48 CFR 42.603 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Responsibilities. (a) The CACO shall perform, on a corporate-wide basis, the contract administration functions as designated by the responsible agency. Typical CACO functions include (1) the determination of final indirect cost rates for cost-reimbursement contracts, (2) establishment of advance agreements or recommendations...

Organizational Perspectives on Rapid Response Team Structure, Function, and Cost: A Qualitative Study.

PubMed

Smith, Patricia L; McSweeney, Jean

Understanding how an organization determines structure and function of a rapid response team (RRT), as well as cost evaluation and implications, can provide foundational knowledge to guide decisions about RRTs. The objectives were to (1) identify influencing factors in organizational development of RRT structure and function and (2) describe evaluation of RRT costs. Using a qualitative, ethnographic design, nurse executives and experts in 15 moderate-size hospitals were interviewed to explore their decision-making processes in determining RRT structure and function. Face-to-face interviews were audio recorded and transcribed verbatim and verified for accurateness. Using content analysis and constant comparison, interview data were analyzed. Demographic data were analyzed using descriptive statistics. The sample included 27 participants from 15 hospitals in 5 south-central states. They described a variety of RRT responders and functions, with the majority of hospitals having a critical care charge nurse attending all RRT calls for assistance. Others described a designated RRT nurse with primary RRT duties as responder to all RRT calls. Themes of RRT development from the data included influencers, decision processes, and thoughts about cost. It is important to understand how hospitals determine optimal structure and function to enhance support of quality nursing care. Determining the impact of an RRT on costs and benefits is vital in balancing patient safety and limited resources. Future research should focus on clarifying differences between team structure and function in outcomes as well as the most effective means to estimate costs and benefits.

10 CFR 1009.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... allocable to a particular cost objective (i.e., a specific function, project, process, or organization) if...) Direct materials. (4) Other direct costs. (5) Processing materials and chemicals. (6) Power and other... equipment. (10) Added factor includes general and administrative costs and other support costs that are...

The cost of sustaining a patient-centered medical home: experience from 2 states.

PubMed

Magill, Michael K; Ehrenberger, David; Scammon, Debra L; Day, Julie; Allen, Tatiana; Reall, Andreu J; Sides, Rhonda W; Kim, Jaewhan

2015-09-01

As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these "advanced primary care" functions. A key required input is personnel effort. This study's objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. © 2015 Annals of Family Medicine, Inc.

The Cost of Sustaining a Patient-Centered Medical Home: Experience From 2 States

PubMed Central

Magill, Michael K.; Ehrenberger, David; Scammon, Debra L.; Day, Julie; Allen, Tatiana; Reall, Andreu J.; Sides, Rhonda W.; Kim, Jaewhan

2015-01-01

PURPOSE As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these “advanced primary care” functions. A key required input is personnel effort. This study’s objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. METHODS We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. RESULTS Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. CONCLUSIONS Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. PMID:26371263

Economic Impact of Dementia by Disease Severity: Exploring the Relationship between Stage of Dementia and Cost of Care in Taiwan.

PubMed

Ku, Li-Jung Elizabeth; Pai, Ming-Chyi; Shih, Pei-Yu

2016-01-01

Given the shortage of cost-of-illness studies in dementia outside of the Western population, the current study estimated the annual cost of dementia in Taiwan and assessed whether different categories of care costs vary by severity using multiple disease-severity measures. This study included 231 dementia patient-caregiver dyads in a dementia clinic at a national university hospital in southern Taiwan. Three disease measures including cognitive, functional, and behavioral disturbances were obtained from patients based on medical history. A societal perspective was used to estimate the total costs of dementia according to three cost sub-categories. The association between dementia severity and cost of care was examined through bivariate and multivariate analyses. Total costs of care for moderate dementia patient were 1.4 times the costs for mild dementia and doubled from mild to severe dementia among our community-dwelling dementia sample. Multivariate analysis indicated that functional declines had a greater impact on all cost outcomes as compared to behavioral disturbance, which showed no impact on any costs. Informal care costs accounted for the greatest share in total cost of care for both mild (42%) and severe (43%) dementia patients. Since the total costs of dementia increased with severity, providing care to delay disease progression, with a focus on maintaining patient physical function, may reduce the overall cost of dementia. The greater contribution of informal care to total costs as opposed to social care also suggests a need for more publicly-funded long-term care services to assist family caregivers of dementia patients in Taiwan.

Parametric Cost Analysis: A Design Function

NASA Technical Reports Server (NTRS)

Dean, Edwin B.

1989-01-01

Parametric cost analysis uses equations to map measurable system attributes into cost. The measures of the system attributes are called metrics. The equations are called cost estimating relationships (CER's), and are obtained by the analysis of cost and technical metric data of products analogous to those to be estimated. Examples of system metrics include mass, power, failure_rate, mean_time_to_repair, energy _consumed, payload_to_orbit, pointing_accuracy, manufacturing_complexity, number_of_fasteners, and percent_of_electronics_weight. The basic assumption is that a measurable relationship exists between system attributes and the cost of the system. If a function exists, the attributes are cost drivers. Candidates for metrics include system requirement metrics and engineering process metrics. Requirements are constraints on the engineering process. From optimization theory we know that any active constraint generates cost by not permitting full optimization of the objective. Thus, requirements are cost drivers. Engineering processes reflect a projection of the requirements onto the corporate culture, engineering technology, and system technology. Engineering processes are an indirect measure of the requirements and, hence, are cost drivers.

48 CFR 31.205-1 - Public relations and advertising costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Organizations 31.205-1 Public relations and advertising costs. (a) Public relations means all functions and... public relations and advertising costs include the following: (1) All public relations and advertising..., imprinted clothing, buttons, and other mementos provided to customers or the public. (7) Costs of...

Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs.

PubMed

Neelemaat, Floor; Bosmans, Judith E; Thijs, Abel; Seidell, Jaap C; van Bokhorst-de van der Schueren, Marian A E

2012-04-01

Older people are vulnerable to malnutrition which leads to increased health care costs. The aim of this study was to evaluate the cost-effectiveness of nutritional supplementation from a societal perspective. This randomized controlled trial included hospital admitted malnourished elderly (≥ 60 y) patients. Patients in the intervention group received nutritional supplementation (energy and protein enriched diet, oral nutritional support, calcium-vitamin D supplement, telephone counselling by a dietician) until three months after discharge from hospital. Patients in the control group received usual care (control). Primary outcomes were Quality Adjusted Life Years (QALYs), physical activities and functional limitations. Measurements were performed at hospital admission and three months after discharge. Data were analyzed according to the intention-to-treat principle and multiple imputation was used to impute missing data. Incremental cost-effectiveness ratios were calculated and bootstrapping was applied to evaluate cost-effectiveness. Cost-effectiveness was expressed by cost-effectiveness planes and cost-effectiveness acceptability curves. 210 patients were included, 105 in each group. After three months, no statistically significant differences in quality of life and physical activities were observed between groups. Functional limitations decreased significantly more in the intervention group (mean difference -0.72, 95% CI-1.15; -0.28). There were no differences in costs between groups. Cost-effectiveness for QALYs and physical activities could not be demonstrated. For functional limitations we found a 0.95 probability that the intervention is cost-effective in comparison with usual care for ceiling ratios > €6500. A multi-component nutritional intervention to malnourished elderly patients for three months after hospital discharge leads to significant improvement in functional limitations and is neutral in costs. A follow-up of three months is probably too short to detect changes in QALYs or physical activities. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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

PubMed Central

2013-01-01

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

Novel model of direct and indirect cost-benefit analysis of mechanical embolectomy over IV tPA for large vessel occlusions: a real-world dollar analysis based on improvements in mRS.

PubMed

Mangla, Sundeep; O'Connell, Keara; Kumari, Divya; Shahrzad, Maryam

2016-01-20

Ischemic strokes result in significant healthcare expenditures (direct costs) and loss of quality-adjusted life years (QALYs) (indirect costs). Interventional therapy has demonstrated improved functional outcomes in patients with large vessel occlusions (LVOs), which are likely to reduce the economic burden of strokes. To develop a novel real-world dollar model to assess the direct and indirect cost-benefit of mechanical embolectomy compared with medical treatment with intravenous tissue plasminogen activator (IV tPA) based on shifts in modified Rankin scores (mRS). A cost model was developed including multiple parameters to account for both direct and indirect stroke costs. These were adjusted based upon functional outcome (mRS). The model compared IV tPA with mechanical embolectomy to assess the costs and benefits of both therapies. Direct stroke-related costs included hospitalization, inpatient and outpatient rehabilitation, home care, skilled nursing facilities, and long-term care facility costs. Indirect costs included years of life expectancy lost and lost QALYs. Values for the model cost parameters were derived from numerous resources and functional outcomes were derived from the MR CLEAN study as a reflective sample of LVOs. Direct and indirect costs and benefits for the two treatments were assessed using Microsoft Excel 2013. This cost-benefit model found a cost-benefit of mechanical embolectomy over IV tPA of $163 624.27 per patient and the cost benefit for 50 000 patients on an annual basis is $8 181 213 653.77. If applied widely within the USA, mechanical embolectomy will significantly reduce the direct and indirect financial burden of stroke ($8 billion/50 000 patients). 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/

Relationship between functional disability and costs one and two years post stroke

PubMed Central

Lekander, Ingrid; Willers, Carl; von Euler, Mia; Lilja, Mikael; Sunnerhagen, Katharina S.; Pessah-Rasmussen, Hélène; Borgström, Fredrik

2017-01-01

Background and purpose Stroke affects mortality, functional ability, quality of life and incurs costs. The primary objective of this study was to estimate the costs of stroke care in Sweden by level of disability and stroke type (ischemic (IS) or hemorrhagic stroke (ICH)). Method Resource use during first and second year following a stroke was estimated based on a research database containing linked data from several registries. Costs were estimated for the acute and post-acute management of stroke, including direct (health care consumption and municipal services) and indirect (productivity losses) costs. Resources and costs were estimated per stroke type and functional disability categorised by Modified Rankin Scale (mRS). Results The results indicated that the average costs per patient following a stroke were 350,000SEK/€37,000–480,000SEK/€50,000, dependent on stroke type and whether it was the first or second year post stroke. Large variations were identified between different subgroups of functional disability and stroke type, ranging from annual costs of 100,000SEK/€10,000–1,100,000SEK/€120,000 per patient, with higher costs for patients with ICH compared to IS and increasing costs with more severe functional disability. Conclusion Functional outcome is a major determinant on costs of stroke care. The stroke type associated with worse outcome (ICH) was also consistently associated to higher costs. Measures to improve function are not only important to individual patients and their family but may also decrease the societal burden of stroke. PMID:28384164

Implementation of activity-based costing (ABC) to drive cost reduction efforts in a semiconductor manufacturing operation

NASA Astrophysics Data System (ADS)

Naguib, Hussein; Bol, Igor I.; Lora, J.; Chowdhry, R.

1994-09-01

This paper presents a case study on the implementation of ABC to calculate the cost per wafer and to drive cost reduction efforts for a new IC product line. The cost reduction activities were conducted through the efforts of 11 cross-functional teams which included members of the finance, purchasing, technology development, process engineering, equipment engineering, production control, and facility groups. The activities of these cross functional teams were coordinated by a cost council. It will be shown that these activities have resulted in a 57% reduction in the wafer manufacturing cost of the new product line. Factors contributed to successful implementation of an ABC management system are discussed.

The costs of turnover in nursing homes.

PubMed

Mukamel, Dana B; Spector, William D; Limcangco, Rhona; Wang, Ying; Feng, Zhanlian; Mor, Vincent

2009-10-01

Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. To estimate the net costs associated with turnover of direct care staff in nursing homes. DATA AND SAMPLE: Nine hundred two nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set, Medicare enrollment files, Census, and Area Resource File. We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The instrumental variable estimate of turnover costs was negative and significant (P = 0.039). The marginal cost savings associated with a 10% point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs.

Low cost Ku-band earth terminals for voice/data/facsimile

NASA Technical Reports Server (NTRS)

Kelley, R. L.

1977-01-01

A Ku-band satellite earth terminal capable of providing two way voice/facsimile teleconferencing, 128 Kbps data, telephone, and high-speed imagery services is proposed. Optimized terminal cost and configuration are presented as a function of FDMA and TDMA approaches to multiple access. The entire terminal from the antenna to microphones, speakers and facsimile equipment is considered. Component cost versus performance has been projected as a function of size of the procurement and predicted hardware innovations and production techniques through 1985. The lowest cost combinations of components has been determined in a computer optimization algorithm. The system requirements including terminal EIRP and G/T, satellite size, power per spacecraft transponder, satellite antenna characteristics, and link propagation outage were selected using a computerized system cost/performance optimization algorithm. System cost and terminal cost and performance requirements are presented as a function of the size of a nationwide U.S. network. Service costs are compared with typical conference travel costs to show the viability of the proposed terminal.

Economic Impact of Dementia by Disease Severity: Exploring the Relationship between Stage of Dementia and Cost of Care in Taiwan

PubMed Central

Ku, Li-Jung Elizabeth; Pai, Ming-Chyi; Shih, Pei-Yu

2016-01-01

Objective Given the shortage of cost-of-illness studies in dementia outside of the Western population, the current study estimated the annual cost of dementia in Taiwan and assessed whether different categories of care costs vary by severity using multiple disease-severity measures. Methods This study included 231 dementia patient–caregiver dyads in a dementia clinic at a national university hospital in southern Taiwan. Three disease measures including cognitive, functional, and behavioral disturbances were obtained from patients based on medical history. A societal perspective was used to estimate the total costs of dementia according to three cost sub-categories. The association between dementia severity and cost of care was examined through bivariate and multivariate analyses. Results Total costs of care for moderate dementia patient were 1.4 times the costs for mild dementia and doubled from mild to severe dementia among our community-dwelling dementia sample. Multivariate analysis indicated that functional declines had a greater impact on all cost outcomes as compared to behavioral disturbance, which showed no impact on any costs. Informal care costs accounted for the greatest share in total cost of care for both mild (42%) and severe (43%) dementia patients. Conclusions Since the total costs of dementia increased with severity, providing care to delay disease progression, with a focus on maintaining patient physical function, may reduce the overall cost of dementia. The greater contribution of informal care to total costs as opposed to social care also suggests a need for more publicly-funded long-term care services to assist family caregivers of dementia patients in Taiwan. PMID:26859891

Ecosystem Services in Conservation Planning: Targeted Benefits vs. Co-Benefits or Costs?

PubMed Central

Chan, Kai M. A.; Hoshizaki, Lara; Klinkenberg, Brian

2011-01-01

There is growing support for characterizing ecosystem services in order to link conservation and human well-being. However, few studies have explicitly included ecosystem services within systematic conservation planning, and those that have follow two fundamentally different approaches: ecosystem services as intrinsically-important targeted benefits vs. substitutable co-benefits. We present a first comparison of these two approaches in a case study in the Central Interior of British Columbia. We calculated and mapped economic values for carbon storage, timber production, and recreational angling using a geographical information system (GIS). These ‘marginal’ values represent the difference in service-provision between conservation and managed forestry as land uses. We compared two approaches to including ecosystem services in the site-selection software Marxan: as Targeted Benefits, and as Co-Benefits/Costs (in Marxan's cost function); we also compared these approaches with a Hybrid approach (carbon and angling as targeted benefits, timber as an opportunity cost). For this analysis, the Co-Benefit/Cost approach yielded a less costly reserve network than the Hybrid approach (1.6% cheaper). Including timber harvest as an opportunity cost in the cost function resulted in a reserve network that achieved targets equivalently, but at 15% lower total cost. We found counter-intuitive results for conservation: conservation-compatible services (carbon, angling) were positively correlated with each other and biodiversity, whereas the conservation-incompatible service (timber) was negatively correlated with all other networks. Our findings suggest that including ecosystem services within a conservation plan may be most cost-effective when they are represented as substitutable co-benefits/costs, rather than as targeted benefits. By explicitly valuing the costs and benefits associated with services, we may be able to achieve meaningful biodiversity conservation at lower cost and with greater co-benefits. PMID:21915318

Optimal allocation of resources over health care programmes: dealing with decreasing marginal utility and uncertainty.

PubMed

Al, Maiwenn J; Feenstra, Talitha L; Hout, Ben A van

2005-07-01

This paper addresses the problem of how to value health care programmes with different ratios of costs to effects, specifically when taking into account that these costs and effects are uncertain. First, the traditional framework of maximising health effects with a given health care budget is extended to a flexible budget using a value function over money and health effects. Second, uncertainty surrounding costs and effects is included in the model using expected utility. Other approaches to uncertainty that do not specify a utility function are discussed and it is argued that these also include implicit notions about risk attitude.

An Ownership/Lease Cost Comparison Analysis of Heavy Equipment Motor Vehicles in Air Force Materiel Command

DTIC Science & Technology

1994-09-01

costs are the costs associated with a particular piece of equipment that do not change despite change in variable operating cost ( Horngren and Foster...The Operating and maintenance costs account for direct and indirect costs associated with their respective functions and vary with the utilization of...each vehicle. The operating direct cost includes all on-base and off- base fuel cost . Indirect operations costs account for bench 28 stock items

Admitting the Inadmissible: Adjoint Formulation for Incomplete Cost Functionals in Aerodynamic Optimization

NASA Technical Reports Server (NTRS)

Arian, Eyal; Salas, Manuel D.

1997-01-01

We derive the adjoint equations for problems in aerodynamic optimization which are improperly considered as "inadmissible." For example, a cost functional which depends on the density, rather than on the pressure, is considered "inadmissible" for an optimization problem governed by the Euler equations. We show that for such problems additional terms should be included in the Lagrangian functional when deriving the adjoint equations. These terms are obtained from the restriction of the interior PDE to the control surface. Demonstrations of the explicit derivation of the adjoint equations for "inadmissible" cost functionals are given for the potential, Euler, and Navier-Stokes equations.

20 CFR 641.856 - What functions and activities constitute costs of administration?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and purchasing functions; (iii) Property management functions; (iv) Personnel management functions; (v) Payroll... example, personnel, procurement, purchasing, property management, accounting, and payroll systems...

Comparative cost-effectiveness of two interventions to promote work functioning by targeting mental health complaints among nurses: pragmatic cluster randomised trial.

PubMed

Noben, Cindy; Smit, Filip; Nieuwenhuijsen, Karen; Ketelaar, Sarah; Gärtner, Fania; Boon, Brigitte; Sluiter, Judith; Evers, Silvia

2014-10-01

The specific job demands of working in a hospital may place nurses at elevated risk for developing distress, anxiety and depression. Screening followed by referral to early interventions may reduce the incidence of these health problems and promote work functioning. To evaluate the comparative cost-effectiveness of two strategies to promote work functioning among nurses by reducing symptoms of mental health complaints. Three conditions were compared: the control condition consisted of online screening for mental health problems without feedback about the screening results. The occupational physician condition consisted of screening, feedback and referral to the occupational physician for screen-positive nurses. The third condition included screening, feedback, and referral to e-mental health. The study was designed as an economic evaluation alongside a pragmatic cluster randomised controlled trial with randomisation at hospital-ward level. The study included 617 nurses in one academic medical centre in the Netherlands. Treatment response was defined as an improvement on the Nurses Work Functioning Questionnaire of at least 40% between baseline and follow-up. Total per-participant costs encompassed intervention costs, direct medical and non-medical costs, and indirect costs stemming from lost productivity due to absenteeism and presenteeism. All costs were indexed for the year 2011. At 6 months follow-up, significant improvement in work functioning occurred in 20%, 24% and 16% of the participating nurses in the control condition, the occupational physician condition and the e-mental health condition, respectively. In these conditions the total average annualised costs were €1752, €1266 and €1375 per nurse. The median incremental cost-effectiveness ratio for the occupational physician condition versus the control condition was dominant, suggesting cost savings of €5049 per treatment responder. The incremental cost-effectiveness ratio for the e-mental health condition versus the control condition was estimated at €4054 (added costs) per treatment responder. Sensitivity analyses attested to the robustness of these findings. The occupational physician condition resulted in greater treatment responses for less costs relative to the control condition and can therefore be recommended. The e-mental health condition produced less treatment response than the control condition and cannot be recommended as an intervention to improve work functioning among nurses. Copyright © 2014 Elsevier Ltd. All rights reserved.

Manpower Mix for Health Services

PubMed Central

Shuman, Larry J.; Young, John P.; Naddor, Eliezer

1971-01-01

A model is formulated to determine the mix of manpower and technology needed to provide health services of acceptable quality at a minimum total cost to the community. Total costs include both the direct costs associated with providing the services and with developing additional manpower and the indirect costs (shortage costs) resulting from not providing needed services. The model is applied to a hypothetical neighborhood health center, and its sensitivity to alternative policies is investigated by cost-benefit analyses. Possible extensions of the model to include dynamic elements in health delivery systems are discussed, as is its adaptation for use in hospital planning, with a changed objective function. PMID:5095652

The costs of turnover in nursing homes

PubMed Central

Mukamel, Dana B.; Spector, William D.; Limcangco, Rhona; Wang, Ying; Feng, Zhanlian; Mor, Vincent

2009-01-01

Background Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. Objectives To estimate the net costs associated with turnover of direct care staff in nursing homes. Data and sample 902 nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set (MDS), Medicare enrollment files, Census and Area Resource File (ARF). Research Design We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable (IV) limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. Results The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The IV estimate of turnover costs was negative and significant (p=0.039). The marginal cost savings associated with a 10 percentage point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. Conclusion The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs. PMID:19648834

Functional design specification: NASA form 1510

NASA Technical Reports Server (NTRS)

1979-01-01

The 1510 worksheet used to calculate approved facility project cost estimates is explained. Topics covered include data base considerations, program structure, relationship of the 1510 form to the 1509 form, and functions which the application must perform: WHATIF, TENENTER, TENTYPE, and data base utilities. A sample NASA form 1510 printout and a 1510 data dictionary are presented in the appendices along with the cost adjustment table, the floppy disk index, and methods for generating the calculated values (TENCALC) and for calculating cost adjustment (CONSTADJ). Storage requirements are given.

Fitting of full Cobb-Douglas and full VRTS cost frontiers by solving goal programming problem

NASA Astrophysics Data System (ADS)

Venkateswarlu, B.; Mahaboob, B.; Subbarami Reddy, C.; Madhusudhana Rao, B.

2017-11-01

The present research article first defines two popular production functions viz, Cobb-Douglas and VRTS production frontiers and their dual cost functions and then derives their cost limited maximal outputs. This paper tells us that the cost limited maximal output is cost efficient. Here the one side goal programming problem is proposed by which the full Cobb-Douglas cost frontier, full VRTS frontier can be fitted. This paper includes the framing of goal programming by which stochastic cost frontier and stochastic VRTS frontiers are fitted. Hasan et al. [1] used a parameter approach Stochastic Frontier Approach (SFA) to examine the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur stock Exchange (KLSE) market over the period 2005-2010. AshkanHassani [2] exposed Cobb-Douglas Production Functions application in construction schedule crashing and project risk analysis related to the duration of construction projects. Nan Jiang [3] applied Stochastic Frontier analysis to a panel of New Zealand dairy forms in 1998/99-2006/2007.

Library Labor Cost Accounting System.

ERIC Educational Resources Information Center

Du Bois, Dan

The Library Labor Cost Accounting System will provide visibility on current costs of manually processing library materials, at each campus as well as system-wide. The scope of the study includes the following: (1) 100 individual activities, grouped into 14 functional areas, e.g., Ordering, Receiving; and into 3 major operations: Acquisitions,…

Minimum entropy deconvolution and blind equalisation

NASA Technical Reports Server (NTRS)

Satorius, E. H.; Mulligan, J. J.

1992-01-01

Relationships between minimum entropy deconvolution, developed primarily for geophysics applications, and blind equalization are pointed out. It is seen that a large class of existing blind equalization algorithms are directly related to the scale-invariant cost functions used in minimum entropy deconvolution. Thus the extensive analyses of these cost functions can be directly applied to blind equalization, including the important asymptotic results of Donoho.

On spatial mutation-selection models

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

Kondratiev, Yuri, E-mail: kondrat@math.uni-bielefeld.de; Kutoviy, Oleksandr, E-mail: kutoviy@math.uni-bielefeld.de, E-mail: kutovyi@mit.edu; Department of Mathematics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139

2013-11-15

We discuss the selection procedure in the framework of mutation models. We study the regulation for stochastically developing systems based on a transformation of the initial Markov process which includes a cost functional. The transformation of initial Markov process by cost functional has an analytic realization in terms of a Kimura-Maruyama type equation for the time evolution of states or in terms of the corresponding Feynman-Kac formula on the path space. The state evolution of the system including the limiting behavior is studied for two types of mutation-selection models.

Balancing reliability and cost to choose the best power subsystem

NASA Technical Reports Server (NTRS)

Suich, Ronald C.; Patterson, Richard L.

1991-01-01

A mathematical model is presented for computing total (spacecraft) subsystem cost including both the basic subsystem cost and the expected cost due to the failure of the subsystem. This model is then used to determine power subsystem cost as a function of reliability and redundancy. Minimum cost and maximum reliability and/or redundancy are not generally equivalent. Two example cases are presented. One is a small satellite, and the other is an interplanetary spacecraft.

Treatment for ADHD: Is More Complex Treatment Cost-Effective for More Complex Cases?

PubMed Central

Foster, E Michael; Jensen, Peter S; Schlander, Michael; Pelham, William E; Hechtman, Lily; Arnold, L Eugene; Swanson, James M; Wigal, Timothy

2007-01-01

Objective To determine the cost-effectiveness of three alternative high-quality treatments for attention deficit hyperactivity disorder (ADHD) relative to community care (CC) and to determine whether cost-effectiveness varies with the presence of comorbid disorders. Data Sources/Collection The study included 579 children ages 7–9.9 with diagnosed ADHD at six sites. Data for the study were distilled from administrative data and from interviews with parents, including estimates of the child's functional impairment. These analyses focus on changes in functional impairment over 14 months. Study Design The study involved a large clinical trial that randomized participants to one of four arms: routine CC, intensive medication management (MedMgt), multicomponent behavioral treatment, and a combination of behavioral treatment and medication. Principal Findings We assessed the cost-effectiveness of the alternatives using costs measured from a payer perspective. The preferred cost-effective treatment varies as a function of the child's comorbidity and of the policy maker's willingness to pay. For pure (no comorbidity) ADHD, high-quality MedMgt appears likely to be cost-effective at all levels of willingness to pay. In contrast, for some comorbid conditions, willingness to pay is critical: the policy maker with low willingness to pay likely will judge MedMgt most cost-effective. On the other hand, a policy maker willing to pay more now in expectation of future costs savings (involving, for example, juvenile justice), will recognize that the most cost-effective choice for comorbid conditions likely involves behavior therapy, with or without medication. Conclusions Analyses of costs and effectiveness of treatment for ADHD must consider the role of comorbidities. PMID:17355587

Comparison of seating, powered characteristics and functions and costs of electrically powered wheelchairs in a general population of users.

PubMed

Dolan, Michael John; Bolton, Megan Jennifer; Henderson, Graham Iain

2017-10-26

To profile and compare the seating and powered characteristics and functions of electrically powered wheelchairs (EPWs) in a general user population including equipment costs. Case notes of adult EPW users of a regional NHS service were reviewed retrospectively. Seating equipment complexity and type were categorized using the Edinburgh classification. Powered characteristics and functions, including control device type, were recorded. 482 cases were included; 53.9% female; mean duration EPW use 8.1 years (SD 7.4); rear wheel drive 88.0%; hand joystick 94.8%. Seating complexity: low 73.2%, medium 18.0%, high 8.7%. Most prevalent diagnoses: multiple sclerosis (MS) 25.3%, cerebral palsy (CP) 18.7%, muscular dystrophy (8.5%). Compared to CP users, MS users were significantly older at first use, less experienced, more likely to have mid-wheel drive and less complex seating. Additional costs for muscular dystrophy and spinal cord injury users were 3-4 times stroke users. This is the first large study of a general EPW user population using a seating classification. Significant differences were found between diagnostic groups; nevertheless, there was also high diversity within each group. The differences in provision and the equipment costs across diagnostic groups can be used to improve service planning. Implications for Rehabilitation At a service planning level, knowledge of a population's diagnostic group and age distribution can be used to inform decisions about the number of required EPWs and equipment costs. At a user level, purchasing decisions about powered characteristics and functions of EPWs and specialised seating equipment need to be taken on a case by case basis because of the diversity of users' needs within diagnostic groups. The additional equipment costs for SCI and MD users are several times those of stroke users and add between 60 and 70% of the cost of basic provision.

Economics

NASA Technical Reports Server (NTRS)

1975-01-01

Tables covering the selling price of hydrogen as a function of each process temperature studied are presented. Estimated selling price, based on capital costs and operating and maintenance costs, is included. In all cases, no credit was given for the methane component of hydrogen.

20 CFR 645.235 - What types of activities are subject to the administrative cost limit on Welfare-to-Work grants?

Code of Federal Regulations, 2010 CFR

2010-04-01

... WtW including: (i) Accounting, budgeting, financial and cash management functions; (ii) Procurement and purchasing functions; (iii) Property management functions; (iv) Personnel management functions; (v... administrative functions (for example, personnel, procurement, purchasing, property management, accounting and...

24 CFR 208.112 - Cost.

Code of Federal Regulations, 2011 CFR

2011-04-01

.../or software is not cost effective may contract out the electronic data transmission function to organizations that provide such services, including, but not limited to the following organizations: local management agents, local management associations and management agents with centralized facilities. Owners of...

Functional Outcomes and Efficiency of Rehabilitation in a National Cohort of Patients with Guillain - Barré Syndrome and Other Inflammatory Polyneuropathies

PubMed Central

Alexandrescu, Roxana; Siegert, Richard John; Turner-Stokes, Lynne

2014-01-01

Objectives To describe functional outcomes, care needs and cost-efficiency of hospital rehabilitation for a UK cohort of inpatients with complex rehabilitation needs arising from inflammatory polyneuropathies. Subjects and Setting 186 patients consecutively admitted to specialist neurorehabilitation centres in England with Guillain-Barré Syndrome (n = 118 (63.4%)) or other inflammatory polyneuropathies, including chronic inflammatory demyelinating polyneuropathy (n = 15 (8.1%) or critical illness neuropathy (n = 32 (17.2%)). Methods Cohort analysis of data from the UK Rehabilitation Outcomes Collaborative national clinical dataset. Outcome measures include the UK Functional Assessment Measure, Northwick Park Dependency Score (NPDS) and Care Needs Assessment (NPCNA). Patients were analysed in three groups of dependency based on their admission NPDS score: ‘low’ (NPDS<10), ‘medium’ (NPDS 10–24) and ‘high’ (NPDS ≥25). Cost-efficiency was measured as the time taken to offset the cost of rehabilitation by savings in NPCNA-estimated costs of on-going care in the community. Results The mean rehabilitation length of stay was 72.2 (sd = 66.6) days. Significant differences were seen between the diagnostic groups on admission, but all showed significant improvements between admission and discharge, in both motor and cognitive function (p<0.0001). Patients who were highly dependent on admission had the longest lengths of stay (mean 97.0 (SD 79.0) days), but also showed the greatest reduction in on-going care costs (£1049 per week (SD £994)), so that overall they were the most cost-efficient to treat. Conclusions Patients with polyneuropathies have both physical and cognitive disabilities that are amenable to change with rehabilitation, resulting in significant reduction in on-going care-costs, especially for highly dependent patients. PMID:25402491

30 CFR 227.300 - What audit functions may a State perform?

Code of Federal Regulations, 2010 CFR

2010-07-01

... royalty reports and payments accurately reflect actual production, sales, revenues and costs, and...; (2) Examining royalty and production reports; (3) Examining lessee production and sales records, including contracts, payments, invoices, and transportation and processing costs to substantiate production...

Long-term outcomes and costs of an integrated rehabilitation program for chronic knee pain: a pragmatic, cluster randomized, controlled trial.

PubMed

Hurley, M V; Walsh, N E; Mitchell, H; Nicholas, J; Patel, A

2012-02-01

Chronic joint pain is a major cause of pain and disability. Exercise and self-management have short-term benefits, but few studies follow participants for more than 6 months. We investigated the long-term (up to 30 months) clinical and cost effectiveness of a rehabilitation program combining self-management and exercise: Enabling Self-Management and Coping of Arthritic Knee Pain Through Exercise (ESCAPE-knee pain). In this pragmatic, cluster randomized, controlled trial, 418 people with chronic knee pain (recruited from 54 primary care surgeries) were randomized to usual care (pragmatic control) or the ESCAPE-knee pain program. The primary outcome was physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] function), with a clinically meaningful improvement in physical function defined as a ≥15% change from baseline. Secondary outcomes included pain, psychosocial and physiologic variables, costs, and cost effectiveness. Compared to usual care, ESCAPE-knee pain participants had large initial improvements in function (mean difference in WOMAC function -5.5; 95% confidence interval [95% CI] -7.8, -3.2). These improvements declined over time, but 30 months after completing the program, ESCAPE-knee pain participants still had better physical function (difference in WOMAC function -2.8; 95% CI -5.3, -0.2); lower community-based health care costs (£-47; 95% CI £-94, £-7), medication costs (£-16; 95% CI £-29, £-3), and total health and social care costs (£-1,118; 95% CI £-2,566, £-221); and a high probability (80-100%) of being cost effective. Clinical and cost benefits of ESCAPE-knee pain were still evident 30 months after completing the program. ESCAPE-knee pain is a more effective and efficient model of care that could substantially improve the health, well-being, and independence of many people, while reducing health care costs. Copyright © 2012 by the American College of Rheumatology.

Systems engineering and integration: Cost estimation and benefits analysis

NASA Technical Reports Server (NTRS)

Dean, ED; Fridge, Ernie; Hamaker, Joe

1990-01-01

Space Transportation Avionics hardware and software cost has traditionally been estimated in Phase A and B using cost techniques which predict cost as a function of various cost predictive variables such as weight, lines of code, functions to be performed, quantities of test hardware, quantities of flight hardware, design and development heritage, complexity, etc. The output of such analyses has been life cycle costs, economic benefits and related data. The major objectives of Cost Estimation and Benefits analysis are twofold: (1) to play a role in the evaluation of potential new space transportation avionics technologies, and (2) to benefit from emerging technological innovations. Both aspects of cost estimation and technology are discussed here. The role of cost analysis in the evaluation of potential technologies should be one of offering additional quantitative and qualitative information to aid decision-making. The cost analyses process needs to be fully integrated into the design process in such a way that cost trades, optimizations and sensitivities are understood. Current hardware cost models tend to primarily use weights, functional specifications, quantities, design heritage and complexity as metrics to predict cost. Software models mostly use functionality, volume of code, heritage and complexity as cost descriptive variables. Basic research needs to be initiated to develop metrics more responsive to the trades which are required for future launch vehicle avionics systems. These would include cost estimating capabilities that are sensitive to technological innovations such as improved materials and fabrication processes, computer aided design and manufacturing, self checkout and many others. In addition to basic cost estimating improvements, the process must be sensitive to the fact that no cost estimate can be quoted without also quoting a confidence associated with the estimate. In order to achieve this, better cost risk evaluation techniques are needed as well as improved usage of risk data by decision-makers. More and better ways to display and communicate cost and cost risk to management are required.

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.

The costs of highway crashes.

DOT National Transportation Integrated Search

1991-12-01

In 1988, an estimated 14.8 million motor vehicle crashes involved 47,000 deaths and almost 5,000,000 injuries. More than 4.8 million years of life and functioning were lost. Crash costs totalled $334 billion. They included $71 billion in out-of pocke...

Optimal design of earth-moving machine elements with cusp catastrophe theory application

NASA Astrophysics Data System (ADS)

Pitukhin, A. V.; Skobtsov, I. G.

2017-10-01

This paper deals with the optimal design problem solution for the operator of an earth-moving machine with a roll-over protective structure (ROPS) in terms of the catastrophe theory. A brief description of the catastrophe theory is presented, the cusp catastrophe is considered, control parameters are viewed as Gaussian stochastic quantities in the first part of the paper. The statement of optimal design problem is given in the second part of the paper. It includes the choice of the objective function and independent design variables, establishment of system limits. The objective function is determined as mean total cost that includes initial cost and cost of failure according to the cusp catastrophe probability. Algorithm of random search method with an interval reduction subject to side and functional constraints is given in the last part of the paper. The way of optimal design problem solution can be applied to choose rational ROPS parameters, which will increase safety and reduce production and exploitation expenses.

Longitudinal study of effects of patient characteristics on direct costs in Alzheimer disease.

PubMed

Zhu, C W; Scarmeas, N; Torgan, R; Albert, M; Brandt, J; Blacker, D; Sano, M; Stern, Y

2006-09-26

To estimate long-term trajectories of direct cost of caring for patients with Alzheimer disease (AD) and examine the effects of patients' characteristics on cost longitudinally. The sample is drawn from the Predictors Study, a large, multicenter cohort of patients with probable AD, prospectively followed up annually for up to 7 years in three university-based AD centers in the United States. Random effects models estimated the effects of patients' clinical and sociodemographic characteristics on direct cost of care. Direct cost included cost associated with medical and nonmedical care. Clinical characteristics included cognitive status (measured by Mini-Mental State Examination), functional capacity (measured by Blessed Dementia Rating Scale [BDRS]), psychotic symptoms, behavioral problems, depressive symptoms, extrapyramidal signs, and comorbidities. The model also controlled for patients' sex, age, and living arrangements. Total direct cost increased from approximately 9,239 dollars per patient per year at baseline, when all patients were at the early stages of the disease, to 19,925 dollars by year 4. After controlling for other variables, a one-point increase in the BDRS score increased total direct cost by 7.7%. One more comorbid condition increased total direct cost by 14.3%. Total direct cost was 20.8% lower for patients living at home compared with those living in an institutional setting. Total direct cost of caring for patients with Alzheimer disease increased substantially over time. Much of the cost increases were explained by patients' clinical and demographic variables. Comorbidities and functional capacity were associated with higher direct cost over time.

Simple Automatic File Exchange (SAFE) to Support Low-Cost Spacecraft Operation via the Internet

NASA Technical Reports Server (NTRS)

Baker, Paul; Repaci, Max; Sames, David

1998-01-01

Various issues associated with Simple Automatic File Exchange (SAFE) are presented in viewgraph form. Specific topics include: 1) Packet telemetry, Internet IP networks and cost reduction; 2) Basic functions and technical features of SAFE; 3) Project goals, including low-cost satellite transmission to data centers to be distributed via an Internet; 4) Operations with a replicated file protocol; 5) File exchange operation; 6) Ground stations as gateways; 7) Lessons learned from demonstrations and tests with SAFE; and 8) Feedback and future initiatives.

[Socioeconomic costs of food-borne disease using the cost-of-illness model: applying the QALY method].

PubMed

Shin, Hosung; Lee, Suehyung; Kim, Jong Soo; Kim, Jinsuk; Han, Kyu Hong

2010-07-01

This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 - 76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.

Monopoly Output and Welfare: The Role of Curvature of the Demand Function.

ERIC Educational Resources Information Center

Malueg, David A.

1994-01-01

Discusses linear demand functions and constant marginal costs related to a monopoly in a market economy. Illustrates the demand function by using a curve. Includes an appendix with two figures and accompanying mathematical formulae illustrating the concepts presented in the article. (CFR)

A Survey of Reliability, Maintainability, Supportability, and Testability Software Tools

DTIC Science & Technology

1991-04-01

designs in terms of their contributions toward forced mission termination and vehicle or function loss . Includes the ability to treat failure modes of...ABSTRACT: Inputs: MTBFs, MTTRs, support equipment costs, equipment weights and costs, available targets, military occupational specialty skill level and...US Army CECOM NAME: SPARECOST ABSTRACT: Calculates expected number of failures and performs spares holding optimization based on cost, weight , or

Automotive Maintenance Data Base for Model Years 1976-1979. Part I

DOT National Transportation Integrated Search

1980-12-01

An update of the existing data base was developed to include life cycle maintenance costs of representative vehicles for the model years 1976-1979. Repair costs as a function of time are also developed for a passenger car in each of the compact, subc...

78 FR 52234 - Agency Information Collection Activity Under OMB Review; Reports, Forms and Recordkeeping...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... OMB Review; Reports, Forms and Recordkeeping Requirements AGENCY: Maritime Administration, DOT. ACTION... operators to submit annual vessel operating costs and capital costs data to Maritime Administration... of information is necessary for the proper performance of the functions of the agency, including...

A Comparative Analysis of the Safety, Efficacy, and Cost of Islet Versus Pancreas Transplantation in Nonuremic Patients With Type 1 Diabetes

PubMed Central

Moassesfar, S.; Masharani, U.; Frassetto, L. A.; Szot, G. L.; Tavakol, M.; Stock, P. G.; Posselt, A. M.

2017-01-01

Few current studies compare the outcomes of islet transplantation alone (ITA) and pancreas transplantation alone (PTA) for type 1 diabetes (T1D). We examined these two beta cell replacement therapies in nonuremic patients with T1D with respect to safety, graft function and cost. Sequential patients received PTA (n = 15) or ITA (n = 10) at our institution. Assessments of graft function included duration of insulin independence; glycemic control, as measured by hemoglobin A1c; and elimination of severe hypoglycemia. Cost analysis included all normalized costs associated with transplantation and inpatient management. ITA patients received one (n = 6) or two (n = 4) islet transplants. Mean duration of insulin independence in this group was 35 mo; 90% were independent at 1 year, and 70% were independent at 3 years. Mean duration of insulin independence in PTA was 55 mo; 93% were insulin independent at 1 year, and 64% were independent at 3 years. Glycemic control was comparable in all patients with functioning grafts, as were overall costs ($138 872 for ITA, $134 748 for PTA). We conclude that with advances in islet isolation and posttransplant management, ITA can produce outcomes similar to PTA and represents a clinically viable option to achieve long-term insulin independence in selected patients with T1D. PMID:26595767

Ab initio molecular dynamics with nuclear quantum effects at classical cost: Ring polymer contraction for density functional theory.

PubMed

Marsalek, Ondrej; Markland, Thomas E

2016-02-07

Path integral molecular dynamics simulations, combined with an ab initio evaluation of interactions using electronic structure theory, incorporate the quantum mechanical nature of both the electrons and nuclei, which are essential to accurately describe systems containing light nuclei. However, path integral simulations have traditionally required a computational cost around two orders of magnitude greater than treating the nuclei classically, making them prohibitively costly for most applications. Here we show that the cost of path integral simulations can be dramatically reduced by extending our ring polymer contraction approach to ab initio molecular dynamics simulations. By using density functional tight binding as a reference system, we show that our ring polymer contraction scheme gives rapid and systematic convergence to the full path integral density functional theory result. We demonstrate the efficiency of this approach in ab initio simulations of liquid water and the reactive protonated and deprotonated water dimer systems. We find that the vast majority of the nuclear quantum effects are accurately captured using contraction to just the ring polymer centroid, which requires the same number of density functional theory calculations as a classical simulation. Combined with a multiple time step scheme using the same reference system, which allows the time step to be increased, this approach is as fast as a typical classical ab initio molecular dynamics simulation and 35× faster than a full path integral calculation, while still exactly including the quantum sampling of nuclei. This development thus offers a route to routinely include nuclear quantum effects in ab initio molecular dynamics simulations at negligible computational cost.

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

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1974-01-01

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

Automotive Maintenance Data Base for Model Years 1976-1979. Part II : Appendix E and F

DOT National Transportation Integrated Search

1980-12-01

An update of the existing data base was developed to include life cycle maintenance costs of representative vehicles for the model years 1976-1979. Repair costs as a function of time are also developed for a passenger car in each of the compact, subc...

Coal flow aids reduce coke plant operating costs and improve production rates

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

Bedard, R.A.; Bradacs, D.J.; Kluck, R.W.

2005-06-01

Chemical coal flow aids can provide many benefits to coke plants, including improved production rates, reduced maintenance and lower cleaning costs. This article discusses the mechanisms by which coal flow aids function and analyzes several successful case histories. 2 refs., 10 figs., 1 tab.

Microbiology of Wind-eroded Sediments: Current Knowledge and Future Research Directions

USDA-ARS?s Scientific Manuscript database

Wind erosion is a threat to the sustainability and productivity of soils that takes place at local, regional, and global scales. Current estimates of cost of wind erosion have not included the costs associated with the loss of soil biodiversity and reduced ecosystem functions. Microorganisms carrie...

Diabetes-Associated Factors as Predictors of Nursing Home Admission and Costs in the Elderly Across Europe.

PubMed

Rodríguez-Sánchez, Beatriz; Angelini, Viola; Feenstra, Talitha; Alessie, Rob J M

2017-01-01

To identify the main factors associated with the use of nursing home facilities and to calculate their costs among older people with diabetes in Europe. The sample included 48,464 individuals aged 50 years and older in 12 European countries participating in the Survey of Health, Aging, and Retirement in Europe study from 2004 to 2010. Cost data were obtained from the Organization for Economic Cooperation and Development and the World Bank. Logit regressions were used to assess the impact of diabetes, comorbidities, and functional status on the frequency of nursing home admission. Etiologic fractions were calculated to obtain the nursing home costs attributable to diabetes and its clinical and functional complications. Diabetes is a predictor for institutionalization. When adjusted for clinical and functional complications, impairment of physical function [mild: odds ratio (OR) 3.27; 95% confidence interval (CI) 2.60-4.19; moderate: OR 8.48, 95% CI 6.02-13.09; severe: OR 12.53, 95% CI 8.03-19.98] and cognition (OR 2.00, 95% CI 1.60-2.68), as well as stroke (OR 2.08, 95% CI 1.61-2.80) showed the strongest association with increased risk of institutionalization. Moreover, this relationship between diabetes, function, and cost was age-dependent, increasing as people get older. Total average nursing home costs incurred by patients with diabetes reached nearly US $13/capita, ranging between countries from US $61 to $0.5. Diabetes-related complications accounted for one-third of these costs (US $4) and, of these, 78% resulted from functional impairment. Diabetes is associated with higher risk of institutionalization even after adjusting for complications. Among them, functional impairment explains the major part of the association between diabetes and nursing home admission and leads to increasing costs. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Survey Available Computer Software for Automated Production Planning and Inventory Control, and Software and Hardware for Data Logging and Monitoring Shop Floor Activities

DTIC Science & Technology

1993-08-01

pricing and sales, order processing , and purchasing. The class of manufacturing planning functions include aggregate production planning, materials...level. I Depending on the application, each control level will have a number of functions associated with it. For instance, order processing , purchasing...include accounting, sales forecasting, product costing, pricing and sales, order processing , and purchasing. The class of manufacturing planning functions

Information prioritization for control and automation of space operations

NASA Technical Reports Server (NTRS)

Ray, Asock; Joshi, Suresh M.; Whitney, Cynthia K.; Jow, Hong N.

1987-01-01

The applicability of a real-time information prioritization technique to the development of a decision support system for control and automation of Space Station operations is considered. The steps involved in the technique are described, including the definition of abnormal scenarios and of attributes, measures of individual attributes, formulation and optimization of a cost function, simulation of test cases on the basis of the cost function, and examination of the simulation scenerios. A list is given comparing the intrinsic importances of various Space Station information data.

Cost-benefit decision circuitry: proposed modulatory role for acetylcholine.

PubMed

Fobbs, Wambura C; Mizumori, Sheri J Y

2014-01-01

In order to select which action should be taken, an animal must weigh the costs and benefits of possible outcomes associate with each action. Such decisions, called cost-benefit decisions, likely involve several cognitive processes (including memory) and a vast neural circuitry. Rodent models have allowed research to begin to probe the neural basis of three forms of cost-benefit decision making: effort-, delay-, and risk-based decision making. In this review, we detail the current understanding of the functional circuits that subserve each form of decision making. We highlight the extensive literature by detailing the ability of dopamine to influence decisions by modulating structures within these circuits. Since acetylcholine projects to all of the same important structures, we propose several ways in which the cholinergic system may play a local modulatory role that will allow it to shape these behaviors. A greater understanding of the contribution of the cholinergic system to cost-benefit decisions will permit us to better link the decision and memory processes, and this will help us to better understand and/or treat individuals with deficits in a number of higher cognitive functions including decision making, learning, memory, and language. © 2014 Elsevier Inc. All rights reserved.

Respiratory viral infections in infancy and school age respiratory outcomes and healthcare costs.

PubMed

MacBean, Victoria; Drysdale, Simon B; Yarzi, Muska N; Peacock, Janet L; Rafferty, Gerrard F; Greenough, Anne

2018-03-01

To determine the impact of viral lower respiratory tract infections (LRTIs) in infancy including rhinovirus (RV) and infancy respiratory syncytial virus (RSV), on school age pulmonary function and healthcare utilization in prematurely born children. School age respiratory outcomes would be worse and healthcare utilization greater in children who had viral LRTIs in infancy. Prospective study. A cohort of prematurely born children who had symptomatic LRTIs during infancy documented, was recalled. Pulmonary function was assessed at 5 to 7 years of age and health related costs of care from aged one to follow-up determined. Fifty-one children, median gestational age 33 +6 weeks, were assessed at a median (IQR) age 7.03 (6.37-7.26) years. Twenty-one children had no LRTI, 14 RV LRTI, 10 RSV LRTI, and 6 another viral LRTI (other LRTI). Compared to the no LRTI group, the RV group had a lower FEV 1 (P = 0.033) and the other LRTI group a lower FVC (P = 0.006). Non-respiratory medication costs were higher in the RV (P = 0.018) and RSV (P = 0.013) groups. Overall respiratory healthcare costs in the RV (£153/year) and RSV (£27/year) groups did not differ significantly from the no LRTI group (£56/year); the other LRTI group (£431/year) had higher respiratory healthcare costs (P = 0.042). In moderately prematurely born children, RV and RSV LRTIs in infancy were not associated with higher respiratory healthcare costs after infancy. Children who experienced LRTIs caused by other respiratory viruses (including RV) had higher respiratory healthcare costs and greater pulmonary function impairment. © 2018 Wiley Periodicals, Inc.

The "Let's Get Alarmed!" initiative: a smoke alarm giveaway programme.

PubMed

DiGuiseppi, C; Slater, S; Roberts, I; Adams, L; Sculpher, M; Wade, A; McCarthy, M

1999-09-01

To reduce fires and fire related injuries by increasing the prevalence of functioning smoke alarms in high risk households. The programme was delivered in an inner London area with above average material deprivation and below average smoke alarm ownership. The target population included low income and rental households and households with elderly persons or young children. Forty wards, averaging 4000 households each, were randomised to intervention or control status. Free smoke alarms and fire safety information were distributed in intervention wards by community groups and workers as part of routine activities and by paid workers who visited target neighbourhoods. Recipients provided data on household age distribution and housing tenure. Programme costs were documented from a societal perspective. Data are being collected on smoke alarm ownership and function, and on fires and related injuries and their costs. Community and paid workers distributed 20,050 smoke alarms, potentially sufficient to increase smoke alarm ownership by 50% in intervention wards. Compared with the total study population, recipients included greater proportions of low income and rental households and households including children under 5 years or adults aged 65 and older. Total programme costs were 145,087 Pounds. It is possible to implement a large scale smoke alarm giveaway programme targeted to high risk households in a densely populated, multicultural, materially deprived community. The programme's effects on the prevalence of installed and functioning alarms and the incidence of fires and fire related injuries, and its cost effectiveness, are being evaluated as a randomized controlled trial.

Early versus late initiation of rehabilitation after lumbar spinal fusion: economic evaluation alongside a randomized controlled trial.

PubMed

Oestergaard, Lisa G; Christensen, Finn B; Nielsen, Claus V; Bünger, Cody E; Fruensgaard, Soeren; Sogaard, Rikke

2013-11-01

Economic evaluation conducted alongside a randomized controlled trial with 1-year follow-up. To examine the cost-effectiveness of initiating rehabilitation 6 weeks after surgery as opposed to 12 weeks after surgery. In a previously reported randomized controlled trial, we assessed the impact of timing of rehabilitation after a lumbar spinal fusion and found that a fast-track strategy led to poorer functional ability. Before making recommendations, it seems relevant to address the societal perspective including return to work, quality of life, and costs. A cost-effectiveness analysis and a cost-utility analysis were conducted. Eighty-two patients undergoing instrumented lumbar spinal fusion due to degenerative disc disease or spondylolisthesis (grade I or II) were randomized to an identical protocol of 4 sessions of group-based rehabilitation and were instructed in home exercises focusing on active stability training. Outcome parameters included functional disability (Oswestry Disability Index) and quality-adjusted life years. Health care and productivity costs were estimated from national registries and reported in euros. Costs and effects were transformed into net benefit. Bootstrapping was used to estimate 95% confidence intervals (95% CI). The fast-track strategy tended to be costlier by €6869 (95% CI, -4640 to 18,378) while at the same time leading to significantly poorer outcomes of functional disability by -9 points (95% CI, -18 to -3) and a tendency for a reduced gain in quality-adjusted life years by -0.04 (95% CI, -0.13 to 0.01). The overall probability for the fast-track strategy being cost-effective does not reach 10% at conventional thresholds for cost-effectiveness. Initiating rehabilitation at 6 weeks as opposed to 12 weeks after surgery is on average more costly and less effective. The uncertainty of this result did not seem to be sensitive to methodological issues, and clinical managements who have already adapted fast-track rehabilitation strategies have reason to reconsider their choice. .

Space Shuttle avionics upgrade - Issues and opportunities

NASA Astrophysics Data System (ADS)

Swaim, Richard A.; Wingert, William B.

An overview is conducted of existing Space Shuttle avionics and the possibilities for upgrading the cockpit to reduce costs and increase functionability. The current avionics include five general-purpose computers fitted with multifunction displays, dedicated switches and indicators, and dedicated flight instruments. The operational needs of the Shuttle are reviewed in the light of the avionics and potential upgrades in the form of microprocessors and display systems. The use of better processors can provide hardware support for multitasking and memory management and can reduce the life-cycle cost for software. Some limitations of the current technology are acknowledged including the Shuttle's power budget and structural configuration. A phased infusion of upgraded avionics is proposed that provides a functionally transparent replacement of crew-interface equipment as well as the addition of interface enhancements and the migration of selected functions.

Optimal cost for strengthening or destroying a given network

NASA Astrophysics Data System (ADS)

Patron, Amikam; Cohen, Reuven; Li, Daqing; Havlin, Shlomo

2017-05-01

Strengthening or destroying a network is a very important issue in designing resilient networks or in planning attacks against networks, including planning strategies to immunize a network against diseases, viruses, etc. Here we develop a method for strengthening or destroying a random network with a minimum cost. We assume a correlation between the cost required to strengthen or destroy a node and the degree of the node. Accordingly, we define a cost function c (k ) , which is the cost of strengthening or destroying a node with degree k . Using the degrees k in a network and the cost function c (k ) , we develop a method for defining a list of priorities of degrees and for choosing the right group of degrees to be strengthened or destroyed that minimizes the total price of strengthening or destroying the entire network. We find that the list of priorities of degrees is universal and independent of the network's degree distribution, for all kinds of random networks. The list of priorities is the same for both strengthening a network and for destroying a network with minimum cost. However, in spite of this similarity, there is a difference between their pc, the critical fraction of nodes that has to be functional to guarantee the existence of a giant component in the network.

Optimal cost for strengthening or destroying a given network.

PubMed

Patron, Amikam; Cohen, Reuven; Li, Daqing; Havlin, Shlomo

2017-05-01

Strengthening or destroying a network is a very important issue in designing resilient networks or in planning attacks against networks, including planning strategies to immunize a network against diseases, viruses, etc. Here we develop a method for strengthening or destroying a random network with a minimum cost. We assume a correlation between the cost required to strengthen or destroy a node and the degree of the node. Accordingly, we define a cost function c(k), which is the cost of strengthening or destroying a node with degree k. Using the degrees k in a network and the cost function c(k), we develop a method for defining a list of priorities of degrees and for choosing the right group of degrees to be strengthened or destroyed that minimizes the total price of strengthening or destroying the entire network. We find that the list of priorities of degrees is universal and independent of the network's degree distribution, for all kinds of random networks. The list of priorities is the same for both strengthening a network and for destroying a network with minimum cost. However, in spite of this similarity, there is a difference between their p_{c}, the critical fraction of nodes that has to be functional to guarantee the existence of a giant component in the network.

Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: the PALMS study protocol.

PubMed

Jerosch-Herold, Christina; Shepstone, Lee; Wilson, Edward C F; Dyer, Tony; Blake, Julian

2014-02-07

Carpal tunnel syndrome (CTS) is the most common neuropathy of the upper limb and a significant contributor to hand functional impairment and disability. Effective treatment options include conservative and surgical interventions, however it is not possible at present to predict the outcome of treatment. The primary aim of this study is to identify which baseline clinical factors predict a good outcome from conservative treatment (by injection) or surgery in patients diagnosed with carpal tunnel syndrome. Secondary aims are to describe the clinical course and progression of CTS, and to describe and predict the UK cost of CTS to the individual, National Health Service (NHS) and society over a two year period. In this prospective observational cohort study patients presenting with clinical signs and symptoms typical of CTS and in whom the diagnosis is confirmed by nerve conduction studies are invited to participate. Data on putative predictive factors are collected at baseline and follow-up through patient questionnaires and include standardised measures of symptom severity, hand function, psychological and physical health, comorbidity and quality of life. Resource use and cost over the 2 year period such as prescribed medications, NHS and private healthcare contacts are also collected through patient self-report at 6, 12, 18 and 24 months. The primary outcome used to classify treatment success or failures will be a 5-point global assessment of change. Secondary outcomes include changes in clinical symptoms, functioning, psychological health, quality of life and resource use. A multivariable model of factors which predict outcome and cost will be developed. This prospective cohort study will provide important data on the clinical course and UK costs of CTS over a two-year period and begin to identify predictive factors for treatment success from conservative and surgical interventions.

School Cost Functions: A Meta-Regression Analysis

ERIC Educational Resources Information Center

Colegrave, Andrew D.; Giles, Margaret J.

2008-01-01

The education cost literature includes econometric studies attempting to determine economies of scale, or estimate an optimal school or district size. Not only do their results differ, but the studies use dissimilar data, techniques, and models. To derive value from these studies requires that the estimates be made comparable. One method to do…

The real world cost and health resource utilization associated to manic episodes: The MANACOR study.

PubMed

Hidalgo-Mazzei, Diego; Undurraga, Juan; Reinares, María; Bonnín, Caterina del Mar; Sáez, Cristina; Mur, María; Nieto, Evaristo; Vieta, Eduard

2015-01-01

Bipolar disorder is a relapsing-remitting condition affecting approximately 1-2% of the population. Even when the treatments available are effective, relapses are still very frequent. Therefore, the burden and cost associated to every new episode of the disorder have relevant implications in public health. The main objective of this study was to estimate the associated health resource consumption and direct costs of manic episodes in a real world clinical setting, taking into consideration clinical variables. Bipolar I disorder patients who recently presented an acute manic episode based on DSM-IV criteria were consecutively included. Sociodemographic variables were retrospectively collected and during the 6 following months clinical variables were prospectively assessed (YMRS,HDRS-17,FAST and CGI-BP-M). The health resource consumption and associate cost were estimated based on hospitalization days, pharmacological treatment, emergency department and outpatient consultations. One hundred sixty-nine patients patients from 4 different university hospitals in Catalonia (Spain) were included. The mean direct cost of the manic episodes was €4,771. The 77% (€3,651) was attributable to hospitalization costs while 14% (€684) was related to pharmacological treatment, 8% (€386) to outpatient visits and only 1% (€50) to emergency room visits. The hospitalization days were the main cost driver. An initial FAST score>41 significantly predicted a higher direct cost. Our results show the high cost and burden associated with BD and the need to design more cost-efficient strategies in the prevention and management of manic relapses in order to avoid hospital admissions. Poor baseline functioning predicted high costs, indicating the importance of functional assessment in bipolar disorder. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

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.

Design standards. Cutting the costs you don't see.

PubMed

Jolley, K

1995-07-01

In an era of hospital cost cutting and reengineering at all levels, it is still important to implement interior design standards in planning, selecting, and arranging the products that affect hospital image and function. Design standards manuals include manufacturer and model of furniture, fixtures, and equipment from desks, chairs, and computer stands to window treatments. This article reviews how to save on interior design costs while keeping a professional healthcare image.

LOGAM (Logistic Analysis Model). Volume 2. Users Manual.

DTIC Science & Technology

1982-08-01

as opposed to simulation models which represent a system’s behavior as a function of time. These latter classes of models are often complex. They...includes the cost of ammunition and missiles comsumed by the system being costed during unit training. Excluded is the cost of ammunition consumed during...data. The results obtained from sensitivity testing may be used to construct graphs which display the behavior of the maintenance concept over the range

Ab initio molecular dynamics with nuclear quantum effects at classical cost: Ring polymer contraction for density functional theory

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

Marsalek, Ondrej; Markland, Thomas E., E-mail: tmarkland@stanford.edu

Path integral molecular dynamics simulations, combined with an ab initio evaluation of interactions using electronic structure theory, incorporate the quantum mechanical nature of both the electrons and nuclei, which are essential to accurately describe systems containing light nuclei. However, path integral simulations have traditionally required a computational cost around two orders of magnitude greater than treating the nuclei classically, making them prohibitively costly for most applications. Here we show that the cost of path integral simulations can be dramatically reduced by extending our ring polymer contraction approach to ab initio molecular dynamics simulations. By using density functional tight binding asmore » a reference system, we show that our ring polymer contraction scheme gives rapid and systematic convergence to the full path integral density functional theory result. We demonstrate the efficiency of this approach in ab initio simulations of liquid water and the reactive protonated and deprotonated water dimer systems. We find that the vast majority of the nuclear quantum effects are accurately captured using contraction to just the ring polymer centroid, which requires the same number of density functional theory calculations as a classical simulation. Combined with a multiple time step scheme using the same reference system, which allows the time step to be increased, this approach is as fast as a typical classical ab initio molecular dynamics simulation and 35× faster than a full path integral calculation, while still exactly including the quantum sampling of nuclei. This development thus offers a route to routinely include nuclear quantum effects in ab initio molecular dynamics simulations at negligible computational cost.« less

Economic impact of heart failure according to the effects of kidney failure.

PubMed

Sicras Mainar, Antoni; Navarro Artieda, Ruth; Ibáñez Nolla, Jordi

2015-01-01

To evaluate the use of health care resources and their cost according to the effects of kidney failure in heart failure patients during 2-year follow-up in a population setting. Observational retrospective study based on a review of medical records. The study included patients ≥ 45 years treated for heart failure from 2008 to 2010. The patients were divided into 2 groups according to the presence/absence of KF. Main outcome variables were comorbidity, clinical status (functional class, etiology), metabolic syndrome, costs, and new cases of cardiovascular events and kidney failure. The cost model included direct and indirect health care costs. Statistical analysis included multiple regression models. The study recruited 1600 patients (prevalence, 4.0%; mean age 72.4 years; women, 59.7%). Of these patients, 70.1% had hypertension, 47.1% had dyslipidemia, and 36.2% had diabetes mellitus. We analyzed 433 patients (27.1%) with kidney failure and 1167 (72.9%) without kidney failure. Patients with kidney failure were associated with functional class III-IV (54.1% vs 40.8%) and metabolic syndrome (65.3% vs 51.9%, P<.01). The average unit cost was €10,711.40. The corrected cost in the presence of kidney failure was €14,868.20 vs €9,364.50 (P=.001). During follow-up, 11.7% patients developed ischemic heart disease, 18.8% developed kidney failure, and 36.1% developed heart failure exacerbation. Comorbidity associated with heart failure is high. The presence of kidney failure increases the use of health resources and leads to higher costs within the National Health System. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Functional digestive disorders (FDD) in the year 2000--economic impact.

PubMed

Fullerton, S

1998-01-01

The objective of this study is to quantify the future worldwide economic impact of functional gastrointestinal disease and to describe international differences that might exist between major industrialized countries. This study employs an econometric projection using data from the only known survey of national economic impact of functional gastrointestinal disease. Economic costs from this survey are combined with country specific population estimates, health care spending characteristics, and growth rates to estimate economic impact for major industrial countries. The estimated economic impact of functional gastrointestinal disease for eight major industrial countries is over 41 billion U.S. dollars annually. This estimate includes both direct and indirect costs of disease. The economic impact of functional gastrointestinal disease is large. Economic estimates are useful in policy decision making regarding the allocation of health care resources.

A real-space approach to the X-ray phase problem

NASA Astrophysics Data System (ADS)

Liu, Xiangan

Over the past few decades, the phase problem of X-ray crystallography has been explored in reciprocal space in the so called direct methods . Here we investigate the problem using a real-space approach that bypasses the laborious procedure of frequent Fourier synthesis and peak picking. Starting from a completely random structure, we move the atoms around in real space to minimize a cost function. A Monte Carlo method named simulated annealing (SA) is employed to search the global minimum of the cost function which could be constructed in either real space or reciprocal space. In the hybrid minimal principle, we combine the dual space costs together. One part of the cost function monitors the probability distribution of the phase triplets, while the other is a real space cost function which represents the discrepancy between measured and calculated intensities. Compared to the single space cost functions, the dual space cost function has a greatly improved landscape and therefore could prevent the system from being trapped in metastable states. Thus, the structures of large molecules such as virginiamycin (C43H 49N7O10 · 3CH0OH), isoleucinomycin (C60H102N 6O18) and hexadecaisoleucinomycin (HEXIL) (C80H136 N8O24) can now be solved, whereas it would not be possible using the single cost function. When a molecule gets larger, the configurational space becomes larger, and the requirement of CPU time increases exponentially. The method of improved Monte Carlo sampling has demonstrated its capability to solve large molecular structures. The atoms are encouraged to sample the high density regions in space determined by an approximate density map which in turn is updated and modified by averaging and Fourier synthesis. This type of biased sampling has led to considerable reduction of the configurational space. It greatly improves the algorithm compared to the previous uniform sampling. Hence, for instance, 90% of computer run time could be cut in solving the complex structure of isoleucinomycin. Successful trial calculations include larger molecular structures such as HEXIL and a collagen-like peptide (PPG). Moving chemical fragment is proposed to reduce the degrees of freedom. Furthermore, stereochemical parameters are considered for geometric constraints and for a cost function related to chemical energy.

Model reduction by weighted Component Cost Analysis

NASA Technical Reports Server (NTRS)

Kim, Jae H.; Skelton, Robert E.

1990-01-01

Component Cost Analysis considers any given system driven by a white noise process as an interconnection of different components, and assigns a metric called 'component cost' to each component. These component costs measure the contribution of each component to a predefined quadratic cost function. A reduced-order model of the given system may be obtained by deleting those components that have the smallest component costs. The theory of Component Cost Analysis is extended to include finite-bandwidth colored noises. The results also apply when actuators have dynamics of their own. Closed-form analytical expressions of component costs are also derived for a mechanical system described by its modal data. This is very useful to compute the modal costs of very high order systems. A numerical example for MINIMAST system is presented.

Accounting for the cost of scaling-up health interventions.

PubMed

Johns, Benjamin; Baltussen, Rob

2004-11-01

Recent studies such as the Commission on Macroeconomics and Health have highlighted the need for expanding the coverage of services for HIV/AIDS, malaria, tuberculosis, immunisations and other diseases. In order for policy makers to plan for these changes, they need to analyse the change in costs when interventions are 'scaled-up' to cover greater percentages of the population. Previous studies suggest that applying current unit costs to an entire population can misconstrue the true costs of an intervention. This study presents the methodology used in WHO-CHOICE's generalised cost effectiveness analysis, which includes non-linear cost functions for health centres, transportation and supervision costs, as well as the presence of fixed costs of establishing a health infrastructure. Results show changing marginal costs as predicted by economic theory. 2004 John Wiley & Sons, Ltd.

28 CFR 36.403 - Alterations: Path of travel.

Code of Federal Regulations, 2010 CFR

2010-07-01

... access to an area of a facility that contains a primary function shall be made so as to ensure that, to... disproportionate to the cost of the overall alteration. (b) Primary function. A “primary function” is a major activity for which the facility is intended. Areas that contain a primary function include, but are not...

Development of termination and utilization concepts for flat conductor cables. Volume 3: Cost study comparison, flat versus round conductor cable

NASA Technical Reports Server (NTRS)

1972-01-01

A cost study comparing flat conductor cable (FCC) with small-gage wire (SGW) and conventional round conductor cable (RCC) is presented. This study was based on a vehicle wiring system consisting of 110,000 ft of conventional RCC equally divided between AWG sizes 20,22, and 24 using MIL-W-81044-type wire and MIL-C-26500 circular connectors. Basic cost data were developed on a similar-sized commercial jet airplane wiring system on a previous company R&D program in which advanced wiring techniques were carried through equivalent installations on an airplane mockup; and on data developed on typical average bundles during this program. Various cost elements included were engineering labor, operations (manufacturing) labor, material costs, and cost impact on payload. Engineering labor includes design, wiring system integration, wiring diagrams and cable assembly drawings, wire installations, and other related supporting functions such as the electronic data processing for the wiring. Operations labor includes mockup, tooling and production planning, fabrication, assembly, installation, and quality control cost impact on payload is the conversion of wiring system weight variations through use of different wiring concepts to program payload benefits in terms of dollars.

A Study to Develop a Methodology to Enable Direct Cost UCA (Uniform Chart of Accounts) Data to Be Expressed in Terms of Cost per Admission for Specific Diagnosis Related Groups

DTIC Science & Technology

1985-07-01

environment in which it functions . A particular debt of gratitude in this respect is owed to my preceptor, Colonel James Helgeson, for his enthusiasm...patient conditions might run from heart attacks, which often receive intensive care and extensive follow-up support, to episodes of acute respiratory ...to include the following features: a. No disruption of existing IAS and UCA functions as defined by appropriate regulations b. Minimized additional

Harvest operations for density management: planning requirements, production, costs, stand damage, and recommendations

Treesearch

Loren D. Kellogg; Stephen J. Pilkerton

2013-01-01

Since the early 1990s, several studies have been undertaken to determine the planning requirements, productivity, costs, and residual stand damage of harvest operations in thinning treatments designed to promote development of complex forest structure in order to enhance ecological functioning and biological diversity. Th ese studies include the Oregon State...

Cost-effectiveness of manual therapy versus physiotherapy in patients with sub-acute and chronic neck pain: a randomised controlled trial.

PubMed

van Dongen, J M; Groeneweg, R; Rubinstein, S M; Bosmans, J E; Oostendorp, R A B; Ostelo, R W J G; van Tulder, M W

2016-07-01

To evaluate the cost-effectiveness of manual therapy according to the Utrecht School (MTU) in comparison with physiotherapy (PT) in sub-acute and chronic non-specific neck pain patients from a societal perspective. An economic evaluation was conducted alongside a 52-week randomized controlled trial, in which 90 patients were randomized to the MTU group and 91 to the PT group. Clinical outcomes included perceived recovery (yes/no), functional status (continuous and yes/no), and quality-adjusted life-years (QALYs). Costs were measured from a societal perspective using self-reported questionnaires. Missing data were imputed using multiple imputation. To estimate statistical uncertainty, bootstrapping techniques were used. After 52 weeks, there were no significant between-group differences in clinical outcomes. During follow-up, intervention costs (β:€-32; 95 %CI: -54 to -10) and healthcare costs (β:€-126; 95 %CI: -235 to -32) were significantly lower in the MTU group than in the PT group, whereas unpaid productivity costs were significantly higher (β:€186; 95 %CI:19-557). Societal costs did not significantly differ between groups (β:€-96; 95 %CI:-1975-2022). For QALYs and functional status (yes/no), the maximum probability of MTU being cost-effective in comparison with PT was low (≤0.54). For perceived recovery (yes/no) and functional status (continuous), a large amount of money must be paid per additional unit of effect to reach a reasonable probability of cost-effectiveness. From a societal perspective, MTU was not cost-effective in comparison with PT in patients with sub-acute and chronic non-specific neck pain for perceived recovery, functional status, and QALYs. As no clear total societal cost and effect differences were found between MTU and PT, the decision about what intervention to administer, reimburse, and/or implement can be based on the preferences of the patient and the decision-maker at hand. ClinicalTrials.gov Identifier: NCT00713843.

Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

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

Feizollahi, F.; Shropshire, D.

This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosedmore » vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report.« less

Cost-effectiveness of early versus delayed functional restoration for chronic disabling occupational musculoskeletal disorders.

PubMed

Theodore, Brian R; Mayer, Tom G; Gatchel, Robert J

2015-06-01

Despite extensive evidence for the treatment effectiveness of interdisciplinary functional restoration (FR) for chronic disabling occupational musculoskeletal disorders (CDOMD), there is little documentation on the cost-effectiveness of early rehabilitation using FR. A total of 1,119 CDOMD patients were classified according to duration of disability on FR entry, corresponding to early rehabilitation (ER: 4-8 months of disability, N = 373), intermediate duration (ID: 9-18 months, N = 373), and delayed rehabilitation (DR: >18 months, N = 373). Groups were matched on sex, age, ethnicity, and injured musculoskeletal region. One-year post-rehabilitation outcomes included return-to-work, work retention and healthcare utilization. Economic analyses included a cost-effectiveness analysis of the FR program, and estimation of the total cost-of-illness. At 1-year post-rehabilitation, all groups were comparable on return-to-work (overall 88%), work retention (overall 80%), and additional healthcare utilization (overall, 2.2% of patients received re-operations/new surgeries, 2 visits to new healthcare provider). Savings of up to 64% in medical costs, and up to 80% in disability benefits and productivity losses was associated with the ER group. The cost of rehabilitation was also up to 56% lower when administered early. Overall, ER resulted in estimated cost savings of up to 72% (or almost $170,000 per claim). Duration of disability does not negatively impact objective work or healthcare utilization outcomes following interdisciplinary FR. However, early rehabilitation is more likely to be a cost-effective solution compared to cases that progress >8 months and receiving FR as a treatment of "last resort".

Factors contributing to high-cost hospital care for patients with COPD.

PubMed

Mulpuru, Sunita; McKay, Jennifer; Ronksley, Paul E; Thavorn, Kednapa; Kobewka, Daniel M; Forster, Alan J

2017-01-01

Chronic obstructive pulmonary disease (COPD) is a leading cause of hospital admission, the fifth leading cause of death in North America, and is estimated to cost $49 billion annually in North America by 2020. The majority of COPD care costs are attributed to hospitalizations; yet, there are limited data to understand the drivers of high costs among hospitalized patients with COPD. In this study, we aimed to determine the patient and hospital-level factors associated with high-cost hospital care, in order to identify potential targets for the reorganization and planning of health services. We conducted a retrospective cohort study at a Canadian academic hospital between September 2010 and 2014, including adult patients with a first-time admission for COPD exacerbation. We calculated total costs, ranked patients by cost quintiles, and collected data on patient characteristics and health service utilization. We used multivariable regression to determine factors associated with highest hospital costs. Among 1,894 patients included in the study, the mean age was 73±12.6 years, median length of stay was 5 (interquartile range 3-9) days, mortality rate was 7.8% (n=147), and 9% (n=170) required intensive care. Hospital spending totaled $19.8 million, with 63% ($12.5 million) spent on 20% of patients. Factors associated with highest costs for COPD care included intensive care unit admission (odds ratio [OR] 32.4; 95% confidence interval [CI] 20.3, 51.7), death in hospital (OR 2.6; 95% CI 1.3, 5.2), discharge to long-term care facility (OR 5.7; 95% CI 3.5, 9.2), and use of the alternate level of care designation during hospitalization (OR 23.5; 95% CI 14.1, 39.2). High hospital costs are driven by two distinct groups: patients who require acute medical treatment for severe illness and patients with functional limitation who require assisted living facilities upon discharge. Improving quality of care and reducing cost in this high-needs population require a strong focus on early recognition and management of functional impairment for patients living with chronic disease.

Semi-supervised learning via regularized boosting working on multiple semi-supervised assumptions.

PubMed

Chen, Ke; Wang, Shihai

2011-01-01

Semi-supervised learning concerns the problem of learning in the presence of labeled and unlabeled data. Several boosting algorithms have been extended to semi-supervised learning with various strategies. To our knowledge, however, none of them takes all three semi-supervised assumptions, i.e., smoothness, cluster, and manifold assumptions, together into account during boosting learning. In this paper, we propose a novel cost functional consisting of the margin cost on labeled data and the regularization penalty on unlabeled data based on three fundamental semi-supervised assumptions. Thus, minimizing our proposed cost functional with a greedy yet stagewise functional optimization procedure leads to a generic boosting framework for semi-supervised learning. Extensive experiments demonstrate that our algorithm yields favorite results for benchmark and real-world classification tasks in comparison to state-of-the-art semi-supervised learning algorithms, including newly developed boosting algorithms. Finally, we discuss relevant issues and relate our algorithm to the previous work.

Identifying factors of activities of daily living important for cost and caregiver outcomes in Alzheimer's disease.

PubMed

Reed, Catherine; Belger, Mark; Vellas, Bruno; Andrews, Jeffrey Scott; Argimon, Josep M; Bruno, Giuseppe; Dodel, Richard; Jones, Roy W; Wimo, Anders; Haro, Josep Maria

2016-02-01

We aimed to obtain a better understanding of how different aspects of patient functioning affect key cost and caregiver outcomes in Alzheimer's disease (AD). Baseline data from a prospective observational study of community-living AD patients (GERAS) were used. Functioning was assessed using the Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale. Generalized linear models were conducted to analyze the relationship between scores for total activities of daily living (ADL), basic ADL (BADL), instrumental ADL (IADL), ADL subdomains (confirmed through factor analysis) and individual ADL questions, and total societal costs, patient healthcare and social care costs, total and supervision caregiver time, and caregiver burden. Four distinct ADL subdomains were confirmed: basic activities, domestic/household activities, communication, and outside activities. Higher total societal costs were associated with impairments in all aspects of ADL, including all subdomains; patient costs were associated with total ADL and BADL, and basic activities subdomain scores. Both total and supervision caregiver hours were associated with total ADL and IADL scores, and domestic/household and outside activities subdomain scores (greater hours associated with greater functional impairments). There was no association between caregiver burden and BADL or basic activities subdomain scores. The relationship between total ADL, IADL, and the outside activities subdomain and outcomes differed between patients with mild and moderate-to-severe AD. Identification of ADL subdomains may lead to a better understanding of the association between patient function and costs and caregiver outcomes at different stages of AD, in particular the outside activities subdomain within mild AD.

How Costly is Hospital Quality? A Revealed-Preference Approach*

PubMed Central

Romley, John A.; Goldman, Dana P.

2013-01-01

We analyze the cost of quality improvement in hospitals, dealing with two challenges. Hospital quality is multidimensional and hard to measure, while unobserved productivity may influence quality supply. We infer the quality of hospitals in Los Angeles from patient choices. We then incorporate ‘revealed quality’ into a cost function, instrumenting with hospital demand. We find that revealed quality differentiates hospitals, but is not strongly correlated with clinical quality. Revealed quality is quite costly, and tends to increase with hospital productivity. Thus, non-clinical aspects of the hospital experience (perhaps including patient amenities) play important roles in hospital demand, competition, and costs. PMID:22299199

Cost implications of organizing nursing home workforce in teams.

PubMed

Mukamel, Dana B; Cai, Shubing; Temkin-Greener, Helena

2009-08-01

To estimate the costs associated with formal and self-managed daily practice teams in nursing homes. Medicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers. A retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors. Formal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports. Formal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians. Organization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs.

Toward an Integration of Deep Learning and Neuroscience

PubMed Central

Marblestone, Adam H.; Wayne, Greg; Kording, Konrad P.

2016-01-01

Neuroscience has focused on the detailed implementation of computation, studying neural codes, dynamics and circuits. In machine learning, however, artificial neural networks tend to eschew precisely designed codes, dynamics or circuits in favor of brute force optimization of a cost function, often using simple and relatively uniform initial architectures. Two recent developments have emerged within machine learning that create an opportunity to connect these seemingly divergent perspectives. First, structured architectures are used, including dedicated systems for attention, recursion and various forms of short- and long-term memory storage. Second, cost functions and training procedures have become more complex and are varied across layers and over time. Here we think about the brain in terms of these ideas. We hypothesize that (1) the brain optimizes cost functions, (2) the cost functions are diverse and differ across brain locations and over development, and (3) optimization operates within a pre-structured architecture matched to the computational problems posed by behavior. In support of these hypotheses, we argue that a range of implementations of credit assignment through multiple layers of neurons are compatible with our current knowledge of neural circuitry, and that the brain's specialized systems can be interpreted as enabling efficient optimization for specific problem classes. Such a heterogeneously optimized system, enabled by a series of interacting cost functions, serves to make learning data-efficient and precisely targeted to the needs of the organism. We suggest directions by which neuroscience could seek to refine and test these hypotheses. PMID:27683554

Launch vehicle systems design analysis

NASA Technical Reports Server (NTRS)

Ryan, Robert; Verderaime, V.

1993-01-01

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

The Effect of Self-Reported and Performance-Based Functional Impairment on Future Hospital Costs of Community-Dwelling Older Persons

ERIC Educational Resources Information Center

Reuben, David B.; Seeman, Teresa E.; Keeler, Emmett; Hayes, Risa P.; Bowman, Lee; Sewall, Ase; Hirsch, Susan H.; Wallace, Robert B.; Guralnik, Jack M.

2004-01-01

Purpose: We determined the prognostic value of self-reported and performance-based measurement of function, including functional transitions and combining different measurement approaches, on utilization. Design and Methods: Our cohort study used the 6th, 7th, and 10th waves of three sites of the Established Populations for Epidemiologic Studies…

Computer imaging and workflow systems in the business office.

PubMed

Adams, W T; Veale, F H; Helmick, P M

1999-05-01

Computer imaging and workflow technology automates many business processes that currently are performed using paper processes. Documents are scanned into the imaging system and placed in electronic patient account folders. Authorized users throughout the organization, including preadmission, verification, admission, billing, cash posting, customer service, and financial counseling staff, have online access to the information they need when they need it. Such streamlining of business functions can increase collections and customer satisfaction while reducing labor, supply, and storage costs. Because the costs of a comprehensive computer imaging and workflow system can be considerable, healthcare organizations should consider implementing parts of such systems that can be cost-justified or include implementation as part of a larger strategic technology initiative.

Communications network design and costing model users manual

NASA Technical Reports Server (NTRS)

Logan, K. P.; Somes, S. S.; Clark, C. A.

1983-01-01

The information and procedures needed to exercise the communications network design and costing model for performing network analysis are presented. Specific procedures are included for executing the model on the NASA Lewis Research Center IBM 3033 computer. The concepts, functions, and data bases relating to the model are described. Model parameters and their format specifications for running the model are detailed.

Study for analysis of benefit versus cost of low thrust propulsion system

NASA Technical Reports Server (NTRS)

Hamlyn, K. M.; Robertson, R. I.; Rose, L. J.

1983-01-01

The benefits and costs associated with placing large space systems (LSS) in operational orbits were investigated, and a flexible computer model for analyzing these benefits and costs was developed. A mission model for LSS was identified that included both NASA/Commercial and DOD missions. This model included a total of 68 STS launches for the NASA/Commercial missions and 202 launches for the DOD missions. The mission catalog was of sufficient depth to define the structure type, mass and acceleration limits of each LSS. Conceptual primary propulsion stages (PPS) designs for orbital transfer were developed for three low thrust LO2/LH2 engines baselined for the study. The performance characteristics for each of these PPS was compared to the LSS mission catalog to create a mission capture. The costs involved in placing the LSS in their operational orbits were identified. The two primary costs were that of the PPS and of the STS launch. The cost of the LSS was not included as it is not a function of the PPS performance. The basic relationships and algorithms that could be used to describe the costs were established. The benefit criteria for the mission model were also defined. These included mission capture, reliability, technical risk, development time, and growth potential. Rating guidelines were established for each parameter. For flexibility, each parameter is assigned a weighting factor.

Alterations in Aerobic Exercise Performance and Gait Economy Following High-Intensity Dynamic Stepping Training in Persons With Subacute Stroke.

PubMed

Leddy, Abigail L; Connolly, Mark; Holleran, Carey L; Hennessy, Patrick W; Woodward, Jane; Arena, Ross A; Roth, Elliot J; Hornby, T George

2016-10-01

Impairments in metabolic capacity and economy (O2cost) are hallmark characteristics of locomotor dysfunction following stroke. High-intensity (aerobic) training has been shown to improve peak oxygen consumption in this population, with fewer reports of changes in O2cost. However, particularly in persons with subacute stroke, inconsistent gains in walking function are observed with minimal associations with gains in metabolic parameters. The purpose of this study was to evaluate changes in aerobic exercise performance in participants with subacute stroke following high-intensity variable stepping training as compared with conventional therapy. A secondary analysis was performed on data from a randomized controlled trial comparing high-intensity training with conventional interventions, and from the pilot study that formed the basis for the randomized controlled trial. Participants 1 to 6 months poststroke received 40 or fewer sessions of high-intensity variable stepping training (n = 21) or conventional interventions (n = 12). Assessments were performed at baseline (BSL), posttraining, and 2- to 3-month follow-up and included changes in submaximal (Equation is included in full-text article.)O2 ((Equation is included in full-text article.)O2submax) and O2cost at fastest possible treadmill speeds and peak speeds at BSL testing. Significant improvements were observed in (Equation is included in full-text article.)O2submax with less consistent improvements in O2cost, although individual responses varied substantially. Combined changes in both (Equation is included in full-text article.)O2submax and (Equation is included in full-text article.)O2 at matched peak BSL speeds revealed stronger correlations to improvements in walking function as compared with either measure alone. High-intensity stepping training may elicit significant improvements in (Equation is included in full-text article.)O2submax, whereas changes in both peak capacity and economy better reflect gains in walking function. Providing high-intensity training to improve locomotor and aerobic exercise performance may increase the efficiency of rehabilitation sessions.Video Abstract available for more insights from the authors (see Supplemental Digital Content, http://links.lww.com/JNPT/A142).

Economic evaluation of a bio-psycho-social intervention for comorbid disorders in a traumatized population in post-war Kosovo.

PubMed

Chang, Wei-Lun; Andersen, Carit Jacques; Berisha, Besa Shatri; Estrup, Olena; Wang, Shr-Jie

2018-05-08

Post-hoc economic evaluation of a bio-psycho-social intervention in post-war Kosovo from a societal perspective. Cost-effectiveness analysis, cost-utility analysis, and partial cost-benefit analysis using data from a randomized controlled trial. Thirty-four torture/war victims with comorbid conditions enrolled in 2012-2013. Participants were randomly assigned to an "intervention" and a "waiting-list" group. Changes in mental, emotional and physical health and functional impairment were assessed before and after treatment, along with increase in labour income as a proxy for productivity gain. The cost of an extra unit of effectiveness and an additional quality-adjusted life year were calculated. The total cost per participant was €1,322 including, or €1,019 excluding, research costs. Wide variations in costs of changes in mental, emotional and physical effectiveness were demonstrated. Multidisciplinary intervention resulted in functional improvement at a cost of €10,508 per quality-adjusted life year gained. With a mean monthly income increase to €133 (18%) after intervention, the intervention cost per participant would be equal to the total increase in monthly income after 4-5 years, assuming the increased level is maintained. Socio-economic benefit associated with quality-adjusted life year gain is shown, although the cost of an additional quality-adjusted life year is above the World Health Organization cost-effectiveness threshold.

Advanced Technology Composite Fuselage: Program Overview

NASA Technical Reports Server (NTRS)

Ilcewicz, L. B.; Smith, P. J.; Hanson, C. T.; Walker, T. H.; Metschan, S. L.; Mabson, G. E.; Wilden, K. S.; Flynn, B. W.; Scholz, D. B.; Polland, D. R.;

Controlling for endogeneity in attributable costs of vancomycin-resistant enterococci from a Canadian hospital.

PubMed

Lloyd-Smith, Patrick

2017-12-01

Decisions regarding the optimal provision of infection prevention and control resources depend on accurate estimates of the attributable costs of health care-associated infections. This is challenging given the skewed nature of health care cost data and the endogeneity of health care-associated infections. The objective of this study is to determine the hospital costs attributable to vancomycin-resistant enterococci (VRE) while accounting for endogeneity. This study builds on an attributable cost model conducted by a retrospective cohort study including 1,292 patients admitted to an urban hospital in Vancouver, Canada. Attributable hospital costs were estimated with multivariate generalized linear models (GLMs). To account for endogeneity, a control function approach was used. The analysis sample included 217 patients with health care-associated VRE. In the standard GLM, the costs attributable to VRE are $17,949 (SEM, $2,993). However, accounting for endogeneity, the attributable costs were estimated to range from $14,706 (SEM, $7,612) to $42,101 (SEM, $15,533). Across all model specifications, attributable costs are 76% higher on average when controlling for endogeneity. VRE was independently associated with increased hospital costs, and controlling for endogeneity lead to higher attributable cost estimates. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The Impact of Mission Duration on a Mars Orbital Mission

NASA Technical Reports Server (NTRS)

Arney, Dale; Earle, Kevin; Cirillo, Bill; Jones, Christopher; Klovstad, Jordan; Grande, Melanie; Stromgren, Chel

2017-01-01

Performance alone is insufficient to assess the total impact of changing mission parameters on a space mission concept, architecture, or campaign; the benefit, cost, and risk must also be understood. This paper examines the impact to benefit, cost, and risk of changing the total mission duration of a human Mars orbital mission. The changes in the sizing of the crew habitat, including consumables and spares, was assessed as a function of duration, including trades of different life support strategies; this was used to assess the impact on transportation system requirements. The impact to benefit is minimal, while the impact on cost is dominated by the increases in transportation costs to achieve shorter total durations. The risk is expected to be reduced by decreasing total mission duration; however, large uncertainty exists around the magnitude of that reduction.

Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA: cost-effectiveness based on a 2-year randomized trial.

PubMed

Sørensen, J; Primdahl, J; Horn, H C; Hørslev-Petersen, K

2015-01-01

To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient clinics and general practice, prescription and non-prescription medicine, dietary supplements, other health-care resources, and complementary and alternative care. Measures of effectiveness and costs were collected by self-reported questionnaires at inclusion and after 12 and 24 months. Incremental cost-effectiveness rates (ICERs) were estimated in comparison with rheumatologist consultations. Changes in disease activity, functional status, and health-related quality of life were not statistically significantly different for the three groups, although the mean scores were better for the shared care and nurse care groups compared with the rheumatologist group. Shared care and nurse care were non-significantly less costly than rheumatologist care. As both shared care and nurse care were associated with slightly better EQ-5D improvements and lower costs, they dominated rheumatologist care. At EUR 10,000 per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Shared care and nurse care seem to cost less but provide broadly similar health outcomes compared with rheumatologist outpatient care. However, it is still uncertain whether nurse care and shared care are cost-effective in comparison with rheumatologist outpatient care.

45 CFR 1355.57 - Cost allocation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... collection and information retrieval system described in § 1355.53 of this part shall be treated as necessary... includes functions, processing, information collection and management, equipment or services that are not...

45 CFR 1355.57 - Cost allocation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... collection and information retrieval system described in § 1355.53 of this part shall be treated as necessary... includes functions, processing, information collection and management, equipment or services that are not...

Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: the PALMS study protocol

PubMed Central

2014-01-01

Background Carpal tunnel syndrome (CTS) is the most common neuropathy of the upper limb and a significant contributor to hand functional impairment and disability. Effective treatment options include conservative and surgical interventions, however it is not possible at present to predict the outcome of treatment. The primary aim of this study is to identify which baseline clinical factors predict a good outcome from conservative treatment (by injection) or surgery in patients diagnosed with carpal tunnel syndrome. Secondary aims are to describe the clinical course and progression of CTS, and to describe and predict the UK cost of CTS to the individual, National Health Service (NHS) and society over a two year period. Methods/Design In this prospective observational cohort study patients presenting with clinical signs and symptoms typical of CTS and in whom the diagnosis is confirmed by nerve conduction studies are invited to participate. Data on putative predictive factors are collected at baseline and follow-up through patient questionnaires and include standardised measures of symptom severity, hand function, psychological and physical health, comorbidity and quality of life. Resource use and cost over the 2 year period such as prescribed medications, NHS and private healthcare contacts are also collected through patient self-report at 6, 12, 18 and 24 months. The primary outcome used to classify treatment success or failures will be a 5-point global assessment of change. Secondary outcomes include changes in clinical symptoms, functioning, psychological health, quality of life and resource use. A multivariable model of factors which predict outcome and cost will be developed. Discussion This prospective cohort study will provide important data on the clinical course and UK costs of CTS over a two-year period and begin to identify predictive factors for treatment success from conservative and surgical interventions. PMID:24507749

Monolithic Microwave Integrated Circuits Based on GaAs Mesfet Technology

NASA Astrophysics Data System (ADS)

Bahl, Inder J.

Advanced military microwave systems are demanding increased integration, reliability, radiation hardness, compact size and lower cost when produced in large volume, whereas the microwave commercial market, including wireless communications, mandates low cost circuits. Monolithic Microwave Integrated Circuit (MMIC) technology provides an economically viable approach to meeting these needs. In this paper the design considerations for several types of MMICs and their performance status are presented. Multifunction integrated circuits that advance the MMIC technology are described, including integrated microwave/digital functions and a highly integrated transceiver at C-band.

Satellite servicing mission preliminary cost estimation model

NASA Technical Reports Server (NTRS)

1987-01-01

The cost model presented is a preliminary methodology for determining a rough order-of-magnitude cost for implementing a satellite servicing mission. Mission implementation, in this context, encompassess all activities associated with mission design and planning, including both flight and ground crew training and systems integration (payload processing) of servicing hardward with the Shuttle. A basic assumption made in developing this cost model is that a generic set of servicing hardware was developed and flight tested, is inventoried, and is maintained by NASA. This implies that all hardware physical and functional interfaces are well known and therefore recurring CITE testing is not required. The development of the cost model algorithms and examples of their use are discussed.

Economic evaluations of comprehensive geriatric assessment in surgical patients: a systematic review.

PubMed

Eamer, Gilgamesh; Saravana-Bawan, Bianka; van der Westhuizen, Brenden; Chambers, Thane; Ohinmaa, Arto; Khadaroo, Rachel G

2017-10-01

Seniors presenting with surgical disease face increased risk of postoperative morbidity and mortality and have increased treatment costs. Comprehensive Geriatric Assessment (CGA) is proposed to reduce morbidity, mortality, and the cost after surgery. A systematic review of CGA in emergency surgical patients was conducted. The primary outcome was cost-effectiveness; secondary outcomes were length of stay, return of function, and mortality. Inclusion and exclusion criteria were predefined. Systematic searches of MEDLINE, Embase, Cochrane, and National Health Service Economic Evaluation Database were performed. Text screening, bias assessment, and data extraction were performed by two authors. There were 560 articles identified; abstract review excluded 499 articles and full-text review excluded 53 articles. Eight studies were included; one nonorthopedic trauma and seven orthopedic trauma studies. Bias assessment revealed moderate to high risk of bias for all studies. Economic evaluation assessment identified two high-quality studies and six moderate or low quality studies. Pooled analysis from four studies assessed loss of function; loss of function decreased in the experimental arm (odds ratio 0.92, 95% confidence interval [CI]: 0.88-0.97). Pooled results for length of stay from five studies found a significant decrease (mean difference: -1.17, 95% CI: -1.63 to -0.71) after excluding the nonorthopedic trauma study. Pooled mortality was significantly decreased in seven studies (risk ratio: 0.78, 95% CI: 0.67-0.90). All studies decreased cost and improved health outcomes in a cost-effective manner. CGA improved return of function and mortality with reduced cost or improved utility. Our review suggests that CGA is economically dominant and the most cost-effective care model for orthogeriatric patients. Further research should examine other surgical fields. Copyright © 2017 Elsevier Inc. All rights reserved.

The multi-disciplinary design study: A life cycle cost algorithm

NASA Technical Reports Server (NTRS)

Harding, R. R.; Pichi, F. J.

1988-01-01

The approach and results of a Life Cycle Cost (LCC) analysis of the Space Station Solar Dynamic Power Subsystem (SDPS) including gimbal pointing and power output performance are documented. The Multi-Discipline Design Tool (MDDT) computer program developed during the 1986 study has been modified to include the design, performance, and cost algorithms for the SDPS as described. As with the Space Station structural and control subsystems, the LCC of the SDPS can be computed within the MDDT program as a function of the engineering design variables. Two simple examples of MDDT's capability to evaluate cost sensitivity and design based on LCC are included. MDDT was designed to accept NASA's IMAT computer program data as input so that IMAT's detailed structural and controls design capability can be assessed with expected system LCC as computed by MDDT. No changes to IMAT were required. Detailed knowledge of IMAT is not required to perform the LCC analyses as the interface with IMAT is noninteractive.

20 CFR 725.406 - Medical examinations and tests.

Code of Federal Regulations, 2010 CFR

2010-04-01

... complete pulmonary evaluation includes a report of physical examination, a pulmonary function study, a chest roentgenogram and, unless medically contraindicated, a blood gas study. (b) As soon as possible... test authorized under this section, including the cost of travel to and from the examination, shall be...

45 CFR 235.64 - FFP rates, and activities and costs matchable as training expenditures.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., travel and per diem for: (1) Staff development personnel (including support staff) assigned full time to training functions and; (2) Staff development personnel assigned part time to training functions to the... of less than four consecutive work weeks, or part-time training programs; and (4) Stipends, travel...

45 CFR 235.64 - FFP rates, and activities and costs matchable as training expenditures.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., travel and per diem for: (1) Staff development personnel (including support staff) assigned full time to training functions and; (2) Staff development personnel assigned part time to training functions to the... of less than four consecutive work weeks, or part-time training programs; and (4) Stipends, travel...

45 CFR 235.64 - FFP rates, and activities and costs matchable as training expenditures.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., travel and per diem for: (1) Staff development personnel (including support staff) assigned full time to training functions and; (2) Staff development personnel assigned part time to training functions to the... of less than four consecutive work weeks, or part-time training programs; and (4) Stipends, travel...

26 CFR 53.4940-1 - Excise tax on net investment income.

Code of Federal Regulations, 2013 CFR

2013-04-01

... this section) and the capital gain net income (net capital gain for taxable years beginning before... to the basis for determining gain, or section 362(c). Thus, a private foundation must reduce the cost... charitable function shall be no greater than the income earned from such function which is includible as...

26 CFR 53.4940-1 - Excise tax on net investment income.

Code of Federal Regulations, 2012 CFR

2012-04-01

... this section) and the capital gain net income (net capital gain for taxable years beginning before... to the basis for determining gain, or section 362(c). Thus, a private foundation must reduce the cost... charitable function shall be no greater than the income earned from such function which is includible as...

26 CFR 53.4940-1 - Excise tax on net investment income.

Code of Federal Regulations, 2011 CFR

2011-04-01

... this section) and the capital gain net income (net capital gain for taxable years beginning before... to the basis for determining gain, or section 362(c). Thus, a private foundation must reduce the cost... charitable function shall be no greater than the income earned from such function which is includible as...

26 CFR 53.4940-1 - Excise tax on net investment income.

Code of Federal Regulations, 2010 CFR

2010-04-01

... this section) and the capital gain net income (net capital gain for taxable years beginning before... to the basis for determining gain, or section 362(c). Thus, a private foundation must reduce the cost... charitable function shall be no greater than the income earned from such function which is includible as...

26 CFR 53.4940-1 - Excise tax on net investment income.

Code of Federal Regulations, 2014 CFR

2014-04-01

... this section) and the capital gain net income (net capital gain for taxable years beginning before... to the basis for determining gain, or section 362(c). Thus, a private foundation must reduce the cost... charitable function shall be no greater than the income earned from such function which is includible as...

Simultaneous bilateral cataract surgery: economic analysis; Helsinki Simultaneous Bilateral Cataract Surgery Study Report 2.

PubMed

Leivo, Tiina; Sarikkola, Anna-Ulrika; Uusitalo, Risto J; Hellstedt, Timo; Ess, Sirje-Linda; Kivelä, Tero

2011-06-01

To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. Helsinki University Eye Hospital, Helsinki, Finland. Economic analysis. Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

The potential impact of ozone on materials in the U.K.

NASA Astrophysics Data System (ADS)

Lee, David S.; Holland, Michael R.; Falla, Norman

Recent reports have highlighted the potential damage caused to a range of media, including materials, by ozone (O 3). The limited data available indicate significant damage to rubber products and surface coatings but either insignificant or unquantifiable damage to textiles and other polymeric materials at the range of atmospheric concentrations encountered in the U.K. Materials in the indoor environment have been excluded from economic analyses. Legislation was put in place in 1993 in the U.K. in order to reduce NO x (NO x = NO + NO 2) and VOC (volatile organic compounds) emissions from motor vehicles which is likely to result in reduced peak O 3 episodes but increased average levels of O 3 in urban areas which may result in increased damage to materials. A detailed assessment of the costs of O 3 damage to materials is not currently possible because of insufficient information on relevant dose-response functions and the stock at risk. Alternative methods were thus adopted to determine the potential scale of the problem. Scaling of U.S. estimates made in the late 1960s provides a range for the U.K. of £170 million-£345 million yr -1 in current terms. This includes damage to surface coatings and elastomers, and the cost of antiozonant protection applied to rubber goods. Independent estimates were made of the costs of protecting rubber goods in the U.K. These were based on the size of the antiozonant market, and provide cost ranges of £25 million-£63 million yr -1 to manufacturers and £25 million-£189 million yr -1 to consumers. The only rubber goods for which a damage estimate (not including protection costs) could be made were tyres, using data from the U.S.A. and information on annual tyre sales in the U.K. A range of £0-£4 million yr -1 was estimated. The cost of damage to other rubber goods could not be quantified because of a lack of data on both the stock at risk and exposure-response functions. The effect of O 3 on the costs of repainting were estimated under scenarios of increased urban concentrations of O 3 using damage functions derived from the literature. The cost was estimated to be in the range of £0-£60 million yr -1 for a change from 15 to 20 ppb O 3, and £0 to £182 million yr -1 for a change from 15 to 30 ppb O 3. The wide ranges derived for effects on surface coatings are a reflection of the uncertainty associated with the dose-response functions used.

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

PubMed Central

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

2017-01-01

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

A Genetic Algorithm for the Generation of Packetization Masks for Robust Image Communication

PubMed Central

Zapata-Quiñones, Katherine; Duran-Faundez, Cristian; Gutiérrez, Gilberto; Lecuire, Vincent; Arredondo-Flores, Christopher; Jara-Lipán, Hugo

2017-01-01

Image interleaving has proven to be an effective solution to provide the robustness of image communication systems when resource limitations make reliable protocols unsuitable (e.g., in wireless camera sensor networks); however, the search for optimal interleaving patterns is scarcely tackled in the literature. In 2008, Rombaut et al. presented an interesting approach introducing a packetization mask generator based in Simulated Annealing (SA), including a cost function, which allows assessing the suitability of a packetization pattern, avoiding extensive simulations. In this work, we present a complementary study about the non-trivial problem of generating optimal packetization patterns. We propose a genetic algorithm, as an alternative to the cited work, adopting the mentioned cost function, then comparing it to the SA approach and a torus automorphism interleaver. In addition, we engage the validation of the cost function and provide results attempting to conclude about its implication in the quality of reconstructed images. Several scenarios based on visual sensor networks applications were tested in a computer application. Results in terms of the selected cost function and image quality metric PSNR show that our algorithm presents similar results to the other approaches. Finally, we discuss the obtained results and comment about open research challenges. PMID:28452934

Cost Implications of Organizing Nursing Home Workforce in Teams

PubMed Central

Mukamel, Dana B; Cai, Shubing; Temkin-Greener, Helena

2009-01-01

Objective To estimate the costs associated with formal and self-managed daily practice teams in nursing homes. Data Sources/Study Setting Medicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers. Study Design A retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors. Data Collection Formal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports. Principal Findings Formal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians. Conclusions Organization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs. PMID:19486181

Cost function approach for estimating derived demand for composite wood products

Treesearch

T. C. Marcin

1991-01-01

A cost function approach was examined for using the concept of duality between production and input factor demands. A translog cost function was used to represent residential construction costs and derived conditional factor demand equations. Alternative models were derived from the translog cost function by imposing parameter restrictions.

Choosing Models for Health Care Cost Analyses: Issues of Nonlinearity and Endogeneity

PubMed Central

Garrido, Melissa M; Deb, Partha; Burgess, James F; Penrod, Joan D

2012-01-01

Objective To compare methods of analyzing endogenous treatment effect models for nonlinear outcomes and illustrate the impact of model specification on estimates of treatment effects such as health care costs. Data Sources Secondary data on cost and utilization for inpatients hospitalized in five Veterans Affairs acute care facilities in 2005–2006. Study Design We compare results from analyses with full information maximum simulated likelihood (FIMSL); control function (CF) approaches employing different types and functional forms for the residuals, including the special case of two-stage residual inclusion; and two-stage least squares (2SLS). As an example, we examine the effect of an inpatient palliative care (PC) consultation on direct costs of care per day. Data Collection/Extraction Methods We analyzed data for 3,389 inpatients with one or more life-limiting diseases. Principal Findings The distribution of average treatment effects on the treated and local average treatment effects of a PC consultation depended on model specification. CF and FIMSL estimates were more similar to each other than to 2SLS estimates. CF estimates were sensitive to choice and functional form of residual. Conclusions When modeling cost or other nonlinear data with endogeneity, one should be aware of the impact of model specification and treatment effect choice on results. PMID:22524165

The use of locally optimal trajectory management for base reaction control of robots in a microgravity environment

NASA Technical Reports Server (NTRS)

Lin, N. J.; Quinn, R. D.

1991-01-01

A locally-optimal trajectory management (LOTM) approach is analyzed, and it is found that care should be taken in choosing the Ritz expansion and cost function. A modified cost function for the LOTM approach is proposed which includes the kinetic energy along with the base reactions in a weighted and scale sum. The effects of the modified functions are demonstrated with numerical examples for robots operating in two- and three-dimensional space. It is pointed out that this modified LOTM approach shows good performance, the reactions do not fluctuate greatly, joint velocities reach their objectives at the end of the manifestation, and the CPU time is slightly more than twice the manipulation time.

Nonempirical range-separated hybrid functionals for solids and molecules

DOE PAGES

Skone, Jonathan H.; Govoni, Marco; Galli, Giulia

2016-06-03

Dielectric-dependent hybrid (DDH) functionals were recently shown to yield accurate energy gaps and dielectric constants for a wide variety of solids, at a computational cost considerably less than that of GW calculations. The fraction of exact exchange included in the definition of DDH functionals depends (self-consistently) on the dielectric constant of the material. Here we introduce a range-separated (RS) version of DDH functionals where short and long-range components are matched using system dependent, non-empirical parameters. We show that RS DDHs yield accurate electronic properties of inorganic and organic solids, including energy gaps and absolute ionization potentials. Moreover, we show thatmore » these functionals may be generalized to finite systems.« less

A programmatic approach to long-term bridge preventive maintenance.

DOT National Transportation Integrated Search

2016-04-15

State transportation agencies use cost-effective preventive maintenance (PM) programs to preserve existing roadway systems, slow down their deterioration, and improve their functional condition. Currently, KYTCs bridge inventory includes approxima...

Circuit class or seven-day therapy for increasing intensity of rehabilitation after stroke: protocol of the CIRCIT trial.

PubMed

Hillier, Susan; English, Coralie; Crotty, Maria; Segal, Leonie; Bernhardt, Julie; Esterman, Adrian

2011-12-01

There is strong evidence for a dose-response relationship between physical therapy early after stroke and recovery of function. The optimal method of maximizing physical therapy within finite health care resources is unknown. To determine the effectiveness and cost-effectiveness of two alternative models of physical therapy service delivery (seven-days per week therapy services or group circuit class therapy over five-days a week) to usual care for people receiving inpatient rehabilitation after stroke. Multicenter, three-armed randomized controlled trial with blinded assessment of outcomes. A total of 282 people admitted to inpatient rehabilitation facilities after stroke with an admission functional independence measure (FIM) score within the moderate range (total 40-80 points or motor 38-62 points) will be randomized to receive one of three interventions: • usual care therapy over five-days a week • standard care therapy over seven-days a week, or • group circuit class therapy over five-days a week. Participants will receive the allocated intervention for the length of their hospital stay. Analysis will be by intention-to-treat. The primary outcome measure is walking ability (six-minute walk test) at four-week postintervention with three- and six-month follow-up. Economic analysis will include a costing analysis based on length of hospital stay and staffing/resource costs and a cost-utility analysis (incremental quality of life per incremental cost, relative to usual care). Secondary outcomes include walking speed and independence, ability to perform activities of daily living, arm function, quality of life and participant satisfaction. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

Space transfer vehicle concepts and requirements study. Volume 3, book 1: Program cost estimates

NASA Technical Reports Server (NTRS)

Peffley, Al F.

1991-01-01

The Space Transfer Vehicle (STV) Concepts and Requirements Study cost estimate and program planning analysis is presented. The cost estimating technique used to support STV system, subsystem, and component cost analysis is a mixture of parametric cost estimating and selective cost analogy approaches. The parametric cost analysis is aimed at developing cost-effective aerobrake, crew module, tank module, and lander designs with the parametric cost estimates data. This is accomplished using cost as a design parameter in an iterative process with conceptual design input information. The parametric estimating approach segregates costs by major program life cycle phase (development, production, integration, and launch support). These phases are further broken out into major hardware subsystems, software functions, and tasks according to the STV preliminary program work breakdown structure (WBS). The WBS is defined to a low enough level of detail by the study team to highlight STV system cost drivers. This level of cost visibility provided the basis for cost sensitivity analysis against various design approaches aimed at achieving a cost-effective design. The cost approach, methodology, and rationale are described. A chronological record of the interim review material relating to cost analysis is included along with a brief summary of the study contract tasks accomplished during that period of review and the key conclusions or observations identified that relate to STV program cost estimates. The STV life cycle costs are estimated on the proprietary parametric cost model (PCM) with inputs organized by a project WBS. Preliminary life cycle schedules are also included.

A Method of Dynamic Extended Reactive Power Optimization in Distribution Network Containing Photovoltaic-Storage System

NASA Astrophysics Data System (ADS)

Wang, Wu; Huang, Wei; Zhang, Yongjun

2018-03-01

The grid-integration of Photovoltaic-Storage System brings some undefined factors to the network. In order to make full use of the adjusting ability of Photovoltaic-Storage System (PSS), this paper puts forward a reactive power optimization model, which are used to construct the objective function based on power loss and the device adjusting cost, including energy storage adjusting cost. By using Cataclysmic Genetic Algorithm to solve this optimization problem, and comparing with other optimization method, the result proved that: the method of dynamic extended reactive power optimization this article puts forward, can enhance the effect of reactive power optimization, including reducing power loss and device adjusting cost, meanwhile, it gives consideration to the safety of voltage.

Cost-effectiveness of intensive psychiatric community care for high users of inpatient services.

PubMed

Rosenheck, R A; Neale, M S

1998-05-01

This 2-year experimental study evaluated the effectiveness and cost of 10 intensive psychiatric community care (IPCC) programs at Department of Veterans Affairs medical centers in the northeastern United States. High users of inpatient services were randomly assigned to either IPCC or standard Department of Veterans Affairs care at 6 general medical and surgical hospitals (n=271 vs 257) and 4 neuropsychiatric hospitals (n=183 vs 162). Patient interviews every 6 months and national computerized data were used to assess clinical outcomes, health service use, health care costs, and non-health care costs. There was only 1 significant clinical difference between groups across follow-up periods: IPCC patients at general medical and surgical sites had higher community living skills. However, at the final interview, IPCC patients at general medical and surgical sites showed significantly lower symptoms, higher functioning, and greater satisfaction with services. Treatment with IPCC significantly reduced hospital use only at neuropsychiatric sites (320 vs 513 days, P<.001). Total societal costs, including the cost of IPCC, were lower for IPCC at neuropsychiatric sites ($82,454 vs $116,651, P<.001), but greater at general medical and surgical sites ($51,537 vs $46,491, P<.01). When 2 sites that incompletely implemented the model were dropped from the analysis, costs at general medical and surgical sites were $38 lower for IPCC (P=.26). At acute care hospitals, IPCC treatment is associated with greater long-term clinical improvement and, when fully implemented, is cost-neutral. At long-stay hospitals treating older, less-functional patients, it is not associated with clinical or functional improvement but generates substantial cost savings. Intensive psychiatric community care thus has beneficial, but somewhat different, outcome profiles at different types of hospitals.

The Necessity of Functional Analysis for Space Exploration Programs

NASA Technical Reports Server (NTRS)

Morris, A. Terry; Breidenthal, Julian C.

2011-01-01

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

On a cost functional for H2/H(infinity) minimization

NASA Technical Reports Server (NTRS)

Macmartin, Douglas G.; Hall, Steven R.; Mustafa, Denis

1990-01-01

A cost functional is proposed and investigated which is motivated by minimizing the energy in a structure using only collocated feedback. Defined for an H(infinity)-norm bounded system, this cost functional also overbounds the H2 cost. Some properties of this cost functional are given, and preliminary results on the procedure for minimizing it are presented. The frequency domain cost functional is shown to have a time domain representation in terms of a Stackelberg non-zero sum differential game.

A programmatic approach to long-term bridge preventive maintenance : final report.

DOT National Transportation Integrated Search

2016-04-01

State transportation agencies use cost-effective preventive maintenance (PM) programs to preserve existing roadway systems, slow down their deterioration, and improve their functional condition. Currently, KYTCs bridge inventory includes approxima...

Economic lot sizing in a production system with random demand

NASA Astrophysics Data System (ADS)

Lee, Shine-Der; Yang, Chin-Ming; Lan, Shu-Chuan

2016-04-01

An extended economic production quantity model that copes with random demand is developed in this paper. A unique feature of the proposed study is the consideration of transient shortage during the production stage, which has not been explicitly analysed in existing literature. The considered costs include set-up cost for the batch production, inventory carrying cost during the production and depletion stages in one replenishment cycle, and shortage cost when demand cannot be satisfied from the shop floor immediately. Based on renewal reward process, a per-unit-time expected cost model is developed and analysed. Under some mild condition, it can be shown that the approximate cost function is convex. Computational experiments have demonstrated that the average reduction in total cost is significant when the proposed lot sizing policy is compared with those with deterministic demand.

Glucosamine hydrochloride for the treatment of osteoarthritis symptoms

PubMed Central

Fox, Beth Anne; Stephens, Mary M

2007-01-01

Osteoarthritis is the most common arthritis in the world. It affects millions of people with age being the greatest risk factor for developing the disease. The burden of disease will worsen with the aging of the world’s population. The disease causes pain and functional disability. The direct costs of osteoarthritis include hospital and physician visits, medications, and assistive services. The indirect costs include work absences and lost wages. Many studies have sought to find a therapy to relieve pain and reduce disability. Glucosamine hydrochloride (HCl) is one of these therapies. There are limited studies of glucosamine HCl in humans. Although some subjects do report statistically significant improvement in pain and function from products combining glucosamine HCl and other agents, glucosamine HCl by itself appears to offer little benefit to those suffering from osteoarthritis. PMID:18225460

[Changing economic environment of hospitals: management challenges of the 1990s].

PubMed

Rotstein, Z; Noy, S; Goldman, B; Shani, M

1990-12-16

The modern hospital is an organization which is influenced by the external environment in which it functions. A major relevant area is the economic environment. In recent years the western world has been facing the challenge of rising costs of health care and an increase in their proportion to the gross national product of most countries. Consequently, hospitals as major providers of health care are under pressure from governments and health insurance companies to cut costs and to "produce" more efficiently. Since hospitals worldwide are finding it hard and painful to function in the new environment in which attitudes to hospitals are changing, a potential managerial-economic crisis may be the next phase. How can the hospital adapt to these changes? First, by adopting managerial attitudes and the tools of the business sector. These include: the strategic planning process, hospital operative autonomy, creating medical-economic responsibility centers as departments, cost-accounting for medical procedures, and case-mix budgeting. Management information systems are necessary during the transition. The hospital information system should include functions at the operative level, such as outpatient visits, and admissions and discharges of patients; and also clinical, diagnostic and laboratory procedures related to the patient case-mix. The second level is a management information system which includes salaries of personnel, case-mix budgeting with variance analysis, prices of procedures and epidemiological data. The authors believe that only the managerial approach combining medical and economic disciplines can meet the challenges of the changing modern economic environment.

Advanced system functions for the office information system

NASA Astrophysics Data System (ADS)

Ishikawa, Tetsuya

First, author describes the functions needed for information management system in office. Next, he mentions the requisites for the enhancement of system functions. In order to make enhancement of system functions, he states, it is necessary to examine them comprehensively from every point of view including processing hour and cost. In this paper, he concentrates on the enhancement of man-machine interface (= human interface), that is, how to make system easy to use for the office workers.

Techno-economic assessment of novel vanadium redox flow batteries with large-area cells

NASA Astrophysics Data System (ADS)

Minke, Christine; Kunz, Ulrich; Turek, Thomas

2017-09-01

The vanadium redox flow battery (VRFB) is a promising electrochemical storage system for stationary megawatt-class applications. The currently limited cell area determined by the bipolar plate (BPP) could be enlarged significantly with a novel extruded large-area plate. For the first time a techno-economic assessment of VRFB in a power range of 1 MW-20 MW and energy capacities of up to 160 MWh is presented on the basis of the production cost model of large-area BPP. The economic model is based on the configuration of a 250 kW stack and the overall system including stacks, power electronics, electrolyte and auxiliaries. Final results include a simple function for the calculation of system costs within the above described scope. In addition, the impact of cost reduction potentials for key components (membrane, electrode, BPP, vanadium electrolyte) on stack and system costs is quantified and validated.

Solid rocket motor cost model

NASA Technical Reports Server (NTRS)

Harney, A. G.; Raphael, L.; Warren, S.; Yakura, J. K.

1972-01-01

A systematic and standardized procedure for estimating life cycle costs of solid rocket motor booster configurations. The model consists of clearly defined cost categories and appropriate cost equations in which cost is related to program and hardware parameters. Cost estimating relationships are generally based on analogous experience. In this model the experience drawn on is from estimates prepared by the study contractors. Contractors' estimates are derived by means of engineering estimates for some predetermined level of detail of the SRM hardware and program functions of the system life cycle. This method is frequently referred to as bottom-up. A parametric cost analysis is a useful technique when rapid estimates are required. This is particularly true during the planning stages of a system when hardware designs and program definition are conceptual and constantly changing as the selection process, which includes cost comparisons or trade-offs, is performed. The use of cost estimating relationships also facilitates the performance of cost sensitivity studies in which relative and comparable cost comparisons are significant.

Benefits and costs of low thrust propulsion systems

NASA Technical Reports Server (NTRS)

Robertson, R. I.; Rose, L. J.; Maloy, J. E.

1983-01-01

The results of costs/benefits analyses of three chemical propulsion systems that are candidates for transferring high density, low volume STS payloads from LEO to GEO are reported. Separate algorithms were developed for benefits and costs of primary propulsion systems (PPS) as functions of the required thrust levels. The life cycle costs of each system were computed based on the developmental, production, and deployment costs. A weighted criteria rating approach was taken for the benefits, with each benefit assigned a value commensurate to its relative worth to the overall system. Support costs were included in the costs modeling. Reference missions from NASA, commercial, and DoD catalog payloads were examined. The program was concluded reliable and flexible for evaluating benefits and costs of launch and orbit transfer for any catalog mission, with the most beneficial PPS being a dedicated low thrust configuration using the RL-10 system.

Reliability, Risk and Cost Trade-Offs for Composite Designs

NASA Technical Reports Server (NTRS)

Shiao, Michael C.; Singhal, Surendra N.; Chamis, Christos C.

1996-01-01

Risk and cost trade-offs have been simulated using a probabilistic method. The probabilistic method accounts for all naturally-occurring uncertainties including those in constituent material properties, fabrication variables, structure geometry and loading conditions. The probability density function of first buckling load for a set of uncertain variables is computed. The probabilistic sensitivity factors of uncertain variables to the first buckling load is calculated. The reliability-based cost for a composite fuselage panel is defined and minimized with respect to requisite design parameters. The optimization is achieved by solving a system of nonlinear algebraic equations whose coefficients are functions of probabilistic sensitivity factors. With optimum design parameters such as the mean and coefficient of variation (representing range of scatter) of uncertain variables, the most efficient and economical manufacturing procedure can be selected. In this paper, optimum values of the requisite design parameters for a predetermined cost due to failure occurrence are computationally determined. The results for the fuselage panel analysis show that the higher the cost due to failure occurrence, the smaller the optimum coefficient of variation of fiber modulus (design parameter) in longitudinal direction.

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

PubMed

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

2013-07-15

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

Utilizing an Energy Management System with Distributed Resources to Manage Critical Loads and Reduce Energy Costs

DTIC Science & Technology

2014-09-01

peak shaving, conducting power factor correction, matching critical load to most efficient distributed resource, and islanding a system during...photovoltaic arrays during islanding, and power factor correction, the implementation of the ESS by itself is likely to prove cost prohibitive. The DOD...These functions include peak shaving, conducting power factor correction, matching critical load to most efficient distributed resource, and islanding a

Demonstration Advanced Avionics System (DAAS). Phase 1 report

NASA Technical Reports Server (NTRS)

1981-01-01

An integrated avionics system which provides expanded functional capabilities that significantly enhance the utility and safety of general aviation at a cost commensurate with the general aviation market is discussed. Displays and control were designed so that the pilot can use the system after minimum training. Functional and hardware descriptions, operational evaluation and failure modes effects analysis are included.

Minimum noise impact aircraft trajectories

NASA Technical Reports Server (NTRS)

Jacobson, I. D.; Melton, R. G.

1981-01-01

Numerical optimization is used to compute the optimum flight paths, based upon a parametric form that implicitly includes some of the problem restrictions. The other constraints are formulated as penalties in the cost function. Various aircraft on multiple trajectores (landing and takeoff) can be considered. The modular design employed allows for the substitution of alternate models of the population distribution, aircraft noise, flight paths, and annoyance, or for the addition of other features (e.g., fuel consumption) in the cost function. A reduction in the required amount of searching over local minima was achieved through use of the presence of statistical lateral dispersion in the flight paths.

Economies of scale in federally-funded state-organized public health programs: results from the National Breast and Cervical Cancer Early Detection Programs

PubMed Central

Trogdon, Justin G.; Subramanian, Sujha; Crouse, Wesley

2018-01-01

This study investigates the existence of economies of scale in the provision of breast and cervical cancer screening and diagnostic services by state National Breast and Cervical Cancer Early Detection Program (NBCCEDP) grantees. A translog cost function is estimated as a system with input factor share equations. The estimated cost function is then used to determine output levels for which average costs are decreasing (i.e., economies of scale exist). Data were collected from all state NBCCEDP programs and District of Columbia for program years 2006–2007, 2008–2009 and 2009–2010 (N =147). Costs included all programmatic and in-kind contributions from federal and non-federal sources, allocated to breast and cervical cancer screening activities. Output was measured by women served, women screened and cancers detected, separately by breast and cervical services for each measure. Inputs included labor, rent and utilities, clinical services, and quasi-fixed factors (e.g., percent of women eligible for screening by the NBCCEDP). 144 out of 147 program-years demonstrated significant economies of scale for women served and women screened; 136 out of 145 program-years displayed significant economies of scale for cancers detected. The cost data were self-reported by the NBCCEDP State programs. Quasi-fixed inputs were allowed to affect costs but not economies of scale or the share equations. The main analysis accounted for clustering of observations within State programs, but it did not make full use of the panel data. The average cost of providing breast and cervical cancer screening services decreases as the number of women screened and served increases. PMID:24326873

Combining Water Quality and Cost-Benefit Analysis to Examine the Implications of Agricultural Best Management Practices

NASA Astrophysics Data System (ADS)

Rao, N. S.; Easton, Z. M.; Lee, D. R.; Steenhuis, T. S.

2007-12-01

Nutrient runoff from agricultural fields threatens water quality and can impair habitats in many watersheds. Agencies consider these potential risks as they determine acceptable levels of nutrient loading. For example, in the New York City (NYC) watershed, the Environmental Protection Agency's Total Maximum Daily Load (TMDL) for phosphorus (P) has been set at 15μg P L-1 to protect against eutrophication and bacterial outbreaks. In the NYC watersheds agricultural Best Management Practices (BMPs) are the primary means to control nonpoint source P loading. BMPs include riparian buffers, filter strips, manure storage facilities, crop rotation, stripcropping, tree planting and nutrient management plans (NMPs). Water quality research on BMPs to date has included studies on site-specificity of different BMPs, short and long term BMP efficacy, and placement of BMPs with respect to critical source areas. A necessary complement to studies addressing water quality aspects of different BMPs are studies examining the cost-benefit aspects of BMPs. In general, there are installment, maintenance and opportunity costs associated with each BMP, and there are benefits, including cost share agreements between farmers and farm agencies, and increased efficiency of farm production and maintenance. Combining water quality studies and related cost-benefit analyses would help planners and watershed managers determine how best improve water quality. Our research examines the costs-benefit structure associated with BMP scenarios on a one-farm headwater watershed in the Catskill Mountains of NY. The different scenarios include "with and without" BMPs, combinations of BMPs, and different BMP placements across agricultural fields. The costs associated with each BMP scenarios are determined using information from farm agencies and watershed planning agencies. With these data we perform a cost-benefit analysis for the different BMP scenarios and couple the water quality modeling using the Variable Source Loading Function (VSLF) model (Schneiderman et al., 2007) with the cost-benefit analysis to look at the specific water quality and economic consequences of different watershed management scenarios. The results of our study will be useful for planners and watershed managers in determining how best to reduce nonpoint source pollution in a cost-effective manner. References Schneiderman, E.M., T.S. Steenhuis, D.J. Thongs, Z.M. Easton, M.S. Zion, G.F. Mendoza, M.T. Walter, and A.C. Neal. 2007. Incorporating variable source area hydrology into curve number based watershed loading functions. Hydrol. Proc. (In Press).

Statistical Optimality in Multipartite Ranking and Ordinal Regression.

PubMed

Uematsu, Kazuki; Lee, Yoonkyung

2015-05-01

Statistical optimality in multipartite ranking is investigated as an extension of bipartite ranking. We consider the optimality of ranking algorithms through minimization of the theoretical risk which combines pairwise ranking errors of ordinal categories with differential ranking costs. The extension shows that for a certain class of convex loss functions including exponential loss, the optimal ranking function can be represented as a ratio of weighted conditional probability of upper categories to lower categories, where the weights are given by the misranking costs. This result also bridges traditional ranking methods such as proportional odds model in statistics with various ranking algorithms in machine learning. Further, the analysis of multipartite ranking with different costs provides a new perspective on non-smooth list-wise ranking measures such as the discounted cumulative gain and preference learning. We illustrate our findings with simulation study and real data analysis.

The Economic Cost of Communicable Disease Surveillance in Local Public Health Agencies.

PubMed

Atherly, Adam; Whittington, Melanie; VanRaemdonck, Lisa; Lampe, Sarah

2017-12-01

We identify economic costs associated with communicable disease (CD) monitoring/surveillance in Colorado local public health agencies and identify possible economies of scale. Data were collected via a survey of local public health employees engaged in CD work. Survey respondents logged time spent on CD surveillance for 2-week periods in the spring of 2014 and fall of 2014. Forty-three of the 54 local public health agencies in Colorado participated. We used a microcosting approach. We estimated a statistical cost function using cost as a function of the number of reported investigable diseases during the matched 2-week period. We also controlled for other independent variables, including case mix, characteristics of the agency, the community, and services provided. Data were collected from a microcosting survey using time logs. Costs increased at a decreasing rate as cases increased, with both cases (β = 431.5, p < .001) and cases squared (β = -3.62, p = .05) statistically significant. The results of the model suggest economies of scale. Cost per unit is estimated to be one-third lower for high-volume agencies as compared to low-volume agencies. Cost savings could potentially be achieved if smaller agencies shared services. © Health Research and Educational Trust.

Structural Tailoring of Advanced Turboprops (STAT). Theoretical manual

NASA Technical Reports Server (NTRS)

Brown, K. W.

1992-01-01

This manual describes the theories in the Structural Tailoring of Advanced Turboprops (STAT) computer program, which was developed to perform numerical optimizations on highly swept propfan blades. The optimization procedure seeks to minimize an objective function, defined as either direct operating cost or aeroelastic differences between a blade and its scaled model, by tuning internal and external geometry variables that must satisfy realistic blade design constraints. The STAT analyses include an aerodynamic efficiency evaluation, a finite element stress and vibration analysis, an acoustic analysis, a flutter analysis, and a once-per-revolution (1-p) forced response life prediction capability. The STAT constraints include blade stresses, blade resonances, flutter, tip displacements, and a 1-P forced response life fraction. The STAT variables include all blade internal and external geometry parameters needed to define a composite material blade. The STAT objective function is dependent upon a blade baseline definition which the user supplies to describe a current blade design for cost optimization or for the tailoring of an aeroelastic scale model.

Structural Tailoring of Advanced Turboprops (STAT). Theoretical manual

NASA Astrophysics Data System (ADS)

Brown, K. W.

1992-10-01

This manual describes the theories in the Structural Tailoring of Advanced Turboprops (STAT) computer program, which was developed to perform numerical optimizations on highly swept propfan blades. The optimization procedure seeks to minimize an objective function, defined as either direct operating cost or aeroelastic differences between a blade and its scaled model, by tuning internal and external geometry variables that must satisfy realistic blade design constraints. The STAT analyses include an aerodynamic efficiency evaluation, a finite element stress and vibration analysis, an acoustic analysis, a flutter analysis, and a once-per-revolution (1-p) forced response life prediction capability. The STAT constraints include blade stresses, blade resonances, flutter, tip displacements, and a 1-P forced response life fraction. The STAT variables include all blade internal and external geometry parameters needed to define a composite material blade. The STAT objective function is dependent upon a blade baseline definition which the user supplies to describe a current blade design for cost optimization or for the tailoring of an aeroelastic scale model.

38 CFR 39.6 - Preapplication requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... documentation, as needed). (4) A design concept describing the major features of the project including the... that alter the costs of the project, use of space, or functional layout; and it will not enter into a...

Software Review. Macintosh Laboratory Automation: Three Software Packages.

ERIC Educational Resources Information Center

Jezl, Barbara Ann

1990-01-01

Reviewed are "LABTECH NOTEBOOK,""LabVIEW," and "Parameter Manager pmPLUS/pmTALK." Each package is described including functions, uses, hardware, and costs. Advantages and disadvantages of this type of laboratory approach are discussed. (CW)

Cost-effectiveness of open versus laparoscopic versus robotic-assisted laparoscopic cystectomy and urinary diversion.

PubMed

Zehnder, Pascal; Gill, Inderbir S

2011-09-01

To provide insight into the recently published cost comparisons in the context of open, laparoscopic, and robotic-assisted laparoscopic radical cystectomy and to demonstrate the complexity of such economic analyses. Most economic evaluations are from a hospital perspective and summarize short-term perioperative therapeutic costs. However, the contributing factors (e.g. study design, included variables, robotic amortization plan, supply contract, surgical volume, surgeons' experience, etc.) vary substantially between the institutions. In addition, a real cost-effective analysis considering cost per quality-adjusted life-year gained is not feasible because of the lack of long-term oncologic and functional outcome data with the robotic procedure. On the basis of a modeled cost analysis using results from published series, robotic-assisted cystectomy was - with few exceptions - found to be more expensive when compared with the open approach. Immediate costs are affected most by operative time, followed by length of hospital stay, robotic supply, case volume, robotic cost, and transfusion rate. Any complication substantially impacts overall costs. Economic cost evaluations are complex analyses influenced by numerous factors that hardly allow an interinstitutional comparison. Robotic-assisted cystectomy is constantly refined with many institutions being somewhere on their learning curve. Transparent reports of oncologic and functional outcome data from centers of expertise applying standardized methods will help to properly analyze the real long-term benefits of robotic surgery and successor technologies and prevent us from becoming slaves of successful marketing strategies.

An Australian casemix classification for palliative care: technical development and results.

PubMed

Eagar, Kathy; Green, Janette; Gordon, Robert

2004-04-01

To develop a palliative care casemix classification for use in all settings including hospital, hospice and home-based care. 3866 palliative care patients who, in a three-month period, had 4596 episodes of care provided by 58 palliative care services in Australia and New Zealand. A detailed clinical and service utilization profile was collected on each patient with staff time and other resources measured on a daily basis. Each day of care was costed using actual cost data from each study site. Regression tree analysis was used to group episodes of care with similar costs and clinical characteristics. In the resulting classification, the Australian National Sub-acute and Non-acute Patient (AN-SNAP) Classification Version 1, the branch for classifying inpatient palliative care episodes (including hospice care) has 11 classes and explains 20.98% of the variance in inpatient palliative care phase costs using trimmed data. There are 22 classes in the ambulatory palliative care branch that explains 17.14% variation in ambulatory phase cost using trimmed data. The term 'subacute' is used in Australia to describe health care in which the goal--a change in functional status or improvement in quality of life--is a better predictor of the need for, and the cost of, care than the patient's underlying diagnosis. The results suggest that phase of care (stage of illness) is the best predictor of the cost of Australian palliative care. Other predictors of cost are functional status and age. In the ambulatory setting, symptom severity and the model of palliative care are also predictive of cost. These variables are used in the AN-SNAP Version 1 classification to create 33 palliative care classes. The classification has clinical meaning but the overall statistical performance is only moderate. The structure of the classification allows for it to be improved over time as models of palliative care service delivery develop.

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

PubMed Central

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

2018-01-01

Objective To evaluate the clinical and cost-effectiveness of non-medical prescribing (NMP). Design Systematic review. Two reviewers independently completed searches, eligibility assessment and assessment of risk of bias. Data sources Pre-defined search terms/combinations were utilised to search electronic databases. In addition, hand searches of reference lists, key journals and grey literature were employed alongside consultation with authors/experts. Eligibility criteria for included studies Randomised controlled trials (RCTs) evaluating clinical or cost-effectiveness of NMP. Measurements reported on one or more outcome(s) of: pain, function, disability, health, social impact, patient-safety, costs-analysis, quality adjusted life years (QALYs), patient satisfaction, clinician perception of clinical and functional outcomes. Results Three RCTs from two countries were included (n = 932 participants) across primary and tertiary care settings. One RCT was assessed as low risk of bias, one as high risk of bias and one as unclear risk of bias. All RCTs evaluated clinical effectiveness with one also evaluating cost-effectiveness. Clinical effectiveness was evaluated using a range of safety and patient-reported outcome measures. Participants demonstrated significant improvement in outcomes when receiving NMP compared to treatment as usual (TAU) in all RCTs. An associated cost analysis showed NMP to be more expensive than TAU (regression coefficient p = 0.0000), however experimental groups generated increased QALYs compared to TAU. Conclusion Limited evidence with overall unclear risk of bias exists evaluating clinical and cost-effectiveness of NMP across all professions and clinical settings. GRADE assessment revealed moderate quality evidence. Evidence suggests that NMP is safe and can provide beneficial clinical outcomes. Benefits to the health economy remain unclear, with the cost-effectiveness of NMP assessed by a single pilot RCT of low risk of bias. Adequately powered low risk of bias RCTs evaluating clinical and cost effectiveness are required to evaluate NMP across clinical specialities, professions and settings. Registration PROSPERO (CRD42015017212). PMID:29509763

Smoke Alarm Giveaway and Installation Programs

PubMed Central

Liu, Ying; Mack, Karin A.; Diekman, Shane T.

2015-01-01

Background The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. Purpose To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. Methods Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. Results Cost-effectiveness analysis (CEA) resulted in anaverage cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost–benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit–cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. Conclusions Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventionsto reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. PMID:22992356

(abstract) Science-Project Interaction in the Low-Cost Mission

NASA Technical Reports Server (NTRS)

Wall, Stephen D.

1994-01-01

Large, complex, and highly optimized missions have performed most of the preliminary reconnaisance of the solar system. As a result we have now mapped significant fractions of its total surface (or surface-equivalent) area. Now, however, scientific exploration of the solar system is undergoing a major change in scale, and existing missions find it necessary to limit costs while fulfilling existing goals. In the future, NASA's Discovery program will continue the reconnaisance, exploration, and diagnostic phases of planetary research using lower cost missions, which will include lower cost mission operations systems (MOS). Historically, one of the more expensive functions of MOS has been its interaction with the science community. Traditional MOS elements that this interaction have embraced include mission planning, science (and engineering) event conflict resolution, sequence optimization and integration, data production (e.g., assembly, enhancement, quality assurance, documentation, archive), and other science support services. In the past, the payoff from these efforts has been that use of mission resources has been highly optimized, constraining resources have been generally completely consumed, and data products have been accurate and well documented. But because these functions are expensive we are now challenged to reduce their cost while preserving the benefits. In this paper, we will consider ways of revising the traditional MOS approach that might save project resources while retaining a high degree of service to the Projects' customers. Pre-launch, science interaction can be made simplier by limiting numbers of instruments and by providing greater redundancy in mission plans. Post launch, possibilities include prioritizing data collection into a few categories, easing requirements on real-time of quick-look data delivery, and closer integration of scientists into the mission operation.

Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain.

PubMed

Jessep, Sally A; Walsh, Nicola E; Ratcliffe, Julie; Hurley, Michael V

2009-06-01

Chronic knee pain is a major cause of disability in the elderly. Management guidelines recommend exercise and self-management interventions as effective treatments. The authors previously described a rehabilitation programme integrating exercise and self-management [Enabling Self-management and Coping with Arthritic knee Pain through Exercise (ESCAPE-knee pain)] that produced short-term improvements in pain and physical function, but sustaining these improvements is difficult. Moreover, the programme is untried in clinical environments, where it would ultimately be delivered. To establish the feasibility of ESCAPE-knee pain and compare its clinical effectiveness and costs with outpatient physiotherapy. Pragmatic, randomised controlled trial. Outpatient physiotherapy department and community centre. Sixty-four people with chronic knee pain. Outpatient physiotherapy compared with ESCAPE-knee pain. The primary outcome was physical function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcomes included pain, objective functional performance, anxiety, depression, exercise-related health beliefs and healthcare utilisation. All outcomes were assessed at baseline and 12 months after completing the interventions (primary endpoint). ANCOVA investigated between-group differences. Both groups demonstrated similar improvements in clinical outcomes. Outpatient physiotherapy cost pound 130 per person and the healthcare utilisation costs of participants over 1 year were pound 583. The ESCAPE-knee pain programme cost pound 64 per person and the healthcare utilisation costs of participants over 1 year were pound 320. ESCAPE-knee pain can be delivered as a community-based integrated rehabilitation programme for people with chronic knee pain. Both ESCAPE-knee pain and outpatient physiotherapy produced sustained physical and psychosocial benefits, but ESCAPE-knee pain cost less and was more cost-effective.

Lives Saved Tool (LiST) costing: a module to examine costs and prioritize interventions.

PubMed

Bollinger, Lori A; Sanders, Rachel; Winfrey, William; Adesina, Adebiyi

2017-11-07

Achieving the Sustainable Development Goals will require careful allocation of resources in order to achieve the highest impact. The Lives Saved Tool (LiST) has been used widely to calculate the impact of maternal, neonatal and child health (MNCH) interventions for program planning and multi-country estimation in several Lancet Series commissions. As use of the LiST model increases, many have expressed a desire to cost interventions within the model, in order to support budgeting and prioritization of interventions by countries. A limited LiST costing module was introduced several years ago, but with gaps in cost types. Updates to inputs have now been added to make the module fully functional for a range of uses. This paper builds on previous work that developed an initial version of the LiST costing module to provide costs for MNCH interventions using an ingredients-based costing approach. Here, we update in 2016 the previous econometric estimates from 2013 with newly-available data and also include above-facility level costs such as program management. The updated econometric estimates inform percentages of intervention-level costs for some direct costs and indirect costs. These estimates add to existing values for direct cost requirements for items such as drugs and supplies and required provider time which were already available in LiST Costing. Results generated by the LiST costing module include costs for each intervention, as well as disaggregated costs by intervention including drug and supply costs, labor costs, other recurrent costs, capital costs, and above-service delivery costs. These results can be combined with mortality estimates to support prioritization of interventions by countries. The LiST costing module provides an option for countries to identify resource requirements for scaling up a maternal, neonatal, and child health program, and to examine the financial impact of different resource allocation strategies. It can be a useful tool for countries as they seek to identify the best investments for scarce resources. The purpose of the LiST model is to provide a tool to make resource allocation decisions in a strategic planning process through prioritizing interventions based on resulting impact on maternal and child mortality and morbidity.

U.S. Balance-of-Station Cost Drivers and Sensitivities (Presentation)

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

Maples, B.

2012-10-01

With balance-of-system (BOS) costs contributing up to 70% of the installed capital cost, it is fundamental to understanding the BOS costs for offshore wind projects as well as potential cost trends for larger offshore turbines. NREL developed a BOS model using project cost estimates developed by GL Garrad Hassan. Aspects of BOS covered include engineering and permitting, ports and staging, transportation and installation, vessels, foundations, and electrical. The data introduce new scaling relationships for each BOS component to estimate cost as a function of turbine parameters and size, project parameters and size, and soil type. Based on the new BOSmore » model, an analysis to understand the non‐turbine costs has been conducted. This analysis establishes a more robust baseline cost estimate, identifies the largest cost components of offshore wind project BOS, and explores the sensitivity of the levelized cost of energy to permutations in each BOS cost element. This presentation shows results from the model that illustrates the potential impact of turbine size and project size on the cost of energy from U.S. offshore wind plants.« less

White Book on Physical and Rehabilitation Medicine in Europe. Chapter 2. Why rehabilitation is needed by individual and society.

PubMed

2018-04-01

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper describes the background to the context of PRM services and comprises the following: - Epidemiological Aspects of Functioning and Disability - Ethical Aspects and Human Rights - Rehabilitation and Health Systems - Economic Burden of Disability - Effects of Lack of Rehabilitation Health care service planning accounts for the burden of disability among society and the chapter describes the justification for specialist rehabilitation, the background of PRM and why making a functional diagnosis and a management plan based on function is its core competence. The chapter describes the increasing burden of disability due to conditions seen in PRM practice rather than on all those diseases contributing to physical disablement and does not include mental illness, learning disabilities, etc. Ten percent of Western Europe's population have a disability and are surviving longer, resulting in higher costs for health and social care and a greater impact of co-morbidities. The chapter also describes the impact and increased costs in the absence of rehabilitation. Not only is money spent on rehabilitation recovered with five to nine-fold savings (e.g. in return to work), but rehabilitation is effective in all phases of health conditions. Specialized rehabilitation (as delivered by PRM services) is highly cost-efficient for all neurological conditions, producing substantial savings in ongoing care costs, especially in high-dependency patients. Disability discrimination has been outlawed and the text describes the legal context and status of a person living in Europe with a disability. The second part highlights the United Nations Conventions on human rights, confirmed in the World Report on Disability, but also on the principles of ethical practice among PRM physicians. The third part addresses the variability of access to and funding of rehabilitation services across countries. The chapter also distinguishes highly specialist interventions (such as those provided by a PRM physician) from specialized therapies, (such as pressure ulcer management) and generic therapies (e.g. after an uncomplicated limb fracture). It will be important for healthcare authorities, public health organizations, payers, providers, healthcare professionals, consumers and the community. The economic and social burden of disability on society is considerable and will get worse, although this is difficult to quantify. Direct costs are variable and include disabled persons' additional costs for daily living and state disability benefits. Rehabilitation has a pivotal role in reducing these costs through promoting personal recovery and increasing function through altering environmental factors. This part describes cost savings studies through rehabilitation for persons with severe disabilities.

Cost estimation model for advanced planetary programs, fourth edition

NASA Technical Reports Server (NTRS)

Spadoni, D. J.

1983-01-01

The development of the planetary program cost model is discussed. The Model was updated to incorporate cost data from the most recent US planetary flight projects and extensively revised to more accurately capture the information in the historical cost data base. This data base is comprised of the historical cost data for 13 unmanned lunar and planetary flight programs. The revision was made with a two fold objective: to increase the flexibility of the model in its ability to deal with the broad scope of scenarios under consideration for future missions, and to maintain and possibly improve upon the confidence in the model's capabilities with an expected accuracy of 20%. The Model development included a labor/cost proxy analysis, selection of the functional forms of the estimating relationships, and test statistics. An analysis of the Model is discussed and two sample applications of the cost model are presented.

Cost-effectiveness Analysis in R Using a Multi-state Modeling Survival Analysis Framework: A Tutorial.

PubMed

Williams, Claire; Lewsey, James D; Briggs, Andrew H; Mackay, Daniel F

2017-05-01

This tutorial provides a step-by-step guide to performing cost-effectiveness analysis using a multi-state modeling approach. Alongside the tutorial, we provide easy-to-use functions in the statistics package R. We argue that this multi-state modeling approach using a package such as R has advantages over approaches where models are built in a spreadsheet package. In particular, using a syntax-based approach means there is a written record of what was done and the calculations are transparent. Reproducing the analysis is straightforward as the syntax just needs to be run again. The approach can be thought of as an alternative way to build a Markov decision-analytic model, which also has the option to use a state-arrival extended approach. In the state-arrival extended multi-state model, a covariate that represents patients' history is included, allowing the Markov property to be tested. We illustrate the building of multi-state survival models, making predictions from the models and assessing fits. We then proceed to perform a cost-effectiveness analysis, including deterministic and probabilistic sensitivity analyses. Finally, we show how to create 2 common methods of visualizing the results-namely, cost-effectiveness planes and cost-effectiveness acceptability curves. The analysis is implemented entirely within R. It is based on adaptions to functions in the existing R package mstate to accommodate parametric multi-state modeling that facilitates extrapolation of survival curves.

The Effects of Quality of Care on Costs: A Conceptual Framework

PubMed Central

Nuckols, Teryl K; Escarce, José J; Asch, Steven M

2013-01-01

Context The quality of health care and the financial costs affected by receiving care represent two fundamental dimensions for judging health care performance. No existing conceptual framework appears to have described how quality influences costs. Methods We developed the Quality-Cost Framework, drawing from the work of Donabedian, the RAND/UCLA Appropriateness Method, reports by the Institute of Medicine, and other sources. Findings The Quality-Cost Framework describes how health-related quality of care (aspects of quality that influence health status) affects health care and other costs. Structure influences process, which, in turn, affects proximate and ultimate outcomes. Within structure, subdomains include general structural characteristics, circumstance-specific (e.g., disease-specific) structural characteristics, and quality-improvement systems. Process subdomains include appropriateness of care and medical errors. Proximate outcomes consist of disease progression, disease complications, and care complications. Each of the preceding subdomains influences health care costs. For example, quality improvement systems often create costs associated with monitoring and feedback. Providing appropriate care frequently requires additional physician visits and medications. Care complications may result in costly hospitalizations or procedures. Ultimate outcomes include functional status as well as length and quality of life; the economic value of these outcomes can be measured in terms of health utility or health-status-related costs. We illustrate our framework using examples related to glycemic control for type 2 diabetes mellitus or the appropriateness of care for low back pain. Conclusions The Quality-Cost Framework describes the mechanisms by which health-related quality of care affects health care and health status–related costs. Additional work will need to validate the framework by applying it to multiple clinical conditions. Applicability could be assessed by using the framework to classify the measures of quality and cost reported in published studies. Usefulness could be demonstrated by employing the framework to identify design flaws in published cost analyses, such as omitting the costs attributable to a relevant subdomain of quality. PMID:23758513

Functional form and risk adjustment of hospital costs: Bayesian analysis of a Box-Cox random coefficients model.

PubMed

Hollenbeak, Christopher S

2005-10-15

While risk-adjusted outcomes are often used to compare the performance of hospitals and physicians, the most appropriate functional form for the risk adjustment process is not always obvious for continuous outcomes such as costs. Semi-log models are used most often to correct skewness in cost data, but there has been limited research to determine whether the log transformation is sufficient or whether another transformation is more appropriate. This study explores the most appropriate functional form for risk-adjusting the cost of coronary artery bypass graft (CABG) surgery. Data included patients undergoing CABG surgery at four hospitals in the midwest and were fit to a Box-Cox model with random coefficients (BCRC) using Markov chain Monte Carlo methods. Marginal likelihoods and Bayes factors were computed to perform model comparison of alternative model specifications. Rankings of hospital performance were created from the simulation output and the rankings produced by Bayesian estimates were compared to rankings produced by standard models fit using classical methods. Results suggest that, for these data, the most appropriate functional form is not logarithmic, but corresponds to a Box-Cox transformation of -1. Furthermore, Bayes factors overwhelmingly rejected the natural log transformation. However, the hospital ranking induced by the BCRC model was not different from the ranking produced by maximum likelihood estimates of either the linear or semi-log model. Copyright (c) 2005 John Wiley & Sons, Ltd.

Langley applications experiments data management system study. [for space shuttles

NASA Technical Reports Server (NTRS)

Lanham, C. C., Jr.

1975-01-01

A data management system study is presented that defines, in functional terms, the most cost effective ground data management system to support Advanced Technology Laboratory (ATL) flights of the space shuttle. Results from each subtask performed and the recommended system configuration for reformatting the experiment instrumentation tapes to computer compatible tape are examined. Included are cost factors for development of a mini control center for real-time support of the ATL flights.

Modular avionics packaging standardization

NASA Astrophysics Data System (ADS)

Austin, M.; McNichols, J. K.

The Modular Avionics Packaging (MAP) Program for packaging future military avionics systems with the objective of improving reliability, maintainability, and supportability, and reducing equipment life cycle costs is addressed. The basic MAP packaging concepts called the Standard Avionics Module, the Standard Enclosure, and the Integrated Rack are summarized, and the benefits of modular avionics packaging, including low risk design, technology independence with common functions, improved maintainability and life cycle costs are discussed. Progress made in MAP is briefly reviewed.

A Physiological Signature of the Cost of Reproduction Associated with Parental Care.

PubMed

Fowler, Melinda A; Williams, Tony D

2017-12-01

Costs of reproduction are an integral and long-standing component of life-history theory, but we still know relatively little about the specific physiological mechanisms underlying these trade-offs. We experimentally manipulated workload during parental care in female European starlings (Sturnus vulgaris) using attachment of radios and/or wing clipping and assessed measures of workload, current breeding productivity, future fecundity, and survival (local return rate) in relation to treatment. Females with wing clipping and radio attachment paid a clear cost of reproduction compared with all other treatment groups: they had lower future fecundity and lower return rates despite having lower current breeding productivity. We then measured 13 physiological traits, including measures of aerobic/metabolic capacity, oxidative stress and muscle damage, intermediary metabolism and energy supply, and immune function. Our results show that the cost of reproduction in females with wing clipping and radio attachment was associated with lower oxygen-carrying capacity (lower hematocrit and hemoglobin levels), lower energy reserves (plasma nonesterified fatty acid and triglyceride levels), decreased immune function (lower haptoglobin levels), and elevated levels of oxidative stress (higher levels of dROMs [reactive oxygen metabolites] and lower levels of the endogenous antioxidant uric acid). Our study provides evidence that costs of reproduction involve a widespread decline in physiological function across multiple physiological systems consistent with long-standing ideas of cumulative "wear and tear" and allostatic load.

42 CFR 137.79 - What funds must the Secretary include in a funding agreement?

Code of Federal Regulations, 2010 CFR

2010-10-01

... specified under section 106(a)(1) of the Act and amounts for contract support costs specified under section... organizational level within the Department where such functions are carried out. Prohibitions ...

Neural mechanisms and personality correlates of the sunk cost effect

PubMed Central

Fujino, Junya; Fujimoto, Shinsuke; Kodaka, Fumitoshi; Camerer, Colin F.; Kawada, Ryosaku; Tsurumi, Kosuke; Tei, Shisei; Isobe, Masanori; Miyata, Jun; Sugihara, Genichi; Yamada, Makiko; Fukuyama, Hidenao; Murai, Toshiya; Takahashi, Hidehiko

2016-01-01

The sunk cost effect, an interesting and well-known maladaptive behavior, is pervasive in real life, and thus has been studied in various disciplines, including economics, psychology, organizational behavior, politics, and biology. However, the neural mechanisms underlying the sunk cost effect have not been clearly established, nor have their association with differences in individual susceptibility to the effect. Using functional magnetic resonance imaging, we investigated neural responses induced by sunk costs along with measures of core human personality. We found that individuals who tend to adhere to social rules and regulations (who are high in measured agreeableness and conscientiousness) are more susceptible to the sunk cost effect. Furthermore, this behavioral observation was strongly mediated by insula activity during sunk cost decision-making. Tight coupling between the insula and lateral prefrontal cortex was also observed during decision-making under sunk costs. Our findings reveal how individual differences can affect decision-making under sunk costs, thereby contributing to a better understanding of the psychological and neural mechanisms of the sunk cost effect. PMID:27611212

Health care and nonhealth care costs in the treatment of patients with symptomatic chronic heart failure in Spain.

PubMed

Delgado, Juan F; Oliva, Juan; Llano, Miguel; Pascual-Figal, Domingo; Grillo, José J; Comín-Colet, Josep; Díaz, Beatriz; Martínez de La Concha, León; Martí, Belén; Peña, Luz M

2014-08-01

Chronic heart failure is associated with high mortality and utilization of health care and social resources. The objective of this study was to quantify the use of health care and nonhealth care resources and identify variables that help to explain variability in their costs in Spain. This prospective, multicenter, observational study with a 12-month follow-up period included 374 patients with symptomatic heart failure recruited from specialized cardiology clinics. Information was collected on the socioeconomic characteristics of patients and caregivers, health status, health care resources, and professional and nonprofessional caregiving. The monetary cost of the resources used in caring for the health of these patients was evaluated, differentiating among functional classes. The estimated total cost for the 1-year follow-up ranged from € 12,995 to € 18,220, depending on the scenario chosen (base year, 2010). The largest cost item was informal caregiving (59.1%-69.8% of the total cost), followed by health care costs (26.7%- 37.4%), and professional care (3.5%). Of the total health care costs, the largest item corresponded to hospital costs, followed by medication. Total costs differed significantly between patients in functional class II and those in classes III or IV. Heart failure is a disease that requires the mobilization of a considerable amount of resources. The largest item corresponds to informal care. Both health care and nonhealth care costs are higher in the population with more advanced disease. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Lightweight Combat Vehicle S and T Campaign

DTIC Science & Technology

2014-10-06

research in nano-materials, self - healing /diagnosing materials, multi-functional materials, and environmentally acceptable materials. The application...research includes nano-materials, self - healing /diagnosing materials, multi-functional materials, and environmentally acceptable materials.5 The 2003...hubs must be led by a not-for-profit organization, provide 50% cost share match, and are expected to become self -sufficient in 5 years. So far, all

Smoke alarm giveaway and installation programs: an economic evaluation.

PubMed

Liu, Ying; Mack, Karin A; Diekman, Shane T

2012-10-01

The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. Cost-effectiveness analysis (CEA) resulted in an average cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost-benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit-cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventions to reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. Published by Elsevier Inc.

Performance of comorbidity, risk adjustment, and functional status measures in expenditure prediction for patients with diabetes.

PubMed

Maciejewski, Matthew L; Liu, Chuan-Fen; Fihn, Stephan D

2009-01-01

To compare the ability of generic comorbidity and risk adjustment measures, a diabetes-specific measure, and a self-reported functional status measure to explain variation in health care expenditures for individuals with diabetes. This study included a retrospective cohort of 3,092 diabetic veterans participating in a multisite trial. Two comorbidity measures, four risk adjusters, a functional status measure, a diabetes complication count, and baseline expenditures were constructed from administrative and survey data. Outpatient, inpatient, and total expenditure models were estimated using ordinary least squares regression. Adjusted R(2) statistics and predictive ratios were compared across measures to assess overall explanatory power and explanatory power of low- and high-cost subgroups. Administrative data-based risk adjusters performed better than the comorbidity, functional status, and diabetes-specific measures in all expenditure models. The diagnostic cost groups (DCGs) measure had the greatest predictive power overall and for the low- and high-cost subgroups, while the diabetes-specific measure had the lowest predictive power. A model with DCGs and the diabetes-specific measure modestly improved predictive power. Existing generic measures can be useful for diabetes-specific research and policy applications, but more predictive diabetes-specific measures are needed.

Efficient three-dimensional Poisson solvers in open rectangular conducting pipe

NASA Astrophysics Data System (ADS)

Qiang, Ji

2016-06-01

Three-dimensional (3D) Poisson solver plays an important role in the study of space-charge effects on charged particle beam dynamics in particle accelerators. In this paper, we propose three new 3D Poisson solvers for a charged particle beam in an open rectangular conducting pipe. These three solvers include a spectral integrated Green function (IGF) solver, a 3D spectral solver, and a 3D integrated Green function solver. These solvers effectively handle the longitudinal open boundary condition using a finite computational domain that contains the beam itself. This saves the computational cost of using an extra larger longitudinal domain in order to set up an appropriate finite boundary condition. Using an integrated Green function also avoids the need to resolve rapid variation of the Green function inside the beam. The numerical operational cost of the spectral IGF solver and the 3D IGF solver scales as O(N log(N)) , where N is the number of grid points. The cost of the 3D spectral solver scales as O(Nn N) , where Nn is the maximum longitudinal mode number. We compare these three solvers using several numerical examples and discuss the advantageous regime of each solver in the physical application.

What Do Cost Functions Tell Us about the Cost of an Adequate Education?

ERIC Educational Resources Information Center

Costrell, Robert M.; Hanushek, Eric; Loeb, Susanna

2008-01-01

Econometric cost functions have begun to appear in education adequacy cases with greater frequency. Cost functions are superficially attractive because they give the impression of objectivity, holding out the promise of scientifically estimating the cost of achieving specified levels of performance from actual data on spending. By contrast, the…

The business case for the reduction of surgical complications in VA hospitals.

PubMed

Vaughan-Sarrazin, Mary; Bayman, Levent; Rosenthal, Gary; Henderson, William; Hendricks, Ann; Cullen, Joseph J

2011-04-01

Surgical complications contribute substantially to costs. Most important, surgical complications contribute to morbidity and mortality, and some may be preventable. This study estimates costs of specific surgical complications for patients undergoing general surgery in VA hospitals using merged data from the VA Surgical Quality Improvement Program and VA Decision Support System. Costs associated with 19 potentially preventable complications within 6 broader categories were estimated using generalized, linear mixed regression models to control for patient-level determinants of costs (eg, type of operation, demographics, comorbidity, severity) and hospital-level variation in costs. Costs included costs of the index hospitalization and subsequent 30-day readmissions. In 14,639 patients undergoing general surgical procedures from 10/2005 through 9/2006, 20% of patients developed postoperative surgical complications. The presence of any complication significantly increased unadjusted costs nearly 3-fold ($61,083 vs $22,000), with the largest cost differential attributed to respiratory complications. Patients who developed complications had several markers for greater preoperative severity, including increased age and a lesser presurgery functional health status. After controlling for differences in patient severity, costs for patients with any complication were 1.89 times greater compared to costs for patients with no complications (P < .0001). Within major complication categories, adjusted costs were significantly greater for patients with respiratory, cardiac, central nervous system, urinary, wound, or other complications. Surgical complications contribute markedly to costs of inpatient operations. Investment in quality improvement that decreases the incidence of surgical complications could decrease costs. Copyright © 2011 Mosby, Inc. All rights reserved.

The evolutionary ecology of decorating behaviour

PubMed Central

Ruxton, Graeme D.; Stevens, Martin

2015-01-01

Many animals decorate themselves through the accumulation of environmental material on their exterior. Decoration has been studied across a range of different taxa, but there are substantial limits to current understanding. Decoration in non-humans appears to function predominantly in defence against predators and parasites, although an adaptive function is often assumed rather than comprehensively demonstrated. It seems predominantly an aquatic phenomenon—presumably because buoyancy helps reduce energetic costs associated with carrying the decorative material. In terrestrial examples, decorating is relatively common in the larval stages of insects. Insects are small and thus able to generate the power to carry a greater mass of material relative to their own body weight. In adult forms, the need to be lightweight for flight probably rules out decoration. We emphasize that both benefits and costs to decoration are rarely quantified, and that costs should include those associated with collecting as well as carrying the material. PMID:26041868

The Inactivation Principle: Mathematical Solutions Minimizing the Absolute Work and Biological Implications for the Planning of Arm Movements

PubMed Central

Berret, Bastien; Darlot, Christian; Jean, Frédéric; Pozzo, Thierry; Papaxanthis, Charalambos; Gauthier, Jean Paul

2008-01-01

An important question in the literature focusing on motor control is to determine which laws drive biological limb movements. This question has prompted numerous investigations analyzing arm movements in both humans and monkeys. Many theories assume that among all possible movements the one actually performed satisfies an optimality criterion. In the framework of optimal control theory, a first approach is to choose a cost function and test whether the proposed model fits with experimental data. A second approach (generally considered as the more difficult) is to infer the cost function from behavioral data. The cost proposed here includes a term called the absolute work of forces, reflecting the mechanical energy expenditure. Contrary to most investigations studying optimality principles of arm movements, this model has the particularity of using a cost function that is not smooth. First, a mathematical theory related to both direct and inverse optimal control approaches is presented. The first theoretical result is the Inactivation Principle, according to which minimizing a term similar to the absolute work implies simultaneous inactivation of agonistic and antagonistic muscles acting on a single joint, near the time of peak velocity. The second theoretical result is that, conversely, the presence of non-smoothness in the cost function is a necessary condition for the existence of such inactivation. Second, during an experimental study, participants were asked to perform fast vertical arm movements with one, two, and three degrees of freedom. Observed trajectories, velocity profiles, and final postures were accurately simulated by the model. In accordance, electromyographic signals showed brief simultaneous inactivation of opposing muscles during movements. Thus, assuming that human movements are optimal with respect to a certain integral cost, the minimization of an absolute-work-like cost is supported by experimental observations. Such types of optimality criteria may be applied to a large range of biological movements. PMID:18949023

The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data

PubMed Central

Cooksey, Roxanne; Husain, Muhammad J.; Brophy, Sinead; Davies, Helen; Rahman, Muhammad A.; Atkinson, Mark D.; Phillips, Ceri J.; Siebert, Stefan

2015-01-01

Background Ankylosing spondylitis (AS) is a chronic inflammatory arthritis which typically begins in early adulthood and impacts on healthcare resource utilisation and the ability to work. Previous studies examining the cost of AS have relied on patient-reported questionnaires based on recall. This study uses a combination of patient-reported and linked-routine data to examine the cost of AS in Wales, UK. Methods Participants in an existing AS cohort study (n = 570) completed questionnaires regarding work status, out-of-pocket expenses, visits to health professionals and disease severity. Participants gave consent for their data to be linked to routine primary and secondary care clinical datasets. Health resource costs were calculated using a bottom-up micro-costing approach. Human capital costs methods were used to estimate work productivity loss costs, particularly relating to work and early retirement. Regression analyses were used to account for age, gender, disease activity. Results The total cost of AS in the UK is estimated at £19016 per patient per year, calculated to include GP attendance, administration costs and hospital costs derived from routine data records, plus patient-reported non-NHS costs, out-of-pocket AS-related expenses, early retirement, absenteeism, presenteeism and unpaid assistance costs. The majority of the cost (>80%) was as a result of work-related costs. Conclusion The major cost of AS is as a result of loss of working hours, early retirement and unpaid carer’s time. Therefore, much of AS costs are hidden and not easy to quantify. Functional impairment is the main factor associated with increased cost of AS. Interventions which keep people in work to retirement age and reduce functional impairment would have the greatest impact on reducing costs of AS. The combination of patient-reported and linked routine data significantly enhanced the health economic analysis and this methodology that can be applied to other chronic conditions. PMID:26185984

The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data.

PubMed

Cooksey, Roxanne; Husain, Muhammad J; Brophy, Sinead; Davies, Helen; Rahman, Muhammad A; Atkinson, Mark D; Phillips, Ceri J; Siebert, Stefan

2015-01-01

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis which typically begins in early adulthood and impacts on healthcare resource utilisation and the ability to work. Previous studies examining the cost of AS have relied on patient-reported questionnaires based on recall. This study uses a combination of patient-reported and linked-routine data to examine the cost of AS in Wales, UK. Participants in an existing AS cohort study (n = 570) completed questionnaires regarding work status, out-of-pocket expenses, visits to health professionals and disease severity. Participants gave consent for their data to be linked to routine primary and secondary care clinical datasets. Health resource costs were calculated using a bottom-up micro-costing approach. Human capital costs methods were used to estimate work productivity loss costs, particularly relating to work and early retirement. Regression analyses were used to account for age, gender, disease activity. The total cost of AS in the UK is estimated at £19016 per patient per year, calculated to include GP attendance, administration costs and hospital costs derived from routine data records, plus patient-reported non-NHS costs, out-of-pocket AS-related expenses, early retirement, absenteeism, presenteeism and unpaid assistance costs. The majority of the cost (>80%) was as a result of work-related costs. The major cost of AS is as a result of loss of working hours, early retirement and unpaid carer's time. Therefore, much of AS costs are hidden and not easy to quantify. Functional impairment is the main factor associated with increased cost of AS. Interventions which keep people in work to retirement age and reduce functional impairment would have the greatest impact on reducing costs of AS. The combination of patient-reported and linked routine data significantly enhanced the health economic analysis and this methodology that can be applied to other chronic conditions.

Software Reviews.

ERIC Educational Resources Information Center

Wulfson, Stephen, Ed.

1990-01-01

Reviewed are six software packages for Apple and/or IBM computers. Included are "Autograph,""The New Game Show,""Science Probe-Earth Science,""Pollution Patrol,""Investigating Plant Growth," and "AIDS: The Investigation." Discussed are the grade level, function, availability, cost, and hardware requirements of each. (CW)

Finance and supply management project execution plan

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

BENNION, S.I.

As a subproject of the HANDI 2000 project, the Finance and Supply Management system is intended to serve FDH and Project Hanford major subcontractor with financial processes including general ledger, project costing, budgeting, and accounts payable, and supply management process including purchasing, inventory and contracts management. Currently these functions are performed with numerous legacy information systems and suboptimized processes.

Immune defense and host life history.

PubMed

Zuk, Marlene; Stoehr, Andrew M

2002-10-01

Recent interest has focused on immune response in an evolutionary context, with particular attention to disease resistance as a life-history trait, subject to trade-offs against other traits such as reproductive effort. Immune defense has several characteristics that complicate this approach, however; for example, because of the risk of autoimmunity, optimal immune defense is not necessarily maximum immune defense. Two important types of cost associated with immunity in the context of life history are resource costs, those related to the allocation of essential but limited resources, such as energy or nutrients, and option costs, those paid not in the currency of resources but in functional or structural components of the organism. Resource and option costs are likely to apply to different aspects of resistance. Recent investigations into possible trade-offs between reproductive effort, particularly sexual displays, and immunity have suggested interesting functional links between the two. Although all organisms balance the costs of immune defense against the requirements of reproduction, this balance works out differently for males than it does for females, creating sex differences in immune response that in turn are related to ecological factors such as the mating system. We conclude that immune response is indeed costly and that future work would do well to include invertebrates, which have sometimes been neglected in studies of the ecology of immune defense.

Cost and effectiveness of lung lobectomy by video-assisted thoracic surgery for lung cancer

PubMed Central

Mafé, Juan J.; Planelles, Beatriz; Asensio, Santos; Cerezal, Jorge; Inda, María-del-Mar; Lacueva, Javier; Esteban, Maria-Dolores; Hernández, Luis; Martín, Concepción; Baschwitz, Benno

2017-01-01

Background Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. Methods A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed. Results One hundred seventeen patients underwent lung resection by VATS (n=42, 36%; age: 63±9 years old, 57% males) or OPEN (n=75, 64%; age: 61±11 years old, 73% males). Pulmonary function tests decreased just after surgery with a parallel increasing tendency during first 12 months. VATS group tended to recover FEV1 and FVC quicker with significantly less clinical and post-surgical complications (31% vs. 53%, P=0.015). Costs including surgery and associated hospital stay, complications and costs in the 12 months after surgery were significantly lower for VATS (P<0.05). Conclusions The VATS approach surgery allowed earlier recovery at a lower cost than OPEN with a better cost-effectiveness profile. PMID:28932560

Cost characteristics of hospitals.

PubMed

Smet, Mike

2002-09-01

Modern hospitals are complex multi-product organisations. The analysis of a hospital's production and/or cost structure should therefore use the appropriate techniques. Flexible functional forms based on the neo-classical theory of the firm seem to be most suitable. Using neo-classical cost functions implicitly assumes minimisation of (variable) costs given that input prices and outputs are exogenous. Local and global properties of flexible functional forms and short-run versus long-run equilibrium are further issues that require thorough investigation. In order to put the results based on econometric estimations of cost functions in the right perspective, it is important to keep these considerations in mind when using flexible functional forms. The more recent studies seem to agree that hospitals generally do not operate in their long-run equilibrium (they tend to over-invest in capital (capacity and equipment)) and that it is therefore appropriate to estimate a short-run variable cost function. However, few studies explicitly take into account the implicit assumptions and restrictions embedded in the models they use. An alternative method to explain differences in costs uses management accounting techniques to identify the cost drivers of overhead costs. Related issues such as cost-shifting and cost-adjusting behaviour of hospitals and the influence of market structure on competition, prices and costs are also discussed shortly.

The effect of chain membership on hospital costs.

PubMed Central

Menke, T J

1997-01-01

OBJECTIVE: To compare the cost structures of hospitals in multihospital systems and independently owned hospitals. DATA SOURCES: The American Hospital Association's Annual Survey from 1990 for data on hospital costs and attributes. Area characteristics came from the Area Resource File, and the Medicare case-mix index came from the Health Care Financing Administration. Data on wages are from the Bureau of the Census' State and Metropolitan Area Data Book. The Guide to Hospital Performance from HCIA, Inc. provided data on quality of care. STUDY DESIGN: Separate cost functions were estimated for chain and independent hospitals. Hybrid translog cost functions included measures of outputs, input prices, and hospital and area characteristics. The estimation method accounted for the simultaneous determination of costs and chain membership, and for any nonrandom selection of hospitals into chains. Several economic cost measures were calculated to compare the cost structures of the two types of hospitals. DATA EXTRACTION METHODS: Data from all sources were merged at the hospital level to form the study sample. PRINCIPAL FINDINGS: Hospitals in multihospital systems were less costly than independently owned hospitals. Among independent hospitals, for-profits had the highest costs. There were no statistically significant differences in costs by ownership among chain members. Economies of scale were enjoyed in both types of hospitals only at high volumes of output, while economies of scope occurred at all volumes for chain hospitals, but only at low and medium volumes for independent hospitals. CONCLUSIONS: This study provides support for the idea that growth of the multihospital system sector can provide a market solution to the problem of constraining costs. It does not, however, support the property rights theory that proprietary hospitals are more efficient than nonprofit hospitals. PMID:9180615

The effect of chain membership on hospital costs.

PubMed

Menke, T J

1997-06-01

To compare the cost structures of hospitals in multihospital systems and independently owned hospitals. The American Hospital Association's Annual Survey from 1990 for data on hospital costs and attributes. Area characteristics came from the Area Resource File, and the Medicare case-mix index came from the Health Care Financing Administration. Data on wages are from the Bureau of the Census' State and Metropolitan Area Data Book. The Guide to Hospital Performance from HCIA, Inc. provided data on quality of care. Separate cost functions were estimated for chain and independent hospitals. Hybrid translog cost functions included measures of outputs, input prices, and hospital and area characteristics. The estimation method accounted for the simultaneous determination of costs and chain membership, and for any nonrandom selection of hospitals into chains. Several economic cost measures were calculated to compare the cost structures of the two types of hospitals. Data from all sources were merged at the hospital level to form the study sample. Hospitals in multihospital systems were less costly than independently owned hospitals. Among independent hospitals, for-profits had the highest costs. There were no statistically significant differences in costs by ownership among chain members. Economies of scale were enjoyed in both types of hospitals only at high volumes of output, while economies of scope occurred at all volumes for chain hospitals, but only at low and medium volumes for independent hospitals. This study provides support for the idea that growth of the multihospital system sector can provide a market solution to the problem of constraining costs. It does not, however, support the property rights theory that proprietary hospitals are more efficient than nonprofit hospitals.

Fuzzy/Neural Software Estimates Costs of Rocket-Engine Tests

NASA Technical Reports Server (NTRS)

Douglas, Freddie; Bourgeois, Edit Kaminsky

2005-01-01

The Highly Accurate Cost Estimating Model (HACEM) is a software system for estimating the costs of testing rocket engines and components at Stennis Space Center. HACEM is built on a foundation of adaptive-network-based fuzzy inference systems (ANFIS) a hybrid software concept that combines the adaptive capabilities of neural networks with the ease of development and additional benefits of fuzzy-logic-based systems. In ANFIS, fuzzy inference systems are trained by use of neural networks. HACEM includes selectable subsystems that utilize various numbers and types of inputs, various numbers of fuzzy membership functions, and various input-preprocessing techniques. The inputs to HACEM are parameters of specific tests or series of tests. These parameters include test type (component or engine test), number and duration of tests, and thrust level(s) (in the case of engine tests). The ANFIS in HACEM are trained by use of sets of these parameters, along with costs of past tests. Thereafter, the user feeds HACEM a simple input text file that contains the parameters of a planned test or series of tests, the user selects the desired HACEM subsystem, and the subsystem processes the parameters into an estimate of cost(s).

Scoping the parameter space for demo and the engineering test facility (ETF)

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

Meier, Wayne R.

1999-01-19

In our IFE development plan, we have set a goal of building an Engineering Test Facility (ETF) for a total cost of $2B and a Demo for $3B. In Mike Campbell' s presentation at Madison, we included a viewgraph with an example Demo that had 80 to 250 MWe of net power and showed a plausible argument that it could cost less than $3B. In this memo, I examine the design space for the Demo and then briefly for the ETF. Instead of attempting to estimate the costs of the drivers, I pose the question in a way to definemore » R&D goals: As a function of key design and performance parameters, how much can the driver cost if the total facility cost is limited to the specified goal? The design parameters examined for the Demo included target gain, driver energy, driver efficiency, and net power output. For the ETF; the design parameters are target gain, driver energy, and target yield. The resulting graphs of allowable driver cost determine the goals that the driver R&D programs must seek to meet.« less

Smart-device environmental control systems: experiences of people with cervical spinal cord injuries.

PubMed

Hooper, Bethany; Verdonck, Michele; Amsters, Delena; Myburg, Michelle; Allan, Emily

2017-09-06

Environmental control systems (ECS) are devices that enable people with severe physical limitations to independently control household appliances. Recent advancements in the area of environmental control technology have led to the development of ECS that can be controlled through mainstream smart-devices. There is limited research on ECS within Australia and no known research addressing smart-device ECS. The current study sought to explore users' experiences with smart-device ECS within Australia. The study followed a single embedded case study method. Participants (n = 5) were existing ECS users with a cervical spinal cord injury. Data were collected through semi-structured interviews with participants, reflexive journals and field notes. An inductive approach was used to analyze the data thematically. The experience of using a smart-device ECS presented both opportunities and costs to users. The opportunities included: independent control, choice, peace of mind, connection, effective resource use, and control over smart-phone functions and applications. The associated costs included: financial, time, frustration, and technical limitations. While findings are similar to previous research into traditional ECS this study indicates that smart-device ECS also offered a new opportunity for users to access mainstream smart-device functions and applications. Future research should investigate methods and resources that practitioners could utilize to better support new users of smart-device ECS. Implications for Rehabilitation As with traditional environmental control systems, users of smart environmental control systems report increased independence, choice and control. Smart-device environmental control systems provide users with access to mainstream smart-device functions and applications, which facilitate connection to family and the outside world. The costs to the user of smart-device environmental control systems include monetary and time investment, dealing with technical limitations and resulting frustration. Prescribers and installers must consider ways to mitigate these costs experienced by users.

Silicon photonic integrated circuit swept-source optical coherence tomography receiver with dual polarization, dual balanced, in-phase and quadrature detection.

PubMed

Wang, Zhao; Lee, Hsiang-Chieh; Vermeulen, Diedrik; Chen, Long; Nielsen, Torben; Park, Seo Yeon; Ghaemi, Allan; Swanson, Eric; Doerr, Chris; Fujimoto, James

2015-07-01

Optical coherence tomography (OCT) is a widely used three-dimensional (3D) optical imaging method with many biomedical and non-medical applications. Miniaturization, cost reduction, and increased functionality of OCT systems will be critical for future emerging clinical applications. We present a silicon photonic integrated circuit swept-source OCT (SS-OCT) coherent receiver with dual polarization, dual balanced, in-phase and quadrature (IQ) detection. We demonstrate multiple functional capabilities of IQ polarization resolved detection including: complex-conjugate suppressed full-range OCT, polarization diversity detection, and polarization-sensitive OCT. To our knowledge, this is the first demonstration of a silicon photonic integrated receiver for OCT. The integrated coherent receiver provides a miniaturized, low-cost solution for SS-OCT, and is also a key step towards a fully integrated high speed SS-OCT system with good performance and multi-functional capabilities. With further performance improvement and cost reduction, photonic integrated technology promises to greatly increase penetration of OCT systems in existing applications and enable new applications.

A parameter optimization approach to controller partitioning for integrated flight/propulsion control application

NASA Technical Reports Server (NTRS)

Schmidt, Phillip; Garg, Sanjay; Holowecky, Brian

1992-01-01

A parameter optimization framework is presented to solve the problem of partitioning a centralized controller into a decentralized hierarchical structure suitable for integrated flight/propulsion control implementation. The controller partitioning problem is briefly discussed and a cost function to be minimized is formulated, such that the resulting 'optimal' partitioned subsystem controllers will closely match the performance (including robustness) properties of the closed-loop system with the centralized controller while maintaining the desired controller partitioning structure. The cost function is written in terms of parameters in a state-space representation of the partitioned sub-controllers. Analytical expressions are obtained for the gradient of this cost function with respect to parameters, and an optimization algorithm is developed using modern computer-aided control design and analysis software. The capabilities of the algorithm are demonstrated by application to partitioned integrated flight/propulsion control design for a modern fighter aircraft in the short approach to landing task. The partitioning optimization is shown to lead to reduced-order subcontrollers that match the closed-loop command tracking and decoupling performance achieved by a high-order centralized controller.

A parameter optimization approach to controller partitioning for integrated flight/propulsion control application

NASA Technical Reports Server (NTRS)

Schmidt, Phillip H.; Garg, Sanjay; Holowecky, Brian R.

1993-01-01

A parameter optimization framework is presented to solve the problem of partitioning a centralized controller into a decentralized hierarchical structure suitable for integrated flight/propulsion control implementation. The controller partitioning problem is briefly discussed and a cost function to be minimized is formulated, such that the resulting 'optimal' partitioned subsystem controllers will closely match the performance (including robustness) properties of the closed-loop system with the centralized controller while maintaining the desired controller partitioning structure. The cost function is written in terms of parameters in a state-space representation of the partitioned sub-controllers. Analytical expressions are obtained for the gradient of this cost function with respect to parameters, and an optimization algorithm is developed using modern computer-aided control design and analysis software. The capabilities of the algorithm are demonstrated by application to partitioned integrated flight/propulsion control design for a modern fighter aircraft in the short approach to landing task. The partitioning optimization is shown to lead to reduced-order subcontrollers that match the closed-loop command tracking and decoupling performance achieved by a high-order centralized controller.

Silicon photonic integrated circuit swept-source optical coherence tomography receiver with dual polarization, dual balanced, in-phase and quadrature detection

PubMed Central

Wang, Zhao; Lee, Hsiang-Chieh; Vermeulen, Diedrik; Chen, Long; Nielsen, Torben; Park, Seo Yeon; Ghaemi, Allan; Swanson, Eric; Doerr, Chris; Fujimoto, James

2015-01-01

Optical coherence tomography (OCT) is a widely used three-dimensional (3D) optical imaging method with many biomedical and non-medical applications. Miniaturization, cost reduction, and increased functionality of OCT systems will be critical for future emerging clinical applications. We present a silicon photonic integrated circuit swept-source OCT (SS-OCT) coherent receiver with dual polarization, dual balanced, in-phase and quadrature (IQ) detection. We demonstrate multiple functional capabilities of IQ polarization resolved detection including: complex-conjugate suppressed full-range OCT, polarization diversity detection, and polarization-sensitive OCT. To our knowledge, this is the first demonstration of a silicon photonic integrated receiver for OCT. The integrated coherent receiver provides a miniaturized, low-cost solution for SS-OCT, and is also a key step towards a fully integrated high speed SS-OCT system with good performance and multi-functional capabilities. With further performance improvement and cost reduction, photonic integrated technology promises to greatly increase penetration of OCT systems in existing applications and enable new applications. PMID:26203382

Consensus for nonmelanoma skin cancer treatment: basal cell carcinoma, including a cost analysis of treatment methods.

PubMed

Kauvar, Arielle N B; Cronin, Terrence; Roenigk, Randall; Hruza, George; Bennett, Richard

2015-05-01

Basal cell carcinoma (BCC) is the most common cancer in the US population affecting approximately 2.8 million people per year. Basal cell carcinomas are usually slow-growing and rarely metastasize, but they do cause localized tissue destruction, compromised function, and cosmetic disfigurement. To provide clinicians with guidelines for the management of BCC based on evidence from a comprehensive literature review, and consensus among the authors. An extensive review of the medical literature was conducted to evaluate the optimal treatment methods for cutaneous BCC, taking into consideration cure rates, recurrence rates, aesthetic and functional outcomes, and cost-effectiveness of the procedures. Surgical approaches provide the best outcomes for BCCs. Mohs micrographic surgery provides the highest cure rates while maximizing tissue preservation, maintenance of function, and cosmesis. Mohs micrographic surgery is an efficient and cost-effective procedure and remains the treatment of choice for high-risk BCCs and for those in cosmetically sensitive locations. Nonsurgical modalities may be used for low-risk BCCs when surgery is contraindicated or impractical, but the cure rates are lower.

Orbit Clustering Based on Transfer Cost

NASA Technical Reports Server (NTRS)

Gustafson, Eric D.; Arrieta-Camacho, Juan J.; Petropoulos, Anastassios E.

2013-01-01

We propose using cluster analysis to perform quick screening for combinatorial global optimization problems. The key missing component currently preventing cluster analysis from use in this context is the lack of a useable metric function that defines the cost to transfer between two orbits. We study several proposed metrics and clustering algorithms, including k-means and the expectation maximization algorithm. We also show that proven heuristic methods such as the Q-law can be modified to work with cluster analysis.

Life cycle costing of food waste: A review of methodological approaches.

PubMed

De Menna, Fabio; Dietershagen, Jana; Loubiere, Marion; Vittuari, Matteo

2018-03-01

Food waste (FW) is a global problem that is receiving increasing attention due to its environmental and economic impacts. Appropriate FW prevention, valorization, and management routes could mitigate or avoid these effects. Life cycle thinking and approaches, such as life cycle costing (LCC), may represent suitable tools to assess the sustainability of these routes. This study analyzes different LCC methodological aspects and approaches to evaluate FW management and valorization routes. A systematic literature review was carried out with a focus on different LCC approaches, their application to food, FW, and waste systems, as well as on specific methodological aspects. The review consisted of three phases: a collection phase, an iterative phase with experts' consultation, and a final literature classification. Journal papers and reports were retrieved from selected databases and search engines. The standardization of LCC methodologies is still in its infancy due to a lack of consensus over definitions and approaches. Research on the life cycle cost of FW is limited and generally focused on FW management, rather than prevention or valorization of specific flows. FW prevention, valorization, and management require a consistent integration of LCC and Life Cycle Assessment (LCA) to avoid tradeoffs between environmental and economic impacts. This entails a proper investigation of methodological differences between attributional and consequential modelling in LCC, especially with regard to functional unit, system boundaries, multi-functionality, included cost, and assessed impacts. Further efforts could also aim at finding the most effective and transparent categorization of costs, in particular when dealing with multiple stakeholders sustaining costs of FW. Interpretation of results from LCC of FW should take into account the effect on larger economic systems. Additional key performance indicators and analytical tools could be included in consequential approaches. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Prevalence, recovery patterns and predictors of quality of life and costs after non-fatal injury: the Brabant Injury Outcome Surveillance (BIOS) study.

PubMed

de Jongh, M A C; Kruithof, N; Gosens, T; van de Ree, C L P; de Munter, L; Brouwers, L; Polinder, S; Lansink, K W W

2017-02-01

Trauma is a major public health problem worldwide that leads to high medical and societal costs. Overall, improved understanding of the full spectrum of the societal impact and burden of injury is needed. The main purpose of the Brabant Injury Outcome Surveillance (BIOS) study is to provide insight into prevalence, predictors and recovery patterns of short-term and long-term health-related quality of life (HRQoL) and costs after injury. This is a prospective, observational, follow-up cohort study in which HRQoL, psychological, social and functional outcome, and costs after trauma will be assessed during 24 months follow-up within injured patients admitted in 1 of 10 hospitals in the county Noord-Brabant, the Netherlands. Data will be collected by self-reported questionnaires at 1 week (including preinjury assessment), and 1, 3, 6, 12 and 24 months after injury. If patients are not capable of filling out the questionnaires, proxies will be asked to participate. Also, information about mechanism and severity of injury, comorbidity and indirect and direct costs will be collected. Mixed models will be used to examine the course of HRQoL, functional and psychological outcome, costs over time and between different groups, and to identify predictors for poor or good outcome. This study should make a substantial contribution to the international collaborative effort to assess the societal impact and burden of injuries more accurately. The BIOS results will also be used to develop an outcome prediction model for outcome evaluation including, besides the classic fatal, non-fatal outcome. NCT02508675. 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/.

Simulation of value stream mapping and discrete optimization of energy consumption in modular construction

NASA Astrophysics Data System (ADS)

Chowdhury, Md Mukul

With the increased practice of modularization and prefabrication, the construction industry gained the benefits of quality management, improved completion time, reduced site disruption and vehicular traffic, and improved overall safety and security. Whereas industrialized construction methods, such as modular and manufactured buildings, have evolved over decades, core techniques used in prefabrication plants vary only slightly from those employed in traditional site-built construction. With a focus on energy and cost efficient modular construction, this research presents the development of a simulation, measurement and optimization system for energy consumption in the manufacturing process of modular construction. The system is based on Lean Six Sigma principles and loosely coupled system operation to identify the non-value adding tasks and possible causes of low energy efficiency. The proposed system will also include visualization functions for demonstration of energy consumption in modular construction. The benefits of implementing this system include a reduction in the energy consumption in production cost, decrease of energy cost in the production of lean-modular construction, and increase profit. In addition, the visualization functions will provide detailed information about energy efficiency and operation flexibility in modular construction. A case study is presented to validate the reliability of the system.

The Vibrational Frequencies of CaO2, ScO2, and TiO2: A Comparison of Theoretical Methods

NASA Technical Reports Server (NTRS)

Rosi, Marzio; Bauschlicher, Charles W., Jr.; Chertihin, George V.; Andrews, Lester; Arnold, James O. (Technical Monitor)

1997-01-01

The vibrational frequencies of several states of CaO2, ScO2, and TiO2 are computed at using density functional theory (DFT), the Hatree-Fock approach, second order Moller-Plesset perturbation theory (MP2), and the complete-active-space self-consistent-field theory. Three different functionals are used in the DFT calculations, including two hybrid functionals. The coupled cluster singles and doubles approach including the effect of unlinked triples, determined using perturbation theory, is applied to selected states. The Becke-Perdew 86 functional appears to be the cost effective method of choice, although even this functional does not perform well for one state of CaO2. The MP2 approach is significantly inferior to the DFT approaches.

Managerial innovation in the hospital: an analysis of the diffusion of hospital cost-accounting systems.

PubMed

Counte, M A; Glandon, G L

1988-01-01

Currently much interest is focused on the uses of cost-accounting systems within the hospital industry. Proponents frequently contend that such systems will help hospitals successfully adapt to new methods of financial reimbursement because they are essential to a number of major management functions, including competitive bidding, cost management, pricing, and profitability assessment. This article reports the results of a study conducted to examine the extent to which hospitals in a major market are actually beginning to use standard cost-accounting systems and identify factors that either aid or hinder the diffusion of these methods. Chief financial officers from 94 hospitals (83 percent response rate) participated in the study during the summer of 1986 where less than half of the hospitals (43 percent) had recently purchased a cost-accounting system. Detailed information about the interface of cost-accounting systems with other application systems and their specific management uses is reported.

Cost of ownership for inspection equipment

NASA Astrophysics Data System (ADS)

Dance, Daren L.; Bryson, Phil

1993-08-01

Cost of Ownership (CoO) models are increasingly a part of the semiconductor equipment evaluation and selection process. These models enable semiconductor manufacturers and equipment suppliers to quantify a system in terms of dollars per wafer. Because of the complex nature of the semiconductor manufacturing process, there are several key attributes that must be considered in order to accurately reflect the true 'cost of ownership'. While most CoO work to date has been applied to production equipment, the need to understand cost of ownership for inspection and metrology equipment presents unique challenges. Critical parameters such as detection sensitivity as a function of size and type of defect are not included in current CoO models yet are, without question, major factors in the technical evaluation process and life-cycle cost. This paper illustrates the relationship between these parameters, as components of the alpha and beta risk, and cost of ownership.

Uso de recursos y costos de hospitalizaciones por insufi ciencia card í aca: un estudio retrospective multic é ntrico en Argentina.

PubMed

Augustovski, Federico; Caporale, Joaquín; Fosco, Matías; Alcaraz, Andrea; Diez, Mirta; Thierer, Jorge; Peradejordi, Margarita; Pichon Riviere, Andrés

2017-12-01

Heart failure has a great impact on health budget, mainly due to the cost of hospitalizations. Our aim was to describe health resource use and costs of heart failure admissions in three important institutions in Argentina. Multi-center retrospective cohort study, with descriptive and analytical analysis by subgroups of ejection fraction, blood pressure and renal function at admission. Generalized linear models were used to assess the association of independent variables to main outcomes. We included 301 subjects; age 75.3±11.8 years; 37% women; 57% with depressed ejection fraction; 46% of coronary etiology. Blood pressure at admission was 129.8±29.7 mmHg; renal function 57.9±26.2 ml/min/1.73 m 2 . Overall mortality was 7%. Average length of stay was 7.82±7.06 days (median 5.69), and was significantly longer in patients with renal impairment (8.9 vs. 8.18; p=0.03) and shorter in those with high initial blood pressure (6.08±4.03; p=0.009). Mean cost per patient was AR$68,861±96,066 (US$=8,071; 1US$=AR$8.532); 71% attributable to hospital stay, 20% to interventional procedures and 6.7% to diagnostic studies. Variables independently associated with higher costs were depressed ejection fraction, presence of valvular disease, and impaired renal function. Resource use and costs associated to hospitalizations for heart failure is high, and the highest proportion is attributable to the costs related to hospital stay. Copyright © 2017. Published by Elsevier Inc.

Medicare capitation model, functional status, and multiple comorbidities: model accuracy

PubMed Central

Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena

2012-01-01

Objective This study examined financial implications of CMS-Hierarchical Condition Categories (HCC) risk-adjustment model on Medicare payments for individuals with comorbid chronic conditions. Study Design The study used 1992-2000 data from the Medicare Current Beneficiary Survey and corresponding Medicare claims. The pairs of comorbidities were formed based on the prior evidence about possible synergy between these conditions and activities of daily living (ADL) deficiencies and included heart disease and cancer, lung disease and cancer, stroke and hypertension, stroke and arthritis, congestive heart failure (CHF) and osteoporosis, diabetes and coronary artery disease, CHF and dementia. Methods For each beneficiary, we calculated the actual Medicare cost ratio as the ratio of the individual’s annualized costs to the mean annual Medicare cost of all people in the study. The actual Medicare cost ratios, by ADLs, were compared to the HCC ratios under the CMS-HCC payment model. Using multivariate regression models, we tested whether having the identified pairs of comorbidities affects the accuracy of CMS-HCC model predictions. Results The CMS-HCC model underpredicted Medicare capitation payments for patients with hypertension, lung disease, congestive heart failure and dementia. The difference between the actual costs and predicted payments was partially explained by beneficiary functional status and less than optimal adjustment for these chronic conditions. Conclusions Information about beneficiary functional status should be incorporated in reimbursement models since underpaying providers for caring for population with multiple comorbidities may provide severe disincentives for managed care plans to enroll such individuals and to appropriately manage their complex and costly conditions. PMID:18837646

Asbestos Utilization Costs on the Example of Functioning Landfill of Hazardous Waste

NASA Astrophysics Data System (ADS)

Polek, Daria

2017-12-01

Asbestos is a trademark of mineral fibres, which are the natural minerals found in nature. Products containing asbestos fibres, in accordance with the national and EU legislation, are covered by the production prohibition and forced to be removed. In Poland, the asbestos removal process started with the adaptation of the EU law by the Council of Ministers Treatment Program of the National Asbestos for the years 2009-2032. The purpose of the dissertation was to analyse the costs associated with the disposal of the costs of collection, transport and disposal of waste. Methodology consisted in obtaining information on the raw materials needed to produce asbestos sheets. The analysis allowed us to determine the asbestos removal cost and include state subsidies in the calculations.

Satellite services system analysis study. Volume 2, part 2: Study results

NASA Technical Reports Server (NTRS)

1981-01-01

The development of an effective satellite services system was investigated. Satek Satellite user market, design reference missions, satellite service functions, service equipment, and cost estimates are discussed. Extensive program plans for a satellite service system implementation are included.

75 FR 12540 - Notice of Public Information Collection Being Submitted to the Office of Management and Budget...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-16

..., including the use of automated collection techniques or other forms of information technology and (e) ways... on an identical security function without the additional costs of physical separation inherent in the...

Position Paper: Dental General Practice Residency Programs: Financing and Operations.

ERIC Educational Resources Information Center

Hanson, Paul W.

1983-01-01

A discussion of changeable economic issues that can affect dental general practice residency program planning includes costs and resource allocation, maximizing efficiency and productivity, ambulatory and inpatient revenue sources, management functions, faculty as practitioners, faculty appointments, and marketing. (MSE)

Information Systems: Fact or Fiction.

ERIC Educational Resources Information Center

Bearley, William

Rising costs of programming and program maintenance have caused discussion concerning the need for generalized information systems. These would provide data base functions plus complete report writing and file maintenance capabilities. All administrative applications, including online registration, student records, and financial applications are…

7 CFR 1709.117 - Application requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... and the eligible extremely high energy cost communities to be served. (6) Project management. The... perform project management functions. If the applicant proposes to use the equipment or design.... Each application must include a narrative proposal describing the proposed project and addressing...

7 CFR 1709.117 - Application requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... and the eligible extremely high energy cost communities to be served. (6) Project management. The... perform project management functions. If the applicant proposes to use the equipment or design.... Each application must include a narrative proposal describing the proposed project and addressing...

The costs of dementia from the societal perspective: is care provided in the community really cheaper than nursing home care?

PubMed

König, Hans-Helmut; Leicht, Hanna; Brettschneider, Christian; Bachmann, Cadja; Bickel, Horst; Fuchs, Angela; Jessen, Frank; Köhler, Mirjam; Luppa, Melanie; Mösch, Edelgard; Pentzek, Michael; Werle, Jochen; Weyerer, Siegfried; Wiese, Birgitt; Scherer, Martin; Maier, Wolfgang; Riedel-Heller, Steffi G

2014-02-01

To compare the costs of care for community-dwelling dementia patients with the costs of care for dementia patients living in nursing homes from the societal perspective. Cross-sectional bottom-up cost of illness study nested within the multicenter German AgeCoDe-cohort. Community and nursing homes. One hundred twenty-eight community-dwelling dementia patients and 48 dementia patients living in nursing homes. None. Utilization and costs of medical care and long term care, including formal and informal social and nursing care based on proxy interviews. Informal care was valued using the replacement cost method. Unadjusted mean annual total costs including informal care were €29,930 ($43,997) for community-dwelling patients and €33,482 ($49,218) for patients living in nursing homes. However, multiple regression analysis controlling for age, sex, deficits in basic and instrumental activities of daily living and comorbidity showed that living in the community significantly increased total costs by €11,344 ($16,676; P < .01) compared with living in a nursing home, mainly due to higher costs of informal care (+€20,585; +$30,260; P < .001). From the societal perspective care for dementia patients living in the community tends to cost more than care in nursing homes when functional impairment is controlled for. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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

Granderson, G.D.

The purpose of the dissertation is to examine the impact of rate-of-return regulation on the cost of transporting natural gas in interstate commerce. Of particular interest is the effect of the regulation on the input choice of a firm. Does regulation induce a regulated firm to produce its selected level of output at greater than minimum cost The theoretical model is based on the work of Rolf Faere and James Logan who investigate the duality relationship between the cost and production functions of a rate-of-return regulated firm. Faere and Logan derive the cost function for a regulated firm as themore » minimum cost of producing the firm's selected level of output, subject to the regulatory constraint. The regulated cost function is used to recover the unregulated cost function. A firm's unregulated cost function is the minimum cost of producing its selected level of output. Characteristics of the production technology are obtained from duality between the production and unregulated cost functions. Using data on 20 pipeline companies from 1977 to 1987, the author estimates a random effects model that consists of a regulated cost function and its associated input share equations. The model is estimated as a set of seemingly unrelated regressions. The empirical results are used to test the Faere and Logan theory and the traditional Averch-Johnson hypothesis of overcapitalization. Parameter estimates are used to recover the unregulated cost function and to calculate the amount by which transportation costs are increased by the regulation of the industry. Empirical results show that a firm's transportation cost decreases as the allowed rate of return increases and the regulatory constraint becomes less tight. Elimination of the regulatory constraint would lead to a reduction in costs on average of 5.278%. There is evidence that firms overcapitalize on pipeline capital. There is inconclusive evidence on whether firms overcapitalized on compressor station capital.« less

A class of solution-invariant transformations of cost functions for minimum cost flow phase unwrapping.

PubMed

Hubig, Michael; Suchandt, Steffen; Adam, Nico

2004-10-01

Phase unwrapping (PU) represents an important step in synthetic aperture radar interferometry (InSAR) and other interferometric applications. Among the different PU methods, the so called branch-cut approaches play an important role. In 1996 M. Costantini [Proceedings of the Fringe '96 Workshop ERS SAR Interferometry (European Space Agency, Munich, 1996), pp. 261-272] proposed to transform the problem of correctly placing branch cuts into a minimum cost flow (MCF) problem. The crucial point of this new approach is to generate cost functions that represent the a priori knowledge necessary for PU. Since cost functions are derived from measured data, they are random variables. This leads to the question of MCF solution stability: How much can the cost functions be varied without changing the cheapest flow that represents the correct branch cuts? This question is partially answered: The existence of a whole linear subspace in the space of cost functions is shown; this subspace contains all cost differences by which a cost function can be changed without changing the cost difference between any two flows that are discharging any residue configuration. These cost differences are called strictly stable cost differences. For quadrangular nonclosed networks (the most important type of MCF networks for interferometric purposes) a complete classification of strictly stable cost differences is presented. Further, the role of the well-known class of node potentials in the framework of strictly stable cost differences is investigated, and information on the vector-space structure representing the MCF environment is provided.

Value of botulinum toxin injections preceding a comprehensive rehabilitation period for children with spastic cerebral palsy: A cost-effectiveness study.

PubMed

Schasfoort, Fabienne; Dallmeijer, Annet; Pangalila, Robert; Catsman, Coriene; Stam, Henk; Becher, Jules; Steyerberg, Ewout; Polinder, Suzanne; Bussmann, Johannes

2018-01-10

Despite the widespread use of botulinum toxin in ambulatory children with spastic cerebral palsy, its value prior to intensive physiotherapy with adjunctive casting/orthoses remains unclear. A pragmatically designed, multi-centre trial, comparing the effectiveness of botulinum toxin + intensive physiotherapy with intensive physiotherapy alone, including economic evaluation. Children with spastic cerebral palsy, age range 4-12 years, cerebral palsy-severity Gross Motor Function Classification System levels I-III, received either botulinum toxin type A + intensive physiotherapy or intensive physiotherapy alone and, if necessary, ankle-foot orthoses and/or casting. Primary outcomes were gross motor func-tion, physical activity levels, and health-related quality-of-life, assessed at baseline, 12 (primary end-point) and 24 weeks (follow-up). Economic outcomes included healthcare and patient costs. Intention-to-treat analyses were performed with linear mixed models. There were 65 participants (37 males), with a mean age of 7.3 years (standard deviation 2.3 years), equally distributed across Gross Motor Function Classification System levels. Forty-one children received botulinum toxin type A plus intensive physio-therapy and 24 received intensive physiotherapy treatment only. At primary end-point, one statistically significant difference was found in favour of intensive physiotherapy alone: objectively measured percentage of sedentary behaviour (-3.42, 95% confidence interval 0.20-6.64, p=0.038). Treatment costs were significantly higher for botulinum toxin type A plus intensive physiotherapy (8,963 vs 6,182 euro, p=0.001). No statistically significant differences were found between groups at follow-up. The addition of botulinum toxin type A to intensive physiotherapy did not improve the effectiveness of rehabilitation for ambulatory children with spastic cerebral palsy and was also not cost-effective. Thus botulinum toxin is not recommended for use in improving gross motor function, activity levels or health-related quality-of-life in this cerebral palsy age- and severity-subgroup.

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SYSTEM COST METHODOLOGY FOR SALES FROM UTILITIES TO BONNEVILLE POWER ADMINISTRATION UNDER NORTHWEST POWER... functionalization under its Direct Analysis assigns costs, revenues, debits or credits based upon the actual and/or...) Functionalization methods. (1) Direct analysis, if allowed or required by Table 1, assigns costs, revenues, debits...

Survey of Costs Arising From Potential Radionuclide Scattering Events

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

Luna, R.E.; Pe, Ph.D.; Yoshimura, H.R.

The potential effects from scattering radioactive materials in public places include health, social, and economic consequences. These are substantial consequences relative to potential terror activities that include use of radioactive material dispersal devices (RDDs). Such an event with radionuclides released and deposited on surfaces outside and inside people's residences and places of work, commerce, and recreation will require decisions on how to recover from the event. One aspect of those decisions will be the cost to clean up the residual radioactive contamination to make the area functional again versus abandonment and/or razing and rebuilding. Development of cleanup processes have beenmore » the subject of experiment from the beginning of the nuclear age, but formalized cost breakdowns are relatively rare and mostly applicable to long term releases in non-public sites. Pre-event cleanup cost estimation of cost for cleanup of radioactive materials released to the public environment is an issue that has seen sporadic activity over the last 20 to 30 years. This paper will briefly review several of the more important efforts to estimate the costs of remediation or razing and reconstruction of radioactively contaminated areas. The cost estimates for such recoveries will be compared in terms of 2005 dollars for the sake of consistency. Dependence of cost estimates on population density and needed degree of decontamination will be shown to be quite strong in the overall presentation of the data. (authors)« less

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

Investigation of test methods, material properties, and processes for solar cell encapsulants. Encapsulation task of the low-cost silicon solar array project

NASA Technical Reports Server (NTRS)

1977-01-01

During this quarter, flat-plate solar collector systems were considered and six basic construction elements were identified: outer coatings, superstrates, pottants, substrates, undercoats, and adhesives. Materials surveys were then initiated to discover either generic classes or/and specific products to function as each construction element. Cost data included in the surveys permit ready evaluation of each material. Silicones, fluorocarbons, glass, and acrylic polymers have the highest inherent weatherability of materials studied to date. Only acrylics, however, combine low costs, environmental resistance, and potential processability. This class will receive particular emphasis.

Costing the supply chain for delivery of ACT and RDTs in the public sector in Benin and Kenya.

PubMed

Shretta, Rima; Johnson, Brittany; Smith, Lisa; Doumbia, Seydou; de Savigny, Don; Anupindi, Ravi; Yadav, Prashant

2015-02-05

Studies have shown that supply chain costs are a significant proportion of total programme costs. Nevertheless, the costs of delivering specific products are poorly understood and ballpark estimates are often used to inadequately plan for the budgetary implications of supply chain expenses. The purpose of this research was to estimate the country level costs of the public sector supply chain for artemisinin-based combination therapy (ACT) and rapid diagnostic tests (RDTs) from the central to the peripheral levels in Benin and Kenya. A micro-costing approach was used and primary data on the various cost components of the supply chain was collected at the central, intermediate, and facility levels between September and November 2013. Information sources included central warehouse databases, health facility records, transport schedules, and expenditure reports. Data from document reviews and semi-structured interviews were used to identify cost inputs and estimate actual costs. Sampling was purposive to isolate key variables of interest. Survey guides were developed and administered electronically. Data were extracted into Microsoft Excel, and the supply chain cost per unit of ACT and RDT distributed by function and level of system was calculated. In Benin, supply chain costs added USD 0.2011 to the initial acquisition cost of ACT and USD 0.3375 to RDTs (normalized to USD 1). In Kenya, they added USD 0.2443 to the acquisition cost of ACT and USD 0.1895 to RDTs (normalized to USD 1). Total supply chain costs accounted for more than 30% of the initial acquisition cost of the products in some cases and these costs were highly sensitive to product volumes. The major cost drivers were found to be labour, transport, and utilities with health facilities carrying the majority of the cost per unit of product. Accurate cost estimates are needed to ensure adequate resources are available for supply chain activities. Product volumes should be considered when costing supply chain functions rather than dollar value. Further work is needed to develop extrapolative costing models that can be applied at country level without extensive micro-costing exercises. This will allow other countries to generate more accurate estimates in the future.

Adaptive pattern recognition by mini-max neural networks as a part of an intelligent processor

NASA Technical Reports Server (NTRS)

Szu, Harold H.

1990-01-01

In this decade and progressing into 21st Century, NASA will have missions including Space Station and the Earth related Planet Sciences. To support these missions, a high degree of sophistication in machine automation and an increasing amount of data processing throughput rate are necessary. Meeting these challenges requires intelligent machines, designed to support the necessary automations in a remote space and hazardous environment. There are two approaches to designing these intelligent machines. One of these is the knowledge-based expert system approach, namely AI. The other is a non-rule approach based on parallel and distributed computing for adaptive fault-tolerances, namely Neural or Natural Intelligence (NI). The union of AI and NI is the solution to the problem stated above. The NI segment of this unit extracts features automatically by applying Cauchy simulated annealing to a mini-max cost energy function. The feature discovered by NI can then be passed to the AI system for future processing, and vice versa. This passing increases reliability, for AI can follow the NI formulated algorithm exactly, and can provide the context knowledge base as the constraints of neurocomputing. The mini-max cost function that solves the unknown feature can furthermore give us a top-down architectural design of neural networks by means of Taylor series expansion of the cost function. A typical mini-max cost function consists of the sample variance of each class in the numerator, and separation of the center of each class in the denominator. Thus, when the total cost energy is minimized, the conflicting goals of intraclass clustering and interclass segregation are achieved simultaneously.

Utility of functioning in predicting costs of care for patients with mood and anxiety disorders: a prospective cohort study

PubMed Central

Cieza, Alarcos; Baldwin, David S.

2017-01-01

Development of payment systems for mental health services has been hindered by limited evidence for the utility of diagnosis or symptoms in predicting costs of care. We investigated the utility of functioning information in predicting costs for patients with mood and anxiety disorders. This was a prospective cohort study involving 102 adult patients attending a tertiary referral specialist clinic for mood and anxiety disorders. The main outcome was total costs, calculated by applying unit costs to healthcare use data. After adjusting for covariates, a significant total costs association was yielded for functioning (eβ=1.02; 95% confidence interval: 1.01–1.03), but not depressive symptom severity or anxiety symptom severity. When we accounted for the correlations between the main independent variables by constructing an abridged functioning metric, a significant total costs association was again yielded for functioning (eβ=1.04; 95% confidence interval: 1.01–1.09), but not symptom severity. The utility of functioning in predicting costs for patients with mood and anxiety disorders was supported. Functioning information could be useful within mental health payment systems. PMID:28383309

18 CFR 11.12 - Determination of section 10(f) costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... costs of the project. (2) If power is not an authorized function of the headwater project, the section... costs designated as the joint-use power cost, derived by deeming a power function at the project. The value of the benefits assigned to the deemed power function, for purposes of determining the value of...

18 CFR 11.12 - Determination of section 10(f) costs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... costs of the project. (2) If power is not an authorized function of the headwater project, the section... costs designated as the joint-use power cost, derived by deeming a power function at the project. The value of the benefits assigned to the deemed power function, for purposes of determining the value of...

18 CFR 11.12 - Determination of section 10(f) costs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... costs of the project. (2) If power is not an authorized function of the headwater project, the section... costs designated as the joint-use power cost, derived by deeming a power function at the project. The value of the benefits assigned to the deemed power function, for purposes of determining the value of...

18 CFR 11.12 - Determination of section 10(f) costs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... costs of the project. (2) If power is not an authorized function of the headwater project, the section... costs designated as the joint-use power cost, derived by deeming a power function at the project. The value of the benefits assigned to the deemed power function, for purposes of determining the value of...

18 CFR 11.12 - Determination of section 10(f) costs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... costs of the project. (2) If power is not an authorized function of the headwater project, the section... costs designated as the joint-use power cost, derived by deeming a power function at the project. The value of the benefits assigned to the deemed power function, for purposes of determining the value of...

Development of Activity-based Cost Functions for Cellulase, Invertase, and Other Enzymes

NASA Astrophysics Data System (ADS)

Stowers, Chris C.; Ferguson, Elizabeth M.; Tanner, Robert D.

As enzyme chemistry plays an increasingly important role in the chemical industry, cost analysis of these enzymes becomes a necessity. In this paper, we examine the aspects that affect the cost of enzymes based upon enzyme activity. The basis for this study stems from a previously developed objective function that quantifies the tradeoffs in enzyme purification via the foam fractionation process (Cherry et al., Braz J Chem Eng 17:233-238, 2000). A generalized cost function is developed from our results that could be used to aid in both industrial and lab scale chemical processing. The generalized cost function shows several nonobvious results that could lead to significant savings. Additionally, the parameters involved in the operation and scaling up of enzyme processing could be optimized to minimize costs. We show that there are typically three regimes in the enzyme cost analysis function: the low activity prelinear region, the moderate activity linear region, and high activity power-law region. The overall form of the cost analysis function appears to robustly fit the power law form.

Asteroid Crewed Segment Mission Lean Development

NASA Technical Reports Server (NTRS)

Gard, Joe; McDonald, Mark; Jermstad, Wayne

2014-01-01

The next generation of human spaceflight missions presents numerous challenges to designers that must be addressed to produce a feasible concept. The specific challenges of designing an exploration mission utilizing the Space Launch System and the Orion spacecraft to carry astronauts beyond earth orbit to explore an asteroid stored in a distant retrograde orbit around the moon will be addressed. Mission designers must carefully balance competing constraints including cost, schedule, risk, and numerous spacecraft performance metrics including launch mass, nominal landed mass, abort landed mass, mission duration, consumable limits and many others. The Asteroid Redirect Crewed Mission will be described along with results from the concurrent mission design trades that led to its formulation. While the trades presented are specific to this mission, the integrated process is applicable to any potential future mission. The following trades were critical in the mission formulation and will be described in detail: 1) crew size, 2) mission duration, 3) trajectory design, 4) docking vs grapple, 5) extravehicular activity tasks, 6) launch mass and integrated vehicle performance, 7) contingency performance, 8) crew consumables including food, clothing, oxygen, nitrogen and water, and 9) mission risk. The additional Orion functionality required to perform the Asteroid Redirect Crewed Mission and how it is incorporated while minimizing cost, schedule and mass impacts will be identified. Existing investments in the NASA technology portfolio were leveraged to provide the added functionality that will be beneficial to future exploration missions. Mission kits are utilized to augment Orion with the necessary functionality without introducing costly new requirements to the mature Orion spacecraft design effort. The Asteroid Redirect Crewed Mission provides an exciting early mission for the Orion and SLS while providing a stepping stone to even more ambitious missions in the future.

Relations between Housing Characteristics and the Well-Being of Low-Income Children and Adolescents

PubMed Central

Coley, Rebekah Levine; Leventhal, Tama; Lynch, Alicia Doyle; Kull, Melissa

2013-01-01

Extant research has highlighted the importance of multiple characteristics of housing, but has not comprehensively assessed a broad range of housing characteristics and their relative contributions to children's well-being. Using a representative, longitudinal sample of low-income children and adolescents from low-income urban neighborhoods (N = 2,437, ages 2 through 21 years) from the Three-City Study, this study assessed housing quality, stability, type (i.e., ownership status and subsidy status), and cost simultaneously to delineate their unique associations with children's development. Hierarchical linear models found that poor housing quality was most consistently associated with children's and adolescents’ development, including worse emotional and behavioral functioning and lower cognitive skills. These associations operated in part through mothers’ psychological functioning. Residential instability showed mixed links with functioning, whereas housing cost and type were not consistently predictive. Results suggest that housing contexts are associated with functioning across the developmental span from early childhood through late adolescence, with some differences in patterns by child age. PMID:23244408

Multiple advanced logic gates made of DNA-Ag nanocluster and the application for intelligent detection of pathogenic bacterial genes.

PubMed

Lin, Xiaodong; Liu, Yaqing; Deng, Jiankang; Lyu, Yanlong; Qian, Pengcheng; Li, Yunfei; Wang, Shuo

2018-02-21

The integration of multiple DNA logic gates on a universal platform to implement advance logic functions is a critical challenge for DNA computing. Herein, a straightforward and powerful strategy in which a guanine-rich DNA sequence lighting up a silver nanocluster and fluorophore was developed to construct a library of logic gates on a simple DNA-templated silver nanoclusters (DNA-AgNCs) platform. This library included basic logic gates, YES, AND, OR, INHIBIT, and XOR, which were further integrated into complex logic circuits to implement diverse advanced arithmetic/non-arithmetic functions including half-adder, half-subtractor, multiplexer, and demultiplexer. Under UV irradiation, all the logic functions could be instantly visualized, confirming an excellent repeatability. The logic operations were entirely based on DNA hybridization in an enzyme-free and label-free condition, avoiding waste accumulation and reducing cost consumption. Interestingly, a DNA-AgNCs-based multiplexer was, for the first time, used as an intelligent biosensor to identify pathogenic genes, E. coli and S. aureus genes, with a high sensitivity. The investigation provides a prototype for the wireless integration of multiple devices on even the simplest single-strand DNA platform to perform diverse complex functions in a straightforward and cost-effective way.

Impulsive Control for Continuous-Time Markov Decision Processes: A Linear Programming Approach

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

Dufour, F., E-mail: dufour@math.u-bordeaux1.fr; Piunovskiy, A. B., E-mail: piunov@liv.ac.uk

2016-08-15

In this paper, we investigate an optimization problem for continuous-time Markov decision processes with both impulsive and continuous controls. We consider the so-called constrained problem where the objective of the controller is to minimize a total expected discounted optimality criterion associated with a cost rate function while keeping other performance criteria of the same form, but associated with different cost rate functions, below some given bounds. Our model allows multiple impulses at the same time moment. The main objective of this work is to study the associated linear program defined on a space of measures including the occupation measures ofmore » the controlled process and to provide sufficient conditions to ensure the existence of an optimal control.« less

Integrated billing and accounts receivable management system needed to maximize payments and cope with managed care.

PubMed

Sanders, J; Wold, D; Sullivan, T

1999-01-01

The billing and accounts receivable management process in medical practices today has evolved into a multidisciplinary function. This function requires efficient, coordinated performance by physicians and all staff members, from the point of initial patient contact through aggressive follow-up on delinquent payments for services rendered. Offices with deficient or nonexistent billing and accounts receivable management systems typically experience collection ratios that are less than industry norms. They also experience poor cash flow and unnecessary overhead costs. To avoid costly inefficiencies and ensure that it maximizes payments from third-party payors and patients, a medical practice must have an integrated billing and accounts receivable management system that includes components outlined in this article.

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

18 CFR 301.7 - Average System Cost methodology functionalization.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

Low-rank separated representation surrogates of high-dimensional stochastic functions: Application in Bayesian inference

NASA Astrophysics Data System (ADS)

Validi, AbdoulAhad

2014-03-01

This study introduces a non-intrusive approach in the context of low-rank separated representation to construct a surrogate of high-dimensional stochastic functions, e.g., PDEs/ODEs, in order to decrease the computational cost of Markov Chain Monte Carlo simulations in Bayesian inference. The surrogate model is constructed via a regularized alternative least-square regression with Tikhonov regularization using a roughening matrix computing the gradient of the solution, in conjunction with a perturbation-based error indicator to detect optimal model complexities. The model approximates a vector of a continuous solution at discrete values of a physical variable. The required number of random realizations to achieve a successful approximation linearly depends on the function dimensionality. The computational cost of the model construction is quadratic in the number of random inputs, which potentially tackles the curse of dimensionality in high-dimensional stochastic functions. Furthermore, this vector-valued separated representation-based model, in comparison to the available scalar-valued case, leads to a significant reduction in the cost of approximation by an order of magnitude equal to the vector size. The performance of the method is studied through its application to three numerical examples including a 41-dimensional elliptic PDE and a 21-dimensional cavity flow.

Performance of Comorbidity, Risk Adjustment, and Functional Status Measures in Expenditure Prediction for Patients With Diabetes

PubMed Central

Maciejewski, Matthew L.; Liu, Chuan-Fen; Fihn, Stephan D.

2009-01-01

OBJECTIVE—To compare the ability of generic comorbidity and risk adjustment measures, a diabetes-specific measure, and a self-reported functional status measure to explain variation in health care expenditures for individuals with diabetes. RESEARCH DESIGN AND METHODS—This study included a retrospective cohort of 3,092 diabetic veterans participating in a multisite trial. Two comorbidity measures, four risk adjusters, a functional status measure, a diabetes complication count, and baseline expenditures were constructed from administrative and survey data. Outpatient, inpatient, and total expenditure models were estimated using ordinary least squares regression. Adjusted R2 statistics and predictive ratios were compared across measures to assess overall explanatory power and explanatory power of low- and high-cost subgroups. RESULTS—Administrative data–based risk adjusters performed better than the comorbidity, functional status, and diabetes-specific measures in all expenditure models. The diagnostic cost groups (DCGs) measure had the greatest predictive power overall and for the low- and high-cost subgroups, while the diabetes-specific measure had the lowest predictive power. A model with DCGs and the diabetes-specific measure modestly improved predictive power. CONCLUSIONS—Existing generic measures can be useful for diabetes-specific research and policy applications, but more predictive diabetes-specific measures are needed. PMID:18945927

Evaluation of a long-term home care program.

PubMed

Hughes, S L; Cordray, D S; Spiker, V A

1984-05-01

This article reports the outcomes of a 9-month evaluation of the Five Hospital Homebound Elderly Program ( FHHEP ), a model long-term, comprehensive, coordinated home care program in Chicago. Outcomes assessed include the mortality, comprehensive functional status, and rates of hospitalization and of institutionalization of the elderly (mean age, 80.4 years), chronically impaired population served by the FHHEP . The evaluation utilized a quasi-experimental, preposttest design with a nonequivalent control group consisting of similarly elderly and impaired subjects who received OAA Title III-c home-delivered meals. Consecutively accepted experimental (n = 122) and control group clients (n = 123) were interviewed using the Duke/ OARS Multi-dimensional Functional Assessment Questionnaire at the time of acceptance to service and 9 months later. Service utilization data were also obtained for both groups to correlate client outcomes and characteristics with level and type of services used. Data collection took place over a 31-month period. Posttest functional status measures were obtained for 83% of experimental and 81% of control subjects. Multivariate analysis was used to control measured pretest differences. Major findings include a significant reduction in the nursing home admissions (16 vs. 28) and nursing home days (including sheltered care) of experimental group clients. The reported analyses also show an increase in experimental clients' sense of physical health well-being and a decrease in their number of previously unmet needs for community services. Somewhat paradoxically, the experimental sample also demonstrated a decrease in physical activities of daily living ( PADL ) functioning. The mortality and hospitalization rate were equal for both groups. Despite savings in nursing home days of care, average per-capita costs for experimental group clients were 19% higher than for controls. However, this additional cost was accompanied by an increase in quality of life. Longer-range cost and outcomes are being assessed through a 4-year follow-up study currently in progress.

Cost analysis of incidental durotomy in spine surgery.

PubMed

Nandyala, Sreeharsha V; Elboghdady, Islam M; Marquez-Lara, Alejandro; Noureldin, Mohamed N B; Sankaranarayanan, Sriram; Singh, Kern

2014-08-01

Retrospective database analysis. To characterize the consequences of an incidental durotomy with regard to perioperative complications and total hospital costs. There is a paucity of data regarding how an incidental durotomy and its associated complications may relate to total hospital costs. The Nationwide Inpatient Sample database was queried from 2008 to 2011. Patients who underwent cervical or lumbar decompression and/or fusion procedures were identified, stratified by approach, and separated into cohorts based on a documented intraoperative incidental durotomy. Patient demographics, comorbidities (Charlson Comorbidity Index), length of hospital stay, perioperative outcomes, and costs were assessed. Analysis of covariance and multivariate linear regression were used to assess the adjusted mean costs of hospitalization as a function of durotomy. The incidental durotomy rate in cervical and lumbar spine surgery is 0.4% and 2.9%, respectively. Patients with an incidental durotomy incurred a longer hospitalization and a greater incidence of perioperative complications including hematoma and neurological injury (P < 0.001). Regression analysis demonstrated that a cervical durotomy and its postoperative sequelae contributed an additional adjusted $7638 (95% confidence interval, 6489-8787; P < 0.001) to the total hospital costs. Similarly, lumbar durotomy contributed an additional adjusted $2412 (95% confidence interval, 1920-2902; P < 0.001) to the total hospital costs. The approach-specific procedural groups demonstrated similar discrepancies in the mean total hospital costs as a function of durotomy. This analysis of the Nationwide Inpatient Sample database demonstrates that incidental durotomies increase hospital resource utilization and costs. In addition, it seems that a cervical durotomy and its associated complications carry a greater financial burden than a lumbar durotomy. Further studies are warranted to investigate the long-term financial implications of incidental durotomies in spine surgery and to reduce the costs associated with this complication. 3.

Financial risk management of pharmacy benefits.

PubMed

Saikami, D

1997-10-01

Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

Future Concepts for Modular, Intelligent Aerospace Power Systems

NASA Technical Reports Server (NTRS)

Button, Robert M.; Soeder, James F.

2004-01-01

Nasa's resent commitment to Human and Robotic Space Exploration obviates the need for more affordable and sustainable systems and missions. Increased use of modularity and on-board intelligent technologies will enable these lofty goals. To support this new paradigm, an advanced technology program to develop modular, intelligent power management and distribution (PMAD) system technologies is presented. The many benefits to developing and including modular functionality in electrical power components and systems are shown to include lower costs and lower mass for highly reliable systems. The details of several modular technologies being developed by NASA are presented, broken down into hierarchical levels. Modularity at the device level, including the use of power electronic building blocks, is shown to provide benefits in lowering the development time and costs of new power electronic components.

Functional Neuroimaging in Psychopathy.

PubMed

Del Casale, Antonio; Kotzalidis, Georgios D; Rapinesi, Chiara; Di Pietro, Simone; Alessi, Maria Chiara; Di Cesare, Gianluigi; Criscuolo, Silvia; De Rossi, Pietro; Tatarelli, Roberto; Girardi, Paolo; Ferracuti, Stefano

2015-01-01

Psychopathy is associated with cognitive and affective deficits causing disruptive, harmful and selfish behaviour. These have considerable societal costs due to recurrent crime and property damage. A better understanding of the neurobiological bases of psychopathy could improve therapeutic interventions, reducing the related social costs. To analyse the major functional neural correlates of psychopathy, we reviewed functional neuroimaging studies conducted on persons with this condition. We searched the PubMed database for papers dealing with functional neuroimaging and psychopathy, with a specific focus on how neural functional changes may correlate with task performances and human behaviour. Psychopathy-related behavioural disorders consistently correlated with dysfunctions in brain areas of the orbitofrontal-limbic (emotional processing and somatic reaction to emotions; behavioural planning and responsibility taking), anterior cingulate-orbitofrontal (correct assignment of emotional valence to social stimuli; violent/aggressive behaviour and challenging attitude) and prefrontal-temporal-limbic (emotional stimuli processing/response) networks. Dysfunctional areas more consistently included the inferior frontal, orbitofrontal, dorsolateral prefrontal, ventromedial prefrontal, temporal (mainly the superior temporal sulcus) and cingulated cortices, the insula, amygdala, ventral striatum and other basal ganglia. Emotional processing and learning, and several social and affective decision-making functions are impaired in psychopathy, which correlates with specific changes in neural functions. © 2015 S. Karger AG, Basel.

Are Education Cost Functions Ready for Prime Time? An Examination of Their Validity and Reliability

ERIC Educational Resources Information Center

Duncombe, William; Yinger, John

2011-01-01

This article makes the case that cost functions are the best available methodology for ensuring consistency between a state's educational accountability system and its education finance system. Because they are based on historical data and well-known statistical methods, cost functions are a particularly flexible and low-cost way to forecast what…

Costs and quality of life of patients with ankylosing spondylitis in Hong Kong.

PubMed

Zhu, T Y; Tam, L-S; Lee, V W-Y; Hwang, W W; Li, T K; Lee, K K; Li, E K

2008-09-01

To assess the annual direct, indirect and total societal costs, quality of life (QoL) of AS in a Chinese population in Hong Kong and determine the cost determinants. A retrospective, non-randomized, cross-sectional study was performed in a cohort of 145 patients with AS in Hong Kong. Participants completed questionnaires on sociodemographics, work status and out-of-pocket expenses. Health resources consumption was recorded by chart review. Functional impairment and disease activity were measured using the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), respectively. Patients' QoL was assessed using the Short Form-36 (SF-36). The mean age of the patients was 40 yrs with mean disease duration of 10 yrs. The mean BASDAI score was 4.7 and BASFI score was 3.3. Annual total costs averaged USD 9120. Direct costs accounted for 38% of the total costs while indirect costs accounted for 62%. Costs of technical examinations represented the largest proportion of total cost. Patients with AS reported significantly impaired QoL. Functional impairment became the major cost driver of direct costs and total costs. There is a substantial societal cost related to the treatment of AS in Hong Kong. Functional impairment is the most important cost driver. Treatments that reduce functional impairment may be effective to decrease the costs of AS and improve the patient's QoL, and ease the pressure on the healthcare system.

Effect of various features on the life cycle cost of the timing/synchronization subsystem of the DCS digital communications network

NASA Technical Reports Server (NTRS)

Kimsey, D. B.

1978-01-01

The effect on the life cycle cost of the timing subsystem was examined, when these optional features were included in various combinations. The features included mutual control, directed control, double-ended reference links, independence of clock error measurement and correction, phase reference combining, self-organization, smoothing for link and nodal dropouts, unequal reference weightings, and a master in a mutual control network. An overall design of a microprocessor-based timing subsystem was formulated. The microprocessor (8080) implements the digital filter portion of a digital phase locked loop, as well as other control functions such as organization of the network through communication with processors at neighboring nodes.

Early neurologically focused follow-up after cardiac arrest is cost-effective: A trial-based economic evaluation.

PubMed

Moulaert, Véronique R M; Goossens, Mariëlle; Heijnders, Irene L C; Verbunt, Jeanine A; Heugten, Caroline M van

2016-09-01

To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still …, and move on' from a societal perspective. This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life. In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the incremental cost effectiveness ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively. Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54-76% for the SF-36 and 94% for the QOLIBRI. Findings were robust. The intervention 'Stand still …, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended. ISRCTN74835019. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Defining the Value Framework for Prostate Brachytherapy using Patient-Centered Outcome Metrics and Time-Driven Activity-Based Costing

PubMed Central

Thaker, Nikhil G.; Pugh, Thomas J.; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E.; Martin, Neil E.; Sio, Terence T.; Kudchadker, Rajat J.; Kaplan, Robert S.; Kuban, Deborah A.; Swanson, David A.; Orio, Peter F.; Zelefsky, Michael J.; Cox, Brett W.; Potters, Louis; Buchholz, Thomas A.; Feeley, Thomas W.; Frank, Steven J.

2017-01-01

PURPOSE Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. METHODS AND MATERIALS Patients with low-risk PCa treated with low-dose rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement (ICHOM) standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to one year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. RESULTS A total of 238 men were eligible for analysis. Median age was 64 (range, 46–81). Median follow-up was 5 years (0.5–12.1). There were no acute grade 3–5 complications. EPIC-50 scores were favorable, with no clinically significant changes from baseline to last follow-up at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. CONCLUSIONS We successfully created a visual framework to define the value of PBT using the ICHOM standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. PMID:26916105

The Gauntlet for Multicampus Systems.

ERIC Educational Resources Information Center

Callan, Patrick M.

1994-01-01

Higher education and public policy leaders need to reconsider how and whether the multicampus form of organization can continue to be useful. Issues include whether multicampus systems respond effectively to social, economic, demographic, and technological change; real costs; vulnerability to political influence; how leadership functions; and the…

Navigating the Internet: Evaluating Gopher Clients for Windows.

ERIC Educational Resources Information Center

Lonardo, Angela; And Others

1995-01-01

Identifies and discusses the criteria that end users might employ when evaluating a gopher client, particularly for the Windows environment. Topics include cost and availability, help features, functionality, viewing, searching, navigating, bookmarks, retrieving and displaying files, robustness, and gopher clients available via FTP (file transfer…

Launch Vehicle Design Process Description and Training Formulation

NASA Technical Reports Server (NTRS)

Atherton, James; Morris, Charles; Settle, Gray; Teal, Marion; Schuerer, Paul; Blair, James; Ryan, Robert; Schutzenhofer, Luke

1999-01-01

A primary NASA priority is to reduce the cost and improve the effectiveness of launching payloads into space. As a consequence, significant improvements are being sought in the effectiveness, cost, and schedule of the launch vehicle design process. In order to provide a basis for understanding and improving the current design process, a model has been developed for this complex, interactive process, as reported in the references. This model requires further expansion in some specific design functions. Also, a training course for less-experienced engineers is needed to provide understanding of the process, to provide guidance for its effective implementation, and to provide a basis for major improvements in launch vehicle design process technology. The objective of this activity is to expand the description of the design process to include all pertinent design functions, and to develop a detailed outline of a training course on the design process for launch vehicles for use in educating engineers whose experience with the process has been minimal. Building on a previously-developed partial design process description, parallel sections have been written for the Avionics Design Function, the Materials Design Function, and the Manufacturing Design Function. Upon inclusion of these results, the total process description will be released as a NASA TP. The design function sections herein include descriptions of the design function responsibilities, interfaces, interactive processes, decisions (gates), and tasks. Associated figures include design function planes, gates, and tasks, along with other pertinent graphics. Also included is an expanded discussion of how the design process is divided, or compartmentalized, into manageable parts to achieve efficient and effective design. A detailed outline for an intensive two-day course on the launch vehicle design process has been developed herein, and is available for further expansion. The course is in an interactive lecture/workshop format to engage the participants in active learning. The course addresses the breadth and depth of the process, requirements, phases, participants, multidisciplinary aspects, tasks, critical elements,as well as providing guidance from previous lessons learned. The participants are led to develop their own understanding of the current process and how it can be improved. Included are course objectives and a session-by-session outline of course content. Also included is an initial identification of visual aid requirements.

Effects of oral versus long-acting antipsychotics on social functioning: A psychiatrists' survey in India.

PubMed

Gundugurti, Prasad Rao; Nagpal, Rajesh; Sheth, Ashit; Narang, Prashant; Gawande, Sonal; Singh, Vikram

2017-12-01

Schizophrenia is associated with functional challenges for patients; relapses in schizophrenia may lead to increased treatment costs and poor quality of life. This SUSTAIN-I study was conducted to establish psychiatrists' perspective on impact of long-acting injectables (LAIs) antipsychotics on the socio-economic and functional burden of schizophrenia. This cross-sectional, survey-based study was conducted in 5 cities in India. Psychiatrists (≥5years of experience) working in clinics, psychiatric, government hospitals and rehabilitation centers were included and administered a specially designed questionnaire to elicit information on their clinical practice and prescription patterns. Perceived treatment costs for LAI versus oral antipsychotic treatments (OATs) and relapse rates were assessed. Descriptive statistics were used to summarize results. Total 31 physicians completed this survey. In acute phase, OAT prescription was higher whereas chronic patients were treated with either OATs or LAIs. Treatment with LAIs was the preferred treatment in 9% of chronic cases. Reduced relapse rates were observed with LAI treatment: 12% patients on LAIs relapsed as compared with 60% patients on OATs. Monthly medication cost for oral medications was lower ($8-$17) than short-acting injectables ($22-$50). For chronic cases, atypical antipsychotics cost (oral: $11.7-25, LAI: $150-167) was higher than typical antipsychotics (oral: $4-5, LAI: $5-25). Of the total expenses incurred, cost for hospital admissions was the largest component (78%). Despite enhanced treatment adherence and potential to lower risk of rehospitalizations from relapse, LAIs are not the preferred treatment choice for patients with schizophrenia in India, owing to their perceived high costs. Copyright © 2017 Elsevier B.V. All rights reserved.

Gradient corrections to the exchange-correlation free energy

DOE PAGES

Sjostrom, Travis; Daligault, Jerome

2014-10-07

We develop the first-order gradient correction to the exchange-correlation free energy of the homogeneous electron gas for use in finite-temperature density functional calculations. Based on this, we propose and implement a simple temperature-dependent extension for functionals beyond the local density approximation. These finite-temperature functionals show improvement over zero-temperature functionals, as compared to path-integral Monte Carlo calculations for deuterium equations of state, and perform without computational cost increase compared to zero-temperature functionals and so should be used for finite-temperature calculations. Furthermore, while the present functionals are valid at all temperatures including zero, non-negligible difference with zero-temperature functionals begins at temperatures abovemore » 10 000 K.« less

Goserelin (Zoladex) or orchiectomy in metastatic prostate cancer? A quality of life and cost-effectiveness analysis.

PubMed

Nygård, R; Norum, J; Due, J

2001-01-01

We have today two treatment alternatives (orchiectomy or LHRH-analogue) in metastatic prostate cancer offering the same expectations of survival. This study documents the quality of life (QoL) and cost-effectiveness of these alternatives. 65 consecutive patients treated at the University Hospital of Tromsø (UHT), Norway, between 1994 and 1999 were registered. At evaluation, 45 patients (LHRH-analogue--15 patients, orchiectomy--30 patients) were alive and included in the QoL-study (EORTC QLQ C-30, QoL 15D). 45 patients were followed-up at the UHT and included in the cost-analysis. Costs were calculated for a 36-month interval and converted to British pounds (1 Pound = 13 NOK). A 5% d.r. was employed. The mean QoL (15D) was 76.4 (orchiectomy) and 72 (LHRH) (0-100 scale). Constipation, urinating problems, fatigue, pain and loss of sexual functioning were the dominant symptoms. The treatment costs per patient treated were 8,895 Pounds (orchiectomy) and 10,937 Pounds (LHRH-analogue). The crossover in cost was located at 25 months. A sensitivity analysis varying discount rate (0-10%), drug charges (25-50% off) and treatment time (12-18 months) did not alter the conclusion. Orchiectomy is the treatment of choice when life expectancy is more than two years.

Comparing hospital costs: what is gained by accounting for more than a case-mix index?

PubMed

Hvenegaard, Anne; Street, Andrew; Sørensen, Torben Højmark; Gyrd-Hansen, Dorte

2009-08-01

We explore what effect controlling for various patient characteristics beyond a case-mix index (DRG) has on inferences drawn about the relative cost performance of hospital departments. We estimate fixed effect cost models in which 3754 patients are clustered within six Danish vascular departments. We compare a basic model including a DRG index only with models also including age and gender, health related characteristics, such as smoking status, diabetes, and American Society of Anesthesiogists score (ASA-score), and socioeconomic characteristics such as income, employment and whether the patient lives alone. We find that the DRG index is a robust and important explanatory factor and adding other routinely collected characteristics such as age and gender and other health related or socioeconomic characteristics do not seem to alter the results significantly. The results are more sensitive to choice of functional form, i.e. in particular to whether costs are log transformed. Our results suggest that the routinely collected characteristics such as DRG index, age and gender are sufficient when drawing inferences about relative cost performance. Adding health related or socioeconomic patient characteristics only slightly improves our model in terms of explanatory power but not when drawing inferences about relative performance. The results are, however, sensitive to whether costs are log transformed.

On the Balancing of the SMOS Ocean Salinity Retrieval Cost Function

NASA Astrophysics Data System (ADS)

Sabia, R.; Camps, A.; Portabella, M.; Talone, M.; Ballabrera, J.; Gourrion, J.; Gabarró, C.; Aretxabaleta, A. L.; Font, J.

2009-04-01

The Soil Moisture and Ocean Salinity (SMOS) mission will be launched in mid 2009 to provide synoptic sea surface salinity (SSS) measurements with good temporal resolution [1]. To obtain a proper estimation of the SSS fields derived from the multi-angular brightness temperatures (TB) measured by the Microwave Interferometric Radiometer by Aperture Synthesis (MIRAS) sensor, a comprehensive inversion procedure has been defined [2]. Nevertheless, several salinity retrieval issues remain critical, namely: 1) Scene-dependent bias in the simulated TBs, 2) L-band forward geophysical model function definition, 3) Auxiliary data uncertainties, 4) Constraints in the cost function (inversion), especially in salinity term, and 5) Adequate spatio-temporal averaging. These issues will have to be properly addressed in order to meet the proposed accuracy requirement of the mission: a demanding 0.1 psu (practical salinity units) after averaging in a 30-day and 2°x2° spatio-temporal boxes. The salinity retrieval cost function minimizes the difference between the multi-angular measured SMOS TBs (yet simulated, so far) and the modeled TBs, weighted by the corresponding radiometric noise of the measurements. Furthermore, due to the fact that the minimization problem is both non-linear and ill-posed, background reference terms are needed to nudge the solution and ensuring convergence at the same time [3]. Constraining terms in SSS, sea surface temperature (SST) and wind speed are considered with their respective uncertainties. Moreover, whether SSS constraints have to be included or not as part of the retrieval procedure is still a matter of debate. On one hand, neglecting background reference information on SSS might prevent from retrieving salinity with the prescribed accuracy or at least within reasonable error. Conversely, including constraints in SSS, relying for instance on the climatology, may force the retrieved value to be too close to the reference prior values, thus producing spurious retrievals. In [4] it has been studied the impact of the different auxiliary salinity uncertainties in the accuracy of the retrieval. It has been shown that using physically-consistent salinity field uncertainties of the order of less than 0.5 psu (either as the standard deviation of the considered SSS field or as the standard deviation of the misfit between the original and the auxiliary SSS field) the SSS term turns out to be too constraining. A half-way solution could be envisaged by using empirical weights (regularization factors) which could smooth the overall influence of the SSS term still using the auxiliary fields with their corresponding physically-sounded uncertainties. This operation should be performed for the SST and wind speed term as well. The need for a comprehensive balancing of the different terms included in the cost function is also stressed by recent studies [5], which point out that the even the observational term (TBs) will need to be properly weighted by an effective ratio, taking into account the specific correlation patterns existing in the MIRAS measurements. Simulated data using the SMOS End-to-end Processor Simulator (SEPS), in its full-mode, including the measured antenna patterns for each antenna and all the instrument errors, are used in this study. The salinity retrieval process and the SSS maps (for each satellite overpass) are performed with UPC SMOS-Level 2 Processor Simulator (SMOS-L2PS). The relative weight for each of the terms included in the cost function (observational and background terms) is assessed in different cost function configurations. Regularization factors are introduced to ensure that SMOS information content is fully exploited. Preliminary results on the cost function balancing will be shown at the conference. References [1] Font, J., G. Lagerloef, D. Le Vine, A. Camps, and O.Z. Zanife, The Determination of Surface Salinity with the European SMOS Space Mission, IEEE Trans. Geosci. Remote Sens., 42 (10), 2196-2205, 2004. [2] Zine, S., J. Boutin, J. Font, N. Reul, P. Waldteufel, C. Gabarró, J. Tenerelli, F. Petitcolin, J.L. Vergely, M. Talone, and S. Delwart, Overview of the SMOS Sea Surface Salinity Prototype Processor, IEEE Trans. Geosc. Remote Sens, 46 (3), 621-645, 2008. [3] Gabarró, C., M. Portabella, M. Talone and J. Font, Analysis of the SMOS Ocean Salinity Inversion Algorithm, Proceedings of the International Geoscience and Remote Sensing Symposium (IGARSS), Barcelona, Spain, 971-974, 2007. [4] Sabia, R, Sea Surface Salinity Retrieval Error Budget within the ESA Soil Moisture and Ocean Salinity Mission, Ph.D. Dissertation, Barcelona, Spain, October 2008. [5] Talone, M., A. Camps, C. Gabarró, R. Sabia, J. Gourrion, M. Vall•llossera, B. Mourre, and J. Font, Contributions to the Improvement of the SMOS Level 2 Retrieval Algorithm: Optimization of the Cost Function, Proceedings of the International Geoscience and Remote Sensing Symposium (IGARSS), Boston, Massachusetts USA, 2008.

Development of Miniaturized Optimized Smart Sensors (MOSS) for space plasmas

NASA Technical Reports Server (NTRS)

Young, D. T.

1993-01-01

The cost of space plasma sensors is high for several reasons: (1) Most are one-of-a-kind and state-of-the-art, (2) the cost of launch to orbit is high, (3) ruggedness and reliability requirements lead to costly development and test programs, and (4) overhead is added by overly elaborate or generalized spacecraft interface requirements. Possible approaches to reducing costs include development of small 'sensors' (defined as including all necessary optics, detectors, and related electronics) that will ultimately lead to cheaper missions by reducing (2), improving (3), and, through work with spacecraft designers, reducing (4). Despite this logical approach, there is no guarantee that smaller sensors are necessarily either better or cheaper. We have previously advocated applying analytical 'quality factors' to plasma sensors (and spacecraft) and have begun to develop miniaturized particle optical systems by applying quantitative optimization criteria. We are currently designing a Miniaturized Optimized Smart Sensor (MOSS) in which miniaturized electronics (e.g., employing new power supply topology and extensive us of gate arrays and hybrid circuits) are fully integrated with newly developed particle optics to give significant savings in volume and mass. The goal of the SwRI MOSS program is development of a fully self-contained and functional plasma sensor weighing 1 lb and requiring 1 W. MOSS will require only a typical spacecraft DC power source (e.g., 30 V) and command/data interfaces in order to be fully functional, and will provide measurement capabilities comparable in most ways to current sensors.

Directional biases reveal utilization of arm's biomechanical properties for optimization of motor behavior.

PubMed

Goble, Jacob A; Zhang, Yanxin; Shimansky, Yury; Sharma, Siddharth; Dounskaia, Natalia V

2007-09-01

Strategies used by the CNS to optimize arm movements in terms of speed, accuracy, and resistance to fatigue remain largely unknown. A hypothesis is studied that the CNS exploits biomechanical properties of multijoint limbs to increase efficiency of movement control. To test this notion, a novel free-stroke drawing task was used that instructs subjects to make straight strokes in as many different directions as possible in the horizontal plane through rotations of the elbow and shoulder joints. Despite explicit instructions to distribute strokes uniformly, subjects showed biases to move in specific directions. These biases were associated with a tendency to perform movements that included active motion at one joint and largely passive motion at the other joint, revealing a tendency to minimize intervention of muscle torque for regulation of the effect of interaction torque. Other biomechanical factors, such as inertial resistance and kinematic manipulability, were unable to adequately account for these significant biases. Also, minimizations of jerk, muscle torque change, and sum of squared muscle torque were analyzed; however, these cost functions failed to explain the observed directional biases. Collectively, these results suggest that knowledge of biomechanical cost functions regarding interaction torque (IT) regulation is available to the control system. This knowledge may be used to evaluate potential movements and to select movement of "low cost." The preference to reduce active regulation of interaction torque suggests that, in addition to muscle energy, the criterion for movement cost may include neural activity required for movement control.

Development of an Objective Space Suit Mobility Performance Metric Using Metabolic Cost and Functional Tasks

NASA Technical Reports Server (NTRS)

McFarland, Shane M.; Norcross, Jason

2016-01-01

Existing methods for evaluating EVA suit performance and mobility have historically concentrated on isolated joint range of motion and torque. However, these techniques do little to evaluate how well a suited crewmember can actually perform during an EVA. An alternative method of characterizing suited mobility through measurement of metabolic cost to the wearer has been evaluated at Johnson Space Center over the past several years. The most recent study involved six test subjects completing multiple trials of various functional tasks in each of three different space suits; the results indicated it was often possible to discern between different suit designs on the basis of metabolic cost alone. However, other variables may have an effect on real-world suited performance; namely, completion time of the task, the gravity field in which the task is completed, etc. While previous results have analyzed completion time, metabolic cost, and metabolic cost normalized to system mass individually, it is desirable to develop a single metric comprising these (and potentially other) performance metrics. This paper outlines the background upon which this single-score metric is determined to be feasible, and initial efforts to develop such a metric. Forward work includes variable coefficient determination and verification of the metric through repeated testing.

Resting-State Functional Connectivity Underlying Costly Punishment: A Machine-Learning Approach.

PubMed

Feng, Chunliang; Zhu, Zhiyuan; Gu, Ruolei; Wu, Xia; Luo, Yue-Jia; Krueger, Frank

2018-06-08

A large number of studies have demonstrated costly punishment to unfair events across human societies. However, individuals exhibit a large heterogeneity in costly punishment decisions, whereas the neuropsychological substrates underlying the heterogeneity remain poorly understood. Here, we addressed this issue by applying a multivariate machine-learning approach to compare topological properties of resting-state brain networks as a potential neuromarker between individuals exhibiting different punishment propensities. A linear support vector machine classifier obtained an accuracy of 74.19% employing the features derived from resting-state brain networks to distinguish two groups of individuals with different punishment tendencies. Importantly, the most discriminative features that contributed to the classification were those regions frequently implicated in costly punishment decisions, including dorsal anterior cingulate cortex (dACC) and putamen (salience network), dorsomedial prefrontal cortex (dmPFC) and temporoparietal junction (mentalizing network), and lateral prefrontal cortex (central-executive network). These networks are previously implicated in encoding norm violation and intentions of others and integrating this information for punishment decisions. Our findings thus demonstrated that resting-state functional connectivity (RSFC) provides a promising neuromarker of social preferences, and bolster the assertion that human costly punishment behaviors emerge from interactions among multiple neural systems. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

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.

Cost drivers and resource allocation in military health care systems.

PubMed

Fulton, Larry; Lasdon, Leon S; McDaniel, Reuben R

2007-03-01

This study illustrates the feasibility of incorporating technical efficiency considerations in the funding of military hospitals and identifies the primary drivers for hospital costs. Secondary data collected for 24 U.S.-based Army hospitals and medical centers for the years 2001 to 2003 are the basis for this analysis. Technical efficiency was measured by using data envelopment analysis; subsequently, efficiency estimates were included in logarithmic-linear cost models that specified cost as a function of volume, complexity, efficiency, time, and facility type. These logarithmic-linear models were compared against stochastic frontier analysis models. A parsimonious, three-variable, logarithmic-linear model composed of volume, complexity, and efficiency variables exhibited a strong linear relationship with observed costs (R(2) = 0.98). This model also proved reliable in forecasting (R(2) = 0.96). Based on our analysis, as much as $120 million might be reallocated to improve the United States-based Army hospital performance evaluated in this study.

Computational approaches for drug discovery.

PubMed

Hung, Che-Lun; Chen, Chi-Chun

2014-09-01

Cellular proteins are the mediators of multiple organism functions being involved in physiological mechanisms and disease. By discovering lead compounds that affect the function of target proteins, the target diseases or physiological mechanisms can be modulated. Based on knowledge of the ligand-receptor interaction, the chemical structures of leads can be modified to improve efficacy, selectivity and reduce side effects. One rational drug design technology, which enables drug discovery based on knowledge of target structures, functional properties and mechanisms, is computer-aided drug design (CADD). The application of CADD can be cost-effective using experiments to compare predicted and actual drug activity, the results from which can used iteratively to improve compound properties. The two major CADD-based approaches are structure-based drug design, where protein structures are required, and ligand-based drug design, where ligand and ligand activities can be used to design compounds interacting with the protein structure. Approaches in structure-based drug design include docking, de novo design, fragment-based drug discovery and structure-based pharmacophore modeling. Approaches in ligand-based drug design include quantitative structure-affinity relationship and pharmacophore modeling based on ligand properties. Based on whether the structure of the receptor and its interaction with the ligand are known, different design strategies can be seed. After lead compounds are generated, the rule of five can be used to assess whether these have drug-like properties. Several quality validation methods, such as cost function analysis, Fisher's cross-validation analysis and goodness of hit test, can be used to estimate the metrics of different drug design strategies. To further improve CADD performance, multi-computers and graphics processing units may be applied to reduce costs. © 2014 Wiley Periodicals, Inc.

Report on Alternative Devices to Pyrotechnics on Spacecraft

NASA Technical Reports Server (NTRS)

Lucy, M. H.; Hardy, R. C.; Kist, E. H., Jr.; Watson, J. J.; Wise, S. A.

1996-01-01

Pyrotechnics accomplish many functions on today's spacecraft, possessing minimum volume/weight, providing instantaneous operation on demand, and requiring little input energy. However, functional shock, safety, and overall system cost issues, combined with emergence and availability of new technologies question their continued use on space missions. Upon request from the National Aeronautics and Space Administration's (NASA) Program Management Council (PMC), Langley Research Center (LaRC) conducted a survey to identify and evaluate state-of-the-art non-explosively actuated (NEA) alternatives to pyrotechnics, identify NEA devices planned for NASA use, and investigate potential interagency cooperative efforts. In this study, over 135 organizations were contacted, including NASA field centers, Department of Defense (DOD) and other government laboratories, universities, and American and European industrial sources resulting in further detailed discussions with over half, and 18 face-to-face briefings. Unlike their single use pyrotechnic predecessors, NEA mechanisms are typically reusable or refurbishable, allowing flight of actual tested units. NEAs surveyed include spool-based devices, thermal knife, Fast Acting Shockless Separation Nut (FASSN), paraffin actuators, and shape memory alloy (SMA) devices (e.g., Frangibolt). The electro-mechanical spool, paraffin actuator and thermal knife are mature, flight proven technologies, while SMA devices have a limited flight history. There is a relationship between shock, input energy requirements, and mechanism functioning rate. Some devices (e.g., Frangibolt and spool based mechanisms) produce significant levels of functional shock. Paraffin, thermal knife, and SMA devices can provide gentle, shock-free release but cannot perform critically timed, simultaneous functions. The FASSN flywheel-nut release device possesses significant potential for reducing functional shock while activating nearly instantaneously. Specific study recommendations include: (1) development of NEA standards, specifically in areas of material characterization, functioning rates, and test methods; (2) a systems level approach to assure successful NEA technology application; and (3) further investigations into user needs, along with industry/government system-level real spacecraft cost benefit trade studies to determine NEA application foci and performance requirements. Additional survey observations reveal an industry and government desire to establish partnerships to investigate remaining unknowns and formulate NEA standards, specifically those driven by SMAs. Finally, there is increased interest and need to investigate alternative devices for such functions as stage/shroud separation and high pressure valving. This paper summarizes results of the NASA-LaRC survey of pyrotechnic alternatives. State of-the-art devices with their associated weight and cost savings are presented. Additionally, a comparison of functional shock characteristics of several devices are shown, and potentially related technology developments are highlighted.

Metabolic costs of daily activity in older adults (Chores XL) study: design and methods.

PubMed

Corbett, Duane B; Wanigatunga, Amal A; Valiani, Vincenzo; Handberg, Eileen M; Buford, Thomas W; Brumback, Babette; Casanova, Ramon; Janelle, Christopher M; Manini, Todd M

2017-06-01

For over 20 years, normative data has guided the prescription of physical activity. This data has since been applied to research and used to plan interventions. While this data seemingly provides accurate estimates of the metabolic cost of daily activities in young adults, the accuracy of use among older adults is less clear. As such, a thorough evaluation of the metabolic cost of daily activities in community dwelling adults across the lifespan is needed. The Metabolic Costs of Daily Activity in Older Adults Study is a cross-sectional study designed to compare the metabolic cost of daily activities in 250 community dwelling adults across the lifespan. Participants (20+ years) performed 38 common daily activities while expiratory gases were measured using a portable indirect calorimeter (Cosmed K4b2). The metabolic cost was examined as a metabolic equivalent value (O 2 uptake relative to 3.5 milliliter• min-1•kg-1), a function of work rate - metabolic economy, and a relative value of resting and peak oxygen uptake. The primary objective is to determine age-related differences in the metabolic cost of common lifestyle and exercise activities. Secondary objectives include (a) investigating the effect of functional impairment on the metabolic cost of daily activities, (b) evaluating the validity of perception-based measurement of exertion across the lifespan, and (c) validating activity sensors for estimating the type and intensity of physical activity. Results of this study are expected to improve the effectiveness by which physical activity and nutrition is recommended for adults across the lifespan.

A structured bowel management program for patients with severe functional constipation can help decrease emergency department visits, hospital admissions, and healthcare costs.

PubMed

Reck-Burneo, Carlos A; Vilanova-Sanchez, Alejandra; Gasior, Alessandra C; Dingemans, Alexander J M; Lane, Victoria A; Dyckes, Robert; Nash, Onnalisa; Weaver, Laura; Maloof, Tassiana; Wood, Richard J; Zobell, Sarah; Rollins, Michael D; Levitt, Marc A

2018-03-24

Published health-care costs related to constipation in children in the USA are estimated at $3.9 billion/year. We sought to assess the effect of a bowel management program (BMP) on health-care utilization and costs. At two collaborating centers, BMP involves an outpatient week during which a treatment plan is implemented and objective assessment of stool burden is performed with daily radiography. We reviewed all patients with severe functional constipation who participated in the program from March 2011 to June 2015 in center 1 and from April 2014 to April 2016 in center 2. ED visits, hospital admissions, and constipation-related morbidities (abdominal pain, fecal impaction, urinary retention, urinary tract infections) 12 months before and 12 months after completion of the BMP were recorded. One hundred eighty-four patients were included (center 1 = 96, center 2 = 88). Sixty-three (34.2%) patients had at least one unplanned visit to the ED before treatment. ED visits decreased to 23 (12.5%) or by 64% (p < 0.0005). Unplanned hospital admissions decreased from 65 to 28, i.e., a 56.9% reduction (p < 0.0005). In children with severe functional constipation, a structured BMP decreases unplanned visits to the ED, hospital admissions, and costs for constipation-related health care. 3. Copyright © 2018. Published by Elsevier Inc.

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

PubMed Central

van der Roer, Nicole; van Tulder, Maurits W; Barendse, Johanna M; van Mechelen, Willem; Franken, Willemien K; Ooms, Arjan C; de Vet, Henrica CW

2004-01-01

Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity") and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. Discussion No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available. PMID:15560843

Home health care cost-function analysis

PubMed Central

Hay, Joel W.; Mandes, George

1984-01-01

An exploratory home health care (HHC) cost-function model is estimated using State rate-setting data for the 74 traditional (nonprofit) Connecticut agencies. The analysis demonstrates U-shaped average costs curves for agencies' provision of skilled nursing visits, with substantial diseconomies of scale in the observable range. It is determined from the estimated cost function that the sample representative agency is providing fewer visits than optimal, and its marginal cost is significantly below average cost. The finding that an agency's costs are predominantly related to output levels, with little systematic variation due to other agency or patient characteristics, suggests that the economic inefficiency in a cost-based HHC reimbursement policy may be substantial. PMID:10310596

Removing Barriers for Effective Deployment of Intermittent Renewable Generation

NASA Astrophysics Data System (ADS)

Arabali, Amirsaman

The stochastic nature of intermittent renewable resources is the main barrier to effective integration of renewable generation. This problem can be studied from feeder-scale and grid-scale perspectives. Two new stochastic methods are proposed to meet the feeder-scale controllable load with a hybrid renewable generation (including wind and PV) and energy storage system. For the first method, an optimization problem is developed whose objective function is the cost of the hybrid system including the cost of renewable generation and storage subject to constraints on energy storage and shifted load. A smart-grid strategy is developed to shift the load and match the renewable energy generation and controllable load. Minimizing the cost function guarantees minimum PV and wind generation installation, as well as storage capacity selection for supplying the controllable load. A confidence coefficient is allocated to each stochastic constraint which shows to what degree the constraint is satisfied. In the second method, a stochastic framework is developed for optimal sizing and reliability analysis of a hybrid power system including renewable resources (PV and wind) and energy storage system. The hybrid power system is optimally sized to satisfy the controllable load with a specified reliability level. A load-shifting strategy is added to provide more flexibility for the system and decrease the installation cost. Load shifting strategies and their potential impacts on the hybrid system reliability/cost analysis are evaluated trough different scenarios. Using a compromise-solution method, the best compromise between the reliability and cost will be realized for the hybrid system. For the second problem, a grid-scale stochastic framework is developed to examine the storage application and its optimal placement for the social cost and transmission congestion relief of wind integration. Storage systems are optimally placed and adequately sized to minimize the sum of operation and congestion costs over a scheduling period. A technical assessment framework is developed to enhance the efficiency of wind integration and evaluate the economics of storage technologies and conventional gas-fired alternatives. The proposed method is used to carry out a cost-benefit analysis for the IEEE 24-bus system and determine the most economical technology. In order to mitigate the financial and technical concerns of renewable energy integration into the power system, a stochastic framework is proposed for transmission grid reinforcement studies in a power system with wind generation. A multi-stage multi-objective transmission network expansion planning (TNEP) methodology is developed which considers the investment cost, absorption of private investment and reliability of the system as the objective functions. A Non-dominated Sorting Genetic Algorithm (NSGA II) optimization approach is used in combination with a probabilistic optimal power flow (POPF) to determine the Pareto optimal solutions considering the power system uncertainties. Using a compromise-solution method, the best final plan is then realized based on the decision maker preferences. The proposed methodology is applied to the IEEE 24-bus Reliability Tests System (RTS) to evaluate the feasibility and practicality of the developed planning strategy.

Project Interface Requirements Process Including Shuttle Lessons Learned

NASA Technical Reports Server (NTRS)

Bauch, Garland T.

2010-01-01

Most failures occur at interfaces between organizations and hardware. Processing interface requirements at the start of a project life cycle will reduce the likelihood of costly interface changes/failures later. This can be done by adding Interface Control Documents (ICDs) to the Project top level drawing tree, providing technical direction to the Projects for interface requirements, and by funding the interface requirements function directly from the Project Manager's office. The interface requirements function within the Project Systems Engineering and Integration (SE&I) Office would work in-line with the project element design engineers early in the life cycle to enhance communications and negotiate technical issues between the elements. This function would work as the technical arm of the Project Manager to help ensure that the Project cost, schedule, and risk objectives can be met during the Life Cycle. Some ICD Lessons Learned during the Space Shuttle Program (SSP) Life Cycle will include the use of hardware interface photos in the ICD, progressive life cycle design certification by analysis, test, & operations experience, assigning interface design engineers to Element Interface (EI) and Project technical panels, and linking interface design drawings with project build drawings

Valuation of opportunity costs by rats working for rewarding electrical brain stimulation.

PubMed

Solomon, Rebecca Brana; Conover, Kent; Shizgal, Peter

2017-01-01

Pursuit of one goal typically precludes simultaneous pursuit of another. Thus, each exclusive activity entails an "opportunity cost:" the forgone benefits from the next-best activity eschewed. The present experiment estimates, in laboratory rats, the function that maps objective opportunity costs into subjective ones. In an operant chamber, rewarding electrical brain stimulation was delivered when the cumulative time a lever had been depressed reached a criterion duration. The value of the activities forgone during this duration is the opportunity cost of the electrical reward. We determined which of four functions best describes how objective opportunity costs, expressed as the required duration of lever depression, are translated into their subjective equivalents. The simplest account is the identity function, which equates subjective and objective opportunity costs. A variant of this function called the "sigmoidal-slope function," converges on the identity function at longer durations but deviates from it at shorter durations. The sigmoidal-slope function has the form of a hockey stick. The flat "blade" denotes a range over which opportunity costs are subjectively equivalent; these durations are too short to allow substitution of more beneficial activities. The blade extends into an upward-curving portion over which costs become discriminable and finally into the straight "handle," over which objective and subjective costs match. The two remaining functions are based on hyperbolic and exponential temporal discounting, respectively. The results are best described by the sigmoidal-slope function. That this is so suggests that different principles of intertemporal choice are involved in the evaluation of time spent working for a reward or waiting for its delivery. The subjective opportunity-cost function plays a key role in the evaluation and selection of goals. An accurate description of its form and parameters is essential to successful modeling and prediction of instrumental performance and reward-related decision making.

Offshore Wind Plant Balance-of-Station Cost Drivers and Sensitivities (Poster)

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

Saur, G.; Maples, B.; Meadows, B.

2012-09-01

With Balance of System (BOS) costs contributing up to 70% of the installed capital cost, it is fundamental to understanding the BOS costs for offshore wind projects as well as potential cost trends for larger offshore turbines. NREL developed a BOS model using project cost estimates developed by GL Garrad Hassan. Aspects of BOS covered include engineering and permitting, ports and staging, transportation and installation, vessels, foundations, and electrical. The data introduce new scaling relationships for each BOS component to estimate cost as a function of turbine parameters and size, project parameters and size, and soil type. Based on themore » new BOS model, an analysis to understand the non-turbine costs associated with offshore turbine sizes ranging from 3 MW to 6 MW and offshore wind plant sizes ranging from 100 MW to 1000 MW has been conducted. This analysis establishes a more robust baseline cost estimate, identifies the largest cost components of offshore wind project BOS, and explores the sensitivity of the levelized cost of energy to permutations in each BOS cost element. This presentation shows results from the model that illustrates the potential impact of turbine size and project size on the cost of energy from US offshore wind plants.« less

An Assemblable, Multi-Angle Fluorescence and Ellipsometric Microscope

PubMed Central

Nguyen, Victoria; Rizzo, John

2016-01-01

We introduce a multi-functional microscope for research laboratories that have significant cost and space limitations. The microscope pivots around the sample, operating in upright, inverted, side-on and oblique geometries. At these geometries it is able to perform bright-field, fluorescence and qualitative ellipsometric imaging. It is the first single instrument in the literature to be able to perform all of these functionalities. The system can be assembled by two undergraduate students from a provided manual in less than a day, from off-the-shelf and 3D printed components, which together cost approximately $16k at 2016 market prices. We include a highly specified assembly manual, a summary of design methodologies, and all associated 3D-printing files in hopes that the utility of the design outlives the current component market. This open design approach prepares readers to customize the instrument to specific needs and applications. We also discuss how to select household LEDs as low-cost light sources for fluorescence microscopy. We demonstrate the utility of the microscope in varied geometries and functionalities, with particular emphasis on studying hydrated, solid-supported lipid films and wet biological samples. PMID:27907008

Optimal control of nonlinear continuous-time systems in strict-feedback form.

PubMed

Zargarzadeh, Hassan; Dierks, Travis; Jagannathan, Sarangapani

2015-10-01

This paper proposes a novel optimal tracking control scheme for nonlinear continuous-time systems in strict-feedback form with uncertain dynamics. The optimal tracking problem is transformed into an equivalent optimal regulation problem through a feedforward adaptive control input that is generated by modifying the standard backstepping technique. Subsequently, a neural network-based optimal control scheme is introduced to estimate the cost, or value function, over an infinite horizon for the resulting nonlinear continuous-time systems in affine form when the internal dynamics are unknown. The estimated cost function is then used to obtain the optimal feedback control input; therefore, the overall optimal control input for the nonlinear continuous-time system in strict-feedback form includes the feedforward plus the optimal feedback terms. It is shown that the estimated cost function minimizes the Hamilton-Jacobi-Bellman estimation error in a forward-in-time manner without using any value or policy iterations. Finally, optimal output feedback control is introduced through the design of a suitable observer. Lyapunov theory is utilized to show the overall stability of the proposed schemes without requiring an initial admissible controller. Simulation examples are provided to validate the theoretical results.

Printed organo-functionalized graphene for biosensing applications.

PubMed

Wisitsoraat, A; Mensing, J Ph; Karuwan, C; Sriprachuabwong, C; Jaruwongrungsee, K; Phokharatkul, D; Daniels, T M; Liewhiran, C; Tuantranont, A

2017-01-15

Graphene is a highly promising material for biosensors due to its excellent physical and chemical properties which facilitate electron transfer between the active locales of enzymes or other biomaterials and a transducer surface. Printing technology has recently emerged as a low-cost and practical method for fabrication of flexible and disposable electronics devices. The combination of these technologies is promising for the production and commercialization of low cost sensors. In this review, recent developments in organo-functionalized graphene and printed biosensor technologies are comprehensively covered. Firstly, various methods for printing graphene-based fluids on different substrates are discussed. Secondly, different graphene-based ink materials and preparation methods are described. Lastly, biosensing performances of printed or printable graphene-based electrochemical and field effect transistor sensors for some important analytes are elaborated. The reported printed graphene based sensors exhibit promising properties with good reliability suitable for commercial applications. Among most reports, only a few printed graphene-based biosensors including screen-printed oxidase-functionalized graphene biosensor have been demonstrated. The technology is still at early stage but rapidly growing and will earn great attention in the near future due to increasing demand of low-cost and disposable biosensors. Copyright © 2016 Elsevier B.V. All rights reserved.

Evaluating a biomass resource: The TVA region-wide biomass resource assessment model

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

Downing, M.; Graham, R.L.

1993-12-31

The economic and supply structures of short rotation woody crop (SRWC) markets have not been established. Establishing the likely price and supply of SRWC biomass in a region is a complex task because biomass is not an established commodity as are oil, natural gas and coal. In this study we project the cost and supply of short-rotation woody biomass for the TVA region -- a 276 county area that includes all of Tennessee and portions of 10 contiguous states in the southeastern United States. Projected prices and quantities of SRWC are assumed to be a function of the amount andmore » quality of crop and pasture land available in a region, expected SRWC yields and production costs on differing soils and land types, and the profit that could be obtained from current conventional crop production on these same lands. Results include the supply curve of SRWC biomass that is projected to be available from the entire region, the amount and location of crop and pasture land that would be used, and the conventional agricultural crops that would be displaced as a function of SRWC production. Finally, we show the results of sensitivity analysis on the projected cost and supply of SRWC biomass. In particular, we examine the separate impacts of varying SRWC production yields.« less

The direct and indirect costs of Dravet Syndrome.

PubMed

Whittington, Melanie D; Knupp, Kelly G; Vanderveen, Gina; Kim, Chong; Gammaitoni, Arnold; Campbell, Jonathan D

2018-03-01

The objective of this study was to estimate the annual direct and indirect costs associated with Dravet Syndrome (DS). A survey was electronically administered to the caregivers of patients with DS treated at Children's Hospital Colorado. Survey domains included healthcare utilization of the patient with DS and DS caregiver work productivity and activity impairment. Patient healthcare utilization was measured using modified questions from the National Health Interview Survey; caregiver work productivity and activity impairment were measured using modified questions from the Work Productivity and Activity Impairment questionnaire. Direct costs were calculated by multiplying the caregiver-reported healthcare utilization rates by the mean unit cost for each healthcare utilization category. Indirect costs included lost productivity, income loss, and lost leisure time. The indirect costs were a function of caregiver-reported hours spent caregiving and an hourly unit cost. The survey was emailed to 60 DS caregivers, of which 34 (57% response rate) responded. Direct costs on average were $27,276 (95% interval: $15,757, $41,904) per patient with DS. Hospitalizations ($11,565 a year) and in-home medical care visits ($9894 a year) were substantial cost drivers. Additionally, caregivers reported extensive time spent providing care to an individual with DS. This caregiver time resulted in average annual indirect costs of $81,582 (95% interval: $57,253, $110,151), resulting in an average total annual financial burden of $106,378 (95% interval: $78,894, $137,906). Dravet Syndrome results in substantial healthcare utilization, financial burden, and time commitment. Establishing evidence on the financial burden of DS is essential to understanding the overall impact of DS, identifying potential areas for support needs, and assessing the impact of novel treatments as they become available. Based on the study findings, in-home visits, hospitalizations, and lost productivity and leisure time of caregivers are key domains for DS economic evaluations. Future research should extend these estimates to include the potential additional healthcare utilization of the DS caregiver. Copyright © 2018 Elsevier Inc. All rights reserved.

Detailed requirements document for the Interactive Financial Management System (IFMS), volume 1

NASA Technical Reports Server (NTRS)

Dodson, D. B.

1975-01-01

The detailed requirements for phase 1 (online fund control, subauthorization accounting, and accounts receivable functional capabilities) of the Interactive Financial Management System (IFMS) are described. This includes information on the following: systems requirements, performance requirements, test requirements, and production implementation. Most of the work is centered on systems requirements, and includes discussions on the following processes: resources authority, allotment, primary work authorization, reimbursable order acceptance, purchase request, obligation, cost accrual, cost distribution, disbursement, subauthorization performance, travel, accounts receivable, payroll, property, edit table maintenance, end-of-year, backup input. Other subjects covered include: external systems interfaces, general inquiries, general report requirements, communication requirements, and miscellaneous. Subjects covered under performance requirements include: response time, processing volumes, system reliability, and accuracy. Under test requirements come test data sources, general test approach, and acceptance criteria. Under production implementation come data base establishment, operational stages, and operational requirements.

Cost effectiveness of lung-volume-reduction surgery for patients with severe emphysema.

PubMed

Ramsey, Scott D; Berry, Kristin; Etzioni, Ruth; Kaplan, Robert M; Sullivan, Sean D; Wood, Douglas E

2003-05-22

The National Emphysema Treatment Trial, a randomized clinical trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema, included a prospective economic analysis. After pulmonary rehabilitation, 1218 patients at 17 medical centers were randomly assigned to lung-volume-reduction surgery or continued medical treatment. Costs for the use of medical care, medications, transportation, and time spent receiving treatment were derived from Medicare claims and data from the trial. Cost effectiveness was calculated over the duration of the trial and was estimated for 10 years of follow-up with the use of modeling based on observed trends in survival, cost, and quality of life. Interim analyses identified a group of patients with excess mortality and little chance of improved functional status after surgery. When these patients were excluded, the cost-effectiveness ratio for lung-volume-reduction surgery as compared with medical therapy was 190,000 dollars per quality-adjusted life-year gained at 3 years and 53,000 dollars per quality-adjusted life-year gained at 10 years. Subgroup analyses identified patients with predominantly upper-lobe emphysema and low exercise capacity after pulmonary rehabilitation who had lower mortality and better functional status than patients who received medical therapy. The cost-effectiveness ratio in this subgroup was 98,000 dollars per quality-adjusted life-year gained at 3 years and 21,000 dollars at 10 years. Bootstrap analysis revealed substantial uncertainty for the subgroup and 10-year estimates. Given its cost and benefits over three years of follow-up, lung-volume-reduction surgery is costly relative to medical therapy. Although the predictions are subject to substantial uncertainty, the procedure may be cost effective if benefits can be maintained over time. Copyright 2003 Massachusetts Medical Society

Review: Interactions between temperament, stress, and immune function in cattle

USDA-ARS?s Scientific Manuscript database

Stressors encountered by animals can pose economic problems for the livestock industry due to increased costs to the producer as well as the consumer. Stress can also adversely affect many physiological systems, including the reproductive and immune systems. In recent years, stress has been associat...

Applying Fingerprint Fourier Transformed Infrared Spectroscopy and Chemometrics to Assess Soil Ecosystem Disturbance and Recovery

USDA-ARS?s Scientific Manuscript database

The assessment and monitoring of soil ecosystem function has been hindered due to the shortcomings of many traditional analytical techniques (e.g., soil enzyme activities, microbial incubations), including: high cost, long time investment and difficulties with data interpretation. Consequently, ther...

Wake County Public School System Design Guidelines.

ERIC Educational Resources Information Center

Wake County Public School System, Raleigh, NC.

The Wake County Public School System has published its guidelines for planning and design of functional, cost effective, and durable educational facilities that are attractive and enhance the students' educational experience. The guidelines present basic planning requirement and design criteria for the entire construction process, including: codes…

Expected 10-year treatment cost of breast cancer detected within and outside a public screening program in Norway.

PubMed

Moger, Tron A; Bjørnelv, Gudrun M W; Aas, Eline

2016-07-01

The shift towards earlier stages of disease advancement at diagnosis when introducing mammography screening is expected to affect the treatment costs of breast cancer. We collected data on hospital resource use in Norway following a breast cancer diagnosis for the period 1 January, 2008 through 31 December, 2009 for women aged 50-69 years, diagnosed with breast cancer during the period 1 January, 1999 through 31 December, 2009. We estimated treatment costs using a function that included the probability of being at risk for receiving treatment, estimated by means of the Cox proportional hazard model. In total, 16,045 patients were included for the analyses among which 10.5 % died during the study period. The mean 10-year per-person treatment cost was €31,940 (95 % CI €31,030-32,880), and lower for cancers detected within the public screening program (€30,730) than for those detected elsewhere (€36,230). For ductal carcinoma in situ (DCIS) and cancers in stages I thru IV, treatment costs were €15,740, €23,570, €46,550, €55,230 and €60,430, respectively. Interval cancers occurring within the screening program were generally more resource demanding than both cancers detected at screening or elsewhere. Ten-year treatment costs increased by increasing stage at diagnosis. Patients whose cancer was detected within the public screening program had lower treatment costs than those detected elsewhere. Interval cancers had higher costs than others.

Systematic review of the incremental costs of interventions that increase immunization coverage.

PubMed

Ozawa, Sachiko; Yemeke, Tatenda T; Thompson, Kimberly M

2018-05-10

Achieving and maintaining high vaccination coverage requires investments, but the costs and effectiveness of interventions to increase coverage remain poorly characterized. We conducted a systematic review of the literature to identify peer-reviewed studies published in English that reported interventions aimed at increasing immunization coverage and the associated costs and effectiveness of the interventions. We found limited information in the literature, with many studies reporting effectiveness estimates, but not providing cost information. Using the available data, we developed a cost function to support future programmatic decisions about investments in interventions to increase immunization coverage for relatively low and high-income countries. The cost function estimates the non-vaccine cost per dose of interventions to increase absolute immunization coverage by one percent, through either campaigns or routine immunization. The cost per dose per percent increase in absolute coverage increased with higher baseline coverage, demonstrating increasing incremental costs required to reach higher coverage levels. Future studies should evaluate the performance of the cost function and add to the database of available evidence to better characterize heterogeneity in costs and generalizability of the cost function. Copyright © 2018. Published by Elsevier Ltd.

Cost-effectiveness of dialectical behaviour therapy vs. enhanced usual care in the treatment of adolescents with self-harm.

PubMed

Haga, Egil; Aas, Eline; Grøholt, Berit; Tørmoen, Anita J; Mehlum, Lars

2018-01-01

Studies have shown that dialectical behaviour therapy (DBT) is effective in reducing self-harm in adults and adolescents. To evaluate the cost-effectiveness of DBT for adolescents (DBT-A) compared to enhanced usual care (EUC). In a randomised study, 77 adolescents with repeated self-harm were allocated to 19 weeks of outpatient treatment, either DBT-A ( n  = 39) or EUC ( n  = 38). Cost-effective analyses, including estimation of incremental cost-effectiveness ratios, were conducted with self-harm and global functioning (CGAS) as health outcomes. Using self-harm as effect outcome measure, the probability of DBT being cost-effective compared to EUC increased with increasing willingness to pay up to a ceiling of 99.5% (threshold of € 1400), while with CGAS as effect outcome measure, this ceiling was 94.9% (threshold of € 1600). Given the data, DBT-A had a high probability of being a cost-effective treatment.

How much does a tokamak reactor cost?

NASA Astrophysics Data System (ADS)

Freidberg, J.; Cerfon, A.; Ballinger, S.; Barber, J.; Dogra, A.; McCarthy, W.; Milanese, L.; Mouratidis, T.; Redman, W.; Sandberg, A.; Segal, D.; Simpson, R.; Sorensen, C.; Zhou, M.

2017-10-01

The cost of a fusion reactor is of critical importance to its ultimate acceptability as a commercial source of electricity. While there are general rules of thumb for scaling both overnight cost and levelized cost of electricity the corresponding relations are not very accurate or universally agreed upon. We have carried out a series of scaling studies of tokamak reactor costs based on reasonably sophisticated plasma and engineering models. The analysis is largely analytic, requiring only a simple numerical code, thus allowing a very large number of designs. Importantly, the studies are aimed at plasma physicists rather than fusion engineers. The goals are to assess the pros and cons of steady state burning plasma experiments and reactors. One specific set of results discusses the benefits of higher magnetic fields, now possible because of the recent development of high T rare earth superconductors (REBCO); with this goal in mind, we calculate quantitative expressions, including both scaling and multiplicative constants, for cost and major radius as a function of central magnetic field.

Influence of cost functions and optimization methods on solving the inverse problem in spatially resolved diffuse reflectance spectroscopy

NASA Astrophysics Data System (ADS)

Rakotomanga, Prisca; Soussen, Charles; Blondel, Walter C. P. M.

2017-03-01

Diffuse reflectance spectroscopy (DRS) has been acknowledged as a valuable optical biopsy tool for in vivo characterizing pathological modifications in epithelial tissues such as cancer. In spatially resolved DRS, accurate and robust estimation of the optical parameters (OP) of biological tissues is a major challenge due to the complexity of the physical models. Solving this inverse problem requires to consider 3 components: the forward model, the cost function, and the optimization algorithm. This paper presents a comparative numerical study of the performances in estimating OP depending on the choice made for each of the latter components. Mono- and bi-layer tissue models are considered. Monowavelength (scalar) absorption and scattering coefficients are estimated. As a forward model, diffusion approximation analytical solutions with and without noise are implemented. Several cost functions are evaluated possibly including normalized data terms. Two local optimization methods, Levenberg-Marquardt and TrustRegion-Reflective, are considered. Because they may be sensitive to the initial setting, a global optimization approach is proposed to improve the estimation accuracy. This algorithm is based on repeated calls to the above-mentioned local methods, with initial parameters randomly sampled. Two global optimization methods, Genetic Algorithm (GA) and Particle Swarm Optimization (PSO), are also implemented. Estimation performances are evaluated in terms of relative errors between the ground truth and the estimated values for each set of unknown OP. The combination between the number of variables to be estimated, the nature of the forward model, the cost function to be minimized and the optimization method are discussed.

Placebo effect of medication cost in Parkinson disease: a randomized double-blind study.

PubMed

Espay, Alberto J; Norris, Matthew M; Eliassen, James C; Dwivedi, Alok; Smith, Matthew S; Banks, Christi; Allendorfer, Jane B; Lang, Anthony E; Fleck, David E; Linke, Michael J; Szaflarski, Jerzy P

2015-02-24

To examine the effect of cost, a traditionally "inactive" trait of intervention, as contributor to the response to therapeutic interventions. We conducted a prospective double-blind study in 12 patients with moderate to severe Parkinson disease and motor fluctuations (mean age 62.4 ± 7.9 years; mean disease duration 11 ± 6 years) who were randomized to a "cheap" or "expensive" subcutaneous "novel injectable dopamine agonist" placebo (normal saline). Patients were crossed over to the alternate arm approximately 4 hours later. Blinded motor assessments in the "practically defined off" state, before and after each intervention, included the Unified Parkinson's Disease Rating Scale motor subscale, the Purdue Pegboard Test, and a tapping task. Measurements of brain activity were performed using a feedback-based visual-motor associative learning functional MRI task. Order effect was examined using stratified analysis. Although both placebos improved motor function, benefit was greater when patients were randomized first to expensive placebo, with a magnitude halfway between that of cheap placebo and levodopa. Brain activation was greater upon first-given cheap but not upon first-given expensive placebo or by levodopa. Regardless of order of administration, only cheap placebo increased activation in the left lateral sensorimotor cortex and other regions. Expensive placebo significantly improved motor function and decreased brain activation in a direction and magnitude comparable to, albeit less than, levodopa. Perceptions of cost are capable of altering the placebo response in clinical studies. This study provides Class III evidence that perception of cost is capable of influencing motor function and brain activation in Parkinson disease. © 2015 American Academy of Neurology.

NALNET book system: Cost benefit study

NASA Technical Reports Server (NTRS)

Dewath, N. V.; Palmour, V. E.; Foley, J. R.; Henderson, M. M.; Shockley, C. W.

1981-01-01

The goals of the NASA's library network system, NALNET, the functions of the current book system, the products and services of a book system required by NASA Center libraries, and the characteristics of a system that would best supply those products and services were assessed. Emphasis was placed on determining the most cost effective means of meeting NASA's requirements for an automated book system. Various operating modes were examined including the current STIMS file, the PUBFILE, developing software improvements for products as appropriate to the Center needs, and obtaining cataloging and products from the bibliographic utilities including at least OCLC, RLIN, BNA, and STIF. It is recommended that NALNET operate under the STIMS file mode and obtain cataloging and products from the bibliographic utilities. The recommendations are based on the premise that given the current state of the art in library automation it is not cost effective for NASA to maintain a full range of cataloging services on its own system. The bibliographic utilities can support higher quality systems with a greater range of services at a lower total cost.

Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.

PubMed

van der Roer, Nicole; van Tulder, Maurits; van Mechelen, Willem; de Vet, Henrica

2008-02-15

Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks. To evaluate the cost effectiveness and cost utility of an intensive group training protocol compared with usual care physiotherapy in patients with nonspecific chronic low back pain. The intensive group training protocol combines exercise therapy, back school, and behavioral principles. Two studies found a significant reduction in absenteeism for a graded activity program in occupational health care. This program has not yet been evaluated in a primary care physiotherapy setting. Participating physical therapists in primary care recruited 114 patients with chronic nonspecific low back pain. Eligible patients were randomized to either the protocol group or the guideline group. Outcome measures included functional status (Roland Morris Disability Questionnaire), pain intensity (11-point numerical rating scale), general perceived effect and quality of life (EuroQol-5D). Cost data were measured with cost diaries and included direct and indirect costs related to low back pain. After 52 weeks, the direct health care costs were significantly higher for patients in the protocol group, largely due to the costs of the intervention. The mean difference in total costs amounted to [Euro sign] 233 (95% confidence interval: [Euro sign] -2.185; [Euro sign] 2.764). The cost-effectiveness planes indicated no significant differences in cost effectiveness between the 2 groups. The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group. The differences in effects were small and not statistically significant. At present, national implementation of the protocol is not recommended.

On the Convergence Analysis of the Optimized Gradient Method.

PubMed

Kim, Donghwan; Fessler, Jeffrey A

2017-01-01

This paper considers the problem of unconstrained minimization of smooth convex functions having Lipschitz continuous gradients with known Lipschitz constant. We recently proposed the optimized gradient method for this problem and showed that it has a worst-case convergence bound for the cost function decrease that is twice as small as that of Nesterov's fast gradient method, yet has a similarly efficient practical implementation. Drori showed recently that the optimized gradient method has optimal complexity for the cost function decrease over the general class of first-order methods. This optimality makes it important to study fully the convergence properties of the optimized gradient method. The previous worst-case convergence bound for the optimized gradient method was derived for only the last iterate of a secondary sequence. This paper provides an analytic convergence bound for the primary sequence generated by the optimized gradient method. We then discuss additional convergence properties of the optimized gradient method, including the interesting fact that the optimized gradient method has two types of worstcase functions: a piecewise affine-quadratic function and a quadratic function. These results help complete the theory of an optimal first-order method for smooth convex minimization.

On the Convergence Analysis of the Optimized Gradient Method

PubMed Central

Kim, Donghwan; Fessler, Jeffrey A.

2016-01-01

This paper considers the problem of unconstrained minimization of smooth convex functions having Lipschitz continuous gradients with known Lipschitz constant. We recently proposed the optimized gradient method for this problem and showed that it has a worst-case convergence bound for the cost function decrease that is twice as small as that of Nesterov’s fast gradient method, yet has a similarly efficient practical implementation. Drori showed recently that the optimized gradient method has optimal complexity for the cost function decrease over the general class of first-order methods. This optimality makes it important to study fully the convergence properties of the optimized gradient method. The previous worst-case convergence bound for the optimized gradient method was derived for only the last iterate of a secondary sequence. This paper provides an analytic convergence bound for the primary sequence generated by the optimized gradient method. We then discuss additional convergence properties of the optimized gradient method, including the interesting fact that the optimized gradient method has two types of worstcase functions: a piecewise affine-quadratic function and a quadratic function. These results help complete the theory of an optimal first-order method for smooth convex minimization. PMID:28461707

Cost Efficiency in Public Higher Education.

ERIC Educational Resources Information Center

Robst, John

This study used the frontier cost function framework to examine cost efficiency in public higher education. The frontier cost function estimates the minimum predicted cost for producing a given amount of output. Data from the annual Almanac issues of the "Chronicle of Higher Education" were used to calculate state level enrollments at two-year and…

Estimation of marginal costs at existing waste treatment facilities.

PubMed

Martinez-Sanchez, Veronica; Hulgaard, Tore; Hindsgaul, Claus; Riber, Christian; Kamuk, Bettina; Astrup, Thomas F

2016-04-01

This investigation aims at providing an improved basis for assessing economic consequences of alternative Solid Waste Management (SWM) strategies for existing waste facilities. A bottom-up methodology was developed to determine marginal costs in existing facilities due to changes in the SWM system, based on the determination of average costs in such waste facilities as function of key facility and waste compositional parameters. The applicability of the method was demonstrated through a case study including two existing Waste-to-Energy (WtE) facilities, one with co-generation of heat and power (CHP) and another with only power generation (Power), affected by diversion strategies of five waste fractions (fibres, plastic, metals, organics and glass), named "target fractions". The study assumed three possible responses to waste diversion in the WtE facilities: (i) biomass was added to maintain a constant thermal load, (ii) Refused-Derived-Fuel (RDF) was included to maintain a constant thermal load, or (iii) no reaction occurred resulting in a reduced waste throughput without full utilization of the facility capacity. Results demonstrated that marginal costs of diversion from WtE were up to eleven times larger than average costs and dependent on the response in the WtE plant. Marginal cost of diversion were between 39 and 287 € Mg(-1) target fraction when biomass was added in a CHP (from 34 to 303 € Mg(-1) target fraction in the only Power case), between -2 and 300 € Mg(-1) target fraction when RDF was added in a CHP (from -2 to 294 € Mg(-1) target fraction in the only Power case) and between 40 and 303 € Mg(-1) target fraction when no reaction happened in a CHP (from 35 to 296 € Mg(-1) target fraction in the only Power case). Although average costs at WtE facilities were highly influenced by energy selling prices, marginal costs were not (provided a response was initiated at the WtE to keep constant the utilized thermal capacity). Failing to systematically address and include costs in existing waste facilities in decision-making may unintendedly lead to higher overall costs at societal level. To avoid misleading conclusions, economic assessment of alternative SWM solutions should not only consider potential costs associated with alternative treatment but also include marginal costs associated with existing facilities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integrating QoS and security functions in an IP-VPN gateway

NASA Astrophysics Data System (ADS)

Fan, Kuo-Pao; Chang, Shu-Hsin; Lin, Kuan-Ming; Pen, Mau-Jy

2001-10-01

IP-based Virtual Private Network becomes more and more popular. It can not only reduce the enterprise communication cost but also increase the revenue of the service provider. The common IP-VPN application types include Intranet VPN, Extranet VPN, and remote access VPN. For the large IP-VPN market, some vendors develop dedicated IP-VPN devices; while some vendors add the VPN functions into their existing network equipment such as router, access gateway, etc. The functions in the IP-VPN device include security, QoS, and management. The common security functions supported are IPSec (IP Security), IKE (Internet Key Exchange), and Firewall. The QoS functions include bandwidth control and packet scheduling. In the management component, policy-based network management is under standardization in IETF. In this paper, we discuss issues on how to integrate the QoS and security functions in an IP-VPN Gateway. We propose three approaches to do this. They are (1) perform Qos first (2) perform IPSec first and (3) reserve fixed bandwidth for IPSec. We also compare the advantages and disadvantages of the three proposed approaches.

Usability evaluation of low-cost virtual reality hand and arm rehabilitation games.

PubMed

Seo, Na Jin; Arun Kumar, Jayashree; Hur, Pilwon; Crocher, Vincent; Motawar, Binal; Lakshminarayanan, Kishor

2016-01-01

The emergence of lower-cost motion tracking devices enables home-based virtual reality rehabilitation activities and increased accessibility to patients. Currently, little documentation on patients' expectations for virtual reality rehabilitation is available. This study surveyed 10 people with stroke for their expectations of virtual reality rehabilitation games. This study also evaluated the usability of three lower-cost virtual reality rehabilitation games using a survey and House of Quality analysis. The games (kitchen, archery, and puzzle) were developed in the laboratory to encourage coordinated finger and arm movements. Lower-cost motion tracking devices, the P5 Glove and Microsoft Kinect, were used to record the movements. People with stroke were found to desire motivating and easy-to-use games with clinical insights and encouragement from therapists. The House of Quality analysis revealed that the games should be improved by obtaining evidence for clinical effectiveness, including clinical feedback regarding improving functional abilities, adapting the games to the user's changing functional ability, and improving usability of the motion-tracking devices. This study reports the expectations of people with stroke for rehabilitation games and usability analysis that can help guide development of future games.

Hanford business structure for HANDI 2000 business management system

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

Wilson, D.

The Hanford Business Structure integrates the project`s technical, schedule, and cost baselines; implements the use of a standard code of accounts; and streamlines performance reporting and cost collection. Technical requirements drive the technical functions and come from the RDD 100 database. The functions will be identified in the P3 scheduling system and also in the PeopleSoft system. Projects will break their work down from the technical requirements in the P3 schedules. When the level at which they want to track cost via the code of accounts is reached, a Project ID will be generated in the PeopleSoft system. P3 maymore » carry more detailed schedules below the Project ID level. The standard code of accounts will identify discrete work activities done across the site and various projects. They will include direct and overhead type work scopes. Activities in P3 will roll up to this standard code of accounts. The field that will be used to record this in PeopleSoft is ``Activity``. In Passport it is a user-defined field. It will have to be added to other feeder systems. Project ID and code of accounts are required fields on all cost records.« less

Locally optimal control under unknown dynamics with learnt cost function: application to industrial robot positioning

NASA Astrophysics Data System (ADS)

Guérin, Joris; Gibaru, Olivier; Thiery, Stéphane; Nyiri, Eric

2017-01-01

Recent methods of Reinforcement Learning have enabled to solve difficult, high dimensional, robotic tasks under unknown dynamics using iterative Linear Quadratic Gaussian control theory. These algorithms are based on building a local time-varying linear model of the dynamics from data gathered through interaction with the environment. In such tasks, the cost function is often expressed directly in terms of the state and control variables so that it can be locally quadratized to run the algorithm. If the cost is expressed in terms of other variables, a model is required to compute the cost function from the variables manipulated. We propose a method to learn the cost function directly from the data, in the same way as for the dynamics. This way, the cost function can be defined in terms of any measurable quantity and thus can be chosen more appropriately for the task to be carried out. With our method, any sensor information can be used to design the cost function. We demonstrate the efficiency of this method through simulating, with the V-REP software, the learning of a Cartesian positioning task on several industrial robots with different characteristics. The robots are controlled in joint space and no model is provided a priori. Our results are compared with another model free technique, consisting in writing the cost function as a state variable.

Cyberspace security system

DOEpatents

Abercrombie, Robert K; Sheldon, Frederick T; Ferragut, Erik M

2014-06-24

A system evaluates reliability, performance and/or safety by automatically assessing the targeted system's requirements. A cost metric quantifies the impact of failures as a function of failure cost per unit of time. The metrics or measurements may render real-time (or near real-time) outcomes by initiating active response against one or more high ranked threats. The system may support or may be executed in many domains including physical domains, cyber security domains, cyber-physical domains, infrastructure domains, etc. or any other domains that are subject to a threat or a loss.

Production Functions for Water Delivery Systems: Analysis and Estimation Using Dual Cost Function and Implicit Price Specifications

NASA Astrophysics Data System (ADS)

Teeples, Ronald; Glyer, David

1987-05-01

Both policy and technical analysis of water delivery systems have been based on cost functions that are inconsistent with or are incomplete representations of the neoclassical production functions of economics. We present a full-featured production function model of water delivery which can be estimated from a multiproduct, dual cost function. The model features implicit prices for own-water inputs and is implemented as a jointly estimated system of input share equations and a translog cost function. Likelihood ratio tests are performed showing that a minimally constrained, full-featured production function is a necessary specification of the water delivery operations in our sample. This, plus the model's highly efficient and economically correct parameter estimates, confirms the usefulness of a production function approach to modeling the economic activities of water delivery systems.

Cost-benefit and cost-savings analyses of antiarrhythmic medication monitoring.

PubMed

Snider, Melissa; Carnes, Cynthia; Grover, Janel; Davis, Rich; Kalbfleisch, Steven

2012-09-15

The economic impact of pharmacist-managed antiarrhythmic drug therapy monitoring on an academic medical center's electrophysiology (EP) program was investigated. Data were collected for the initial two years of patient visits (n = 816) to a pharmacist-run clinic for antiarrhythmic drug therapy monitoring. A retrospective cost analysis was conducted to assess the direct costs associated with three appointment models: (1) a clinic office visit only, (2) a clinic visit involving electrocardiography and basic laboratory tests, and (3) a clinic visit including pulmonary function testing and chest x-rays in addition to electrocardiography and laboratory testing. A subset of patient cases (n = 18) were included in a crossover analysis comparing pharmacist clinic care and usual care in an EP physician clinic. The primary endpoints were the cost benefits and cost savings associated with pharmacy-clinic care versus usual care. A secondary endpoint was improvement of overall EP program efficiency. The payer mix was 61.6% (n = 498) Medicare, 33.2% (n = 268) managed care, and 5.2% (n = 42) other. Positive contribution margins were demonstrated for all appointment models. The pharmacist-managed clinic also yielded cost savings by reducing overall patient care charges by 21% relative to usual care. By the second year, the pharmacy clinic improved EP program efficiency by scheduling an average of 24 patients per week, in effect freeing up one day per week of EP physician time to spend on other clinical activities. Pharmacist monitoring of antiarrhythmic drug therapy in an out-patient clinic provided cost benefits, cost savings, and improved overall EP program efficiency.

Effectiveness and cost-effectiveness of outpatient physiotherapy after knee replacement for osteoarthritis: study protocol for a randomised controlled trial.

PubMed

Wylde, Vikki; Artz, Neil; Marques, Elsa; Lenguerrand, Erik; Dixon, Samantha; Beswick, Andrew D; Burston, Amanda; Murray, James; Parwez, Tarique; Blom, Ashley W; Gooberman-Hill, Rachael

2016-06-13

Primary total knee replacement is a common operation that is performed to provide pain relief and restore functional ability. Inpatient physiotherapy is routinely provided after surgery to enhance recovery prior to hospital discharge. However, international variation exists in the provision of outpatient physiotherapy after hospital discharge. While evidence indicates that outpatient physiotherapy can improve short-term function, the longer term benefits are unknown. The aim of this randomised controlled trial is to evaluate the long-term clinical effectiveness and cost-effectiveness of a 6-week group-based outpatient physiotherapy intervention following knee replacement. Two hundred and fifty-six patients waiting for knee replacement because of osteoarthritis will be recruited from two orthopaedic centres. Participants randomised to the usual-care group (n = 128) will be given a booklet about exercise and referred for physiotherapy if deemed appropriate by the clinical care team. The intervention group (n = 128) will receive the same usual care and additionally be invited to attend a group-based outpatient physiotherapy class starting 6 weeks after surgery. The 1-hour class will be run on a weekly basis over 6 weeks and will involve task-orientated and individualised exercises. The primary outcome will be the Lower Extremity Functional Scale at 12 months post-operative. Secondary outcomes include: quality of life, knee pain and function, depression, anxiety and satisfaction. Data collection will be by questionnaire prior to surgery and 3, 6 and 12 months after surgery and will include a resource-use questionnaire to enable a trial-based economic evaluation. Trial participation and satisfaction with the classes will be evaluated through structured telephone interviews. The primary statistical and economic analyses will be conducted on an intention-to-treat basis with and without imputation of missing data. The primary economic result will estimate the incremental cost per quality-adjusted life year gained from this intervention from a National Health Services (NHS) and personal social services perspective. This research aims to benefit patients and the NHS by providing evidence on the long-term effectiveness and cost-effectiveness of outpatient physiotherapy after knee replacement. If the intervention is found to be effective and cost-effective, implementation into clinical practice could lead to improvement in patients' outcomes and improved health care resource efficiency. ISRCTN32087234 , registered on 11 February 2015.

Optimizing cost-efficiency in mean exposure assessment - cost functions reconsidered

PubMed Central

2011-01-01

Background Reliable exposure data is a vital concern in medical epidemiology and intervention studies. The present study addresses the needs of the medical researcher to spend monetary resources devoted to exposure assessment with an optimal cost-efficiency, i.e. obtain the best possible statistical performance at a specified budget. A few previous studies have suggested mathematical optimization procedures based on very simple cost models; this study extends the methodology to cover even non-linear cost scenarios. Methods Statistical performance, i.e. efficiency, was assessed in terms of the precision of an exposure mean value, as determined in a hierarchical, nested measurement model with three stages. Total costs were assessed using a corresponding three-stage cost model, allowing costs at each stage to vary non-linearly with the number of measurements according to a power function. Using these models, procedures for identifying the optimally cost-efficient allocation of measurements under a constrained budget were developed, and applied on 225 scenarios combining different sizes of unit costs, cost function exponents, and exposure variance components. Results Explicit mathematical rules for identifying optimal allocation could be developed when cost functions were linear, while non-linear cost functions implied that parts of or the entire optimization procedure had to be carried out using numerical methods. For many of the 225 scenarios, the optimal strategy consisted in measuring on only one occasion from each of as many subjects as allowed by the budget. Significant deviations from this principle occurred if costs for recruiting subjects were large compared to costs for setting up measurement occasions, and, at the same time, the between-subjects to within-subject variance ratio was small. In these cases, non-linearities had a profound influence on the optimal allocation and on the eventual size of the exposure data set. Conclusions The analysis procedures developed in the present study can be used for informed design of exposure assessment strategies, provided that data are available on exposure variability and the costs of collecting and processing data. The present shortage of empirical evidence on costs and appropriate cost functions however impedes general conclusions on optimal exposure measurement strategies in different epidemiologic scenarios. PMID:21600023

Optimizing cost-efficiency in mean exposure assessment--cost functions reconsidered.

PubMed

Mathiassen, Svend Erik; Bolin, Kristian

2011-05-21

Reliable exposure data is a vital concern in medical epidemiology and intervention studies. The present study addresses the needs of the medical researcher to spend monetary resources devoted to exposure assessment with an optimal cost-efficiency, i.e. obtain the best possible statistical performance at a specified budget. A few previous studies have suggested mathematical optimization procedures based on very simple cost models; this study extends the methodology to cover even non-linear cost scenarios. Statistical performance, i.e. efficiency, was assessed in terms of the precision of an exposure mean value, as determined in a hierarchical, nested measurement model with three stages. Total costs were assessed using a corresponding three-stage cost model, allowing costs at each stage to vary non-linearly with the number of measurements according to a power function. Using these models, procedures for identifying the optimally cost-efficient allocation of measurements under a constrained budget were developed, and applied on 225 scenarios combining different sizes of unit costs, cost function exponents, and exposure variance components. Explicit mathematical rules for identifying optimal allocation could be developed when cost functions were linear, while non-linear cost functions implied that parts of or the entire optimization procedure had to be carried out using numerical methods.For many of the 225 scenarios, the optimal strategy consisted in measuring on only one occasion from each of as many subjects as allowed by the budget. Significant deviations from this principle occurred if costs for recruiting subjects were large compared to costs for setting up measurement occasions, and, at the same time, the between-subjects to within-subject variance ratio was small. In these cases, non-linearities had a profound influence on the optimal allocation and on the eventual size of the exposure data set. The analysis procedures developed in the present study can be used for informed design of exposure assessment strategies, provided that data are available on exposure variability and the costs of collecting and processing data. The present shortage of empirical evidence on costs and appropriate cost functions however impedes general conclusions on optimal exposure measurement strategies in different epidemiologic scenarios.

Photovoltaic module electrical termination design requirement study

NASA Technical Reports Server (NTRS)

Mosna, F. J., Jr.; Donlinger, J.

1980-01-01

Pertinent electrical termination attributes were identified and used in the development of selection criteria which included function, environmental durability, utility, manufacturing, code, and cost. Significant aspects of each criteria are discussed, and eight different types of terminations are ranked according to their performance in remote, residential, intermediate, and industrial applications.

SPIRES Tailored to a Special Library: A Mainframe Answer for a Small Online Catalog.

ERIC Educational Resources Information Center

Newton, Mary

1989-01-01

Describes the design and functions of a technical library database maintained on a mainframe computer and supported by the SPIRES database management system. The topics covered include record structures, vocabulary control, input procedures, searching features, time considerations, and cost effectiveness. (three references) (CLB)

20 CFR 641.864 - What functions and activities constitute program costs?

Code of Federal Regulations, 2010 CFR

2010-04-01

... assignments, as described in § 641.565; (b) Outreach, recruitment and selection, intake, orientation, assessment, and preparation and updating of IEPs; (c) Participant training provided on the job, in a... the restrictions in § 641.535(c), job placement assistance, including job development and job search...

Space station needs, attributes and architectural options study

NASA Technical Reports Server (NTRS)

1983-01-01

All the candidate Technology Development missions investigated during the space station needs, attributes, and architectural options study are described. All the mission data forms plus additional information such as, cost, drawings, functional flows, etc., generated in support of these mission is included with a computer generated mission data form.

20 CFR 641.864 - What functions and activities constitute programmatic activity costs?

Code of Federal Regulations, 2012 CFR

2012-04-01

..., DEPARTMENT OF LABOR PROVISIONS GOVERNING THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM Administrative... training, as described in § 641.540, which may be provided before commencing or during a community service..., including job development and job search assistance, job fairs, job clubs, and job referrals; and (e...

20 CFR 641.864 - What functions and activities constitute programmatic activity costs?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF LABOR PROVISIONS GOVERNING THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM Administrative... training, as described in § 641.540, which may be provided before commencing or during a community service..., including job development and job search assistance, job fairs, job clubs, and job referrals; and (e...

A new methodology for modeling of direct landslide costs for transportation infrastructures

NASA Astrophysics Data System (ADS)

Klose, Martin; Terhorst, Birgit

2014-05-01

The world's transportation infrastructure is at risk of landslides in many areas across the globe. A safe and affordable operation of traffic routes are the two main criteria for transportation planning in landslide-prone areas. The right balancing of these often conflicting priorities requires, amongst others, profound knowledge of the direct costs of landslide damage. These costs include capital investments for landslide repair and mitigation as well as operational expenditures for first response and maintenance works. This contribution presents a new methodology for ex post assessment of direct landslide costs for transportation infrastructures. The methodology includes tools to compile, model, and extrapolate landslide losses on different spatial scales over time. A landslide susceptibility model enables regional cost extrapolation by means of a cost figure obtained from local cost compilation for representative case study areas. On local level, cost survey is closely linked with cost modeling, a toolset for cost estimation based on landslide databases. Cost modeling uses Landslide Disaster Management Process Models (LDMMs) and cost modules to simulate and monetize cost factors for certain types of landslide damage. The landslide susceptibility model provides a regional exposure index and updates the cost figure to a cost index which describes the costs per km of traffic route at risk of landslides. Both indexes enable the regionalization of local landslide losses. The methodology is applied and tested in a cost assessment for highways in the Lower Saxon Uplands, NW Germany, in the period 1980 to 2010. The basis of this research is a regional subset of a landslide database for the Federal Republic of Germany. In the 7,000 km² large Lower Saxon Uplands, 77 km of highway are located in potential landslide hazard area. Annual average costs of 52k per km of highway at risk of landslides are identified as cost index for a local case study area in this region. The cost extrapolation for the Lower Saxon Uplands results in annual average costs for highways of 4.02mn. This test application as well as a validation of selected modeling tools verifies the functionality of this methodology.

Economic Studies in Motor Neurone Disease: A Systematic Methodological Review.

PubMed

Moore, Alan; Young, Carolyn A; Hughes, Dyfrig A

2017-04-01

Motor neurone disease (MND) is a devastating condition which greatly diminishes patients' quality of life and limits life expectancy. Health technology appraisals of future interventions in MND need robust data on costs and utilities. Existing economic evaluations have been noted to be limited and fraught with challenges. The aim of this study was to identify and critique methodological aspects of all published economic evaluations, cost studies, and utility studies in MND. We systematically reviewed all relevant published studies in English from 1946 until January 2016, searching the databases of Medline, EMBASE, Econlit, NHS Economic Evaluation Database (NHS EED) and the Health Economics Evaluation Database (HEED). Key data were extracted and synthesised narratively. A total of 1830 articles were identified, of which 15 economic evaluations, 23 cost and 3 utility studies were included. Most economic studies focused on riluzole (n = 9). Six studies modelled the progressive decline in motor function using a Markov design but did not include mutually exclusive health states. Cost estimates for a number of evaluations were based on expert opinion and were hampered by high variability and location-specific characteristics. Few cost studies reported disease-stage-specific costs (n = 3) or fully captured indirect costs. Utilities in three studies of MND patients used the EuroQol EQ-5D questionnaire or standard gamble, but included potentially unrepresentative cohorts and did not consider any health impacts on caregivers. Economic evaluations in MND suffer from significant methodological issues such as a lack of data, uncertainty with the disease course and use of inappropriate modelling framework. Limitations may be addressed through the collection of detailed and representative data from large cohorts of patients.

Optimal Design and Operation of In-Situ Chemical Oxidation Using Stochastic Cost Optimization Toolkit

NASA Astrophysics Data System (ADS)

Kim, U.; Parker, J.; Borden, R. C.

2014-12-01

In-situ chemical oxidation (ISCO) has been applied at many dense non-aqueous phase liquid (DNAPL) contaminated sites. A stirred reactor-type model was developed that considers DNAPL dissolution using a field-scale mass transfer function, instantaneous reaction of oxidant with aqueous and adsorbed contaminant and with readily oxidizable natural oxygen demand ("fast NOD"), and second-order kinetic reactions with "slow NOD." DNAPL dissolution enhancement as a function of oxidant concentration and inhibition due to manganese dioxide precipitation during permanganate injection are included in the model. The DNAPL source area is divided into multiple treatment zones with different areas, depths, and contaminant masses based on site characterization data. The performance model is coupled with a cost module that involves a set of unit costs representing specific fixed and operating costs. Monitoring of groundwater and/or soil concentrations in each treatment zone is employed to assess ISCO performance and make real-time decisions on oxidant reinjection or ISCO termination. Key ISCO design variables include the oxidant concentration to be injected, time to begin performance monitoring, groundwater and/or soil contaminant concentrations to trigger reinjection or terminate ISCO, number of monitoring wells or geoprobe locations per treatment zone, number of samples per sampling event and location, and monitoring frequency. Design variables for each treatment zone may be optimized to minimize expected cost over a set of Monte Carlo simulations that consider uncertainty in site parameters. The model is incorporated in the Stochastic Cost Optimization Toolkit (SCOToolkit) program, which couples the ISCO model with a dissolved plume transport model and with modules for other remediation strategies. An example problem is presented that illustrates design tradeoffs required to deal with characterization and monitoring uncertainty. Monitoring soil concentration changes during ISCO was found to be important to avoid decision errors associated with slow rebound of groundwater concentrations.

Estimating lifetime healthcare costs with morbidity data.

PubMed

Carreras, Marc; Ibern, Pere; Coderch, Jordi; Sánchez, Inma; Inoriza, Jose M

2013-10-25

In many developed countries, the economic crisis started in 2008 producing a serious contraction of the financial resources spent on healthcare. Identifying which individuals will require more resources and the moment in their lives these resources have to be allocated becomes essential. It is well known that a small number of individuals with complex healthcare needs consume a high percentage of health expenditures. Conversely, little is known on how morbidity evolves throughout life. The aim of this study is to introduce a longitudinal perspective to chronic disease management. Data used relate to the population of the county of Baix Empordà in Catalonia for the period 2004-2007 (average population was N = 88,858). The database included individual information on morbidity, resource consumption, costs and activity records. The population was classified using the Clinical Risk Groups (CRG) model. Future morbidity evolution was simulated under different assumptions using a stationary Markov chain. We obtained morbidity patterns for the lifetime and the distribution function of the random variable lifetime costs. Individual information on acute episodes, chronic conditions and multimorbidity patterns were included in the model. The probability of having a specific health status in the future (healthy, acute process or different combinations of chronic illness) and the distribution function of healthcare costs for the individual lifetime were obtained for the sample population. The mean lifetime cost for women was €111,936, a third higher than for men, at €81,566 (all amounts calculated in 2007 Euros). Healthy life expectancy at birth for females was 46.99, lower than for males (50.22). Females also spent 28.41 years of life suffering from some type of chronic disease, a longer period than men (21.9). Future morbidity and whole population costs can be reasonably predicted, combining stochastic microsimulation with a morbidity classification system. Potential ways of efficiency arose by introducing a time perspective to chronic disease management.

Estimating lifetime healthcare costs with morbidity data

PubMed Central

2013-01-01

Background In many developed countries, the economic crisis started in 2008 producing a serious contraction of the financial resources spent on healthcare. Identifying which individuals will require more resources and the moment in their lives these resources have to be allocated becomes essential. It is well known that a small number of individuals with complex healthcare needs consume a high percentage of health expenditures. Conversely, little is known on how morbidity evolves throughout life. The aim of this study is to introduce a longitudinal perspective to chronic disease management. Methods Data used relate to the population of the county of Baix Empordà in Catalonia for the period 2004–2007 (average population was N = 88,858). The database included individual information on morbidity, resource consumption, costs and activity records. The population was classified using the Clinical Risk Groups (CRG) model. Future morbidity evolution was simulated under different assumptions using a stationary Markov chain. We obtained morbidity patterns for the lifetime and the distribution function of the random variable lifetime costs. Individual information on acute episodes, chronic conditions and multimorbidity patterns were included in the model. Results The probability of having a specific health status in the future (healthy, acute process or different combinations of chronic illness) and the distribution function of healthcare costs for the individual lifetime were obtained for the sample population. The mean lifetime cost for women was €111,936, a third higher than for men, at €81,566 (all amounts calculated in 2007 Euros). Healthy life expectancy at birth for females was 46.99, lower than for males (50.22). Females also spent 28.41 years of life suffering from some type of chronic disease, a longer period than men (21.9). Conclusions Future morbidity and whole population costs can be reasonably predicted, combining stochastic microsimulation with a morbidity classification system. Potential ways of efficiency arose by introducing a time perspective to chronic disease management. PMID:24156613

Space shuttle low cost/risk avionics study

NASA Technical Reports Server (NTRS)

1971-01-01

All work breakdown structure elements containing any avionics related effort were examined for pricing the life cycle costs. The analytical, testing, and integration efforts are included for the basic onboard avionics and electrical power systems. The design and procurement of special test equipment and maintenance and repair equipment are considered. Program management associated with these efforts is described. Flight test spares and labor and materials associated with the operations and maintenance of the avionics systems throughout the horizontal flight test are examined. It was determined that cost savings can be achieved by using existing hardware, maximizing orbiter-booster commonality, specifying new equipments to MIL quality standards, basing redundancy on cost effective analysis, minimizing software complexity and reducing cross strapping and computer-managed functions, utilizing compilers and floating point computers, and evolving the design as dictated by the horizontal flight test schedules.

Improving the quantum cost of reversible Boolean functions using reorder algorithm

NASA Astrophysics Data System (ADS)

Ahmed, Taghreed; Younes, Ahmed; Elsayed, Ashraf

2018-05-01

This paper introduces a novel algorithm to synthesize a low-cost reversible circuits for any Boolean function with n inputs represented as a Positive Polarity Reed-Muller expansion. The proposed algorithm applies a predefined rules to reorder the terms in the function to minimize the multi-calculation of common parts of the Boolean function to decrease the quantum cost of the reversible circuit. The paper achieves a decrease in the quantum cost and/or the circuit length, on average, when compared with relevant work in the literature.

Analysis of Different Cost Functions in the Geosect Airspace Partitioning Tool

NASA Technical Reports Server (NTRS)

Wong, Gregory L.

2010-01-01

A new cost function representing air traffic controller workload is implemented in the Geosect airspace partitioning tool. Geosect currently uses a combination of aircraft count and dwell time to select optimal airspace partitions that balance controller workload. This is referred to as the aircraft count/dwell time hybrid cost function. The new cost function is based on Simplified Dynamic Density, a measure of different aspects of air traffic controller workload. Three sectorizations are compared. These are the current sectorization, Geosect's sectorization based on the aircraft count/dwell time hybrid cost function, and Geosect s sectorization based on the Simplified Dynamic Density cost function. Each sectorization is evaluated for maximum and average workload along with workload balance using the Simplified Dynamic Density as the workload measure. In addition, the Airspace Concept Evaluation System, a nationwide air traffic simulator, is used to determine the capacity and delay incurred by each sectorization. The sectorization resulting from the Simplified Dynamic Density cost function had a lower maximum workload measure than the other sectorizations, and the sectorization based on the combination of aircraft count and dwell time did a better job of balancing workload and balancing capacity. However, the current sectorization had the lowest average workload, highest sector capacity, and the least system delay.

A standard description and costing methodology for the balance-of-plant items of a solar thermal electric power plant. Report of a multi-institutional working group

NASA Technical Reports Server (NTRS)

1983-01-01

Standard descriptions for solar thermal power plants are established and uniform costing methodologies for nondevelopmental balance of plant (BOP) items are developed. The descriptions and methodologies developed are applicable to the major systems. These systems include the central receiver, parabolic dish, parabolic trough, hemispherical bowl, and solar pond. The standard plant is defined in terms of four categories comprising (1) solar energy collection, (2) power conversion, (3) energy storage, and (4) balance of plant. Each of these categories is described in terms of the type and function of components and/or subsystems within the category. A detailed description is given for the BOP category. BOP contains a number of nondevelopmental items that are common to all solar thermal systems. A standard methodology for determining the costs of these nondevelopmental BOP items is given. The methodology is presented in the form of cost equations involving cost factors such as unit costs. A set of baseline values for the normalized cost factors is also given.

Integrated Analysis and Visualization of Group Differences in Structural and Functional Brain Connectivity: Applications in Typical Ageing and Schizophrenia.

PubMed

Langen, Carolyn D; White, Tonya; Ikram, M Arfan; Vernooij, Meike W; Niessen, Wiro J

2015-01-01

Structural and functional brain connectivity are increasingly used to identify and analyze group differences in studies of brain disease. This study presents methods to analyze uni- and bi-modal brain connectivity and evaluate their ability to identify differences. Novel visualizations of significantly different connections comparing multiple metrics are presented. On the global level, "bi-modal comparison plots" show the distribution of uni- and bi-modal group differences and the relationship between structure and function. Differences between brain lobes are visualized using "worm plots". Group differences in connections are examined with an existing visualization, the "connectogram". These visualizations were evaluated in two proof-of-concept studies: (1) middle-aged versus elderly subjects; and (2) patients with schizophrenia versus controls. Each included two measures derived from diffusion weighted images and two from functional magnetic resonance images. The structural measures were minimum cost path between two anatomical regions according to the "Statistical Analysis of Minimum cost path based Structural Connectivity" method and the average fractional anisotropy along the fiber. The functional measures were Pearson's correlation and partial correlation of mean regional time series. The relationship between structure and function was similar in both studies. Uni-modal group differences varied greatly between connectivity types. Group differences were identified in both studies globally, within brain lobes and between regions. In the aging study, minimum cost path was highly effective in identifying group differences on all levels; fractional anisotropy and mean correlation showed smaller differences on the brain lobe and regional levels. In the schizophrenia study, minimum cost path and fractional anisotropy showed differences on the global level and within brain lobes; mean correlation showed small differences on the lobe level. Only fractional anisotropy and mean correlation showed regional differences. The presented visualizations were helpful in comparing and evaluating connectivity measures on multiple levels in both studies.

Incremental cost of postacute care in nursing homes.

PubMed

Spector, William D; Limcangco, Maria Rhona; Ladd, Heather; Mukamel, Dana

2011-02-01

To determine whether the case mix index (CMI) based on the 53-Resource Utilization Groups (RUGs) captures all the cross-sectional variation in nursing home (NH) costs or whether NHs that have a higher percent of Medicare skilled care days (%SKILLED) have additional costs. DATA AND SAMPLE: Nine hundred and eighty-eight NHs in California in 2005. Data are from Medicaid cost reports, the Minimum Data Set, and the Economic Census. We estimate hybrid cost functions, which include in addition to outputs, case mix, ownership, wages, and %SKILLED. Two-stage least-square (2SLS) analysis was used to deal with the potential endogeneity of %SKILLED and CMI. On average 11 percent of NHs days were due to skilled care. Based on the 2SLS model, %SKILLED is associated with costs even when controlling for CMI. The marginal cost of a one percentage point increase in %SKILLED is estimated at U.S.$70,474 or about 1.2 percent of annual costs for the average cost facility. Subanalyses show that the increase in costs is mainly due to additional expenses for nontherapy ancillaries and rehabilitation. The 53-RUGs case mix does not account completely for all the variation in actual costs of care for postacute patients in NHs. © Health Research and Educational Trust.

Incremental Cost of Postacute Care in Nursing Homes

PubMed Central

Spector, William D; Limcangco, Maria Rhona; Ladd, Heather; Mukamel, Dana A

2011-01-01

Objectives To determine whether the case mix index (CMI) based on the 53-Resource Utilization Groups (RUGs) captures all the cross-sectional variation in nursing home (NH) costs or whether NHs that have a higher percent of Medicare skilled care days (%SKILLED) have additional costs. Data and Sample Nine hundred and eighty-eight NHs in California in 2005. Data are from Medicaid cost reports, the Minimum Data Set, and the Economic Census. Research Design We estimate hybrid cost functions, which include in addition to outputs, case mix, ownership, wages, and %SKILLED. Two-stage least-square (2SLS) analysis was used to deal with the potential endogeneity of %SKILLED and CMI. Results On average 11 percent of NHs days were due to skilled care. Based on the 2SLS model, %SKILLED is associated with costs even when controlling for CMI. The marginal cost of a one percentage point increase in %SKILLED is estimated at U.S.$70,474 or about 1.2 percent of annual costs for the average cost facility. Subanalyses show that the increase in costs is mainly due to additional expenses for nontherapy ancillaries and rehabilitation. Conclusion The 53-RUGs case mix does not account completely for all the variation in actual costs of care for postacute patients in NHs. PMID:21029085

Funding the new biologics--public policy issues in drug formulary decision making.

PubMed

Lewis, Steven

2002-12-01

One function of drug formularies is to allow health care providers to exert some control over spending. Decisions about whether to include a given medication in a formulary are based on estimates of its costs and effectiveness, relative to other treatment strategies. These decisions are made from a societal perspective, as opposed to that of individual patients, which sometimes results in conflicts. The clinical response to a medication often varies widely among subjects, which means that a small subgroup of patients might benefit dramatically, while others with the same disease do not. The result would be that a drug might appear not to be cost effective in an economic analysis, even though it is of proven value for some patients. New and innovative medications are assessed according to high standards of cost effectiveness, even though established treatments are wasteful of valuable health care resources. Moreover, quality-adjusted life-years (QALYs) discriminate against certain patient groups, including those with diseases that are associated with a high morbidity but a low mortality. Such patients often incur high indirect costs, including loss of employment income and costs incurred by family caregivers that QALYs do not reflect. Therefore, even though QALYs are transparent and widely applicable, they are not necessarily appropriate in the evaluation of a particular therapeutic intervention. A new paradigm should be developed for evaluating emerging therapies. An example would be a risk-sharing approach, whereby the pharmaceutical industry and public insurers share in the costs and rewards of introducing new treatments. This would have implications for the prices charged for new medications.

Two-photon reduction: a cost-effective method for fabrication of functional metallic nanostructures

NASA Astrophysics Data System (ADS)

Tabrizi, Sahar; Cao, YaoYu; Lin, Han; Jia, BaoHua

2017-03-01

Metallic nanostructures have underpinned plasmonic-based advanced photonic devices in a broad range of research fields over the last decade including physics, engineering, material science and bioscience. The key to realizing functional plasmonic resonances that can manipulate light at the optical frequencies relies on the creation of conductive metallic structures at the nanoscale with low structural defects. Currently, most plasmonic nanostructures are fabricated either by electron beam lithography (EBL) or by focused ion beam (FIB) milling, which are expensive, complicated and time-consuming. In comparison, the direct laser writing (DLW) technique has demonstrated its high spatial resolution and cost-effectiveness in three-dimensional fabrication of micro/nanostructures. Furthermore, the recent breakthroughs in superresolution nanofabrication and parallel writing have significantly advanced the fabrication resolution and throughput of the DLW method and made it one of the promising future nanofabrication technologies with low-cost and scalability. In this review, we provide a comprehensive summary of the state-of-the-art DLW fabrication technology for nanometer scale metallic structures. The fabrication mechanisms, different material choices, fabrication capability, including resolution, conductivity and structure surface smoothness, as well as the characterization methods and achievable devices for different applications are presented. In particular, the development trends of the field and the perspectives for future opportunities and challenges are provided at the end of the review. It has been demonstrated that the quality of the metallic structures fabricated using the DLW method is excellent compared with other methods providing a new and enabling platform for functional nanophotonic device fabrication.

What makes a reach movement effortful? Physical effort discounting supports common minimization principles in decision making and motor control

PubMed Central

Ulbrich, Philipp; Gail, Alexander

2017-01-01

When deciding between alternative options, a rational agent chooses on the basis of the desirability of each outcome, including associated costs. As different options typically result in different actions, the effort associated with each action is an essential cost parameter. How do humans discount physical effort when deciding between movements? We used an action-selection task to characterize how subjective effort depends on the parameters of arm transport movements and controlled for potential confounding factors such as delay discounting and performance. First, by repeatedly asking subjects to choose between 2 arm movements of different amplitudes or durations, performed against different levels of force, we identified parameter combinations that subjects experienced as identical in effort (isoeffort curves). Movements with a long duration were judged more effortful than short-duration movements against the same force, while movement amplitudes did not influence effort. Biomechanics of the movements also affected effort, as movements towards the body midline were preferred to movements away from it. Second, by introducing movement repetitions, we further determined that the cost function for choosing between effortful movements had a quadratic relationship with force, while choices were made on the basis of the logarithm of these costs. Our results show that effort-based action selection during reaching cannot easily be explained by metabolic costs. Instead, force-loaded reaches, a widely occurring natural behavior, imposed an effort cost for decision making similar to cost functions in motor control. Our results thereby support the idea that motor control and economic choice are governed by partly overlapping optimization principles. PMID:28586347

Functional Impairment: An Unmeasured Marker of Medicare Costs for Postacute Care of Older Adults.

PubMed

Greysen, S Ryan; Stijacic Cenzer, Irena; Boscardin, W John; Covinsky, Kenneth E

2017-09-01

To assess the effects of preadmission functional impairment on Medicare costs of postacute care up to 365 days after hospital discharge. Longitudinal cohort study. Health and Retirement Study (HRS). Nationally representative sample of 16,673 Medicare hospitalizations of 8,559 community-dwelling older adults from 2000 to 2012. The main outcome was total Medicare costs in the year after hospital discharge, assessed according to Medicare claims data. The main predictor was functional impairment (level of difficulty or dependence in activities of daily living (ADLs)), determined from HRS interview preceding hospitalization. Multivariable linear regression was performed, adjusted for age, race, sex, income, net worth, and comorbidities, with clustering at the individual level to characterize the association between functional impairment and costs of postacute care. Unadjusted mean Medicare costs for 1 year after discharge increased with severity of impairment in a dose-response fashion (P < .001 for trend); 68% had no functional impairment ($25,931), 17% had difficulty with one ADL ($32,501), 7% had dependency in one ADL ($39,928), and 8% had dependency in two or more ADLs ($45,895). The most severely impaired participants cost 77% more than those with no impairment; adjusted analyses showed attenuated effect size (33% more) but no change in trend. Considering costs attributable to comorbidities, only three conditions were more expensive than severe functional impairment (lymphoma, metastatic cancer, paralysis). Functional impairment is associated with greater Medicare costs for postacute care and may be an unmeasured but important marker of long-term costs that cuts across conditions. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Association Between Cognitive Function and Health Care Costs 3 Months and 6 Months After Initiating Antidepressant Medication for Depressive Disorders.

PubMed

Walker, Valery; Patel, Haridarshan; Kurlander, Jonathan L; Essoi, Breanna; Yang, Jiao; Mahableshwarkar, Atul R; Samp, Jennifer C; Akhras, Kasem S

2015-09-01

Major depressive disorder is one of the most common and disabling mental health disorders and is associated with substantial costs in terms of direct health care utilization and workplace productivity. Cognitive dysfunction, which alone substantially increases health care costs, is commonly associated with major depressive disorder. However, the health care costs of cognitive dysfunction in the context of depressive disorder are unknown. Recovery from mood symptoms is not always associated with resolution of cognitive dysfunction. Thus, cognitive dysfunction may contribute to health care burden even with successful antidepressant therapy.  To compare health care utilization and costs for patients with a depressive disorder with and without cognitive dysfunction, at 3 and 6 months after initiation of antidepressant medication.  This was an observational study, combining a cross-sectional patient survey, administered during a telephone interview, with health care claims data from a large, geographically diverse U.S. health plan. Included patients had at least 1 pharmacy claim for an antidepressant medication between August 1 and September 30, 2012, and no claim for any antidepressant during the 6 months prior to the index date. In addition to other criteria assessed in the claims data, patients confirmed a diagnosis of depression or major depressive disorder and the absence of any exclusionary neurological diagnoses possibly associated with cognitive impairment. Eligible patients were administered validated cognitive function assessments of verbal episodic memory (Hopkins Verbal Learning Test-Revised, Delayed and Total); attention (Digit Span Forward Maximum Sequence Length); working memory (Digit Span Backward Maximum Sequence Length); and executive function (D-KEFS-Letter Fluency Test). Based on comparison of scores with normative data, patients were assigned to cognitive dysfunction or cognitive normal cohorts. All-cause (all diagnoses) and depressive disorder-related health care utilization and costs (all from a payer perspective) were assessed 6 months prior (baseline) to antidepressant initiation and 3 months and 6 months after (follow-up) initiation of antidepressant medication. Health care utilization and costs included ambulatory (office and hospital outpatient), emergency room, inpatient hospital, pharmacy, other medical (e.g., laboratory and diagnostics), and total (all categories combined). All-cause and depressive disorder-related total costs during the 3- and 6-month follow-up periods were modeled with generalized linear modeling with gamma distribution and log link, while adjusting for potential confounders (age, race, gender, education, employment, and comorbidities). Of the 13,537 patients who were mailed an invitation, 824 (6%) were eligible and agreed to participate. Of these, 563 patients provided informed consent, completed the interview, maintained eligibility, and were included in the 3-month calculations. Among these, 255 (45%) were classified as having cognitive dysfunction. Mean patient age was 41.3 (± 12.5) years; 80% were female. Most patients were white and employed. More patients in the cognitive normal cohort were white (P  less than  0.001) and employed full time (P = 0.029), had higher education attainment (P  less than    0.001), and had fewer comorbidities (P = 0.007) than those in the cognitive dysfunction cohort. Over the first 3 months, patients with cognitive dysfunction had higher adjusted all-cause costs ($3,309 vs. $2,157, P = 0.002) and higher adjusted depressive disorder-related costs ($718 vs. $406, P  less than  0.001) than patients without cognitive dysfunction. At 6 months, data from 4 patients were removed from the analysis because of exclusionary diagnoses. Over 6 months, patients with cognitive dysfunction had higher adjusted all-cause costs ($4,793) than patients without cognitive dysfunction ($3,683, P = 0.034). Over 6 months, depressive disorder-related costs did not significantly differ between patients with ($771) and without cognitive dysfunction ($594, P = 0.071). The main drivers of all-cause costs were office visits, outpatient hospital visits, and inpatient costs, and the main driver of depressive disorder-related costs was inpatient costs. Cognitive dysfunction was associated with higher adjusted all-cause and depressive disorder-related costs 3 months after initiation of an antidepressant medication. This difference persisted for all-cause costs through 6 months. Identification and treatment of cognitive dysfunction in patients with depressive disorder might reduce health care costs.

Conservative treatment for incontinence in women in rest home care in Christchurch: Outcomes and cost.

PubMed

Arnold, Edwin Paterson; Milne, Dorothy Joan; English, Sharon

2016-06-01

To assess if conservative therapy can reduce urinary leakage and pad usage and improve quality of life in elderly incontinent women living in a rest home setting; and if so at what additional cost. Sixty-eight elderly women with urinary incontinence, and preserved cognitive ability, living in 26 rest homes were identified. Clinical evaluation, included bladder diary, pad weigh tests, pad usage, and quality of life and activities questionnaires (FIM: Functional Impairment Measure; EQ-5D: Euroquol 5 dimension score; ICIQ-SF: International Consultation on Incontinence-Short Form). A specialist Continence Advisor Nurse provided conservative treatment according to the needs of each participant. Outcomes were recorded after 12 weeks of treatment by repeating above evaluations, and the costs involved were measured. Leakage was reduced by a mean of 60 ml per 24 hr, and four fewer pads were required per week. The ICIQ-SF improved significantly. The EQ-5D did not demonstrate significant improvement, so a cost-utility analysis was not possible. The mean cost of the Advisor's time and mileage in providing the 12 week course was $247.75 per participant. Conservative therapies tailored to each individual, can improve the severity of leakage in the short term, even in this elderly group of women with preserved cognitive function, at modest additional cost. Measuring quality of life and the impact of incontinence, has challenges in this age group. Neurourol. Urodynam. 35:636-641, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Does the use of Nintendo Wii SportsTM improve arm function? Trial of WiiTM in Stroke: a randomized controlled trial and economics analysis.

PubMed

Adie, Katja; Schofield, Christine; Berrow, Margie; Wingham, Jennifer; Humfryes, John; Pritchard, Colin; James, Martin; Allison, Rhoda

2017-02-01

The Trial of Wii™ in Stroke investigated the efficacy of using the Nintendo Wii Sports™ (Wii TM ) to improve affected arm function after stroke. Multicentre, pragmatic, parallel group, randomized controlled trial. Home-based rehabilitation. A total of 240 participants aged 24-90 years with arm weakness following a stroke within the previous six months. Participants were randomly assigned to exercise daily for six weeks using the Wii TM or arm exercises at home. Primary outcome was change in the affected arm function at six weeks follow-up using the Action Research Arm Test. Secondary outcomes included occupational performance, quality of life, arm function at six months and a cost effectiveness analysis. The study was completed by 209 participants (87.1%). There was no significant difference in the primary outcome of affected arm function at six weeks follow-up (mean difference -1.7, 95% CI -3.9 to 0.5, p = 0.12) and no significant difference in secondary outcomes, including occupational performance, quality of life or arm function at six months, between the two groups. No serious adverse events related to the study treatment were reported. The cost effectiveness analysis showed that the Wii TM was more expensive than arm exercises £1106 (SD 1656) vs. £730 (SD 829) (probability 0.866). The trial showed that the Wii TM was not superior to arm exercises in home-based rehabilitation for stroke survivors with arm weakness. The Wii TM was well tolerated but more expensive than arm exercises.

Trade-space Analysis for Constellations

NASA Astrophysics Data System (ADS)

Le Moigne, J.; Dabney, P.; de Weck, O. L.; Foreman, V.; Grogan, P.; Holland, M. P.; Hughes, S. P.; Nag, S.

2016-12-01

Traditionally, space missions have relied on relatively large and monolithic satellites, but in the past few years, under a changing technological and economic environment, including instrument and spacecraft miniaturization, scalable launchers, secondary launches as well as hosted payloads, there is growing interest in implementing future NASA missions as Distributed Spacecraft Missions (DSM). The objective of our project is to provide a framework that facilitates DSM Pre-Phase A investigations and optimizes DSM designs with respect to a-priori Science goals. In this first version of our Trade-space Analysis Tool for Constellations (TAT-C), we are investigating questions such as: "How many spacecraft should be included in the constellation? Which design has the best cost/risk value?" The main goals of TAT-C are to: Handle multiple spacecraft sharing a mission objective, from SmallSats up through flagships, Explore the variables trade space for pre-defined science, cost and risk goals, and pre-defined metrics Optimize cost and performance across multiple instruments and platforms vs. one at a time. This paper describes the overall architecture of TAT-C including: a User Interface (UI) interacting with multiple users - scientists, missions designers or program managers; an Executive Driver gathering requirements from UI, then formulating Trade-space Search Requests for the Trade-space Search Iterator first with inputs from the Knowledge Base, then, in collaboration with the Orbit & Coverage, Reduction & Metrics, and Cost& Risk modules, generating multiple potential architectures and their associated characteristics. TAT-C leverages the use of the Goddard Mission Analysis Tool (GMAT) to compute coverage and ancillary data, streamlining the computations by modeling orbits in a way that balances accuracy and performance. TAT-C current version includes uniform Walker constellations as well as Ad-Hoc constellations, and its cost model represents an aggregate model consisting of Cost Estimating Relationships (CERs) from widely accepted models. The Knowledge Base supports both analysis and exploration, and the current GUI prototype automatically generates graphics representing metrics such as average revisit time or coverage as a function of cost.

Theoretical and experimental researches on the operating costs of a wastewater treatment plant

NASA Astrophysics Data System (ADS)

Panaitescu, M.; Panaitescu, F.-V.; Anton, I.-A.

2015-11-01

Purpose of the work: The total cost of a sewage plants is often determined by the present value method. All of the annual operating costs for each process are converted to the value of today's correspondence and added to the costs of investment for each process, which leads to getting the current net value. The operating costs of the sewage plants are subdivided, in general, in the premises of the investment and operating costs. The latter can be stable (normal operation and maintenance, the establishment of power) or variables (chemical and power sludge treatment and disposal, of effluent charges). For the purpose of evaluating the preliminary costs so that an installation can choose between different alternatives in an incipient phase of a project, can be used cost functions. In this paper will be calculated the operational cost to make several scenarios in order to optimize its. Total operational cost (fixed and variable) is dependent global parameters of wastewater treatment plant. Research and methodology: The wastewater treatment plant costs are subdivided in investment and operating costs. We can use different cost functions to estimate fixed and variable operating costs. In this study we have used the statistical formulas for cost functions. The method which was applied to study the impact of the influent characteristics on the costs is economic analysis. Optimization of plant design consist in firstly, to assess the ability of the smallest design to treat the maximum loading rates to a given effluent quality and, secondly, to compare the cost of the two alternatives for average and maximum loading rates. Results: In this paper we obtained the statistical values for the investment cost functions, operational fixed costs and operational variable costs for wastewater treatment plant and its graphical representations. All costs were compared to the net values. Finally we observe that it is more economical to build a larger plant, especially if maximum loading rates are reached. The actual target of operational management is to directly implement the presented cost functions in a software tool, in which the design of a plant and the simulation of its behaviour are evaluated simultaneously.

An intervention program with the aim to improve and maintain work productivity for workers with rheumatoid arthritis: design of a randomized controlled trial and cost-effectiveness study

PubMed Central

2012-01-01

Background Workers with rheumatoid arthritis (RA) often experience restrictions in functioning at work and participation in employment. Strategies to maintain work productivity exist, but these interventions do not involve the actual workplace. Therefore the aim of this study is to investigate the (cost)effectiveness of an intervention program at the workplace on work productivity for workers with RA. Methods/design This study is a randomized controlled trial (RCT) in specialized rheumatology treatment centers in or near Amsterdam, the Netherlands. Randomisation to either the control or the intervention group is performed at patient level. Both groups will receive care as usual by the rheumatologist, and patients in the intervention group will also take part in the intervention program. The intervention program consists of two components; integrated care, including a participatory workplace intervention. Integrated care involves a clinical occupational physician, who will act as care manager, to coordinate the care. The care manager has an intermediate role between clinical and occupational care. The participatory workplace intervention will be guided by an occupational therapist, and involves problem solving by the patient and the patients’ supervisor. The aim of the workplace intervention is to achieve consensus between patient and supervisor concerning feasible solutions for the obstacles for functioning at work. Data collection will take place at baseline and after 6 and 12 months by means of a questionnaire. The primary outcome measure is work productivity, measured by hours lost from work due to presenteeism. Secondary outcome measures include sick leave, quality of life, pain and fatigue. Cost-effectiveness of the intervention program will be evaluated from the societal perspective. Discussion Usual care of primary and outpatient health services is not aimed at improving work productivity. Therefore it is desirable to develop interventions aimed at improving functioning at work. If the intervention program will be (cost)effective, substantial improvements in work productivity might be obtained among workers with RA at lower costs. Results are expected in 2015. Trial registration number NTR2886 PMID:22747949

An intervention program with the aim to improve and maintain work productivity for workers with rheumatoid arthritis: design of a randomized controlled trial and cost-effectiveness study.

PubMed

van Vilsteren, Myrthe; Boot, Cécile R L; Steenbeek, Romy; van Schaardenburg, Dirkjan; Voskuyl, Alexandre E; Anema, Johannes R

2012-07-02

Workers with rheumatoid arthritis (RA) often experience restrictions in functioning at work and participation in employment. Strategies to maintain work productivity exist, but these interventions do not involve the actual workplace. Therefore the aim of this study is to investigate the (cost)effectiveness of an intervention program at the workplace on work productivity for workers with RA. This study is a randomized controlled trial (RCT) in specialized rheumatology treatment centers in or near Amsterdam, the Netherlands. Randomisation to either the control or the intervention group is performed at patient level. Both groups will receive care as usual by the rheumatologist, and patients in the intervention group will also take part in the intervention program. The intervention program consists of two components; integrated care, including a participatory workplace intervention. Integrated care involves a clinical occupational physician, who will act as care manager, to coordinate the care. The care manager has an intermediate role between clinical and occupational care. The participatory workplace intervention will be guided by an occupational therapist, and involves problem solving by the patient and the patients' supervisor. The aim of the workplace intervention is to achieve consensus between patient and supervisor concerning feasible solutions for the obstacles for functioning at work. Data collection will take place at baseline and after 6 and 12 months by means of a questionnaire. The primary outcome measure is work productivity, measured by hours lost from work due to presenteeism. Secondary outcome measures include sick leave, quality of life, pain and fatigue. Cost-effectiveness of the intervention program will be evaluated from the societal perspective. Usual care of primary and outpatient health services is not aimed at improving work productivity. Therefore it is desirable to develop interventions aimed at improving functioning at work. If the intervention program will be (cost)effective, substantial improvements in work productivity might be obtained among workers with RA at lower costs. Results are expected in 2015. NTR2886.

NASA Project Constellation Systems Engineering Approach

NASA Technical Reports Server (NTRS)

Dumbacher, Daniel L.

2005-01-01

NASA's Office of Exploration Systems (OExS) is organized to empower the Vision for Space Exploration with transportation systems that result in achievable, affordable, and sustainable human and robotic journeys to the Moon, Mars, and beyond. In the process of delivering these capabilities, the systems engineering function is key to implementing policies, managing mission requirements, and ensuring technical integration and verification of hardware and support systems in a timely, cost-effective manner. The OExS Development Programs Division includes three main areas: (1) human and robotic technology, (2) Project Prometheus for nuclear propulsion development, and (3) Constellation Systems for space transportation systems development, including a Crew Exploration Vehicle (CEV). Constellation Systems include Earth-to-orbit, in-space, and surface transportation systems; maintenance and science instrumentation; and robotic investigators and assistants. In parallel with development of the CEV, robotic explorers will serve as trailblazers to reduce the risk and costs of future human operations on the Moon, as well as missions to other destinations, including Mars. Additional information is included in the original extended abstract.

A model-based analysis of the clinical and economic impact of personalising P2Y12-receptor inhibition with platelet function testing in acute coronary syndrome patients.

PubMed

Straub, Niels; Beivers, Andreas; Lenk, Ekaterina; Aradi, Daniel; Sibbing, Dirk

2014-02-01

Although some observational studies reported that the measured level of P2Y12-inhibition is predictive for thrombotic events, the clinical and economic benefit of incorporating PFT to personalize P2Y12-receptor directed antiplatelet treatment is unknown. Here, we assessed the clinical impact and cost-effectiveness of selecting P2Y12-inhibitors based on platelet function testing (PFT) in acute coronary syndrome (ACS) patients undergoing PCI. A decision model was developed to analyse the health economic effects of different strategies. PFT-guided treatment was compared with the three options of general clopidogrel, prasugrel or ticagrelor treatment. In the PFT arm, low responders to clopidogrel received prasugrel, while normal responders carried on with clopidogrel. The associated endpoints in the model were cardiovascular death, stent thrombosis and major bleeding. With a simulated cohort of 10,000 patients treated for one year, there were 93 less events in the PFT arm compared to general clopidogrel. In prasugrel and ticagrelor arms, 110 and 86 events were prevented compared to clopidogrel treatment, respectively. The total expected costs (including event costs, drug costs and PFT costs) for generic clopidogrel therapy were US$ 1,059/patient. In the PFT arm, total costs were US$ 1,494, while in the prasugrel and ticagrelor branches they were US$ 3,102 and US$ 3,771, respectively. The incremental-cost-effectiveness-ratio (ICER) was US$ 46,770 for PFT-guided therapy, US$ 185,783 for prasugrel and US$ 315,360 for ticagrelor. In this model-based analysis, a PFT-guided therapy may have fewer adverse outcomes than general treatment with clopidogrel and may be more cost-effective than prasugrel or ticagrelor treatment in ACS patients undergoing PCI.

Carpal tunnel syndrome, the search for a cost-effective surgical intervention: a randomised controlled trial.

PubMed Central

Lorgelly, Paula K.; Dias, Joseph J.; Bradley, Mary J.; Burke, Frank D.

2005-01-01

OBJECTIVE: There is insufficient evidence regarding the clinical and cost-effectiveness of surgical interventions for carpal tunnel syndrome. This study evaluates the cost, effectiveness and cost-effectiveness of minimally invasive surgery compared with conventional open surgery. PATIENTS AND METHODS: 194 sufferers (208 hands) of carpal tunnel syndrome were randomly assigned to each treatment option. A self-administered questionnaire assessed the severity of patients' symptoms and functional status pre- and postoperatively. Treatment costs were estimated from resource use and hospital financial data. RESULTS: Minimally invasive carpal tunnel decompression is marginally more effective than open surgery in terms of functional status, but not significantly so. Little improvement in symptom severity was recorded for either intervention. Minimally invasive surgery was found to be significantly more costly than open surgery. The incremental cost effectiveness ratio for functional status was estimated to be 197 UK pounds, such that a one percentage point improvement in functioning costs 197 UK pounds when using the minimally invasive technique. CONCLUSIONS: Minimally invasive carpal tunnel decompression appears to be more effective but more costly. Initial analysis suggests that the additional expense for such a small improvement in function and no improvement in symptoms would not be regarded as value-for-money, such that minimally invasive carpal tunnel release is unlikely to be considered a cost-effective alternative to the traditional open surgery procedure. PMID:15720906

Research without billing data. Econometric estimation of patient-specific costs.

PubMed

Barnett, P G

1997-06-01

This article describes a method for computing the cost of care provided to individual patients in health care systems that do not routinely generate billing data, but gather information on patient utilization and total facility costs. Aggregate data on cost and utilization were used to estimate how costs vary with characteristics of patients and facilities of the US Department of Veterans Affairs. A set of cost functions was estimated, taking advantage of the department-level organization of the data. Casemix measures were used to determine the costs of acute hospital and long-term care. Hospitalization for medical conditions cost an average of $5,642 per US Health Care Financing Administration diagnosis-related group weight; surgical hospitalizations cost $11,836. Nursing home care cost $197.33 per day, intermediate care cost $280.66 per day, psychiatric care cost $307.33 per day, and domiciliary care cost $111.84 per day. Outpatient visits cost an average of $90.36. These estimates include the cost of physician services. The econometric method presented here accounts for variation in resource use caused by casemix that is not reflected in length of stay and for the effects of medical education, research, facility size, and wage rates. Data on non-Veteran's Affairs hospital stays suggest that the method accounts for 40% of the variation in acute hospital care costs and is superior to cost estimates based on length of stay or diagnosis-related group weight alone.

2 CFR Appendix E to Part 225 - State and Local Indirect Cost Rate Proposals

Code of Federal Regulations, 2013 CFR

2013-01-01

.... 1. General. a. Where a governmental unit's department or agency has only one major function, or where all its major functions benefit from the indirect costs to approximately the same degree, the...'s department or agency has several major functions which benefit from its indirect costs in varying...

2 CFR Appendix E to Part 225 - State and Local Indirect Cost Rate Proposals

Code of Federal Regulations, 2011 CFR

2011-01-01

.... 1. General. a. Where a governmental unit's department or agency has only one major function, or where all its major functions benefit from the indirect costs to approximately the same degree, the...'s department or agency has several major functions which benefit from its indirect costs in varying...

Chitosan in Molecularly-Imprinted Polymers: Current and Future Prospects.

PubMed

Xu, Long; Huang, Yun-An; Zhu, Qiu-Jin; Ye, Chun

2015-08-07

Chitosan is widely used in molecular imprinting technology (MIT) as a functional monomer or supporting matrix because of its low cost and high contents of amino and hydroxyl functional groups. The various excellent properties of chitosan, which include nontoxicity, biodegradability, biocompatibility, and attractive physical and mechanical performances, make chitosan a promising alternative to conventional functional monomers. Recently, chitosan molecularly-imprinted polymers have gained considerable attention and showed significant potential in many fields, such as curbing environmental pollution, medicine, protein separation and identification, and chiral-compound separation. These extensive applications are due to the polymers' desired selectivity, physical robustness, and thermal stability, as well as their low cost and easy preparation. Cross-linkers, which fix the functional groups of chitosan around imprinted molecules, play an important role in chitosan molecularly-imprinted polymers. This review summarizes the important cross-linkers of chitosan molecularly-imprinted polymers and illustrates the cross-linking mechanism of chitosan and cross-linkers based on the two glucosamine units. Finally, some significant attempts to further develop the application of chitosan in MIT are proposed.

Costs explained by function rather than diagnosis--results from the SNAC Nordanstig elderly cohort in Sweden.

PubMed

Lindholm, C; Gustavsson, A; Jönsson, L; Wimo, A

2013-05-01

Because the prevalence of many brain disorders rises with age, and brain disorders are costly, the economic burden of brain disorders will increase markedly during the next decades. The purpose of this study is to analyze how the costs to society vary with different levels of functioning and with the presence of a brain disorder. Resource utilization and costs from a societal viewpoint were analyzed versus cognition, activities of daily living (ADL), instrumental activities of daily living (IADL), brain disorder diagnosis and age in a population-based cohort of people aged 65 years and older in Nordanstig in Northern Sweden. Descriptive statistics, non-parametric bootstrapping and a generalized linear model (GLM) were used for the statistical analyses. Most people were zero users of care. Societal costs of dementia were by far the highest, ranging from SEK 262,000 (mild) to SEK 519,000 per year (severe dementia). In univariate analysis, all measures of functioning were significantly related to costs. When controlling for ADL and IADL in the multivariate GLM, cognition did not have a statistically significant effect on total cost. The presence of a brain disorder did not impact total cost when controlling for function. The greatest shift in costs was seen when comparing no dependency in ADL and dependency in one basic ADL function. It is the level of functioning, rather than the presence of a brain disorder diagnosis, which predicts costs. ADLs are better explanatory variables of costs than Mini mental state examination. Most people in a population-based cohort are zero users of care. Copyright © 2012 John Wiley & Sons, Ltd.

2 CFR Appendix A to Part 230 - General Principles

Code of Federal Regulations, 2010 CFR

2010-01-01

... accordance with the relative benefits received. A cost is allocable to a Federal award if it is treated... personnel, occupy space, and benefit from the organization's indirect costs. 4. The costs of activities... major function, or where all its major functions benefit from its indirect costs to approximately the...

The Finnish experience to save asthma costs by improving care in 1987-2013.

PubMed

Haahtela, Tari; Herse, Fredrik; Karjalainen, Jussi; Klaukka, Timo; Linna, Miika; Leskelä, Riikka-Leena; Selroos, Olof; Reissell, Eeva

2017-02-01

The Finnish National Asthma Program 1994-2004 markedly improved asthma care in the 1990s. We evaluated the changes in costs during 26 years from 1987 to 2013. Direct and indirect costs were calculated by using data from national registries. Costs from both the societal and patient perspectives were included. The costs were based on patients with persistent, physician-diagnosed asthma verified by lung function measurements. We constructed minimum and maximum scenarios to assess the effect of improved asthma care on total costs. The number of patients with persistent asthma in the national drug reimbursement register increased from 83,000 to 247,583. Improved asthma control reduced health care use and disability, resulting in major cost savings. Despite a 3-fold increase in patients, the total costs decreased by 14%, from €222 million to €191 million. Costs for medication and primary care visits increased, but overall annual costs per patient decreased by 72%, from €2656 to €749. The theoretical total cost savings for 2013, comparing actual with predicted costs, were between €120 and €475 million, depending on the scenario used. The Finnish Asthma Program resulted in significant cost savings at both the societal and patient levels during a 26-year period. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Exploring indicators of use of costly health services in community-dwelling adults with multiple chronic conditions.

PubMed

Holland, Diane E; Vanderboom, Catherine E; Lohse, Christine M; Mandrekar, Jay; Targonski, Paul V; Madigan, Elizabeth; Powell, Suzanne K

2015-01-01

Although experts recognize that including patient functional and social variables would improve models predicting risk of using costly health services, these self-reported variables are not widely used. Explore differences in predisposing characteristics, enabling resources, patient-perceived need for care and professionally evaluated need for care variables between patients receiving primary care within a Health Care Home who did and did not use hospital, emergency department, or skilled nursing facility services in a 3-month period of time. Primary care. Guided by the Behavioral Model of Health Service Use, a secondary analysis was conducted on data from a study that included 57 community-dwelling older adults receiving primary care in a Health Care Home. Because of the exploratory nature of the study, group differences in the use of costly care services were compared at the 0.10 level of statistical significance. Seventeen patients (29.8%) experienced costly care services. The greatest number of differences in variables between groups was in the category of patient-perceived need for care (functional impairments, dependencies, difficulties). Targeting case management services using evidence-based decision support tools such as prediction models enhances the opportunity to maximize outcomes and minimize waste of resources. Patient-perceived and clinician-evaluated need for care may need to be combined to fully describe the contextual needs that drive the use of health services. Difficulty with Activities with Daily Living and Instrumental Activities of Daily Living should be considered in future studies as candidate predictor variables for need for case management services in primary care settings.

Functional outcome and cost-effectiveness of pulsed electromagnetic fields in the treatment of acute scaphoid fractures: a cost-utility analysis.

PubMed

Hannemann, Pascal F W; Essers, Brigitte A B; Schots, Judith P M; Dullaert, Koen; Poeze, Martijn; Brink, Peter R G

2015-04-11

Physical forces have been widely used to stimulate bone growth in fracture repair. Addition of bone growth stimulation to the conservative treatment regime is more costly than standard health care. However, it might lead to cost-savings due to a reduction of the total amount of working days lost. This economic evaluation was performed to assess the cost-effectiveness of Pulsed Electromagnetic Fields (PEMF) compared to standard health care in the treatment of acute scaphoid fractures. An economic evaluation was carried out from a societal perspective, alongside a double-blind, randomized, placebo-controlled, multicenter trial involving five centres in The Netherlands. One hundred and two patients with a clinically and radiographically proven fracture of the scaphoid were included in the study and randomly allocated to either active bone growth stimulation or standard health care, using a placebo. All costs (medical costs and costs due to productivity loss) were measured during one year follow up. Functional outcome and general health related quality of life were assessed by the EuroQol-5D and PRWHE (patient rated wrist and hand evaluation) questionnaires. Utility scores were derived from the EuroQol-5D. The average total number of working days lost was lower in the active PEMF group (9.82 days) compared to the placebo group (12.91 days) (p = 0.651). Total medical costs of the intervention group (€1594) were significantly higher compared to the standard health care (€875). The total amount of mean QALY's (quality-adjusted life year) for the active PEMF group was 0.84 and 0.85 for the control group. The cost-effectiveness plane shows that the majority of all cost-effectiveness ratios fall into the quadrant where PEMF is not only less effective in terms of QALY's but also more costly. This study demonstrates that the desired effects in terms of cost-effectiveness are not met. When comparing the effects of PEMF to standard health care in terms of QALY's, PEMF cannot be considered a cost-effective treatment for acute fractures of the scaphoid bone. Netherlands Trial Register (NTR): NTR2064.

Adaptive non-linear control for cancer therapy through a Fokker-Planck observer.

PubMed

Shakeri, Ehsan; Latif-Shabgahi, Gholamreza; Esmaeili Abharian, Amir

2018-04-01

In recent years, many efforts have been made to present optimal strategies for cancer therapy through the mathematical modelling of tumour-cell population dynamics and optimal control theory. In many cases, therapy effect is included in the drift term of the stochastic Gompertz model. By fitting the model with empirical data, the parameters of therapy function are estimated. The reported research works have not presented any algorithm to determine the optimal parameters of therapy function. In this study, a logarithmic therapy function is entered in the drift term of the Gompertz model. Using the proposed control algorithm, the therapy function parameters are predicted and adaptively adjusted. To control the growth of tumour-cell population, its moments must be manipulated. This study employs the probability density function (PDF) control approach because of its ability to control all the process moments. A Fokker-Planck-based non-linear stochastic observer will be used to determine the PDF of the process. A cost function based on the difference between a predefined desired PDF and PDF of tumour-cell population is defined. Using the proposed algorithm, the therapy function parameters are adjusted in such a manner that the cost function is minimised. The existence of an optimal therapy function is also proved. The numerical results are finally given to demonstrate the effectiveness of the proposed method.

OPTIM: Computer program to generate a vertical profile which minimizes aircraft fuel burn or direct operating cost. User's guide

NASA Technical Reports Server (NTRS)

1983-01-01

A profile of altitude, airspeed, and flight path angle as a function of range between a given set of origin and destination points for particular models of transport aircraft provided by NASA is generated. Inputs to the program include the vertical wind profile, the aircraft takeoff weight, the costs of time and fuel, certain constraint parameters and control flags. The profile can be near optimum in the sense of minimizing: (1) fuel, (2) time, or (3) a combination of fuel and time (direct operating cost (DOC)). The user can also, as an option, specify the length of time the flight is to span. The theory behind the technical details of this program is also presented.

Technoeconomic study on steam explosion application in biomass processing.

PubMed

Zimbardi, Francesco; Ricci, Esmeralda; Braccio, Giacobbe

2002-01-01

This work is based on the data collected during trials of a continuous steam explosion (SE) plant, with a treatment capacity of about 350 kg/h, including the biomass fractionation section. The energy and water consumption, equipment cost, and manpower needed to run this plant have been used as the base case for a techno-economic evaluation of productive plants. Three processing plant configurations have been considered: (I) SE pretreatment only; (II) SE followed by the hemicellulose extraction; (III) SE followed by the sequential hemicellulose and lignin extractions. The biomass treatment cost has been evaluated as a function of the plant scale. For each configuration, variable and fixed cost breakdown has been detailed in the case of a 50,000 t/y plant.

iTunes song-gifting is a low-cost, efficient recruitment tool to engage high-risk MSM in internet research.

PubMed

Holland, Christine M; Ritchie, Natalie D; Du Bois, Steve N

2015-10-01

This brief report describes methodology and results of a novel, efficient, and low-cost recruitment tool to engage high-risk MSM in online research. We developed an incentivization protocol using iTunes song-gifting to encourage participation of high-risk MSM in an Internet-based survey of HIV status, childhood sexual abuse, and adult behavior and functioning. Our recruitment methodology yielded 489 participants in 4.5 months at a total incentive cost of $1.43USD per participant. The sample comprised a critically high-risk group of MSM, including 71.0 % who reported recent condomless anal intercourse. We offer a "how-to" guide to aid future investigators in using iTunes song-gifting incentives.

A novel method of estimating cost of therapy by using patient population characteristics: analysis of fluoroquinolones in various populations with different distributions of renal function.

PubMed

Enzweiler, Kevin A; Bosso, John A; White, Roger L

2003-07-01

Formulary decisions regarding a given drug class are often made in the absence of patient outcome and/or sophisticated pharmacoeconomic data. Analyses that consider factors beyond simple acquisition costs may be useful in such situations. For example, the cost implications of using manufacturers' recommendations for dosing in patients with renal dysfunction may be important, depending on the distribution of various levels of renal function within a patient population. Using four 1000-patient populations representing different renal function distributions and a fifth population of our medical center's distribution, we determined the costs of therapy for intravenous and oral levofloxacin, gatifloxacin, and moxifloxacin for a 10-day course of therapy for community-acquired pneumonia. Costs considered were average wholesale prices (AWPs), 50% of AWP, or same daily price, plus intravenous dose preparation and administration costs when applicable. Costs for each renal function distribution were examined for significant differences with an analysis-of-variance test. Also, costs of failing to adjust dosing regimens for decreased renal function were determined. Differences in fluoroquinolone costs (AWP, 50% AWP, or when matched as the same daily price) among the populations were found. When considering same daily prices, differences among populations ranged from about 35,000 dollars with intravenous gatifloxacin to more than 51,000 dollars for intravenous levofloxacin (all fluoroquinolones, p>0.05). Within a population, differences in costs among the intravenous fluoroquinolones ranged from 47,000-99,000 dollars. Rank orders of the drugs and population costs of therapy were affected by the pricing structure used and varied by the specific population and drug. Differences among the fluoroquinolones or populations were much smaller (<2100 dollars) when considering oral regimens. Costs potentially incurred by failing to adjust dosing for renal function were substantial. Formulary decisions can be facilitated by considering factors such as patient characteristics and related dosing in addition to simple acquisition costs. In our example, consideration of the distribution of renal function within a given patient population and related dosing for these fluoroquinolones revealed potentially important differences within the class.

Investing in innovation: trade-offs in the costs and cost-efficiency of school feeding using community-based kitchens in Bangladesh.

PubMed

Gelli, Aulo; Suwa, Yuko

2014-09-01

School feeding programs have been a key response to the recent food and economic crises and function to some degree in nearly every country in the world. However, school feeding programs are complex and exhibit different, context-specific models or configurations. To examine the trade-offs, including the costs and cost-efficiency, of an innovative cluster kitchen implementation model in Bangladesh using a standardized framework. A supply chain framework based on international standards was used to provide benchmarks for meaningful comparisons across models. Implementation processes specific to the program in Bangladesh were mapped against this reference to provide a basis for standardized performance measures. Qualitative and quantitative data on key metrics were collected retrospectively using semistructured questionnaires following an ingredients approach, including both financial and economic costs. Costs were standardized to a 200-feeding-day year and 700 kcal daily. The cluster kitchen model had similarities with the semidecentralized model and outsourced models in the literature, the main differences involving implementation scale, scale of purchasing volumes, and frequency of purchasing. Two important features stand out in terms of implementation: the nutritional quality of meals and the level of community involvement. The standardized full cost per child per year was US$110. Despite the nutritious content of the meals, the overall cost-efficiency in cost per nutrient output was lower than the benchmark for centralized programs, due mainly to support and start-up costs. Cluster kitchens provide an example of an innovative implementation model, combining an emphasis on quality meal delivery with strong community engagement. However, the standardized costs-per child were above the average benchmarks for both low-and middle-income countries. In contrast to the existing benchmark data from mature, centralized models, the main cost drivers of the program were associated with support and start-up activities. Further research is required to better understand changes in cost drivers as programs mature.

Breast Cancer–Related Lymphedema: Comparing Direct Costs of a Prospective Surveillance Model and a Traditional Model of Care

PubMed Central

Pfalzer, Lucinda A.; Springer, Barbara; Levy, Ellen; McGarvey, Charles L.; Danoff, Jerome V.; Gerber, Lynn H.; Soballe, Peter W.

2012-01-01

Secondary prevention involves monitoring and screening to prevent negative sequelae from chronic diseases such as cancer. Breast cancer treatment sequelae, such as lymphedema, may occur early or late and often negatively affect function. Secondary prevention through prospective physical therapy surveillance aids in early identification and treatment of breast cancer–related lymphedema (BCRL). Early intervention may reduce the need for intensive rehabilitation and may be cost saving. This perspective article compares a prospective surveillance model with a traditional model of impairment-based care and examines direct treatment costs associated with each program. Intervention and supply costs were estimated based on the Medicare 2009 physician fee schedule for 2 groups: (1) a prospective surveillance model group (PSM group) and (2) a traditional model group (TM group). The PSM group comprised all women with breast cancer who were receiving interval prospective surveillance, assuming that one third would develop early-stage BCRL. The prospective surveillance model includes the cost of screening all women plus the cost of intervention for early-stage BCRL. The TM group comprised women referred for BCRL treatment using a traditional model of referral based on late-stage lymphedema. The traditional model cost includes the direct cost of treating patients with advanced-stage lymphedema. The cost to manage early-stage BCRL per patient per year using a prospective surveillance model is $636.19. The cost to manage late-stage BCRL per patient per year using a traditional model is $3,124.92. The prospective surveillance model is emerging as the standard of care in breast cancer treatment and is a potential cost-saving mechanism for BCRL treatment. Further analysis of indirect costs and utility is necessary to assess cost-effectiveness. A shift in the paradigm of physical therapy toward a prospective surveillance model is warranted. PMID:21921254

Cost-effectiveness Analysis of an Aftercare Service vs Treatment-As-Usual for Patients with Severe Mental Disorders.

PubMed

Barfar, Eshagh; Sharifi, Vandad; Amini, Homayoun; Mottaghipour, Yasaman; Yunesian, Masud; Tehranidoost, Mehdi; Sobhebidari, Payam; Rashidian, Arash

2017-09-01

There have been claims that community mental health principles leads to the maintenance of better health and functioning in patients and can be more economical for patients with severe and chronic mental disorders. Economic evaluation studies have been used to assess the cost-effectiveness of national health programs, or to propose efficient strategies for health care delivery. The current study is intended to test the cost-effectiveness of an Aftercare Service when compared with Treatment-As-Usual for patients with severe mental disorders in Iran. This study was a parallel group randomized controlled trial. A total of 160 post-discharge eligible patients were randomized into two equal patient groups, Aftercare Service (that includes either Home Visiting Care, or Telephone Follow-up for outpatient treatment) vs Treatment-As-Usual, using stratified balanced block randomization method. All patients were followed for 12 months after discharge. The perspective of the present study was the societal perspective. The outcome measures were the rate of readmission at the hospitals after discharge, psychotic symptoms, manic symptoms, depressive symptoms, illness severity, global functioning, quality of life, and patients' satisfaction with the services. The costs included the intervention costs and the patient and family costs in the evaluation period. There was no significant difference in effectiveness measures between the two groups. The Aftercare Service arm was about 66,000 US$ cheaper than Treatment-As-Usual arm. The average total cost per patient in the Treatment-As-Usual group was about 4651 USD, while it was reduced to 3823 US$ in the Aftercare Service group; equivalent to a cost reduction of about 800 USD per patient per year. Given that there was no significant difference in effectiveness measures between the two groups (slightly in favor of the intervention), the Aftercare Service was cost-effective. The most important limitation of the study was the relatively small sample size due to limited budget for the implementation of the study. A larger sample size and longer follow-ups are warranted. Considering the limited resources and equity concerns for health systems, the importance of making decisions about healthcare interventions based on cost-effectiveness evidence is increasing. Our results suggest that the aftercare service can be recommended as an efficient service delivery mode, especially when psychiatric bed requirements are insufficient for a population. Further research should continue the work done with a larger sample size and longer follow-ups to further establish the cost-effectiveness analysis of an aftercare service program compared with routine conventional care.

Quantitative evolutionary design

PubMed Central

Diamond, Jared

2002-01-01

The field of quantitative evolutionary design uses evolutionary reasoning (in terms of natural selection and ultimate causation) to understand the magnitudes of biological reserve capacities, i.e. excesses of capacities over natural loads. Ratios of capacities to loads, defined as safety factors, fall in the range 1.2-10 for most engineered and biological components, even though engineered safety factors are specified intentionally by humans while biological safety factors arise through natural selection. Familiar examples of engineered safety factors include those of buildings, bridges and elevators (lifts), while biological examples include factors of bones and other structural elements, of enzymes and transporters, and of organ metabolic performances. Safety factors serve to minimize the overlap zone (resulting in performance failure) between the low tail of capacity distributions and the high tail of load distributions. Safety factors increase with coefficients of variation of load and capacity, with capacity deterioration with time, and with cost of failure, and decrease with costs of initial construction, maintenance, operation, and opportunity. Adaptive regulation of many biological systems involves capacity increases with increasing load; several quantitative examples suggest sublinear increases, such that safety factors decrease towards 1.0. Unsolved questions include safety factors of series systems, parallel or branched pathways, elements with multiple functions, enzyme reaction chains, and equilibrium enzymes. The modest sizes of safety factors imply the existence of costs that penalize excess capacities. Those costs are likely to involve wasted energy or space for large or expensive components, but opportunity costs of wasted space at the molecular level for minor components. PMID:12122135

Do "premium" joint implants add value?: analysis of high cost joint implants in a community registry.

PubMed

Gioe, Terence J; Sharma, Amit; Tatman, Penny; Mehle, Susan

2011-01-01

Numerous joint implant options of varying cost are available to the surgeon, but it is unclear whether more costly implants add value in terms of function or longevity. We evaluated registry survival of higher-cost "premium" knee and hip components compared to lower-priced standard components. Premium TKA components were defined as mobile-bearing designs, high-flexion designs, oxidized-zirconium designs, those including moderately crosslinked polyethylene inserts, or some combination. Premium THAs included ceramic-on-ceramic, metal-on-metal, and ceramic-on-highly crosslinked polyethylene designs. We compared 3462 standard TKAs to 2806 premium TKAs and 868 standard THAs to 1311 premium THAs using standard statistical methods. The cost of the premium implants was on average approximately $1000 higher than the standard implants. There was no difference in the cumulative revision rate at 7-8 years between premium and standard TKAs or THAs. In this time frame, premium implants did not demonstrate better survival than standard implants. Revision indications for TKA did not differ, and infection and instability remained contributors. Longer followup is necessary to demonstrate whether premium implants add value in younger patient groups. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Optimizing and Diversifying Electric Vehicle Driving Range for U.S. Drivers

DOE PAGES

Lin, Zhenhong

2014-08-11

Properly determining the driving range is critical for accurately predicting the sales and social benefits of battery electric vehicles (BEVs). This study proposes a framework for optimizing the driving range by minimizing the sum of battery price, electricity cost, and range limitation cost referred to as the "range-related cost" as a measurement of range anxiety. The objective function is linked to policy-relevant parameters, including battery cost and price markup, battery utilization, charging infrastructure availability, vehicle efficiency, electricity and gasoline prices, household vehicle ownership, daily driving patterns, discount rate, and perceived vehicle lifetime. Qualitative discussion of the framework and its empiricalmore » application to a sample (N=36664) representing new car drivers in the United States is included. The quantitative results strongly suggest that ranges of less than 100 miles are likely to be more popular in the BEV market for a long period of time. The average optimal range among U.S. drivers is found to be largely inelastic. Still, battery cost reduction significantly drives BEV demand toward longer ranges, whereas improvement in the charging infrastructure is found to significantly drive BEV demand toward shorter ranges. In conclusion, the bias of a single-range assumption and the effects of range optimization and diversification in reducing such biases are both found to be significant.« less

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

Optimizing and Diversifying Electric Vehicle Driving Range for U.S. Drivers

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

Lin, Zhenhong

Properly determining the driving range is critical for accurately predicting the sales and social benefits of battery electric vehicles (BEVs). This study proposes a framework for optimizing the driving range by minimizing the sum of battery price, electricity cost, and range limitation cost referred to as the "range-related cost" as a measurement of range anxiety. The objective function is linked to policy-relevant parameters, including battery cost and price markup, battery utilization, charging infrastructure availability, vehicle efficiency, electricity and gasoline prices, household vehicle ownership, daily driving patterns, discount rate, and perceived vehicle lifetime. Qualitative discussion of the framework and its empiricalmore » application to a sample (N=36664) representing new car drivers in the United States is included. The quantitative results strongly suggest that ranges of less than 100 miles are likely to be more popular in the BEV market for a long period of time. The average optimal range among U.S. drivers is found to be largely inelastic. Still, battery cost reduction significantly drives BEV demand toward longer ranges, whereas improvement in the charging infrastructure is found to significantly drive BEV demand toward shorter ranges. In conclusion, the bias of a single-range assumption and the effects of range optimization and diversification in reducing such biases are both found to be significant.« less

Cost-effectiveness and cost-utility of combination therapy in early rheumatoid arthritis: randomized comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone. COBRA Trial Group. Combinatietherapie Bij Reumatoïde Artritis.

PubMed

Verhoeven, A C; Bibo, J C; Boers, M; Engel, G L; van der Linden, S

1998-10-01

Assessment of the cost-effectiveness and cost-utility of early intervention in rheumatoid arthritis (RA) patients, with combined step-down prednisolone, methotrexate and sulphasalazine, compared to sulphasalazine alone. Multicentre 56 week randomized double-blind trial with full economic analysis of direct costs and utility analysis with rating scale and standard gamble measurement techniques. The combined-treatment group included 76 patients and the sulphasalazine group 78 patients. The mean total costs per patient in the first 56 weeks of follow-up were $5519 for combined treatment and $6511 for treatment with sulphasalazine alone (P = 0.37). Out-patient care, in-patient care and non-health care each contributed about one-third to the total costs. The combined-treatment group appeared to generate savings in the length of hospital stay for RA, non-protocol drugs and costs of home help, but comparisons were not statistically significant. Protocol drugs and monitoring were slightly more expensive in the combined-treatment group. Clinical, radiographic and functional outcomes significantly favoured combined treatment at week 28 (radiography also at week 56). Utility scores also favoured combined treatment. Combined treatment is cost-effective due to enhanced efficacy at lower or equal direct costs.

Generalized shading analysis for paraboloidal collector fields

NASA Technical Reports Server (NTRS)

Osborn, D. B.

1980-01-01

This paper presents the development and results of a generalized shading analysis for a field of point-focus parabolic dish concentrators. Shading of one concentrator by another with attendant loss of energy is a function of the position of the sun and the relative locations of the concentrators within the field. A method is presented for determining the annualized energy loss which includes a trade-off of system life-cycle energy as a function of concentrator spacing and field geometric layout. System energy output is computed on an annualized basis, employing 15 minute-increment environmental data tapes for the year 1976 at Barstow, California. For a land cost of $5000 per acre, lowest system energy cost occurs at about a 25 percent packing fraction (concentrator area/land area) for a typical 1-MWe dish-Stirling solar thermal power plant. Basic equations are given for computing the shading and concomitant energy loss as a function of concentrator center-to-center spacing, field layout site location.

Combining self-organizing mapping and supervised affinity propagation clustering approach to investigate functional brain networks involved in motor imagery and execution with fMRI measurements.

PubMed

Zhang, Jiang; Liu, Qi; Chen, Huafu; Yuan, Zhen; Huang, Jin; Deng, Lihua; Lu, Fengmei; Zhang, Junpeng; Wang, Yuqing; Wang, Mingwen; Chen, Liangyin

2015-01-01

Clustering analysis methods have been widely applied to identifying the functional brain networks of a multitask paradigm. However, the previously used clustering analysis techniques are computationally expensive and thus impractical for clinical applications. In this study a novel method, called SOM-SAPC that combines self-organizing mapping (SOM) and supervised affinity propagation clustering (SAPC), is proposed and implemented to identify the motor execution (ME) and motor imagery (MI) networks. In SOM-SAPC, SOM was first performed to process fMRI data and SAPC is further utilized for clustering the patterns of functional networks. As a result, SOM-SAPC is able to significantly reduce the computational cost for brain network analysis. Simulation and clinical tests involving ME and MI were conducted based on SOM-SAPC, and the analysis results indicated that functional brain networks were clearly identified with different response patterns and reduced computational cost. In particular, three activation clusters were clearly revealed, which include parts of the visual, ME and MI functional networks. These findings validated that SOM-SAPC is an effective and robust method to analyze the fMRI data with multitasks.

National Airspace System Plan: Facilities, Equipment, Associated Development and Other Capital Needs

DTIC Science & Technology

1988-06-01

services will reflect a yes include: better balance between trip frequency and cost than would be the case under a closely regulated 0 Having an operating...terminal system). 0 Improved traffic flow planning and manage- ment, resulting in a more balanced workload. 0 A major improvement and integration of the...The AAS supervisors and specialists to assist them in will include AERA I functions and facilitate balancing sector staffing levels, later

A LiDAR data-based camera self-calibration method

NASA Astrophysics Data System (ADS)

Xu, Lijun; Feng, Jing; Li, Xiaolu; Chen, Jianjun

2018-07-01

To find the intrinsic parameters of a camera, a LiDAR data-based camera self-calibration method is presented here. Parameters have been estimated using particle swarm optimization (PSO), enhancing the optimal solution of a multivariate cost function. The main procedure of camera intrinsic parameter estimation has three parts, which include extraction and fine matching of interest points in the images, establishment of cost function, based on Kruppa equations and optimization of PSO using LiDAR data as the initialization input. To improve the precision of matching pairs, a new method of maximal information coefficient (MIC) and maximum asymmetry score (MAS) was used to remove false matching pairs based on the RANSAC algorithm. Highly precise matching pairs were used to calculate the fundamental matrix so that the new cost function (deduced from Kruppa equations in terms of the fundamental matrix) was more accurate. The cost function involving four intrinsic parameters was minimized by PSO for the optimal solution. To overcome the issue of optimization pushed to a local optimum, LiDAR data was used to determine the scope of initialization, based on the solution to the P4P problem for camera focal length. To verify the accuracy and robustness of the proposed method, simulations and experiments were implemented and compared with two typical methods. Simulation results indicated that the intrinsic parameters estimated by the proposed method had absolute errors less than 1.0 pixel and relative errors smaller than 0.01%. Based on ground truth obtained from a meter ruler, the distance inversion accuracy in the experiments was smaller than 1.0 cm. Experimental and simulated results demonstrated that the proposed method was highly accurate and robust.

Energetic Constraints Produce Self-sustained Oscillatory Dynamics in Neuronal Networks

PubMed Central

Burroni, Javier; Taylor, P.; Corey, Cassian; Vachnadze, Tengiz; Siegelmann, Hava T.

2017-01-01

Overview: We model energy constraints in a network of spiking neurons, while exploring general questions of resource limitation on network function abstractly. Background: Metabolic states like dietary ketosis or hypoglycemia have a large impact on brain function and disease outcomes. Glia provide metabolic support for neurons, among other functions. Yet, in computational models of glia-neuron cooperation, there have been no previous attempts to explore the effects of direct realistic energy costs on network activity in spiking neurons. Currently, biologically realistic spiking neural networks assume that membrane potential is the main driving factor for neural spiking, and do not take into consideration energetic costs. Methods: We define local energy pools to constrain a neuron model, termed Spiking Neuron Energy Pool (SNEP), which explicitly incorporates energy limitations. Each neuron requires energy to spike, and resources in the pool regenerate over time. Our simulation displays an easy-to-use GUI, which can be run locally in a web browser, and is freely available. Results: Energy dependence drastically changes behavior of these neural networks, causing emergent oscillations similar to those in networks of biological neurons. We analyze the system via Lotka-Volterra equations, producing several observations: (1) energy can drive self-sustained oscillations, (2) the energetic cost of spiking modulates the degree and type of oscillations, (3) harmonics emerge with frequencies determined by energy parameters, and (4) varying energetic costs have non-linear effects on energy consumption and firing rates. Conclusions: Models of neuron function which attempt biological realism may benefit from including energy constraints. Further, we assert that observed oscillatory effects of energy limitations exist in networks of many kinds, and that these findings generalize to abstract graphs and technological applications. PMID:28289370

Home inotropic therapy in advanced heart failure: cost analysis and clinical outcomes.

PubMed

Harjai, K J; Mehra, M R; Ventura, H O; Lapeyre, Y M; Murgo, J P; Stapleton, D D; Smart, F W

1997-11-05

This study was conducted to assess cost savings and clinical outcomes associated with the use of home i.v. inotropic therapy in patients with advanced (New York Heart Association [NYHA] class IV) heart failure. Retrospective analysis. Tertiary care referral center. Twenty-four patients (13 men, 11 women; age, 61+/-12 years) with left ventricular ejection fraction <30% and heart failure refractory to oral agents required home i.v. inotropic therapy for at least 4 consecutive weeks between May 1994 and April 1996. Inotropic agents used included dobutamine (n=20; dose, 5.0+/-2.2 microg/kg/min) or milrinone (n=7; dose, 0.53+/-0.05 microg/kg/min). Cost of care and clinical outcomes (hospital admissions, length of hospital stay, NYHA functional class) were compared during the period of inotropic therapy (study period) and the immediate preceding period of equal duration (control period). In comparison to the control period, the study period (3.9+/-2.7 months) was associated with a 16% reduction in cost, amounting to a calculated savings of $5,700 per patient or $1,465 per patient per month. Concomitantly, a decrease in the number of hospital admissions from 2.7+/-2.6 to 1.3+/-1.3 (p=0.056) and length of hospital stay from 20.9+/-12.7 to 5.5+/-5.4 days (p=0.0004) was observed with improvement in NYHA functional class from 4.0+/-0.0 to 2.7+/-0.9 (p<0.0001). Eight patients (38%) died after 2.8+/-1.7 months of home i.v. inotropic therapy. Home i.v. inotropic therapy reduces hospital admissions, length of stay, and cost of care and improves functional class in patients with advanced (NYHA class IV) heart failure.

Economies of Scale and Scope in Australian Higher Education

ERIC Educational Resources Information Center

Worthington, A. C.; Higgs, H.

2011-01-01

This paper estimates economies of scale and scope for 36 Australian universities using a multiple-input, multiple-output cost function over the period 1998-2006. The three inputs included in the analysis are full-time equivalent academic and non-academic staff and physical capital. The five outputs are undergraduate, postgraduate and PhD…

7 CFR 4290.1620 - Functions of agents, including Central Registration Agent, Selling Agent and Fiscal Agent.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Debentures and/or TCs. (iv) Arranging for the production of Offering Circulars, certificates, and such other... to determine those factors that will minimize or reduce the cost of funding Debentures. (iii) Monitor... the Secretary; (vii) Remain custodian of such other documentation as the Secretary shall direct by...

13 CFR 108.1620 - Functions of agents, including Central Registration Agent, Selling Agent and Fiscal Agent.

Code of Federal Regulations, 2010 CFR

2010-01-01

... periodic sales of Debentures and/or TCs. (iv) Arranging for the production of Offering Circulars... financial markets to determine those factors that will minimize or reduce the cost of funding Debentures... SBA; (vii) Remain custodian of such other documentation as SBA shall direct by written instructions...

13 CFR 107.1620 - Functions of agents, including Central Registration Agent, Selling Agent and Fiscal Agent.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Participating Securities and/or TCs. (iv) Arranging for the production of the Offering Circular, certificates... markets to determine those factors that will minimize or reduce the cost of funding Debentures or... instructions from SBA; (vii) Remain custodian of such other documentation as SBA shall direct by written...

Exploring the Psycho-Social Therapies Through the Personalities of Effective Therapists.

ERIC Educational Resources Information Center

Dent, James K.; Furse, George A.

Several specific research approaches are compared with regard to cost-effectiveness, types of disorders to which they best respond, general strategies, and therapist personality. Replicated findings include: (1) support for both the functional reversal and semantic reversal of the "A-B Scale;" (2) characterization of therapists who are effective…

Management Information System for ESD Program Offices.

DTIC Science & Technology

1978-03-01

Management Information System (MIS) functional requirements for the ESD Program Office are defined in terms of the Computer-Aided Design and Specification Tool. The development of the computer data base and a description of the MIS structure is included in the report. This report addresses management areas such as cost/budgeting, scheduling, tracking capabilities, and ECP

The Application of Function Points to Predict Source Lines of Code for Software Development

DTIC Science & Technology

1992-09-01

there are some disadvantages. Software estimating tools are expensive. A single tool may cost more than $15,000 due to the high market value of the...term and Lang variables simultaneously onlN added marginal improvements over models with these terms included singularly. Using all the available

77 FR 24206 - Agency Information Collection Request. 30-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... performance of the agency's functions; (2) the accuracy of the estimated burden; (3) ways to enhance the... key research questions, ASPE will draw on 5 primary data collections including (1) Collecting administrative cost data from ELE and non-ELE states, (2) collecting enrollment data from ELE and non-ELE states...

OPTIMAL AIRCRAFT TRAJECTORIES FOR SPECIFIED RANGE

NASA Technical Reports Server (NTRS)

Lee, H.

1994-01-01

For an aircraft operating over a fixed range, the operating costs are basically a sum of fuel cost and time cost. While minimum fuel and minimum time trajectories are relatively easy to calculate, the determination of a minimum cost trajectory can be a complex undertaking. This computer program was developed to optimize trajectories with respect to a cost function based on a weighted sum of fuel cost and time cost. As a research tool, the program could be used to study various characteristics of optimum trajectories and their comparison to standard trajectories. It might also be used to generate a model for the development of an airborne trajectory optimization system. The program could be incorporated into an airline flight planning system, with optimum flight plans determined at takeoff time for the prevailing flight conditions. The use of trajectory optimization could significantly reduce the cost for a given aircraft mission. The algorithm incorporated in the program assumes that a trajectory consists of climb, cruise, and descent segments. The optimization of each segment is not done independently, as in classical procedures, but is performed in a manner which accounts for interaction between the segments. This is accomplished by the application of optimal control theory. The climb and descent profiles are generated by integrating a set of kinematic and dynamic equations, where the total energy of the aircraft is the independent variable. At each energy level of the climb and descent profiles, the air speed and power setting necessary for an optimal trajectory are determined. The variational Hamiltonian of the problem consists of the rate of change of cost with respect to total energy and a term dependent on the adjoint variable, which is identical to the optimum cruise cost at a specified altitude. This variable uniquely specifies the optimal cruise energy, cruise altitude, cruise Mach number, and, indirectly, the climb and descent profiles. If the optimum cruise cost is specified, an optimum trajectory can easily be generated; however, the range obtained for a particular optimum cruise cost is not known a priori. For short range flights, the program iteratively varies the optimum cruise cost until the computed range converges to the specified range. For long-range flights, iteration is unnecessary since the specified range can be divided into a cruise segment distance and full climb and descent distances. The user must supply the program with engine fuel flow rate coefficients and an aircraft aerodynamic model. The program currently includes coefficients for the Pratt-Whitney JT8D-7 engine and an aerodynamic model for the Boeing 727. Input to the program consists of the flight range to be covered and the prevailing flight conditions including pressure, temperature, and wind profiles. Information output by the program includes: optimum cruise tables at selected weights, optimal cruise quantities as a function of cruise weight and cruise distance, climb and descent profiles, and a summary of the complete synthesized optimal trajectory. This program is written in FORTRAN IV for batch execution and has been implemented on a CDC 6000 series computer with a central memory requirement of approximately 100K (octal) of 60 bit words. This aircraft trajectory optimization program was developed in 1979.

Minimization for conditional simulation: Relationship to optimal transport

NASA Astrophysics Data System (ADS)

Oliver, Dean S.

2014-05-01

In this paper, we consider the problem of generating independent samples from a conditional distribution when independent samples from the prior distribution are available. Although there are exact methods for sampling from the posterior (e.g. Markov chain Monte Carlo or acceptance/rejection), these methods tend to be computationally demanding when evaluation of the likelihood function is expensive, as it is for most geoscience applications. As an alternative, in this paper we discuss deterministic mappings of variables distributed according to the prior to variables distributed according to the posterior. Although any deterministic mappings might be equally useful, we will focus our discussion on a class of algorithms that obtain implicit mappings by minimization of a cost function that includes measures of data mismatch and model variable mismatch. Algorithms of this type include quasi-linear estimation, randomized maximum likelihood, perturbed observation ensemble Kalman filter, and ensemble of perturbed analyses (4D-Var). When the prior pdf is Gaussian and the observation operators are linear, we show that these minimization-based simulation methods solve an optimal transport problem with a nonstandard cost function. When the observation operators are nonlinear, however, the mapping of variables from the prior to the posterior obtained from those methods is only approximate. Errors arise from neglect of the Jacobian determinant of the transformation and from the possibility of discontinuous mappings.

A study of acoustic-to-articulatory inversion of speech by analysis-by-synthesis using chain matrices and the Maeda articulatory model

PubMed Central

Panchapagesan, Sankaran; Alwan, Abeer

2011-01-01

In this paper, a quantitative study of acoustic-to-articulatory inversion for vowel speech sounds by analysis-by-synthesis using the Maeda articulatory model is performed. For chain matrix calculation of vocal tract (VT) acoustics, the chain matrix derivatives with respect to area function are calculated and used in a quasi-Newton method for optimizing articulatory trajectories. The cost function includes a distance measure between natural and synthesized first three formants, and parameter regularization and continuity terms. Calibration of the Maeda model to two speakers, one male and one female, from the University of Wisconsin x-ray microbeam (XRMB) database, using a cost function, is discussed. Model adaptation includes scaling the overall VT and the pharyngeal region and modifying the outer VT outline using measured palate and pharyngeal traces. The inversion optimization is initialized by a fast search of an articulatory codebook, which was pruned using XRMB data to improve inversion results. Good agreement between estimated midsagittal VT outlines and measured XRMB tongue pellet positions was achieved for several vowels and diphthongs for the male speaker, with average pellet-VT outline distances around 0.15 cm, smooth articulatory trajectories, and less than 1% average error in the first three formants. PMID:21476670

Biokinetic model-based multi-objective optimization of Dunaliella tertiolecta cultivation using elitist non-dominated sorting genetic algorithm with inheritance.

PubMed

Sinha, Snehal K; Kumar, Mithilesh; Guria, Chandan; Kumar, Anup; Banerjee, Chiranjib

2017-10-01

Algal model based multi-objective optimization using elitist non-dominated sorting genetic algorithm with inheritance was carried out for batch cultivation of Dunaliella tertiolecta using NPK-fertilizer. Optimization problems involving two- and three-objective functions were solved simultaneously. The objective functions are: maximization of algae-biomass and lipid productivity with minimization of cultivation time and cost. Time variant light intensity and temperature including NPK-fertilizer, NaCl and NaHCO 3 loadings are the important decision variables. Algal model involving Monod/Andrews adsorption kinetics and Droop model with internal nutrient cell quota was used for optimization studies. Sets of non-dominated (equally good) Pareto optimal solutions were obtained for the problems studied. It was observed that time variant optimal light intensity and temperature trajectories, including optimum NPK fertilizer, NaCl and NaHCO 3 concentration has significant influence to improve biomass and lipid productivity under minimum cultivation time and cost. Proposed optimization studies may be helpful to implement the control strategy in scale-up operation. Copyright © 2017 Elsevier Ltd. All rights reserved.

45 CFR 1301.32 - Limitations on costs of development and administration of a Head Start program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Limitations on costs of development and... administrative staff functions such as the costs allocated to fringe benefits, travel, per diem, transportation... staff functions, such as the allocable costs of fringe benefits, travel, per diem and transportation...

Global Spent Fuel Logistics Systems Study (GSFLS). Volume 3A. GSFLS technical analysis (appendix). Interim report

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

Kriger, A.

1978-01-31

This report is a part of the interim report documentation for the Global Spent Fuel Logistics System (GSFLS) study. The technical and financial considerations underlying a global spent fuel logistics systems have been studied and are reported. The Pacific Basin is used as a model throughout this report; however the stated methodology and, in many cases, considerations and conclusions are applicable to other global regions. Spent fuel discharge profiles for Pacific Basin Countries were used to determine the technical systems requirements for alternative concepts. Functional analyses and flows were generated to define both system design requirements and logistics parameters. Amore » technology review was made to ascertain the state-of-the-art of relevant GSFLS technical systems. Modular GSFLS facility designs were developed using the information generated from the functional analysis and technology review. The modular facility designs were used as a basis for siting and cost estimates for various GSFLS alternatives. Various GSFLS concepts were analyzed from a financial and economic perspective in order to provide total concepts costs and ascertain financial and economic sensitivities to key GSFLS variations. Results of the study include quantification of GSFLS facility and hardware requirements; drawings of relevant GSFLS facility designs; system cost estimates; financial reports - including user service charges; and comparative analyses of various GSFLS alternatives.« less

Teleradiology costs in a rural area

NASA Astrophysics Data System (ADS)

Chimiak, William J.

1994-05-01

There have been several excellent papers providing architectures for teleradiology. Effective teleradiology systems can be fielded today. However, cost issues arise which easily blur a decision to deploy a teleradiology system for a given hospital or regional hospital system. In this paper, a T1 infrastructure is assumed that is comprised of dedicated T1 links as well as fractional T1 links. The effects of teleconferencing are included in the analysis. Plots of the telecommunication costs provide visualization of the cost and performance issues as a function of varying degrees teleradiology and teleconference utilization. 1993 tariffs in North Carolina will be used as a baseline to arrive at some basic teleradiology cost plots and metrics. The graphs are produced by gnuplot that is freely available on many anonymous ftp sites and runs on Unix workstations as well as personal computers. The plotting commands used for the graphs are available at The Bowman Gray School of Medicine of Wake Forest University anonymous ftp site.

SOAP-V: Introducing a method to empower medical students to be change agents in bending the cost curve.

PubMed

Moser, Eileen M; Huang, Grace C; Packer, Clifford D; Glod, Susan; Smith, Cynthia D; Alguire, Patrick C; Fazio, Sara B

2016-03-01

Medical students must learn how to practice high-value, cost-conscious care. By modifying the traditional SOAP (Subjective-Objective-Assessment-Plan) presentation to include a discussion of value (SOAP-V), we developed a cognitive forcing function designed to promote discussion of high-value, cost-conscious care during patient delivery. The SOAP-V model prompts the student to consider (1) the evidence that supports a test or treatment, (2) the patient's preferences and values, and (3) the financial cost of a test or treatment compared to alternatives. Students report their findings to their teams during patient care rounds. This tool has been successfully used at 3 medical schools. Preliminary results find that students who have been trained in SOAP-V feel more empowered to address the economic healthcare crisis, are more comfortable in initiating discussions about value, and are more likely to consider potential costs to the healthcare system. © 2015 Society of Hospital Medicine.

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.

Is it time to rebalance the case mix? A portfolio analysis of direct catheterization laboratory costs over a 5-year period.

PubMed

Plehn, Gunnar; Butz, Thomas; Maagh, Petra; Oernek, Ahmet; Meissner, Axel; Plehn, Natalie

2016-11-03

Cardiac catheterization laboratories (CLL) have continued to function as profit centers for hospitals. Due to a high percentage of material and labor costs, they are natural targets for process improvement. Our study applied a contribution margin (CBM) concept to evaluate costs and cost dynamics over a 5-year period. We retrospectively analyzed all procedures performed at a tertiary heart center between 2007 and 2011. Total variable costs, including labor time, material, and maintenance-expenses, were allocated at a global as well as a procedural level. CBM and CBM ratios were calculated by integration of individual DRG revenues. Annual case volume increased from 1288 to 1545. In parallel, overall profitability improved as indicated by a 2% increase in CBM ratio and a higher CBM generated per hour of CLL working time (4325 vs. 5892 €, p < 0.001). Coronary angiography generated higher average CBMs per hour than coronary or electrophysiological interventions (5831 vs. 3458 vs. 1495 €; p < 0.001). The latter are characterized by relatively high per case material expenditures. On a procedural level, DRG-specific trends as a steady improvement of examination time or an increase in material costs were detectable. The CBM concept allows a comprehensive analysis of CLL costs and cost dynamics. From a health service providers view, its range of application includes global profitability analysis, portfolio evaluation, and a detailed cost analysis of specific service lines. From a healthcare payers perspective, it may help to monitor hospital activities and to provide a solid data basis in cases where inappropriate developments are suspected. The calculation principle is simple which may increase user acceptance and thus the motivation of team members.

Modeling the lowest-cost splitting of a herd of cows by optimizing a cost function

NASA Astrophysics Data System (ADS)

Gajamannage, Kelum; Bollt, Erik M.; Porter, Mason A.; Dawkins, Marian S.

2017-06-01

Animals live in groups to defend against predation and to obtain food. However, for some animals—especially ones that spend long periods of time feeding—there are costs if a group chooses to move on before their nutritional needs are satisfied. If the conflict between feeding and keeping up with a group becomes too large, it may be advantageous for some groups of animals to split into subgroups with similar nutritional needs. We model the costs and benefits of splitting in a herd of cows using a cost function that quantifies individual variation in hunger, desire to lie down, and predation risk. We model the costs associated with hunger and lying desire as the standard deviations of individuals within a group, and we model predation risk as an inverse exponential function of the group size. We minimize the cost function over all plausible groups that can arise from a given herd and study the dynamics of group splitting. We examine how the cow dynamics and cost function depend on the parameters in the model and consider two biologically-motivated examples: (1) group switching and group fission in a herd of relatively homogeneous cows, and (2) a herd with an equal number of adult males (larger animals) and adult females (smaller animals).

Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing.

PubMed

Thaker, Nikhil G; Pugh, Thomas J; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E; Martin, Neil E; Sio, Terence T; Kudchadker, Rajat J; Kaplan, Robert S; Kuban, Deborah A; Swanson, David A; Orio, Peter F; Zelefsky, Michael J; Cox, Brett W; Potters, Louis; Buchholz, Thomas A; Feeley, Thomas W; Frank, Steven J

2016-01-01

Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. Patients with low-risk PCa treated with low-dose-rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to 1 year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. A total of 238 men were eligible for analysis. Median age was 64 (range, 46-81). Median followup was 5 years (0.5-12.1). There were no acute Grade 3-5 complications. Expanded Prostate Cancer Index Composite 50 scores were favorable, with no clinically significant changes from baseline to last followup at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. We successfully created a visual framework to define the value of PBT using the International Consortium for Health Outcomes Measurement standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Successful and stable orthodontic camouflage of a mandibular asymmetry with sliding jigs.

PubMed

Oliveira, Dauro Douglas; Oliveira, Bruno Franco de; Mordente, Carolina Morsani; Godoy, Gabriela Martins; Soares, Rodrigo Villamarim; Seraidarian, Paulo Isaías

2018-03-12

The purpose of this paper is to present and discuss a simple and low-cost clinical approach to correct an asymmetric skeletal Class III combined to an extensive dental open bite that significantly compromised the occlusal function and smile aesthetics of an adult male patient. The patient did not accept the idealistic surgical-orthodontic treatment option, neither the use of temporary anchorage devices to facilitate the camouflage of the asymmetrical skeletal Class III/open bite. Therefore, a very simple and inexpensive biomechanical approach using sliding jigs in the mandibular arch was implemented as the compensatory treatment of the malocclusion. Although minor enhancements in facial aesthetics were obtained, the occlusal function and dental aesthetics were significantly improved. Furthermore, the patient was very satisfied with his new smile appearance. Some advantages of this treatment option included the small invasiveness and the remarkably low financial costs involved. Moreover, the final results fulfilled all realistic treatment objectives and the patient's expectations. Results remained stable 5 years post-treatment demonstrating that excellent results can be obtained when simple and low cost, but well-controlled mechanics are conducted.

Seamless interworking architecture for WBAN in heterogeneous wireless networks with QoS guarantees.

PubMed

Khan, Pervez; Ullah, Niamat; Ullah, Sana; Kwak, Kyung Sup

2011-10-01

The IEEE 802.15.6 standard is a communication standard optimized for low-power and short-range in-body/on-body nodes to serve a variety of medical, consumer electronics and entertainment applications. Providing high mobility with guaranteed Quality of Service (QoS) to a WBAN user in heterogeneous wireless networks is a challenging task. A WBAN uses a Personal Digital Assistant (PDA) to gather data from body sensors and forwards it to a remote server through wide range wireless networks. In this paper, we present a coexistence study of WBAN with Wireless Local Area Networks (WLAN) and Wireless Wide Area Networks (WWANs). The main issue is interworking of WBAN in heterogenous wireless networks including seamless handover, QoS, emergency services, cooperation and security. We propose a Seamless Interworking Architecture (SIA) for WBAN in heterogenous wireless networks based on a cost function. The cost function is based on power consumption and data throughput costs. Our simulation results show that the proposed scheme outperforms typical approaches in terms of throughput, delay and packet loss rate.

3D Printing of Biomolecular Models for Research and Pedagogy

PubMed Central

Da Veiga Beltrame, Eduardo; Tyrwhitt-Drake, James; Roy, Ian; Shalaby, Raed; Suckale, Jakob; Pomeranz Krummel, Daniel

2017-01-01

The construction of physical three-dimensional (3D) models of biomolecules can uniquely contribute to the study of the structure-function relationship. 3D structures are most often perceived using the two-dimensional and exclusively visual medium of the computer screen. Converting digital 3D molecular data into real objects enables information to be perceived through an expanded range of human senses, including direct stereoscopic vision, touch, and interaction. Such tangible models facilitate new insights, enable hypothesis testing, and serve as psychological or sensory anchors for conceptual information about the functions of biomolecules. Recent advances in consumer 3D printing technology enable, for the first time, the cost-effective fabrication of high-quality and scientifically accurate models of biomolecules in a variety of molecular representations. However, the optimization of the virtual model and its printing parameters is difficult and time consuming without detailed guidance. Here, we provide a guide on the digital design and physical fabrication of biomolecule models for research and pedagogy using open source or low-cost software and low-cost 3D printers that use fused filament fabrication technology. PMID:28362403

Cost-utility and budget impact analysis of drug treatments in pulmonary arterial hypertension associated with congenital heart diseases in Thailand.

PubMed

Thongsri, Watsamon; Bussabawalai, Thanaporn; Leelahavarong, Pattara; Wanitkun, Suthep; Durongpisitkul, Kritvikrom; Chaikledkaew, Usa; Teerawattananon, Yot

2016-08-01

This study aims to compare the lifetime costs and health outcomes of both first-line and sequential combination treatments with standard treatment for pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD) (PAH-CHD) patients. A cost-utility analysis was performed using a Markov model based on a societal perspective. One-way and probabilistic sensitivity analyses were performed to investigate the effect of parameter uncertainty. As first-line treatments, both beraprost (incremental cost-effectiveness ratio (ICER) = 192,752 and 201,308 Thai baht (THB) per quality-adjusted life year (QALY) gained) and sildenafil (ICER = 249,770 and 226,802 THB per QALY gained) seemed cost-effective for PAH-CHD patients aged ≤30 years in functional classes II and III, respectively, while no treatment was cost-effective for the sequential combination therapy. Sildenafil should be included in the National Drug List of Essential Medicines as the first-line treatment for PAH-CHD, and its price per dose should be negotiated to be reduced by 43-57%.

Analysis of Tactical Automation Requirements for the Maneuver Functional Area.

DTIC Science & Technology

1987-11-06

34Big 5" format for each alternative ("Big 5" format includes: development, production , military construction, fielding, and sustainment). 1-6...h a1 based upon recurring unit production costs per system and initial spares plus sustainment (i.e., materiel and labor) costs. (2) Figure 2-15...GRAND TOTALS: C 0 24 C C ’ IT-. SV -II-4 %#g Np MOE : .EVEL TE OF T ;TAA 92; 1-As IT E Th DESC-NATED 3-AR : (V 1) M)2 fViI ’ M.)’S 17 20 o,. D:v CAVALRY

Life sciences payload definition and integration study. Volume 1: Executive summary. [carry-on laboratory for Spacelab

NASA Technical Reports Server (NTRS)

1974-01-01

The definition and integration tasks involved in the development of design concepts for a carry-on laboratory (COL), to be compatible with Spacelab operations, were divided into the following study areas: (1) identification of research and equipment requirements of the COL; (2) development of a number of conceptual layouts for COL based on the defined research of final conceptual designs; and (4) development of COL planning information for definition of COL/Spacelab interface data, cost data, and program cost schedules, including design drawings of a selected COL to permit fabrication of a functional breadboard.

The 20 kW battery study program

NASA Technical Reports Server (NTRS)

1971-01-01

Six battery configurations were selected for detailed study and these are described. A computer program was modified for use in estimation of the weights, costs, and reliabilities of each of the configurations, as a function of several important independent variables, such as system voltage, battery voltage ratio (battery voltage/bus voltage), and the number of parallel units into which each of the components of the power subsystem was divided. The computer program was used to develop the relationship between the independent variables alone and in combination, and the dependent variables: weight, cost, and availability. Parametric data, including power loss curves, are given.

Use of optimization to predict the effect of selected parameters on commuter aircraft performance

NASA Technical Reports Server (NTRS)

Wells, V. L.; Shevell, R. S.

1982-01-01

An optimizing computer program determined the turboprop aircraft with lowest direct operating cost for various sets of cruise speed and field length constraints. External variables included wing area, wing aspect ratio and engine sea level static horsepower; tail sizes, climb speed and cruise altitude were varied within the function evaluation program. Direct operating cost was minimized for a 150 n.mi typical mission. Generally, DOC increased with increasing speed and decreasing field length but not by a large amount. Ride roughness, however, increased considerably as speed became higher and field length became shorter.

MEMS applications in space exploration

NASA Astrophysics Data System (ADS)

Tang, William C.

1997-09-01

Space exploration in the coming century will emphasize cost effectiveness and highly focused mission objectives, which will result in frequent multiple missions that broaden the scope of space science and to validate new technologies on a timely basis. MEMS is one of the key enabling technology to create cost-effective, ultra-miniaturized, robust, and functionally focused spacecraft for both robotic and human exploration programs. Examples of MEMS devices at various stages of development include microgyroscope, microseismometer, microhygrometer, quadrupole mass spectrometer, and micropropulsion engine. These devices, when proven successful, will serve as models for developing components and systems for new-millennium spacecraft.

Applications of MEMS for Space Exploration

NASA Astrophysics Data System (ADS)

Tang, William C.

1998-03-01

Space exploration in the coming century will emphasize cost effectiveness and highly focused mission objectives, which will result in frequent multiple missions that broaden the scope of space science and to validate new technologies on a timely basis. Micro Electro Mechanical Systems (MEMS) is one of the key enabling technologies to create cost-effective, ultra-miniaturized, robust, and functionally focused spacecraft for both robotic and human exploration programs. Examples of MEMS devices at various stages of development include microgyroscope, microseismometer, microhygrometer, quadrupole mass spectrometer, and micropropulsion engine. These devices, when proven successful, will serve as models for developing components and systems for new-millennium spacecraft.

Telecommunications technology in cognitive rehabilitation.

PubMed

Caltagirone, Carlo; Zannino, Gian Daniele

2008-01-01

Cognitive disorders are a common long-term consequence of many forms of acquired neurological damage of different aetiology. The already high prevalence of diseases causing cognitive deficits (in particular stroke) is expected to increase in the near future, leading to a greater need for cognitive rehabilitation. The impact of cognitive impairment on daily functioning may be even greater than that of physical limitations in affected patients, contributing to the high cost of brain disorders. New technologies, including telerehabilitation, may provide an effective response to this challenge, allowing increased access to rehabilitation services as well as reduced care costs for individuals needing cognitive rehabilitation.

Budget impact of everolimus for the treatment of progressive, well-differentiated, non-functional neuroendocrine tumors of gastrointestinal or lung origin that are advanced or metastatic.

PubMed

Rose, Darya B; Nellesen, Dave; Neary, Maureen P; Cai, Beilei

2017-04-01

Advanced neuroendocrine tumors (NETs) are a rare malignancy with considerable need for effective therapies. Everolimus is a mammalian target of rapamycin (mTOR) inhibitor approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) in 2016 for treatment of adults with progressive, well-differentiated, non-functional NETs of gastrointestinal (GI) or lung origin that are unresectable, locally advanced, or metastatic. To assess the 3-year budget impact for a typical US health plan following availability of everolimus for treatment of GI and lung NETs. Methods An economic model was developed that considered two perspectives: an entire health plan and a pharmacy budget. The total budget impact included costs of drug therapies, administration, hospitalizations, physician visits, monitoring, and adverse events (AEs). The pharmacy model only considered drug costs. In a US health plan with 1 million members, the model estimated 66 patients with well-differentiated, non-functional, and advanced or metastatic GI NETs and 20 with lung NETs undergoing treatment each year. Total budget impact in the first through third year after FDA approval ranged from $0.0568-$0.1443 per member per month (PMPM) for GI NETs and from $0.0181-$0.0355 PMPM for lung NETs. The total budget impact was lower than the pharmacy budget impact because it included cost offsets from administration and AE management for everolimus compared with alternative therapies (e.g. chemotherapies). Because GI and lung NETs are rare diseases with limited published data, several assumptions were made that may influence interpretation of results. The budget impact for everolimus was minimal in this rare disease area with a high unmet need, largely due to low disease prevalence. These results should be considered in the context of significant clinical benefits potentially provided by everolimus, including significantly longer progression-free survival (PFS) for advanced GI and lung NET patients.

A non-stationary cost-benefit analysis approach for extreme flood estimation to explore the nexus of 'Risk, Cost and Non-stationarity'

NASA Astrophysics Data System (ADS)

Qi, Wei

2017-11-01

Cost-benefit analysis is commonly used for engineering planning and design problems in practice. However, previous cost-benefit based design flood estimation is based on stationary assumption. This study develops a non-stationary cost-benefit based design flood estimation approach. This approach integrates a non-stationary probability distribution function into cost-benefit analysis, and influence of non-stationarity on expected total cost (including flood damage and construction costs) and design flood estimation can be quantified. To facilitate design flood selections, a 'Risk-Cost' analysis approach is developed, which reveals the nexus of extreme flood risk, expected total cost and design life periods. Two basins, with 54-year and 104-year flood data respectively, are utilized to illustrate the application. It is found that the developed approach can effectively reveal changes of expected total cost and extreme floods in different design life periods. In addition, trade-offs are found between extreme flood risk and expected total cost, which reflect increases in cost to mitigate risk. Comparing with stationary approaches which generate only one expected total cost curve and therefore only one design flood estimation, the proposed new approach generate design flood estimation intervals and the 'Risk-Cost' approach selects a design flood value from the intervals based on the trade-offs between extreme flood risk and expected total cost. This study provides a new approach towards a better understanding of the influence of non-stationarity on expected total cost and design floods, and could be beneficial to cost-benefit based non-stationary design flood estimation across the world.

The Ariane Transfer Vehicle (ATV) system studies

NASA Astrophysics Data System (ADS)

Thomas, U.; Thirkettle, A.

1991-08-01

Two distinct concepts of the Ariane transfer vehicle (ATV) are compared which incorporate existing ATV technology and offer logistics delivery at competitive costs. One concept is based on the Ariane-5 upper stage and the Vehicle Equipment Bay, and the other does not include Ariane-5 functions so that existing upper-stage limitations can be eliminated. Both concepts are required to accomplish the same transport, rendezvous, and berthing maneuvers and allow for controlled destructive reentry. An ATV reference mission is outlined, and key ATV design drivers are listed which include safety requirements, debris protection, and propulsion criteria. The Ariane-5 upgrade is the most cost-effective design although the second design is more operationally efficient. The ATV can potentially be used to relieve the schedule of the shuttle flights required for building the Space Station Freedom.

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2013 CFR

2013-07-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2010 CFR

2010-07-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2014 CFR

2014-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2012 CFR

2012-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2011 CFR

2011-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

Cost Function and Its Use for Intergovernmental Educational Transfers in Vietnam

ERIC Educational Resources Information Center

Nguyen-Hoang, Phuong

2012-01-01

The purpose of this paper is twofold. First, although many cost function studies have been done in developed countries, there has been no such study for the developing countries such as Vietnam. This paper will make the first attempt at conducting a cost function analysis for Vietnam. Second, it also demonstrates how the results of the cost…

On Asymptotic Behaviour and W 2, p Regularity of Potentials in Optimal Transportation

NASA Astrophysics Data System (ADS)

Liu, Jiakun; Trudinger, Neil S.; Wang, Xu-Jia

2015-03-01

In this paper we study local properties of cost and potential functions in optimal transportation. We prove that in a proper normalization process, the cost function is uniformly smooth and converges locally smoothly to a quadratic cost x · y, while the potential function converges to a quadratic function. As applications we obtain the interior W 2, p estimates and sharp C 1, α estimates for the potentials, which satisfy a Monge-Ampère type equation. The W 2, p estimate was previously proved by Caffarelli for the quadratic transport cost and the associated standard Monge-Ampère equation.

Experimental demonstration of using divergence cost-function in SPGD algorithm for coherent beam combining with tip/tilt control.

PubMed

Geng, Chao; Luo, Wen; Tan, Yi; Liu, Hongmei; Mu, Jinbo; Li, Xinyang

2013-10-21

A novel approach of tip/tilt control by using divergence cost function in stochastic parallel gradient descent (SPGD) algorithm for coherent beam combining (CBC) is proposed and demonstrated experimentally in a seven-channel 2-W fiber amplifier array with both phase-locking and tip/tilt control, for the first time to our best knowledge. Compared with the conventional power-in-the-bucket (PIB) cost function for SPGD optimization, the tip/tilt control using divergence cost function ensures wider correction range, automatic switching control of program, and freedom of camera's intensity-saturation. Homemade piezoelectric-ring phase-modulator (PZT PM) and adaptive fiber-optics collimator (AFOC) are developed to correct piston- and tip/tilt-type aberrations, respectively. The PIB cost function is employed for phase-locking via maximization of SPGD optimization, while the divergence cost function is used for tip/tilt control via minimization. An average of 432-μrad of divergence metrics in open loop has decreased to 89-μrad when tip/tilt control implemented. In CBC, the power in the full width at half maximum (FWHM) of the main lobe increases by 32 times, and the phase residual error is less than λ/15.

Operations and support cost modeling of conceptual space vehicles

NASA Technical Reports Server (NTRS)

Ebeling, Charles

1994-01-01

The University of Dayton is pleased to submit this annual report to the National Aeronautics and Space Administration (NASA) Langley Research Center which documents the development of an operations and support (O&S) cost model as part of a larger life cycle cost (LCC) structure. It is intended for use during the conceptual design of new launch vehicles and spacecraft. This research is being conducted under NASA Research Grant NAG-1-1327. This research effort changes the focus from that of the first two years in which a reliability and maintainability model was developed to the initial development of an operations and support life cycle cost model. Cost categories were initially patterned after NASA's three axis work breakdown structure consisting of a configuration axis (vehicle), a function axis, and a cost axis. A revised cost element structure (CES), which is currently under study by NASA, was used to established the basic cost elements used in the model. While the focus of the effort was on operations and maintenance costs and other recurring costs, the computerized model allowed for other cost categories such as RDT&E and production costs to be addressed. Secondary tasks performed concurrent with the development of the costing model included support and upgrades to the reliability and maintainability (R&M) model. The primary result of the current research has been a methodology and a computer implementation of the methodology to provide for timely operations and support cost analysis during the conceptual design activities.

Exergy & economic analysis of biogas fueled solid oxide fuel cell systems

NASA Astrophysics Data System (ADS)

Siefert, Nicholas S.; Litster, Shawn

2014-12-01

We present an exergy and an economic analysis of a power plant that uses biogas produced from a thermophilic anaerobic digester (AD) to fuel a solid oxide fuel cell (SOFC). We performed a 4-variable parametric analysis of the AD-SOFC system in order to determine the optimal design operation conditions, depending on the objective function of interest. We present results on the exergy efficiency (%), power normalized capital cost ( kW-1), and the internal rate of return on investment, IRR, (% yr-1) as a function of the current density, the stack pressure, the fuel utilization, and the total air stoichiometric ratio. To the authors' knowledge, this is the first AD-SOFC paper to include the cost of the AD when conducting economic optimization of the AD-SOFC plant. Our calculations show that adding a new AD-SOFC system to an existing waste water treatment (WWT) plant could yield positives values of IRR at today's average electricity prices and could significantly out-compete other options for using biogas to generate electricity. AD-SOFC systems could likely convert WWT plants into net generators of electricity rather than net consumers of electricity while generating economically viable rates of return on investment if the costs of SOFC systems are within a factor of two of the DOE/SECA cost targets.

Brain correlates of the intrinsic subjective cost of effort in sedentary volunteers.

PubMed

Bernacer, J; Martinez-Valbuena, I; Martinez, M; Pujol, N; Luis, E; Ramirez-Castillo, D; Pastor, M A

2016-01-01

One key aspect of motivation is the ability of agents to overcome excessive weighting of intrinsic subjective costs. This contribution aims to analyze the subjective cost of effort and assess its neural correlates in sedentary volunteers. We recruited a sample of 57 subjects who underwent a decision-making task using a prospective, moderate, and sustained physical effort as devaluating factor. Effort discounting followed a hyperbolic function, and individual discounting constants correlated with an indicator of sedentary lifestyle (global physical activity questionnaire; R=-0.302, P=0.033). A subsample of 24 sedentary volunteers received a functional magnetic resonance imaging scan while performing a similar effort-discounting task. BOLD signal of a cluster located in the dorsomedial prefrontal cortex correlated with the subjective value of the pair of options under consideration (Z>2.3, P<0.05; cluster corrected for multiple comparisons for the whole brain). Furthermore, effort-related discounting of reward correlated with the signal of a cluster in the ventrolateral prefrontal cortex (Z>2.3, P<0.05; small volume cluster corrected for a region of interest including the ventral prefrontal cortex and striatum). This study offers empirical data about the intrinsic subjective cost of effort and its neural correlates in sedentary individuals. © 2016 Elsevier B.V. All rights reserved.

Methodology of functionality selection for water management software and examples of its application.

PubMed

Vasilyev, K N

2013-01-01

When developing new software products and adapting existing software, project leaders have to decide which functionalities to keep, adapt or develop. They have to consider that the cost of making errors during the specification phase is extremely high. In this paper a formalised approach is proposed that considers the main criteria for selecting new software functions. The application of this approach minimises the chances of making errors in selecting the functions to apply. Based on the work on software development and support projects in the area of water resources and flood damage evaluation in economic terms at CH2M HILL (the developers of the flood modelling package ISIS), the author has defined seven criteria for selecting functions to be included in a software product. The approach is based on the evaluation of the relative significance of the functions to be included into the software product. Evaluation is achieved by considering each criterion and the weighting coefficients of each criterion in turn and applying the method of normalisation. This paper includes a description of this new approach and examples of its application in the development of new software products in the are of the water resources management.

A cost-performance model for ground-based optical communications receiving telescopes

NASA Technical Reports Server (NTRS)

Lesh, J. R.; Robinson, D. L.

1986-01-01

An analytical cost-performance model for a ground-based optical communications receiving telescope is presented. The model considers costs of existing telescopes as a function of diameter and field of view. This, coupled with communication performance as a function of receiver diameter and field of view, yields the appropriate telescope cost versus communication performance curve.

Commercial insurance vs community-based health plans: time for a policy option with clinical emphasis to address the cost spiral.

PubMed

Amundson, Bruce

2005-01-01

The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship between various clinical strategies and reductions in utilization and costs. This article describes the organization of health services, including integration of delivery and financing systems, at the community level as a model that effectively addresses the critical structural flaws that have frustrated control of costs. Community-based health plans (CHPs) have been developed and have demonstrated viability. The key elements of CHPs are a legal organizational structure, a full provider network, advanced care-management systems, and the ability to assume financial risk. Common misconceptions regarding obstacles to CHP development are the complexity of the undertaking, difficulty assuming the insurance function, and insured pools that are too small to be viable. The characteristics of successful CHPs and 2 case studies are described, including the types of advanced care-management systems that have resulted in strong financial performance. The demonstrated ability of CHPs to establish financial viability with small numbers of enrollees challenges the common assumption that there is a fixed relationship between health plan enrollment size and financial performance. Organizing the health system at the community/regional level provides an attractive alternative model in the health-reform debate. There is an opportunity for clinical systems and state and federal leaders to support the development of community-based integrated delivery and financing system models that, among other advantages, have significant potential to modulate the pernicious cost spiral.

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

PubMed

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

2015-10-23

The present study protocol describes the evaluation of a comprehensive integrated care model implemented at two hospital sites at the University Hospital of North Norway (UNN). The PAtient Centred Team (PACT) model includes proactive, patient-centred interdisciplinary teams that aim to improve the continuum and quality of care of frail elderly patients and reduce health care costs. The main objectives of the evaluation are to analyse the effectiveness and cost effectiveness of using patient-centred teams as part of routine service provision for this patient group. The evaluation will analyse the effect on patient health and functional status, patient experiences and hospital utilisation, and it will conduct an economic evaluation. This paper describes the PACT model and the rationale for and design of the planned effectiveness and cost-effectiveness study. This is a prospective, non-randomised matched control before-and-after intervention study. Patients in the intervention group will be recruited from the hospital sites that have implemented the PACT model. The controls will be recruited from two hospitals without the model. The control patients and the index patients will be matched according to sex, age and number of long-term conditions. The study aims to include 600 patients in each group, which will provide sufficient power to detect a clinical change in the primary outcome. The primary outcome is the physical dimension of the Short Form Health Survey (SF-36). Secondary outcomes are the Patient Generated Index (PGI), the Patient Activation Measure (PAM), the Patient Assessment of Chronic Illness Care (PACIC), hospitalisation and length of stay. The cost-effectiveness study takes a health provider perspective and calculates the cost per quality-adjusted life-years (QALYs) gained. The data will be collected at baseline, 6 and 12 months. The data will be analysed using techniques and models that recognise the lack of randomisation and the correlation of cost and effect data. The study results will provide knowledge about whether the integrated care model implemented at UNN improves the quality of care for the frail elderly with multiple conditions. The study will establish whether the PAC. T model improves health and functional status and is cost effective compared to the usual care for this patient group. ClinicalTrials.gov: NCT02541474.

Cost-effectiveness of postural exercise therapy versus physiotherapy in computer screen-workers with early non-specific work-related upper limb disorders (WRULD); a randomized controlled trial.

PubMed

van Eijsden, Marjon D; Gerhards, Sylvia A; de Bie, Rob A; Severens, Johan L

2009-11-17

Exercise therapies generate substantial costs in computer workers with non-specific work-related upper limb disorders (WRULD). To study if postural exercise therapy is cost-effective compared to regular physiotherapy in screen-workers with early complaints, both from health care and societal perspective. Prospective randomized trial including cost-effectiveness analysis; one year follow-up. Eighty-eight screen-workers with early non-specific WRULD; six drop-outs. A ten week postural exercise program versus regular physiotherapy. Effectiveness measures: Pain: visual analogous scale (VAS), self-perceived WRULD (yes/no). Functional outcome: Disabilities of Arm, Shoulder and Hand- Dutch Language Version (DASH-DLV). Quality of life outcome: EQ-5D.Economic measures: health care costs including patient and family costs and productivity costs resulting in societal costs. Cost-effectiveness measures: health care costs and societal costs related to the effectiveness measures. OUTCOME MEASURES were assessed at baseline; three, six and twelve months after baseline. At baseline both groups were comparable for baseline characteristics except scores on the Pain Catastrophizing Scale and comparable for costs. No significant differences between the groups concerning effectiveness at one year follow-up were found. Effectiveness scores slightly improved over time. After one year 55% of participants were free of complaints. After one year the postural exercise group had higher mean total health care costs, but lower productivity costs compared to the physiotherapy group. Mean societal costs after one year (therefore) were in favor of postural exercise therapy [- euro622; 95% CI -2087; +590)]. After one year, only self- perceived WRULD seemed to result in acceptable cost-effectiveness of the postural exercise strategy over physiotherapy; however the probability of acceptable cost-effectiveness did not exceed 60%.Considering societal costs related to QALYs, postural exercise therapy had a probability of over 80% to be cost-effective over a wide range of cost-effectiveness ceiling ratios; however based on a marginal QALY-difference of 0.1 over a 12 month time frame. Although our trial failed to find significant differences in VAS, QALYs and ICERs based on VAS and QALYs at one-year follow-up, CEACs suggest that postural exercise therapy according to Mensendieck/Cesar has a higher probability of being cost-effective compared to regular physiotherapy; however further research is required. ISRCTN 15872455.

Cost versus utility of aclidinium bromide 400 µg plus formoterol fumarate dihydrate 12 µg compared to aclidinium bromide 400 µg alone in the management of moderate-to-severe COPD

PubMed Central

Ramos, Mafalda; Haughney, John; Henry, Nathaniel; Lindner, Leandro; Lamotte, Mark

2016-01-01

Purpose Aclidinium–formoterol 400/12 µg is a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist in a fixed-dose combination used in the management of patients with COPD. This study aimed to assess the cost-effectiveness of aclidinium–formoterol 400/12 µg against the long-acting muscarinic antagonist aclidinium bromide 400 µg. Materials and methods A five-health-state Markov transition model with monthly cycles was developed using MS Excel to simulate patients with moderate-to-severe COPD and their initial lung-function improvement following treatment with aclidinium–formoterol 400/12 µg or aclidinium 400 µg. Health states were based on severity levels defined by Global Initiative for Chronic Obstructive Lung Disease 2010 criteria. The analysis was a head-to-head comparison without step-up therapy, from the NHS Scotland perspective, over a 5-year time horizon. Clinical data on initial lung-function improvement were provided by a pooled analysis of the ACLIFORM and AUGMENT trials. Management, event costs, and utilities were health state-specific. Costs and effects were discounted at an annual rate of 3.5%. The outcome of the analysis was expressed as cost (UK£) per quality-adjusted life-year (QALY) gained. The analysis included one way and probabilistic sensitivity analyses to investigate the impact of parameter uncertainty on model outputs. Results Aclidinium–formoterol 400/12 µg provided marginally higher costs (£41) and more QALYs (0.014), resulting in an incremental cost-effectiveness ratio of £2,976/QALY. Sensitivity analyses indicated that results were robust to key parameter variations, and the main drivers were: mean baseline forced expiratory volume in 1 second (FEV1), risk of exacerbation, FEV1 improvement from aclidinium–formoterol 400/12 µg, and lung-function decline. The probability of aclidinium–formoterol 400/12 µg being cost-effective (using a willingness-to-pay threshold of £20,000/QALY) versus aclidinium 400 µg was 79%. Conclusion In Scotland, aclidinium–formoterol 400/12 µg can be considered a cost-effective treatment option compared to aclidinium 400 µg alone in patients with moderate-to-severe COPD. PMID:27672337

Scale Issues in Modeling the Water Resources Sector in National Economic Models: A Case study of China

NASA Astrophysics Data System (ADS)

Strzepek, K. M.; Kirshen, P.; Yohe, G.

2001-05-01

The fundamental theme of this research was to investigate tradeoffs in model resolution for modeling water resources in the context of national economic development and capital investment decisions.. Based on a case study of China, the research team has developed water resource models at relatively fine scales, then investigated how they can be aggregated to regional or national scales and for use in national level planning decisions or global scale integrated assessment models of food and/or environmental change issues. The team has developed regional water supply and water demand functions.. Simplifying and aggregating the supply and demand functions will allow reduced form functions of the water sector for inclusion in large scale national economic models. Water Supply Cost functions were developed looking at both surface and groundwater supplies. Surface Water: Long time series of flows at the mouths of the 36 major river sub-basins in China are used in conjunction with different basin reservoir storage quantities to obtain storage-yield curves. These are then combined with reservoir and transmission cost data to obtain yield-cost or surface water demand curves. The methodology to obtain the long time series of flows for each basin is to fit a simple abcd water balance model to each basin. The costs of reservoir storage have been estimated by using a methodology developed in the USA that relates marginal storage costs to existing storage, slope and geological conditions. USA costs functions have then been adjusted to Chinese costs. The costs of some actual dams in China were used to "ground-truth" the methodology. Groundwater: The purpose of the groundwater work is to estimate the recharge in each basin, and the depths and quality of water of aquifers. A byproduct of the application of the abcd water balance model is the recharge. Depths and quality of aquifers are being taken from many separate reports on groundwater in different parts of China; we have been unable to find any global or regional datasets of groundwater.. Combining Surface and Groundwater Supply Functions Water Demand Curves. Water Use data is reported on political regions. Water Supply is reported and modeled on river basin regions. It is necessary to allocate water demands to river basins. To accomplish this China's 9 major river basins were divided into 36 hydroeconomic regions. The counties were then allocated to one of the 36-hydroeconomic zones. The county-level water use data was aggregated to 5 major water use sectors: 1)industry; 2)urban municipal and vegetable gardens: 3) major irrigation; 4) Energy and 5)Other agriculture (forestry, pasture; fishery). Sectoral Demand functions that include price and income elasticity were developed for the 5 sectors for each of the 9 major river basin. The supply and demand curves were aggregated at a variety of geographical scales as well as levels of economic sectoral aggregation. Implications for investment and sustainable development policies were examined for the various aggregation using partial and general equilibrium modeling of the Chinese economy. These results and policy implications for China as well as insights and recommendation for other developing countries will be presented.

Mobile communications satellite antenna flight experiment definition

NASA Technical Reports Server (NTRS)

Freeland, Robert E.

1987-01-01

Results of a NASA-sponsored study to determine the technical feasibility and cost of a Shuttle-based flight experiment specifically intended for the MSAT commercial user community are presented. The experiment will include demonstrations of technology in the areas of radio frequency, sensing and control, and structures. The results of the structural subsystem study summarized here include experiment objective and technical approach, experiment structural description, structure/environment interactions, structural characterization, thermal characterization, structural measurement system, and experiment functional description.

Highly Integrated Quality Assurance – An Empirical Case

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

Drake Kirkham; Amy Powell; Lucas Rich

2011-02-01

Highly Integrated Quality Assurance – An Empirical Case Drake Kirkham1, Amy Powell2, Lucas Rich3 1Quality Manager, Radioisotope Power Systems (RPS) Program, Idaho National Laboratory, P.O. Box 1625 M/S 6122, Idaho Falls, ID 83415-6122 2Quality Engineer, RPS Program, Idaho National Laboratory 3Quality Engineer, RPS Program, Idaho National Laboratory Contact: Voice: (208) 533-7550 Email: Drake.Kirkham@inl.gov Abstract. The Radioisotope Power Systems Program of the Idaho National Laboratory makes an empirical case for a highly integrated Quality Assurance function pertaining to the preparation, assembly, testing, storage and transportation of 238Pu fueled radioisotope thermoelectric generators. Case data represents multiple campaigns including the Pluto/New Horizons mission,more » the Mars Science Laboratory mission in progress, and other related projects. Traditional Quality Assurance models would attempt to reduce cost by minimizing the role of dedicated Quality Assurance personnel in favor of either functional tasking or peer-based implementations. Highly integrated Quality Assurance adds value by placing trained quality inspectors on the production floor side-by-side with nuclear facility operators to enhance team dynamics, reduce inspection wait time, and provide for immediate, independent feedback. Value is also added by maintaining dedicated Quality Engineers to provide for rapid identification and resolution of corrective action, enhanced and expedited supply chain interfaces, improved bonded storage capabilities, and technical resources for requirements management including data package development and Certificates of Inspection. A broad examination of cost-benefit indicates highly integrated Quality Assurance can reduce cost through the mitigation of risk and reducing administrative burden thereby allowing engineers to be engineers, nuclear operators to be nuclear operators, and the cross-functional team to operate more efficiently. Applicability of this case extends to any high-value, long-term project where traceability and accountability are determining factors.« less

Extension of Murray's law using a non-Newtonian model of blood flow.

PubMed

Revellin, Rémi; Rousset, François; Baud, David; Bonjour, Jocelyn

2009-05-15

So far, none of the existing methods on Murray's law deal with the non-Newtonian behavior of blood flow although the non-Newtonian approach for blood flow modelling looks more accurate. MODELING: In the present paper, Murray's law which is applicable to an arterial bifurcation, is generalized to a non-Newtonian blood flow model (power-law model). When the vessel size reaches the capillary limitation, blood can be modeled using a non-Newtonian constitutive equation. It is assumed two different constraints in addition to the pumping power: the volume constraint or the surface constraint (related to the internal surface of the vessel). For a seek of generality, the relationships are given for an arbitrary number of daughter vessels. It is shown that for a cost function including the volume constraint, classical Murray's law remains valid (i.e. SigmaR(c) = cste with c = 3 is verified and is independent of n, the dimensionless index in the viscosity equation; R being the radius of the vessel). On the contrary, for a cost function including the surface constraint, different values of c may be calculated depending on the value of n. We find that c varies for blood from 2.42 to 3 depending on the constraint and the fluid properties. For the Newtonian model, the surface constraint leads to c = 2.5. The cost function (based on the surface constraint) can be related to entropy generation, by dividing it by the temperature. It is demonstrated that the entropy generated in all the daughter vessels is greater than the entropy generated in the parent vessel. Furthermore, it is shown that the difference of entropy generation between the parent and daughter vessels is smaller for a non-Newtonian fluid than for a Newtonian fluid.

Microwave power transmission system studies. Volume 4: Sections 9 through 14 with appendices. [ground tests and antenna design

NASA Technical Reports Server (NTRS)

Maynard, O. E.; Brown, W. C.; Edwards, A.; Haley, J. T.; Meltz, G.; Howell, J. M.; Nathan, A.

1975-01-01

The microwave rectifier technology, approaches to the receiving antenna, topology of rectenna circuits, assembly and construction, ROM cost estimates are discussed. Analyses and cost estimates for the equipment required to transmit the ground power to an external user. Noise and harmonic considerations are presented for both the amplitron and klystron and interference limits are identified and evaluated. The risk assessment discussion is discussed wherein technology risks are rated and ranked with regard to their importance in impacting the microwave power transmission system. The system analyses and evaluation are included of parametric studies of system relationships pertaining to geometry, materials, specific cost, specific weight, efficiency, converter packing, frequency selection, power distribution, power density, power output magnitude, power source, transportation and assembly. Capital costs per kW and energy costs as a function of rate of return, power source and transportation costs as well as build cycle time are presented. The critical technology and ground test program are discussed along with ROM costs and schedule. The orbital test program with associated critical technology and ground based program based on full implementation of the defined objectives is discussed.

Small Habitat Commonality Reduces Cost for Human Mars Missions

NASA Technical Reports Server (NTRS)

Griffin, Brand N.; Lepsch, Roger; Martin, John; Howard, Robert; Rucker, Michelle; Zapata, Edgar; McCleskey, Carey; Howe, Scott; Mary, Natalie; Nerren, Philip (Inventor)

2015-01-01

Most view the Apollo Program as expensive. It was. But, a human mission to Mars will be orders of magnitude more difficult and costly. Recently, NASA's Evolvable Mars Campaign (EMC) mapped out a step-wise approach for exploring Mars and the Mars-moon system. It is early in the planning process but because approximately 80% of the total life cycle cost is committed during preliminary design, there is an effort to emphasize cost reduction methods up front. Amongst the options, commonality across small habitat elements shows promise for consolidating the high bow-wave costs of Design, Development, Test and Evaluation (DDT&E) while still accommodating each end-item's functionality. In addition to DDT&E, there are other cost and operations benefits to commonality such as reduced logistics, simplified infrastructure integration and with inter-operability, improved safety and simplified training. These benefits are not without a cost. Some habitats are sub-optimized giving up unique attributes for the benefit of the overall architecture and because the first item sets the course for those to follow, rapidly developing technology may be excluded. The small habitats within the EMC include the pressurized crew cabins for the ascent vehicle,

A cost-efficiency and health benefit approach to improve urban air quality.

PubMed

Miranda, A I; Ferreira, J; Silveira, C; Relvas, H; Duque, L; Roebeling, P; Lopes, M; Costa, S; Monteiro, A; Gama, C; Sá, E; Borrego, C; Teixeira, J P

2016-11-01

When ambient air quality standards established in the EU Directive 2008/50/EC are exceeded, Member States are obliged to develop and implement Air Quality Plans (AQP) to improve air quality and health. Notwithstanding the achievements in emission reductions and air quality improvement, additional efforts need to be undertaken to improve air quality in a sustainable way - i.e. through a cost-efficiency approach. This work was developed in the scope of the recently concluded MAPLIA project "Moving from Air Pollution to Local Integrated Assessment", and focuses on the definition and assessment of emission abatement measures and their associated costs, air quality and health impacts and benefits by means of air quality modelling tools, health impact functions and cost-efficiency analysis. The MAPLIA system was applied to the Grande Porto urban area (Portugal), addressing PM10 and NOx as the most important pollutants in the region. Four different measures to reduce PM10 and NOx emissions were defined and characterized in terms of emissions and implementation costs, and combined into 15 emission scenarios, simulated by the TAPM air quality modelling tool. Air pollutant concentration fields were then used to estimate health benefits in terms of avoided costs (external costs), using dose-response health impact functions. Results revealed that, among the 15 scenarios analysed, the scenario including all 4 measures lead to a total net benefit of 0.3M€·y(-1). The largest net benefit is obtained for the scenario considering the conversion of 50% of open fire places into heat recovery wood stoves. Although the implementation costs of this measure are high, the benefits outweigh the costs. Research outcomes confirm that the MAPLIA system is useful for policy decision support on air quality improvement strategies, and could be applied to other urban areas where AQP need to be implemented and monitored. Copyright © 2016. Published by Elsevier B.V.

Systematic overview of economic evaluations of health-related rehabilitation.

PubMed

Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

2016-01-01

Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Cost-effectiveness in the contemporary management of critical limb ischemia with tissue loss.

PubMed

Barshes, Neal R; Chambers, James D; Cohen, Joshua; Belkin, Michael

2012-10-01

The care of patients with critical limb ischemia (CLI) and tissue loss is notoriously challenging and expensive. We evaluated the cost-effectiveness of various management strategies to identify those that would optimize value to patients. A probabilistic Markov model was used to create a detailed simulation of patient-oriented outcomes, including clinical events, wound healing, functional outcomes, and quality-adjusted life-years (QALYs) after various management strategies in a CLI patient cohort during a 10-year period. Direct and indirect cost estimates for these strategies were obtained using transition cost-accounting methodology. Incremental cost-effectiveness ratios (ICERs), in 2009 U.S. dollars per QALYs, were calculated compared with the most conservative management strategy of local wound care with amputation as needed. With an ICER of $47,735/QALY, an initial surgical bypass with subsequent endovascular revision(s) as needed was the most cost-effective alternative to local wound care alone. Endovascular-first management strategies achieved comparable clinical outcomes but at higher cost (ICERs ≥$101,702/QALY); however, endovascular management did become cost-effective when the initial foot wound closure rate was >37% or when procedural costs were decreased by >42%. Primary amputation was dominated (less effectiveness and more costly than wound care alone). Contemporary clinical effectiveness and cost estimates show an initial surgical bypass is the most cost-effective alternative to local wound care alone for CLI with tissue loss and can be supported even in a cost-averse health care environment. Copyright © 2012. Published by Mosby, Inc.

Capturing patients' needs in casemix: a systematic literature review on the value of adding functioning information in reimbursement systems.

PubMed

Hopfe, Maren; Stucki, Gerold; Marshall, Ric; Twomey, Conal D; Üstün, T Bedirhan; Prodinger, Birgit

2016-02-03

Contemporary casemix systems for health services need to ensure that payment rates adequately account for actual resource consumption based on patients' needs for services. It has been argued that functioning information, as one important determinant of health service provision and resource use, should be taken into account when developing casemix systems. However, there has to date been little systematic collation of the evidence on the extent to which the addition of functioning information into existing casemix systems adds value to those systems with regard to the predictive power and resource variation explained by the groupings of these systems. Thus, the objective of this research was to examine the value of adding functioning information into casemix systems with respect to the prediction of resource use as measured by costs and length of stay. A systematic literature review was performed. Peer-reviewed studies, published before May 2014 were retrieved from CINAHL, EconLit, Embase, JSTOR, PubMed and Sociological Abstracts using keywords related to functioning ('Functioning', 'Functional status', 'Function*, 'ICF', 'International Classification of Functioning, Disability and Health', 'Activities of Daily Living' or 'ADL') and casemix systems ('Casemix', 'case mix', 'Diagnosis Related Groups', 'Function Related Groups', 'Resource Utilization Groups' or 'AN-SNAP'). In addition, a hand search of reference lists of included articles was conducted. Information about study aims, design, country, setting, methods, outcome variables, study results, and information regarding the authors' discussion of results, study limitations and implications was extracted. Ten included studies provided evidence demonstrating that adding functioning information into casemix systems improves predictive ability and fosters homogeneity in casemix groups with regard to costs and length of stay. Collection and integration of functioning information varied across studies. Results suggest that, in particular, DRG casemix systems can be improved in predicting resource use and capturing outcomes for frail elderly or severely functioning-impaired patients. Further exploration of the value of adding functioning information into casemix systems is one promising approach to improve casemix systems ability to adequately capture the differences in patient's needs for services and to better predict resource use.

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2010 CFR

2010-07-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2012 CFR

2012-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2013 CFR

2013-07-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2011 CFR

2011-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2014 CFR

2014-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

Dynamic Programming and Error Estimates for Stochastic Control Problems with Maximum Cost

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

Bokanowski, Olivier, E-mail: boka@math.jussieu.fr; Picarelli, Athena, E-mail: athena.picarelli@inria.fr; Zidani, Hasnaa, E-mail: hasnaa.zidani@ensta.fr

2015-02-15

This work is concerned with stochastic optimal control for a running maximum cost. A direct approach based on dynamic programming techniques is studied leading to the characterization of the value function as the unique viscosity solution of a second order Hamilton–Jacobi–Bellman (HJB) equation with an oblique derivative boundary condition. A general numerical scheme is proposed and a convergence result is provided. Error estimates are obtained for the semi-Lagrangian scheme. These results can apply to the case of lookback options in finance. Moreover, optimal control problems with maximum cost arise in the characterization of the reachable sets for a system ofmore » controlled stochastic differential equations. Some numerical simulations on examples of reachable analysis are included to illustrate our approach.« less

Multiple advanced logic gates made of DNA-Ag nanocluster and the application for intelligent detection of pathogenic bacterial genes† †Electronic supplementary information (ESI) available: Chemicals, materials and DNA sequences used in the investigation, the construction of YES, AND, OR, XOR and INH logic gates, CD and PAGE experimental results. See DOI: 10.1039/c7sc05246d

PubMed Central

Lin, Xiaodong; Deng, Jiankang; Lyu, Yanlong; Qian, Pengcheng; Li, Yunfei

2018-01-01

The integration of multiple DNA logic gates on a universal platform to implement advance logic functions is a critical challenge for DNA computing. Herein, a straightforward and powerful strategy in which a guanine-rich DNA sequence lighting up a silver nanocluster and fluorophore was developed to construct a library of logic gates on a simple DNA-templated silver nanoclusters (DNA-AgNCs) platform. This library included basic logic gates, YES, AND, OR, INHIBIT, and XOR, which were further integrated into complex logic circuits to implement diverse advanced arithmetic/non-arithmetic functions including half-adder, half-subtractor, multiplexer, and demultiplexer. Under UV irradiation, all the logic functions could be instantly visualized, confirming an excellent repeatability. The logic operations were entirely based on DNA hybridization in an enzyme-free and label-free condition, avoiding waste accumulation and reducing cost consumption. Interestingly, a DNA-AgNCs-based multiplexer was, for the first time, used as an intelligent biosensor to identify pathogenic genes, E. coli and S. aureus genes, with a high sensitivity. The investigation provides a prototype for the wireless integration of multiple devices on even the simplest single-strand DNA platform to perform diverse complex functions in a straightforward and cost-effective way. PMID:29675221

Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges

PubMed Central

Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S.; Mattke, Soeren

2016-01-01

Abstract Overhauling the individual health insurance market—including through the creation of health insurance exchanges—was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges—privately facilitated exchanges—which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment. PMID:28083414

Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges.

PubMed

Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S; Mattke, Soeren

2016-05-09

Overhauling the individual health insurance market-including through the creation of health insurance exchanges-was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges-privately facilitated exchanges-which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment.

Resource utilisation and direct costs in patients with recently diagnosed fibromyalgia who are offered one of three different interventions in a randomised pragmatic trial.

PubMed

van Eijk-Hustings, Yvonne; Kroese, Mariëlle; Creemers, An; Landewé, Robert; Boonen, Annelies

2016-05-01

The purpose of this study is to understand the course of costs over a 2-year period in a cohort of recently diagnosed fibromyalgia (FM) patients receiving different treatment strategies. Following the diagnosis, patients were randomly assigned to a multidisciplinary programme (MD), aerobic exercise (AE) or usual care (UC) without being aware of alternative interventions. Time between diagnosis and start of treatment varied between patients. Resource utilisation, health care costs and costs for patients and families were collected through cost diaries. Mixed linear model analyses (MLM) examined the course of costs over time. Linear regression was used to explore predictors of health care costs in the post-intervention period. Two hundred three participants, 90 % women, mean (SD) age 41.7 (9.8) years, were included in the cohort. Intervention costs per patient varied from €864 to 1392 for MD and were €121 for AE. Health care costs (excluding intervention costs) decreased after diagnosis, but before the intervention in each group, and increased again afterwards to the level close to the diagnostic phase. In contrast, patient and family costs slightly increased over time in all groups without initial decrease immediately after diagnosis. Annualised health care costs post-intervention varied between €1872 and 2310 per patient and were predicted by worse functioning and high health care costs at diagnosis. In patients with FM, health care costs decreased following the diagnosis by a rheumatologist. Offering patients a specific intervention after diagnosis incurred substantial costs while having only marginal effects on costs.

Trade-Space Analysis Tool for Constellations (TAT-C)

NASA Technical Reports Server (NTRS)

Le Moigne, Jacqueline; Dabney, Philip; de Weck, Olivier; Foreman, Veronica; Grogan, Paul; Holland, Matthew; Hughes, Steven; Nag, Sreeja

2016-01-01

Traditionally, space missions have relied on relatively large and monolithic satellites, but in the past few years, under a changing technological and economic environment, including instrument and spacecraft miniaturization, scalable launchers, secondary launches as well as hosted payloads, there is growing interest in implementing future NASA missions as Distributed Spacecraft Missions (DSM). The objective of our project is to provide a framework that facilitates DSM Pre-Phase A investigations and optimizes DSM designs with respect to a-priori Science goals. In this first version of our Trade-space Analysis Tool for Constellations (TAT-C), we are investigating questions such as: How many spacecraft should be included in the constellation? Which design has the best costrisk value? The main goals of TAT-C are to: Handle multiple spacecraft sharing a mission objective, from SmallSats up through flagships, Explore the variables trade space for pre-defined science, cost and risk goals, and pre-defined metrics Optimize cost and performance across multiple instruments and platforms vs. one at a time.This paper describes the overall architecture of TAT-C including: a User Interface (UI) interacting with multiple users - scientists, missions designers or program managers; an Executive Driver gathering requirements from UI, then formulating Trade-space Search Requests for the Trade-space Search Iterator first with inputs from the Knowledge Base, then, in collaboration with the Orbit Coverage, Reduction Metrics, and Cost Risk modules, generating multiple potential architectures and their associated characteristics. TAT-C leverages the use of the Goddard Mission Analysis Tool (GMAT) to compute coverage and ancillary data, streamlining the computations by modeling orbits in a way that balances accuracy and performance.TAT-C current version includes uniform Walker constellations as well as Ad-Hoc constellations, and its cost model represents an aggregate model consisting of Cost Estimating Relationships (CERs) from widely accepted models. The Knowledge Base supports both analysis and exploration, and the current GUI prototype automatically generates graphics representing metrics such as average revisit time or coverage as a function of cost.

Development of low-cost high-performance multispectral camera system at Banpil

NASA Astrophysics Data System (ADS)

Oduor, Patrick; Mizuno, Genki; Olah, Robert; Dutta, Achyut K.

2014-05-01

Banpil Photonics (Banpil) has developed a low-cost high-performance multispectral camera system for Visible to Short- Wave Infrared (VIS-SWIR) imaging for the most demanding high-sensitivity and high-speed military, commercial and industrial applications. The 640x512 pixel InGaAs uncooled camera system is designed to provide a compact, smallform factor to within a cubic inch, high sensitivity needing less than 100 electrons, high dynamic range exceeding 190 dB, high-frame rates greater than 1000 frames per second (FPS) at full resolution, and low power consumption below 1W. This is practically all the feature benefits highly desirable in military imaging applications to expand deployment to every warfighter, while also maintaining a low-cost structure demanded for scaling into commercial markets. This paper describes Banpil's development of the camera system including the features of the image sensor with an innovation integrating advanced digital electronics functionality, which has made the confluence of high-performance capabilities on the same imaging platform practical at low cost. It discusses the strategies employed including innovations of the key components (e.g. focal plane array (FPA) and Read-Out Integrated Circuitry (ROIC)) within our control while maintaining a fabless model, and strategic collaboration with partners to attain additional cost reductions on optics, electronics, and packaging. We highlight the challenges and potential opportunities for further cost reductions to achieve a goal of a sub-$1000 uncooled high-performance camera system. Finally, a brief overview of emerging military, commercial and industrial applications that will benefit from this high performance imaging system and their forecast cost structure is presented.

Cost effectiveness of using surgery versus skeletal traction in management of femoral shaft fractures at Thika level 5 hospital, Kenya.

PubMed

Opondo, Everisto; Wanzala, Peter; Makokha, Ansellimo

2013-01-01

A prospective quasi experimental study was undertaken at the Thika level 5 hospital. The study aimed to compare the costs of managing femoral shaft fracture by surgery as compared to skeletal traction. Sixty nine (46.6%) patients were enrolled in group A and managed surgically by intramedullary nailing while 79 (53.4%) patients were enrolled in group B and managed by skeletal traction. Exclusion criteria included patients with pathological fractures and previous femoral fractures. Data was collected by evaluation of patients in patient bills using a standardized questionnaire. The questionnaire included cost of haematological and radiological tests, bed fees, theatre fees and physiotherapy costs. The data was compiled and analyzed using SPSS version 16. Person's chi square and odds ratios were used to measure associations and risk analysis respectively. A higher proportion of patients (88.4%) in group A were hospitalized for less than one month compared to 20 patients (30.4%) in group B (p, 0.001).Total cost of treatment in group A was significantly lower than in group B. Nineteen (27.9%) patients who underwent surgery paid a total bill of Ksh 5000-7500 compared to 7(10.4%) who were treated by traction. The financial cost benefit of surgery was further complimented by better functional outcomes. The data indicates a cost advantage of managing femoral shaft fracture by surgery compared to traction. Furthermore the longer hospital stay in the traction group is associated with more malunion, limb deformity and shortening.

Military Personnel Procurement Resources Report

DTIC Science & Technology

1991-05-28

directed at enlistment in the Military Service. Include cost of advertising agency contract spent on marketing research (to include cost of advertising...programs. Include cost of advertising agency contract spent on marketing research (to include cost of advertising agency subcontractors). 7. Printed...Include cost of advertising agency contract spent on marketing research (to include cost of advertising agency sub- contractors). 7. Printed

University Faculty and the Value of Their Intellectual Property: Comparing IP in Teaching and Research

ERIC Educational Resources Information Center

Hentschke, Guilbert C.

2017-01-01

This chapter describes the protectionist and access functions of intellectual property for the teaching and research work of university faculty. The degree to which an individual piece of IP is protected or made accessible to others depends in large measure on its market-related characteristics, including costs of production, availability of…

The Nation's Report Card[TM]: Economics 2006--National Assessment of Educational Progress at Grade 12. NCES 2007-475

ERIC Educational Resources Information Center

Mead, N.; Sandene, B.

2007-01-01

Knowledge of economics is important for individuals to function effectively as citizens in an increasingly connected world economy. Economic literacy includes understanding how economies and markets work, what the benefits and costs of economic interaction and interdependence are, and that people have to make choices because resources are…

Are we there yet? Tracking the development of new model systems

Treesearch

A. Abzhanov; C. Extavour; A. Groover; S. Hodges; H. Hoekstra; E. Kramer; A. Monteiro

2008-01-01

It is increasingly clear that additional ‘model’ systems are needed to elucidate the genetic and developmental basis of organismal diversity. Whereas model system development previously required enormous investment, recent advances including the decreasing cost of DNA sequencing and the power of reverse genetics to study gene function are greatly facilitating...

SLA Negotiation for VO Formation

NASA Astrophysics Data System (ADS)

Paurobally, Shamimabi

Resource management systems are changing from localized resources and services towards virtual organizations (VOs) sharing millions of heterogeneous resources across multiple organizations and domains. The virtual organizations and usage models include a variety of owners and consumers with different usage, access policies, cost models, varying loads, requirements and availability. The stakeholders have private utility functions that must be satisfied and possibly maximized.

Cost-effectiveness of food, supplement and environmental interventions to address malnutrition in residential aged care: a systematic review.

PubMed

Hugo, Cherie; Isenring, Elisabeth; Miller, Michelle; Marshall, Skye

2018-05-01

observational studies have shown that nutritional strategies to manage malnutrition may be cost-effective in aged care; but more robust economic data is needed to support and encourage translation to practice. Therefore, the aim of this systematic review is to compare the cost-effectiveness of implementing nutrition interventions targeting malnutrition in aged care homes versus usual care. residential aged care homes. systematic literature review of studies published between January 2000 and August 2017 across 10 electronic databases. Cochrane Risk of Bias tool and GRADE were used to evaluate the quality of the studies. eight included studies (3,098 studies initially screened) reported on 11 intervention groups, evaluating the effect of modifications to dining environment (n = 1), supplements (n = 5) and food-based interventions (n = 5). Interventions had a low cost of implementation (<£2.30/resident/day) and provided clinical improvement for a range of outcomes including weight, nutritional status and dietary intake. Supplements and food-based interventions further demonstrated a low cost per quality adjusted life year or unit of physical function improvement. GRADE assessment revealed the quality of the body of evidence that introducing malnutrition interventions, whether they be environmental, supplements or food-based, are cost-effective in aged care homes was low. this review suggests supplements and food-based nutrition interventions in the aged care setting are clinically effective, have a low cost of implementation and may be cost-effective at improving clinical outcomes associated with malnutrition. More studies using well-defined frameworks for economic analysis, stronger study designs with improved quality, along with validated malnutrition measures are needed to confirm and increase confidence with these findings.

Perturbations in reward-related decision-making induced by reduced prefrontal cortical GABA transmission: Relevance for psychiatric disorders.

PubMed

Piantadosi, Patrick T; Khayambashi, Shahin; Schluter, Magdalen G; Kutarna, Agnes; Floresco, Stan B

2016-02-01

The prefrontal cortex (PFC) is critical for higher-order cognitive functions, including decision-making. In psychiatric conditions such as schizophrenia, prefrontal dysfunction co-occurs with pronounced alterations in decision-making ability. These alterations include a diminished ability to utilize probabilistic reinforcement in guiding future choice, and a reduced willingness to expend effort to receive reward. Among the neurochemical abnormalities observed in the PFC of individuals with schizophrenia are alterations in the production and function of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). To probe how PFC GABA hypofunction may contribute to alterations in cost/benefit decision-making, we assessed the effects GABAA-receptor antagonist bicuculline (BIC; 50 ng in 0.5 μl saline/hemisphere) infusion in the medial PFC of rats during performance on a series of well-validated cost/benefit decision-making tasks. Intra-PFC BIC reduced risky choice and reward sensitivity during probabilistic discounting and decreased the preference for larger rewards associated with a greater effort cost, similar to the behavioral sequelae observed in schizophrenia. Additional experiments revealed that these treatments did not alter instrumental responding on a progressive ratio schedule, nor did they impair the ability to discriminate between reward and no reward. However, BIC induced a subtle but consistent impairment in preference for larger vs. smaller rewards of equal cost. BIC infusion also increased decision latencies and impaired the ability to "stay on task" as indexed by reduced rates of instrumental responding. Collectively, these results implicate prefrontal GABAergic dysfunction as a key contributing factor to abnormal decision-making observed in schizophrenia and other neuropsychiatric conditions with similar neurobiological and behavioral alterations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pursuing cost-effectiveness in mental health service delivery for youth with complex needs.

PubMed

Grimes, Katherine E; Schulz, Margaret F; Cohen, Steven A; Mullin, Brian O; Lehar, Sophie E; Tien, Shelly

2011-06-01

Mental health advocates seek to expand children's services, noting widespread failure to meet the needs of public sector youth suffering from serious emotional disturbance (SED). However, state and national budgets face deepening cuts, with rising health care costs taking the blame. As the gap between needs and finances widens, identification of cost-effective treatments that will benefit children with SED and their families is of increasing importance. Community-based interventions for this population, such as the wraparound approach and systems-of-care, are being disseminated but literature is scant regarding effects on expense. The Mental Health Services Program for Youth (MHSPY) model is aligned philosophically with wraparound and systems-of-care but unique in blending public agency dollars to deliver integrated medical, mental health and social services. MHSPY's linked clinical and expense data is useful to study community-based treatment cost-effectiveness. To examine the cost-effectiveness of an intensively integrated, family and community-based clinical intervention for youth with mental health needs in comparison to "usual care.'' Study and reference populations were matched on age, gender, community, psychiatric diagnosis, morbidity and insurance type. Claims analyses included patterns of service utilization and medical expense for both groups. Using propensity score matching, results for study youth are compared with results for the population receiving "usual care.'' Clinical functioning was measured for the intervention group at baseline and 12 months. The intervention group used lower intensity services and had substantially lower claims expense (e.g. 32% lower for emergency room, 74% lower for inpatient psychiatry) than their matched counterparts in the "usual care'' group. Intervention youth were consistently maintained in least restrictive settings, with over 88% of days spent at home and showed improved clinical functioning on standard measures. The intensive MHSPY model of service delivery offers potential as a cost-effective intervention for complex youth. Its integrated approach, recognizing needs across multiple life domains, appears to enhance engagement and the effectiveness of mental health treatment, resulting in statistically significant clinical improvements. Functional measures are not collected in "usual care,'' limiting comparisons. However, claims expense for intervention youth was substantially lower than claims expense for Medicaid comparison youth, suggesting clinical needs for intervention youth post-enrollment were lower than for those receiving "usual care.'' The MHSPY model, which intentionally engages families in "clustered'' traditional and non-traditional services, represents a replicable strategy for enhancing the impact of clinical interventions, thereby reducing medical expense. Blending categorical state agency dollars and insurance funds creates flexibility to support community-based care, including individualized services for high-risk youth. Resulting expenses total no more, and are often less, than "treatment as usual'' but yield greater clinical benefits. Further research is needed regarding which intervention elements contribute the most towards improved clinical functioning, as well as which patients are most likely to benefit. A randomized trial of MHSPY vs. "usual care,'' including examination of the sustainability of effects post-disenrollment, would provide a chance to further test this innovative model.

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

NASA Astrophysics Data System (ADS)

Han, Bo; Wang, Jin

2008-03-01

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

Complete blood counts, liver function tests, and chest x-rays as routine screening in early-stage breast cancer: value added or just cost?

PubMed

Louie, Raphael J; Tonneson, Jennifer E; Gowarty, Minda; Goodney, Philip P; Barth, Richard J; Rosenkranz, Kari M

2015-11-01

Current National Comprehensive Cancer Network guidelines for breast cancer staging include pre-treatment complete blood count (CBC) and liver function tests (LFT) to screen for occult metastatic disease. To date, the relevance of these tests in detecting metastatic disease in asymptomatic women with early-stage breast cancer (Stage I/II) has not been demonstrated. Although chest x-rays are no longer recommended in the NCCN guidelines, many centers continue to include this imaging as part of their screening process. We aim to determine the clinical and financial impact of these labs and x-rays in the evaluation of early-stage breast cancer patients. A single institution IRB-approved retrospective chart review was conducted of patients with biopsy-proven invasive breast cancer treated from January 1, 2005–December 31, 2009. We collected patient demographics, clinical and pathologic staging, chest x-ray, CBC, and LFT results at the time of referral. Patients were stratified according to radiographic stage at the time of diagnosis. We obtained Medicare reimbursement fees for cost analysis. From 2005 to 2009, 1609 patients with biopsy-proven invasive breast cancer were treated at our institution. Of the 1082 patients with radiographic stage I/II disease, 27.3 % of patients had abnormal CBCs. No additional testing was performed to evaluate these abnormalities. In the early-stage population, 24.7 % of patients had elevated LFTs, resulting in 84 additional imaging studies. No metastatic disease was detected. The cost of CBC, LFTs and chest x-rays was $110.20 per patient, totaling $106,410.99. Additional tests prompted by abnormal results cost $58,143.30 over the five-year period. We found that pre-treatment CBCs, LFTs, and chest x-rays did not improve detection of occult metastatic disease but resulted in additional financial costs. Avoiding routine ordering of these tests would save the US healthcare system $25.7 million annually.

Clinical effectiveness and cost-effectiveness of treatments for patients with chronic pain.

PubMed

Turk, Dennis C

2002-01-01

Chronic pain is a prevalent and costly problem. This review addresses the question of the clinical effectiveness and cost-effectiveness of the most common treatments for patients with chronic pain. Representative published studies that evaluate the clinical effectiveness of pharmacological treatments, conservative (standard) care, surgery, spinal cord stimulators, implantable drug delivery systems (IDDSs), and pain rehabilitation programs (PRPs) are examined and compared. The cost-effectiveness of these treatment approaches is also considered. Outcome criteria including pain reduction, medication use, health care consumption, functional activities, and closure of disability compensation cases are examined. In addition to clinical effectiveness, the cost-effectiveness of PRPs, conservative care, surgery, spinal cord stimulators, and IDDSs are compared using costs to return a treated patient to work to illustrate the relative expenses for each of these treatments. There are limitations to the success of all the available treatments. The author urges caution in interpreting the results, particularly in comparisons between treatments and across studies, because there are broad differences in the pain syndromes and inclusion criteria used, the drug dosages, comparability of treatments, the definition of "chronic" used, the outcome criteria selected to determine success, and societal differences. None of the currently available treatments eliminates pain for the majority of patients. Pain rehabilitation programs provide comparable reduction in pain to alternative pain treatment modalities, but with significantly better outcomes for medication use, health care utilization, functional activities, return to work, closure of disability claims, and with substantially fewer iatrogenic consequences and adverse events. Surgery, spinal cord stimulators, and IDDSs appear to have substantial benefits on some outcome criteria for carefully selected patients. These modalities are, however, expensive. Pain rehabilitation programs are significantly more cost effective than implantation of spinal cord stimulators, IDDSs, conservative care, and surgery, even for selected patients. Research is needed to identify which patients are most likely to benefit from the available treatments and to study combinations of the available treatments since none of them appear capable of eliminating pain or significantly improving functional outcomes for all treated.

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

PubMed

Henchoz, Yves; Pinget, Christophe; Wasserfallen, Jean-Blaise; Paillex, Roland; de Goumoëns, Pierre; Norberg, Michael; Kai-Lik So, Alexander

2010-10-01

To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. Cost-utility analysis alongside a randomized controlled trial. A total of 105 patients with chronic low back pain. Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

Process-Based Cost Modeling of Photonics Manufacture: The Cost Competitiveness of Monolithic Integration of a 1550-nm DFB Laser and an Electroabsorptive Modulator on an InP Platform

NASA Astrophysics Data System (ADS)

Fuchs, Erica R. H.; Bruce, E. J.; Ram, R. J.; Kirchain, Randolph E.

2006-08-01

The monolithic integration of components holds promise to increase network functionality and reduce packaging expense. Integration also drives down yield due to manufacturing complexity and the compounding of failures across devices. Consensus is lacking on the economically preferred extent of integration. Previous studies on the cost feasibility of integration have used high-level estimation methods. This study instead focuses on accurate-to-industry detail, basing a process-based cost model of device manufacture on data collected from 20 firms across the optoelectronics supply chain. The model presented allows for the definition of process organization, including testing, as well as processing conditions, operational characteristics, and level of automation at each step. This study focuses on the cost implications of integration of a 1550-nm DFB laser with an electroabsorptive modulator on an InP platform. Results show the monolithically integrated design to be more cost competitive over discrete component options regardless of production scale. Dominant cost drivers are packaging, testing, and assembly. Leveraging the technical detail underlying model projections, component alignment, bonding, and metal-organic chemical vapor deposition (MOCVD) are identified as processes where technical improvements are most critical to lowering costs. Such results should encourage exploration of the cost advantages of further integration and focus cost-driven technology development.

Life Cycle Analysis of Dedicated Nano-Launch Technologies

NASA Technical Reports Server (NTRS)

Zapata, Edgar; McCleskey, Carey; Martin, John; Lepsch, Roger; Hernani, Tosoc

2014-01-01

Recent technology advancements have enabled the development of small cheap satellites that can perform useful functions in the space environment. Currently, the only low cost option for getting these payloads into orbit is through ride share programs. As a result, these launch opportunities await primary payload launches and a backlog exists. An alternative option would be dedicated nano-launch systems built and operated to provide more flexible launch services, higher availability, and affordable prices. The potential customer base that would drive requirements or support a business case includes commercial, academia, civil government and defense. Further, NASA technology investments could enable these alternative game changing options.With this context, in 2013 the Game Changing Development (GCD) program funded a NASA team to investigate the feasibility of dedicated nano-satellite launch systems with a recurring cost of less than $2 million per launch for a 5 kg payload to low Earth orbit. The team products would include potential concepts, technologies and factors for enabling the ambitious cost goal, exploring the nature of the goal itself, and informing the GCD program technology investment decision making process. This paper provides an overview of the life cycle analysis effort that was conducted in 2013 by an inter-center NASA team. This effort included the development of reference nano-launch system concepts, developing analysis processes and models, establishing a basis for cost estimates (development, manufacturing and launch) suitable to the scale of the systems, and especially, understanding the relationship of potential game changing technologies to life cycle costs, as well as other factors, such as flights per year.

Getting the most out of additional guidance information in deformable image registration by leveraging multi-objective optimization

NASA Astrophysics Data System (ADS)

Alderliesten, Tanja; Bosman, Peter A. N.; Bel, Arjan

2015-03-01

Incorporating additional guidance information, e.g., landmark/contour correspondence, in deformable image registration is often desirable and is typically done by adding constraints or cost terms to the optimization function. Commonly, deciding between a "hard" constraint and a "soft" additional cost term as well as the weighting of cost terms in the optimization function is done on a trial-and-error basis. The aim of this study is to investigate the advantages of exploiting guidance information by taking a multi-objective optimization perspective. Hereto, next to objectives related to match quality and amount of deformation, we define a third objective related to guidance information. Multi-objective optimization eliminates the need to a-priori tune a weighting of objectives in a single optimization function or the strict requirement of fulfilling hard guidance constraints. Instead, Pareto-efficient trade-offs between all objectives are found, effectively making the introduction of guidance information straightforward, independent of its type or scale. Further, since complete Pareto fronts also contain less interesting parts (i.e., solutions with near-zero deformation effort), we study how adaptive steering mechanisms can be incorporated to automatically focus more on solutions of interest. We performed experiments on artificial and real clinical data with large differences, including disappearing structures. Results show the substantial benefit of using additional guidance information. Moreover, compared to the 2-objective case, additional computational cost is negligible. Finally, with the same computational budget, use of the adaptive steering mechanism provides superior solutions in the area of interest.

ECONOMIC EVALUATIONS OF INTERVENTIONS FOR TRANSTIBIAL AMPUTEES: A SCOPING REVIEW OF COMPARATIVE STUDIES.

PubMed

Highsmith, M Jason; Kahle, Jason T; Lewandowski, Amanda; Klenow, Tyler D; Orriola, John J; Miro, Rebecca M; Hill, Owen T; Raschke, Sylvia Ursula; Orendurff, Michael S; Highsmith, James T; Sutton, Bryce S

2016-09-01

Transtibial amputation (TTA) is life-altering emotionally, functionally, and economically. The economic impact to all stakeholders is largely unknown, as is the cost-effectiveness of prosthetic intervention. This scoping report's purpose was to determine if there is sufficient evidence to conduct a formal systematic review or meta-analysis in any particular prosthetic intervention area and to determine if any evidence statements could be synthesized relative to economic evaluation of interventions provided to patients with TTA. The scoping review revealed six articles representing three topical areas of transtibial care: Care Models, Prosthetic Treatment, and Prosthetic Sockets. All six articles were cost-identification or cost-consequence design and included a total of 704 subjects. Presently, it can be concluded with moderate confidence that specific weight-bearing and total-contact sockets for transtibial amputees are functionally and economically equivalent in the short term when costs, delivery time, and all stakeholder perspectives are considered. Long-term socket outcomes are relatively unexplored. Further primary research is needed beyond this to determine cost-effectiveness for other areas of transtibial prosthetic care although clinical outcomes are somewhat established through systematic review and meta-analysis in other areas of care. Conversely, evaluation of narrative economic reports relative to transtibial care may be sufficient to warrant further analysis. Guidance from the profession may also be useful in devising a strategy for how to assure economic analyses are a routine element of future prosthetic science.

Advanced RF and microwave functions based on an integrated optical frequency comb source.

PubMed

Xu, Xingyuan; Wu, Jiayang; Nguyen, Thach G; Shoeiby, Mehrdad; Chu, Sai T; Little, Brent E; Morandotti, Roberto; Mitchell, Arnan; Moss, David J

2018-02-05

We demonstrate advanced transversal radio frequency (RF) and microwave functions based on a Kerr optical comb source generated by an integrated micro-ring resonator. We achieve extremely high performance for an optical true time delay aimed at tunable phased array antenna applications, as well as reconfigurable microwave photonic filters. Our results agree well with theory. We show that our true time delay would yield a phased array antenna with features that include high angular resolution and a wide range of beam steering angles, while the microwave photonic filters feature high Q factors, wideband tunability, and highly reconfigurable filtering shapes. These results show that our approach is a competitive solution to implementing reconfigurable, high performance and potentially low cost RF and microwave signal processing functions for applications including radar and communication systems.

Functional abdominal pain in childhood: background studies and recent research trends.

PubMed

Levy, Rona L; van Tilburg, Miranda A L

2012-01-01

The present review summarizes many of the major research trends investigated in the past five years regarding pediatric functional abdominal pain, and also summarizes the primary related findings from the authors' research program. Specific areas discussed based on work within the authors' group include familial illness patterns, genetics, traits, and mechanisms or processes related to abdominal pain. Topics covered from research published in the past five years include prevalence and cost, longitudinal follow-up, overlap with other disorders, etiology and mechanisms behind functional abdominal pain and treatment studies. It is hoped that findings from this work in abdominal pain will be interpreted as a framework for understanding the processes by which other pain phenomena and, more broadly, reactions to any physical state, can be developed and maintained in children. The present article concludes with recommendations for clinical practice and research.

From functional structure to packaging: full-printing fabrication of a microfluidic chip.

PubMed

Zheng, Fengyi; Pu, Zhihua; He, Enqi; Huang, Jiasheng; Yu, Bocheng; Li, Dachao; Li, Zhihong

2018-05-24

This paper presents a concept of a full-printing methodology aiming at convenient and fast fabrication of microfluidic devices. For the first time, we achieved a microfluidic biochemical sensor with all functional structures fabricated by inkjet printing, including electrodes, immobilized enzymes, microfluidic components and packaging. With the cost-effective and rapid process, this method provides the possibility of quick model validation of a novel lab-on-chip system. In this study, a three-electrode electrochemical system was integrated successfully with glucose oxidase immobilization gel and sealed in an ice channel, forming a disposable microfluidic sensor for glucose detection. This fully-printed chip was characterized and showed good sensitivity and a linear section at a low-level concentration of glucose (0-10 mM). With the aid of automatic equipment, the fully-printed sensor can be massively produced with low cost.

Low-cost virtual reality intervention program for children with developmental coordination disorder: a pilot feasibility study.

PubMed

Ashkenazi, Tal; Weiss, Patrice L; Orian, Danielle; Laufer, Yocheved

2013-01-01

To explore the feasibility of using a low-cost, off-the-shelf virtual reality (VR) game to treat young children with developmental coordination disorder (DCD) and to determine the effect of this intervention on motor function. Nine children, aged 4 to 6 years, referred to physical therapy because of suspected DCD participated in 10 game-based intervention sessions. Outcome measures included Movement Assessment Battery for Children-2 (M-ABC-2), the DCD Questionnaire (DCD-Q), the 6-minute walk test, and 10-m walk test. Statistically significant changes were observed in the total standard score (P = .024) and the balance subscore (P = .012) of the M-ABC-2 and in the DCD-Q (P < .05). The children seemed to be motivated and to enjoy the interaction with the VR environment. VR games seemed to be beneficial in improving the children's motor function.

RETScreen Plus Software Tutorial

NASA Technical Reports Server (NTRS)

Ganoe, Rene D.; Stackhouse, Paul W., Jr.; DeYoung, Russell J.

2014-01-01

Greater emphasis is being placed on reducing both the carbon footprint and energy cost of buildings. A building's energy usage depends upon many factors one of the most important is the local weather and climate conditions to which it's electrical, heating and air conditioning systems must respond. Incorporating renewable energy systems, including solar systems, to supplement energy supplies and increase energy efficiency is important to saving costs and reducing emissions. Also retrofitting technologies to buildings requires knowledge of building performance in its current state, potential future climate state, projection of potential savings with capital investment, and then monitoring the performance once the improvements are made. RETScreen Plus is a performance analysis software module that supplies the needed functions of monitoring current building performance, targeting projected energy efficiency improvements and verifying improvements once completed. This tutorial defines the functions of RETScreen Plus as well as outlines the general procedure for monitoring and reporting building energy performance.

Modeling and Simulation of Bus Dispatching Policy for Timed Transfers on Signalized Networks

NASA Astrophysics Data System (ADS)

Cho, Hsun-Jung; Lin, Guey-Shii

2007-12-01

The major work of this study is to formulate the system cost functions and to integrate the bus dispatching policy with signal control. The integrated model mainly includes the flow dispersion model for links, signal control model for nodes, and dispatching control model for transfer terminals. All such models are inter-related for transfer operations in one-center transit network. The integrated model that combines dispatching policies with flexible signal control modes can be applied to assess the effectiveness of transfer operations. It is found that, if bus arrival information is reliable, an early dispatching decision made at the mean bus arrival times is preferable. The costs for coordinated operations with slack times are relatively low at the optimal common headway when applying adaptive route control. Based on such findings, a threshold function of bus headway for justifying an adaptive signal route control under various time values of auto drivers is developed.

Population dynamics and mutualism: Functional responses of benefits and costs

USGS Publications Warehouse

Holland, J. Nathaniel; DeAngelis, Donald L.; Bronstein, Judith L.

2002-01-01

We develop an approach for studying population dynamics resulting from mutualism by employing functional responses based on density‐dependent benefits and costs. These functional responses express how the population growth rate of a mutualist is modified by the density of its partner. We present several possible dependencies of gross benefits and costs, and hence net effects, to a mutualist as functions of the density of its partner. Net effects to mutualists are likely a monotonically saturating or unimodal function of the density of their partner. We show that fundamental differences in the growth, limitation, and dynamics of a population can occur when net effects to that population change linearly, unimodally, or in a saturating fashion. We use the mutualism between senita cactus and its pollinating seed‐eating moth as an example to show the influence of different benefit and cost functional responses on population dynamics and stability of mutualisms. We investigated two mechanisms that may alter this mutualism's functional responses: distribution of eggs among flowers and fruit abortion. Differences in how benefits and costs vary with density can alter the stability of this mutualism. In particular, fruit abortion may allow for a stable equilibrium where none could otherwise exist.

Using ant colony optimization on the quadratic assignment problem to achieve low energy cost in geo-distributed data centers

NASA Astrophysics Data System (ADS)

Osei, Richard

There are many problems associated with operating a data center. Some of these problems include data security, system performance, increasing infrastructure complexity, increasing storage utilization, keeping up with data growth, and increasing energy costs. Energy cost differs by location, and at most locations fluctuates over time. The rising cost of energy makes it harder for data centers to function properly and provide a good quality of service. With reduced energy cost, data centers will have longer lasting servers/equipment, higher availability of resources, better quality of service, a greener environment, and reduced service and software costs for consumers. Some of the ways that data centers have tried to using to reduce energy costs include dynamically switching on and off servers based on the number of users and some predefined conditions, the use of environmental monitoring sensors, and the use of dynamic voltage and frequency scaling (DVFS), which enables processors to run at different combinations of frequencies with voltages to reduce energy cost. This thesis presents another method by which energy cost at data centers could be reduced. This method involves the use of Ant Colony Optimization (ACO) on a Quadratic Assignment Problem (QAP) in assigning user request to servers in geo-distributed data centers. In this paper, an effort to reduce data center energy cost involves the use of front portals, which handle users' requests, were used as ants to find cost effective ways to assign users requests to a server in heterogeneous geo-distributed data centers. The simulation results indicate that the ACO for Optimal Server Activation and Task Placement algorithm reduces energy cost on a small and large number of users' requests in a geo-distributed data center and its performance increases as the input data grows. In a simulation with 3 geo-distributed data centers, and user's resource request ranging from 25,000 to 25,000,000, the ACO algorithm was able to reduce energy cost on an average of $.70 per second. The ACO for Optimal Server Activation and Task Placement algorithm has proven to work as an alternative or improvement in reducing energy cost in geo-distributed data centers.

Methods of data collection and analysis for the economic evaluation alongside a national, multi-centre trial in the UK: Conventional ventilation or ECMO for Severe Adult Respiratory Failure (CESAR)

PubMed Central

Thalanany, Mariamma M; Mugford, Miranda; Hibbert, Clare; Cooper, Nicola J; Truesdale, Ann; Robinson, Steven; Tiruvoipati, Ravindranath; Elbourne, Diana R; Peek, Giles J; Clemens, Felicity; Hardy, Polly; Wilson, Andrew

2008-01-01

Background Extracorporeal Membrane Oxygenation (ECMO) is a technology used in treatment of patients with severe but potentially reversible respiratory failure. A multi-centre randomised controlled trial (CESAR) was funded in the UK to compare care including ECMO with conventional intensive care management. The protocol and funding for the CESAR trial included plans for economic data collection and analysis. Given the high cost of treatment, ECMO is considered an expensive technology for many funding systems. However, conventional treatment for severe respiratory failure is also one of the more costly forms of care in any health system. Methods/Design The objectives of the economic evaluation are to compare the costs of a policy of referral for ECMO with those of conventional treatment; to assess cost-effectiveness and the cost-utility at 6 months follow-up; and to assess the cost-utility over a predicted lifetime. Resources used by patients in the trial are identified. Resource use data are collected from clinical report forms and through follow up interviews with patients. Unit costs of hospital intensive care resources are based on parallel research on cost functions in UK NHS intensive care units. Other unit costs are based on published NHS tariffs. Cost effectiveness analysis uses the outcome: survival without severe disability. Cost utility analysis is based on quality adjusted life years gained based on the Euroqol EQ-5D at 6 months. Sensitivity analysis is planned to vary assumptions about transport costs and method of costing intensive care. Uncertainty will also be expressed in analysis of individual patient data. Probabilities of cost effectiveness given different funding thresholds will be estimated. Discussion In our view it is important to record our methods in detail and present them before publication of the results of the trial so that a record of detail not normally found in the final trial reports can be made available in the public domain. Trial Registrations The CESAR trial registration number is ISRCTN47279827. PMID:18447931

Estimating costs of sea lice control strategy in Norway.

PubMed

Liu, Yajie; Bjelland, Hans Vanhauwaer

2014-12-01

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

New approach to the retrieval of AOD and its uncertainty from MISR observations over dark water

NASA Astrophysics Data System (ADS)

Witek, Marcin L.; Garay, Michael J.; Diner, David J.; Bull, Michael A.; Seidel, Felix C.

2018-01-01

A new method for retrieving aerosol optical depth (AOD) and its uncertainty from Multi-angle Imaging SpectroRadiometer (MISR) observations over dark water is outlined. MISR's aerosol retrieval algorithm calculates cost functions between observed and pre-simulated radiances for a range of AODs (from 0.0 to 3.0) and a prescribed set of aerosol mixtures. The previous version 22 (V22) operational algorithm considered only the AOD that minimized the cost function for each aerosol mixture and then used a combination of these values to compute the final, best estimate AOD and associated uncertainty. The new approach considers the entire range of cost functions associated with each aerosol mixture. The uncertainty of the reported AOD depends on a combination of (a) the absolute values of the cost functions for each aerosol mixture, (b) the widths of the cost function distributions as a function of AOD, and (c) the spread of the cost function distributions among the ensemble of mixtures. A key benefit of the new approach is that, unlike the V22 algorithm, it does not rely on empirical thresholds imposed on the cost function to determine the success or failure of a particular mixture. Furthermore, a new aerosol retrieval confidence index (ARCI) is established that can be used to screen high-AOD retrieval blunders caused by cloud contamination or other factors. Requiring ARCI ≥ 0.15 as a condition for retrieval success is supported through statistical analysis and outperforms the thresholds used in the V22 algorithm. The described changes to the MISR dark water algorithm will become operational in the new MISR aerosol product (V23), planned for release in 2017.

New Approach to the Retrieval of AOD and its Uncertainty from MISR Observations Over Dark Water

NASA Astrophysics Data System (ADS)

Witek, M. L.; Garay, M. J.; Diner, D. J.; Bull, M. A.; Seidel, F.

2017-12-01

A new method for retrieving aerosol optical depth (AOD) and its uncertainty from Multi-angle Imaging SpectroRadiometer (MISR) observations over dark water is outlined. MISR's aerosol retrieval algorithm calculates cost functions between observed and pre-simulated radiances for a range of AODs (from 0.0 to 3.0) and a prescribed set of aerosol mixtures. The previous Version 22 (V22) operational algorithm considered only the AOD that minimized the cost function for each aerosol mixture, then used a combination of these values to compute the final, "best estimate" AOD and associated uncertainty. The new approach considers the entire range of cost functions associated with each aerosol mixture. The uncertainty of the reported AOD depends on a combination of a) the absolute values of the cost functions for each aerosol mixture, b) the widths of the cost function distributions as a function of AOD, and c) the spread of the cost function distributions among the ensemble of mixtures. A key benefit of the new approach is that, unlike the V22 algorithm, it does not rely on arbitrary thresholds imposed on the cost function to determine the success or failure of a particular mixture. Furthermore, a new Aerosol Retrieval Confidence Index (ARCI) is established that can be used to screen high-AOD retrieval blunders caused by cloud contamination or other factors. Requiring ARCI≥0.15 as a condition for retrieval success is supported through statistical analysis and outperforms the thresholds used in the V22 algorithm. The described changes to the MISR dark water algorithm will become operational in the new MISR aerosol product (V23), planned for release in 2017.

Retinal Prosthesis System for Advanced Retinitis Pigmentosa: A Health Technology Assessment Update

PubMed Central

Lee, Christine; Tu, Hong Anh; Wells, David; Holubowich, Corinne

2017-01-01

Background Retinitis pigmentosa is a group of inherited disorders characterized by the degeneration of the photoreceptors in the retina, resulting in progressive vision loss. The Argus II system is designed to restore partial functional vision in patients with profound vision loss from advanced retinitis pigmentosa. At present, it is the only treatment option approved by Health Canada for this patient population. In June 2016, Health Quality Ontario published a health technology assessment of the Argus II retinal prosthesis system for patients with advanced retinitis pigmentosa. Based on that assessment, the Ontario Health Technology Advisory Committee recommended against publicly funding the Argus II system for this population. It also recommended that Health Quality Ontario re-evaluate the evidence in 1 year. The objective of this report was to examine new evidence published since the 2016 health technology assessment. Methods We completed a health technology assessment, which included an evaluation of clinical benefits and harms, value for money, and patient preferences related to the Argus II system. We performed a systematic literature search for studies published since the 2016 Argus II health technology assessment. We developed a Markov decision-analytic model to assess the cost-effectiveness of the Argus II system compared with standard care, and we calculated incremental cost-effectiveness ratios over a 20-year time horizon. We also conducted a five-year budget impact analysis. Finally, we interviewed people with retinitis pigmentosa about their lived experience with vision loss, and with the Argus II system. Results Four publications from one multicentre international study were included in the clinical review. Patients showed significant improvements in visual function and functional outcomes with the Argus II system, and these outcomes were sustained up to a 5-year follow-up (moderate quality of evidence). The safety profile was generally acceptable. In the base case economic analysis, the Argus II system was cost-effective compared with standard care if the willingness to pay was more than $97,429 per quality-adjusted life-year. We estimated that funding the Argus II system would cost the province $0.71 to $0.78 million per year over 5 years, assuming 4 implants per year. People with lived experience spoke about the challenges of retinitis pigmentosa, including the gradual but persistent progression of the disease; its impact on their quality of life and their families; and the accessibility challenges they faced. Those who used the Argus II system spoke about its positive impact on their quality of life. Conclusions Based on evidence of moderate quality, the Argus II retinal prosthesis system improved visual function, real-life functional outcomes, and quality of life in patients with advanced retinitis pigmentosa. The Argus II system is expensive, but the cost to publicly fund it would be low, because of the small number of eligible patients. The Argus II system can only enable perception of light/dark and shapes/objects, but these advancements represent important gains for people with retinitis pigmentosa in terms of mobility and quality of life. PMID:29201260

What is the best imaging strategy for acute stroke?

PubMed

Wardlaw, J M; Keir, S L; Seymour, J; Lewis, S; Sandercock, P A G; Dennis, M S; Cairns, J

2004-01-01

To determine the cost-effectiveness of computed tomographic (CT) scanning after acute stroke. To assess the contribution of brain imaging to the diagnosis and management of stroke, and to estimate the costs, benefits and risks of different imaging strategies in order to provide data to inform national and local policy on the use of brain imaging in stroke. A decision-analysis model was developed to represent the pathway of care in acute stroke using 'scan all patients within 48 hours' as the comparator against which to cost 12 alternative scan strategies. Hospitals in Scotland. Subjects were patients admitted to hospital with a first stroke and those managed as outpatients. The effect on functional outcome after ischaemic or haemorrhagic stroke, tumours or infections, of correctly administered antithrombotic or other treatment; of time to scan and stroke severity on diagnosis by CT or MRI; on management, including length of stay, functional outcome, and quality-adjusted life years (QALYs), of the diagnostic information provided by CT scanning; the cost-effectiveness (cost versus QALYs) of different strategies for use of CT after acute stroke. Death and functional outcome at long-term follow-up; accuracy of CT and MRI; cost of CT scanning by time of day and week; effect of CT diagnosis on change in health outcome, length of stay in hospital and QALYs; cost-effectiveness of various scanning strategies. CT is very sensitive and specific for haemorrhage within the first 8 days of stroke only. Suboptimal scanning used in epidemiology studies suggests that the frequency of primary intracerebral haemorrhage (PICH) has been underestimated. Aspirin increases the risk of PICH. There were no reliable data on functional outcome or on the effect of antithrombotic treatment given long term after PICH. In 60% of patients with recurrent stroke after PICH, the cause is another PICH and mortality is high among PICH patients. A specific MR sequence (gradient echo) is required to identify prior PICH reliably. CT scanners were distributed unevenly in Scotland, 65% provided CT scanning within 48 hours of stroke, and 100% within 7 days for hospital-admitted patients, but access out of hours was very variable, and for outpatients was poor. The average cost of a CT brain scan for stroke was pounds 30.23 to pounds 89.56 in normal working hours and pounds 55.05 to pounds 173.46 out of hours. Average length of stay was greatest for severe strokes and those who survived in a dependent state. For a cohort of 1000 patients aged 70-74 years, the policy 'scan all strokes within 48 hours', cost pounds 10,279,728 and achieved 1982.3 QALYS. The most cost-effective strategy was 'scan all immediately' (pounds 9,993,676 and 1982.4 QALYS). The least cost-effective was to 'scan patients on anticoagulants, in a life-threatening condition immediately and the rest within 14 days'. In general, strategies in which most patients were scanned immediately cost least and achieved the most QALYs, as the cost of providing CT (even out of hours) was less than the cost of inpatient care. Increasing independent survival by even a small proportion through early use of aspirin in the majority with ischaemic stroke, avoiding aspirin in those with haemorrhagic stroke, and appropriate early management of those who have not had a stroke, reduced costs and increased QALYs.

Exploring the Sensitivity of Education Costs to Racial Composition of Schools and Race-Neutral Alternative Measures: A Cost Function Application to Missouri

ERIC Educational Resources Information Center

Baker, Bruce D.

2011-01-01

This article applies the education cost function methodology in order to estimate additional costs associated with black student concentration and with alternative, race-neutral measures of urban poverty. Recent research highlights the continued importance of the role of race in educational outcomes, and how the intersection of peer group effects…

Earth Observatory Satellite system definition study. Report no. 3: Design/cost tradeoff studies. Appendix A: EOS program WBS dictionary. Appendix B: EOS mission functional analysis

NASA Technical Reports Server (NTRS)

1974-01-01

The work breakdown structure (WBS) dictionary for the Earth Observatory Satellite (EOS) is defined. The various elements of the EOS program are examined to include the aggregate of hardware, computer software, services, and data required to develop, produce, test, support, and operate the space vehicle and the companion ground data management system. A functional analysis of the EOS mission is developed. The operations for three typical EOS missions, Delta, Titan, and Shuttle launched are considered. The functions were determined for the top program elements, and the mission operations, function 2.0, was expanded to level one functions. Selection of ten level one functions for further analysis to level two and three functions were based on concern for the EOS operations and associated interfaces.

Cost Function Network-based Design of Protein-Protein Interactions: predicting changes in binding affinity.

PubMed

Viricel, Clément; de Givry, Simon; Schiex, Thomas; Barbe, Sophie

2018-02-20

Accurate and economic methods to predict change in protein binding free energy upon mutation are imperative to accelerate the design of proteins for a wide range of applications. Free energy is defined by enthalpic and entropic contributions. Following the recent progresses of Artificial Intelligence-based algorithms for guaranteed NP-hard energy optimization and partition function computation, it becomes possible to quickly compute minimum energy conformations and to reliably estimate the entropic contribution of side-chains in the change of free energy of large protein interfaces. Using guaranteed Cost Function Network algorithms, Rosetta energy functions and Dunbrack's rotamer library, we developed and assessed EasyE and JayZ, two methods for binding affinity estimation that ignore or include conformational entropic contributions on a large benchmark of binding affinity experimental measures. If both approaches outperform most established tools, we observe that side-chain conformational entropy brings little or no improvement on most systems but becomes crucial in some rare cases. as open-source Python/C ++ code at sourcesup.renater.fr/projects/easy-jayz. thomas.schiex@inra.fr and sophie.barbe@insa-toulouse.fr. Supplementary data are available at Bioinformatics online.

Engineering the bioelectrochemical interface using functional nanomaterials and microchip technique toward sensitive and portable electrochemical biosensors.

PubMed

Jia, Xiaofang; Dong, Shaojun; Wang, Erkang

2016-02-15

Electrochemical biosensors have played active roles at the forefront of bioanalysis because they have the potential to achieve sensitive, specific and low-cost detection of biomolecules and many others. Engineering the electrochemical sensing interface with functional nanomaterials leads to novel electrochemical biosensors with improved performances in terms of sensitivity, selectivity, stability and simplicity. Functional nanomaterials possess good conductivity, catalytic activity, biocompatibility and high surface area. Coupled with bio-recognition elements, these features can amplify signal transduction and biorecognition events, resulting in highly sensitive biosensing. Additionally, microfluidic electrochemical biosensors have attracted considerable attention on account of their miniature, portable and low-cost systems as well as high fabrication throughput and ease of scaleup. For example, electrochemical enzymetic biosensors and aptamer biosensors (aptasensors) based on the integrated microchip can be used for portable point-of-care diagnostics and environmental monitoring. This review is a summary of our recent progress in the field of electrochemical biosensors, including aptasensors, cytosensors, enzymatic biosensors and self-powered biosensors based on biofuel cells. We presented the advantages that functional nanomaterials and microfluidic chip technology bring to the electrochemical biosensors, together with future prospects and possible challenges. Copyright © 2015 Elsevier B.V. All rights reserved.

Empirical Assessment of Spatial Prediction Methods for Location Cost Adjustment Factors

PubMed Central

Migliaccio, Giovanni C.; Guindani, Michele; D'Incognito, Maria; Zhang, Linlin

2014-01-01

In the feasibility stage, the correct prediction of construction costs ensures that budget requirements are met from the start of a project's lifecycle. A very common approach for performing quick-order-of-magnitude estimates is based on using Location Cost Adjustment Factors (LCAFs) that compute historically based costs by project location. Nowadays, numerous LCAF datasets are commercially available in North America, but, obviously, they do not include all locations. Hence, LCAFs for un-sampled locations need to be inferred through spatial interpolation or prediction methods. Currently, practitioners tend to select the value for a location using only one variable, namely the nearest linear-distance between two sites. However, construction costs could be affected by socio-economic variables as suggested by macroeconomic theories. Using a commonly used set of LCAFs, the City Cost Indexes (CCI) by RSMeans, and the socio-economic variables included in the ESRI Community Sourcebook, this article provides several contributions to the body of knowledge. First, the accuracy of various spatial prediction methods in estimating LCAF values for un-sampled locations was evaluated and assessed in respect to spatial interpolation methods. Two Regression-based prediction models were selected, a Global Regression Analysis and a Geographically-weighted regression analysis (GWR). Once these models were compared against interpolation methods, the results showed that GWR is the most appropriate way to model CCI as a function of multiple covariates. The outcome of GWR, for each covariate, was studied for all the 48 states in the contiguous US. As a direct consequence of spatial non-stationarity, it was possible to discuss the influence of each single covariate differently from state to state. In addition, the article includes a first attempt to determine if the observed variability in cost index values could be, at least partially explained by independent socio-economic variables. PMID:25018582

Implementation of Arithmetic and Nonarithmetic Functions on a Label-free and DNA-based Platform

NASA Astrophysics Data System (ADS)

Wang, Kun; He, Mengqi; Wang, Jin; He, Ronghuan; Wang, Jianhua

2016-10-01

A series of complex logic gates were constructed based on graphene oxide and DNA-templated silver nanoclusters to perform both arithmetic and nonarithmetic functions. For the purpose of satisfying the requirements of progressive computational complexity and cost-effectiveness, a label-free and universal platform was developed by integration of various functions, including half adder, half subtractor, multiplexer and demultiplexer. The label-free system avoided laborious modification of biomolecules. The designed DNA-based logic gates can be implemented with readout of near-infrared fluorescence, and exhibit great potential applications in the field of bioimaging as well as disease diagnosis.

The economic burden of schizophrenia in Canada in 2004.

PubMed

Goeree, R; Farahati, F; Burke, N; Blackhouse, G; O'Reilly, D; Pyne, J; Tarride, J-E

2005-12-01

To estimate the financial burden of schizophrenia in Canada in 2004. A prevalence-based cost-of-illness (COI) approach was used. The primary sources of information for the study included a review of the published literature, a review of published reports and documents, secondary analysis of administrative datasets, and information collected directly from various federal and provincial government programs and services. The literature review included publications up to April 2005 reported in MedLine, EMBASE and PsychINFO. Where specific information from a province was not available, the method of mean substitution from other provinces was used. Costs incurred by various levels/departments of government were separated into healthcare and non-healthcare costs. Also included in the analysis was the value of lost productivity for premature mortality and morbidity associated with schizophrenia. Sensitivity analysis was used to test major cost assumptions used in the analysis. Where possible, all resource utilization estimates for the financial burden of schizophrenia were obtained for 2004 and are expressed in 2004 Canadian dollars (CAN dollars). The estimated number of persons with schizophrenia in Canada in 2004 was 234 305 (95% CI, 136 201-333 402). The direct healthcare and non-healthcare costs were estimated to be 2.02 billion CAN dollars in 2004. There were 374 deaths attributed to schizophrenia. This combined with the high unemployment rate due to schizophrenia resulted in an additional productivity morbidity and mortality loss estimate of 4.83 billion CAN dollars, for a total cost estimate in 2004 of 6.85 billion CAN dollars. By far the largest component of the total cost estimate was for productivity losses associated with morbidity in schizophrenia (70% of total costs) and the results showed that total cost estimates were most sensitive to alternative assumptions regarding the additional unemployment due to schizophrenia in Canada. Despite significant improvements in the past decade in pharmacotherapy, programs and services available for patients with schizophrenia, the economic burden of schizophrenia in Canada remains high. The most significant factor affecting the cost of schizophrenia in Canada is lost productivity due to morbidity. Programs targeted at improving patient symptoms and functioning to increase workforce participation has the potential to make a significant contribution in reducing the cost of this severe mental illness in Canada.