.

2016-01-01

Organic field-effect transistors (OFETs) represent a low-cost transistor technology for creating next-generation large-area, flexible and ultra-low-cost electronics. Conjugated electron donor-acceptor (D-A) polymers have surfaced as ideal channel semiconductor candidates for OFETs. However, high-molecular weight (MW) D-A polymer semiconductors, which offer high field-effect mobility, generally suffer from processing complications due to limited solubility. Conversely, the readily soluble, low-MW D-A polymers give low mobility. We report herein a facile solution process which transformed a lower-MW, low-mobility diketopyrrolopyrrole-dithienylthieno[3,2-b]thiophene (I) into a high crystalline order and high-mobility semiconductor for OFETs applications. The process involved solution fabrication of a channel semiconductor film from a lower-MW (I) and polystyrene blends. With the help of cooperative shifting motion of polystyrene chain segments, (I) readily self-assembled and crystallized out in the polystyrene matrix as an interpenetrating, nanowire semiconductor network, providing significantly enhanced mobility (over 8 cm2V−1s−1), on/off ratio (107), and other desirable field-effect properties that meet impactful OFET application requirements. PMID:27091315

An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier.

PubMed

Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D

2016-01-01

Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. © The Author(s) 2015.

An Efficient, Non-iterative Method of Identifying the Cost-Effectiveness Frontier

PubMed Central

Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D.

2015-01-01

Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we additionally provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. PMID:25926282

Performance benefits and costs in forced choice perceptual identification in amnesia: Effects of prior exposure and word frequency.

PubMed

Keane, Margaret M; Martin, Elizabeth; Verfaellie, Mieke

2009-07-01

Accuracy in identifying a perceptually degraded word (e.g., stake) can be either enhanced by recent exposure to the same stimulus or reduced by recent exposure to a similar stimulus (e.g., stare). In the present study, we explored the mechanisms underlying these benefits and costs by examining the performance of amnesic and control groups in a forced choice perceptual identification (FCPI) task in which briefly flashed words (that were identical to studied words, similar to studied words, or new) had to be identified, and two response choices were provided that differed from each other by one letter. Control participants showed a performance benefit and cost in FCPI with both high- and low-frequency words. Amnesic participants showed a benefit (but no cost) with high-frequency words and a benefit and a cost with low-frequency words. The benefit/cost pattern with low-frequency words in amnesia was obtained even when the to-be-identified stimulus in the FCPI task was eliminated (Experiment 2), suggesting that this effect was driven by processes operating at the level of the response choices. Our findings suggest that implicit memory effects in FCPI reflect the operation of multiple mechanisms, the relative contributions of which may vary with the frequency of the test stimuli. The results also highlight the need for caution in interpreting results from normal participants in the FCPI task, since those findings may reflect a contribution of explicit memory processes.

Time-driven activity-based costing: A dynamic value assessment model in pediatric appendicitis.

PubMed

Yu, Yangyang R; Abbas, Paulette I; Smith, Carolyn M; Carberry, Kathleen E; Ren, Hui; Patel, Binita; Nuchtern, Jed G; Lopez, Monica E

2017-06-01

Healthcare reform policies are emphasizing value-based healthcare delivery. We hypothesize that time-driven activity-based costing (TDABC) can be used to appraise healthcare interventions in pediatric appendicitis. Triage-based standing delegation orders, surgical advanced practice providers, and a same-day discharge protocol were implemented to target deficiencies identified in our initial TDABC model. Post-intervention process maps for a hospital episode were created using electronic time stamp data for simple appendicitis cases during February to March 2016. Total personnel and consumable costs were determined using TDABC methodology. The post-intervention TDABC model featured 6 phases of care, 33 processes, and 19 personnel types. Our interventions reduced duration and costs in the emergency department (-41min, -$23) and pre-operative floor (-57min, -$18). While post-anesthesia care unit duration and costs increased (+224min, +$41), the same-day discharge protocol eliminated post-operative floor costs (-$306). Our model incorporating all three interventions reduced total direct costs by 11% ($2753.39 to $2447.68) and duration of hospitalization by 51% (1984min to 966min). Time-driven activity-based costing can dynamically model changes in our healthcare delivery as a result of process improvement interventions. It is an effective tool to continuously assess the impact of these interventions on the value of appendicitis care. II, Type of study: Economic Analysis. Copyright © 2017 Elsevier Inc. All rights reserved.

Pathology economic model tool: a novel approach to workflow and budget cost analysis in an anatomic pathology laboratory.

PubMed

Muirhead, David; Aoun, Patricia; Powell, Michael; Juncker, Flemming; Mollerup, Jens

2010-08-01

The need for higher efficiency, maximum quality, and faster turnaround time is a continuous focus for anatomic pathology laboratories and drives changes in work scheduling, instrumentation, and management control systems. To determine the costs of generating routine, special, and immunohistochemical microscopic slides in a large, academic anatomic pathology laboratory using a top-down approach. The Pathology Economic Model Tool was used to analyze workflow processes at The Nebraska Medical Center's anatomic pathology laboratory. Data from the analysis were used to generate complete cost estimates, which included not only materials, consumables, and instrumentation but also specific labor and overhead components for each of the laboratory's subareas. The cost data generated by the Pathology Economic Model Tool were compared with the cost estimates generated using relative value units. Despite the use of automated systems for different processes, the workflow in the laboratory was found to be relatively labor intensive. The effect of labor and overhead on per-slide costs was significantly underestimated by traditional relative-value unit calculations when compared with the Pathology Economic Model Tool. Specific workflow defects with significant contributions to the cost per slide were identified. The cost of providing routine, special, and immunohistochemical slides may be significantly underestimated by traditional methods that rely on relative value units. Furthermore, a comprehensive analysis may identify specific workflow processes requiring improvement.

Procedure for minimizing the cost per watt of photovoltaic systems

NASA Technical Reports Server (NTRS)

Redfield, D.

1977-01-01

A general analytic procedure is developed that provides a quantitative method for optimizing any element or process in the fabrication of a photovoltaic energy conversion system by minimizing its impact on the cost per watt of the complete system. By determining the effective value of any power loss associated with each element of the system, this procedure furnishes the design specifications that optimize the cost-performance tradeoffs for each element. A general equation is derived that optimizes the properties of any part of the system in terms of appropriate cost and performance functions, although the power-handling components are found to have a different character from the cell and array steps. Another principal result is that a fractional performance loss occurring at any cell- or array-fabrication step produces that same fractional increase in the cost per watt of the complete array. It also follows that no element or process step can be optimized correctly by considering only its own cost and performance

Achieving cost reductions in EOSDIS operations through technology evolution

NASA Technical Reports Server (NTRS)

Newsome, Penny; Moe, Karen; Harberts, Robert

1996-01-01

The earth observing system (EOS) data information system (EOSDIS) mission includes the cost-effective management and distribution of large amounts of data to the earth science community. The effect of the introduction of new information system technologies on the evolution of EOSDIS is considered. One of the steps taken by NASA to enable the introduction of new information system technologies into the EOSDIS is the funding of technology development through prototyping. Recent and ongoing prototyping efforts and their potential impact on the performance and cost-effectiveness of the EOSDIS are discussed. The technology evolution process as it related to the effective operation of EOSDIS is described, and methods are identified for the support of the transfer of relevant technology to EOSDIS components.

Summary and recommendations. [reduced gravitational effects on materials manufactured in space

NASA Technical Reports Server (NTRS)

1975-01-01

An economic analysis using econometric and cost benefit analysis techniques was performed to determine the feasibility of space processing of certain products. The overall objectives of the analysis were (1) to determine specific products or processes uniquely connected with space manufacturing, (2) to select a specific product or process from each of the areas of semiconductors, metals, and biochemicals, and (3) to determine the overall price/cost structure of each product or process considered. The economic elements of the analysis involved a generalized decision making format for analyzing space manufacturing, a comparative cost study of the selected processes in space vs. earth manufacturing, and a supply and demand study of the economic relationships of one of the manufacturing processes. Space processing concepts were explored. The first involved the use of the shuttle as the factory with all operations performed during individual flights. The second concept involved a permanent unmanned space factory which would be launched separately. The shuttle in this case would be used only for maintenance and refurbishment. Finally, some consideration was given to a permanent manned space factory.

An introduction to clinical microeconomic analysis: purposes and analytic methods.

PubMed

Weintraub, W S; Mauldin, P D; Becker, E R

1994-06-01

The recent concern with health care economics has fostered the development of a new discipline that is generally called clinical microeconomics. This is a discipline in which microeconomic methods are used to study the economics of specific medical therapies. It is possible to perform stand alone cost analyses, but more profound insight into the medical decision making process may be accomplished by combining cost studies with measures of outcome. This is most often accomplished with cost-effectiveness or cost-utility studies. In cost-effectiveness studies there is one measure of outcome, often death. In cost-utility studies there are multiple measures of outcome, which must be grouped together to give an overall picture of outcome or utility. There are theoretical limitations to the determination of utility that must be accepted to perform this type of analysis. A summary statement of outcome is quality adjusted life years (QALYs), which is utility time socially discounted survival. Discounting is used because people value a year of future life less than a year of present life. Costs are made up of in-hospital direct, professional, follow-up direct, and follow-up indirect costs. Direct costs are for medical services. Indirect costs reflect opportunity costs such as lost time at work. Cost estimates are often based on marginal costs, or the cost for one additional procedure of the same type. Finally an overall statistic may be generated as cost per unit increase in effectiveness, such as dollars per QALY.(ABSTRACT TRUNCATED AT 250 WORDS)

The missing link in preconceptional care: the role of comparative effectiveness research.

PubMed

Salihu, Hamisu M; Salinas, Abraham; Mogos, Mulubrhan

2013-07-01

This paper discusses an important element that is missing from the existing algorithm of preconception care, namely, comparative effectiveness research (CER). To our knowledge, there has been limited assessment of the comparative effectiveness of diverse interventions that promote preconception health, conditions under which these are most effective, for which particular populations, and their comparative costs. CER can improve the decision making process for the funding, development, implementation, and evaluation of comprehensive preconception care programs, specifically by identifying the most effective interventions with acceptable costs to society. This paper will examine the framework behind preconception care and how the inclusion of comparative effectiveness research and evaluation into the existing algorithm of preconception care could foster improvement in maternal and child health. We discuss challenges and opportunities regarding the utilization of CER in the decision making process in preconception health, and finally, we provide recommendations for future directions.

The Missing Link in Preconceptional Care: The Role of Comparative Effectiveness Research

PubMed Central

Salihu, Hamisu M.; Salinas, Abraham; Mogos, Mulubrhan

2012-01-01

This paper discusses an important element that is missing from the existing algorithm of preconception care, namely, comparative effectiveness research (CER). To our knowledge, there has been limited assessment of the comparative effectiveness of diverse interventions that promote preconception health, conditions under which these are most effective, for which particular populations, and their comparative costs. CER can improve the decision making process for the funding, development, implementation, and evaluation of comprehensive preconception care programs, specifically by identifying the most effective interventions with acceptable costs to society. This paper will examine the framework behind preconception care and how the inclusion of comparative effectiveness research and evaluation into the existing algorithm of preconception care could foster improvement in maternal and child health. We discuss challenges and opportunities regarding the utilization of CER in the decision making process in preconception health, and finally, we provide recommendations for future directions. PMID:22718466

Multidisciplinary Design Optimization for Glass-Fiber Epoxy-Matrix Composite 5 MW Horizontal-Axis Wind-Turbine Blades

NASA Astrophysics Data System (ADS)

Grujicic, M.; Arakere, G.; Pandurangan, B.; Sellappan, V.; Vallejo, A.; Ozen, M.

2010-11-01

A multi-disciplinary design-optimization procedure has been introduced and used for the development of cost-effective glass-fiber reinforced epoxy-matrix composite 5 MW horizontal-axis wind-turbine (HAWT) blades. The turbine-blade cost-effectiveness has been defined using the cost of energy (CoE), i.e., a ratio of the three-blade HAWT rotor development/fabrication cost and the associated annual energy production. To assess the annual energy production as a function of the blade design and operating conditions, an aerodynamics-based computational analysis had to be employed. As far as the turbine blade cost is concerned, it is assessed for a given aerodynamic design by separately computing the blade mass and the associated blade-mass/size-dependent production cost. For each aerodynamic design analyzed, a structural finite element-based and a post-processing life-cycle assessment analyses were employed in order to determine a minimal blade mass which ensures that the functional requirements pertaining to the quasi-static strength of the blade, fatigue-controlled blade durability and blade stiffness are satisfied. To determine the turbine-blade production cost (for the currently prevailing fabrication process, the wet lay-up) available data regarding the industry manufacturing experience were combined with the attendant blade mass, surface area, and the duration of the assumed production run. The work clearly revealed the challenges associated with simultaneously satisfying the strength, durability and stiffness requirements while maintaining a high level of wind-energy capture efficiency and a lower production cost.

Analyzing the cost effectiveness of Santiago, Chile's policy of using urban forests to improve air quality.

PubMed

Escobedo, Francisco J; Wagner, John E; Nowak, David J; De la Maza, Carmen Luz; Rodriguez, Manuel; Crane, Daniel E

2008-01-01

Santiago, Chile has the distinction of having among the worst urban air pollution problems in Latin America. As part of an atmospheric pollution reduction plan, the Santiago Regional Metropolitan government defined an environmental policy goal of using urban forests to remove particulate matter less than 10 microm (PM(10)) in the Gran Santiago area. We used cost effectiveness, or the process of establishing costs and selecting least cost alternatives for obtaining a defined policy goal of PM(10) removal, to analyze this policy goal. For this study, we quantified PM(10) removal by Santiago's urban forests based on socioeconomic strata and using field and real-time pollution and climate data via a dry deposition urban forest effects model. Municipal urban forest management costs were estimated using management cost surveys and Chilean Ministry of Planning and Cooperation documents. Results indicate that managing municipal urban forests (trees, shrubs, and grass whose management is under the jurisdiction of Santiago's 36 municipalities) to remove PM(10) was a cost-effective policy for abating PM(10) based on criteria set by the World Bank. In addition, we compared the cost effectiveness of managing municipal urban forests and street trees to other control policies (e.g. alternative fuels) to abate PM(10) in Santiago and determined that municipal urban forest management efficiency was similar to these other air quality improvement measures.

Cost-effectiveness analysis and efficient use of the pharmaceutical budget: the key role of clinical pharmacologists

PubMed Central

Edlin, Richard; Round, Jeff; Hulme, Claire; McCabe, Christopher

2010-01-01

The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of ‘off-label prescribing’ and ‘indication creep’ behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists. PMID:20716234

Cost-effectiveness analysis and efficient use of the pharmaceutical budget: the key role of clinical pharmacologists.

PubMed

Edlin, Richard; Round, Jeff; Hulme, Claire; McCabe, Christopher

2010-09-01

The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of 'off-label prescribing' and 'indication creep' behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists.

Enhancing efficiency of production cost on seafood process with activity based management method

NASA Astrophysics Data System (ADS)

Tarigan, U.; Tarigan, U. P. P.

2018-02-01

The efficiency of production costs has an important impact maintaining company presence in the business world, as well as in the face of increasingly sharp global competition. It was done by identifying and reducing non-value-added activities to decrease production costs and increase profits. The study was conducted at a company engaged in the production of squid (seafood). It has a higher product price than the market as Rp 50,000 per kg while the market price of squid is only Rp 35,000 per kg. The price of the product to be more expensive compared with market price, and thereby a lot more consumers choose the lower market price. Based on the discussions conducted, the implementation of Activity Based Management was seen in the reduction of activities that are not added value in the production process. Since each activities consumers cost, the reduction of nonvalue-added activities has effects on the decline of production cost. The production’s decline costs mainly occur in the reduction of material transfer costs. The results showed that there was an increase after the improvement of 2.60%. Increased production cost efficiency causes decreased production costs and increased profits.

Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes.

PubMed

Souza, Nathan M; Sebaldt, Rolf J; Mackay, Jean A; Prorok, Jeanette C; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

Computerized clinical decision support systems (CCDSSs) are claimed to improve processes and outcomes of primary preventive care (PPC), but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs) assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63%) RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34%) trials assessed patient outcomes, and four (29%) reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15%) and two (5%) trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Evidence supports the effectiveness of CCDSSs for screening and treatment of dyslipidaemia in primary care with less consistent evidence for CCDSSs used in screening for cancer and mental health-related conditions, vaccinations, and other preventive care. CCDSS effects on patient outcomes, safety, costs of care, and provider satisfaction remain poorly supported.

Cost and quality trends in direct contracting arrangements.

PubMed

Lyles, Alan; Weiner, Jonathan P; Shore, Andrew D; Christianson, Jon; Solberg, Leif I; Drury, Patricia

2002-01-01

This paper presents the first empirical analysis of a 1997 initiative of the Buyers Health Care Action Group (BHCAG) known as Choice Plus. This initiative entailed direct contracts with provider-controlled delivery systems; annual care system bidding; public reports of consumer satisfaction and quality; uniform benefits; and risk-adjusted payment. After case-mix adjustment, hospital costs decreased, ambulatory care costs rose modestly, and pharmacy costs increased substantially. Process-oriented quality indicators were stable or improved. The BHCAG employer-to-provider direct contracting and consumer choice model appeared to perform reasonably well in containing costs, without measurable adverse effects on quality.

Cost considerations for long-term ecological monitoring

USGS Publications Warehouse

Caughlan, L.; Oakley, K.L.

2001-01-01

For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program's focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs--what dollars are spent on--and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program's longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occur during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost-effectiveness, of each program element can be evaluated. Moving into the implementation phase without careful evaluation of costs and benefits is risky because if costs are later found to exceed benefits, the program will fail. The costs of development, which can be quite high, will have been largely wasted. Realistic expectations of costs and benefits will help ensure that monitoring programs survive the early, turbulent stages of development and the challenges posed by fluctuating budgets during implementation.

The Role of Advocacy Organizations in Reducing Negative Externalities

PubMed Central

Biglan, Anthony

2009-01-01

An externality is a cost that a corporation’s actions impose on society. For example, a power plant may emit mercury, but might not pay for the cost of that pollution to the people living near the plant. It is possible to analyze a diverse range of problems of society in these terms, including the health effects of corporate practices, the unsustainability of manufacturing processes, and marketing of products contributing to environmental damage, and economic policies that maintain high levels of poverty due to effective lobbying by the business community. This paper examines the problem of externalities in terms of metacontingencies. Externalities continue precisely because there is no cost to the organizations for practices that impose these costs on third parties. The paper describes the cultural practices needed to influence governments are motivated to make corporations bear the true costs of their practices—costs that are currently imposed on others. PMID:20011073

A Module Experimental Process System Development Unit (MEPSDU)

NASA Technical Reports Server (NTRS)

1981-01-01

A cost effective process sequence and machinery for the production of flat plate photovoltaic modules are described. Cells were fabricated using the process sequence which was optimized, as was a lamination procedure. Insulator tapes and edge seal material were identified and tested. Encapsulation materials were evaluated.

Cost-effective treatment of swine wastes through recovery of energy and nutrients.

PubMed

Amini, Adib; Aponte-Morales, Veronica; Wang, Meng; Dilbeck, Merrill; Lahav, Ori; Zhang, Qiong; Cunningham, Jeffrey A; Ergas, Sarina J

2017-11-01

Wastes from concentrated animal feeding operations (CAFOs) are challenging to treat because they are high in organic matter and nutrients. Conventional swine waste treatment options in the U.S., such as uncovered anaerobic lagoons, result in poor effluent quality and greenhouse gas emissions, and implementation of advanced treatment introduces high costs. Therefore, the purpose of this paper is to evaluate the performance and life cycle costs of an alternative system for treating swine CAFO waste, which recovers valuable energy (as biogas) and nutrients (N, P, K + ) as saleable fertilizers. The system uses in-vessel anaerobic digestion (AD) for methane production and solids stabilization, followed by struvite precipitation and ion exchange (IX) onto natural zeolites (chabazite or clinoptilolite) for nutrient recovery. An alternative approach that integrated struvite recovery and IX into a single reactor, termed STRIEX, was also investigated. Pilot- and bench-scale reactor experiments were used to evaluate the performance of each stage in the treatment train. Data from these studies were integrated into a life cycle cost analysis (LCCA) to assess the cost-effectiveness of various process alternatives. Significant improvement in water quality, high methane production, and high nutrient recovery (generally over 90%) were observed with both the AD-struvite-IX process and the AD-STRIEX process. The LCCA showed that the STRIEX system can provide considerable financial savings compared to conventional systems. AD, however, incurs high capital costs compared to conventional anaerobic lagoons and may require larger scales to become financially attractive. Copyright © 2017 Elsevier Ltd. All rights reserved.

Value based care and bundled payments: Anesthesia care costs for outpatient oncology surgery using time-driven activity-based costing.

PubMed

French, Katy E; Guzman, Alexis B; Rubio, Augustin C; Frenzel, John C; Feeley, Thomas W

2016-09-01

With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13% and 28% across the 11 procedures. TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. Copyright © 2015 Elsevier Inc. All rights reserved.

Value Based Care and Bundled Payments: Anesthesia Care Costs for Outpatient Oncology Surgery Using Time-Driven Activity-Based Costing

PubMed Central

French, Katy E.; Guzman, Alexis B.; Rubio, Augustin C.; Frenzel, John C.; Feeley, Thomas W

2015-01-01

Background With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Methods Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Results Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13-28% across the 11 procedures. Conclusions TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. PMID:27637823

Cost-Utility Analysis: Current Methodological Issues and Future Perspectives

PubMed Central

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

2011-01-01

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

Industrial innovations for tomorrow: Advances in industrial energy-efficiency technologies. Degradable plastic made from potato peels

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

Not Available

Stimulated by public demand and state and federal legislation, industry has begun to develop bio- and photo- degradable plastics. so far, however, none of these degradable plastics meets all of the criteria for success - adequate physical and mechanical properties for the desired use, cost-effectiveness, and 100% degradability. Polylactic acid (PLA) plastic is one degradable plastic that shows promise. It has the desired properties and is 100% degradable. However, PLA plastic made by conventional techniques is not cost effective. Made from lactic acid, which is typically made form petroleum using a very costly synthesis process. Lactic acid can also bemore » made from carbohydrates (starches), found in food processing wastes such as potato wastes, cheese whey, and sorghum. Conversion of starch to simple sugars, and fermentation of these sugars can produce lactic acid.« less

The Economics of Organ Transplantation.

PubMed

Altınörs, Nur; Haberal, Mehmet

2018-03-01

To determine the cost effectiveness of transplantation, we analyzed the financial economics of the organ and tissue transplant process. We compared the cost of this process with traditional modalities for treating endstage liver and kidney disease. Medical, surgical, legal, social, ethical, and religious issues are important in organ transplant procedures. Government, health insurance companies, and uninsured individuals are affected by the financial economics of organ transplantation. The distribution of financial burden differs among countries and is dependent on the unique circumstances of each country.

The establishment of a production-ready manufacturing process utilizing thin silicon substrates for solar cells

NASA Technical Reports Server (NTRS)

Pryor, R. A.

1980-01-01

Three inch diameter Czochralski silicon substrates sliced directly to 5 mil, 8 mil, and 27 mil thicknesses with wire saw techniques were procured. Processing sequences incorporating either diffusion or ion implantation technologies were employed to produce n+p or n+pp+ solar cell structures. These cells were evaluated for performance, ease of fabrication, and cost effectiveness. It was determined that the use of 7 mil or even 4 mil wafers would provide near term cost reductions for solar cell manufacturers.

Automated Array Assembly Task In-depth Study of Silicon Wafer Surface Texturizing

NASA Technical Reports Server (NTRS)

Jones, G. T.; Chitre, S.; Rhee, S. S.; Allison, K. L.

1979-01-01

A low cost wafer surface texturizing process was studied. An investigation of low cost cleaning operations to clean residual wax and organics from the surface of silicon wafers was made. The feasibility of replacing dry nitrogen with clean dry air for drying silicon wafers was examined. The two stage texturizing process was studied for the purpose of characterizing relevant parameters in large volume applications. The effect of gettering solar cells on photovoltaic energy conversion efficiency is described.

Metal matrix composite fabrication processes for high performance aerospace structures

NASA Astrophysics Data System (ADS)

Ponzi, C.

A survey is conducted of extant methods of metal matrix composite (MMC) production in order to serve as a basis for prospective MMC users' selection of a matrix/reinforcement combination, cost-effective primary fabrication methods, and secondary fabrication techniques for the achievement of desired performance levels. Attention is given to the illustrative cases of structural fittings, control-surface connecting rods, hypersonic aircraft air inlet ramps, helicopter swash plates, and turbine rotor disks. Methods for technical and cost analysis modeling useful in process optimization are noted.

Animated-simulation modeling facilitates clinical-process costing.

PubMed

Zelman, W N; Glick, N D; Blackmore, C C

2001-09-01

Traditionally, the finance department has assumed responsibility for assessing process costs in healthcare organizations. To enhance process-improvement efforts, however, many healthcare providers need to include clinical staff in process cost analysis. Although clinical staff often use electronic spreadsheets to model the cost of specific processes, PC-based animated-simulation tools offer two major advantages over spreadsheets: they allow clinicians to interact more easily with the costing model so that it more closely represents the process being modeled, and they represent cost output as a cost range rather than as a single cost estimate, thereby providing more useful information for decision making.

Beyond cost-effectiveness: Using systems analysis for infectious disease preparedness.

PubMed

Phelps, Charles; Madhavan, Guruprasad; Rappuoli, Rino; Colwell, Rita; Fineberg, Harvey

2017-01-20

Until the recent outbreaks, Ebola vaccines ranked low in decision makers' priority lists based on cost-effectiveness analysis and (or) corporate profitability. Despite a relatively small number of Ebola-related cases and deaths (compared to other causes), Ebola vaccines suddenly leapt to highest priority among international health agencies and vaccine developers. Clearly, earlier cost-effectiveness analyses badly missed some factors affecting real world decisions. Multi-criteria systems analysis can improve evaluation and prioritization of vaccine development and also of many other health policy and investment decisions. Neither cost-effectiveness nor cost-benefit analysis can capture important aspects of problems such as Ebola or the emerging threat of Zika, especially issues of inequality and disparity-issues that dominate the planning of many global health and economic organizations. Cost-benefit analysis requires assumptions about the specific value of life-an idea objectionable to many analysts and policy makers. Additionally, standard cost-effectiveness calculations cannot generally capture effects on people uninfected with Ebola for example, but nevertheless affected through such factors as contagion, herd immunity, and fear of dread disease, reduction of travel and commerce, and even the hope of disease eradication. Using SMART Vaccines, we demonstrate how systems analysis can visibly include important "other factors" and more usefully guide decision making and beneficially alter priority setting processes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cost-effectiveness of minimally invasive sacroiliac joint fusion.

PubMed

Cher, Daniel J; Frasco, Melissa A; Arnold, Renée Jg; Polly, David W

2016-01-01

Sacroiliac joint (SIJ) disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction. To determine the cost-effectiveness of minimally invasive SIJ fusion. Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed. SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs) at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER) <$26,000/QALY. Probabilistic analyses showed a high degree of certainty that the maximum ICER for SIJ fusion was less than commonly selected thresholds for acceptability (mean ICER =$13,687, 95% confidence interval $5,162-$28,085). SIJ fusion provided potential cost savings per QALY gained compared to non-surgical treatment after a treatment horizon of greater than 13 years. Compared to traditional non-surgical treatments, SIJ fusion is a cost-effective, and, in the long term, cost-saving strategy for the treatment of SIJ dysfunction due to degenerative sacroiliitis or SIJ disruption.

Cost-effectiveness of minimally invasive sacroiliac joint fusion

PubMed Central

Cher, Daniel J; Frasco, Melissa A; Arnold, Renée JG; Polly, David W

2016-01-01

Background Sacroiliac joint (SIJ) disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction. Objective To determine the cost-effectiveness of minimally invasive SIJ fusion. Methods Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed. Results SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs) at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER) <$26,000/QALY. Probabilistic analyses showed a high degree of certainty that the maximum ICER for SIJ fusion was less than commonly selected thresholds for acceptability (mean ICER =$13,687, 95% confidence interval $5,162–$28,085). SIJ fusion provided potential cost savings per QALY gained compared to non-surgical treatment after a treatment horizon of greater than 13 years. Conclusion Compared to traditional non-surgical treatments, SIJ fusion is a cost-effective, and, in the long term, cost-saving strategy for the treatment of SIJ dysfunction due to degenerative sacroiliitis or SIJ disruption. PMID:26719717

BER balanced program plan: oil shale technology. [23 suggested biomedical and environmental research projects

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

Schulte, H.F.; Stoker, A.K.; Campbell, E.E.

1976-06-01

Oil shale technology has been divided into two sub-technologies: surface processing and in-situ processing. Definition of the research programs is essentially an amplification of the five King-Muir categories: (A) pollutants: characterization, measurement, and monitoring; (B) physical and chemical processes and effects; (C) health effects; (D) ecological processes and effects; and (E) integrated assessment. Twenty-three biomedical and environmental research projects are described as to program title, scope, milestones, technolgy time frame, program unit priority, and estimated program unit cost.

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.

Low Cost and Energy Efficient Methods for the Manufacture of Semi-Solid (SSM) Feedstock

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

Diran Apelian; Qingyue Pan; Makhlouf Makhlouf

2005-11-07

The SSM Consortium (now ACRC) at WPI has been carrying out fundamental, pre-competitive research in SSM for several years. Current and past research (at WPI) has generated many results of fundamental and applied nature, which are available to the SSM community. These include materials characterization, yield stress effects, alloy development, rheological properties, process modeling/simulation, semi-solid slurry formation, etc. Alternative method to produce SSM slurries at lower processing costs and with reduced energy consumption is a critical need. The production of low cost SSM feedstock will certainly lead to a dramatic increase in the tonnage of castings produced by SSM, andmore » will provide end users such as the transportation industry, with lighter, cheaper and high performance materials. In this program, the research team has addressed three critical issues in semi-solid processing. They are: (1) Development of low cost, reliable slurry-on-demand approaches for semi-solid processing; (2) Application of the novel permanent grain refining technology-SiBloy for the manufacture of high-quality SSM feedstock, and (3) Development of computational and modeling tools for semi-solid processing to enhance SSM process control. Salient results from these studies are summarized and detailed in our final technical report.« less

Using Life-Cycle Human Factors Engineering to Avoid $2.4 Million in Costs: Lessons Learned from NASA's Requirements Verification Process for Space Payloads

NASA Technical Reports Server (NTRS)

Carr, Daniel; Ellenberger, Rich

2008-01-01

The Human Factors Implementation Team (HFIT) process has been used to verify human factors requirements for NASA International Space Station (ISS) payloads since 2003, resulting in $2.4 million in avoided costs. This cost benefit has been realized by greatly reducing the need to process time-consuming formal waivers (exceptions) for individual requirements violations. The HFIT team, which includes astronauts and their technical staff, acts as the single source for human factors requirements integration of payloads. HFIT has the authority to provide inputs during early design phases, thus eliminating many potential requirements violations in a cost-effective manner. In those instances where it is not economically or technically feasible to meet the precise metric of a given requirement, HFIT can work with the payload engineers to develop common sense solutions and formally document that the resulting payload design does not materially affect the astronaut s ability to operate and interact with the payload. The HFIT process is fully ISO 9000 compliant and works concurrently with NASA s formal systems engineering work flow. Due to its success with payloads, the HFIT process is being adapted and extended to ISS systems hardware. Key aspects of this process are also being considered for NASA's Space Shuttle replacement, the Crew Exploration Vehicle.

Interface and facet control during Czochralski growth of (111) InSb crystals for cost reduction and yield improvement of IR focal plane array substrates

NASA Astrophysics Data System (ADS)

Gray, Nathan W.; Perez-Rubio, Victor; Bolke, Joseph G.; Alexander, W. B.

2014-10-01

Focal plane arrays (FPAs) made on InSb wafers are the key cost-driving component in IR imaging systems. The electronic and crystallographic properties of the wafer directly determine the imaging device performance. The "facet effect" describes the non-uniform electronic properties of crystals resulting from anisotropic dopant segregation during bulk growth. When the segregation coefficient of dopant impurities changes notably across the melt/solid interface of a growing crystal the result is non-uniform electronic properties across wafers made from these crystals. The effect is more pronounced in InSb crystals grown on the (111) axis compared with other orientations and crystal systems. FPA devices made on these wafers suffer costly yield hits due to inconsistent device response and performance. Historically, InSb crystal growers have grown approximately 9-19 degree off-axis from the (111) to avoid the facet effect and produced wafers with improved uniformity of electronic properties. It has been shown by researchers in the 1960s that control of the facet effect can produce uniform small diameter crystals. In this paper, we share results employing a process that controls the facet effect when growing large diameter crystals from which 4, 5, and 6" wafers can be manufactured. The process change resulted in an increase in wafers yielded per crystal by several times, all with high crystal quality and uniform electronic properties. Since the crystals are grown on the (111) axis, manufacturing (111) oriented wafers is straightforward with standard semiconductor equipment and processes common to the high-volume silicon wafer industry. These benefits result in significant manufacturing cost savings and increased value to our customers.

Comparative Evaluation of Financing Programs: Insights From California’s Experience

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

Deason, Jeff

Berkeley Lab examines criteria for a comparative assessment of multiple financing programs for energy efficiency, developed through a statewide public process in California. The state legislature directed the California Alternative Energy and Advanced Transportation Financing Authority (CAEATFA) to develop these criteria. CAEATFA's report to the legislature, an invaluable reference for other jurisdictions considering these topics, discusses the proposed criteria and the rationales behind them in detail. Berkeley Lab's brief focuses on several salient issues that emerged during the criteria development and discussion process. Many of these issues are likely to arise in other states that plan to evaluate the impactsmore » of energy efficiency financing programs, whether for a single program or multiple programs. Issues discussed in the brief include: -The stakeholder process to develop the proposed assessment criteria -Attribution of outcomes - such as energy savings - to financing programs vs. other drivers -Choosing the outcome metric of primary interest: program take-up levels vs. savings -The use of net benefits vs. benefit-cost ratios for cost-effectiveness evaluation -Non-energy factors -Consumer protection factors -Market transformation impacts -Accommodating varying program goals in a multi-program evaluation -Accounting for costs and risks borne by various parties, including taxpayers and utility customers, in cost-effectiveness analysis -How to account for potential synergies among programs in a multi-program evaluation« less

Bio-plastic (poly-hydroxy-alkanoate) production from municipal sewage sludge in the Netherlands: a technology push or a demand driven process?

PubMed

Bluemink, E D; van Nieuwenhuijzen, A F; Wypkema, E; Uijterlinde, C A

Valorisation of components from municipal 'waste' water and sewage sludge gets more and more attention in order to come to a circular economy by developing an efficient 'waste' to value concept. On behalf of the transition team 'Grondstoffenfabriek' ('Resource factory') a preliminary research was performed for all the Dutch water boards to assess the technical and economical feasibility of poly-hydroxy-alkanoate (PHA)-production from sewage sludge, a valuable product to produce bio-plastics. This study reveals that the production of bio-plastics from sewage sludge is feasible based on technical aspects, but not yet economically interesting, even though the selling price is relatively close to the actual PHA market price. (Selling price is in this particular case the indicative cost effective selling price. The cost effective selling price covers only the total production costs of the product.) Future process optimization (maximizing the volatile fatty acids production, PHA storage capacity, etc.) and market developments are needed and will result in cost reductions of the various sub-processes. PHA-production from sewage sludge at this stage is just a technology; every further research is needed to incorporate the backward integration approach, taking into account the market demand including associated product quality aspects.

Attention and Visuospatial Working Memory Share the Same Processing Resources

PubMed Central

Feng, Jing; Pratt, Jay; Spence, Ian

2012-01-01

Attention and visuospatial working memory (VWM) share very similar characteristics; both have the same upper bound of about four items in capacity and they recruit overlapping brain regions. We examined whether both attention and VWM share the same processing resources using a novel dual-task costs approach based on a load-varying dual-task technique. With sufficiently large loads on attention and VWM, considerable interference between the two processes was observed. A further load increase on either process produced reciprocal increases in interference on both processes, indicating that attention and VWM share common resources. More critically, comparison among four experiments on the reciprocal interference effects, as measured by the dual-task costs, demonstrates no significant contribution from additional processing other than the shared processes. These results support the notion that attention and VWM share the same processing resources. PMID:22529826

Impacts of supplyshed-level differences in productivity and land Costs on the economics of hybrid poplar production in Minnesota, USA

Treesearch

William Lazarus; William L. Headlee; Ronald S. Zalesny

2015-01-01

The joint effects of poplar biomass productivity and land costs on poplar production economics were compared for 12 Minnesota counties and two genetic groups, using a process-based model (3-PG) to estimate productivity. The counties represent three levels of productivity and a range of land costs (annual rental rates) from $128/ha to $534/ha. An optimal rotation age...

Potential improvement to a citric wastewater treatment plant using bio-hydrogen and a hybrid energy system

NASA Astrophysics Data System (ADS)

Zhi, Xiaohua; Yang, Haijun; Berthold, Sascha; Doetsch, Christian; Shen, Jianquan

Treatment of highly concentrated organic wastewater is characterized as cost-consuming. The conventional technology uses the anaerobic-anoxic-oxic process (A 2/O), which does not produce hydrogen. There is potential for energy saving using hydrogen utilization associated with wastewater treatment because hydrogen can be produced from organic wastewater using anaerobic fermentation. A 50 m 3 pilot bio-reactor for hydrogen production was constructed in Shandong Province, China in 2006 but to date the hydrogen produced has not been utilized. In this work, a technical-economic model based on hydrogen utilization is presented and analyzed to estimate the potential improvement to a citric wastewater plant. The model assesses the size, capital cost, annual cost, system efficiency and electricity cost under different configurations. In a stand-alone situation, the power production from hydrogen is not sufficient for the required load, thus a photovoltaic array (PV) is employed as the power supply. The simulated results show that the combination of solar and bio-hydrogen has a much higher cost compared with the A 2/O process. When the grid is connected, the system cost achieved is 0.238 US t -1 wastewater, which is lower than 0.257 US t -1 by the A 2/O process. The results reveal that a simulated improvement by using bio-hydrogen and a FC system is effective and feasible for the citric wastewater plant, even when compared to the current cost of the A 2/O process. In addition, lead acid and vanadium flow batteries were compared for energy storage service. The results show that a vanadium battery has lower cost and higher efficiency due to its long lifespan and energy efficiency. Additionally, the cost distribution of components shows that the PV dominates the cost in the stand-alone situation, while the bio-reactor is the main cost component in the parallel grid.

Cost-effectiveness and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru

PubMed Central

2013-01-01

Background The clinical and economic burden associated with invasive and non-invasive pneumococcal and non-typeable Haemophilus influenzae (NTHi) diseases is substantial in the Latin America and Caribbean region, where pneumococcal vaccines have only been introduced to a few countries. This study analyzed the cost-effectiveness and cost utility of three different pneumococcal conjugate vaccines (PCVs) for Peru. Methods A Markov model that simulated the disease processes in a birth cohort over a lifetime, within 1,128 month cycles was used to evaluate the cost-effectiveness of 10-valent pneumococcal NTHi protein D conjugate vaccine (PHiD-CV) and 7- and 13-valent PCVs (PCV-7 and PCV-13). Expected quality-adjusted life years (QALYs), cost-savings and incremental cost-effectiveness ratios (ICERs) were calculated. Results Without vaccination, pneumonia was associated with the greatest health economic burden (90% of QALYs lost and 63% of lifetime direct medical costs); while acute otitis media (AOM) was responsible for 1% of QALYs lost and 25% of direct medical costs. All vaccines were predicted to be cost-effective for Peru, with PHiD-CV being most cost-effective. PHiD-CV was predicted to generate 50 more QALYs gained and required a reduced investment (−US$ 3.4 million) versus PCV-13 (discounted data), and was therefore dominant and cost saving. The probabilistic sensitivity analysis showed that PHiD-CV generated more QALYs gained at a reduced cost than PCV-13 in 84% of the simulations and less QALYs gains at a reduced cost in 16%. Additional scenarios using different assumptions on vaccine efficacies based on previous evidence were explored, but no significant change in the overall cost-effective results were observed. Conclusions The results of this modeling study predict that PCVs are likely to be a cost-effective strategy to help relieve the epidemiological and economic burden associated with pediatric pneumococcal and NTHi diseases for Peru. PHiD-CV is likely to be a dominant (better health gains at a reduced net cost) intervention compared to PCV-13 or PCV-7. The most significant drivers for these results are the better health and economic profile of PHiD-CV against AOM and its reduced cost per dose available through the PAHO Revolving Fund in the LAC region. PMID:24171921

Cost-effectiveness and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru.

PubMed

Gomez, Jorge Alberto; Tirado, Juan Carlos; Navarro Rojas, Aldo Amador; Castrejon Alba, Maria Mercedes; Topachevskyi, Oleksandr

2013-10-30

The clinical and economic burden associated with invasive and non-invasive pneumococcal and non-typeable Haemophilus influenzae (NTHi) diseases is substantial in the Latin America and Caribbean region, where pneumococcal vaccines have only been introduced to a few countries. This study analyzed the cost-effectiveness and cost utility of three different pneumococcal conjugate vaccines (PCVs) for Peru. A Markov model that simulated the disease processes in a birth cohort over a lifetime, within 1,128 month cycles was used to evaluate the cost-effectiveness of 10-valent pneumococcal NTHi protein D conjugate vaccine (PHiD-CV) and 7- and 13-valent PCVs (PCV-7 and PCV-13). Expected quality-adjusted life years (QALYs), cost-savings and incremental cost-effectiveness ratios (ICERs) were calculated. Without vaccination, pneumonia was associated with the greatest health economic burden (90% of QALYs lost and 63% of lifetime direct medical costs); while acute otitis media (AOM) was responsible for 1% of QALYs lost and 25% of direct medical costs. All vaccines were predicted to be cost-effective for Peru, with PHiD-CV being most cost-effective. PHiD-CV was predicted to generate 50 more QALYs gained and required a reduced investment (-US$ 3.4 million) versus PCV-13 (discounted data), and was therefore dominant and cost saving. The probabilistic sensitivity analysis showed that PHiD-CV generated more QALYs gained at a reduced cost than PCV-13 in 84% of the simulations and less QALYs gains at a reduced cost in 16%. Additional scenarios using different assumptions on vaccine efficacies based on previous evidence were explored, but no significant change in the overall cost-effective results were observed. The results of this modeling study predict that PCVs are likely to be a cost-effective strategy to help relieve the epidemiological and economic burden associated with pediatric pneumococcal and NTHi diseases for Peru. PHiD-CV is likely to be a dominant (better health gains at a reduced net cost) intervention compared to PCV-13 or PCV-7. The most significant drivers for these results are the better health and economic profile of PHiD-CV against AOM and its reduced cost per dose available through the PAHO Revolving Fund in the LAC region.

Tolerance assignment in optical design

NASA Astrophysics Data System (ADS)

Youngworth, Richard Neil

2002-09-01

Tolerance assignment is necessary in any engineering endeavor because fabricated systems---due to the stochastic nature of manufacturing and assembly processes---necessarily deviate from the nominal design. This thesis addresses the problem of optical tolerancing. The work can logically be split into three different components that all play an essential role. The first part addresses the modeling of manufacturing errors in contemporary fabrication and assembly methods. The second component is derived from the design aspect---the development of a cost-based tolerancing procedure. The third part addresses the modeling of image quality in an efficient manner that is conducive to the tolerance assignment process. The purpose of the first component, modeling manufacturing errors, is twofold---to determine the most critical tolerancing parameters and to understand better the effects of fabrication errors. Specifically, mid-spatial-frequency errors, typically introduced in sub-aperture grinding and polishing fabrication processes, are modeled. The implication is that improving process control and understanding better the effects of the errors makes the task of tolerance assignment more manageable. Conventional tolerancing methods do not directly incorporate cost. Consequently, tolerancing approaches tend to focus more on image quality. The goal of the second part of the thesis is to develop cost-based tolerancing procedures that facilitate optimum system fabrication by generating the loosest acceptable tolerances. This work has the potential to impact a wide range of optical designs. The third element, efficient modeling of image quality, is directly related to the cost-based optical tolerancing method. Cost-based tolerancing requires efficient and accurate modeling of the effects of errors on the performance of optical systems. Thus it is important to be able to compute the gradient and the Hessian, with respect to the parameters that need to be toleranced, of the figure of merit that measures the image quality of a system. An algebraic method for computing the gradient and the Hessian is developed using perturbation theory.

Don't Discount Societal Value in Cost-Effectiveness Comment on "Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness".

PubMed

Hall, William

2017-01-14

As healthcare resources become increasingly scarce due to growing demand and stagnating budgets, the need for effective priority setting and resource allocation will become ever more critical to providing sustainable care to patients. While societal values should certainly play a part in guiding these processes, the methodology used to capture these values need not necessarily be limited to multi-criterion decision analysis (MCDA)-based processes including 'evidence-informed deliberative processes.' However, if decision-makers intend to not only incorporates the values of the public they serve into decisions but have the decisions enacted as well, consideration should be given to more direct involvement of stakeholders. Based on the examples provided by Baltussen et al, MCDA-based processes like 'evidence-informed deliberative processes' could be one way of achieving this laudable goal. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Development of cost-effective surfactant flooding technology, Quarterly report, October 1995--December 1995

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

Pope, G.A.; Sepehrnoori, K.

1995-12-31

The objective of this research is to develop cost-effective surfactant flooding technology by using simulation studies to evaluate and optimize alternative design strategies taking into account reservoir characteristics process chemistry, and process design options such as horizontal wells. Task 1 is the development of an improved numerical method for our simulator that will enable us to solve a wider class of these difficult simulation problems accurately and affordably. Task 2 is the application of this simulator to the optimization of surfactant flooding to reduce its risk and cost. In this quarter, we have continued working on Task 2 to optimizemore » surfactant flooding design and have included economic analysis to the optimization process. An economic model was developed using a spreadsheet and the discounted cash flow (DCF) method of economic analysis. The model was designed specifically for a domestic onshore surfactant flood and has been used to economically evaluate previous work that used a technical approach to optimization. The DCF model outputs common economic decision making criteria, such as net present value (NPV), internal rate of return (IRR), and payback period.« less

A Cost-Utility Analysis of Prostate Cancer Screening in Australia.

PubMed

Keller, Andrew; Gericke, Christian; Whitty, Jennifer A; Yaxley, John; Kua, Boon; Coughlin, Geoff; Gianduzzo, Troy

2017-02-01

The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. A decision model that incorporated Markov processes was developed from a health system perspective. The base-case scenario compared a population-based screening programme with current opportunistic screening practices. Costs, utility values, treatment patterns and background mortality rates were derived from Australian data. All costs were adjusted to reflect July 2015 Australian dollars (A$). An alternative scenario compared systematic with opportunistic screening but with optimisation of active surveillance (AS) uptake in both groups. A discount rate of 5 % for costs and benefits was utilised. Univariate and probabilistic sensitivity analyses were performed to assess the effect of variable uncertainty on model outcomes. Our model very closely replicated the number of deaths from both prostate cancer and background mortality in the Göteborg study. The incremental cost per quality-adjusted life-year (QALY) for PSA screening was A$147,528. However, for years of life gained (LYGs), PSA-based screening (A$45,890/LYG) appeared more favourable. Our alternative scenario with optimised AS improved cost utility to A$45,881/QALY, with screening becoming cost effective at a 92 % AS uptake rate. Both modelled scenarios were most sensitive to the utility of patients before and after intervention, and the discount rate used. PSA-based screening is not cost effective compared with Australia's assumed willingness-to-pay threshold of A$50,000/QALY. It appears more cost effective if LYGs are used as the relevant outcome, and is more cost effective than the established Australian breast cancer screening programme on this basis. Optimised utilisation of AS increases the cost effectiveness of prostate cancer screening dramatically.

Comparison of Swiss basic health insurance costs of complementary and conventional medicine.

PubMed

Studer, Hans-Peter; Busato, André

2011-01-01

From 1999 to 2005, 5 methods of complementary and alternative medicine (CAM) applied by physicians were provisionally included into mandatory Swiss basic health insurance. Between 2012 and 2017, this will be the case again. Within this process, an evaluation of cost-effectiveness is required. The goal of this study is to compare practice costs of physicians applying CAM with those of physicians applying solely conventional medicine (COM). The study was designed as a cross-sectional investigation of claims data of mandatory health insurance. For the years 2002 and 2003, practice costs of 562 primary care physicians with and without a certificate for CAM were analyzed and compared with patient-reported outcomes. Linear models were used to obtain estimates of practice costs controlling for different patient populations and structural characteristics of practices across CAM and COM. Statistical procedures show similar total practice costs for CAM and COM, with the exception of homeopathy with 15.4% lower costs than COM. Furthermore, there were significant differences between CAM and COM in cost structure especially for the ratio between costs for consultations and costs for medication at the expense of basic health insurance. Patients reported better quality of the patient-physician relationship and fewer adverse side effects in CAM; higher cost-effectiveness for CAM can be deduced from this perspective. This study uses a health system perspective and demonstrates at least equal or better cost-effectiveness of CAM in the setting of Swiss ambulatory care. CAM can therefore be seen as a valid complement to COM within Swiss health care. Copyright © 2011 S. Karger AG, Basel.

A Multifaceted Intervention to Improve the Quality of Care of Children in District Hospitals in Kenya: A Cost-Effectiveness Analysis

PubMed Central

Barasa, Edwine W.; Ayieko, Philip; Cleary, Susan; English, Mike

2012-01-01

Background To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+) strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale. Methods and Findings Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals) with a partial intervention (n = 4 hospitals). Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$). Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average) quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26–67.06) in intervention hospitals compared to US$31.1 (95% CI 30.67–47.18) in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19–2.31) per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A “what-if” analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY) averted by scaling up would vary between US$39.8 and US$398.3. Conclusion Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be cost-effective when compared to incremental cost-effectiveness ratios of other priority child health interventions. Please see later in the article for the Editors' Summary PMID:22719233

A multifaceted intervention to improve the quality of care of children in district hospitals in Kenya: a cost-effectiveness analysis.

PubMed

Barasa, Edwine W; Ayieko, Philip; Cleary, Susan; English, Mike

2012-01-01

To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+) strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale. Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals) with a partial intervention (n = 4 hospitals). Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$). Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average) quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26-67.06) in intervention hospitals compared to US$31.1 (95% CI 30.67-47.18) in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19-2.31) per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A "what-if" analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY) averted by scaling up would vary between US$39.8 and US$398.3. Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be cost-effective when compared to incremental cost-effectiveness ratios of other priority child health interventions.

Language control in bilingual language comprehension: evidence from the maze task

PubMed Central

Wang, Xin

2015-01-01

Most empirical evidence on switch costs is based on bilingual production and interpreted as a result of inhibitory control. It is unclear whether such a top–down control process exists in language switching during comprehension. This study investigates whether a non-lexical switch cost is involved in reading code-switched sentences and its relation to language dominance with cross-script bilingual readers. A maze task is adopted in order to separate top–down inhibitory effects, from lexical effects driven by input. The key findings are: (1) switch costs were observed in both L1–L2 and L2–L1 directions; (2) these effects were driven by two mechanisms: lexical activation and inhibitory control; (3) language dominance modulated the lexical effects, but did not affect the inhibitory effects. These results suggest that a language control mechanism is involved in bilingual reading, even though the control process is not driven by selection as in production. At the theoretical level, these results lend support for the Inhibitory Control model during language switching in comprehension; while the BIA/BIA+ model needs to incorporate a top–down control mechanism to be able to explain the current findings. PMID:26347675

Cost-effectiveness analysis of thiazolidinediones in uncontrolled type 2 diabetic patients receiving sulfonylureas and metformin in Thailand.

PubMed

Chirakup, Suphachai; Chaiyakunapruk, Nathorn; Chaikledkeaw, Usa; Pongcharoensuk, Petcharat; Ongphiphadhanakul, Boonsong; Roze, Stephane; Valentine, William J; Palmer, Andrew J

2008-03-01

The national essential drug committee in Thailand suggested that only one of thiazolidinediones be included in hospital formulary but little was know about their cost-effectiveness values. This study aims to determine an incremental cost-effectiveness ratio of pioglitazone 45 mg compared with rosiglitazone 8 mg in uncontrolled type 2 diabetic patients receiving sulfonylureas and metformin in Thailand. A Markov diabetes model (Center for Outcome Research model) was used in this study. Baseline characteristics of patients were based on Thai diabetes registry project. Costs of diabetes were calculated mainly from Buddhachinaraj hospital. Nonspecific mortality rate and transition probabilities of death from renal replacement therapy were obtained from Thai sources. Clinical effectiveness of thiazolidinediones was retrieved from a meta-analysis. All analyses were based on the government hospital policymaker perspective. Both cost and outcomes were discounted with the rate of 3%. Base-case analyses were analyzed as incremental cost per quality-adjusted life year (QALY) gained. A series of sensitive analyses were performed. In base-case analysis, the pioglitazone group had a better clinical outcomes and higher lifetime costs. The incremental cost per QALY gained was 186,246 baht (US$ 5389). The acceptability curves showed that the probability of pioglitazone being cost-effective was 29% at the willingness to pay of one time of Thai gross domestic product per capita (GDP per capita). The effect of pioglitazone on %HbA1c decrease was the most sensitive to the final outcomes. Our findings showed that in type 2 diabetic patients who cannot control their blood glucose under the combination of sulfonylurea and metformin, the use of pioglitazone 45 mg fell in the cost-effective range recommended by World Health Organization (one to three times of GDP per capita) on average, compared to rosiglitazone 8 mg. Nevertheless, based on sensitivity analysis, its probability of being cost-effective was quite low. Hospital policymakers may consider our findings as part of information for the decision-making process.

Application of Motion Induced Remote-Field Eddy-Current effect to online inspection and quality examination of rolling metallic strips

NASA Astrophysics Data System (ADS)

Sun, Yushi; Udpa, Satish; Lord, William; Udpa, Lalita; Ouyang, Tianhe

2001-04-01

The Motion Induced Remote-Field Eddy-Current (MIRFEC) effect was first observed in 1994. The effect was first exploited for detecting pipeline stress corrosion cracks as a part of a research project sponsored by the U.S. Department of Transportation. This paper presents a new application of the MIRFEC effect for online inspection of rolling metallic strips. Currently, rolled metallic strips and sheets are inspected off-line, which is costly, time consuming and not ideal for quality control. A well-designed online diagnostic and control system for metal rolling process may be able to reduce cost, improve quality, and hence enhance competitiveness of the product. The overall objective of this paper is to demonstrate the feasibility of a new nondestructive measurement system for on-line diagnostics and control of metallic rolling process using the MIRFEC effect. The system can be used to monitor, in real time, metallic strips/sheets for possible anomalies, inclusions, voids, bubbles, lamination, as well as variations in its magnetic and other properties. The potential advantages of the MIRFEC system include simplicity, robustness, low cost, high reliability, quick and accurate signal classification and characterization. Such systems can be used for real-time process control, or off-line data analysis. The technique also allows operation at high temperatures, tolerates large lift-off and vibration, and high rolling speed. Results of finite element modeling of the MIRFEC effect and experimental measurement data obtained from a prototype system are presented.

Low-Cost Detection of Thin Film Stress during Fabrication

NASA Technical Reports Server (NTRS)

Nabors, Sammy A.

2015-01-01

NASA's Marshall Space Flight Center has developed a simple, cost-effective optical method for thin film stress measurements during growth and/or subsequent annealing processes. Stress arising in thin film fabrication presents production challenges for electronic devices, sensors, and optical coatings; it can lead to substrate distortion and deformation, impacting the performance of thin film products. NASA's technique measures in-situ stress using a simple, noncontact fiber optic probe in the thin film vacuum deposition chamber. This enables real-time monitoring of stress during the fabrication process and allows for efficient control of deposition process parameters. By modifying process parameters in real time during fabrication, thin film stress can be optimized or controlled, improving thin film product performance.

Evaluate styrene production

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

Hagopian, C.R.; Lewis, P.J.; McDonald, J.J.

1983-02-01

Improvements and innovations in styrene production since 1966 are outlined. Rigorous process models are attributed to the changes. Such models are used to evaluate the effects of changing raw material costs, utility costs, and available catalyst choices. The process model can also evaluate the best operating configuration and catalyst choice for a plant. All specified innovations are incorporated in the Mobil/Badger ethylbenzene and the Cosden/Badger styrene processes (both of which are schematicized). Badger's training programs are reviewed. Badger's Styrenics Business Team converts information into plant design basis. A reaction model with input derived from isothermal and adiabatic pilot plant unitsmore » is at the heart of complete computer simulation of ethylbenzene and styrene processes.« less

High-efficiency cell concepts on low-cost silicon sheets

NASA Technical Reports Server (NTRS)

Bell, R. O.; Ravi, K. V.

1985-01-01

The limitations on sheet growth material in terms of the defect structure and minority carrier lifetime are discussed. The effect of various defects on performance are estimated. Given these limitations designs for a sheet growth cell that will make the best of the material characteristics are proposed. Achievement of optimum synergy between base material quality and device processing variables is proposed. A strong coupling exists between material quality and the variables during crystal growth, and device processing variables. Two objectives are outlined: (1) optimization of the coupling for maximum performance at minimal cost; and (2) decoupling of materials from processing by improvement in base material quality to make it less sensitive to processing variables.

Analysis and evaluation in the production process and equipment area of the low-cost solar array project

NASA Technical Reports Server (NTRS)

Wolf, M.; Goldman, H.

1981-01-01

The attributes of the various metallization processes were investigated. It is shown that several metallization process sequences will lead to adequate metallization for large area, high performance solar cells at a metallization add on price in the range of $6. to 12. m squared, or 4 to $.8/W(peak), assuming 15% efficiency. Conduction layer formation by thick film silver or by tin or tin/lead solder leads to metallization add-on prices significantly above the $6. to 12/m squared range c.) The wet chemical processes of electroless and electrolytic plating for strike/barrier layer and conduction layer formation, respectively, seem to be most cost effective.

Balanced program plan: analysis for biomedical and environmental research. Volume 5. Oil shale technology

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

Not Available

1976-06-01

Oil shale technology has been divided into two sub-technologies: surfaceprocessing and in-situ processing. Definition of the research programs is essentially an amplification of the five King-Muir categories: (A) pollutants: characterization, measurement, and monitoring; (B) physical and chemical processes and effects; (C) health effects; (D) ecological processes and effects; and (E) integrated assessment. Twenty-three biomedical and environmental research projects are described as to program title, scope, milestones, technology time frame, program unit priority, and estimated program unit cost.

Cost-effectiveness of a herpes zoster vaccination program among the French elderly people.

PubMed

Belchior, Emmanuel; Lévy-Bruhl, Daniel; Le Strat, Yann; Herida, Magid

2016-09-01

A vaccine against herpes zoster (HZ) and its complications has already proven safe and effective against infection and pain and against the related deterioration of quality of life in the elderly. In order to inform the vaccination decision-making process regarding inclusion of this vaccine in the French immunization schedule, we assessed the cost-effectiveness of several vaccination scenarios, compared to no vaccination. We chose to use a previously published Markov model. Starting vaccination in elderly individuals aged 65, 70 and 75 y old appears more cost-effective than vaccination for those aged 60 y old, with a cost-effectiveness ratio between 30,000 and 35,000 euros per quality-adjusted-life year (QALY) gained for the first 3 age groups versus 54,500 €; for the latter group. These results largely contributed to the recommendation to include the HZ vaccination in the French immunization schedule for people aged between 65 and 74 y old in France.

Putting the process of care into practice.

PubMed

Houck, S; Baum, N

1997-01-01

"Putting the process of care into practice" provides an interactive, visual model of outpatient resources and processes. It illustrates an episode of care from a fee-for-service as well as managed care perspective. The Care Process Matrix can be used for planning and staffing, as well as retrospectively to assess appropriate resource use within a practice. It identifies effective strategies for reducing the cost per episode of care and optimizing quality while moving from managing costs to managing the care process. Because of an overbuilt health care system, including an oversupply of physicians, success in the future will require redesigning the process of care and a coherent customer service strategy. The growing complexities of practice will require physicians to focus on several key competencies while outsourcing other functions such as billing and contracting.

Recent development on sustainable biodiesel production using sewage sludge.

PubMed

Srivastava, Neha; Srivastava, Manish; Gupta, Vijai Kumar; Manikanta, Ambepu; Mishra, Kajal; Singh, Shipra; Singh, Sangram; Ramteke, P W; Mishra, P K

2018-05-01

Biodiesel as a renewable energy is an important alternative to biofuels in current scenario to explore green energy sources. It is well known that the major cost involved in biodiesel production technology is dependent upon the used feedstock. This review presents an overview of biodiesel production using municipal sewage sludge as a cost-effective substrate. Municipal sewage sludge which possesses high lipid content with zero cost availability can meet the characteristics of a potential feedstock to produce biodiesel. Different types of substrates based processes to produce biodiesel have been also explored in brief. In addition, limitations of the existing process technology for biodiesel production with sustainable solutions have been also discussed.

Process Approach to Determining Quality Inspection Deployment

DTIC Science & Technology

2015-06-08

27 B.1 The Deming Rule...inspection is effective. The Deming rule is explained in more detail in Appendix B. Basically the probability of error is compared to the cost of...cost or risk to repair defects escaped from inspection justify reducing inspectors. (See Appendix B for Deming rule discussion.) Three quantities must

Potential uses for peroxymonosulfate in pulping and bleaching

Treesearch

Edward L. Springer

1992-01-01

Practical and cost-effective uses for peroxymonosulfate can be developed in pulping and bleaching. Peroxymonosulfate pulping produces strong pulps, has lower capital requirements, and is less environmentally troublesome compared with current pulping processes. The cost of oxidant may, however, be somewhat too high for practical use. We discuss means for reducing the...

A Health Economics Approach to US Value Assessment Frameworks-Summary and Recommendations of the ISPOR Special Task Force Report [7].

PubMed

Garrison, Louis P; Neumann, Peter J; Willke, Richard J; Basu, Anirban; Danzon, Patricia M; Doshi, Jalpa A; Drummond, Michael F; Lakdawalla, Darius N; Pauly, Mark V; Phelps, Charles E; Ramsey, Scott D; Towse, Adrian; Weinstein, Milton C

2018-02-01

This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e.g., insurance value and equity) as part of either an "augmented" cost-effectiveness analysis or a multicriteria decision analysis. Given an aggregation of elements to a measure of value, consistent use of a cost-effectiveness threshold can help ensure the maximization of health gain and well-being for a given budget. These decisions can benefit from the use of deliberative processes. The six recommendations are to: 1) be explicit about decision context and perspective in value assessment frameworks; 2) base health plan coverage and reimbursement decisions on an evaluation of the incremental costs and benefits of health care technologies as is provided by cost-effectiveness analysis; 3) develop value thresholds to serve as one important input to help guide coverage and reimbursement decisions; 4) manage budget constraints and affordability on the basis of cost-effectiveness principles; 5) test and consider using structured deliberative processes for health plan coverage and reimbursement decisions; and 6) explore and test novel elements of benefit to improve value measures that reflect the perspectives of both plan members and patients. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Friction Stir Processing of As-Cast AA5083: Superplastic Response

DTIC Science & Technology

2009-06-01

3 A. ALUMINUM ALLOY 5083............................................................................3 B. SUPERPLASTICITY...ALUMINUM ALLOY 5083 The United States Navy is always considering the most effective and cost effective materials and manufacturing processes. These...desires have lead to a long-term interest in aluminum alloys for naval shipbuilding and design. The 5 -series aluminum alloys (Al-Mg system) are widely

Advanced in-duct sorbent injection for SO{sub 2} control. Final technical report

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

Stouffer, M.R.; Withium, J.A.; Rosenhoover, W.A.

1994-12-01

The objective of this research project was to develop a second generation duct sorbent injection technology as a cost-effective compliance option for the 1990 Clean Air Act Amendments. Research and development work was focused on the Advanced Coolside process, which showed the potential for exceeding the original performance targets of 90% SO{sub 2} removal and 60% sorbent utilization. Process development was conducted in a 1000 acfm pilot plant. The pilot plant testing showed that the Advanced Coolside process can achieve 90% SO{sub 2} removal at sorbent utilizations up to 75%. The testing also showed that the process has the potentialmore » to achieve very high removal efficiency (90 to >99%). By conducting conceptual process design and economic evaluations periodically during the project, development work was focused on process design improvements which substantially lowered process capital and operating costs, A final process economic study projects capital costs less than one half of those for limestone forced oxidation wet FGD. Projected total SO{sub 2} control cost is about 25% lower than wet FGD for a 260 MWe plant burning a 2.5% sulfur coal. A waste management study showed the acceptability of landfill disposal; it also identified a potential avenue for by-product utilization which should be further investigated. Based on the pilot plant performance and on the above economic projections, future work to scale up the Advanced Coolside process is recommended.« less

Low cost fabrication development for oxide dispersion strengthened alloy vanes

NASA Technical Reports Server (NTRS)

Perkins, R. J.; Bailey, P. G.

1978-01-01

Viable processes were developed for secondary working of oxide dispersion strengthened (ODS) alloys to near-net shapes (NNS) for aircraft turbine vanes. These processes were shown capable of producing required microstructure and properties for vane applications. Material cost savings of 40 to 50% are projected for the NNS process over the current procedures which involve machining from rectangular bar. Additional machining cost savings are projected. Of three secondary working processes evaluated, directional forging and plate bending were determined to be viable NNS processes for ODS vanes. Directional forging was deemed most applicable to high pressure turbine (HPT) vanes with their large thickness variations while plate bending was determined to be most cost effective for low pressure turbine (LPT) vanes because of their limited thickness variations. Since the F101 LPT vane was selected for study in this program, development of plate bending was carried through to establishment of a preliminary process. Preparation of ODS alloy plate for bending was found to be a straight forward process using currently available bar stock, providing that the capability for reheating between roll passes is available. Advanced ODS-NiCrAl and ODS-FeCrAl alloys were utilized on this program. Workability of all alloys was adequate for directional forging and plate bending, but only the ODS-FeCrAl had adequate workability for shaped preform extrustion.

Cost-effectiveness and budget impact analysis of a population-based screening program for colorectal cancer.

PubMed

Pil, L; Fobelets, M; Putman, K; Trybou, J; Annemans, L

2016-07-01

Colorectal cancer (CRC) is one of the leading causes of cancer mortality in Belgium. In Flanders (Belgium), a population-based screening program with a biennial immunochemical faecal occult blood test (iFOBT) in women and men aged 56-74 has been organised since 2013. This study assessed the cost-effectiveness and budget impact of the colorectal population-based screening program in Flanders (Belgium). A health economic model was conducted, consisting of a decision tree simulating the screening process and a Markov model, with a time horizon of 20years, simulating natural progression. Predicted mortality and incidence, total costs, and quality-adjusted life-years (QALYs) with and without the screening program were calculated in order to determine the incremental cost-effectiveness ratio of CRC screening. Deterministic and probabilistic sensitivity analyses were conducted, taking into account uncertainty of the model parameters. Mortality and incidence were predicted to decrease over 20years. The colorectal screening program in Flanders is found to be cost-effective with an ICER of 1681/QALY (95% CI -1317 to 6601) in males and €4,484/QALY (95% CI -3254 to 18,163). The probability of being cost-effective given a threshold of €35,000/QALY was 100% and 97.3%, respectively. The budget impact analysis showed the extra cost for the health care payer to be limited. This health economic analysis has shown that despite the possible adverse effects of screening and the extra costs for the health care payer and the patient, the population-based screening program for CRC in Flanders is cost-effective and should therefore be maintained. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients

PubMed Central

Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

2017-01-01

Abstract Background: Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Methods: Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. Results: The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. Conclusions: For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Translational Impacts: Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions. PMID:28445256

A systematic review and cost-effectiveness analysis of tonometer disinfection methods.

PubMed

Omar Akhtar, Ahmad; Singh, Hargurinder; Si, Francie; Hodge, William G

2014-08-01

The Goldmann applanation tonometer presents the problem of being one of the most widely used pieces of equipment in the ophthalmic clinic and a known risk factor for the transmission of epidemic keratoconjunctivitis (EKC). The purpose of this review is to assess the effectiveness of 3 methods of disinfection: alcohol swabs, immersion in peroxide, and the use of disposable prisms. An economic evaluation is undertaken to assess the cost-effectiveness of the 3 alternatives. In doing so, we contribute an evidence-based overview of the issue at an opportune time, because several jurisdictions are developing protocols regarding tonometer tip disinfection. Systematic review and cost-effectiveness analysis. A comprehensive literature review was undertaken with a librarian, comprising searches of 6 electronic databases and hand searches of the grey literature. A 3-level screening process was undertaken by 2 reviewers according to prespecified inclusion and exclusion criteria. Values from included papers were used to inform a cost-effectiveness analysis undertaken using a decision tree model implemented in TreeAge. The analysis was undertaken from the hospital perspective and included all equipment and labour costs. Synthesis of in vitro data indicates that all 3 methods are plausible methods of disinfection with a 64% reduction in log growth of EKC when peroxide is used compared with alcohol swabs. The incremental cost-effective ratios from the cost-effectiveness analysis were $12,000/case averted using peroxide and $61,000/case averted with Tonosafe as compared with alcohol. Assuming clinical infection rates match in vitro disinfection data, the cost of bleach is high and the cost of Tonosafe is unacceptably high to reduce 1 potential case of adenoviral keratoconjunctivitis. Copyright © 2014. Published by Elsevier Inc.

Hospital cost structure in the USA: what's behind the costs? A business case.

PubMed

Chandra, Charu; Kumar, Sameer; Ghildayal, Neha S

2011-01-01

Hospital costs in the USA are a large part of the national GDP. Medical billing and supplies processes are significant and growing contributors to hospital operations costs in the USA. This article aims to identify cost drivers associated with these processes and to suggest improvements to reduce hospital costs. A Monte Carlo simulation model that uses @Risk software facilitates cost analysis and captures variability associated with the medical billing process (administrative) and medical supplies process (variable). The model produces estimated savings for implementing new processes. Significant waste exists across the entire medical supply process that needs to be eliminated. Annual savings, by implementing the improved process, have the potential to save several billion dollars annually in US hospitals. The other analysis in this study is related to hospital billing processes. Increased spending on hospital billing processes is not entirely due to hospital inefficiency. The study lacks concrete data for accurately measuring cost savings, but there is obviously room for improvement in the two US healthcare processes. This article only looks at two specific costs associated with medical supply and medical billing processes, respectively. This study facilitates awareness of escalating US hospital expenditures. Cost categories, namely, fixed, variable and administrative, are presented to identify the greatest areas for improvement. The study will be valuable to US Congress policy makers and US healthcare industry decision makers. Medical billing process, part of a hospital's administrative costs, and hospital supplies management processes are part of variable costs. These are the two major cost drivers of US hospitals' expenditures that were examined and analyzed.

Cueing cognitive flexibility: Item-specific learning of switch readiness.

PubMed

Chiu, Yu-Chin; Egner, Tobias

2017-12-01

The rich behavioral repertoire of the human species derives from our ability to flexibly reconfigure processing strategies (task sets) in response to changing requirements. This updating of task sets is effortful, as reflected by longer response times when switching a task than repeating it (switch costs). However, some recent data suggest that switch costs can be reduced by cueing switch readiness bottom-up, by associating particular stimuli with frequent switch requirements. This type of "stimulus-control (S-C) learning" would be highly adaptive, as it combines the speed of automatic (bottom-up) processing with the flexibility and generalizability of controlled (top-down) processing. However, it is unclear whether S-C learning of switch readiness is truly possible, and what the underlying mechanisms are. Here we address these questions by pairing specific stimuli with a need to update task-sets either frequently or rarely. In all 3 experiments, we observe robust item-specific switch probability (ISSP) effects as revealed by smaller switch costs for frequent switch items than for rare switch items. By including a neutral condition, we also show that the ISSP effect is primarily driven by S-C learning reducing switch costs in frequent switch items. Furthermore, by employing 3 tasks in Experiment 3, we establish that the ISSP effect reflects an enhancement of general switch readiness, rather than of the readiness to switch to a specific alternate task. These results firmly establish that switch readiness is malleable by item-specific S-C learning processes, documenting that a generalizable state of cognitive flexibility can be primed by a bottom-up stimulus. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Potential of powdered activated mustard cake for decolorising raw sugar.

PubMed

Singh, Kaman; Bharose, Ram; Verma, Sudhir Kumar; Singh, Vimalesh Kumar

2013-01-15

Carbon decolorisation has become customary in the food processing industries; however, it is not economical. Extensive research has therefore been directed towards investigating potential substitutes for commercial activated carbons which might have the advantage of offering an effective, lower-cost replacement for existing bone char or coal-based granular activated carbon (GAC). The physical (bulk density and hardness), chemical (pH and mineral content) and adsorption characteristics (iodine test, molasses test and raw sugar decolorisation efficiency) of powdered activated mustard cake (PAMC) made from de-oiled mustard cake were determined and compared to commercial adsorbents. Although the colour removal efficiency of the PAMC is lower than that of commercial materials, it is cost effective and eco-friendly compared to the existing decolorisation/refining processes. To reduce the load on GAC/activated carbon/charcoal, PAMC could be used on an industrial scale. A decolorisation mechanism has been postulated on the basis of oxygen surface functionalities and surface charge of the PAMC and, accordingly, charge transfer interaction seems to be responsible for the decolorisation mechanism. In addition, a complex interplay of electrostatics and dispersive interaction seem to be involved during the decolorisation process. A low-cost agricultural waste product in the form of de-oiled mustard cake was converted to an efficient adsorbent, PAMC, for use in decolorising raw as well as coloured sugar solutions. The physical, chemical, adsorption characteristics and raw sugar decolorisation efficiency of PAMC were determined and compared to those of commercial adsorbents. The colour removal efficiency of the PAMC is lower than that of commercial materials but it is cost effective and eco-friendly as compared to existing decolorisation/refining processes. The availability of the raw material for the production of PAMC further demands its use on an industrial scale. Copyright © 2012 Society of Chemical Industry.

Fuel ethanol production: process design trends and integration opportunities.

PubMed

Cardona, Carlos A; Sánchez, Oscar J

2007-09-01

Current fuel ethanol research and development deals with process engineering trends for improving biotechnological production of ethanol. In this work, the key role that process design plays during the development of cost-effective technologies is recognized through the analysis of major trends in process synthesis, modeling, simulation and optimization related to ethanol production. Main directions in techno-economical evaluation of fuel ethanol processes are described as well as some prospecting configurations. The most promising alternatives for compensating ethanol production costs by the generation of valuable co-products are analyzed. Opportunities for integration of fuel ethanol production processes and their implications are underlined. Main ways of process intensification through reaction-reaction, reaction-separation and separation-separation processes are analyzed in the case of bioethanol production. Some examples of energy integration during ethanol production are also highlighted. Finally, some concluding considerations on current and future research tendencies in fuel ethanol production regarding process design and integration are presented.

Cost-effective large-scale fabrication of diffractive optical elements by using conventional semiconducting processes.

PubMed

Yoo, Seunghwan; Song, Ho Young; Lee, Junghoon; Jang, Cheol-Yong; Jeong, Hakgeun

2012-11-20

In this article, we introduce a simple fabrication method for SiO(2)-based thin diffractive optical elements (DOEs) that uses the conventional processes widely used in the semiconductor industry. Photolithography and an inductively coupled plasma etching technique are easy and cost-effective methods for fabricating subnanometer-scale and thin DOEs with a refractive index of 1.45, based on SiO(2). After fabricating DOEs, we confirmed the shape of the output light emitted from the laser diode light source and applied to a light-emitting diode (LED) module. The results represent a new approach to mass-produce DOEs and realize a high-brightness LED module.

The minicell TMirradiator: A new system for a new market

NASA Astrophysics Data System (ADS)

Clouser, James F.; Beers, Eric W.

1998-06-01

Since the commissioning of the first industrial Gamma Irradiator design, designers and operators of irradiation systems have been attempting to meet the specific production requirements and challenges presented to them. This objective has resulted in many different versions of irradiators currently in service today, all of which had original charters and many of which still perform very well within even the new requirements of this industry. Continuing changes in the marketplace have, however, placed pressures on existing designs due to a combination of changing dose requirements for sterlization, increased economic pressures from the specific industry served for both time and location and the increasing variety of product types requiring processing. Additionally, certain market areas which could never economically support a typical gamma processing facility have either not been serviced, or have forced potential gamma users to transport product long distances to one of these existing facilities. The MiniCell TM removes many of the traditional barriers previously accepted in the radiation processing industry for building a processing facility in a location. Its reduced size and cost have allowed many potential users to consider in-house processing and its ability to be quickly assembled allow it to meet market needs in a much more timely fashion than the previous designs. The MiniCell system can cost effectively meet many of the current market needs of reducing total cost of processing and also be flexible enough to process product in a wide range of industries effectively.

Pre-immigration screening process and pulmonary tuberculosis among Ethiopian migrants in Israel.

PubMed

Mor, Z; Lerman, Y; Leventhal, A

2008-08-01

More than 75,000 displaced Ethiopians have moved to Israel. Tuberculosis (TB) incidence in Ethiopia is 44 times higher than in Israel (344 versus 8 cases per 100,000 inhabitants, respectively). The aims of the present retrospective cohort study were to evaluate the pre-immigration screening process initiated in 2001 on pulmonary TB (PTB) morbidity and to assess its cost-effectiveness. Ethiopian immigrants who were screened before departure (study group) were compared with those who were screened after arrival (comparison group). Between 1998 and 2005, 24,051 Ethiopian immigrants arrived in Israel. PTB was diagnosed in 332 (1.4%) immigrants, an incidence density of 325 patients per 100,000 person-yrs. PTB cumulative incidence was lower in the study group than in the comparison group: 711 compared with 1,746 patients per 100,000 immigrants, respectively (rate ratio 0.4). PTB was detected significantly earlier in the study group than in the comparison group: 193 versus 487 days after entry, respectively. Disease incidence declined significantly during the first 2 yrs following immigration. A 5-yr predictive model indicated that 98 individuals would be free of PTB, saving US$91,055 on annual treatment cost, due to screening. The pre-immigration screening process reduced pulmonary tuberculosis incidence in subsequent years following immigration. Pulmonary tuberculosis was diagnosed earlier in the screened group than in the comparison group and the process was found to be both cost-beneficial and cost-effective.

Models of Community-Based Hepatitis B Surface Antigen Screening Programs in the U.S. and Their Estimated Outcomes and Costs

PubMed Central

Rein, David B.; Lesesne, Sarah B.; Smith, Bryce D.; Weinbaum, Cindy M.

2011-01-01

Objectives Information on the process and method of service delivery is sparse for hepatitis B surface antigen (HBsAg) testing, and no systematic study has evaluated the relative effectiveness or cost-effectiveness of different HBsAg screening models. To address this need, we compared five specific community-based screening programs. Methods We funded five HBsAg screening programs to collect information on their design, costs, and outcomes of participants during a six-month observation period. We categorized programs into four types of models. For each model, we calculated the number screened, the number screened as per Centers for Disease Control and Prevention (CDC) recommendations, and the cost per screening. Results The models varied by cost per person screened and total number of people screened, but they did not differ meaningfully in the proportion of people screened following CDC recommendations, the proportion of those screened who tested positive, or the proportion of those who newly tested positive. Conclusions Integrating screening into outpatient service settings is the most cost-effective method but may not reach all people needing to be screened. Future research should examine cost-effective methods that expand the reach of screening into communities in outpatient settings. PMID:21800750

2D net shape weaving for cost effective manufacture of textile reinforced composites

NASA Astrophysics Data System (ADS)

Vo, D. M. P.; Kern, M.; Hoffmann, G.; Cherif, C.

2017-10-01

Despite significant weight and performance advantages over metal parts, the today’s demand for fibre-reinforced polymer composites (FRPC) has been limited mainly by their large manufacturing cost. The combination of dry textile preforms and low-cost consolidation processes such as resin transfer molding (RTM) has been appointed as a promising approach to low-cost FRPC manufacture. At the current state of the art, tooling and impregnation technology is well understood whereas preform fabrication technology has not been developed effectively. This paper presents an advanced 2D net shape weaving technology developed with the aim to establish a more cost effective system for the manufacture of dry textile preforms for FRPC. 2D net shape weaving is developed based on open reed weave (ORW) technology and enables the manufacture of 2D contoured woven fabrics with firm edge, so that oversize cutting and hand trimming after molding are no longer required. The introduction of 2D net shape woven fabrics helps to reduce material waste, cycle time and preform manufacturing cost significantly. Furthermore, higher grade of automation in preform fabrication can be achieved.

Permanent magnets for vehicle-propulsion motors: Cost/availability

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

Oman, H.; Simpson-Clark, R.

1996-12-31

Alternating-current induction motors have been used for fuel-pumping and air-conditioning in airplanes. Series and shunt dc motors have propelled vehicles. The power received by motors goes into producing output torque and magnetic fields. Today these fields can be produced with rare-earth permanent magnets which do not consume input power. Dramatic improvements in motor efficiency can result. Furthermore, with efficient variable-speed controllers using MOSFET and IGBT semiconductors, electric motors can replace the hydraulic actuators that move aircraft surfaces and retract landing gear. The 1993 cost for the magnets in a 100 kW motor was $1,500. Improved production processes are expected tomore » drop this cost to around $400. However, today`s rare-earth magnet-materials are by-products of mines that produce other metals and minerals. The authors explore the effect on cost of increased demand for the pertinent rare-earth elements, neodymium, cobalt, and samarium. A higher price will cause more elements to be extracted from existing mines. The opening of new rare-earth-element mines is another possibility. In 1993 the $250-per-kg cost for neodymium-iron-boron magnets included $190 for processing. Processing cost can drop to $30 per kg of magnet when production reaches 60 tons per month. The cost of the raw material for the magnets will be affected by man factors in a complex scenario.« less

An optimal staggered harvesting strategy for herbaceous biomass energy crops

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

Bhat, M.G.; English, B.C.

1993-12-31

Biofuel research over the past two decades indicates lignocellulosic crops are a reliable source of feedstock for alternative energy. However, under the current technology of producing, harvesting and converting biomass crops, the cost of biofuel is not competitive with conventional biofuel. Cost of harvesting biomass feedstock is a single largest component of feedstock cost so there is a cost advantage in designing a biomass harvesting system. Traditional farmer-initiated harvesting operation causes over investment. This study develops a least-cost, time-distributed (staggered) harvesting system for example switch grass, that calls for an effective coordination between farmers, processing plant and a single third-partymore » custom harvester. A linear programming model explicitly accounts for the trade-off between yield loss and benefit of reduced machinery overhead cost, associated with the staggered harvesting system. Total cost of producing and harvesting switch grass will decline by 17.94 percent from conventional non-staggered to proposed staggered harvesting strategy. Harvesting machinery cost alone experiences a significant reduction of 39.68 percent from moving from former to latter. The net return to farmers is estimated to increase by 160.40 percent. Per tonne and per hectare costs of feedstock production will decline by 17.94 percent and 24.78 percent, respectively. These results clearly lend support to the view that the traditional system of single period harvesting calls for over investment on agricultural machinery which escalates the feedstock cost. This social loss to the society in the form of escalated harvesting cost can be avoided if there is a proper coordination among farmers, processing plant and custom harvesters as to when and how biomass crop needs to be planted and harvested. Such an institutional arrangement benefits producers, processing plant and, in turn, end users of biofuels.« less

Techno-economic analysis of the industrial production of a low-cost enzyme using E. coli: the case of recombinant β-glucosidase.

PubMed

Ferreira, Rafael da Gama; Azzoni, Adriano Rodrigues; Freitas, Sindelia

2018-01-01

The enzymatic conversion of lignocellulosic biomass into fermentable sugars is a promising approach for producing renewable fuels and chemicals. However, the cost and efficiency of the fungal enzyme cocktails that are normally employed in these processes remain a significant bottleneck. A potential route to increase hydrolysis yields and thereby reduce the hydrolysis costs would be to supplement the fungal enzymes with their lacking enzymatic activities, such as β-glucosidase. In this context, it is not clear from the literature whether recombinant E. coli could be a cost-effective platform for the production of some of these low-value enzymes, especially in the case of on-site production. Here, we present a conceptual design and techno-economic evaluation of the production of a low-cost industrial enzyme using recombinant E. coli . In a simulated baseline scenario for β-glucosidase demand in a hypothetical second-generation ethanol (2G) plant in Brazil, we found that the production cost (316 US$/kg) was higher than what is commonly assumed in the literature for fungal enzymes, owing especially to the facility-dependent costs (45%) and to consumables (23%) and raw materials (25%). Sensitivity analyses of process scale, inoculation volume, and volumetric productivity indicated that optimized conditions may promote a dramatic reduction in enzyme cost and also revealed the most relevant factors affecting production costs. Despite the considerable technical and economic uncertainties that surround 2G ethanol and the large-scale production of low-cost recombinant enzymes, this work sheds light on some relevant questions and supports future studies in this field. In particular, we conclude that process optimization, on many fronts, may strongly reduce the costs of E. coli recombinant enzymes, in the context of tailor-made enzymatic cocktails for 2G ethanol production.

A Comparison of Two Fat Grafting Methods on Operating Room Efficiency and Costs.

PubMed

Gabriel, Allen; Maxwell, G Patrick; Griffin, Leah; Champaneria, Manish C; Parekh, Mousam; Macarios, David

2017-02-01

Centrifugation (Cf) is a common method of fat processing but may be time consuming, especially when processing large volumes. To determine the effects on fat grafting time, volume efficiency, reoperations, and complication rates of Cf vs an autologous fat processing system (Rv) that incorporates fat harvesting and processing in a single unit. We performed a retrospective cohort study of consecutive patients who underwent autologous fat grafting during reconstructive breast surgery with Rv or Cf. Endpoints measured were volume of fat harvested (lipoaspirate) and volume injected after processing, time to complete processing, reoperations, and complications. A budget impact model was used to estimate cost of Rv vs Cf. Ninety-eight patients underwent fat grafting with Rv, and 96 patients received Cf. Mean volumes of lipoaspirate (506.0 vs 126.1 mL) and fat injected (177.3 vs 79.2 mL) were significantly higher (P < .0001) in the Rv vs Cf group, respectively. Mean time to complete fat grafting was significantly shorter in the Rv vs Cf group (34.6 vs 90.1 minutes, respectively; P < .0001). Proportions of patients with nodule and cyst formation and/or who received reoperations were significantly less in the Rv vs Cf group. Based on these outcomes and an assumed per minute operating room cost, an average per patient cost savings of $2,870.08 was estimated with Rv vs Cf. Compared to Cf, the Rv fat processing system allowed for a larger volume of fat to be processed for injection and decreased operative time in these patients, potentially translating to cost savings. LEVEL OF EVIDENCE 3. © 2016 The American Society for Aesthetic Plastic Surgery, Inc.

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.

Mammographic screening: measurement of the cost in a population based programme in Victoria, Australia.

PubMed

Hurley, S F; Livingston, P M; Thane, N; Quang, L

1994-08-01

To estimate the cost per woman participating in a mammographic screening programme, and to describe methods for measuring costs. Expenditure, resource usage, and throughput were monitored over a 12 month period. Unit costs for each phase of the screening process were estimated and linked with the probabilities of each screening outcome to obtain the cost per woman screened and the cost per breast cancer detected. A pilot, population based Australian programme offering free two-view mammographic screening. A total of 5986 women aged 50-69 years who lived in the target area, were listed on the electoral roll, had no previous breast cancer, and attended the programme. Unit costs for recruitment, screening, and recall mammography were $17.54, $60.04, and $175.54, respectively. The costs of clinical assessment for women with subsequent clear, benign, malignant (palpable), and malignant (impalpable) diagnoses were $173.71, $527.29, $436.62, and $567.22, respectively. The cost per woman screened was $117.70, and the cost per breast cancer detected was $11,550. The cost per woman screened is a key variable in assessment of the cost effectiveness of mammographic screening, and is likely to vary between health care settings. Its measurement is justified if decisions about health care services are to be based on cost effectiveness criteria.

Applying Cost-Sensitive Extreme Learning Machine and Dissimilarity Integration to Gene Expression Data Classification.

PubMed

Liu, Yanqiu; Lu, Huijuan; Yan, Ke; Xia, Haixia; An, Chunlin

2016-01-01

Embedding cost-sensitive factors into the classifiers increases the classification stability and reduces the classification costs for classifying high-scale, redundant, and imbalanced datasets, such as the gene expression data. In this study, we extend our previous work, that is, Dissimilar ELM (D-ELM), by introducing misclassification costs into the classifier. We name the proposed algorithm as the cost-sensitive D-ELM (CS-D-ELM). Furthermore, we embed rejection cost into the CS-D-ELM to increase the classification stability of the proposed algorithm. Experimental results show that the rejection cost embedded CS-D-ELM algorithm effectively reduces the average and overall cost of the classification process, while the classification accuracy still remains competitive. The proposed method can be extended to classification problems of other redundant and imbalanced data.

A new vision of the post-NIST civil infrastructure program: the challenges of next-generation construction materials and processes

NASA Astrophysics Data System (ADS)

Wu, H. Felix; Wan, Yan

2014-03-01

Our nation's infrastructural systems are crumbling. The deteriorating process grows over time. The physical aging of these vital facilities and the remediation of their current critical state pose a key societal challenge to the United States. Current sensing technologies, while well developed in controlled laboratory environments, have not yet yielded tools for producing real-time, in-situ data that are adequately comprehensible for infrastructure decision-makers. The need for advanced sensing technologies is national because every municipality and state in the nation faces infrastructure management challenges. The need is critical because portions of infrastructure are reaching the end of their life-spans and there are few cost-effective means to monitor infrastructure integrity and to prioritize the renovation and replacement of infrastructure elements. New advanced sensing technologies that produce cost-effective inspection and real-time monitoring data, and that can also help or aid in meaningful interpretation of the acquired data, therefore will enhance the safety in regard to the public on structural integrity by issuing timely and accurate alert data for effective maintenance to avoid disasters happening. New advanced sensing technologies also allow more informed management of infrastructural investments by avoiding premature replacement of infrastructure and identifying those structures in need of immediate action to prevent from catastrophic failure. Infrastructure management requires that once a structural defect is detected, an economical and efficient repair be made. Advancing the technologies of repairing infrastructure elements in contact with water, road salt, and subjected to thermal changes requires innovative research to significantly extend the service life of repairs, lower the costs of repairs, and provide repair technologies that are suitable for a wide range of conditions. All these new technologies will provide increased lifetimes, security, and safety of elements of critical infrastructure for the Nation's already deteriorating civil infrastructure. It is envisioned that the Nation should look far beyond: not only should we efficiently and effectively address current problems of the aging infrastructure, but we must also further develop next-generation construction materials and processes for new construction. To accomplish this ambitious goal, we must include process efficiency that will help select the most reliable and cost-effective materials in construction processes; performance and cost will be the prime consideration for selections construction materials based on life-cycle cost and materials performance; energy efficiency will drive reduced energy consumption from current levels by 50 % per unit of output; and environmental responsiveness will achieve net-zero waste from construction materials and its constituents. Should it be successfully implemented, we will transform the current 21st century infrastructure systems to enable the vital functioning of society and improve competitiveness of the economy to ensure that our quality of life remains high.

47 CFR 36.379 - Message processing expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS... Customer Operations Expenses § 36.379 Message processing expense. (a) This classification includes the... exchange operation. (1) Effective July 1, 2001 through June 30, 2011, study areas subject to price cap...

All about Listening.

ERIC Educational Resources Information Center

Grunkemeyer, Florence B.

1992-01-01

Discusses the importance of effective listening and problems in the listening process. Presents a matrix evaluating 18 listening inventories on 8 criteria: cost effectiveness, educational use, business use, reliability, validity, adult audience, high school audience, and potential barriers. (JOW)

A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons.

PubMed

Bagnall, Anne-Marie; South, Jane; Hulme, Claire; Woodall, James; Vinall-Collier, Karen; Raine, Gary; Kinsella, Karina; Dixey, Rachael; Harris, Linda; Wright, Nat M J

2015-03-25

Prisoners experience significantly worse health than the general population. This review examines the effectiveness and cost-effectiveness of peer interventions in prison settings. A mixed methods systematic review of effectiveness and cost-effectiveness studies, including qualitative and quantitative synthesis was conducted. In addition to grey literature identified and searches of websites, nineteen electronic databases were searched from 1985 to 2012. Study selection criteria were: Prisoners resident in adult prisons and children resident in Young Offender Institutions (YOIs). Peer-based interventions. Review questions 3 and 4 compared peer and professionally led approaches. Prisoner health or determinants of health; organisational/process outcomes; views of prison populations. Quantitative, qualitative and mixed method evaluations. Fifty-seven studies were included in the effectiveness review and one study in the cost-effectiveness review; most were of poor methodological quality. Evidence suggested that peer education interventions are effective at reducing risky behaviours, and that peer support services are acceptable within the prison environment and have a positive effect on recipients, practically or emotionally. Consistent evidence from many, predominantly qualitative, studies, suggested that being a peer deliverer was associated with positive effects. There was little evidence on cost-effectiveness of peer-based interventions. There is consistent evidence from a large number of studies that being a peer worker is associated with positive health; peer support services are also an acceptable source of help within the prison environment and can have a positive effect on recipients. Research into cost-effectiveness is sparse. PROSPERO ref: CRD42012002349.

Evaluating the nondrug costs of formulary coverage restrictions.

PubMed

Abourjaily, Paul; Gouveia, William A; Selker, Harry P; Zucker, Deborah R

2005-08-01

Clinicians often are required to switch prescribed therapy for their patients in response to health plan initiatives for controlling drug expenditures. To explore the effect of these initiatives, we sought clinicians' feedback regarding their practices and processes for switching patients' medications to accommodate insurance coverage. Self-administered Intranet-based survey of clinicians at an urban, tertiary-care hospital. Using survey responses, we calculate nondrug costs induced by formulary cost-saving measures. A total of 91 responses were received from 569 providers who were sent a request to complete the questionnaire via electronic mail (18 percent response rate). It took an average of 11.1, 18.9, and 16.4 minutes for physicians, nurses, and nurse practitioners/physician assistants, respectively, to make the medication switch. The mean number of switches per month ranged from 10.6 to 36.9. More than half the time spent on these switches is not directly reimbursed. Specific switch-induced intervention costs differed for different drug types. The effect on clinician workload tended to be an inconvenience. While the majority of physicians and nurse practitioners/physician assistants did not feel this process damaged patient-provider relations, most nurses did. In response to formulary restrictions, other costs are induced and incurred by providers and patients. The extent of patient costs, including those from adverse drug reactions, needs further study. More research is needed to elucidate costs and burden shifts as all parties involved evaluate and modify plans to moderate prescription drug expenditures.

Exploring the relationship between planning and procurement in Western U.S. electric utilities

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

Carvallo Bodelon, Juan Pablo; Sanstad, Alan H.; Larsen, Peter H.

Integrated resource planning (IRP) is an important regulatory process used in many U.S. states to formulate and evaluate least-cost and risk-assessed portfolios to meet future load requirements for electric utilities. In principle, effective implementation of IRP seeks to assure regulators and the public that utility investment decisions, given uncertainty, are as cost-effective as possible. However, to date, there is no empirical assessment on the effectiveness of IRP implementation. In this analysis, we compare planning, procurement processes and actual decisions for a sample of twelve load serving entities (LSEs) across the Western U. S. from 2003-2014. The 2008/2009 recession provides amore » unique “stress test” to the planning process and offers an excellent opportunity to trace how procurement decisions responded to this largely unforeseen event. In aggregate, there is a general alignment between planned and procured supply-side capacity. However, there are significant differences in the choice of supply-side resources and type of ownership for individual LSEs. We develop case studies for three LSEs and find that subsequent plans differ significantly due to changes in the planning environment and that procurement decisions in some cases are impacted by factors that are not accounted for in the planning process. Our results reveal that a limited amount of information produced during the long-term planning process (e.g., forecasts, methods, and least cost/risk portfolios) are ultimately used during the procurement process, and that the latter process relies extensively on the most recent information available for decision making. These findings suggest that states' IRP rules and regulations mandating long-term planning horizons with the same analytical complexity throughout the planning period may not create useful information for the procurement process. The social value of a long-term planning process that departs from procurement and the balance between transparency and complexity of the planning and procurement processes is an open question.« less

Health economics in haemophilia: a review from the clinician's perspective.

PubMed

Escobar, M A

2010-05-01

Health economic evaluations provide valuable information for healthcare providers, facilitating the treatment decision-making process in a climate where demand for healthcare exceeds the supply. Although an uncommon disease, haemophilia is a life-long condition that places a considerable burden on patients, healthcare systems and society. This burden is particularly large for patients with haemophilia with inhibitors, who can develop serious bleeding complications unresponsive to standard factor replacement therapies. Hence, bleeding episodes in these patients are treated with bypassing agents such as recombinant activated FVII (rFVIIa) and plasma-derived activated prothrombin complex concentrates (pd-APCC). With the efficacy of these agents now well established, a number of health economic studies have been conducted to compare their cost-effectiveness for the on-demand treatment of bleeding episodes in haemophiliacs with inhibitors. In a cost-utility analysis, which assesses the effects of treatment on quality of life (QoL) and quantity of life, the incremental cost per quality-adjusted life-year (QALY) gained (US $44,834) indicated that rFVIIa was cost-effective. Similarly, eight of 11 other economic modelling evaluations found that rFVIIa was more cost-effective than pd-APCC in the on-demand treatment of bleeding episodes. These findings indicate that treating patients with haemophilia promptly and with the most effective therapy available may result in cost savings.

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

Costs and outcomes of the German disease management programme (DMP) for chronic obstructive pulmonary disease (COPD)-A large population-based cohort study.

PubMed

Achelrod, Dmitrij; Welte, Tobias; Schreyögg, Jonas; Stargardt, Tom

2016-09-01

To curb costs and improve health outcomes in chronic obstructive pulmonary disease (COPD), a nationwide disease management programme (DMP) was introduced in Germany in 2005. Yet, its effectiveness has not been comprehensively evaluated. To examine the effects of the German COPD DMP over three years on costs and health resource utilisation from the payer perspective, process quality, morbidity and mortality. A retrospective, population-based cohort study design is applied, using administrative data. After eliminating differences in observable characteristics between the DMP and the control group with entropy balancing, difference-in-difference estimators were computed to account for time-invariant unobservable heterogeneity. 215,104 individuals were included into the analysis of whom 25,269 were enrolled in the DMP. DMP patients had a reduced mortality hazard ratio (0.89, 95%CI: 0.84-0.94) but incurred excess costs of €553 per year. DMP enrolees reveal higher healthcare utilisation with larger shares of individuals being hospitalised (3.14%), consulting an outpatient clinic due to exacerbations (11.13%) and pharmaceutical prescriptions (2.78). However, average length of hospitalisation due to COPD fell by 0.49 days, adherence to medication guidelines as well as indicators for morbidity improved. The German COPD DMP achieved significant improvements in mortality, morbidity and process quality, but at higher costs. Given the low ICER per life year gained, DMP COPD may constitute a cost-effective option to promote COPD population health. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Tying supply chain costs to patient care.

PubMed

Parkinson, Rosalind C

2014-05-01

In September 2014, the FDA will establish a unique device identification (UDI) system to aid hospitals in better tracking and managing medical devices and analyzing their effectiveness. When these identifiers become part of patient medical records, the UDI system will provide a much-needed link between supply cost and patient outcomes. Hospitals should invest in technology and processes that can enable them to trace supply usage patterns directly to patients and analyze how these usage patterns affect cost and quality.

Near-Neighbor Algorithms for Processing Bearing Data

DTIC Science & Technology

1989-05-10

neighbor algorithms need not be universally more cost -effective than brute force methods. While the data access time of near-neighbor techniques scales with...the number of objects N better than brute force, the cost of setting up the data structure could scale worse than (Continues) 20...for the near neighbors NN2 1 (i). Depending on the particular NN algorithm, the cost of accessing near neighbors for each ai E S1 scales as either N

Earth Sciences Data and Information System (ESDIS) program planning and evaluation methodology development

NASA Technical Reports Server (NTRS)

Dickinson, William B.

1995-01-01

An Earth Sciences Data and Information System (ESDIS) Project Management Plan (PMP) is prepared. An ESDIS Project Systems Engineering Management Plan (SEMP) consistent with the developed PMP is also prepared. ESDIS and related EOS program requirements developments, management and analysis processes are evaluated. Opportunities to improve the effectiveness of these processes and program/project responsiveness to requirements are identified. Overall ESDIS cost estimation processes are evaluated, and recommendations to improve cost estimating and modeling techniques are developed. ESDIS schedules and scheduling tools are evaluated. Risk assessment, risk mitigation strategies and approaches, and use of risk information in management decision-making are addressed.

Filament winding - Waking the sleeping giant

NASA Technical Reports Server (NTRS)

Freeman, W. T., Jr.; Stein, B. A.

1985-01-01

The use of filament winding (FW) in the production of aerospace composite structures is examined. The FW process applies spools of fiber and prepreg tow or prepreg tape to a male mandrel; the process is more efficient and cost effective than metallic construction. The fibers used in FW and the curing process are explained. The reduced storage and fabrication costs that result from FW are discussed. The use of FW to produce a filament-wound case for a solid rocket motor and the substructure and skin of an aircraft fuselage are described. Areas which require further development in order to expand the use of FW are listed and discussed.

Three-Dimensional (3-D) Printing: A Cost-Effective Solution for Improving Global Accessibility to Prostheses.

PubMed

Silva, Kyle; Rand, Stephanie; Cancel, David; Chen, Yuxi; Kathirithamby, Rani; Stern, Michelle

2015-12-01

The lack of access to prostheses is a global problem, partially caused by the high cost associated with the current manufacturing process. Three-dimensional printing is gaining use in the medical field, and one such area is prosthetics. In addition to using cost-effective materials, this technology allows for rapid prototyping, making it an efficient solution for the development of affordable prostheses. If the rehabilitation medicine community embraces this novel technology, we can help alleviate the global disparity of access to prostheses. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Differential pricing of drugs: a role for cost-effectiveness analysis?

PubMed

Lopert, Ruth; Lang, Danielle L; Hill, Suzanne R; Henry, David A

2002-06-15

Internationally, the high costs of pharmaceutical products limit access to treatment. The principle of differential pricing is that drug prices should vary according to some measure of affordability. How differential prices should be determined is, however, unclear. Here we describe a method whereby differential prices for essential drugs could be derived in countries of variable national wealth, and, using angiotensin-converting enzyme inhibitors provide an example of how the process might work. Indicative prices for drugs can be derived by cost-effectiveness analysis that incorporates a measure of national wealth. Such prices could be used internationally as a basis of differential price negotiations.

Erosion processes by water in agricultural landscapes: a low-cost methodology for post-event analyses

NASA Astrophysics Data System (ADS)

Prosdocimi, Massimo; Calligaro, Simone; Sofia, Giulia; Tarolli, Paolo

2015-04-01

Throughout the world, agricultural landscapes assume a great importance, especially for supplying food and a livelihood. Among the land degradation phenomena, erosion processes caused by water are those that may most affect the benefits provided by agricultural lands and endanger people who work and live there. In particular, erosion processes that affect the banks of agricultural channels may cause the bank failure and represent, in this way, a severe threat to floodplain inhabitants and agricultural crops. Similarly, rills and gullies are critical soil erosion processes as well, because they bear upon the productivity of a farm and represent a cost that growers have to deal with. To estimate quantitatively soil losses due to bank erosion and rills processes, area based measurements of surface changes are necessary but, sometimes, they may be difficult to realize. In fact, surface changes due to short-term events have to be represented with fine resolution and their monitoring may entail too much money and time. The main objective of this work is to show the effectiveness of a user-friendly and low-cost technique that may even rely on smart-phones, for the post-event analyses of i) bank erosion affecting agricultural channels, and ii) rill processes occurring on an agricultural plot. Two case studies were selected and located in the Veneto floodplain (northeast Italy) and Marche countryside (central Italy), respectively. The work is based on high-resolution topographic data obtained by the emerging, low-cost photogrammetric method named Structure-from-Motion (SfM). Extensive photosets of the case studies were obtained using both standalone reflex digital cameras and smart-phone built-in cameras. Digital Terrain Models (DTMs) derived from SfM revealed to be effective to estimate quantitatively erosion volumes and, in the case of the bank eroded, deposited materials as well. SfM applied to pictures taken by smartphones is useful for the analysis of the topography and Earth surface processes at very low-cost. This methodology should be of great help for farmers and/or technician who work at Land Reclamation Consortia or at Civil Protection for taking suitable post-event field surveys in support to flood risk and soil management.

49 CFR 594.9 - Fee for reimbursement of bond processing costs and costs for processing offers of cash deposits...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Fee for reimbursement of bond processing costs and costs for processing offers of cash deposits or obligations of the United States in lieu of sureties on... indirect costs the agency incurs for receipt, processing, handling, and disbursement of cash deposits or...

Costs and benefits in item-method directed forgetting: differential effects of encoding and retrieval.

PubMed

Lee, Yuh-Shiow

2013-01-01

This study examined how encoding and retrieval factors affected directed forgetting costs and benefits in an item-method procedure. Experiment 1 used a typical item-method procedure and revealed a levels-of-processing effect in overall recall. However, the deep encoding condition showed a smaller directed forgetting effect than the shallow encoding conditions. More importantly, "remember" (R) words were selectively rehearsed as indicated by greater recall from the primacy portion of the list and more apt to be recalled before "forget" (F) words. Experiment 2 showed that a deep encoding operation reduced directed forgetting costs and that directed forgetting benefits occurred only when R words were recalled before F words. These findings supported the hypotheses that encoding manipulation affected directed forgetting costs and that directed forgetting benefits were associated with output order bias. Results were discussed in terms of mechanisms that produce item-method directed forgetting.

Simple and cost-effective method of highly conductive and elastic carbon nanotube/polydimethylsiloxane composite for wearable electronics.

PubMed

Kim, Jeong Hun; Hwang, Ji-Young; Hwang, Ha Ryeon; Kim, Han Seop; Lee, Joong Hoon; Seo, Jae-Won; Shin, Ueon Sang; Lee, Sang-Hoon

2018-01-22

The development of various flexible and stretchable materials has attracted interest for promising applications in biomedical engineering and electronics industries. This interest in wearable electronics, stretchable circuits, and flexible displays has created a demand for stable, easily manufactured, and cheap materials. However, the construction of flexible and elastic electronics, on which commercial electronic components can be mounted through simple and cost-effective processing, remains challenging. We have developed a nanocomposite of carbon nanotubes (CNTs) and polydimethylsiloxane (PDMS) elastomer. To achieve uniform distributions of CNTs within the polymer, an optimized dispersion process was developed using isopropyl alcohol (IPA) and methyl-terminated PDMS in combination with ultrasonication. After vaporizing the IPA, various shapes and sizes can be easily created with the nanocomposite, depending on the mold. The material provides high flexibility, elasticity, and electrical conductivity without requiring a sandwich structure. It is also biocompatible and mechanically stable, as demonstrated by cytotoxicity assays and cyclic strain tests (over 10,000 times). We demonstrate the potential for the healthcare field through strain sensor, flexible electric circuits, and biopotential measurements such as EEG, ECG, and EMG. This simple and cost-effective fabrication method for CNT/PDMS composites provides a promising process and material for various applications of wearable electronics.

Nonisothermal glass molding for the cost-efficient production of precision freeform optics

NASA Astrophysics Data System (ADS)

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

2016-07-01

Glass molding has become a key replication-based technology to satisfy intensively growing demands of complex precision optics in the today's photonic market. However, the state-of-the-art replicative technologies are still limited, mainly due to their insufficiency to meet the requirements of mass production. This paper introduces a newly developed nonisothermal glass molding in which a complex-shaped optic is produced in a very short process cycle. The innovative molding technology promises a cost-efficient production because of increased mold lifetime, less energy consumption, and high throughput from a fast process chain. At the early stage of the process development, the research focuses on an integration of finite element simulation into the process chain to reduce time and labor-intensive cost. By virtue of numerical modeling, defects including chill ripples and glass sticking in the nonisothermal molding process can be predicted and the consequent effects are avoided. In addition, the influences of process parameters and glass preforms on the surface quality, form accuracy, and residual stress are discussed. A series of experiments was carried out to validate the simulation results. The successful modeling, therefore, provides a systematic strategy for glass preform design, mold compensation, and optimization of the process parameters. In conclusion, the integration of simulation into the entire nonisothermal glass molding process chain will significantly increase the manufacturing efficiency as well as reduce the time-to-market for the mass production of complex precision yet low-cost glass optics.

Protocol for process evaluation of a randomised controlled trial of family-led rehabilitation post stroke (ATTEND) in India.

PubMed

Liu, Hueiming; Lindley, Richard; Alim, Mohammed; Felix, Cynthia; Gandhi, Dorcas B C; Verma, Shweta J; Tugnawat, Deepak Kumar; Syrigapu, Anuradha; Ramamurthy, Ramaprabhu Krishnappa; Pandian, Jeyaraj D; Walker, Marion; Forster, Anne; Anderson, Craig S; Langhorne, Peter; Murthy, Gudlavalleti Venkata Satyanarayana; Shamanna, Bindiganavale Ramaswamy; Hackett, Maree L; Maulik, Pallab K; Harvey, Lisa A; Jan, Stephen

2016-09-15

We are undertaking a randomised controlled trial (fAmily led rehabiliTaTion aftEr stroke in INDia, ATTEND) evaluating training a family carer to enable maximal rehabilitation of patients with stroke-related disability; as a potentially affordable, culturally acceptable and effective intervention for use in India. A process evaluation is needed to understand how and why this complex intervention may be effective, and to capture important barriers and facilitators to its implementation. We describe the protocol for our process evaluation to encourage the development of in-process evaluation methodology and transparency in reporting. The realist and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) frameworks informed the design. Mixed methods include semistructured interviews with health providers, patients and their carers, analysis of quantitative process data describing fidelity and dose of intervention, observations of trial set up and implementation, and the analysis of the cost data from the patients and their families perspective and programme budgets. These qualitative and quantitative data will be analysed iteratively prior to knowing the quantitative outcomes of the trial, and then triangulated with the results from the primary outcome evaluation. The process evaluation has received ethical approval for all sites in India. In low-income and middle-income countries, the available human capital can form an approach to reducing the evidence practice gap, compared with the high cost alternatives available in established market economies. This process evaluation will provide insights into how such a programme can be implemented in practice and brought to scale. Through local stakeholder engagement and dissemination of findings globally we hope to build on patient-centred, cost-effective and sustainable models of stroke rehabilitation. CTRI/2013/04/003557. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effect of membrane and process characteristics on cost and energy usage for separating alcohol–water mixtures using a hybrid vapor stripping–vapor permeation process

EPA Science Inventory

BACKGROUND: Alcohols, including ethanol and butanol, are receiving increased attention as renewable liquid biofuels. Alcohol concentrations may be low in a biological process due to product inhibition and, for non-starch feedstocks, limited substrate concentrations. The result is...

The Effects of a Low-Level Uniform Ultrasound Field on Enzymatic Bio-Processing of Cotton: An Investigation of Three Fabric Weights

USDA-ARS?s Scientific Manuscript database

Enzymatic bio-processing of cotton generates significantly less hazardous wastewater effluents, which are readily biodegradable, but it also has several critical shortcomings that impede its acceptance by industries: expensive processing costs and slow reaction rates. Our research has found that t...

Development of a material processing plant for lunar soil

NASA Technical Reports Server (NTRS)

Goettsch, Ulix; Ousterhout, Karl

1992-01-01

Currently there is considerable interest in developing in-situ materials processing plants for both the Moon and Mars. Two of the most important aspects of developing such a materials processing plant is the overall system design and the integration of the different technologies into a reliable, lightweight, and cost-effective unit. The concept of an autonomous materials processing plant that is capable of producing useful substances from lunar regolith was developed. In order for such a materials processing plant to be considered as a viable option, it must be totally self-contained, able to operate autonomously, cost effective, light weight, and fault tolerant. In order to assess the impact of different technologies on the overall systems design and integration, a one-half scale model was constructed that is capable of scooping up (or digging) lunar soil, transferring the soil to a solar furnace, heating the soil in the furnace to liberate the gasses, and transferring the spent soil to a 'tile' processing center. All aspects of the control system are handled by a 386 class PC via D/A, A/D, and DSP (Digital Signal Processor) control cards.

Use of Lymph Node Ultrasound Prior to Sentinel Lymph Node Biopsy in 384 Patients with Melanoma: A Cost-Effectiveness Analysis.

PubMed

Olmedo, D; Brotons-Seguí, M; Del Toro, C; González, M; Requena, C; Traves, V; Pla, A; Bolumar, I; Moreno-Ramírez, D; Nagore, E

2017-12-01

Locoregional lymph node ultrasound is not typically included in guidelines as part of the staging process prior to sentinel lymph node biopsy (SLNB). The objective of the present study was to make a clinical and economic analysis of lymph node ultrasound prior to SLNB. We performed a retrospective study of 384 patients with clinical stage I-II primary melanoma who underwent locorregional lymph node ultrasound (with or without ultrasound-guided biopsy) prior to SLNB between 2004 and 2015. We evaluated the reliability and cost-effectiveness of the strategy. Use of locorregional lymph node ultrasound avoided SLNB in 23 patients (6%). Ultrasound had a sensitivity of 46% and specificity of 76% for the detection of metastatic lymph nodes that were not clinically palpable. False negatives were significantly more common in patients aged over 60 years and in tumors with a thickness of less than 2mm. The staging process using SLNB and ultrasound with ultrasound-guided biopsy produced an increase of €16.30 in the unit price. Our cost-effectiveness analysis identified the staging protocol with ultrasound and SLNB as the dominant strategy, with a lower cost-effectiveness ratio than the alternative, consisting of SLNB alone (8,095.24 vs. €28,605.00). Ultrasound with ultrasound-guided biopsy for the diagnostic staging of melanoma prior to SLNB is a useful and cost-effective tool. This procedure does not substitute SLNB, though it does allow to avoid SLNB in a not insignificant proportion of patients. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Scale-up of Carbon/Carbon Bipolar Plates

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

David P. Haack

2009-04-08

This project was focused upon developing a unique material technology for use in PEM fuel cell bipolar plates. The carbon/carbon composite material developed in this program is uniquely suited for use in fuel cell systems, as it is lightweight, highly conductive and corrosion resistant. The project further focused upon developing the manufacturing methodology to cost-effectively produce this material for use in commercial fuel cell systems. United Technology Fuel Cells Corp., a leading fuel cell developer was a subcontractor to the project was interested in the performance and low-cost potential of the material. The accomplishments of the program included the developmentmore » and testing of a low-cost, fully molded, net-shape carbon-carbon bipolar plate. The process to cost-effectively manufacture these carbon-carbon bipolar plates was focused on extensively in this program. Key areas for cost-reduction that received attention in this program was net-shape molding of the detailed flow structures according to end-user design. Correlations between feature detail and process parameters were formed so that mold tooling could be accurately designed to meet a variety of flow field dimensions. A cost model was developed that predicted the cost of manufacture for the product in near-term volumes and long-term volumes (10+ million units per year). Because the roduct uses lowcost raw materials in quantities that are less than competitive tech, it was found that the cost of the product in high volume can be less than with other plate echnologies, and can meet the DOE goal of $4/kW for transportation applications. The excellent performance of the all-carbon plate in net shape was verified in fuel cell testing. Performance equivalent to much higher cost, fully machined graphite plates was found.« less

A Nuclear Waste Management Cost Model for Policy Analysis

NASA Astrophysics Data System (ADS)

Barron, R. W.; Hill, M. C.

2017-12-01

Although integrated assessments of climate change policy have frequently identified nuclear energy as a promising alternative to fossil fuels, these studies have often treated nuclear waste disposal very simply. Simple assumptions about nuclear waste are problematic because they may not be adequate to capture relevant costs and uncertainties, which could result in suboptimal policy choices. Modeling nuclear waste management costs is a cross-disciplinary, multi-scale problem that involves economic, geologic and environmental processes that operate at vastly different temporal scales. Similarly, the climate-related costs and benefits of nuclear energy are dependent on environmental sensitivity to CO2 emissions and radiation, nuclear energy's ability to offset carbon emissions, and the risk of nuclear accidents, factors which are all deeply uncertain. Alternative value systems further complicate the problem by suggesting different approaches to valuing intergenerational impacts. Effective policy assessment of nuclear energy requires an integrated approach to modeling nuclear waste management that (1) bridges disciplinary and temporal gaps, (2) supports an iterative, adaptive process that responds to evolving understandings of uncertainties, and (3) supports a broad range of value systems. This work develops the Nuclear Waste Management Cost Model (NWMCM). NWMCM provides a flexible framework for evaluating the cost of nuclear waste management across a range of technology pathways and value systems. We illustrate how NWMCM can support policy analysis by estimating how different nuclear waste disposal scenarios developed using the NWMCM framework affect the results of a recent integrated assessment study of alternative energy futures and their effects on the cost of achieving carbon abatement targets. Results suggest that the optimism reflected in previous works is fragile: Plausible nuclear waste management costs and discount rates appropriate for intergenerational cost-benefit analysis produce many scenarios where nuclear energy is economically unattractive.

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.

Manufacturing Cost Levelization Model – A User’s Guide

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

Morrow, William R.; Shehabi, Arman; Smith, Sarah Josephine

The Manufacturing Cost Levelization Model is a cost-performance techno-economic model that estimates total large-scale manufacturing costs for necessary to produce a given product. It is designed to provide production cost estimates for technology researchers to help guide technology research and development towards an eventual cost-effective product. The model presented in this user’s guide is generic and can be tailored to the manufacturing of any product, including the generation of electricity (as a product). This flexibility, however, requires the user to develop the processes and process efficiencies that represents a full-scale manufacturing facility. The generic model is comprised of several modulesmore » that estimate variable costs (material, labor, and operating), fixed costs (capital & maintenance), financing structures (debt and equity financing), and tax implications (taxable income after equipment and building depreciation, debt interest payments, and expenses) of a notional manufacturing plant. A cash-flow method is used to estimate a selling price necessary for the manufacturing plant to recover its total cost of production. A levelized unit sales price ($ per unit of product) is determined by dividing the net-present value of the manufacturing plant’s expenses ($) by the net present value of its product output. A user defined production schedule drives the cash-flow method that determines the levelized unit price. In addition, an analyst can increase the levelized unit price to include a gross profit margin to estimate a product sales price. This model allows an analyst to understand the effect that any input variables could have on the cost of manufacturing a product. In addition, the tool is able to perform sensitivity analysis, which can be used to identify the key variables and assumptions that have the greatest influence on the levelized costs. This component is intended to help technology researchers focus their research attention on tasks that offer the greatest opportunities for cost reduction early in the research and development stages of technology invention.« less

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India.

PubMed

Masters, William A; Rosettie, Katherine L; Kranz, Sarah; Danaei, Goodarz; Webb, Patrick; Mozaffarian, Dariush

2018-05-01

Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality. This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India. These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country. Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India. When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day). These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings, informing policy discussions and serving as critical inputs to future cost-effectiveness analyses focusing on disease outcomes.

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India

PubMed Central

Rosettie, Katherine L; Kranz, Sarah; Danaei, Goodarz; Webb, Patrick; Mozaffarian, Dariush; Bhattacharjee, Lalita; Chandrasekhar, S; Christensen, Cheryl; Desai, Sonalde; Kazi-Hutchins, Nabeeha; Levin, Carol; Paarlberg, Robert; Vosti, Steven; Adekugbe, Olayinka; Atomsa, Gudina Egata; Badham, Jane; Baye, Kaleab; Beyero, Mesfin; Covic, Namukolo; Dalton, Babukiika; Dufour, Charlotte; Fracassi, Patrizia; Getahun, Zewditu; Haidar, Jemal; Hailu, Tesfaye; Kebede, Aweke; Kinabo, Joyce; Kussaga, Jamal Bakari; Mavrotas, George; Mwanja, Wilson Waiswa; Oguntona, Babatunde; Oladipo, Abiodun; Oniang’o, Ruth; Sibanda, Simbarashe; Sodjinou, Roger; Tom, Carol; Wamani, Henry; Wendelin, Akwilina; Adhikari, Ramesh Kant; Amatya, Archana; Bhattarai, Manav; Brahmbhatt, Viral; Chandyo, Ram Krishna; Gulati, Seema; Kapil, Umesh; Mehta, Ranju; Mohan, Sailesh; Prabhakaran, D; Prakash, V; Puri, Seema; Roy, S K; Sharma, Rekha; Shivakoti, Sabnam; Thorne-Lyman, Andrew; Rana, Pooja Pandey; Trilok-Kumar, Geeta

2018-01-01

Abstract Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality. This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India. These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country. Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India. When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day). These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings, informing policy discussions and serving as critical inputs to future cost-effectiveness analyses focusing on disease outcomes. PMID:29522103

Validated Feasibility Study of Integrally Stiffened Metallic Fuselage Panels for Reducing Manufacturing Costs: Cost Assessment of Manufacturing/Design Concepts

NASA Technical Reports Server (NTRS)

Metschan, S.

2000-01-01

The objective of the Integral Airframe Structures (IAS) program was to demonstrate, for an integrally stiffened structural concept, performance and weight equal to "built-up" structure with lower manufacturing cost. This report presents results of the cost assessment for several design configuration/manufacturing method combinations. The attributes of various cost analysis models were evaluated and COSTRAN selected for this study. A process/design cost evaluation matrix was developed based on material, forming, machining, and assembly of structural sub-elements and assembled structure. 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 built-up technology baseline. This would correspond to a total cost reduction of $1.7 million per ship set for a 777-sized airplane. However, there are important outstanding issues with regard to the cost of capacity of high technology machinery, and the ability to cost-effectively provide surface finish acceptable to the commercial aircraft industry. The projected high raw material cost of large extrusions also played an important role in the trade-off between plate and extruded concepts.

Low cost MATLAB-based pulse oximeter for deployment in research and development applications.

PubMed

Shokouhian, M; Morling, R C S; Kale, I

2013-01-01

Problems such as motion artifact and effects of ambient lights have forced developers to design different signal processing techniques and algorithms to increase the reliability and accuracy of the conventional pulse oximeter device. To evaluate the robustness of these techniques, they are applied either to recorded data or are implemented on chip to be applied to real-time data. Recorded data is the most common method of evaluating however it is not as reliable as real-time measurements. On the other hand, hardware implementation can be both expensive and time consuming. This paper presents a low cost MATLAB-based pulse oximeter that can be used for rapid evaluation of newly developed signal processing techniques and algorithms. Flexibility to apply different signal processing techniques, providing both processed and unprocessed data along with low implementation cost are the important features of this design which makes it ideal for research and development purposes, as well as commercial, hospital and healthcare application.

Comparison of resin film infusion, resin transfer molding, and consolidation of textile preforms for primary aircraft structure

NASA Technical Reports Server (NTRS)

Suarez, J.; Dastin, S.

1992-01-01

Innovative design concepts and cost effective fabrication processes were developed for damage tolerant primary structures that can perform at a design ultimate strain level of 6000 micro inch/inch. Attention focused on the use of textile high performance fiber reinforcement concepts that provide improved damage tolerance and out-of-plane load capability, low cost resin film infusion (RFI) and resin transfer molding (RTM) processes, and thermoplastic forming concepts. The fabrication of wing 'Y' spars by four different materials and/or processes methods is described: fabricated using IM7 angle interlock 0 to 90 deg woven preforms with + or - 45 deg plies stitched with Toray high strength graphite thread and processed using RFI and 3501-6 epoxy; fabricated using G40-800 knitted/stitched preforms and processed using RFI and 3501-6 epoxy; fabricated using G40-800 knitted/stitched preforms using RTM and Tactix 123/H41 epoxy; and fabricated preforms using AS4(6K)/PEEK 150 g commingled angle interlock 0 to 90 deg woven preforms with + or - 45 deg commingled plies stitched using high strength graphite thread and processed by consolidation. Structural efficiency, processability, and acquisition cost are compared.

The Role of Animacy and Thematic Relationships in Processing Active English Sentences: Evidence from Event-Related Potentials

ERIC Educational Resources Information Center

Kuperberg, Gina R.; Kreher, Donna A.; Sitnikova, Tatiana; Caplan, David N.; Holcomb, Phillip J.

2007-01-01

Recent event-related potential studies report a P600 effect to incongruous verbs preceded by semantically associated inanimate noun-phrase (NP) arguments, e.g., "eat" in "At breakfast the eggs would eat...". This P600 effect may reflect the processing cost incurred when semantic-thematic relationships between critical verbs and their preceding NP…

OAST Space Theme Workshop. Volume 3: Working group summary. 2: Data handling, communications (E-2). A. Statement. B. Technology needs (form 1). C. Priority assessment (form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

Technologies required to support the stated OAST thrust to increase information return by X1000, while reducing costs by a factor of 10 are identified. The most significant driver is the need for an overall end-to-end data system management technology. Maximum use of LSI component technology and trade-offs between hardware and software are manifest in most all considerations of technology needs. By far, the greatest need for data handling technology was identified for the space Exploration and Global Services themes. Major advances are needed in NASA's ability to provide cost effective mass reduction of space data, and automated assessment of earth looking imagery, with a concomitant reduction in cost per useful bit. A combined approach embodying end-to-end system analysis, with onboard data set selection, onboard data processing, highly parallel image processing (both ground and space), low cost, high capacity memories, and low cost user data distribution systems would be necessary.

Transitioning glass-ceramic scintillators for diagnostic x-ray imaging from the laboratory to commercial scale

NASA Astrophysics Data System (ADS)

Beckert, M. Brooke; Gallego, Sabrina; Elder, Eric; Nadler, Jason

2016-10-01

This study sought to mitigate risk in transitioning newly developed glass-ceramic scintillator technology from a laboratory concept to commercial product by identifying the most significant hurdles to increased scale. These included selection of cost effective raw material sources, investigation of process parameters with the most significant impact on performance, and synthesis steps that could see the greatest benefit from participation of an industry partner that specializes in glass or optical component manufacturing. Efforts focused on enhancing the performance of glass-ceramic nanocomposite scintillators developed specifically for medical imaging via composition and process modifications that ensured efficient capture of incident X-ray energy and emission of scintillation light. The use of cost effective raw materials and existing manufacturing methods demonstrated proof-of-concept for economical viable alternatives to existing benchmark materials, as well as possible disruptive applications afforded by novel geometries and comparatively lower cost per volume. The authors now seek the expertise of industry to effectively navigate the transition from laboratory demonstrations to pilot scale production and testing to evince the industry of the viability and usefulness of composite-based scintillators.

Can electrocoagulation process be an appropriate technology for phosphorus removal from municipal wastewater?

PubMed

Nguyen, D Duc; Ngo, H Hao; Guo, W; Nguyen, T Thanh; Chang, Soon W; Jang, A; Yoon, Yong S

2016-09-01

This paper evaluated a novel pilot scale electrocoagulation (EC) system for improving total phosphorus (TP) removal from municipal wastewater. This EC system was operated in continuous and batch operating mode under differing conditions (e.g. flow rate, initial concentration, electrolysis time, conductivity, voltage) to evaluate correlative phosphorus and electrical energy consumption. The results demonstrated that the EC system could effectively remove phosphorus to meet current stringent discharge standards of less than 0.2mg/L within 2 to 5min. This target was achieved in all ranges of initial TP concentrations studied. It was also found that an increase in conductivity of solution, voltages, or electrolysis time, correlated with improved TP removal efficiency and reduced specific energy consumption. Based on these results, some key economic considerations, such as operating costs, cost-effectiveness, product manufacturing feasibility, facility design and retrofitting, and program implementation are also discussed. This EC process can conclusively be highly efficient in a relatively simple, easily managed, and cost-effective for wastewater treatment system. Copyright © 2016 Elsevier B.V. All rights reserved.

The Parallel Episodic Processing (PEP) model 2.0: A single computational model of stimulus-response binding, contingency learning, power curves, and mixing costs.

PubMed

Schmidt, James R; De Houwer, Jan; Rothermund, Klaus

2016-12-01

The current paper presents an extension of the Parallel Episodic Processing model. The model is developed for simulating behaviour in performance (i.e., speeded response time) tasks and learns to anticipate both how and when to respond based on retrieval of memories of previous trials. With one fixed parameter set, the model is shown to successfully simulate a wide range of different findings. These include: practice curves in the Stroop paradigm, contingency learning effects, learning acquisition curves, stimulus-response binding effects, mixing costs, and various findings from the attentional control domain. The results demonstrate several important points. First, the same retrieval mechanism parsimoniously explains stimulus-response binding, contingency learning, and practice effects. Second, as performance improves with practice, any effects will shrink with it. Third, a model of simple learning processes is sufficient to explain phenomena that are typically (but perhaps incorrectly) interpreted in terms of higher-order control processes. More generally, we argue that computational models with a fixed parameter set and wider breadth should be preferred over those that are restricted to a narrow set of phenomena. Copyright © 2016 Elsevier Inc. All rights reserved.

Cost-utility analysis of percutaneous mitral valve repair in inoperable patients with functional mitral regurgitation in German settings.

PubMed

Borisenko, Oleg; Haude, Michael; Hoppe, Uta C; Siminiak, Tomasz; Lipiecki, Janusz; Goldberg, Steve L; Mehta, Nawzer; Bouknight, Omari V; Bjessmo, Staffan; Reuter, David G

2015-05-14

To determine the cost-effectiveness of the percutaneous mitral valve repair (PMVR) using Carillon® Mitral Contour System® (Cardiac Dimensions Inc., Kirkland, WA, USA) in patients with congestive heart failure accompanied by moderate to severe functional mitral regurgitation (FMR) compared to the prolongation of optimal medical treatment (OMT). Cost-utility analysis using a combination of a decision tree and Markov process was performed. The clinical effectiveness was determined based on the results of the Transcatheter Implantation of Carillon Mitral Annuloplasty Device (TITAN) trial. The mean age of the target population was 62 years, 77% of the patients were males, 64% of the patients had severe FMR and all patients had New York Heart Association functional class III. The epidemiological, cost and utility data were derived from the literature. The analysis was performed from the German statutory health insurance perspective over 10-year time horizon. Over 10 years, the total cost was €36,785 in the PMVR arm and €18,944 in the OMT arm. However, PMVR provided additional benefits to patients with an 1.15 incremental quality-adjusted life years (QALY) and an 1.41 incremental life years. The percutaneous procedure was cost-effective in comparison to OMT with an incremental cost-effectiveness ratio of €15,533/QALY. Results were robust in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis with a willingness-to-pay threshold of €35,000/QALY, PMVR had a 84 % probability of being cost-effective. Percutaneous mitral valve repair may be cost-effective in inoperable patients with FMR due to heart failure.

Material selection and assembly method of battery pack for compact electric vehicle

NASA Astrophysics Data System (ADS)

Lewchalermwong, N.; Masomtob, M.; Lailuck, V.; Charoenphonphanich, C.

2018-01-01

Battery packs become the key component in electric vehicles (EVs). The main costs of which are battery cells and assembling processes. The battery cell is indeed priced from battery manufacturers while the assembling cost is dependent on battery pack designs. Battery pack designers need overall cost as cheap as possible, but it still requires high performance and more safety. Material selection and assembly method as well as component design are very important to determine the cost-effectiveness of battery modules and battery packs. Therefore, this work presents Decision Matrix, which can aid in the decision-making process of component materials and assembly methods for a battery module design and a battery pack design. The aim of this study is to take the advantage of incorporating Architecture Analysis method into decision matrix methods by capturing best practices for conducting design architecture analysis in full account of key design components critical to ensure efficient and effective development of the designs. The methodology also considers the impacts of choice-alternatives along multiple dimensions. Various alternatives for materials and assembly techniques of battery pack are evaluated, and some sample costs are presented. Due to many components in the battery pack, only seven components which are positive busbar and Z busbar are represented in this paper for using decision matrix methods.

Transcranial direct current stimulation of the medial prefrontal cortex modulates the propensity to help in costly helping behavior.

PubMed

Liao, Chong; Wu, Song; Luo, Yue-Jia; Guan, Qing; Cui, Fang

2018-05-01

Social decision-making engages traditional decision-making processes (e.g. valuation), as well as social cognition processes (e.g. inferring the affective and mental states of another person). Neuroimaging and neuro-stimulation studies have suggested the involvement of the medial prefrontal cortex (mPFC) in a variety of social decision-making tasks. Yet no study has investigated the effect of the cortical excitability of mPFC in the decision-making of costly helping behavior. Here, we used tDCS to demonstrate the causal relationship between the cortical excitability of mPFC and costly helping decision-making. Subjects assigned to the anodal, cathodal and sham groups were required to decide whether they would like to cost their own money to relieve another subject (a confederate actually) from painful electrical shocks with a certain probability of success. Results showed that the subjects receiving anodal stimulation acted more prosaically than the subjects receiving cathodal stimulation. And this effect was only significant when the probability of success was high. We proposed that tDCS induced modulation of the cortical excitability, targeting the mPFC, can affect the prosocial propensity in costly helping behavior, and the possible underlying mechanisms were discussed. Copyright © 2018 Elsevier B.V. All rights reserved.

Divergent selection for amino-nitrogen concentration in sugarbeet roots

USDA-ARS?s Scientific Manuscript database

Improvements in sugarbeet (Beta vulgaris L.) processing quality, and therefore the cost-effectiveness of processing, will enhance beet sugar’s competitiveness with cane sugar and alternative sweeteners. Amino-nitrogen is one of the naturally occurring constituents of sugarbeet, referred to as impuri...

DEMONSTRATION OF AN INTEGRATED, PASSIVE BIOLOGICAL TREATMENT PROCESS FOR AMD

EPA Science Inventory

An innovative, cost-effective, biological treatment process has been designed by MSE Technology Applications, Inc. to treat acid mine drainage (AMD). A pilot-scale demonstration is being conducted under the Mine Waste Technology Program using water flowing from an abandoned mine ...

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

NASA Technical Reports Server (NTRS)

Redfield, D.

1977-01-01

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

Cost and cost-effectiveness of HIV/AIDS prevention strategies in developing countries: is there an evidence base?

PubMed

Walker, Damian

2003-03-01

Many donors and countries are striving to respond to the HIV/AIDS epidemic by implementing prevention programmes. However, the resources available for providing these activities relative to needs are limited. Hence, decision-makers must choose among various types of interventions. Cost information, both measures of cost and cost-effectiveness, serves as a critical input into the processes of setting priorities and allocating resources efficiently. This paper reviews the cost and cost-effectiveness evidence base of HIV/AIDS prevention programmes in low- and middle-income countries (LMICs). None of the studies found have complete cost data for a full range of HIV/AIDS prevention programmes in any one country. However, the range of studies highlight the relative emphasis of different types of HIV/AIDS prevention strategies by region, reflecting the various modes of transmission and hence, to a certain extent, the stage of the epidemic. The costing methods applied and results obtained in this review give rise to questions of reliability, validity and transparency. First, not all of the studies report the methods used to calculate the costs, and/or do not provide all the necessary data inputs such that recalculation of the results is possible. Secondly, methods that are documented vary widely, rendering different studies, even within the same country and programme setting, largely incomparable. Finally, even with consistent and replicable measurement, the results as presented are generally not comparable because of the lack of a common outcome measure. Therefore, the extent to which the available cost and cost-effectiveness evidence base on HIV/AIDS prevention strategies can provide guidance to decision-makers is limited, and there is an urgent need for the generation of this knowledge for planning and decision-making.

Cost-utility analysis of intravenous immunoglobulin for the treatment of steroid-refractory dermatomyositis in Thailand.

PubMed

Bamrungsawad, Naruemon; Chaiyakunapruk, Nathorn; Upakdee, Nilawan; Pratoomsoot, Chayanin; Sruamsiri, Rosarin; Dilokthornsakul, Piyameth

2015-05-01

Intravenous immunoglobulin (IVIG) has been shown to be effective in treating steroid-refractory dermatomyositis (DM). There remains no evidence of its cost-effectiveness in Thailand. Our objective was to estimate the cost utility of IVIG as a second-line therapy in steroid-refractory DM in Thailand. A Markov model was developed to estimate the relevant costs and health benefits for IVIG plus corticosteroids in comparison with immunosuppressant plus corticosteroids in steroid-refractory DM from a societal perspective over a patient's lifetime. The effectiveness and utility parameters were obtained from clinical literature, meta-analyses, medical record reviews, and patient interviews, whereas cost data were obtained from an electronic hospital database and patient interviews. Costs are presented in $US, year 2012 values. All future costs and outcomes were discounted at a rate of 3% per annum. One-way and probabilistic sensitivity analyses were also performed. Over a lifetime horizon, the model estimated treatment under IVIG plus corticosteroids to be cost saving compared with immunosuppressant plus corticosteroids, where the saving of costs and incremental quality-adjusted life-years (QALYs) were $US4738.92 and 1.96 QALYs, respectively. Sensitivity analyses revealed that probability of response of immunosuppressant plus corticosteroids was the most influential parameter on incremental QALYs and costs. At a societal willingness-to-pay threshold in Thailand of $US5148 per QALY gained, the probability of IVIG being cost effective was 97.6%. The use of IVIG plus corticosteroids is cost saving compared with treatment with immunosuppressant plus corticosteroids in Thai patients with steroid-refractory DM. Policy makers should consider using our findings in their decision-making process for adding IVIG to corticosteroids as the second-line therapy for steroid-refractory DM patients.

How to design a horizontal patient-focused hospital.

PubMed

Murphy, E C; Ruflin, P

1993-05-01

Work Imaging is an executive information system for analyzing the cost effectiveness and efficiency of work processes and structures in health care. Advanced Work Imaging relational database technology allows managers and employees to take a sample work activities profile organization-wide. This is married to financial and organizational data to produce images of work within and across all functions, departments, and levels. The images are benchmarked against best practice data to provide insight on the quality and cost efficiency of work practice patterns, from individual roles to departmental skill mix to organization-wide service processes.

An Analysis of Department of Energy Cost Proposal Process and Effectiveness

DTIC Science & Technology

2011-10-11

processes to mitigate and manage risk , rather than derive upfront assessment and quantification of proposal risk (DoE, 2008a). The proposal...2. GM 2- Enhance the Federal Contract and Project Management Workforce Substantially Complete 3. GM 3 - Improve Project Risk Assessment ...proposal, contract proposal evaluation, risk , cost analysis = = ^Åèìáëáíáçå=oÉëÉ~êÅÜ=mêçÖê~ã= do^ar^qb=p`elli=lc=_rpfkbpp=C=mr_if`=mlif`v - ii

An Industrial Engineering Approach to Cost Containment of Pharmacy Education.

PubMed

Duncan, Wendy; Bottenberg, Michelle; Chase, Marilea; Chesnut, Renae; Clarke, Cheryl; Schott, Kathryn; Torry, Ronald; Welty, Tim

2015-11-25

A 2-semester project explored employing teams of fourth-year industrial engineering students to optimize some of our academic management processes. Results included significant cost savings and increases in efficiency, effectiveness, and student and faculty satisfaction. While we did not adopt all of the students' recommendations, we did learn some important lessons. For example, an initial investment of time in developing a mutually clear understanding of the problems, constraints, and goals maximizes the value of industrial engineering analysis and recommendations. Overall, industrial engineering was a valuable tool for optimizing certain academic management processes.

Effect of fabrication processes on mechanical properties of glass fiber reinforced polymer composites for 49 meter (160 foot) recreational yachts

NASA Astrophysics Data System (ADS)

Kim, Dave (dea-wook); Hennigan, Daniel John; Beavers, Kevin Daniel

2010-03-01

Polymer composite materialsoffer high strength and stiffness to weight ratio, corrosion resistance, and total life cost reductions that appeal to the marine industry. The advantages of composite construction have led to their incorporation in U.S. yacht hull structures over 46 meters (150 feet) in length. In order to construct even larger hull structures, higher quality composites with a lower cost production techniques need to be developed. In this study, the effect of composite hull fabrication processes on mechanical properties of glass fiber reinforced plastic(GFRP) composites is presented. Fabrication techniques used in this study are hand lay-up (HL), vacuum infusion (VI), and hybrid (HL+VI) processes. Mechanical property testing includes: tensile, compressive, and ignition loss sample analysis. Results demonstrate that the vacuum pressure implemented during composite fabrication has an effect on mechanical properties. The VI processed GFRP yields improved mechanical properties in tension/compression strengths and tensile modulus. The hybrid GFRP composites, however, failed in a sequential manor, due to dissimilar failure modes in the HL and VI processed sides. Fractography analysis was conducted to validate the mechanical property testing results

An integer batch scheduling model considering learning, forgetting, and deterioration effects for a single machine to minimize total inventory holding cost

NASA Astrophysics Data System (ADS)

Yusriski, R.; Sukoyo; Samadhi, T. M. A. A.; Halim, A. H.

2018-03-01

This research deals with a single machine batch scheduling model considering the influenced of learning, forgetting, and machine deterioration effects. The objective of the model is to minimize total inventory holding cost, and the decision variables are the number of batches (N), batch sizes (Q[i], i = 1, 2, .., N) and the sequence of processing the resulting batches. The parts to be processed are received at the right time and the right quantities, and all completed parts must be delivered at a common due date. We propose a heuristic procedure based on the Lagrange method to solve the problem. The effectiveness of the procedure is evaluated by comparing the resulting solution to the optimal solution obtained from the enumeration procedure using the integer composition technique and shows that the average effectiveness is 94%.

Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study

PubMed Central

2008-01-01

Objective To assess the cost effectiveness of community based occupational therapy compared with usual care in older patients with dementia and their care givers from a societal viewpoint. Design Cost effectiveness study alongside a single blind randomised controlled trial. Setting Memory clinic, day clinic of a geriatrics department, and participants’ homes. Patients 135 patients aged ≥65 with mild to moderate dementia living in the community and their primary care givers. Intervention 10 sessions of occupational therapy over five weeks, including cognitive and behavioural interventions, to train patients in the use of aids to compensate for cognitive decline and care givers in coping behaviours and supervision. Main outcome measures Incremental cost effectiveness ratio expressed as the difference in mean total care costs per successful treatment (that is, a combined patient and care giver outcome measure of clinically relevant improvement on process, performance, and competence scales) at three months after randomisation. Bootstrap methods used to determine confidence intervals for these measures. Results The intervention cost €1183 (£848, $1738) (95% confidence interval €1128 (£808, $1657) to €1239 (£888, $1820)) per patient and primary care giver unit at three months. Visits to general practitioners and hospital doctors cost the same in both groups but total mean costs were €1748 (£1279, $2621) lower in the intervention group, with the main cost savings in informal care. There was a significant difference in proportions of successful treatments of 36% at three months. The number needed to treat for successful treatment at three months was 2.8 (2.7 to 2.9). Conclusions Community occupational therapy intervention for patients with dementia and their care givers is successful and cost effective, especially in terms of informal care giving. PMID:18171718

A review of the silicon material task

NASA Technical Reports Server (NTRS)

Lutwack, R.

1984-01-01

The Silicon Material Task of the Flat-Plate Solar Array Project was assigned the objective of developing the technology for low-cost processes for producing polysilicon suitable for terrestrial solar-cell applications. The Task program comprised sections for process developments for semiconductor-grade and solar-cell-grade products. To provide information for deciding upon process designs, extensive investigations of the effects of impurities on material properties and the performance of cells were conducted. The silane process of the Union Carbide Corporation was carried through several stages of technical and engineering development; a pilot plant was the culmination of this effort. The work to establish silane fluidized-bed technology for a low-cost process is continuing. The advantages of the use of dichlorosilane is a siemens-type were shown by Hemlock Semiconductor Corporation. The development of other processes is described.

A review of the silicon material task

NASA Astrophysics Data System (ADS)

Lutwack, R.

1984-02-01

The Silicon Material Task of the Flat-Plate Solar Array Project was assigned the objective of developing the technology for low-cost processes for producing polysilicon suitable for terrestrial solar-cell applications. The Task program comprised sections for process developments for semiconductor-grade and solar-cell-grade products. To provide information for deciding upon process designs, extensive investigations of the effects of impurities on material properties and the performance of cells were conducted. The silane process of the Union Carbide Corporation was carried through several stages of technical and engineering development; a pilot plant was the culmination of this effort. The work to establish silane fluidized-bed technology for a low-cost process is continuing. The advantages of the use of dichlorosilane is a siemens-type were shown by Hemlock Semiconductor Corporation. The development of other processes is described.

HANDBOOK ON ADVANCED PHOTOCHEMICAL OXIDATION ...

EPA Pesticide Factsheets

This handbook summarizes commercial-scale system performance and cost data for advanced photochemical oxidation (APO) treatment of contaminated water, air, and solids. Similar information from pilot- and bench-scale evaluations of APO processes is also included to supplement the commercial-scale data. Performance and cost data is summarized for various APO processes, including vacuum ultraviolet (VUV) photolysis, ultraviolet (UV)/oxidation, photo-Fenton, and dye- or semiconductor-sensitized APO processes. This handbook is intended to assist engineering practitioners in evaluating the applicability of APO processes and in selecting one or more such processes for site-specific evaluation.APO has been shown to be effective in treating contaminated water and air. Regarding contaminated water treatment, UV/oxidation has been evaluated for the most contaminants, while VUV photolysis has been evaluated for the fewest. Regarding contaminated air treatment, the sensitized APO processes have been evaluated for the most contaminants, while VUV photolysis has been evaluated for the fewest.APO processes for treating contaminated solids generally involve treatment of contaminated slurry or leachate generated using an extraction process such as soil washing. APO has been shown to be effective in treating contaminated solids, primarily at the bench-scale level. Information

Estimating the cost of cervical cancer screening in five developing countries

PubMed Central

Goldhaber-Fiebert, Jeremy D; Goldie, Sue J

2006-01-01

Background Cost-effectiveness analyses (CEAs) can provide useful information to policymakers concerned with the broad allocation of resources as well as to local decision makers choosing between different options for reducing the burden from a single disease. For the latter, it is important to use country-specific data when possible and to represent cost differences between countries that might make one strategy more or less attractive than another strategy locally. As part of a CEA of cervical cancer screening in five developing countries, we supplemented limited primary cost data by developing other estimation techniques for direct medical and non-medical costs associated with alternative screening approaches using one of three initial screening tests: simple visual screening, HPV DNA testing, and cervical cytology. Here, we report estimation methods and results for three cost areas in which data were lacking. Methods To supplement direct medical costs, including staff, supplies, and equipment depreciation using country-specific data, we used alternative techniques to quantify cervical cytology and HPV DNA laboratory sample processing costs. We used a detailed quantity and price approach whose face validity was compared to an adaptation of a US laboratory estimation methodology. This methodology was also used to project annual sample processing capacities for each laboratory type. The cost of sample transport from the clinic to the laboratory was estimated using spatial models. A plausible range of the cost of patient time spent seeking and receiving screening was estimated using only formal sector employment and wages as well as using both formal and informal sector participation and country-specific minimum wages. Data sources included primary data from country-specific studies, international databases, international prices, and expert opinion. Costs were standardized to year 2000 international dollars using inflation adjustment and purchasing power parity. Results Cervical cytology laboratory processing costs were I$1.57–3.37 using the quantity and price method compared to I$1.58–3.02 from the face validation method. HPV DNA processing costs were I$6.07–6.59. Rural laboratory transport costs for cytology were I$0.12–0.64 and I$0.14–0.74 for HPV DNA laboratories. Under assumptions of lower resource efficiency, these estimates increased to I$0.42–0.83 and I$0.54–1.06. Estimates of the value of an hour of patient time using only formal sector participation were I$0.07–4.16, increasing to I$0.30–4.80 when informal and unpaid labor was also included. The value of patient time for traveling, waiting, and attending a screening visit was I$0.68–17.74. With the total cost of screening for cytology and HPV DNA testing ranging from I$4.85–40.54 and I$11.30–48.77 respectively, the cost of the laboratory transport, processing, and patient time accounted for 26–66% and 33–65% of the total costs. From a payer perspective, laboratory transport and processing accounted for 18–48% and 25–60% of total direct medical costs of I$4.11–19.96 and I$10.57–28.18 respectively. Conclusion Cost estimates of laboratory processing, sample transport, and patient time account for a significant proportion of total cervical cancer screening costs in five developing countries and provide important inputs for CEAs of alternative screening modalities. PMID:16887041

Optimized treatment conditions for textile wastewater reuse using photocatalytic processes under UV and visible light sources.

PubMed

Starling, Maria Clara V M; Castro, Luiz Augusto S; Marcelino, Rafaela B P; Leão, Mônica M D; Amorim, Camila C

2017-03-01

In this study, photo-Fenton systems using visible light sources with iron and ferrioxalate were tested for the DOC degradation and decolorization of textile wastewater. Textile wastewaters originated after the dyeing stage of dark-colored tissue in the textile industry, and the optimization of treatment processes was studied to produce water suitable for reuse. Dissolved organic carbon, absorbance, turbidity, anionic concentrations, carboxylic acids, and preliminary cost analysis were performed for the proposed treatments. Conventional photo-Fenton process achieved near 99 % DOC degradation rates and complete absorbance removal, and no carboxylic acids were found as products of degradation. Ferrioxalate photo-Fenton system achieved 82 % of DOC degradation and showed complete absorbance removal, and oxalic acid has been detected through HPLC analysis in the treated sample. In contrast, photo-peroxidation with UV light was proved effective only for absorbance removal, with DOC degradation efficiency near 50 %. Treated wastewater was compared with reclaimed water and had a similar quality, indicating that these processes can be effectively applied for textile wastewater reuse. The results of the preliminary cost analysis indicated costs of 0.91 to 1.07 US$ m -3 for the conventional and ferrioxalate photo-Fenton systems, respectively. Graphical Abstract ᅟ.

Cryogenic Treatment of Al-Li Alloys for Improved Weldability, Repairability, and Reduction of Residual Stresses

NASA Technical Reports Server (NTRS)

Malone, Tina W.; Graham, Benny F.; Gentz, Steven J. (Technical Monitor)

2001-01-01

Service performance has shown that cryogenic treatment of some metals provides improved strength, fatigue life, and wear resistance to the processed material. Effects such as these were initially discovered by NASA engineers while evaluating spacecraft that had returned from the cold vacuum of space. Factors such as high cost, poor repairability, and poor machinability are currently prohibitive for wide range use of some aerospace aluminum alloys. Application of a cryogenic treatment process to these alloys is expected provide improvements in weldability and weld properties coupled with a reduction in repairs resulting in a significant reduction in the cost to manufacture and life cycle cost of aerospace hardware. The primary purpose of this effort was to evaluate the effects of deep cryogenic treatment of some aluminum alloy plate products, welds, and weld repairs, and optimize a process for the treatment of these materials. The optimized process is being evaluated for improvements in properties of plate and welds, improvements in weldability and repairability of treated materials, and as an alternative technique for the reduction of residual stresses in repaired welds. This paper will present the results of testing and evaluation conducted in this effort. These results will include assessments of changes in strength, toughness, stress corrosion susceptability, weldability, repairability, and reduction in residual stresses of repaired welds.

Clinical process cost analysis.

PubMed

Marrin, C A; Johnson, L C; Beggs, V L; Batalden, P B

1997-09-01

New systems of reimbursement are exerting enormous pressure on clinicians and hospitals to reduce costs. Using cheaper supplies or reducing the length of stay may be a satisfactory short-term solution, but the best strategy for long-term success is radical reduction of costs by reengineering the processes of care. However, few clinicians or institutions know the actual costs of medical care; nor do they understand, in detail, the activities involved in the delivery of care. Finally, there is no accepted method for linking the two. Clinical process cost analysis begins with the construction of a detailed flow diagram incorporating each activity in the process of care. The cost of each activity is then calculated, and the two are linked. This technique was applied to Diagnosis Related Group 75 to analyze the real costs of the operative treatment of lung cancer at one institution. Total costs varied between $6,400 and $7,700. The major driver of costs was personnel time, which accounted for 55% of the total. Forty percent of the total cost was incurred in the operating room. The cost of care decreased progressively during hospitalization. Clinical process cost analysis provides detailed information about the costs and processes of care. The insights thus obtained may be used to reduce costs by reengineering the process.

Investigation of test methods, material properties and processes for solar cell encapsulants

NASA Technical Reports Server (NTRS)

Willis, P. B.; Baum, B.

1977-01-01

The potentially useful encapsulating materials for Task 3 of the Low-Cost Silicon Solar Array project were studied to identify, evaluate, and recommend encapsulant materials and processes for the production of cost-effective, long-life solar cell modules. Materials for study were chosen on the basis of existing knowledge of generic chemical types having high resistance to environmental weathering. The materials varied from rubbers to thermoplastics and presented a broad range of mechanical properties and processing requirements. Basic physical and optical properties were measured on the polymers and were redetermined after exposure to indoor artificial accelerated aging conditions covering four time periods. Strengths and weaknesses of the various materials were revealed and data was accumulated for the development of predictive methodologies. To date, silicone rubbers, fluorocarbons, and acrylic polymers appear to have the most promising combination of characteristics. The fluorocarbons may be used only as films, however, because of their high cost.

The automated array assembly task of the low-cost silicon solar array project, phase 2

NASA Technical Reports Server (NTRS)

Coleman, M. G.; Pryor, R. A.; Sparks, T. G.; Legge, R.; Saltzman, D. L.

1980-01-01

Several specific processing steps as part of a total process sequence for manufacturing silicon solar cells were studied. Ion implantation was identified as the preferred process step for impurity doping. Unanalyzed beam ion implantation was shown to have major cost advantages over analyzed beam implantation. Further, high quality cells were fabricated using a high current unanalyzed beam. Mechanically masked plasma patterning of silicon nitride was shown to be capable of forming fine lines on silicon surfaces with spacings between mask and substrate as great as 250 micrometers. Extensive work was performed on advances in plated metallization. The need for the thick electroless palladium layer was eliminated. Further, copper was successfully utilized as a conductor layer utilizing nickel as a barrier to copper diffusion into the silicon. Plasma etching of silicon for texturing and saw damage removal was shown technically feasible but not cost effective compared to wet chemical etching techniques.

Total quality management in orthodontic practice.

PubMed

Atta, A E

1999-12-01

Quality is the buzz word for the new Millennium. Patients demand it, and we must serve it. Yet one must identify it. Quality is not imaging or public relations; it is a business process. This short article presents quality as a balance of three critical notions: core clinical competence, perceived values that our patients seek and want, and the cost of quality. Customer satisfaction is a variable that must be identified for each practice. In my practice, patients perceive quality as communication and time, be it treatment or waiting time. Time is a value and cost that must be managed effectively. Total quality management is a business function; it involves diagnosis, design, implementation, and measurement of the process, the people, and the service. Kazien is a function that reduces value services, eliminates waste, and manages time and cost in the process. Total quality management is a total commitment for continuous improvement.

Modeling of solar polygeneration plant

NASA Astrophysics Data System (ADS)

Leiva, Roberto; Escobar, Rodrigo; Cardemil, José

2017-06-01

In this work, a exergoeconomic analysis of the joint production of electricity, fresh water, cooling and process heat for a simulated concentrated solar power (CSP) based on parabolic trough collector (PTC) with thermal energy storage (TES) and backup energy system (BS), a multi-effect distillation (MED) module, a refrigeration absorption module, and process heat module is carried out. Polygeneration plant is simulated in northern Chile in Crucero with a yearly total DNI of 3,389 kWh/m2/year. The methodology includes designing and modeling a polygeneration plant and applying exergoeconomic evaluations and calculating levelized cost. Solar polygeneration plant is simulated hourly, in a typical meteorological year, for different solar multiple and hour of storage. This study reveals that the total exergy cost rate of products (sum of exergy cost rate of electricity, water, cooling and heat process) is an alternative method to optimize a solar polygeneration plant.

Clinical process analysis and activity-based costing at a heart center.

PubMed

Ridderstolpe, Lisa; Johansson, Andreas; Skau, Tommy; Rutberg, Hans; Ahlfeldt, Hans

2002-08-01

Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR) containing two interrelated parts, "ProcessGuide and CostControl," was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.

Apremilast for the Treatment of Moderate to Severe Plaque Psoriasis: A Critique of the Evidence.

PubMed

Hinde, Sebastian; Wade, Ros; Palmer, Stephen; Woolacott, Nerys; Spackman, Eldon

2016-06-01

As part of the National Institute for Health and Care Excellence's (NICE) single technology appraisal (STA) process, apremilast was assessed to determine the clinical and cost effectiveness of its use in the treatment of moderate to severe plaque psoriasis in two patient populations, differentiated by the severity of the patient's Psoriasis Area Severity Index (PASI) score. The Centre for Reviews and Dissemination (CRD) and the Centre for Health Economics (CHE) Technology Appraisal Group at the University of York was commissioned to act as the evidence review group (ERG). This article provides a summary of the company's submission, the ERG report and NICE's subsequent guidance. In the company's initial submission, a sequence of treatments including apremilast was found to be both more effective and cheaper than a comparator sequence without it in both populations considered. However, this result was found to be highly sensitive to a series of assumptions made by the company, primarily reflecting the costs of best supportive care once no further treatments are available, and the source of utility estimates. A re-estimation of the cost effectiveness of apremilast by the ERG suggested that the apremilast sequence in the two populations was more effective, but due to high additional costs was not indicative of a cost-effective use of NHS resources. As such, in the final appraisal decision NICE concluded that apremilast was not cost effective in either population.

Probabilistic cost estimation methods for treatment of water extracted during CO 2 storage and EOR

DOE PAGES

Graham, Enid J. Sullivan; Chu, Shaoping; Pawar, Rajesh J.

2015-08-08

Extraction and treatment of in situ water can minimize risk for large-scale CO 2 injection in saline aquifers during carbon capture, utilization, and storage (CCUS), and for enhanced oil recovery (EOR). Additionally, treatment and reuse of oil and gas produced waters for hydraulic fracturing will conserve scarce fresh-water resources. Each treatment step, including transportation and waste disposal, generates economic and engineering challenges and risks; these steps should be factored into a comprehensive assessment. We expand the water treatment model (WTM) coupled within the sequestration system model CO 2-PENS and use chemistry data from seawater and proposed injection sites in Wyoming,more » to demonstrate the relative importance of different water types on costs, including little-studied effects of organic pretreatment and transportation. We compare the WTM with an engineering water treatment model, utilizing energy costs and transportation costs. Specific energy costs for treatment of Madison Formation brackish and saline base cases and for seawater compared closely between the two models, with moderate differences for scenarios incorporating energy recovery. Transportation costs corresponded for all but low flow scenarios (<5000 m 3/d). Some processes that have high costs (e.g., truck transportation) do not contribute the most variance to overall costs. Other factors, including feed-water temperature and water storage costs, are more significant contributors to variance. These results imply that the WTM can provide good estimates of treatment and related process costs (AACEI equivalent level 5, concept screening, or level 4, study or feasibility), and the complex relationships between processes when extracted waters are evaluated for use during CCUS and EOR site development.« less

Carbon footprint analysis as a tool for energy and environmental management in small and medium-sized enterprises

NASA Astrophysics Data System (ADS)

Giama, E.; Papadopoulos, A. M.

2018-01-01

The reduction of carbon emissions has become a top priority in the decision-making process for governments and companies, the strict European legislation framework being a major driving force behind this effort. On the other hand, many companies face difficulties in estimating their footprint and in linking the results derived from environmental evaluation processes with an integrated energy management strategy, which will eventually lead to energy-efficient and cost-effective solutions. The paper highlights the need of companies to establish integrated environmental management practices, with tools such as carbon footprint analysis to monitor the energy performance of production processes. Concepts and methods are analysed, and selected indicators are presented by means of benchmarking, monitoring and reporting the results in order to be used effectively from the companies. The study is based on data from more than 90 Greek small and medium enterprises, followed by a comprehensive discussion of cost-effective and realistic energy-saving measures.

Cost considerations for long-term ecological monitoring

USGS Publications Warehouse

Caughlan, L.; Oakley, K.L.

2001-01-01

For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program’s focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs, what dollars are spent on, and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program’s longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occurs during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost-effectiveness, of each program element can be evaluated. Moving into the implementation phase without careful evaluation of costs and benefits is risky because if costs are later found to exceed benefits, the program will fail. The costs of development, which can be quite high, will have been largely wasted. Realistic expectations of costs and benefits will help ensure that monitoring programs survive the early, turbulent stages of development and the challenges posed by fluctuating budgets during implementation.

Cervical screening programmes: can automation help? Evidence from systematic reviews, an economic analysis and a simulation modelling exercise applied to the UK.

PubMed

Willis, B H; Barton, P; Pearmain, P; Bryan, S; Hyde, C

2005-03-01

To assess the effectiveness and cost-effectiveness of adding automated image analysis to cervical screening programmes. Searching of all major electronic databases to the end of 2000 was supplemented by a detailed survey for unpublished UK literature. Four systematic reviews were conducted according to recognised guidance. The review of 'clinical effectiveness' included studies assessing reproducibility and impact on health outcomes and processes in addition to evaluations of test accuracy. A discrete event simulation model was developed, although the economic evaluation ultimately relied on a cost-minimisation analysis. The predominant finding from the systematic reviews was the very limited amount of rigorous primary research. None of the included studies refers to the only commercially available automated image analysis device in 2002, the AutoPap Guided Screening (GS) System. The results of the included studies were debatably most compatible with automated image analysis being equivalent in test performance to manual screening. Concerning process, there was evidence that automation does lead to reductions in average slide processing times. In the PRISMATIC trial this was reduced from 10.4 to 3.9 minutes, a statistically significant and practically important difference. The economic evaluation tentatively suggested that the AutoPap GS System may be efficient. The key proviso is that credible data become available to support that the AutoPap GS System has test performance and processing times equivalent to those obtained for PAPNET. The available evidence is still insufficient to recommend implementation of automated image analysis systems. The priority for action remains further research, particularly the 'clinical effectiveness' of the AutoPap GS System. Assessing the cost-effectiveness of introducing automation alongside other approaches is also a priority.

Low-complexity camera digital signal imaging for video document projection system

NASA Astrophysics Data System (ADS)

Hsia, Shih-Chang; Tsai, Po-Shien

2011-04-01

We present high-performance and low-complexity algorithms for real-time camera imaging applications. The main functions of the proposed camera digital signal processing (DSP) involve color interpolation, white balance, adaptive binary processing, auto gain control, and edge and color enhancement for video projection systems. A series of simulations demonstrate that the proposed method can achieve good image quality while keeping computation cost and memory requirements low. On the basis of the proposed algorithms, the cost-effective hardware core is developed using Verilog HDL. The prototype chip has been verified with one low-cost programmable device. The real-time camera system can achieve 1270 × 792 resolution with the combination of extra components and can demonstrate each DSP function.

[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.

Economic Statistical Design of Integrated X-bar-S Control Chart with Preventive Maintenance and General Failure Distribution

PubMed Central

Caballero Morales, Santiago Omar

2013-01-01

The application of Preventive Maintenance (PM) and Statistical Process Control (SPC) are important practices to achieve high product quality, small frequency of failures, and cost reduction in a production process. However there are some points that have not been explored in depth about its joint application. First, most SPC is performed with the X-bar control chart which does not fully consider the variability of the production process. Second, many studies of design of control charts consider just the economic aspect while statistical restrictions must be considered to achieve charts with low probabilities of false detection of failures. Third, the effect of PM on processes with different failure probability distributions has not been studied. Hence, this paper covers these points, presenting the Economic Statistical Design (ESD) of joint X-bar-S control charts with a cost model that integrates PM with general failure distribution. Experiments showed statistically significant reductions in costs when PM is performed on processes with high failure rates and reductions in the sampling frequency of units for testing under SPC. PMID:23527082

Bench-Scale Process for Low-Cost Carbon Dioxide (CO2) Capture Using a Phase-Changing Absorbent

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

Westendorf, Tiffany; Caraher, Joel; Chen, Wei

2015-03-31

The objective of this project is to design and build a bench-scale process for a novel phase-changing aminosilicone-based CO2-capture solvent. The project will establish scalability and technical and economic feasibility of using a phase-changing CO2-capture absorbent for post-combustion capture of CO2 from coal-fired power plants with 90% capture efficiency and 95% CO2 purity at a cost of $40/tonne of CO2 captured by 2025 and a cost of <$10/tonne of CO2 captured by 2035. In the first budget period of this project, the bench-scale phase-changing CO2 capture process was designed using data and operating experience generated under a previous project (ARPA-emore » project DE-AR0000084). Sizing and specification of all major unit operations was completed, including detailed process and instrumentation diagrams. The system was designed to operate over a wide range of operating conditions to allow for exploration of the effect of process variables on CO2 capture performance.« less

Effectiveness of a Culturally Adapted Strengthening Families Program 12-16-Years for High-Risk Irish Families

ERIC Educational Resources Information Center

Kumpfer, Karol L.; Xie, Jing; O'Driscoll, Robert

2012-01-01

Background: Evidence-based programs (EBPs) targeting effective family skills are the most cost effective for improving adolescent behavioural health. Cochrane Reviews have found the "Strengthening Families Program" (SFP) to be the most effective substance abuse prevention intervention. Standardized cultural adaptation processes resulted…

A Marxian interpretation of the growth and development of coronary care technology.

PubMed Central

Waitzkin, H

1979-01-01

Cost containment efforts will fail if they continue to ignore the structural relationships between health care costs and private profit in capitalist society. The recent history of coronary care shows that apparent irrationalities of health policy make sense from the standpoint of capitalist profit structure. Coronary care units (CCUs) gained wide acceptance, despite high costs. Studies of CCU effectiveness, using random controlled trials and epidemiologic techniques, do not show a consistent advantage of CCUs over non-intensive ward care or simple rest at home. From a Marxian perspective, the proliferation of CCUs and similar innovations is a complex historical process that includes initiatives by industrial corporations, cooperation by clinical investigators at academic medical centers, support by private philanthropies linked to corporate interests, intervention by state agencies, and changes in the health care labor force. Cost-effective methodology obscures the profit motive as a basic source of high costs and ineffective practices. Health-policy alternatives curtailing corporate involvement in medicine would reduce costs by restricting profit. PMID:116553

Automated installation methods for photovoltaic arrays

NASA Astrophysics Data System (ADS)

Briggs, R.; Daniels, A.; Greenaway, R.; Oster, J., Jr.; Racki, D.; Stoeltzing, R.

1982-11-01

Since installation expenses constitute a substantial portion of the cost of a large photovoltaic power system, methods for reduction of these costs were investigated. The installation of the photovoltaic arrays includes all areas, starting with site preparation (i.e., trenching, wiring, drainage, foundation installation, lightning protection, grounding and installation of the panel) and concluding with the termination of the bus at the power conditioner building. To identify the optimum combination of standard installation procedures and automated/mechanized techniques, the installation process was investigated including the equipment and hardware available, the photovoltaic array structure systems and interfaces, and the array field and site characteristics. Preliminary designs of hardware for both the standard installation method, the automated/mechanized method, and a mix of standard installation procedures and mechanized procedures were identified to determine which process effectively reduced installation costs. In addition, costs associated with each type of installation method and with the design, development and fabrication of new installation hardware were generated.

Evaluation of trade-offs in costs and environmental impacts for returnable packaging implementation

NASA Astrophysics Data System (ADS)

Jarupan, Lerpong; Kamarthi, Sagar V.; Gupta, Surendra M.

2004-02-01

The main thrust of returnable packaging these days is to provide logistical services through transportation and distribution of products and be environmentally friendly. Returnable packaging and reverse logistics concepts have converged to mitigate the adverse effect of packaging materials entering the solid waste stream. Returnable packaging must be designed by considering the trade-offs between costs and environmental impact to satisfy manufacturers and environmentalists alike. The cost of returnable packaging entails such items as materials, manufacturing, collection, storage and disposal. Environmental impacts are explicitly linked with solid waste, air pollution, and water pollution. This paper presents a multi-criteria evaluation technique to assist decision-makers for evaluating the trade-offs in costs and environmental impact during the returnable packaging design process. The proposed evaluation technique involves a combination of multiple objective integer linear programming and analytic hierarchy process. A numerical example is used to illustrate the methodology.