An adaptive supervisory sliding fuzzy cerebellar model articulation controller for sensorless vector-controlled induction motor drive systems.

PubMed

Wang, Shun-Yuan; Tseng, Chwan-Lu; Lin, Shou-Chuang; Chiu, Chun-Jung; Chou, Jen-Hsiang

2015-03-25

This paper presents the implementation of an adaptive supervisory sliding fuzzy cerebellar model articulation controller (FCMAC) in the speed sensorless vector control of an induction motor (IM) drive system. The proposed adaptive supervisory sliding FCMAC comprised a supervisory controller, integral sliding surface, and an adaptive FCMAC. The integral sliding surface was employed to eliminate steady-state errors and enhance the responsiveness of the system. The adaptive FCMAC incorporated an FCMAC with a compensating controller to perform a desired control action. The proposed controller was derived using the Lyapunov approach, which guarantees learning-error convergence. The implementation of three intelligent control schemes--the adaptive supervisory sliding FCMAC, adaptive sliding FCMAC, and adaptive sliding CMAC--were experimentally investigated under various conditions in a realistic sensorless vector-controlled IM drive system. The root mean square error (RMSE) was used as a performance index to evaluate the experimental results of each control scheme. The analysis results indicated that the proposed adaptive supervisory sliding FCMAC substantially improved the system performance compared with the other control schemes.

Rotor Position Sensorless Control and Its Parameter Sensitivity of Permanent Magnet Motor Based on Model Reference Adaptive System

NASA Astrophysics Data System (ADS)

Ohara, Masaki; Noguchi, Toshihiko

This paper describes a new method for a rotor position sensorless control of a surface permanent magnet synchronous motor based on a model reference adaptive system (MRAS). This method features the MRAS in a current control loop to estimate a rotor speed and position by using only current sensors. This method as well as almost all the conventional methods incorporates a mathematical model of the motor, which consists of parameters such as winding resistances, inductances, and an induced voltage constant. Hence, the important thing is to investigate how the deviation of these parameters affects the estimated rotor position. First, this paper proposes a structure of the sensorless control applied in the current control loop. Next, it proves the stability of the proposed method when motor parameters deviate from the nominal values, and derives the relationship between the estimated position and the deviation of the parameters in a steady state. Finally, some experimental results are presented to show performance and effectiveness of the proposed method.

Type-2 fuzzy logic control based MRAS speed estimator for speed sensorless direct torque and flux control of an induction motor drive.

PubMed

Ramesh, Tejavathu; Kumar Panda, Anup; Shiva Kumar, S

2015-07-01

In this research study, a model reference adaptive system (MRAS) speed estimator for speed sensorless direct torque and flux control (DTFC) of an induction motor drive (IMD) using two adaptation mechanism schemes are proposed to replace the conventional proportional integral controller (PIC). The first adaptation mechanism scheme is based on Type-1 fuzzy logic controller (T1FLC), which is used to achieve high performance sensorless drive in both transient as well as steady state conditions. However, the Type-1 fuzzy sets are certain and unable to work effectively when higher degree of uncertainties presents in the system which can be caused by sudden change in speed or different load disturbances, process noise etc. Therefore, a new Type-2 fuzzy logic controller (T2FLC) based adaptation mechanism scheme is proposed to better handle the higher degree of uncertainties and improves the performance and also robust to various load torque and sudden change in speed conditions, respectively. The detailed performances of various adaptation mechanism schemes are carried out in a MATLAB/Simulink environment with a speed sensor and speed sensorless modes of operation when an IMD is operating under different operating conditions, such as, no-load, load and sudden change in speed, respectively. To validate the different control approaches, the system also implemented on real-time system and adequate results are reported for its validation. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

A new technique to control brushless motor for blood pump application.

PubMed

Fonseca, Jeison; Andrade, Aron; Nicolosi, Denys E C; Biscegli, José F; Legendre, Daniel; Bock, Eduardo; Lucchi, Júlio César

2008-04-01

This article presents a back-electromotive force (BEMF)-based technique of detection for sensorless brushless direct current motor (BLDCM) drivers. The BLDCM has been chosen as the energy converter in rotary or pulsatile blood pumps that use electrical motors for pumping. However, in order to operate properly, the BLDCM driver needs to know the shaft position. Usually, that information is obtained through a set of Hall sensors assembled close to the rotor and connected to the electronic controller by wires. Sometimes, a large distance between the motor and controller makes the system susceptible to interference on the sensor signal because of winding current switching. Thus, the goal of the sensorless technique presented in this study is to avoid this problem. First, the operation of BLDCM was evaluated on the electronic simulator PSpice. Then, a BEMF detector circuitry was assembled in our laboratories. For the tests, a sensor-dependent system was assembled where the direct comparison between the Hall sensors signals and the detected signals was performed. The obtained results showed that the output sensorless detector signals are very similar to the Hall signals at speeds of more than 2500 rpm. Therefore, the sensorless technique is recommended as a responsible or redundant system to be used in rotary blood pumps.

Prosthetic design directives: Low-cost hands within reach.

PubMed

Jones, G K; Rosendo, A; Stopforth, R

2017-07-01

Although three million people around the world suffer from the lack of one or both upper limbs 80% of this number is located within developing countries. While prosthetic prices soar with technology 3D printing and low cost electronics present a sensible solution for those that cannot afford expensive prosthetics. The electronic and control design of a low-cost prosthetic hand, the Touch Hand II, is discussed. This paper shows that sensorless techniques can be used to reduce design complexities, costs, and provide easier access to the electronics. A closing and opening finite state machine (COFSM) was developed to handle the actuated digit joint control state and a supervisory switching control scheme, used for speed and grip strength control. Three torque and speed settings were created to be preset for specific grasps. The hand was able to replicate ten frequently used grasps and grip some common objects. Future work is necessary to enable a user to control it with myoelectric signals (MESs) and to solve operational problems related to electromagnetic interference (EMI).

Constant Switching Frequency DTC for Matrix Converter Fed Speed Sensorless Induction Motor Drive

NASA Astrophysics Data System (ADS)

Mir, Tabish Nazir; Singh, Bhim; Bhat, Abdul Hamid

2018-05-01

The paper presents a constant switching frequency scheme for speed sensorless Direct Torque Control (DTC) of Matrix Converter fed Induction Motor Drive. The use of matrix converter facilitates improved power quality on input as well as motor side, along with Input Power Factor control, besides eliminating the need for heavy passive elements. Moreover, DTC through Space Vector Modulation helps in achieving a fast control over the torque and flux of the motor, with added benefit of constant switching frequency. A constant switching frequency aids in maintaining desired power quality of AC mains current even at low motor speeds, and simplifies input filter design of the matrix converter, as compared to conventional hysteresis based DTC. Further, stator voltage estimation from sensed input voltage, and subsequent stator (and rotor) flux estimation is done. For speed sensorless operation, a Model Reference Adaptive System is used, which emulates the speed dependent rotor flux equations of the induction motor. The error between conventionally estimated rotor flux (reference model) and the rotor flux estimated through the adaptive observer is processed through PI controller to generate the rotor speed estimate.

A sensorless method for measuring the point mobility of mechanical structures

NASA Astrophysics Data System (ADS)

Boulandet, R.; Michau, M.; Herzog, P.; Micheau, P.; Berry, A.

2016-09-01

This paper presents a convenient and cost-effective experimental tool for measuring the mobility characteristics of a mechanical structure. The objective is to demonstrate that the point mobility measurement can be performed using only an electrodynamic inertial exciter. Unlike previous work based on voice coil actuators, no load cell or accelerometer is needed. Instead, it is theoretically shown that the mobility characteristics of the structure can be estimated from variations in the electrical input impedance of the actuator fixed onto it, provided that the electromechanical parameters of the actuator are known. The proof of concept is made experimentally using a cheap commercially available actuator on a simply supported plate, leading to a good dynamic range from 100 Hz to 1 kHz. The methodology to assess the basic parameters of the actuator is also given. Measured data are compared to a standard shaker testing and the strengths and weaknesses of the sensorless mobility measuring device are discussed. It is believed that this sensorless mobility measuring device can be a convenient experimental tool to determine the dynamic characteristics of a wide range of mechanical structures.

In vivo imaging of human photoreceptor mosaic with wavefront sensorless adaptive optics optical coherence tomography.

PubMed

Wong, Kevin S K; Jian, Yifan; Cua, Michelle; Bonora, Stefano; Zawadzki, Robert J; Sarunic, Marinko V

2015-02-01

Wavefront sensorless adaptive optics optical coherence tomography (WSAO-OCT) is a novel imaging technique for in vivo high-resolution depth-resolved imaging that mitigates some of the challenges encountered with the use of sensor-based adaptive optics designs. This technique replaces the Hartmann Shack wavefront sensor used to measure aberrations with a depth-resolved image-driven optimization algorithm, with the metric based on the OCT volumes acquired in real-time. The custom-built ultrahigh-speed GPU processing platform and fast modal optimization algorithm presented in this paper was essential in enabling real-time, in vivo imaging of human retinas with wavefront sensorless AO correction. WSAO-OCT is especially advantageous for developing a clinical high-resolution retinal imaging system as it enables the use of a compact, low-cost and robust lens-based adaptive optics design. In this report, we describe our WSAO-OCT system for imaging the human photoreceptor mosaic in vivo. We validated our system performance by imaging the retina at several eccentricities, and demonstrated the improvement in photoreceptor visibility with WSAO compensation.

New Technique of High-Performance Torque Control Developed for Induction Machines

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.

2003-01-01

Two forms of high-performance torque control for motor drives have been described in the literature: field orientation control and direct torque control. Field orientation control has been the method of choice for previous NASA electromechanical actuator research efforts with induction motors. Direct torque control has the potential to offer some advantages over field orientation, including ease of implementation and faster response. However, the most common form of direct torque control is not suitable for the highspeed, low-stator-flux linkage induction machines designed for electromechanical actuators with the presently available sample rates of digital control systems (higher sample rates are required). In addition, this form of direct torque control is not suitable for the addition of a high-frequency carrier signal necessary for the "self-sensing" (sensorless) position estimation technique. This technique enables low- and zero-speed position sensorless operation of the machine. Sensorless operation is desirable to reduce the number of necessary feedback signals and transducers, thus improving the reliability and reducing the mass and volume of the system. This research was directed at developing an alternative form of direct torque control known as a "deadbeat," or inverse model, solution. This form uses pulse-width modulation of the voltage applied to the machine, thus reducing the necessary sample and switching frequency for the high-speed NASA motor. In addition, the structure of the deadbeat form allows the addition of the high-frequency carrier signal so that low- and zero-speed sensorless operation is possible. The new deadbeat solution is based on using the stator and rotor flux as state variables. This choice of state variables leads to a simple graphical representation of the solution as the intersection of a constant torque line with a constant stator flux circle. Previous solutions have been expressed only in complex mathematical terms without a method to clearly visualize the solution. The graphical technique allows a more insightful understanding of the operation of the machine under various conditions.

The Technique of Changing the Drive Method of Micro Step Drive and Sensorless Drive for Hybrid Stepping Motor

NASA Astrophysics Data System (ADS)

Yoneda, Makoto; Dohmeki, Hideo

The position control system with the advantage large torque, low vibration, and high resolution can be obtained by the constant current micro step drive applied to hybrid stepping motor. However loss is large, in order not to be concerned with load torque but to control current uniformly. As the one technique of a position control system in which high efficiency is realizable, the same sensorless control as a permanent magnet motor is effective. But, it was the purpose that the control method proposed until now controls speed. Then, this paper proposed changing the drive method of micro step drive and sensorless drive. The change of the drive method was verified from the simulation and the experiment. On no load, it was checked not producing change of a large speed at the time of a change by making electrical angle and carrying out zero reset of the integrator. On load, it was checked that a large speed change arose. The proposed system could change drive method by setting up the initial value of an integrator using the estimated result, without producing speed change. With this technique, the low loss position control system, which employed the advantage of the hybrid stepping motor, has been built.

Sensorless Control of Permanent Magnet Machine for NASA Flywheel Technology Development

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Kascak, Peter E.

2002-01-01

This paper describes the position sensorless algorithms presently used in the motor control for the NASA "in-house" development work of the flywheel energy storage system. At zero and low speeds a signal injection technique, the self-sensing method, is used to determine rotor position. At higher speeds, an open loop estimate of the back EMF of the machine is made to determine the rotor position. At start up, the rotor is set to a known position by commanding dc into one of the phase windings. Experimental results up to 52,000 rpm are presented.

Sensorless Modeling of Varying Pulse Width Modulator Resolutions in Three-Phase Induction Motors

PubMed Central

Marko, Matthew David; Shevach, Glenn

2017-01-01

A sensorless algorithm was developed to predict rotor speeds in an electric three-phase induction motor. This sensorless model requires a measurement of the stator currents and voltages, and the rotor speed is predicted accurately without any mechanical measurement of the rotor speed. A model of an electric vehicle undergoing acceleration was built, and the sensorless prediction of the simulation rotor speed was determined to be robust even in the presence of fluctuating motor parameters and significant sensor errors. Studies were conducted for varying pulse width modulator resolutions, and the sensorless model was accurate for all resolutions of sinusoidal voltage functions. PMID:28076418

Sensorless Modeling of Varying Pulse Width Modulator Resolutions in Three-Phase Induction Motors.

PubMed

Marko, Matthew David; Shevach, Glenn

2017-01-01

A sensorless algorithm was developed to predict rotor speeds in an electric three-phase induction motor. This sensorless model requires a measurement of the stator currents and voltages, and the rotor speed is predicted accurately without any mechanical measurement of the rotor speed. A model of an electric vehicle undergoing acceleration was built, and the sensorless prediction of the simulation rotor speed was determined to be robust even in the presence of fluctuating motor parameters and significant sensor errors. Studies were conducted for varying pulse width modulator resolutions, and the sensorless model was accurate for all resolutions of sinusoidal voltage functions.

Stator and Rotor Flux Based Deadbeat Direct Torque Control of Induction Machines

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Lorenz, Robert D.

2001-01-01

A new, deadbeat type of direct torque control is proposed, analyzed, and experimentally verified in this paper. The control is based on stator and rotor flux as state variables. This choice of state variables allows a graphical representation which is transparent and insightful. The graphical solution shows the effects of realistic considerations such as voltage and current limits. A position and speed sensorless implementation of the control, based on the self-sensing signal injection technique, is also demonstrated experimentally for low speed operation. The paper first develops the new, deadbeat DTC methodology and graphical representation of the new algorithm. It then evaluates feasibility via simulation and experimentally demonstrates performance of the new method with a laboratory prototype including the sensorless methods.

Stator and Rotor Flux Based Deadbeat Direct Torque Control of Induction Machines

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Lorenz, Robert D.

2003-01-01

A new, deadbeat type of direct torque control is proposed, analyzed and experimentally verified in this paper. The control is based on stator and rotor flux as state variables. This choice of state variables allows a graphical representation which is transparent and insightful. The graphical solution shows the effects of realistic considerations such as voltage and current limits. A position and speed sensorless implementation of the control, based on the self-sensing signal injection technique, is also demonstrated experimentally for low speed operation. The paper first develops the new, deadbeat DTC methodology and graphical representation of the new algorithm. It then evaluates feasibility via simulation and experimentally demonstrates performance of the new method with a laboratory prototype including the sensorless methods.

Stator and Rotor Flux Based Deadbeat Direct Torque Control of Induction Machines. Revision 1

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Lorenz, Robert D.

2002-01-01

A new, deadbeat type of direct torque control is proposed, analyzed, and experimentally verified in this paper. The control is based on stator and rotor flux as state variables. This choice of state variables allows a graphical representation which is transparent and insightful. The graphical solution shows the effects of realistic considerations such as voltage and current limits. A position and speed sensorless implementation of the control, based on the self-sensing signal injection technique, is also demonstrated experimentally for low speed operation. The paper first develops the new, deadbeat DTC methodology and graphical representation of the new algorithm. It then evaluates feasibility via simulation and experimentally demonstrates performance of the new method with a laboratory prototype including the sensorless methods.

Sensorless sliding mode observer for a five-phase permanent magnet synchronous motor drive.

PubMed

Hosseyni, Anissa; Trabelsi, Ramzi; Mimouni, Med Faouzi; Iqbal, Atif; Alammari, Rashid

2015-09-01

This paper deals with the sensorless vector controlled five-phase permanent magnet synchronous motor (PMSM) drive based on a sliding mode observer (SMO). The observer is designed considering the back electromotive force (EMF) of five-phase permanent magnet synchronous motor. The SMO structure and design are illustrated. Stability of the proposed observer is demonstrated using Lyapunov stability criteria. The proposed strategy is asymptotically stable in the context of Lyapunov theory. Simulated results on a five-phase PMSM drive are displayed to validate the feasibility and the effectiveness of the proposed control strategy. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Sensorless position estimation and control of permanent-magnet synchronous motors using a saturation model

NASA Astrophysics Data System (ADS)

Kassem Jebai, Al; Malrait, François; Martin, Philippe; Rouchon, Pierre

2016-03-01

Sensorless control of permanent-magnet synchronous motors at low velocity remains a challenging task. A now well-established method consists of injecting a high-frequency signal and using the rotor saliency, both geometric and magnetic-saturation induced. This paper proposes a clear and original analysis based on second-order averaging of how to recover the position information from signal injection; this analysis blends well with a general model of magnetic saturation. It also proposes a simple parametric model of the saturated motor, based on an energy function which simply encompasses saturation and cross-saturation effects. Experimental results on a surface-mounted motor and an interior magnet motor illustrate the relevance of the approach.

A New Unified Analysis of Estimate Errors by Model-Matching Phase-Estimation Methods for Sensorless Drive of Permanent-Magnet Synchronous Motors and New Trajectory-Oriented Vector Control, Part II

NASA Astrophysics Data System (ADS)

Shinnaka, Shinji

This paper presents a new unified analysis of estimate errors by model-matching extended-back-EMF estimation methods for sensorless drive of permanent-magnet synchronous motors. Analytical solutions about estimate errors, whose validity is confirmed by numerical experiments, are rich in universality and applicability. As an example of universality and applicability, a new trajectory-oriented vector control method is proposed, which can realize directly quasi-optimal strategy minimizing total losses with no additional computational loads by simply orienting one of vector-control coordinates to the associated quasi-optimal trajectory. The coordinate orientation rule, which is analytically derived, is surprisingly simple. Consequently the trajectory-oriented vector control method can be applied to a number of conventional vector control systems using model-matching extended-back-EMF estimation methods.

Analysis of field-oriented controlled induction motor drives under sensor faults and an overview of sensorless schemes.

PubMed

Arun Dominic, D; Chelliah, Thanga Raj

2014-09-01

To obtain high dynamic performance on induction motor drives (IMD), variable voltage and variable frequency operation has to be performed by measuring speed of rotation and stator currents through sensors and fed back them to the controllers. When the sensors are undergone a fault, the stability of control system, may be designed for an industrial process, is disturbed. This paper studies the negative effects on a 12.5 hp induction motor drives when the field oriented control system is subjected to sensor faults. To illustrate the importance of this study mine hoist load diagram is considered as shaft load of the tested machine. The methods to recover the system from sensor faults are discussed. In addition, the various speed sensorless schemes are reviewed comprehensively. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Sensorless Sinusoidal Drives for Fan and Pump Motors by V/f Control

NASA Astrophysics Data System (ADS)

Kiuchi, Mitsuyuki; Ohnishi, Tokuo

This paper proposes sensorless sinusoidal driving methods of permanent magnet synchronous motors for fans and pumps by V/f control. The proposed methods are simple methods that control the motor peak current constant by voltage or frequency control, and are characterized by DC link current detection using a single shunt resistor at carrier wave signal bottom timing. As a result of the dumping factor from square torque load characteristics of fan and pump motors, it is possible to control stable starting and stable steady state by V/f control. In general, pressure losses as a result of the fluid pass of fan and pump systems are nearly constant; therefore, the flow rate and motor torque are determined by revolutions. Accordingly, high efficiency driving is possible by setting corresponding currents to q-axis currents (torque currents) at target revolutions. Because of the simple current detection and motor control methods, the proposed methods are optimum for fan and pump motor driving systems of home appliances.

Fuzzy crane control with sensorless payload deflection feedback for vibration reduction

NASA Astrophysics Data System (ADS)

Smoczek, Jaroslaw

2014-05-01

Different types of cranes are widely used for shifting cargoes in building sites, shipping yards, container terminals and many manufacturing segments where the problem of fast and precise transferring a payload suspended on the ropes with oscillations reduction is frequently important to enhance the productivity, efficiency and safety. The paper presents the fuzzy logic-based robust feedback anti-sway control system which can be applicable either with or without a sensor of sway angle of a payload. The discrete-time control approach is based on the fuzzy interpolation of the controllers and crane dynamic model's parameters with respect to the varying rope length and mass of a payload. The iterative procedure combining a pole placement method and interval analysis of closed-loop characteristic polynomial coefficients is proposed to design the robust control scheme. The sensorless anti-sway control application developed with using PAC system with RX3i controller was verified on the laboratory scaled overhead crane.

EFFICIENCY OPTIMIZATIN CONTROL OF AC INDUCTION MOTORS: INITIAL LABORATORY RESULTS

EPA Science Inventory

The report discusses the development of a fuzzy logic, energy-optimizing controller to improve the efficiency of motor/drive combinations that operate at varying loads and speeds. This energy optimizer is complemented by a sensorless speed controller that maintains motor shaft re...

Electric propulsion using the permanent magnet synchronous motor without rotor position transducers

NASA Astrophysics Data System (ADS)

Batzel, Todd Douglas

The permanent magnet synchronous motor (PMSM) is increasingly playing an important role in electric propulsion systems due to its many advantages over competing technologies. For successful operation of the PMSM, rotor position and speed information is required. A resolver or encoder attached to the shaft of the machine usually provides this information. Many applications, however, cannot tolerate the use of the position sensor because of space and weight limitations, reliability concerns, or packaging issues. Thus, there has been an intense interest in the development of a so-called position sensorless drive, where the PMSM stator itself is used as the rotor position sensor. In this work, a sensorless electric drive is developed for various undersea propulsion applications, where the rotor position sensor is often undesirable due to the harsh operating environment as well as space and weight limitations. In this work, an observer is developed which enables sensorless operation of the PMSM over a wide speed range. In addition, a method is presented for estimating the standstill rotor angle, an operating condition at which the rotor position observers are typically ill conditioned. In this work two design methodologies are applied to the sensorless electric drive application, including a model-based and a neural network-based approach. Implementation issues for the sensorless electric drive are discussed, and experimental results are presented in order to demonstrate the effectiveness of the proposed techniques to the sensorless PMSM.

Implementation of a MFAC based position sensorless drive for high speed BLDC motors with nonideal back EMF.

PubMed

Li, Haitao; Ning, Xin; Li, Wenzhuo

2017-03-01

In order to improve the reliability and reduce power consumption of the high speed BLDC motor system, this paper presents a model free adaptive control (MFAC) based position sensorless drive with only a dc-link current sensor. The initial commutation points are obtained by detecting the phase of EMF zero-crossing point and then delaying 30 electrical degrees. According to the commutation error caused by the low pass filter (LPF) and other factors, the relationship between commutation error angle and dc-link current is analyzed, a corresponding MFAC based control method is proposed, and the commutation error can be corrected by the controller in real time. Both the simulation and experimental results show that the proposed correction method can achieve ideal commutation effect within the entire operating speed range. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Fast Fourier and discrete wavelet transforms applied to sensorless vector control induction motor for rotor bar faults diagnosis.

PubMed

Talhaoui, Hicham; Menacer, Arezki; Kessal, Abdelhalim; Kechida, Ridha

2014-09-01

This paper presents new techniques to evaluate faults in case of broken rotor bars of induction motors. Procedures are applied with closed-loop control. Electrical and mechanical variables are treated using fast Fourier transform (FFT), and discrete wavelet transform (DWT) at start-up and steady state. The wavelet transform has proven to be an excellent mathematical tool for the detection of the faults particularly broken rotor bars type. As a performance, DWT can provide a local representation of the non-stationary current signals for the healthy machine and with fault. For sensorless control, a Luenberger observer is applied; the estimation rotor speed is analyzed; the effect of the faults in the speed pulsation is compensated; a quadratic current appears and used for fault detection. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Design and realization of adaptive optical principle system without wavefront sensing

NASA Astrophysics Data System (ADS)

Wang, Xiaobin; Niu, Chaojun; Guo, Yaxing; Han, Xiang'e.

2018-02-01

In this paper, we focus on the performance improvement of the free space optical communication system and carry out the research on wavefront-sensorless adaptive optics. We use a phase only liquid crystal spatial light modulator (SLM) as the wavefront corrector. The optical intensity distribution of the distorted wavefront is detected by a CCD. We develop a wavefront controller based on ARM and a software based on the Linux operating system. The wavefront controller can control the CCD camera and the wavefront corrector. There being two SLMs in the experimental system, one simulates atmospheric turbulence and the other is used to compensate the wavefront distortion. The experimental results show that the performance quality metric (the total gray value of 25 pixels) increases from 3037 to 4863 after 200 iterations. Besides, it is demonstrated that our wavefront-sensorless adaptive optics system based on SPGD algorithm has a good performance in compensating wavefront distortion.

A New Unified Analysis of Estimate Errors by Model-Matching Phase-Estimation Methods for Sensorless Drive of Permanent-Magnet Synchronous Motors and New Trajectory-Oriented Vector Control, Part I

NASA Astrophysics Data System (ADS)

Shinnaka, Shinji; Sano, Kousuke

This paper presents a new unified analysis of estimate errors by model-matching phase-estimation methods such as rotor-flux state-observers, back EMF state-observers, and back EMF disturbance-observers, for sensorless drive of permanent-magnet synchronous motors. Analytical solutions about estimate errors, whose validity is confirmed by numerical experiments, are rich in universality and applicability. As an example of universality and applicability, a new trajectory-oriented vector control method is proposed, which can realize directly quasi-optimal strategy minimizing total losses with no additional computational loads by simply orienting one of vector-control coordinates to the associated quasi-optimal trajectory. The coordinate orientation rule, which is analytically derived, is surprisingly simple. Consequently the trajectory-oriented vector control method can be applied to a number of conventional vector control systems using one of the model-matching phase-estimation methods.

Full-order Luenberger observer based on fuzzy-logic control for sensorless field-oriented control of a single-sided linear induction motor.

PubMed

Holakooie, Mohammad Hosein; Ojaghi, Mansour; Taheri, Asghar

2016-01-01

This paper investigates sensorless indirect field oriented control (IFOC) of SLIM with full-order Luenberger observer. The dynamic equations of SLIM are first elaborated to draw full-order Luenberger observer with some simplifying assumption. The observer gain matrix is derived from conventional procedure so that observer poles are proportional to SLIM poles to ensure the stability of system for wide range of linear speed. The operation of observer is significantly impressed by adaptive scheme. A fuzzy logic control (FLC) is proposed as adaptive scheme to estimate linear speed using speed tuning signal. The parameters of FLC are tuned using an off-line method through chaotic optimization algorithm (COA). The performance of the proposed observer is verified by both numerical simulation and real-time hardware-in-the-loop (HIL) implementation. Moreover, a detailed comparative study among proposed and other speed observers is obtained under different operation conditions. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Modified artificial fish school algorithm for free space optical communication with sensor-less adaptive optics system

NASA Astrophysics Data System (ADS)

Cao, Jingtai; Zhao, Xiaohui; Li, Zhaokun; Liu, Wei; Gu, Haijun

2017-11-01

The performance of free space optical (FSO) communication system is limited by atmospheric turbulent extremely. Adaptive optics (AO) is the significant method to overcome the atmosphere disturbance. Especially, for the strong scintillation effect, the sensor-less AO system plays a major role for compensation. In this paper, a modified artificial fish school (MAFS) algorithm is proposed to compensate the aberrations in the sensor-less AO system. Both the static and dynamic aberrations compensations are analyzed and the performance of FSO communication before and after aberrations compensations is compared. In addition, MAFS algorithm is compared with artificial fish school (AFS) algorithm, stochastic parallel gradient descent (SPGD) algorithm and simulated annealing (SA) algorithm. It is shown that the MAFS algorithm has a higher convergence speed than SPGD algorithm and SA algorithm, and reaches the better convergence value than AFS algorithm, SPGD algorithm and SA algorithm. The sensor-less AO system with MAFS algorithm effectively increases the coupling efficiency at the receiving terminal with fewer numbers of iterations. In conclusion, the MAFS algorithm has great significance for sensor-less AO system to compensate atmospheric turbulence in FSO communication system.

Wavefront sensorless adaptive optics versus sensor-based adaptive optics for in vivo fluorescence retinal imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Wahl, Daniel J.; Zhang, Pengfei; Jian, Yifan; Bonora, Stefano; Sarunic, Marinko V.; Zawadzki, Robert J.

2017-02-01

Adaptive optics (AO) is essential for achieving diffraction limited resolution in large numerical aperture (NA) in-vivo retinal imaging in small animals. Cellular-resolution in-vivo imaging of fluorescently labeled cells is highly desirable for studying pathophysiology in animal models of retina diseases in pre-clinical vision research. Currently, wavefront sensor-based (WFS-based) AO is widely used for retinal imaging and has demonstrated great success. However, the performance can be limited by several factors including common path errors, wavefront reconstruction errors and an ill-defined reference plane on the retina. Wavefront sensorless (WFS-less) AO has the advantage of avoiding these issues at the cost of algorithmic execution time. We have investigated WFS-less AO on a fluorescence scanning laser ophthalmoscopy (fSLO) system that was originally designed for WFS-based AO. The WFS-based AO uses a Shack-Hartmann WFS and a continuous surface deformable mirror in a closed-loop control system to measure and correct for aberrations induced by the mouse eye. The WFS-less AO performs an open-loop modal optimization with an image quality metric. After WFS-less AO aberration correction, the WFS was used as a control of the closed-loop WFS-less AO operation. We can easily switch between WFS-based and WFS-less control of the deformable mirror multiple times within an imaging session for the same mouse. This allows for a direct comparison between these two types of AO correction for fSLO. Our results demonstrate volumetric AO-fSLO imaging of mouse retinal cells labeled with GFP. Most significantly, we have analyzed and compared the aberration correction results for WFS-based and WFS-less AO imaging.

MRAS state estimator for speed sensorless ISFOC induction motor drives with Luenberger load torque estimation.

PubMed

Zorgani, Youssef Agrebi; Koubaa, Yassine; Boussak, Mohamed

2016-03-01

This paper presents a novel method for estimating the load torque of a sensorless indirect stator flux oriented controlled (ISFOC) induction motor drive based on the model reference adaptive system (MRAS) scheme. As a matter of fact, this method is meant to inter-connect a speed estimator with the load torque observer. For this purpose, a MRAS has been applied to estimate the rotor speed with tuned load torque in order to obtain a high performance ISFOC induction motor drive. The reference and adjustable models, developed in the stationary stator reference frame, are used in the MRAS scheme in an attempt to estimate the speed of the measured terminal voltages and currents. The load torque is estimated by means of a Luenberger observer defined throughout the mechanical equation. Every observer state matrix depends on the mechanical characteristics of the machine taking into account the vicious friction coefficient and inertia moment. Accordingly, some simulation results are presented to validate the proposed method and to highlight the influence of the variation of the inertia moment and the friction coefficient on the speed and the estimated load torque. The experimental results, concerning to the sensorless speed with a load torque estimation, are elaborated in order to validate the effectiveness of the proposed method. The complete sensorless ISFOC with load torque estimation is successfully implemented in real time using a digital signal processor board DSpace DS1104 for a laboratory 3 kW induction motor. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Control algorithms and applications of the wavefront sensorless adaptive optics

NASA Astrophysics Data System (ADS)

Ma, Liang; Wang, Bin; Zhou, Yuanshen; Yang, Huizhen

2017-10-01

Compared with the conventional adaptive optics (AO) system, the wavefront sensorless (WFSless) AO system need not to measure the wavefront and reconstruct it. It is simpler than the conventional AO in system architecture and can be applied to the complex conditions. Based on the analysis of principle and system model of the WFSless AO system, wavefront correction methods of the WFSless AO system were divided into two categories: model-free-based and model-based control algorithms. The WFSless AO system based on model-free-based control algorithms commonly considers the performance metric as a function of the control parameters and then uses certain control algorithm to improve the performance metric. The model-based control algorithms include modal control algorithms, nonlinear control algorithms and control algorithms based on geometrical optics. Based on the brief description of above typical control algorithms, hybrid methods combining the model-free-based control algorithm with the model-based control algorithm were generalized. Additionally, characteristics of various control algorithms were compared and analyzed. We also discussed the extensive applications of WFSless AO system in free space optical communication (FSO), retinal imaging in the human eye, confocal microscope, coherent beam combination (CBC) techniques and extended objects.

Fuel sensor-less control of a liquid feed fuel cell under dynamic loading conditions for portable power sources (II)

NASA Astrophysics Data System (ADS)

Chang, C. L.; Chen, C. Y.; Sung, C. C.; Liou, D. H.; Chang, C. Y.; Cha, H. C.

This work presents a new fuel sensor-less control scheme for liquid feed fuel cells that is able to control the supply to a fuel cell system for operation under dynamic loading conditions. The control scheme uses cell-operating characteristics, such as potential, current, and power, to regulate the fuel concentration of a liquid feed fuel cell without the need for a fuel concentration sensor. A current integral technique has been developed to calculate the quantity of fuel required at each monitoring cycle, which can be combined with the concentration regulating process to control the fuel supply for stable operation. As verified by systematic experiments, this scheme can effectively control the fuel supply of a liquid feed fuel cell with reduced response time, even under conditions where the membrane electrolyte assembly (MEA) deteriorates gradually. This advance will aid the commercialization of liquid feed fuel cells and make them more adaptable for use in portable and automotive power units such as laptops, e-bikes, and handicap cars.

Study on Stability of High Speed Traction Drive CVT for Aircraft Generator

NASA Astrophysics Data System (ADS)

Goi, Tatsuhiko; Tanaka, Hirohisa; Nakashima, Kenichi; Watanabe, Koji

A half-toroidal traction drive CVT has a feature of small spin at traction pitch in whole speed ratio range of 1:4, which suits to transmit high rotational speed with minimum temperature increase of traction surface. Research activity on traction drive CVT has commenced in 1996 for applying it to an aircraft 24,000rpm constant-speed generator instead of a hydro-static transmission. This paper shows fundamental design of 90kW traction drive integrated drive generator, ``T-IDG", and stability analysis on a sensor-less electro-hydraulic speed control servo-mechanism by bond graphs. The performance test of T-IDG mounted on a test bench and an actual jet engine proved that the control system using sensor-less servomechanism can keep the generator speed within MIL-STD-704E allowable limit against steep changes of speed and load.

Sensorless control of ship propulsion interior permanent magnet synchronous motor based on a new sliding mode observer.

PubMed

Ren, Jun-Jie; Liu, Yan-Cheng; Wang, Ning; Liu, Si-Yuan

2015-01-01

This paper proposes a sensorless speed control strategy for ship propulsion interior permanent magnet synchronous motor (IPMSM) based on a new sliding-mode observer (SMO). In the SMO the low-pass filter and the method of arc-tangent calculation of extended electromotive force (EMF) or phase-locked loop (PLL) technique are not used. The calculation of the rotor speed is deduced from the Lyapunov function stability analysis. In order to reduce system chattering, sigmoid functions with switching gains being adaptively updated by fuzzy logic systems are innovatively incorporated into the SMO. Finally, simulation results for a 4.088 MW ship propulsion IPMSM and experimental results from a 7.5 kW IPMSM drive are provided to verify the effectiveness of the proposed SMO method. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Wavefront sensorless adaptive optics temporal focusing-based multiphoton microscopy

PubMed Central

Chang, Chia-Yuan; Cheng, Li-Chung; Su, Hung-Wei; Hu, Yvonne Yuling; Cho, Keng-Chi; Yen, Wei-Chung; Xu, Chris; Dong, Chen Yuan; Chen, Shean-Jen

2014-01-01

Temporal profile distortions reduce excitation efficiency and image quality in temporal focusing-based multiphoton microscopy. In order to compensate the distortions, a wavefront sensorless adaptive optics system (AOS) was integrated into the microscope. The feedback control signal of the AOS was acquired from local image intensity maximization via a hill-climbing algorithm. The control signal was then utilized to drive a deformable mirror in such a way as to eliminate the distortions. With the AOS correction, not only is the axial excitation symmetrically refocused, but the axial resolution with full two-photon excited fluorescence (TPEF) intensity is also maintained. Hence, the contrast of the TPEF image of a R6G-doped PMMA thin film is enhanced along with a 3.7-fold increase in intensity. Furthermore, the TPEF image quality of 1μm fluorescent beads sealed in agarose gel at different depths is improved. PMID:24940539

Wavefront sensorless adaptive optics optical coherence tomography for in vivo retinal imaging in mice

PubMed Central

Jian, Yifan; Xu, Jing; Gradowski, Martin A.; Bonora, Stefano; Zawadzki, Robert J.; Sarunic, Marinko V.

2014-01-01

We present wavefront sensorless adaptive optics (WSAO) Fourier domain optical coherence tomography (FD-OCT) for in vivo small animal retinal imaging. WSAO is attractive especially for mouse retinal imaging because it simplifies optical design and eliminates the need for wavefront sensing, which is difficult in the small animal eye. GPU accelerated processing of the OCT data permitted real-time extraction of image quality metrics (intensity) for arbitrarily selected retinal layers to be optimized. Modal control of a commercially available segmented deformable mirror (IrisAO Inc.) provided rapid convergence using a sequential search algorithm. Image quality improvements with WSAO OCT are presented for both pigmented and albino mouse retinal data, acquired in vivo. PMID:24575347

Fault tolerant operation of switched reluctance machine

NASA Astrophysics Data System (ADS)

Wang, Wei

The energy crisis and environmental challenges have driven industry towards more energy efficient solutions. With nearly 60% of electricity consumed by various electric machines in industry sector, advancement in the efficiency of the electric drive system is of vital importance. Adjustable speed drive system (ASDS) provides excellent speed regulation and dynamic performance as well as dramatically improved system efficiency compared with conventional motors without electronics drives. Industry has witnessed tremendous grow in ASDS applications not only as a driving force but also as an electric auxiliary system for replacing bulky and low efficiency auxiliary hydraulic and mechanical systems. With the vast penetration of ASDS, its fault tolerant operation capability is more widely recognized as an important feature of drive performance especially for aerospace, automotive applications and other industrial drive applications demanding high reliability. The Switched Reluctance Machine (SRM), a low cost, highly reliable electric machine with fault tolerant operation capability, has drawn substantial attention in the past three decades. Nevertheless, SRM is not free of fault. Certain faults such as converter faults, sensor faults, winding shorts, eccentricity and position sensor faults are commonly shared among all ASDS. In this dissertation, a thorough understanding of various faults and their influence on transient and steady state performance of SRM is developed via simulation and experimental study, providing necessary knowledge for fault detection and post fault management. Lumped parameter models are established for fast real time simulation and drive control. Based on the behavior of the faults, a fault detection scheme is developed for the purpose of fast and reliable fault diagnosis. In order to improve the SRM power and torque capacity under faults, the maximum torque per ampere excitation are conceptualized and validated through theoretical analysis and experiments. With the proposed optimal waveform, torque production is greatly improved under the same Root Mean Square (RMS) current constraint. Additionally, position sensorless operation methods under phase faults are investigated to account for the combination of physical position sensor and phase winding faults. A comprehensive solution for position sensorless operation under single and multiple phases fault are proposed and validated through experiments. Continuous position sensorless operation with seamless transition between various numbers of phase fault is achieved.

Model-based wavefront sensorless adaptive optics system for large aberrations and extended objects.

PubMed

Yang, Huizhen; Soloviev, Oleg; Verhaegen, Michel

2015-09-21

A model-based wavefront sensorless (WFSless) adaptive optics (AO) system with a 61-element deformable mirror is simulated to correct the imaging of a turbulence-degraded extended object. A fast closed-loop control algorithm, which is based on the linear relation between the mean square of the aberration gradients and the second moment of the image intensity distribution, is used to generate the control signals for the actuators of the deformable mirror (DM). The restoration capability and the convergence rate of the AO system are investigated with different turbulence strength wave-front aberrations. Simulation results show the model-based WFSless AO system can restore those images degraded by different turbulence strengths successfully and obtain the correction very close to the achievable capability of the given DM. Compared with the ideal correction of 61-element DM, the averaged relative error of RMS value is 6%. The convergence rate of AO system is independent of the turbulence strength and only depends on the number of actuators of DM.

Analysis of sensorless control of brushless DC motor using unknown input observer with different gains

NASA Astrophysics Data System (ADS)

Astik, Mitesh B.; Bhatt, Praghnesh; Bhalja, Bhavesh R.

2017-03-01

A sensorless control scheme based on an unknown input observer is presented in this paper in which back EMF of the Brushless DC Motor (BLDC) is continuously estimated from available line voltages and currents. During negative rotation of motor, actual and estimated speed fail to track the reference speed and if the corrective action is not taken by the observer, the motor goes into saturation. To overcome this problem, the speed estimation algorithm has been implemented in this paper to control the dynamic behavior of the motor during negative rotation. The Ackermans method was used to calculate the gains of an unknown input observer which is based on the appropriate choice of the eigenvalues in advance. The criteria to choose eigenvalue is to obtain a balance between faster convergence rate and the least noise level. Simulations have been carried out for different disturbances such as step changes in motor reference speed and load torque. The comparative simulation results clearly depict that the disturbance effects in actual and estimated responses minimizes as observer gain setting increases.

Method and apparatus for sensorless operation of brushless permanent magnet motors

DOEpatents

Sriram, Tillasthanam V.

1998-01-01

A sensorless method and apparatus for providing commutation timing signals for a brushless permanent magnet motor extracts the third harmonic back-emf of a three-phase stator winding and independently cyclically integrates the positive and negative half-cycles thereof and compares the results to a reference level associated with a desired commutation angle.

Method and apparatus for sensorless operation of brushless permanent magnet motors

DOEpatents

Sriram, T.V.

1998-04-14

A sensorless method and apparatus for providing commutation timing signals for a brushless permanent magnet motor extracts the third harmonic back-emf of a three-phase stator winding and independently cyclically integrates the positive and negative half-cycles thereof and compares the results to a reference level associated with a desired commutation angle. 23 figs.

A high speed model-based approach for wavefront sensorless adaptive optics systems

NASA Astrophysics Data System (ADS)

Lianghua, Wen; Yang, Ping; Shuai, Wang; Wenjing, Liu; Shanqiu, Chen; Xu, Bing

2018-02-01

To improve temporal-frequency property of wavefront sensorless adaptive optics (AO) systems, a fast general model-based aberration correction algorithm is presented. The fast general model-based approach is based on the approximately linear relation between the mean square of the aberration gradients and the second moment of far-field intensity distribution. The presented model-based method is capable of completing a mode aberration effective correction just applying one disturbing onto the deformable mirror(one correction by one disturbing), which is reconstructed by the singular value decomposing the correlation matrix of the Zernike functions' gradients. Numerical simulations of AO corrections under the various random and dynamic aberrations are implemented. The simulation results indicate that the equivalent control bandwidth is 2-3 times than that of the previous method with one aberration correction after applying N times disturbing onto the deformable mirror (one correction by N disturbing).

Wavefront sensorless adaptive optics OCT with the DONE algorithm for in vivo human retinal imaging [Invited

PubMed Central

Verstraete, Hans R. G. W.; Heisler, Morgan; Ju, Myeong Jin; Wahl, Daniel; Bliek, Laurens; Kalkman, Jeroen; Bonora, Stefano; Jian, Yifan; Verhaegen, Michel; Sarunic, Marinko V.

2017-01-01

In this report, which is an international collaboration of OCT, adaptive optics, and control research, we demonstrate the Data-based Online Nonlinear Extremum-seeker (DONE) algorithm to guide the image based optimization for wavefront sensorless adaptive optics (WFSL-AO) OCT for in vivo human retinal imaging. The ocular aberrations were corrected using a multi-actuator adaptive lens after linearization of the hysteresis in the piezoelectric actuators. The DONE algorithm succeeded in drastically improving image quality and the OCT signal intensity, up to a factor seven, while achieving a computational time of 1 ms per iteration, making it applicable for many high speed applications. We demonstrate the correction of five aberrations using 70 iterations of the DONE algorithm performed over 2.8 s of continuous volumetric OCT acquisition. Data acquired from an imaging phantom and in vivo from human research volunteers are presented. PMID:28736670

Wavefront sensorless adaptive optics OCT with the DONE algorithm for in vivo human retinal imaging [Invited].

PubMed

Verstraete, Hans R G W; Heisler, Morgan; Ju, Myeong Jin; Wahl, Daniel; Bliek, Laurens; Kalkman, Jeroen; Bonora, Stefano; Jian, Yifan; Verhaegen, Michel; Sarunic, Marinko V

2017-04-01

In this report, which is an international collaboration of OCT, adaptive optics, and control research, we demonstrate the Data-based Online Nonlinear Extremum-seeker (DONE) algorithm to guide the image based optimization for wavefront sensorless adaptive optics (WFSL-AO) OCT for in vivo human retinal imaging. The ocular aberrations were corrected using a multi-actuator adaptive lens after linearization of the hysteresis in the piezoelectric actuators. The DONE algorithm succeeded in drastically improving image quality and the OCT signal intensity, up to a factor seven, while achieving a computational time of 1 ms per iteration, making it applicable for many high speed applications. We demonstrate the correction of five aberrations using 70 iterations of the DONE algorithm performed over 2.8 s of continuous volumetric OCT acquisition. Data acquired from an imaging phantom and in vivo from human research volunteers are presented.

BP artificial neural network based wave front correction for sensor-less free space optics communication

NASA Astrophysics Data System (ADS)

Li, Zhaokun; Zhao, Xiaohui

2017-02-01

The sensor-less adaptive optics (AO) is one of the most promising methods to compensate strong wave front disturbance in free space optics communication (FSO). The back propagation (BP) artificial neural network is applied for the sensor-less AO system to design a distortion correction scheme in this study. This method only needs one or a few online measurements to correct the wave front distortion compared with other model-based approaches, by which the real-time capacity of the system is enhanced and the Strehl Ratio (SR) is largely improved. Necessary comparisons in numerical simulation with other model-based and model-free correction methods proposed in Refs. [6,8,9,10] are given to show the validity and advantage of the proposed method.

Bearingless Flywheel Systems, Winding and Control Schemes, and Sensorless Control

NASA Technical Reports Server (NTRS)

Kascak, Peter E (Inventor); Jansen, Ralph H (Inventor); Trase, Larry M (Inventor); Dever, Timothy P (Inventor); Kraft, Thomas G (Inventor)

2016-01-01

Flywheel systems are disclosed that provide increased energy density and operational effectiveness. A first bearingless motor and a second bearingless motor may be configured to simultaneously suspend the central rotor in a radial direction and to rotate the central rotor. However, certain implementations may have one motor or more than two motors, depending on the design. A plurality of the flywheel systems may be collectively controlled to perform community energy storage with higher storage capacities than individual flywheel systems.

A Flywheel Energy Storage System Demonstration for Space Applications

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Kascak, Peter E.; Jansen, Ralph; Dever, Timothy

2003-01-01

A novel control algorithm for the charge and discharge modes of operation of a flywheel energy storage system for space applications is presented. The motor control portion of the algorithm uses sensorless field oriented control with position and speed estimates determined from a signal injection technique at low speeds and a back EMF technique at higher speeds. The charge and discharge portion of the algorithm use command feed-forward and disturbance decoupling, respectively, to achieve fast response with low gains. Simulation and experimental results are presented.

Real time optimization algorithm for wavefront sensorless adaptive optics OCT (Conference Presentation)

NASA Astrophysics Data System (ADS)

Verstraete, Hans R. G. W.; Heisler, Morgan; Ju, Myeong Jin; Wahl, Daniel J.; Bliek, Laurens; Kalkman, Jeroen; Bonora, Stefano; Sarunic, Marinko V.; Verhaegen, Michel; Jian, Yifan

2017-02-01

Optical Coherence Tomography (OCT) has revolutionized modern ophthalmology, providing depth resolved images of the retinal layers in a system that is suited to a clinical environment. A limitation of the performance and utilization of the OCT systems has been the lateral resolution. Through the combination of wavefront sensorless adaptive optics with dual variable optical elements, we present a compact lens based OCT system that is capable of imaging the photoreceptor mosaic. We utilized a commercially available variable focal length lens to correct for a wide range of defocus commonly found in patient eyes, and a multi-actuator adaptive lens after linearization of the hysteresis in the piezoelectric actuators for aberration correction to obtain near diffraction limited imaging at the retina. A parallel processing computational platform permitted real-time image acquisition and display. The Data-based Online Nonlinear Extremum seeker (DONE) algorithm was used for real time optimization of the wavefront sensorless adaptive optics OCT, and the performance was compared with a coordinate search algorithm. Cross sectional images of the retinal layers and en face images of the cone photoreceptor mosaic acquired in vivo from research volunteers before and after WSAO optimization are presented. Applying the DONE algorithm in vivo for wavefront sensorless AO-OCT demonstrates that the DONE algorithm succeeds in drastically improving the signal while achieving a computational time of 1 ms per iteration, making it applicable for high speed real time applications.

Fast correction approach for wavefront sensorless adaptive optics based on a linear phase diversity technique.

PubMed

Yue, Dan; Nie, Haitao; Li, Ye; Ying, Changsheng

2018-03-01

Wavefront sensorless (WFSless) adaptive optics (AO) systems have been widely studied in recent years. To reach optimum results, such systems require an efficient correction method. This paper presents a fast wavefront correction approach for a WFSless AO system mainly based on the linear phase diversity (PD) technique. The fast closed-loop control algorithm is set up based on the linear relationship between the drive voltage of the deformable mirror (DM) and the far-field images of the system, which is obtained through the linear PD algorithm combined with the influence function of the DM. A large number of phase screens under different turbulence strengths are simulated to test the performance of the proposed method. The numerical simulation results show that the method has fast convergence rate and strong correction ability, a few correction times can achieve good correction results, and can effectively improve the imaging quality of the system while needing fewer measurements of CCD data.

Adjustable Speed Drive Project for Teaching a Servo Systems Course Laboratory

ERIC Educational Resources Information Center

Rodriguez-Resendiz, J.; Herrera-Ruiz, G.; Rivas-Araiza, E. A.

2011-01-01

This paper describes an adjustable speed drive for a three-phase motor, which has been implemented as a design for a servo system laboratory course in an engineering curriculum. The platform is controlled and analyzed in a LabVIEW environment and run on a PC. Theory is introduced in order to show the sensorless algorithms. These are computed by…

Advanced simulation model for IPM motor drive with considering phase voltage and stator inductance

NASA Astrophysics Data System (ADS)

Lee, Dong-Myung; Park, Hyun-Jong; Lee, Ju

2016-10-01

This paper proposes an advanced simulation model of driving system for Interior Permanent Magnet (IPM) BrushLess Direct Current (BLDC) motors driven by 120-degree conduction method (two-phase conduction method, TPCM) that is widely used for sensorless control of BLDC motors. BLDC motors can be classified as SPM (Surface mounted Permanent Magnet) and IPM motors. Simulation model of driving system with SPM motors is simple due to the constant stator inductance regardless of the rotor position. Simulation models of SPM motor driving system have been proposed in many researches. On the other hand, simulation models for IPM driving system by graphic-based simulation tool such as Matlab/Simulink have not been proposed. Simulation study about driving system of IPMs with TPCM is complex because stator inductances of IPM vary with the rotor position, as permanent magnets are embedded in the rotor. To develop sensorless scheme or improve control performance, development of control algorithm through simulation study is essential, and the simulation model that accurately reflects the characteristic of IPM is required. Therefore, this paper presents the advanced simulation model of IPM driving system, which takes into account the unique characteristic of IPM due to the position-dependent inductances. The validity of the proposed simulation model is validated by comparison to experimental and simulation results using IPM with TPCM control scheme.

Proposition for sensorless self-excitation by a piezoelectric device

NASA Astrophysics Data System (ADS)

Tanaka, Y.; Kokubun, Y.; Yabuno, H.

2018-04-01

In this paper, we propose a method to realize self-excitation in an oscillator actuated by a piezoelectric device without a sensor. In general, the positive feedback associated with the oscillator velocity causes the self-excitation. Instead of measuring the velocity with a sensor, we utilize the electro-mechanical coupling effect in the oscillator and piezoelectric device. We drive the piezoelectric device with a current proportional to the linear combination of the voltage across the terminals of the piezoelectric device and its differential voltage signal. Then, the oscillator with the piezoelectric device behaves like a third-order system, which has three eigenvalues. The self-excitation can be realized because appropriate feedback gains can set two of the eigenvalues to be conjugate complex roots with a positive real part and the other eigenvalue to be a negative real root. To confirm the validity of the proposed method, we experimentally demonstrated the sensorless self-excitation and, as an application example, carried out mass sensing in a sensorless self-excited macrocantilever.

Automating the Transition Between Sensorless Motor Control Methods for the NASA Glenn Research Center Flywheel Energy Storage System

NASA Technical Reports Server (NTRS)

Fehrmann, Elizabeth A.; Kenny, Barbara H.

2004-01-01

The NASA Glenn Research Center (GRC) has been working to advance the technology necessary for a flywheel energy storage system for the past several years. Flywheels offer high efficiency, durability, and near-complete discharge capabilities not produced by typical chemical batteries. These characteristics show flywheels to be an attractive alternative to the more typical energy storage solutions. Flywheels also offer the possibility of combining what are now two separate systems in space applications into one: energy storage, which is currently provided by batteries, and attitude control, which is currently provided by control moment gyroscopes (CMGs) or reaction wheels. To date, NASA Glenn research effort has produced the control algorithms necessary to demonstrate flywheel operation up to a rated speed of 60,000 RPM and the combined operation of two flywheel machines to simultaneously provide energy storage and single axis attitude control. Two position-sensorless algorithms are used to control the motor/generator, one for low (0 to 1200 RPM) speeds and one for high speeds. The algorithm allows the transition from the low speed method to the high speed method, but the transition from the high to low speed method was not originally included. This leads to a limitation in the existing motor/generator control code that does not allow the flywheels to be commanded to zero speed (and back in the negative speed direction) after the initial startup. In a multi-flywheel system providing both energy storage and attitude control to a spacecraft, speed reversal may be necessary.

Motor Control and Regulation for a Flywheel Energy Storage System

NASA Technical Reports Server (NTRS)

Kenny, Barbara; Lyons, Valerie

2003-01-01

This talk will focus on the motor control algorithms used to regulate the flywheel system at the NASA Glenn Research Center. First a discussion of the inner loop torque control technique will be given. It is based on the principle of field orientation and is implemented without a position or speed sensor (sensorless control). Then the outer loop charge and discharge algorithm will be presented. This algorithm controls the acceleration of the flywheel during charging and the deceleration while discharging. The algorithm also allows the flywheel system to regulate the DC bus voltage during the discharge cycle.

Design of BLDCM emulator for transmission control units

NASA Astrophysics Data System (ADS)

Liu, Chang; He, Yongyi; Zhang, Bodong

2018-04-01

According to the testing requirements of the transmission control unit, a brushless DC motor emulating system is designed based on motor simulation and power hardware-in-the-loop. The discrete motor model is established and a real-time numerical method is designed to solve the motor states. The motor emulator directly interacts with power stage of the transmission control unit using a power-efficient circuit topology and is compatible with sensor-less control. Experiments on a laboratory prototype help to verify that the system can emulate the real motor currents and voltages whenever the motor is starting up or suddenly loaded.

Control of a High Speed Flywheel System for Energy Storage in Space Applications

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Kascak, Peter E.; Jansen, Ralph; Dever, Timothy; Santiago, Walter

2004-01-01

A novel control algorithm for the charge and discharge modes of operation of a flywheel energy storage system for space applications is presented. The motor control portion of the algorithm uses sensorless field oriented control with position and speed estimates determined from a signal injection technique at low speeds and a back EMF technique at higher speeds. The charge and discharge portion of the algorithm use command feed-forward and disturbance decoupling, respectively, to achieve fast response with low gains. Simulation and experimental results are presented demonstrating the successful operation of the flywheel control up to the rated speed of 60,000 rpm.

Optimal model-based sensorless adaptive optics for epifluorescence microscopy.

PubMed

Pozzi, Paolo; Soloviev, Oleg; Wilding, Dean; Vdovin, Gleb; Verhaegen, Michel

2018-01-01

We report on a universal sample-independent sensorless adaptive optics method, based on modal optimization of the second moment of the fluorescence emission from a point-like excitation. Our method employs a sample-independent precalibration, performed only once for the particular system, to establish the direct relation between the image quality and the aberration. The method is potentially applicable to any form of microscopy with epifluorescence detection, including the practically important case of incoherent fluorescence emission from a three dimensional object, through minor hardware modifications. We have applied the technique successfully to a widefield epifluorescence microscope and to a multiaperture confocal microscope.

Alert management for home healthcare based on home automation analysis.

PubMed

Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

2010-01-01

Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.

Incremental Adaptive Fuzzy Control for Sensorless Stroke Control of A Halbach-type Linear Oscillatory Motor

NASA Astrophysics Data System (ADS)

Lei, Meizhen; Wang, Liqiang

2018-01-01

The halbach-type linear oscillatory motor (HT-LOM) is multi-variable, highly coupled, nonlinear and uncertain, and difficult to get a satisfied result by conventional PID control. An incremental adaptive fuzzy controller (IAFC) for stroke tracking was presented, which combined the merits of PID control, the fuzzy inference mechanism and the adaptive algorithm. The integral-operation is added to the conventional fuzzy control algorithm. The fuzzy scale factor can be online tuned according to the load force and stroke command. The simulation results indicate that the proposed control scheme can achieve satisfied stroke tracking performance and is robust with respect to parameter variations and external disturbance.

An Approach to Sensorless Detection of Human Input Torque and Its Application to Power Assist Motion in Electric Wheelchair

NASA Astrophysics Data System (ADS)

Kaida, Yukiko; Murakami, Toshiyuki

A wheelchair is an important apparatus of mobility for people with disability. Power-assist motion in an electric wheelchair is to expand the operator's field of activities. This paper describes force sensorless detection of human input torque. Reaction torque estimation observer calculates the total disturbance torque first. Then, the human input torque is extracted from the estimated disturbance. In power-assist motion, assist torque is synthesized according to the product of assist gain and the average torque of the right and left input torque. Finally, the proposed method is verified through the experiments of power-assist motion.

Use of digital micromirror devices as dynamic pinhole arrays for adaptive confocal fluorescence microscopy

NASA Astrophysics Data System (ADS)

Pozzi, Paolo; Wilding, Dean; Soloviev, Oleg; Vdovin, Gleb; Verhaegen, Michel

2018-02-01

In this work, we present a new confocal laser scanning microscope capable to perform sensorless wavefront optimization in real time. The device is a parallelized laser scanning microscope in which the excitation light is structured in a lattice of spots by a spatial light modulator, while a deformable mirror provides aberration correction and scanning. A binary DMD is positioned in an image plane of the detection optical path, acting as a dynamic array of reflective confocal pinholes, images by a high performance cmos camera. A second camera detects images of the light rejected by the pinholes for sensorless aberration correction.

Simulink-aided Design and Implementation of Sensorless BLDC Motor Digital Control System

NASA Astrophysics Data System (ADS)

Zhilenkov, A. A.; Tsvetkov, Y. N.; Chistov, V. B.; Nyrkov, A. P.; Sokolov, S. S.

2017-07-01

The paper describes the process of creating of brushless direct current motor’s digital control system. The target motor has no speed sensor, so back-EMF method is used for commutation control. Authors show how to model the control system in MatLab/Simulink and to test it onboard STM32F4 microcontroller.This technology allows to create the most flexible system, which will control possible with a personal computer by communication lines. It is possible to examine the signals in the circuit of the actuator without any external measuring instruments - testers, oscilloscopes, etc. - and output waveforms and measured values of signals directly on the host PC.

In Vivo Evaluation of Active and Passive Physiological Control Systems for Rotary Left and Right Ventricular Assist Devices.

PubMed

Gregory, Shaun D; Stevens, Michael C; Pauls, Jo P; Schummy, Emma; Diab, Sara; Thomson, Bruce; Anderson, Ben; Tansley, Geoff; Salamonsen, Robert; Fraser, John F; Timms, Daniel

2016-09-01

Preventing ventricular suction and venous congestion through balancing flow rates and circulatory volumes with dual rotary ventricular assist devices (VADs) configured for biventricular support is clinically challenging due to their low preload and high afterload sensitivities relative to the natural heart. This study presents the in vivo evaluation of several physiological control systems, which aim to prevent ventricular suction and venous congestion. The control systems included a sensor-based, master/slave (MS) controller that altered left and right VAD speed based on pressure and flow; a sensor-less compliant inflow cannula (IC), which altered inlet resistance and, therefore, pump flow based on preload; a sensor-less compliant outflow cannula (OC) on the right VAD, which altered outlet resistance and thus pump flow based on afterload; and a combined controller, which incorporated the MS controller, compliant IC, and compliant OC. Each control system was evaluated in vivo under step increases in systemic (SVR ∼1400-2400 dyne/s/cm(5) ) and pulmonary (PVR ∼200-1000 dyne/s/cm(5) ) vascular resistances in four sheep supported by dual rotary VADs in a biventricular assist configuration. Constant speed support was also evaluated for comparison and resulted in suction events during all resistance increases and pulmonary congestion during SVR increases. The MS controller reduced suction events and prevented congestion through an initial sharp reduction in pump flow followed by a gradual return to baseline (5.0 L/min). The compliant IC prevented suction events; however, reduced pump flows and pulmonary congestion were noted during the SVR increase. The compliant OC maintained pump flow close to baseline (5.0 L/min) and prevented suction and congestion during PVR increases. The combined controller responded similarly to the MS controller to prevent suction and congestion events in all cases while providing a backup system in the event of single controller failure. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Model-based sensor-less wavefront aberration correction in optical coherence tomography.

PubMed

Verstraete, Hans R G W; Wahls, Sander; Kalkman, Jeroen; Verhaegen, Michel

2015-12-15

Several sensor-less wavefront aberration correction methods that correct nonlinear wavefront aberrations by maximizing the optical coherence tomography (OCT) signal are tested on an OCT setup. A conventional coordinate search method is compared to two model-based optimization methods. The first model-based method takes advantage of the well-known optimization algorithm (NEWUOA) and utilizes a quadratic model. The second model-based method (DONE) is new and utilizes a random multidimensional Fourier-basis expansion. The model-based algorithms achieve lower wavefront errors with up to ten times fewer measurements. Furthermore, the newly proposed DONE method outperforms the NEWUOA method significantly. The DONE algorithm is tested on OCT images and shows a significantly improved image quality.

Contrast-based sensorless adaptive optics for retinal imaging.

PubMed

Zhou, Xiaolin; Bedggood, Phillip; Bui, Bang; Nguyen, Christine T O; He, Zheng; Metha, Andrew

2015-09-01

Conventional adaptive optics ophthalmoscopes use wavefront sensing methods to characterize ocular aberrations for real-time correction. However, there are important situations in which the wavefront sensing step is susceptible to difficulties that affect the accuracy of the correction. To circumvent these, wavefront sensorless adaptive optics (or non-wavefront sensing AO; NS-AO) imaging has recently been developed and has been applied to point-scanning based retinal imaging modalities. In this study we show, for the first time, contrast-based NS-AO ophthalmoscopy for full-frame in vivo imaging of human and animal eyes. We suggest a robust image quality metric that could be used for any imaging modality, and test its performance against other metrics using (physical) model eyes.

Sensorless speed detection of squirrel-cage induction machines using stator neutral point voltage harmonics

NASA Astrophysics Data System (ADS)

Petrovic, Goran; Kilic, Tomislav; Terzic, Bozo

2009-04-01

In this paper a sensorless speed detection method of induction squirrel-cage machines is presented. This method is based on frequency determination of the stator neutral point voltage primary slot harmonic, which is dependent on rotor speed. In order to prove method in steady state and dynamic conditions the simulation and experimental study was carried out. For theoretical investigation the mathematical model of squirrel cage induction machines, which takes into consideration actual geometry and windings layout, is used. Speed-related harmonics that arise from rotor slotting are analyzed using digital signal processing and DFT algorithm with Hanning window. The performance of the method is demonstrated over a wide range of load conditions.

Contrast-based sensorless adaptive optics for retinal imaging

PubMed Central

Zhou, Xiaolin; Bedggood, Phillip; Bui, Bang; Nguyen, Christine T.O.; He, Zheng; Metha, Andrew

2015-01-01

Conventional adaptive optics ophthalmoscopes use wavefront sensing methods to characterize ocular aberrations for real-time correction. However, there are important situations in which the wavefront sensing step is susceptible to difficulties that affect the accuracy of the correction. To circumvent these, wavefront sensorless adaptive optics (or non-wavefront sensing AO; NS-AO) imaging has recently been developed and has been applied to point-scanning based retinal imaging modalities. In this study we show, for the first time, contrast-based NS-AO ophthalmoscopy for full-frame in vivo imaging of human and animal eyes. We suggest a robust image quality metric that could be used for any imaging modality, and test its performance against other metrics using (physical) model eyes. PMID:26417525

Sensorless position estimator applied to nonlinear IPMC model

NASA Astrophysics Data System (ADS)

Bernat, Jakub; Kolota, Jakub

2016-11-01

This paper addresses the issue of estimating position for an ionic polymer metal composite (IPMC) known as electro active polymer (EAP). The key step is the construction of a sensorless mode considering only current feedback. This work takes into account nonlinearities caused by electrochemical effects in the material. Owing to the recent observer design technique, the authors obtained both Lyapunov function based estimation law as well as sliding mode observer. To accomplish the observer design, the IPMC model was identified through a series of experiments. The research comprises time domain measurements. The identification process was completed by means of geometric scaling of three test samples. In the proposed design, the estimated position accurately tracks the polymer position, which is illustrated by the experiments.

A Drive Method of Permanent Magnet Synchronous Motor Using Torque Angle Estimation without Position Sensor

NASA Astrophysics Data System (ADS)

Tanaka, Takuro; Takahashi, Hisashi

In some motor applications, it is very difficult to attach a position sensor to the motor in housing. One of the examples of such applications is the dental handpiece-motor. In those designs, it is necessary to drive highly efficiency at low speed and variable load condition without a position sensor. We developed a method to control a motor high-efficient and smoothly at low speed without a position sensor. In this paper, the method in which permanent magnet synchronous motor is controlled smoothly and high-efficient by using torque angle control in synchronized operation is shown. The usefulness is confirmed by experimental results. In conclusion, the proposed sensor-less control method has been achieved to be very efficiently and smoothly.

Sensor-less force-reflecting macro-micro telemanipulation systems by piezoelectric actuators.

PubMed

Amini, H; Farzaneh, B; Azimifar, F; Sarhan, A A D

2016-09-01

This paper establishes a novel control strategy for a nonlinear bilateral macro-micro teleoperation system with time delay. Besides position and velocity signals, force signals are additionally utilized in the control scheme. This modification significantly improves the poor transparency during contact with the environment. To eliminate external force measurement, a force estimation algorithm is proposed for the master and slave robots. The closed loop stability of the nonlinear micro-micro teleoperation system with the proposed control scheme is investigated employing the Lyapunov theory. Consequently, the experimental results verify the efficiency of the new control scheme in free motion and during collision between the slave robot and the environment of slave robot with environment, and the efficiency of the force estimation algorithm. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Sensorless adaptive optics for isoSTED nanoscopy

NASA Astrophysics Data System (ADS)

Antonello, Jacopo; Hao, Xiang; Allgeyer, Edward S.; Bewersdorf, Joerg; Rittscher, Jens; Booth, Martin J.

2018-02-01

The presence of aberrations is a major concern when using fluorescence microscopy to image deep inside tissue. Aberrations due to refractive index mismatch and heterogeneity of the specimen under investigation cause severe reduction in the amount of fluorescence emission that is collected by the microscope. Furthermore, aberrations adversely affect the resolution, leading to loss of fine detail in the acquired images. These phenomena are particularly troublesome for super-resolution microscopy techniques such as isotropic stimulated-emission-depletion microscopy (isoSTED), which relies on accurate control of the shape and co-alignment of multiple excitation and depletion foci to operate as expected and to achieve the super-resolution effect. Aberrations can be suppressed by implementing sensorless adaptive optics techniques, whereby aberration correction is achieved by maximising a certain image quality metric. In confocal microscopy for example, one can employ the total image brightness as an image quality metric. Aberration correction is subsequently achieved by iteratively changing the settings of a wavefront corrector device until the metric is maximised. This simplistic approach has limited applicability to isoSTED microscopy where, due to the complex interplay between the excitation and depletion foci, maximising the total image brightness can lead to introducing aberrations in the depletion foci. In this work we first consider the effects that different aberration modes have on isoSTED microscopes. We then propose an iterative, wavelet-based aberration correction algorithm and evaluate its benefits.

Motor Control of Two Flywheels Enabling Combined Attitude Control and Bus Regulation

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.

2004-01-01

This presentation discussed the flywheel technology development work that is ongoing at NASA GRC with a particular emphasis on the flywheel system control. The "field orientation" motor/generator control algorithm was discussed and explained. The position-sensorless angle and speed estimation algorithm was presented. The motor current response to a step change in command at low (10 kRPM) and high (60 kRPM) was discussed. The flywheel DC bus regulation control was explained and experimental results presented. Finally, the combined attitude control and energy storage algorithm that controls two flywheels simultaneously was presented. Experimental results were shown that verified the operational capability of the algorithm. shows high speed flywheel energy storage (60,000 RPM) and the successful implementation of an algorithm to simultaneously control both energy storage and a single axis of attitude with two flywheels. Overall, the presentation demonstrated that GRC has an operational facility that

DSP-based adaptive backstepping using the tracking errors for high-performance sensorless speed control of induction motor drive.

PubMed

Zaafouri, Abderrahmen; Regaya, Chiheb Ben; Azza, Hechmi Ben; Châari, Abdelkader

2016-01-01

This paper presents a modified structure of the backstepping nonlinear control of the induction motor (IM) fitted with an adaptive backstepping speed observer. The control design is based on the backstepping technique complemented by the introduction of integral tracking errors action to improve its robustness. Unlike other research performed on backstepping control with integral action, the control law developed in this paper does not propose the increase of the number of system state so as not increase the complexity of differential equations resolution. The digital simulation and experimental results show the effectiveness of the proposed control compared to the conventional PI control. The results analysis shows the characteristic robustness of the adaptive control to disturbances of the load, the speed variation and low speed. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

A Novelty Design Of Minimization Of Electrical Losses In A Vector Controlled Induction Machine Drive

NASA Astrophysics Data System (ADS)

Aryza, Solly; Irwanto, M.; Lubis, Zulkarnain; Putera Utama Siahaan, Andysah; Rahim, Robbi; Furqan, Mhd.

2018-01-01

The induction motor has in the industry . More attention has been a focus to develop and design of induction motor drive. With the method of vector control novelty prove the efficiency of induction motor over their entire speed range. In this paper desirable to design a loss minimization controller which can improve the efficiency. Also, this research described Modeling of an induction motor with core loss included. Realization of methods vector control for an induction motor drive with loss element included. The case of the loss minimization condition. The procedure was successful to calculate the gains of a PI controller. Though the problem of obtaining a robust and sensorless induction motor drive is by no means completely solved, the results obtained as part of this work point in a promising direction.

Power Maximization Control of Variable Speed Wind Generation System Using Permanent Magnet Synchronous Generator

NASA Astrophysics Data System (ADS)

Morimoto, Shigeo; Nakamura, Tomohiko; Takeda, Yoji

This paper proposes the sensorless output power maximization control of the wind generation system. A permanent magnet synchronous generator (PMSG) is used as a variable speed generator in the proposed system. The generator torque is suitably controlled according to the generator speed and thus the power from a wind turbine settles down on the maximum power point by the proposed MPPT control method, where the information of wind velocity is not required. Moreover, the maximum available generated power is obtained by the optimum current vector control. The current vector of PMSG is optimally controlled according to the generator speed and the required torque in order to minimize the losses of PMSG considering the voltage and current constraints. The proposed wind power generation system can be achieved without mechanical sensors such as a wind velocity detector and a position sensor. Several experimental results show the effectiveness of the proposed control method.

Coherence-Gated Sensorless Adaptive Optics Multiphoton Retinal Imaging

PubMed Central

Cua, Michelle; Wahl, Daniel J.; Zhao, Yuan; Lee, Sujin; Bonora, Stefano; Zawadzki, Robert J.; Jian, Yifan; Sarunic, Marinko V.

2016-01-01

Multiphoton microscopy enables imaging deep into scattering tissues. The efficient generation of non-linear optical effects is related to both the pulse duration (typically on the order of femtoseconds) and the size of the focused spot. Aberrations introduced by refractive index inhomogeneity in the sample distort the wavefront and enlarge the focal spot, which reduces the multiphoton signal. Traditional approaches to adaptive optics wavefront correction are not effective in thick or multi-layered scattering media. In this report, we present sensorless adaptive optics (SAO) using low-coherence interferometric detection of the excitation light for depth-resolved aberration correction of two-photon excited fluorescence (TPEF) in biological tissue. We demonstrate coherence-gated SAO TPEF using a transmissive multi-actuator adaptive lens for in vivo imaging in a mouse retina. This configuration has significant potential for reducing the laser power required for adaptive optics multiphoton imaging, and for facilitating integration with existing systems. PMID:27599635

Coherence-Gated Sensorless Adaptive Optics Multiphoton Retinal Imaging.

PubMed

Cua, Michelle; Wahl, Daniel J; Zhao, Yuan; Lee, Sujin; Bonora, Stefano; Zawadzki, Robert J; Jian, Yifan; Sarunic, Marinko V

2016-09-07

Multiphoton microscopy enables imaging deep into scattering tissues. The efficient generation of non-linear optical effects is related to both the pulse duration (typically on the order of femtoseconds) and the size of the focused spot. Aberrations introduced by refractive index inhomogeneity in the sample distort the wavefront and enlarge the focal spot, which reduces the multiphoton signal. Traditional approaches to adaptive optics wavefront correction are not effective in thick or multi-layered scattering media. In this report, we present sensorless adaptive optics (SAO) using low-coherence interferometric detection of the excitation light for depth-resolved aberration correction of two-photon excited fluorescence (TPEF) in biological tissue. We demonstrate coherence-gated SAO TPEF using a transmissive multi-actuator adaptive lens for in vivo imaging in a mouse retina. This configuration has significant potential for reducing the laser power required for adaptive optics multiphoton imaging, and for facilitating integration with existing systems.

Ensemble machine learning and forecasting can achieve 99% uptime for rural handpumps

PubMed Central

Thomas, Evan A.

2017-01-01

Broken water pumps continue to impede efforts to deliver clean and economically-viable water to the global poor. The literature has demonstrated that customers’ health benefits and willingness to pay for clean water are best realized when clean water infrastructure performs extremely well (>99% uptime). In this paper, we used sensor data from 42 Afridev-brand handpumps observed for 14 months in western Kenya to demonstrate how sensors and supervised ensemble machine learning could be used to increase total fleet uptime from a best-practices baseline of about 70% to >99%. We accomplish this increase in uptime by forecasting pump failures and identifying existing failures very quickly. Comparing the costs of operating the pump per functional year over a lifetime of 10 years, we estimate that implementing this algorithm would save 7% on the levelized cost of water relative to a sensor-less scheduled maintenance program. Combined with a rigorous system for dispatching maintenance personnel, implementing this algorithm in a real-world program could significantly improve health outcomes and customers’ willingness to pay for water services. PMID:29182673

Feasibility Study of Jupiter Icy Moons Orbiter Permanent Magnet Alternator Start Sequence

NASA Technical Reports Server (NTRS)

Kenny, Barbara H.; Tokars, Roger P.

2006-01-01

The Jupiter Icy Moons Orbiter (JIMO) mission was a proposed, (recently cancelled) long duration science mission to study three moons of Jupiter: Callisto, Ganymede, and Europa. One design of the JIMO spacecraft used a nuclear heat source in conjunction with a Brayton rotating machine to generate electrical power for the electric thrusters and the spacecraft bus. The basic operation of the closed cycle Brayton system was as follows. The working fluid, a heliumxenon gas mixture, first entered a compressor, then went through a recuperator and hot-side heat exchanger, then expanded across a turbine that drove an alternator, then entered the cold-side of the recuperator and heat exchanger and finally returned to the compressor. The spacecraft was to be launched with the Brayton system off-line and the nuclear reactor shut down. Once the system was started, the helium-xenon gas would be circulated into the heat exchangers as the nuclear reactors were activated. Initially, the alternator unit would operate as a motor so as to drive the turbine and compressor to get the cycle started. This report investigated the feasibility of the start up sequence of a permanent magnet (PM) machine, similar in operation to the alternator unit, without any position or speed feedback sensors ("sensorless") and with a variable load torque. It is found that the permanent magnet machine can start with sensorless control and a load torque of up to 30 percent of the rated value.

Enhanced visualization of peripheral retinal vasculature with wavefront sensorless adaptive optics OCT angiography in diabetic patients

PubMed Central

Polans, James; Cunefare, David; Cole, Eli; Keller, Brenton; Mettu, Priyatham S.; Cousins, Scott W.; Allingham, Michael J.; Izatt, Joseph A.; Farsiu, Sina

2017-01-01

Optical coherence tomography angiography (OCTA) is a promising technique for non-invasive visualization of vessel networks in the human eye. We debut a system capable of acquiring wide field-of-view (>70°) OCT angiograms without mosaicking. Additionally, we report on enhancing the visualization of peripheral microvasculature using wavefront sensorless adaptive optics (WSAO). We employed a fast WSAO algorithm that enabled wavefront correction in <2 seconds by iterating the mirror shape at the speed of OCT B-scans rather than volumes. Also, we contrasted ~7° field-of-view OCTA angiograms acquired in the periphery with and without WSAO correction. On average, WSAO improved the sharpness of microvasculature by 65% in healthy and 38% in diseased eyes. Preliminary observations demonstrated that the location of 7° images could be identified directly from the wide field-of-view angiogram. A pilot study on a normal subject and patients with diabetic retinopathy showed the impact of utilizing WSAO for OCTA when visualizing peripheral vasculature pathologies. PMID:28059209

A Novel Design of an Automatic Lighting Control System for a Wireless Sensor Network with Increased Sensor Lifetime and Reduced Sensor Numbers

PubMed Central

Mohamaddoust, Reza; Haghighat, Abolfazl Toroghi; Sharif, Mohamad Javad Motahari; Capanni, Niccolo

2011-01-01

Wireless sensor networks (WSN) are currently being applied to energy conservation applications such as light control. We propose a design for such a system called a Lighting Automatic Control System (LACS). The LACS system contains a centralized or distributed architecture determined by application requirements and space usage. The system optimizes the calculations and communications for lighting intensity, incorporates user illumination requirements according to their activities and performs adjustments based on external lighting effects in external sensor and external sensor-less architectures. Methods are proposed for reducing the number of sensors required and increasing the lifetime of those used, for considerably reduced energy consumption. Additionally we suggest methods for improving uniformity of illuminance distribution on a workplane’s surface, which improves user satisfaction. Finally simulation results are presented to verify the effectiveness of our design. PMID:22164114

A novel design of an automatic lighting control system for a wireless sensor network with increased sensor lifetime and reduced sensor numbers.

PubMed

Mohamaddoust, Reza; Haghighat, Abolfazl Toroghi; Sharif, Mohamad Javad Motahari; Capanni, Niccolo

2011-01-01

Wireless sensor networks (WSN) are currently being applied to energy conservation applications such as light control. We propose a design for such a system called a lighting automatic control system (LACS). The LACS system contains a centralized or distributed architecture determined by application requirements and space usage. The system optimizes the calculations and communications for lighting intensity, incorporates user illumination requirements according to their activities and performs adjustments based on external lighting effects in external sensor and external sensor-less architectures. Methods are proposed for reducing the number of sensors required and increasing the lifetime of those used, for considerably reduced energy consumption. Additionally we suggest methods for improving uniformity of illuminance distribution on a workplane's surface, which improves user satisfaction. Finally simulation results are presented to verify the effectiveness of our design.

Sliding mode based fault detection, reconstruction and fault tolerant control scheme for motor systems.

PubMed

Mekki, Hemza; Benzineb, Omar; Boukhetala, Djamel; Tadjine, Mohamed; Benbouzid, Mohamed

2015-07-01

The fault-tolerant control problem belongs to the domain of complex control systems in which inter-control-disciplinary information and expertise are required. This paper proposes an improved faults detection, reconstruction and fault-tolerant control (FTC) scheme for motor systems (MS) with typical faults. For this purpose, a sliding mode controller (SMC) with an integral sliding surface is adopted. This controller can make the output of system to track the desired position reference signal in finite-time and obtain a better dynamic response and anti-disturbance performance. But this controller cannot deal directly with total system failures. However an appropriate combination of the adopted SMC and sliding mode observer (SMO), later it is designed to on-line detect and reconstruct the faults and also to give a sensorless control strategy which can achieve tolerance to a wide class of total additive failures. The closed-loop stability is proved, using the Lyapunov stability theory. Simulation results in healthy and faulty conditions confirm the reliability of the suggested framework. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Shape memory alloy wire for self-sensing servo actuation

NASA Astrophysics Data System (ADS)

Josephine Selvarani Ruth, D.; Dhanalakshmi, K.

2017-01-01

This paper reports on the development of a straightforward approach to realise self-sensing shape memory alloy (SMA) wire actuated control. A differential electrical resistance measurement circuit (the sensorless signal conditioning (SSC) circuit) is designed; this sensing signal is directly used as the feedback for control. Antagonistic SMA wire actuators designed for servo actuation is realized in self-sensing actuation (SSA) mode for direct control with the differential electrical resistance feedback. The self-sensing scheme is established on a 1-DOF manipulator with the discrete time sliding mode controls which demonstrates good control performance, whatever be the disturbance and loading conditions. The uniqueness of this work is the design of the generic electronic SSC circuit for SMA actuated system, for measurement and control. With a concern to the implementation of self-sensing technique in SMA, this scheme retains the systematic control architecture by using the sensing signal (self-sensed, electrical resistance corresponding to the system position) for feedback, without requiring any processing as that of the methods adopted and reported previously for SSA techniques of SMA.

Sensorless FOC Performance Improved with On-Line Speed and Rotor Resistance Estimator Based on an Artificial Neural Network for an Induction Motor Drive

PubMed Central

Gutierrez-Villalobos, Jose M.; Rodriguez-Resendiz, Juvenal; Rivas-Araiza, Edgar A.; Martínez-Hernández, Moisés A.

2015-01-01

Three-phase induction motor drive requires high accuracy in high performance processes in industrial applications. Field oriented control, which is one of the most employed control schemes for induction motors, bases its function on the electrical parameter estimation coming from the motor. These parameters make an electrical machine driver work improperly, since these electrical parameter values change at low speeds, temperature changes, and especially with load and duty changes. The focus of this paper is the real-time and on-line electrical parameters with a CMAC-ADALINE block added in the standard FOC scheme to improve the IM driver performance and endure the driver and the induction motor lifetime. Two kinds of neural network structures are used; one to estimate rotor speed and the other one to estimate rotor resistance of an induction motor. PMID:26131677

Sensorless FOC Performance Improved with On-Line Speed and Rotor Resistance Estimator Based on an Artificial Neural Network for an Induction Motor Drive.

PubMed

Gutierrez-Villalobos, Jose M; Rodriguez-Resendiz, Juvenal; Rivas-Araiza, Edgar A; Martínez-Hernández, Moisés A

2015-06-29

Three-phase induction motor drive requires high accuracy in high performance processes in industrial applications. Field oriented control, which is one of the most employed control schemes for induction motors, bases its function on the electrical parameter estimation coming from the motor. These parameters make an electrical machine driver work improperly, since these electrical parameter values change at low speeds, temperature changes, and especially with load and duty changes. The focus of this paper is the real-time and on-line electrical parameters with a CMAC-ADALINE block added in the standard FOC scheme to improve the IM driver performance and endure the driver and the induction motor lifetime. Two kinds of neural network structures are used; one to estimate rotor speed and the other one to estimate rotor resistance of an induction motor.

Sensorless battery temperature measurements based on electrochemical impedance spectroscopy

NASA Astrophysics Data System (ADS)

Raijmakers, L. H. J.; Danilov, D. L.; van Lammeren, J. P. M.; Lammers, M. J. G.; Notten, P. H. L.

2014-02-01

A new method is proposed to measure the internal temperature of (Li-ion) batteries. Based on electrochemical impedance spectroscopy measurements, an intercept frequency (f0) can be determined which is exclusively related to the internal battery temperature. The intercept frequency is defined as the frequency at which the imaginary part of the impedance is zero (Zim = 0), i.e. where the phase shift between the battery current and voltage is absent. The advantage of the proposed method is twofold: (i) no hardware temperature sensors are required anymore to monitor the battery temperature and (ii) the method does not suffer from heat transfer delays. Mathematical analysis of the equivalent electrical-circuit, representing the battery performance, confirms that the intercept frequency decreases with rising temperatures. Impedance measurements on rechargeable Li-ion cells of various chemistries were conducted to verify the proposed method. These experiments reveal that the intercept frequency is clearly dependent on the temperature and does not depend on State-of-Charge (SoC) and aging. These impedance-based sensorless temperature measurements are therefore simple and convenient for application in a wide range of stationary, mobile and high-power devices, such as hybrid- and full electric vehicles.

Lens-based wavefront sensorless adaptive optics swept source OCT

NASA Astrophysics Data System (ADS)

Jian, Yifan; Lee, Sujin; Ju, Myeong Jin; Heisler, Morgan; Ding, Weiguang; Zawadzki, Robert J.; Bonora, Stefano; Sarunic, Marinko V.

2016-06-01

Optical coherence tomography (OCT) has revolutionized modern ophthalmology, providing depth resolved images of the retinal layers in a system that is suited to a clinical environment. Although the axial resolution of OCT system, which is a function of the light source bandwidth, is sufficient to resolve retinal features at a micrometer scale, the lateral resolution is dependent on the delivery optics and is limited by ocular aberrations. Through the combination of wavefront sensorless adaptive optics and the use of dual deformable transmissive optical elements, we present a compact lens-based OCT system at an imaging wavelength of 1060 nm for high resolution retinal imaging. We utilized a commercially available variable focal length lens to correct for a wide range of defocus commonly found in patient’s eyes, and a novel multi-actuator adaptive lens for aberration correction to achieve near diffraction limited imaging performance at the retina. With a parallel processing computational platform, high resolution cross-sectional and en face retinal image acquisition and display was performed in real time. In order to demonstrate the system functionality and clinical utility, we present images of the photoreceptor cone mosaic and other retinal layers acquired in vivo from research subjects.

Optical coherence tomography with a 2.8-mm beam diameter and sensorless defocus and astigmatism correction

NASA Astrophysics Data System (ADS)

Reddikumar, Maddipatla; Tanabe, Ayano; Hashimoto, Nobuyuki; Cense, Barry

2017-02-01

An optical coherence tomography (OCT) system with a 2.8-mm beam diameter is presented. Sensorless defocus correction can be performed with a Badal optometer and astigmatism correction with a liquid crystal device. OCT B-scans were used in an image-based optimization algorithm for aberration correction. Defocus can be corrected from -4.3 D to +4.3 D and vertical and oblique astigmatism from -2.5 D to +2.5 D. A contrast gain of 6.9 times was measured after aberration correction. In comparison with a 1.3-mm beam diameter OCT system, this concept achieved a 3.7-dB gain in dynamic range on a model retina. Both systems were used to image the retina of a human subject. As the correction of the liquid crystal device can take more than 60 s, the subject's spectacle prescription was adopted instead. This resulted in a 2.5 times smaller speckle size compared with the standard OCT system. The liquid crystal device for astigmatism correction does not need a high-voltage amplifier and can be operated at 5 V. The correction device is small (9 mm×30 mm×38 mm) and can easily be implemented in existing designs for OCT.

Multiscale sensorless adaptive optics OCT angiography system for in vivo human retinal imaging.

PubMed

Ju, Myeong Jin; Heisler, Morgan; Wahl, Daniel; Jian, Yifan; Sarunic, Marinko V

2017-11-01

We present a multiscale sensorless adaptive optics (SAO) OCT system capable of imaging retinal structure and vasculature with various fields-of-view (FOV) and resolutions. Using a single deformable mirror and exploiting the polarization properties of light, the SAO-OCT-A was implemented in a compact and easy to operate system. With the ability to adjust the beam diameter at the pupil, retinal imaging was demonstrated at two different numerical apertures with the same system. The general morphological structure and retinal vasculature could be observed with a few tens of micrometer-scale lateral resolution with conventional OCT and OCT-A scanning protocols with a 1.7-mm-diameter beam incident at the pupil and a large FOV (15 deg× 15 deg). Changing the system to a higher numerical aperture with a 5.0-mm-diameter beam incident at the pupil and the SAO aberration correction, the FOV was reduced to 3 deg× 3 deg for fine detailed imaging of morphological structure and microvasculature such as the photoreceptor mosaic and capillaries. Multiscale functional SAO-OCT imaging was performed on four healthy subjects, demonstrating its functionality and potential for clinical utility. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

MTPA control of mechanical sensorless IPMSM based on adaptive nonlinear control.

PubMed

Najjar-Khodabakhsh, Abbas; Soltani, Jafar

2016-03-01

In this paper, an adaptive nonlinear control scheme has been proposed for implementing maximum torque per ampere (MTPA) control strategy corresponding to interior permanent magnet synchronous motor (IPMSM) drive. This control scheme is developed in the rotor d-q axis reference frame using adaptive input-output state feedback linearization (AIOFL) method. The drive system control stability is supported by Lyapunov theory. The motor inductances are online estimated by an estimation law obtained by AIOFL. The estimation errors of these parameters are proved to be asymptotically converged to zero. Based on minimizing the motor current amplitude, the MTPA control strategy is performed by using the nonlinear optimization technique while considering the online reference torque. The motor reference torque is generated by a conventional rotor speed PI controller. By performing MTPA control strategy, the generated online motor d-q reference currents were used in AIOFL controller to obtain the SV-PWM reference voltages and the online estimation of the motor d-q inductances. In addition, the stator resistance is online estimated using a conventional PI controller. Moreover, the rotor position is detected using the online estimation of the stator flux and online estimation of the motor q-axis inductance. Simulation and experimental results obtained prove the effectiveness and the capability of the proposed control method. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Signal injection as a fault detection technique.

PubMed

Cusidó, Jordi; Romeral, Luis; Ortega, Juan Antonio; Garcia, Antoni; Riba, Jordi

2011-01-01

Double frequency tests are used for evaluating stator windings and analyzing the temperature. Likewise, signal injection on induction machines is used on sensorless motor control fields to find out the rotor position. Motor Current Signature Analysis (MCSA), which focuses on the spectral analysis of stator current, is the most widely used method for identifying faults in induction motors. Motor faults such as broken rotor bars, bearing damage and eccentricity of the rotor axis can be detected. However, the method presents some problems at low speed and low torque, mainly due to the proximity between the frequencies to be detected and the small amplitude of the resulting harmonics. This paper proposes the injection of an additional voltage into the machine being tested at a frequency different from the fundamental one, and then studying the resulting harmonics around the new frequencies appearing due to the composition between injected and main frequencies.

Signal Injection as a Fault Detection Technique

PubMed Central

Cusidó, Jordi; Romeral, Luis; Ortega, Juan Antonio; Garcia, Antoni; Riba, Jordi

2011-01-01

Double frequency tests are used for evaluating stator windings and analyzing the temperature. Likewise, signal injection on induction machines is used on sensorless motor control fields to find out the rotor position. Motor Current Signature Analysis (MCSA), which focuses on the spectral analysis of stator current, is the most widely used method for identifying faults in induction motors. Motor faults such as broken rotor bars, bearing damage and eccentricity of the rotor axis can be detected. However, the method presents some problems at low speed and low torque, mainly due to the proximity between the frequencies to be detected and the small amplitude of the resulting harmonics. This paper proposes the injection of an additional voltage into the machine being tested at a frequency different from the fundamental one, and then studying the resulting harmonics around the new frequencies appearing due to the composition between injected and main frequencies. PMID:22163801

Aircraft panel with sensorless active sound power reduction capabilities through virtual mechanical impedances

NASA Astrophysics Data System (ADS)

Boulandet, R.; Michau, M.; Micheau, P.; Berry, A.

2016-01-01

This paper deals with an active structural acoustic control approach to reduce the transmission of tonal noise in aircraft cabins. The focus is on the practical implementation of the virtual mechanical impedances method by using sensoriactuators instead of conventional control units composed of separate sensors and actuators. The experimental setup includes two sensoriactuators developed from the electrodynamic inertial exciter and distributed over an aircraft trim panel which is subject to a time-harmonic diffuse sound field. The target mechanical impedances are first defined by solving a linear optimization problem from sound power measurements before being applied to the test panel using a complex envelope controller. Measured data are compared to results obtained with sensor-actuator pairs consisting of an accelerometer and an inertial exciter, particularly as regards sound power reduction. It is shown that the two types of control unit provide similar performance, and that here virtual impedance control stands apart from conventional active damping. In particular, it is clear from this study that extra vibrational energy must be provided by the actuators for optimal sound power reduction, mainly due to the high structural damping in the aircraft trim panel. Concluding remarks on the benefits of using these electrodynamic sensoriactuators to control tonal disturbances are also provided.

Generalized predictive control for a coupled four tank MIMO system using a continuous-discrete time observer.

PubMed

Gouta, Houssemeddine; Hadj Saïd, Salim; Barhoumi, Nabil; M'Sahli, Faouzi

2017-03-01

This paper deals with the problem of the observer based control design for a coupled four-tank liquid level system. For this MIMO system's dynamics, motivated by a desire to provide precise and sensorless liquid level control, a nonlinear predictive controller based on a continuous-discrete observer is presented. First, an analytical solution from the model predictive control (MPC) technique is developed for a particular class of nonlinear MIMO systems and its corresponding exponential stability is proven. Then, a high gain observer that runs in continuous-time with an output error correction time that is updated in a mixed continuous-discrete fashion is designed in order to estimate the liquid levels in the two upper tanks. The effectiveness of the designed control schemes are validated by two tests; The first one is maintaining a constant level in the first bottom tank while making the level in the second bottom tank to follow a sinusoidal reference signal. The second test is more difficult and it is made using two trapezoidal reference signals in order to see the decoupling performance of the system's outputs. Simulation and experimental results validate the objective of the paper. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Dynamic Aberration Correction for Conformal Window of High-Speed Aircraft Using Optimized Model-Based Wavefront Sensorless Adaptive Optics.

PubMed

Dong, Bing; Li, Yan; Han, Xin-Li; Hu, Bin

2016-09-02

For high-speed aircraft, a conformal window is used to optimize the aerodynamic performance. However, the local shape of the conformal window leads to large amounts of dynamic aberrations varying with look angle. In this paper, deformable mirror (DM) and model-based wavefront sensorless adaptive optics (WSLAO) are used for dynamic aberration correction of an infrared remote sensor equipped with a conformal window and scanning mirror. In model-based WSLAO, aberration is captured using Lukosz mode, and we use the low spatial frequency content of the image spectral density as the metric function. Simulations show that aberrations induced by the conformal window are dominated by some low-order Lukosz modes. To optimize the dynamic correction, we can only correct dominant Lukosz modes and the image size can be minimized to reduce the time required to compute the metric function. In our experiment, a 37-channel DM is used to mimic the dynamic aberration of conformal window with scanning rate of 10 degrees per second. A 52-channel DM is used for correction. For a 128 × 128 image, the mean value of image sharpness during dynamic correction is 1.436 × 10(-5) in optimized correction and is 1.427 × 10(-5) in un-optimized correction. We also demonstrated that model-based WSLAO can achieve convergence two times faster than traditional stochastic parallel gradient descent (SPGD) method.

Suction prevention and physiologic control of continuous flow left ventricular assist devices using intrinsic pump parameters.

PubMed

Wang, Yu; Koenig, Steven C; Slaughter, Mark S; Giridharan, Guruprasad A

2015-01-01

The risk for left ventricular (LV) suction during left ventricular assist devices (LVAD) support has been a clinical concern. Current development efforts suggest LVAD suction prevention and physiologic control algorithms may require chronic implantation of pressure or flow sensors, which can be unreliable because of baseline drift and short lifespan. To overcome this limitation, we designed a sensorless suction prevention and physiologic control (eSPPC) algorithm that only requires LVAD intrinsic parameters (pump speed and power). Two gain-scheduled, proportional-integral controllers maintain a differential pump speed (ΔRPM) above a user-defined threshold to prevent LV suction while maintaining an average reference differential pressure (ΔP) between the LV and aorta. ΔRPM is calculated from noisy pump speed measurements that are low-pass filtered, and ΔP is estimated using an extended Kalman filter. Efficacy and robustness of the eSPPC algorithm were evaluated in silico during simulated rest and exercise test conditions for 1) excessive ΔP setpoint (ES); 2) rapid eightfold increase in pulmonary vascular resistance (PVR); and 3) ES and PVR. Simulated hemodynamic waveforms (LV pressure and volume; aortic pressure and flow) using only intrinsic pump parameters showed the feasibility of our proposed eSPPC algorithm in preventing LV suction for all test conditions.

Water Pump Development for the EVA PLSS

NASA Technical Reports Server (NTRS)

Schuller, Michael; Kurwitz, Cable; Goldman, Jeff; Morris, Kim; Trevino, Luis

2009-01-01

This paper describes the effort by the Texas Engineering Experiment Station (TEES) and Honeywell for NASA to design, fabricate, and test a preflight prototype pump for use in the Extravehicular activity (EVA) portable life support subsystem (PLSS). Major design decisions were driven by the need to reduce the pump s mass, power, and volume compared to the existing PLSS pump. In addition, the pump will accommodate a much wider range of abnormal conditions than the existing pump, including vapor/gas bubbles and increased pressure drop when employed to cool two suits simultaneously. A positive displacement, external gear type pump was selected because it offers the most compact and highest efficiency solution over the required range of flow rates and pressure drops. An additional benefit of selecting a gear pump design is that it is self priming and capable of ingesting noncondensable gas without becoming "air locked." The chosen pump design consists of a 28 V DC, brushless, sealless, permanent magnet motor driven, external gear pump that utilizes a Honeywell development that eliminates the need for magnetic coupling. Although the planned flight unit will use a sensorless motor with custom designed controller, the preflight prototype to be provided for this project incorporates Hall effect sensors, allowing an interface with a readily available commercial motor controller. This design approach reduced the cost of this project and gives NASA more flexibility in future PLSS laboratory testing. The pump design was based on existing Honeywell designs, but incorporated features specifically for the PLSS application, including all of the key features of the flight pump. Testing at TEES will simulate the vacuum environment in which the flight pump will operate. Testing will verify that the pump meets design requirements for range of flow rates, pressure rise, power consumption, working fluid temperature, operating time, and restart capability. Pump testing is currently scheduled for March, 2009, after which the pump will be delivered to NASA for further testing.

A microfluidic device for simultaneous measurement of viscosity and flow rate of blood in a complex fluidic network

PubMed Central

Jun Kang, Yang; Yeom, Eunseop; Lee, Sang-Joon

2013-01-01

Blood viscosity has been considered as one of important biophysical parameters for effectively monitoring variations in physiological and pathological conditions of circulatory disorders. Standard previous methods make it difficult to evaluate variations of blood viscosity under cardiopulmonary bypass procedures or hemodialysis. In this study, we proposed a unique microfluidic device for simultaneously measuring viscosity and flow rate of whole blood circulating in a complex fluidic network including a rat, a reservoir, a pinch valve, and a peristaltic pump. To demonstrate the proposed method, a twin-shaped microfluidic device, which is composed of two half-circular chambers, two side channels with multiple indicating channels, and one bridge channel, was carefully designed. Based on the microfluidic device, three sequential flow controls were applied to identify viscosity and flow rate of blood, with label-free and sensorless detection. The half-circular chamber was employed to achieve mechanical membrane compliance for flow stabilization in the microfluidic device. To quantify the effect of flow stabilization on flow fluctuations, a formula of pulsation index (PI) was analytically derived using a discrete fluidic circuit model. Using the PI formula, the time constant contributed by the half-circular chamber is estimated to be 8 s. Furthermore, flow fluctuations resulting from the peristaltic pumps are completely removed, especially under periodic flow conditions within short periods (T < 10 s). For performance demonstrations, the proposed method was applied to evaluate blood viscosity with respect to varying flow rate conditions [(a) known blood flow rate via a syringe pump, (b) unknown blood flow rate via a peristaltic pump]. As a result, the flow rate and viscosity of blood can be simultaneously measured with satisfactory accuracy. In addition, the proposed method was successfully applied to identify the viscosity of rat blood, which circulates in a complex fluidic network. These observations confirm that the proposed method can be used for simultaneous measurement of viscosity and flow rate of whole blood circulating in the complex fluid network, with sensorless and label-free detection. Furthermore, the proposed method will be used in evaluating variations in the viscosity of human blood during cardiopulmonary bypass procedures or hemodialysis. PMID:24404074

A microfluidic device for simultaneous measurement of viscosity and flow rate of blood in a complex fluidic network.

PubMed

Jun Kang, Yang; Yeom, Eunseop; Lee, Sang-Joon

2013-01-01

Blood viscosity has been considered as one of important biophysical parameters for effectively monitoring variations in physiological and pathological conditions of circulatory disorders. Standard previous methods make it difficult to evaluate variations of blood viscosity under cardiopulmonary bypass procedures or hemodialysis. In this study, we proposed a unique microfluidic device for simultaneously measuring viscosity and flow rate of whole blood circulating in a complex fluidic network including a rat, a reservoir, a pinch valve, and a peristaltic pump. To demonstrate the proposed method, a twin-shaped microfluidic device, which is composed of two half-circular chambers, two side channels with multiple indicating channels, and one bridge channel, was carefully designed. Based on the microfluidic device, three sequential flow controls were applied to identify viscosity and flow rate of blood, with label-free and sensorless detection. The half-circular chamber was employed to achieve mechanical membrane compliance for flow stabilization in the microfluidic device. To quantify the effect of flow stabilization on flow fluctuations, a formula of pulsation index (PI) was analytically derived using a discrete fluidic circuit model. Using the PI formula, the time constant contributed by the half-circular chamber is estimated to be 8 s. Furthermore, flow fluctuations resulting from the peristaltic pumps are completely removed, especially under periodic flow conditions within short periods (T < 10 s). For performance demonstrations, the proposed method was applied to evaluate blood viscosity with respect to varying flow rate conditions [(a) known blood flow rate via a syringe pump, (b) unknown blood flow rate via a peristaltic pump]. As a result, the flow rate and viscosity of blood can be simultaneously measured with satisfactory accuracy. In addition, the proposed method was successfully applied to identify the viscosity of rat blood, which circulates in a complex fluidic network. These observations confirm that the proposed method can be used for simultaneous measurement of viscosity and flow rate of whole blood circulating in the complex fluid network, with sensorless and label-free detection. Furthermore, the proposed method will be used in evaluating variations in the viscosity of human blood during cardiopulmonary bypass procedures or hemodialysis.

Dynamic Aberration Correction for Conformal Window of High-Speed Aircraft Using Optimized Model-Based Wavefront Sensorless Adaptive Optics

PubMed Central

Dong, Bing; Li, Yan; Han, Xin-li; Hu, Bin

2016-01-01

For high-speed aircraft, a conformal window is used to optimize the aerodynamic performance. However, the local shape of the conformal window leads to large amounts of dynamic aberrations varying with look angle. In this paper, deformable mirror (DM) and model-based wavefront sensorless adaptive optics (WSLAO) are used for dynamic aberration correction of an infrared remote sensor equipped with a conformal window and scanning mirror. In model-based WSLAO, aberration is captured using Lukosz mode, and we use the low spatial frequency content of the image spectral density as the metric function. Simulations show that aberrations induced by the conformal window are dominated by some low-order Lukosz modes. To optimize the dynamic correction, we can only correct dominant Lukosz modes and the image size can be minimized to reduce the time required to compute the metric function. In our experiment, a 37-channel DM is used to mimic the dynamic aberration of conformal window with scanning rate of 10 degrees per second. A 52-channel DM is used for correction. For a 128 × 128 image, the mean value of image sharpness during dynamic correction is 1.436 × 10−5 in optimized correction and is 1.427 × 10−5 in un-optimized correction. We also demonstrated that model-based WSLAO can achieve convergence two times faster than traditional stochastic parallel gradient descent (SPGD) method. PMID:27598161

Sensorless control for permanent magnet synchronous motor using a neural network based adaptive estimator

NASA Astrophysics Data System (ADS)

Kwon, Chung-Jin; Kim, Sung-Joong; Han, Woo-Young; Min, Won-Kyoung

2005-12-01

The rotor position and speed estimation of permanent-magnet synchronous motor(PMSM) was dealt with. By measuring the phase voltages and currents of the PMSM drive, two diagonally recurrent neural network(DRNN) based observers, a neural current observer and a neural velocity observer were developed. DRNN which has self-feedback of the hidden neurons ensures that the outputs of DRNN contain the whole past information of the system even if the inputs of DRNN are only the present states and inputs of the system. Thus the structure of DRNN may be simpler than that of feedforward and fully recurrent neural networks. If the backpropagation method was used for the training of the DRNN the problem of slow convergence arise. In order to reduce this problem, recursive prediction error(RPE) based learning method for the DRNN was presented. The simulation results show that the proposed approach gives a good estimation of rotor speed and position, and RPE based training has requires a shorter computation time compared to backpropagation based training.

Position Estimation for Switched Reluctance Motor Based on the Single Threshold Angle

NASA Astrophysics Data System (ADS)

Zhang, Lei; Li, Pang; Yu, Yue

2017-05-01

This paper presents a position estimate model of switched reluctance motor based on the single threshold angle. In view of the relationship of between the inductance and rotor position, the position is estimated by comparing the real-time dynamic flux linkage with the threshold angle position flux linkage (7.5° threshold angle, 12/8SRM). The sensorless model is built by Maltab/Simulink, the simulation are implemented under the steady state and transient state different condition, and verified its validity and feasibility of the method..

Design and parameter estimation of hybrid magnetic bearings for blood pump applications

NASA Astrophysics Data System (ADS)

Lim, Tau Meng; Zhang, Dongsheng; Yang, Juanjuan; Cheng, Shanbao; Low, Sze Hsien; Chua, Leok Poh; Wu, Xiaowei

2009-10-01

This paper discusses the design and parameter estimation of the dynamics characteristics of a high-speed hybrid magnetic bearings (HMBs) system for axial flow blood pump applications. The rotor/impeller of the pump is driven by a three-phase permanent magnet (PM) brushless and sensorless DC motor. It is levitated by two HMBs at both ends in five-degree-of-freedom with proportional-integral-derivative (PID) controllers; among which four radial directions are actively controlled and one axial direction is passively controlled. Test results show that the rotor can be stably supported to speeds of 14,000 rpm. The frequency domain parameter estimation technique with statistical analysis is adopted to validate the stiffness and damping coefficients of the HMBs system. A specially designed test rig facilitated the estimation of the bearing's coefficients in air—in both the radial and axial directions. The radial stiffness of the HMBs is compared to the Ansoft's Maxwell 2D/3D finite element magnetostatic results. Experimental estimation showed that the dynamics characteristics of the HMBs system are dominated by the frequency-dependent stiffness coefficients. The actuator gain was also successfully calibrated and may potentially extend the parameter estimation technique developed in the study of identification and monitoring of the pump's dynamics properties under normal operating conditions with fluid.

Assessment of duration of the drive operation in the mode of kinetic energy recovery under power supply voltage sags in electrical grids of mechanical engineering enterprises

NASA Astrophysics Data System (ADS)

Shonin, O. B.; Novozhilov, N. G.

2017-02-01

Voltage sags in electric grids of mechanical engineering enterprises may lead to disconnection of important power consumers with variable frequency drives from the power grid and further interruption of the production process. The paper considers a sensorless V/f control system of еру induction motor drive under normal conditions and under voltage sags on the basis of a computer model of the drive and derivation of a formula for assessment of possible duration of the drive operation in the mode of controlled recovery of kinetic energy accumulated in rotating mass of the drive. Results of simulations have been used to validate results of calculations of the rotor velocity deceleration made in a closed form obtained from the equation reflecting the balance of torques. It is shown that results of calculations practically coincide with results of simulations in the range up to 5% of the velocity initial value. The proposed formula may be useful for estimation of the duration of the drive operation in the mode of recovery of kinetic energy depending on parameters of the motor and driven mechanisms.

Development of a prototype magnetically suspended rotor ventricular assist device.

PubMed

Bearnson, G B; Maslen, E H; Olsen, D B; Allaire, P E; Khanwilkar, P S; Long, J W; Kim, H C

1996-01-01

A continuous flow centrifugal blood pump with magnetically suspended impeller has been designed, constructed, and tested. The system can be functionally divided into three subsystem designs: 1) centrifugal pump and flow paths, 2) magnetic bearings, and 3) brushless DC motor. The centrifugal pump is a Francis vane type design with a designed operating point of 6 L/min flow and 100 mmHg pressure rise at 2,300 RPM. Peak hydraulic efficiency is over 50%. The magnetic bearing system is an all active design with five axes of control. Rotor position sensors were developed as part of the system to provide feedback to a proportional-integral-derivative controller. The motor is a sensorless brushless DC motor. Back electromotive force voltage generated by the motor is used to provide commutation for the motor. No slots are employed in the motor design in order to reduce the radial force that the bearings must generate. Tests pumping blood in vitro were very encouraging; an index of hemolysis of 0.0086 +/- 0.0012 was measured. Further design refinement is needed to reduce power dissipation and size of the device. The concept of using magnetic bearings in a blood pump shows promise in a long-term implantable blood pump.

A self-sensing active magnetic bearing based on a direct current measurement approach.

PubMed

Niemann, Andries C; van Schoor, George; du Rand, Carel P

2013-09-11

Active magnetic bearings (AMBs) have become a key technology in various industrial applications. Self-sensing AMBs provide an integrated sensorless solution for position estimation, consolidating the sensing and actuating functions into a single electromagnetic transducer. The approach aims to reduce possible hardware failure points, production costs, and system complexity. Despite these advantages, self-sensing methods must address various technical challenges to maximize the performance thereof. This paper presents the direct current measurement (DCM) approach for self-sensing AMBs, denoting the direct measurement of the current ripple component. In AMB systems, switching power amplifiers (PAs) modulate the rotor position information onto the current waveform. Demodulation self-sensing techniques then use bandpass and lowpass filters to estimate the rotor position from the voltage and current signals. However, the additional phase-shift introduced by these filters results in lower stability margins. The DCM approach utilizes a novel PA switching method that directly measures the current ripple to obtain duty-cycle invariant position estimates. Demodulation filters are largely excluded to minimize additional phase-shift in the position estimates. Basic functionality and performance of the proposed self-sensing approach are demonstrated via a transient simulation model as well as a high current (10 A) experimental system. A digital implementation of amplitude modulation self-sensing serves as a comparative estimator.

Wavefront correction and high-resolution in vivo OCT imaging with an objective integrated multi-actuator adaptive lens.

PubMed

Bonora, Stefano; Jian, Yifan; Zhang, Pengfei; Zam, Azhar; Pugh, Edward N; Zawadzki, Robert J; Sarunic, Marinko V

2015-08-24

Adaptive optics is rapidly transforming microscopy and high-resolution ophthalmic imaging. The adaptive elements commonly used to control optical wavefronts are liquid crystal spatial light modulators and deformable mirrors. We introduce a novel Multi-actuator Adaptive Lens that can correct aberrations to high order, and which has the potential to increase the spread of adaptive optics to many new applications by simplifying its integration with existing systems. Our method combines an adaptive lens with an imaged-based optimization control that allows the correction of images to the diffraction limit, and provides a reduction of hardware complexity with respect to existing state-of-the-art adaptive optics systems. The Multi-actuator Adaptive Lens design that we present can correct wavefront aberrations up to the 4th order of the Zernike polynomial characterization. The performance of the Multi-actuator Adaptive Lens is demonstrated in a wide field microscope, using a Shack-Hartmann wavefront sensor for closed loop control. The Multi-actuator Adaptive Lens and image-based wavefront-sensorless control were also integrated into the objective of a Fourier Domain Optical Coherence Tomography system for in vivo imaging of mouse retinal structures. The experimental results demonstrate that the insertion of the Multi-actuator Objective Lens can generate arbitrary wavefronts to correct aberrations down to the diffraction limit, and can be easily integrated into optical systems to improve the quality of aberrated images.

The analysis of the quality of the frequency control of induction motor carried out on the basis of the processes in the rotor circuit

NASA Astrophysics Data System (ADS)

Kodkin, V. L.; Anikin, A. S.; Baldenkov, A. A.

2018-01-01

The results of researches of asynchronous electric drives with the frequency control which are carried out for the purpose of establishment of causes and effect relationships between a control method, the implementable standard frequency converter of the Schneider Electric company (ATV-71, ATV-32) and its efficiency are given in article. Tests with asynchronous motors with wound rotor were for the first time carried out. It allowed registering during the experiments the instantaneous values not only the stator currents, but also rotor currents. Authors for the first time applied spectrum analysis of stator and rotor currents, it showed that «sensorless vector» control leads to origin of high-frequency harmonicas with the considerable amplitude and, as a result of they are non-sinusoidal of the created torque and inefficiency of the electric drive. The accelerations that are carried out during the researches to 94, 157 and 251 Rad/s confirmed this feature of vector control that appears incapable to linearize the asynchronous electric drive as it was supposed authors of a method. These results do not contradict theoretical provisions if not to neglect assumptions which usually become in case of an output of the equations of vector control. Unfortunately, the modern researchers do not subject these assumptions to doubts. Continued studies make it possible to create an effective frequency management of asynchronous electric drives required for current technology.

Sensorless control for a sophisticated artificial myocardial contraction by using shape memory alloy fibre.

PubMed

Shiraishi, Y; Yambe, T; Saijo, Y; Sato, F; Tanaka, A; Yoshizawa, M; Sugai, T K; Sakata, R; Luo, Y; Park, Y; Uematsu, M; Umezu, M; Fujimoto, T; Masumoto, N; Liu, H; Baba, A; Konno, S; Nitta, S; Imachi, K; Tabayashi, K; Sasada, H; Homma, D

2008-01-01

The authors have been developing an artificial myocardium, which is capable of supporting natural contractile function from the outside of the ventricle. The system was originally designed by using sophisticated covalent shape memory alloy fibres, and the surface did not implicate blood compatibility. The purpose of our study on the development of artificial myocardium was to achieve the assistance of myocardial functional reproduction by the integrative small mechanical elements without sensors, so that the effective circulatory support could be accomplished. In this study, the authors fabricated the prototype artificial myocardial assist unit composed of the sophisticated shape memory alloy fibre (Biometal), the diameter of which was 100 microns, and examined the mechanical response by using pulse width modulation (PWM) control method in each unit. Prior to the evaluation of dynamic characteristics, the relationship between strain and electric resistance and also the initial response of each unit were obtained. The component for the PWM control was designed in order to regulate the myocardial contractile function, which consisted of an originally-designed RISC microcomputer with the input of displacement, and its output signal was controlled by pulse wave modulation method. As a result, the optimal PWM parameters were confirmed and the fibrous displacement was successfully regulated under the different heat transfer conditions simulating internal body temperature as well as bias tensile loading. Then it was indicated that this control theory might be applied for more sophisticated ventricular passive or active restraint by the artificial myocardium on physiological demand.

Multiphoton imaging microscopy at deeper layers with adaptive optics control of spherical aberration.

PubMed

Bueno, Juan M; Skorsetz, Martin; Palacios, Raquel; Gualda, Emilio J; Artal, Pablo

2014-01-01

Despite the inherent confocality and optical sectioning capabilities of multiphoton microscopy, three-dimensional (3-D) imaging of thick samples is limited by the specimen-induced aberrations. The combination of immersion objectives and sensorless adaptive optics (AO) techniques has been suggested to overcome this difficulty. However, a complex plane-by-plane correction of aberrations is required, and its performance depends on a set of image-based merit functions. We propose here an alternative approach to increase penetration depth in 3-D multiphoton microscopy imaging. It is based on the manipulation of the spherical aberration (SA) of the incident beam with an AO device while performing fast tomographic multiphoton imaging. When inducing SA, the image quality at best focus is reduced; however, better quality images are obtained from deeper planes within the sample. This is a compromise that enables registration of improved 3-D multiphoton images using nonimmersion objectives. Examples on ocular tissues and nonbiological samples providing different types of nonlinear signal are presented. The implementation of this technique in a future clinical instrument might provide a better visualization of corneal structures in living eyes.

Wide-field retinal optical coherence tomography with wavefront sensorless adaptive optics for enhanced imaging of targeted regions.

PubMed

Polans, James; Keller, Brenton; Carrasco-Zevallos, Oscar M; LaRocca, Francesco; Cole, Elijah; Whitson, Heather E; Lad, Eleonora M; Farsiu, Sina; Izatt, Joseph A

2017-01-01

The peripheral retina of the human eye offers a unique opportunity for assessment and monitoring of ocular diseases. We have developed a novel wide-field (>70°) optical coherence tomography system (WF-OCT) equipped with wavefront sensorless adaptive optics (WSAO) for enhancing the visualization of smaller (<25°) targeted regions in the peripheral retina. We iterated the WSAO algorithm at the speed of individual OCT B-scans (~20 ms) by using raw spectral interferograms to calculate the optimization metric. Our WSAO approach with a 3 mm beam diameter permitted primarily low- but also high- order peripheral wavefront correction in less than 10 seconds. In preliminary imaging studies in five normal human subjects, we quantified statistically significant changes with WSAO correction, corresponding to a 10.4% improvement in average pixel brightness (signal) and 7.0% improvement in high frequency content (resolution) when visualizing 1 mm (~3.5°) B-scans of the peripheral (>23°) retina. We demonstrated the ability of our WF-OCT system to acquire non wavefront-corrected wide-field images rapidly, which could then be used to locate regions of interest, zoom into targeted features, and visualize the same region at different time points. A pilot clinical study was conducted on seven healthy volunteers and two subjects with prodromal Alzheimer's disease which illustrated the capability to image Drusen-like pathologies as far as 32.5° from the fovea in un-averaged volume scans. This work suggests that the proposed combination of WF-OCT and WSAO may find applications in the diagnosis and treatment of ocular, and potentially neurodegenerative, diseases of the peripheral retina, including diabetes and Alzheimer's disease.

Wide-field retinal optical coherence tomography with wavefront sensorless adaptive optics for enhanced imaging of targeted regions

PubMed Central

Polans, James; Keller, Brenton; Carrasco-Zevallos, Oscar M.; LaRocca, Francesco; Cole, Elijah; Whitson, Heather E.; Lad, Eleonora M.; Farsiu, Sina; Izatt, Joseph A.

2016-01-01

The peripheral retina of the human eye offers a unique opportunity for assessment and monitoring of ocular diseases. We have developed a novel wide-field (>70°) optical coherence tomography system (WF-OCT) equipped with wavefront sensorless adaptive optics (WSAO) for enhancing the visualization of smaller (<25°) targeted regions in the peripheral retina. We iterated the WSAO algorithm at the speed of individual OCT B-scans (~20 ms) by using raw spectral interferograms to calculate the optimization metric. Our WSAO approach with a 3 mm beam diameter permitted primarily low- but also high- order peripheral wavefront correction in less than 10 seconds. In preliminary imaging studies in five normal human subjects, we quantified statistically significant changes with WSAO correction, corresponding to a 10.4% improvement in average pixel brightness (signal) and 7.0% improvement in high frequency content (resolution) when visualizing 1 mm (~3.5°) B-scans of the peripheral (>23°) retina. We demonstrated the ability of our WF-OCT system to acquire non wavefront-corrected wide-field images rapidly, which could then be used to locate regions of interest, zoom into targeted features, and visualize the same region at different time points. A pilot clinical study was conducted on seven healthy volunteers and two subjects with prodromal Alzheimer’s disease which illustrated the capability to image Drusen-like pathologies as far as 32.5° from the fovea in un-averaged volume scans. This work suggests that the proposed combination of WF-OCT and WSAO may find applications in the diagnosis and treatment of ocular, and potentially neurodegenerative, diseases of the peripheral retina, including diabetes and Alzheimer’s disease. PMID:28101398

Wavefront correction and high-resolution in vivo OCT imaging with an objective integrated multi-actuator adaptive lens

PubMed Central

Bonora, Stefano; Jian, Yifan; Zhang, Pengfei; Zam, Azhar; Pugh, Edward N.; Zawadzki, Robert J.; Sarunic, Marinko V.

2015-01-01

Adaptive optics is rapidly transforming microscopy and high-resolution ophthalmic imaging. The adaptive elements commonly used to control optical wavefronts are liquid crystal spatial light modulators and deformable mirrors. We introduce a novel Multi-actuator Adaptive Lens that can correct aberrations to high order, and which has the potential to increase the spread of adaptive optics to many new applications by simplifying its integration with existing systems. Our method combines an adaptive lens with an imaged-based optimization control that allows the correction of images to the diffraction limit, and provides a reduction of hardware complexity with respect to existing state-of-the-art adaptive optics systems. The Multi-actuator Adaptive Lens design that we present can correct wavefront aberrations up to the 4th order of the Zernike polynomial characterization. The performance of the Multi-actuator Adaptive Lens is demonstrated in a wide field microscope, using a Shack-Hartmann wavefront sensor for closed loop control. The Multi-actuator Adaptive Lens and image-based wavefront-sensorless control were also integrated into the objective of a Fourier Domain Optical Coherence Tomography system for in vivo imaging of mouse retinal structures. The experimental results demonstrate that the insertion of the Multi-actuator Objective Lens can generate arbitrary wavefronts to correct aberrations down to the diffraction limit, and can be easily integrated into optical systems to improve the quality of aberrated images. PMID:26368169

Device-Free Passive Identity Identification via WiFi Signals.

PubMed

Lv, Jiguang; Yang, Wu; Man, Dapeng

2017-11-02

Device-free passive identity identification attracts much attention in recent years, and it is a representative application in sensorless sensing. It can be used in many applications such as intrusion detection and smart building. Previous studies show the sensing potential of WiFi signals in a device-free passive manner. It is confirmed that human's gait is unique from each other similar to fingerprint and iris. However, the identification accuracy of existing approaches is not satisfactory in practice. In this paper, we present Wii, a device-free WiFi-based Identity Identification approach utilizing human's gait based on Channel State Information (CSI) of WiFi signals. Principle Component Analysis (PCA) and low pass filter are applied to remove the noises in the signals. We then extract several entities' gait features from both time and frequency domain, and select the most effective features according to information gain. Based on these features, Wii realizes stranger recognition through Gaussian Mixture Model (GMM) and identity identification through a Support Vector Machine (SVM) with Radial Basis Function (RBF) kernel. It is implemented using commercial WiFi devices and evaluated on a dataset with more than 1500 gait instances collected from eight subjects walking in a room. The results indicate that Wii can effectively recognize strangers and can achieves high identification accuracy with low computational cost. As a result, Wii has the potential to work in typical home security systems.

Device-Free Passive Identity Identification via WiFi Signals

PubMed Central

Yang, Wu; Man, Dapeng

2017-01-01

Device-free passive identity identification attracts much attention in recent years, and it is a representative application in sensorless sensing. It can be used in many applications such as intrusion detection and smart building. Previous studies show the sensing potential of WiFi signals in a device-free passive manner. It is confirmed that human’s gait is unique from each other similar to fingerprint and iris. However, the identification accuracy of existing approaches is not satisfactory in practice. In this paper, we present Wii, a device-free WiFi-based Identity Identification approach utilizing human’s gait based on Channel State Information (CSI) of WiFi signals. Principle Component Analysis (PCA) and low pass filter are applied to remove the noises in the signals. We then extract several entities’ gait features from both time and frequency domain, and select the most effective features according to information gain. Based on these features, Wii realizes stranger recognition through Gaussian Mixture Model (GMM) and identity identification through a Support Vector Machine (SVM) with Radial Basis Function (RBF) kernel. It is implemented using commercial WiFi devices and evaluated on a dataset with more than 1500 gait instances collected from eight subjects walking in a room. The results indicate that Wii can effectively recognize strangers and can achieves high identification accuracy with low computational cost. As a result, Wii has the potential to work in typical home security systems. PMID:29099091

Adaptive optics plug-and-play setup for high-resolution microscopes with multi-actuator adaptive lens

NASA Astrophysics Data System (ADS)

Quintavalla, M.; Pozzi, P.; Verhaegen, Michelle; Bijlsma, Hielke; Verstraete, Hans; Bonora, S.

2018-02-01

Adaptive Optics (AO) has revealed as a very promising technique for high-resolution microscopy, where the presence of optical aberrations can easily compromise the image quality. Typical AO systems however, are almost impossible to implement on commercial microscopes. We propose a simple approach by using a Multi-actuator Adaptive Lens (MAL) that can be inserted right after the objective and works in conjunction with an image optimization software allowing for a wavefront sensorless correction. We presented the results obtained on several commercial microscopes among which a confocal microscope, a fluorescence microscope, a light sheet microscope and a multiphoton microscope.

Modeling, Development and Control of Multilevel Converters for Power System Application =

NASA Astrophysics Data System (ADS)

Vahedi, Hani

The main goal of this project is to develop a multilevel converter topology to be useful in power system applications. Although many topologies are introduced rapidly using a bunch of switches and isolated dc sources, having a single-dc-source multilevel inverter is still a matter of controversy. In fact, each isolated dc source means a bulky transformer and a rectifier that have their own losses and costs forcing the industries to avoid entering in this topic conveniently. On the other hand, multilevel inverters topologies with single-dc-source require associated controllers to regulate the dc capacitors voltages in order to have multilevel voltage waveform at the output. Thus, a complex controller would not interest investors properly. Consequently, developing a single-dc-source multilevel inverter topology along with a light and reliable voltage control is still a challenging topic to replace the 2-level inverters in the market effectively. The first effort in this project was devoted to the PUC7 inverter to design a simple and yet efficient controller. A new modelling is performed on the PUC7 inverter and it has been simplified to first order system. Afterwards, a nonlinear cascaded controller is designed and applied to regulate the capacitor voltage at 1/3 of the DC source amplitude and to generate 7 identical voltage levels at the output supplying different type of loads such as RL or rectifier harmonic ones. In next work, the PUC5 topology is proposed as a remedy to the PUC7 that requires a complicated controller to operate properly. The capacitor voltage is regulated at half of dc source amplitude to generate 5 voltage levels at the output. Although the 7-level voltage waveform is replaced by a 5-level one in PUC5 topology, it is shown that the PUC5 needs a very simple and reliable voltage balancing technique due to having some redundant switching states. Moreover, a sensor-less voltage balancing technique is designed and implemented on the PUC5 inverter successfully to work in both stand-alone and gridconnected mode of operation. Eventually, a modified configuration of the PUC5 topology is presented to work as a buck PFC rectifier. The internal performance of the rectifier is like a buck converter to generate stepped down DC voltages at the two output terminals while the grid sees a boost converter externally. As well, a decoupled voltage/current controller is designed and applied to balance the output voltages identically and synchronize the input current with grid voltage to have a PFC operation acceptably. A power balance analysis is done to show the load variation range limit. All the theoretical and simulation studies are validated by experimental results completely.

A new version of Stochastic-parallel-gradient-descent algorithm (SPGD) for phase correction of a distorted orbital angular momentum (OAM) beam

NASA Astrophysics Data System (ADS)

Jiao Ling, LIn; Xiaoli, Yin; Huan, Chang; Xiaozhou, Cui; Yi-Lin, Guo; Huan-Yu, Liao; Chun-YU, Gao; Guohua, Wu; Guang-Yao, Liu; Jin-KUn, Jiang; Qing-Hua, Tian

2018-02-01

Atmospheric turbulence limits the performance of orbital angular momentum-based free-space optical communication (FSO-OAM) system. In order to compensate phase distortion induced by atmospheric turbulence, wavefront sensorless adaptive optics (WSAO) has been proposed and studied in recent years. In this paper a new version of SPGD called MZ-SPGD, which combines the Z-SPGD based on the deformable mirror influence function and the M-SPGD based on the Zernike polynomials, is proposed. Numerical simulations show that the hybrid method decreases convergence times markedly but can achieve the same compensated effect compared to Z-SPGD and M-SPGD.

Smart sensorless prediction diagnosis of electric drives

NASA Astrophysics Data System (ADS)

Kruglova, TN; Glebov, NA; Shoshiashvili, ME

2017-10-01

In this paper, the discuss diagnostic method and prediction of the technical condition of an electrical motor using artificial intelligent method, based on the combination of fuzzy logic and neural networks, are discussed. The fuzzy sub-model determines the degree of development of each fault. The neural network determines the state of the object as a whole and the number of serviceable work periods for motors actuator. The combination of advanced techniques reduces the learning time and increases the forecasting accuracy. The experimental implementation of the method for electric drive diagnosis and associated equipment is carried out at different speeds. As a result, it was found that this method allows troubleshooting the drive at any given speed.

Passive control of a biventricular assist device with compliant inflow cannulae.

PubMed

Gregory, Shaun David; Pearcy, Mark John; Timms, Daniel

2012-08-01

Rotary ventricular assist device (VAD) support of the cardiovascular system is susceptible to suction events due to the limited preload sensitivity of these devices. This may be of particular concern with rotary biventricular support (BiVAD) where the native, flow balancing Starling response is diminished in both ventricles. The reliability of sensor and sensorless-based control systems which aim to control VAD flow based on preload has limitations, and, thus, an alternative solution is desired. This study introduces a compliant inflow cannula (CIC) which could improve the preload sensitivity of a rotary VAD by passively altering VAD flow depending on preload. To evaluate the design, both the CIC and a standard rigid inflow cannula were inserted into a mock circulation loop to enable biventricular heart failure support using configurations of atrial and ventricular inflow, and arterial outflow cannulation. A range of left (LVAD) and right VAD (RVAD) rotational speeds were tested as well as step changes in systemic/pulmonary vascular resistance to alter relative preloads, with resulting flow rates recorded. Simulated suction events were observed, particularly at higher VAD speeds, during support with the rigid inflow cannula, while the CIC prevented suction events under all circumstances. The compliant section passively restricted its internal diameter as preload was reduced, which increased the VAD circuit resistance and thus reduced VAD flow. Therefore, a CIC could potentially be used as a passive control system to prevent suction events in rotary left, right, and biventricular support. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Integration of magnetic bearings in the design of advanced gas turbine engines

NASA Technical Reports Server (NTRS)

Storace, Albert F.; Sood, Devendra K.; Lyons, James P.; Preston, Mark A.

1994-01-01

Active magnetic bearings provide revolutionary advantages for gas turbine engine rotor support. These advantages include tremendously improved vibration and stability characteristics, reduced power loss, improved reliability, fault-tolerance, and greatly extended bearing service life. The marriage of these advantages with innovative structural network design and advanced materials utilization will permit major increases in thrust to weight performance and structural efficiency for future gas turbine engines. However, obtaining the maximum payoff requires two key ingredients. The first key ingredient is the use of modern magnetic bearing technologies such as innovative digital control techniques, high-density power electronics, high-density magnetic actuators, fault-tolerant system architecture, and electronic (sensorless) position estimation. This paper describes these technologies. The second key ingredient is to go beyond the simple replacement of rolling element bearings with magnetic bearings by incorporating magnetic bearings as an integral part of the overall engine design. This is analogous to the proper approach to designing with composites, whereby the designer tailors the geometry and load carrying function of the structural system or component for the composite instead of simply substituting composites in a design originally intended for metal material. This paper describes methodologies for the design integration of magnetic bearings in gas turbine engines.

Design, implementation, and application of 150-degree commutation VSI to improve speed range of sensored BLDC motor

NASA Astrophysics Data System (ADS)

Ozgenel, Mehmet Cihat

2017-09-01

Permanent magnet brushless dc (BLDC) motors are very convenient for many applications such as industrial, medical, robotic, aerospace, small electric vehicles, and home applications because of their inherent satisfying dynamic characteristics. There are numerous studies about these motors and their control schemes such as sensorless control and different speed and torque control schemes. All electric motors need commutation in order to produce speed and torque. Commutation in brushed DC motors is performed by means of a brush and collector. In BLDC motors, commutation is provided electronically in contrast to the brushed dc motors. In BLDC motors, motor phase windings are energized according to the information of the rotor position by inverter transistors. Rotor position information is used for commutation. Therefore, rotor position information is required to produce speed and torque for BLDC motors. The easiest and cheapest way to obtain rotor position information is to use Hall-effect or optical sensors. BLDC motor manufacturers generally produce BLDC motors equipped with three Hall-effect position sensors. Having three position sensors on BLDC motors provides six-step commutation which ensures two phase windings are energized in each moment. The third phase is empty. In this study, all phase windings are energized in the same time. This commutation method is twelve-step or 150 degrees commutation. So that more speed can be achieved from the same BLDC motor by comparison with six-step commutation. In this paper, both six-step and twelve-step commutation methods applied to the same BLDC motor and obtained experimental results from this study were presented, examined, and discussed.

Parameter estimation and actuator characteristics of hybrid magnetic bearings for axial flow blood pump applications.

PubMed

Lim, Tau Meng; Cheng, Shanbao; Chua, Leok Poh

2009-07-01

Axial flow blood pumps are generally smaller as compared to centrifugal pumps. This is very beneficial because they can provide better anatomical fit in the chest cavity, as well as lower the risk of infection. This article discusses the design, levitated responses, and parameter estimation of the dynamic characteristics of a compact hybrid magnetic bearing (HMB) system for axial flow blood pump applications. The rotor/impeller of the pump is driven by a three-phase permanent magnet brushless and sensorless motor. It is levitated by two HMBs at both ends in five degree of freedom with proportional-integral-derivative controllers, among which four radial directions are actively controlled and one axial direction is passively controlled. The frequency domain parameter estimation technique with statistical analysis is adopted to validate the stiffness and damping coefficients of the HMB system. A specially designed test rig facilitated the estimation of the bearing's coefficients in air-in both the radial and axial directions. Experimental estimation showed that the dynamic characteristics of the HMB system are dominated by the frequency-dependent stiffness coefficients. By injecting a multifrequency excitation force signal onto the rotor through the HMBs, it is noticed in the experimental results the maximum displacement linear operating range is 20% of the static eccentricity with respect to the rotor and stator gap clearance. The actuator gain was also successfully calibrated and may potentially extend the parameter estimation technique developed in the study of identification and monitoring of the pump's dynamic properties under normal operating conditions with fluid.

Design, implementation, and application of 150-degree commutation VSI to improve speed range of sensored BLDC motor.

PubMed

Ozgenel, Mehmet Cihat

2017-09-01

Permanent magnet brushless dc (BLDC) motors are very convenient for many applications such as industrial, medical, robotic, aerospace, small electric vehicles, and home applications because of their inherent satisfying dynamic characteristics. There are numerous studies about these motors and their control schemes such as sensorless control and different speed and torque control schemes. All electric motors need commutation in order to produce speed and torque. Commutation in brushed DC motors is performed by means of a brush and collector. In BLDC motors, commutation is provided electronically in contrast to the brushed dc motors. In BLDC motors, motor phase windings are energized according to the information of the rotor position by inverter transistors. Rotor position information is used for commutation. Therefore, rotor position information is required to produce speed and torque for BLDC motors. The easiest and cheapest way to obtain rotor position information is to use Hall-effect or optical sensors. BLDC motor manufacturers generally produce BLDC motors equipped with three Hall-effect position sensors. Having three position sensors on BLDC motors provides six-step commutation which ensures two phase windings are energized in each moment. The third phase is empty. In this study, all phase windings are energized in the same time. This commutation method is twelve-step or 150 degrees commutation. So that more speed can be achieved from the same BLDC motor by comparison with six-step commutation. In this paper, both six-step and twelve-step commutation methods applied to the same BLDC motor and obtained experimental results from this study were presented, examined, and discussed.

Haptograph Representation of Real-World Haptic Information by Wideband Force Control

NASA Astrophysics Data System (ADS)

Katsura, Seiichiro; Irie, Kouhei; Ohishi, Kiyoshi

Artificial acquisition and reproduction of human sensations are basic technologies of communication engineering. For example, auditory information is obtained by a microphone, and a speaker reproduces it by artificial means. Furthermore, a video camera and a television make it possible to transmit visual sensation by broadcasting. On the contrary, since tactile or haptic information is subject to the Newton's “law of action and reaction” in the real world, a device which acquires, transmits, and reproduces the information has not been established. From the point of view, real-world haptics is the key technology for future haptic communication engineering. This paper proposes a novel acquisition method of haptic information named “haptograph”. The haptograph visualizes the haptic information like photograph. The proposed haptograph is applied to haptic recognition of the contact environment. A linear motor contacts to the surface of the environment and its reaction force is used to make a haptograph. A robust contact motion and sensor-less sensing of the reaction force are attained by using a disturbance observer. As a result, an encyclopedia of contact environment is attained. Since temporal and spatial analyses are conducted to represent haptic information as the haptograph, it is possible to be recognized and to be evaluated intuitively.

Development of High Temperature Electro-Magnetic Actuators (HTEMA) for Aircraft Propulsion Systems (Preprint)

DTIC Science & Technology

2013-05-01

an 18 inch gap diameter has roughly a 2 foot outer diameter                                                              2 “ Brushless  Permanent...require PMs include wound rotor DC (brush and brushless ), Variable or Switched reluctance (VR or SR) machines and squirrel cage induction motors...Trades have identified Brushless DC PM and SR machines are of primary interest. Both motors can use sensorless commutation methods. A VR resolver can

Adaptive optics compensation of orbital angular momentum beams with a modified Gerchberg-Saxton-based phase retrieval algorithm

NASA Astrophysics Data System (ADS)

Chang, Huan; Yin, Xiao-li; Cui, Xiao-zhou; Zhang, Zhi-chao; Ma, Jian-xin; Wu, Guo-hua; Zhang, Li-jia; Xin, Xiang-jun

2017-12-01

Practical orbital angular momentum (OAM)-based free-space optical (FSO) communications commonly experience serious performance degradation and crosstalk due to atmospheric turbulence. In this paper, we propose a wave-front sensorless adaptive optics (WSAO) system with a modified Gerchberg-Saxton (GS)-based phase retrieval algorithm to correct distorted OAM beams. We use the spatial phase perturbation (SPP) GS algorithm with a distorted probe Gaussian beam as the only input. The principle and parameter selections of the algorithm are analyzed, and the performance of the algorithm is discussed. The simulation results show that the proposed adaptive optics (AO) system can significantly compensate for distorted OAM beams in single-channel or multiplexed OAM systems, which provides new insights into adaptive correction systems using OAM beams.

Brillouin micro-spectroscopy through aberrations via sensorless adaptive optics

NASA Astrophysics Data System (ADS)

Edrei, Eitan; Scarcelli, Giuliano

2018-04-01

Brillouin spectroscopy is a powerful optical technique for non-contact viscoelastic characterizations which has recently found applications in three-dimensional mapping of biological samples. Brillouin spectroscopy performances are rapidly degraded by optical aberrations and have therefore been limited to homogenous transparent samples. In this work, we developed an adaptive optics (AO) configuration designed for Brillouin scattering spectroscopy to engineer the incident wavefront and correct for aberrations. Our configuration does not require direct wavefront sensing and the injection of a "guide-star"; hence, it can be implemented without the need for sample pre-treatment. We used our AO-Brillouin spectrometer in aberrated phantoms and biological samples and obtained improved precision and resolution of Brillouin spectral analysis; we demonstrated 2.5-fold enhancement in Brillouin signal strength and 1.4-fold improvement in axial resolution because of the correction of optical aberrations.

Custom Unit Pump Design and Testing for the EVA PLSS

NASA Technical Reports Server (NTRS)

Schuller, Michael; Kurwitz, Cable; Goldman, Jeff; Morris, Kim; Trevino, Luis

2009-01-01

This paper describes the effort by the Texas Engineering Experiment Station (TEES) and Honeywell for NASA to design and test a pre-flight prototype pump for use in the Extra-vehicular activity (EVA) portable life support subsystem (PLSS). Major design decisions were driven by the need to reduce the pump s mass, power, and volume compared to the existing PLSS pump. In addition, the pump must accommodate a much wider range of abnormal conditions than the existing pump, including vapor/gas bubbles and increased pressure drop when employed to cool two suits simultaneously. A positive displacement, external gear type pump was selected because it offers the most compact and highest efficiency solution over the required range of flow rates and pressure drops. An additional benefit of selecting a gear pump design is that it is self priming and capable of ingesting non-condensable gas without becoming air locked. The chosen pump design consists of a 28 V DC, brushless, sealless, permanent magnet motor driven, external gear pump that utilizes a Honeywell development that eliminates the need for magnetic coupling. Although the planned flight unit will use a sensorless motor with custom designed controller, the pre-flight prototype to be provided for this project incorporates Hall effect sensors, allowing an interface with a readily available commercial motor controller. This design approach reduced the cost of this project and gives NASA more flexibility in future PLSS laboratory testing. The pump design was based on existing Honeywell designs, but incorporated features specifically for the PLSS application, including all of the key features of the flight pump. Testing at TEES verified that the pump meets the design requirements for range of flow rates, pressure drop, power consumption, working fluid temperature, operating time, gas ingestion , and restart capability under both ambient and vacuum conditions. The pump operated between 40 and 240 lbm/hr flowrate, 35 to 100 F pump temperature range, and 5 to 10 psid pressure rise. Power consumption of the pump controller at the nominal operating point in both ambient and vacuum conditions was 9.5 W, which was less than the 12 W predicted. Gas ingestion capabilities were tested by injecting 100 cc of air into the fluid line; the pump operated normally throughout this test. The test results contained a number of anomalies, specifically power increases and a few flow stoppages, that prompted TEES and Honeywell to disassemble and inspect the pump. Inspection indicated contamination in the pump and fit issues may have played roles in the observed anomalies. Testing following reassembly indicated that the performance of the pump 1) matched both the predicted performance values, 2) the performance values measured prior to disassembly, and 3) was free of the anomalies noted in the pre-disassembly testing.

Indirect rotor position sensing in real time for brushless permanent magnet motor drives

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

Ertugrul, N.; Acarnley, P.P.

1998-07-01

This paper describes a modern solution to real-time rotor position estimation of brushless permanent magnet (PM) motor drives. The position estimation scheme, based on flux linkage and line-current estimation, is implemented in real time by using the abc reference frame, and it is tested dynamically. The position estimation model of the test motor, development of hardware, and basic operation of the digital signal processor (DSP) are discussed. The overall position estimation strategy is accomplished with a fast DSP (TMS320C30). The method is a shaft position sensorless method that is applicable to a wide range of excitation types in brushless PMmore » motors without any restriction on the motor model and the current excitation. Both rectangular and sinewave-excited brushless PM motor drives are examined, and the results are given to demonstrate the effectiveness of the method with dynamic loads in closed estimated position loop.« less

A compliant, banded outflow cannula for decreased afterload sensitivity of rotary right ventricular assist devices.

PubMed

Gregory, Shaun D; Schummy, Emma; Pearcy, Mark; Pauls, Jo P; Tansley, Geoff; Fraser, John F; Timms, Daniel

2015-02-01

Biventricular support with dual rotary ventricular assist devices (VADs) has been implemented clinically with restriction of the right VAD (RVAD) outflow cannula to artificially increase afterload and, therefore, operate within recommended design speed ranges. However, the low preload and high afterload sensitivity of these devices increase the susceptibility of suction events. Active control systems are prone to sensor drift or inaccurate inferred (sensor-less) data, therefore an alternative solution may be of benefit. This study presents the in vitro evaluation of a compliant outflow cannula designed to passively decrease the afterload sensitivity of rotary RVADs and minimize left-sided suction events. A one-way fluid-structure interaction model was initially used to produce a design with suitable flow dynamics and radial deformation. The resultant geometry was cast with different initial cross-sectional restrictions and concentrations of a softening diluent before evaluation in a mock circulation loop. Pulmonary vascular resistance (PVR) was increased from 50 dyne s/cm(5) until left-sided suction events occurred with each compliant cannula and a rigid, 4.5 mm diameter outflow cannula for comparison. Early suction events (PVR ∼ 300 dyne s/cm(5) ) were observed with the rigid outflow cannula. Addition of the compliant section with an initial 3 mm diameter restriction and 10% diluent expanded the outflow restriction as PVR increased, thus increasing RVAD flow rate and preventing left-sided suction events at PVR levels beyond 1000 dyne s/cm(5) . Therefore, the compliant, restricted outflow cannula provided a passive control system to assist in the prevention of suction events with rotary biventricular support while maintaining pump speeds within normal ranges of operation. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The Sensorless Pore Module of Voltage-gated K+ Channel Family 7 Embodies the Target Site for the Anticonvulsant Retigabine.

PubMed

Syeda, Ruhma; Santos, Jose S; Montal, Mauricio

2016-02-05

KCNQ (voltage-gated K(+) channel family 7 (Kv7)) channels control cellular excitability and underlie the K(+) current sensitive to muscarinic receptor signaling (the M current) in sympathetic neurons. Here we show that the novel anti-epileptic drug retigabine (RTG) modulates channel function of pore-only modules (PMs) of the human Kv7.2 and Kv7.3 homomeric channels and of Kv7.2/3 heteromeric channels by prolonging the residence time in the open state. In addition, the Kv7 channel PMs are shown to recapitulate the single-channel permeation and pharmacological specificity characteristics of the corresponding full-length proteins in their native cellular context. A mutation (W265L) in the reconstituted Kv7.3 PM renders the channel insensitive to RTG and favors the conductive conformation of the PM, in agreement to what is observed when the Kv7.3 mutant is heterologously expressed. On the basis of the new findings and homology models of the closed and open conformations of the Kv7.3 PM, we propose a structural mechanism for the gating of the Kv7.3 PM and for the site of action of RTG as a Kv7.2/Kv7.3 K(+) current activator. The results validate the modular design of human Kv channels and highlight the PM as a high-fidelity target for drug screening of Kv channels. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

The Sensorless Pore Module of Voltage-gated K+ Channel Family 7 Embodies the Target Site for the Anticonvulsant Retigabine*

PubMed Central

Syeda, Ruhma; Santos, Jose S.; Montal, Mauricio

2016-01-01

KCNQ (voltage-gated K+ channel family 7 (Kv7)) channels control cellular excitability and underlie the K+ current sensitive to muscarinic receptor signaling (the M current) in sympathetic neurons. Here we show that the novel anti-epileptic drug retigabine (RTG) modulates channel function of pore-only modules (PMs) of the human Kv7.2 and Kv7.3 homomeric channels and of Kv7.2/3 heteromeric channels by prolonging the residence time in the open state. In addition, the Kv7 channel PMs are shown to recapitulate the single-channel permeation and pharmacological specificity characteristics of the corresponding full-length proteins in their native cellular context. A mutation (W265L) in the reconstituted Kv7.3 PM renders the channel insensitive to RTG and favors the conductive conformation of the PM, in agreement to what is observed when the Kv7.3 mutant is heterologously expressed. On the basis of the new findings and homology models of the closed and open conformations of the Kv7.3 PM, we propose a structural mechanism for the gating of the Kv7.3 PM and for the site of action of RTG as a Kv7.2/Kv7.3 K+ current activator. The results validate the modular design of human Kv channels and highlight the PM as a high-fidelity target for drug screening of Kv channels. PMID:26627826

500  Gb/s free-space optical transmission over strong atmospheric turbulence channels.

PubMed

Qu, Zhen; Djordjevic, Ivan B

2016-07-15

We experimentally demonstrate a high-spectral-efficiency, large-capacity, featured free-space-optical (FSO) transmission system by using low-density, parity-check (LDPC) coded quadrature phase shift keying (QPSK) combined with orbital angular momentum (OAM) multiplexing. The strong atmospheric turbulence channel is emulated by two spatial light modulators on which four randomly generated azimuthal phase patterns yielding the Andrews spectrum are recorded. The validity of such an approach is verified by reproducing the intensity distribution and irradiance correlation function (ICF) from the full-scale simulator. Excellent agreement of experimental, numerical, and analytical results is found. To reduce the phase distortion induced by the turbulence emulator, the inexpensive wavefront sensorless adaptive optics (AO) is used. To deal with remaining channel impairments, a large-girth LDPC code is used. To further improve the aggregate data rate, the OAM multiplexing is combined with WDM, and 500 Gb/s optical transmission over the strong atmospheric turbulence channels is demonstrated.

High speed wavefront sensorless aberration correction in digital micromirror based confocal microscopy.

PubMed

Pozzi, P; Wilding, D; Soloviev, O; Verstraete, H; Bliek, L; Vdovin, G; Verhaegen, M

2017-01-23

The quality of fluorescence microscopy images is often impaired by the presence of sample induced optical aberrations. Adaptive optical elements such as deformable mirrors or spatial light modulators can be used to correct aberrations. However, previously reported techniques either require special sample preparation, or time consuming optimization procedures for the correction of static aberrations. This paper reports a technique for optical sectioning fluorescence microscopy capable of correcting dynamic aberrations in any fluorescent sample during the acquisition. This is achieved by implementing adaptive optics in a non conventional confocal microscopy setup, with multiple programmable confocal apertures, in which out of focus light can be separately detected, and used to optimize the correction performance with a sampling frequency an order of magnitude faster than the imaging rate of the system. The paper reports results comparing the correction performances to traditional image optimization algorithms, and demonstrates how the system can compensate for dynamic changes in the aberrations, such as those introduced during a focal stack acquisition though a thick sample.

Model for Sucker-Rod Pumping Unit Operating Modes Analysis Based on SimMechanics Library

NASA Astrophysics Data System (ADS)

Zyuzev, A. M.; Bubnov, M. V.

2018-01-01

The article provides basic information about the process of a sucker-rod pumping unit (SRPU) model developing by means of SimMechanics library in the MATLAB Simulink environment. The model is designed for the development of a pump productivity optimal management algorithms, sensorless diagnostics of the plunger pump and pumpjack, acquisition of the dynamometer card and determination of a dynamic fluid level in the well, normalization of the faulty unit operation before troubleshooting is performed by staff as well as equilibrium ratio determining by energy indicators and outputting of manual balancing recommendations to achieve optimal power consumption efficiency. Particular attention is given to the application of various blocks from SimMechanics library to take into account the pumpjack construction principal characteristic and to obtain an adequate model. The article explains in depth the developed tools features for collecting and analysis of simulated mechanism data. The conclusions were drawn about practical implementation possibility of the SRPU modelling results and areas for further development of investigation.

Increasing the field of view of adaptive optics scanning laser ophthalmoscopy.

PubMed

Laslandes, Marie; Salas, Matthias; Hitzenberger, Christoph K; Pircher, Michael

2017-11-01

An adaptive optics scanning laser ophthalmoscope (AO-SLO) set-up with two deformable mirrors (DM) is presented. It allows high resolution imaging of the retina on a 4°×4° field of view (FoV), considering a 7 mm pupil diameter at the entrance of the eye. Imaging on such a FoV, which is larger compared to classical AO-SLO instruments, is allowed by the use of the two DMs. The first DM is located in a plane that is conjugated to the pupil of the eye and corrects for aberrations that are constant in the FoV. The second DM is conjugated to a plane that is located ∼0.7 mm anterior to the retina. This DM corrects for anisoplanatism effects within the FoV. The control of the DMs is performed by combining the classical AO technique, using a Shack-Hartmann wave-front sensor, and sensorless AO, which uses a criterion characterizing the image quality. The retinas of four healthy volunteers were imaged in-vivo with the developed instrument. In order to assess the performance of the set-up and to demonstrate the benefits of the 2 DM configuration, the acquired images were compared with images taken in conventional conditions, on a smaller FoV and with only one DM. Moreover, an image of a larger patch of the retina was obtained by stitching of 9 images acquired with a 4°×4° FoV, resulting in a total FoV of 10°×10°. Finally, different retinal layers were imaged by shifting the focal plane.

Linear dependence between the wavefront gradient and the masked intensity for the point source with a CCD sensor

NASA Astrophysics Data System (ADS)

Yang, Huizhen; Ma, Liang; Wang, Bin

2018-01-01

In contrast to the conventional adaptive optics (AO) system, the wavefront sensorless (WFSless) AO system doesn't need a WFS to measure the wavefront aberrations. It is simpler than the conventional AO in system architecture and can be applied to the complex conditions. The model-based WFSless system has a great potential in real-time correction applications because of its fast convergence. The control algorithm of the model-based WFSless system is based on an important theory result that is the linear relation between the Mean-Square Gradient (MSG) magnitude of the wavefront aberration and the second moment of the masked intensity distribution in the focal plane (also called as Masked Detector Signal-MDS). The linear dependence between MSG and MDS for the point source imaging with a CCD sensor will be discussed from theory and simulation in this paper. The theory relationship between MSG and MDS is given based on our previous work. To verify the linear relation for the point source, we set up an imaging model under atmospheric turbulence. Additionally, the value of MDS will be deviate from that of theory because of the noise of detector and further the deviation will affect the correction effect. The theory results under noise will be obtained through theoretical derivation and then the linear relation between MDS and MDS under noise will be discussed through the imaging model. Results show the linear relation between MDS and MDS under noise is also maintained well, which provides a theoretical support to applications of the model-based WFSless system.

High Technology Centrifugal Compressor for Commercial Air Conditioning Systems

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

Ruckes, John

2006-04-15

R&D Dynamics, Bloomfield, CT in partnership with the State of Connecticut has been developing a high technology, oil-free, energy-efficient centrifugal compressor called CENVA for commercial air conditioning systems under a program funded by the US Department of Energy. The CENVA compressor applies the foil bearing technology used in all modern aircraft, civil and military, air conditioning systems. The CENVA compressor will enhance the efficiency of water and air cooled chillers, packaged roof top units, and other air conditioning systems by providing an 18% reduction in energy consumption in the unit capacity range of 25 to 350 tons of refrigeration Themore » technical approach for CENVA involved the design and development of a high-speed, oil-free foil gas bearing-supported two-stage centrifugal compressor, CENVA encompassed the following high technologies, which are not currently utilized in commercial air conditioning systems: Foil gas bearings operating in HFC-134a; Efficient centrifugal impellers and diffusers; High speed motors and drives; and System integration of above technologies. Extensive design, development and testing efforts were carried out. Significant accomplishments achieved under this program are: (1) A total of 26 builds and over 200 tests were successfully completed with successively improved designs; (2) Use of foil gas bearings in refrigerant R134a was successfully proven; (3) A high speed, high power permanent magnet motor was developed; (4) An encoder was used for signal feedback between motor and controller. Due to temperature limitations of the encoder, the compressor could not operate at higher speed and in turn at higher pressure. In order to alleviate this problem a unique sensorless controller was developed; (5) This controller has successfully been tested as stand alone; however, it has not yet been integrated and tested as a system; (6) The compressor successfully operated at water cooled condensing temperatures Due to temperature limitations of the encoder, it could not be operated at air cooled condensing temperatures. (7) The two-stage impellers/diffusers worked well separately but combined did not match well.« less

Improved artificial bee colony algorithm for wavefront sensor-less system in free space optical communication

NASA Astrophysics Data System (ADS)

Niu, Chaojun; Han, Xiang'e.

2015-10-01

Adaptive optics (AO) technology is an effective way to alleviate the effect of turbulence on free space optical communication (FSO). A new adaptive compensation method can be used without a wave-front sensor. Artificial bee colony algorithm (ABC) is a population-based heuristic evolutionary algorithm inspired by the intelligent foraging behaviour of the honeybee swarm with the advantage of simple, good convergence rate, robust and less parameter setting. In this paper, we simulate the application of the improved ABC to correct the distorted wavefront and proved its effectiveness. Then we simulate the application of ABC algorithm, differential evolution (DE) algorithm and stochastic parallel gradient descent (SPGD) algorithm to the FSO system and analyze the wavefront correction capabilities by comparison of the coupling efficiency, the error rate and the intensity fluctuation in different turbulence before and after the correction. The results show that the ABC algorithm has much faster correction speed than DE algorithm and better correct ability for strong turbulence than SPGD algorithm. Intensity fluctuation can be effectively reduced in strong turbulence, but not so effective in week turbulence.

Cost Estimation and Control for Flight Systems

NASA Technical Reports Server (NTRS)

Hammond, Walter E.; Vanhook, Michael E. (Technical Monitor)

2002-01-01

Good program management practices, cost analysis, cost estimation, and cost control for aerospace flight systems are interrelated and depend upon each other. The best cost control process cannot overcome poor design or poor systems trades that lead to the wrong approach. The project needs robust Technical, Schedule, Cost, Risk, and Cost Risk practices before it can incorporate adequate Cost Control. Cost analysis both precedes and follows cost estimation -- the two are closely coupled with each other and with Risk analysis. Parametric cost estimating relationships and computerized models are most often used. NASA has learned some valuable lessons in controlling cost problems, and recommends use of a summary Project Manager's checklist as shown here.

Control Strategy Tool (CoST)

EPA Pesticide Factsheets

The EPA Control Strategy Tool (CoST) is a software tool for projecting potential future control scenarios, their effects on emissions and estimated costs. This tool uses the NEI and the Control Measures Dataset as key inputs. CoST outputs are projections of future control scenarios.

COSTS OF URBAN STORMWATER CONTROL

EPA Science Inventory

This report presents information on the cost of stormwater pollution control facilities in urban areas, including collection, control, and treatment systems. Information on prior cost studies of control technologies and cost estimating models used in these studies was collected,...

COSTS OF URBAN STORMWATER CONTROL

EPA Science Inventory

This paper presents information on the cost of stormwater pollution control facilities in urban areas, including collection, control, and treatment systems. Information on prior cost studies of control technologies and cost estimating models used in these studies was collected, r...

Non-woody weed control in pine plantations

Treesearch

Phillip M. Dougherty; Bob Lowery

1986-01-01

The cost and benefits derived from controlling non-woody competitors in pine planations were reviewed. Cost considerations included both the capital cost and biological cost that may be incurred when weed control treatments are applied. Several methods for reducing the cost of herbicide treatments were explored. Cost reduction considerations included adjustments in...

Research on cost control and management in high voltage transmission line construction

NASA Astrophysics Data System (ADS)

Xu, Xiaobin

2017-05-01

Enterprises. The cost control is of vital importance to the construction enterprises. It is the key to the profitability of the transmission line project, which is related to the survival and development of the electric power construction enterprises. Due to the long construction line, complex and changeable construction terrain as well as large construction costs of transmission line, it is difficult for us to take accurate and effective cost control on the project implementation of entire transmission line. Therefore, the cost control of transmission line project is a complicated and arduous task. It is of great theoretical and practical significance to study the cost control scheme of transmission line project by a more scientific and efficient way. Based on the characteristics of the construction project of the transmission line project, this paper analyzes the construction cost structure of the transmission line project and the current cost control problem of the transmission line project, and demonstrates the necessity and feasibility of studying the cost control scheme of the transmission line project more accurately. In this way, the dynamic cycle cost control process including plan, implementation, feedback, correction, modification and re-implement is achieved to realize the accurate and effective cost control of entire electric power transmission line project.

Unhealthy health care costs.

PubMed

Shelton, J K; Janosi, J M

1992-02-01

The private sector has implemented many cost containment measures in efforts to control rising health care costs. However, these measures have not controlled costs in the long run, and can be expected not to succeed as long as business cannot control factors within the health care system which affect costs. Controlling private sector health care costs requires constraints on cost shifting which necessitates a unified financing system with expenditure limits. A unified financing system will involve a partnership between the public and private sectors.

EPA Air Pollution Control Cost Manual

EPA Science Inventory

EPA's Air Pollution Control Cost Manual provides guidance for the development of accurate and consistent costs for air pollution control devices. A long-standing document prepared by EPA, the Control Cost Manual focuses on point source and stationary area source air pollution con...

The Need for Full Cost Control in Universities and Colleges Capital Expenditure Programmes.

ERIC Educational Resources Information Center

Aitchison, Ian A.

Cost control techniques as applied to university and college capital expenditure programs are discussed, as is the need for control of costs as an integral part of the design and construction of campus projects. The following phases of the cost control process are presented: pre-design advice and cost studies, preparation of the budget for the…

The economics of malaria control and elimination: a systematic review.

PubMed

Shretta, Rima; Avanceña, Anton L V; Hatefi, Arian

2016-12-12

Declining donor funding and competing health priorities threaten the sustainability of malaria programmes. Elucidating the cost and benefits of continued investments in malaria could encourage sustained political and financial commitments. The evidence, although available, remains disparate. This paper reviews the existing literature on the economic and financial cost and return of malaria control, elimination and eradication. A review of articles that were published on or before September 2014 on the cost and benefits of malaria control and elimination was performed. Studies were classified based on their scope and were analysed according to two major categories: cost of malaria control and elimination to a health system, and cost-benefit studies. Only studies involving more than two control or elimination interventions were included. Outcomes of interest were total programmatic cost, cost per capita, and benefit-cost ratios (BCRs). All costs were converted to 2013 US$ for standardization. Of the 6425 articles identified, 54 studies were included in this review. Twenty-two were focused on elimination or eradication while 32 focused on intensive control. Forty-eight per cent of studies included in this review were published on or after 2000. Overall, the annual per capita cost of malaria control to a health system ranged from $0.11 to $39.06 (median: $2.21) while that for malaria elimination ranged from $0.18 to $27 (median: $3.00). BCRs of investing in malaria control and elimination ranged from 2.4 to over 145. Overall, investments needed for malaria control and elimination varied greatly amongst the various countries and contexts. In most cases, the cost of elimination was greater than the cost of control. At the same time, the benefits of investing in malaria greatly outweighed the costs. While the cost of elimination in most cases was greater than the cost of control, the benefits greatly outweighed the cost. Information from this review provides guidance to national malaria programmes on the cost and benefits of malaria elimination in the absence of data. Importantly, the review highlights the need for more robust economic analyses using standard inputs and methods to strengthen the evidence needed for sustained financing for malaria elimination.

Contributions a l'etude et a l'application industrielle de la machine asynchrone

NASA Astrophysics Data System (ADS)

Ouhrouche, Mohand-Ameziane

The work presented in this thesis, done in the Electrical Drives Laboratory of Electrical and Computer Engineering Department, deals with the industrial applications of a three-phase induction machine (electrical drives and electricity generation). This thesis, characterized by its multidisciplinary content, has two major parts. The first one deals with the on-line and off-line parametric identification of the induction machine model necessary to achieve accurate vector control strategy. The second part, which is a resume of a research work sponsored by Hydro-Quebec, deals with the application of an induction machine in Asynchronous Non Utility Generators units (ANUG). As it is shown in the following, major scientific contributions are made in both two parts. In the first part of our research work, we propose a new speed sensorless vector control strategy for an induction machine, which is adaptive to the rotor resistance variations. The proposed control strategy is based on the Extended Kalman Filter approach and a decoupling controller which takes into account the rotor resistance variations. The consideration of coupled electrical and mechanical modes leads to a fifth order nonlinear model of the induction machine. The load torque is taken as a function of the rotor angular speed. The Extended Kalman Filter, based on the process's nonlinear (bilinear) model, estimate simultaneously the rotor resistance, angular speed and the flux vector from the startup to the steady state equilibrium point. The machine-converter-control system is implemented in MATLAB/SIMULINK environment and the obtained results confirm the robustness of the proposed scheme. As in the electrical drives erea, the induction machine is now widely used by small to medium power Non Utility Generator units (NUG) to produce electricity. In Quebec, these NUGs units are integrated into the Hydro-Quebec 25 kV distribution system via transformer which exhibit nonlinear characteristics. We have shown by using the ElectroMagnetic Program (EMTP) that, in some islanding scenarios, i.e. that the NUG unit is disconnected from the power grid, in addition to frequency variations, appearence of high an abnormal overvoltages, ferroresonance should occur. As a consequence, normal protective devices could fail to securely operate, which could cause serious damages to the equipment and the maintenance staff. This result, established for the first time , can be useful to improve the reliability of the NUGs units and is considered important by the power engineering community. This has led to a publication in the John Wiley & Sons Encyclopedia of Electrical and Electronics Engineering which will be available in February 1999 ( http://www.engr.wisc.edu/ ece/ece).

COSTS OF BEST MANAGEMENT PRACTICES AND ASSOCIATED LAND FOR URBAN STORMWATER CONTROL

EPA Science Inventory

The purpose of this paper is to present information on the cost of stormwater pollution control facilities in urban areas, including collection, control, and treatment systems. Information on prior cost studies of control technologies and cost estimating models used in these stu...

Incremental costs associated with physician and pharmacist collaboration to improve blood pressure control.

PubMed

Kulchaitanaroaj, Puttarin; Brooks, John M; Ardery, Gail; Newman, Dana; Carter, Barry L

2012-08-01

To compare costs associated with a physician-pharmacist collaborative intervention with costs of usual care. Cost analysis using health care utilization and outcome data from two prospective, cluster-randomized, controlled clinical trials. Eleven community-based medical offices. A total of 496 patients with hypertension; 244 were in the usual care (control) group and 252 were in the intervention group. To compare the costs, we combined cost data from the two trials. Total costs included costs of provider time, laboratory tests, and antihypertensive drugs. Provider time was calculated based on an online survey of intervention pharmacists and the National Ambulatory Medical Care Survey. Cost parameters were taken from the Bureau of Labor Statistics for average wage rates, the Medicare laboratory fee schedule, and a publicly available Web site for drug prices. Total costs were adjusted for patient characteristics. Adjusted total costs were $774.90 in the intervention group and $445.75 in the control group (difference $329.16, p<0.001). In a sensitivity analysis, the difference in adjusted total costs between the two groups ranged from $224.27-515.56. The intervention cost required to have one additional patient achieve blood pressure control within 6 months was $1338.05, determined by the difference in costs divided by the difference in hypertension control rates between the groups ($329.16/24.6%). The cost over 6 months to lower systolic and diastolic blood pressure 1 mm Hg was $36.25 and $94.32, respectively. The physician-pharmacist collaborative intervention increased not only blood pressure control but also the cost of care. Additional research, such as a cost-benefit or a cost-minimization analysis, is needed to assess whether financial savings related to reduced morbidity and mortality achieved from better blood pressure control outweigh the cost of the intervention. © 2012 Pharmacotherapy Publications, Inc. All rights reserved.

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation.

PubMed

Baly, Alberto; Toledo, Maria Eugenia; Lambert, Isora; Benítez, Elizabeth; Rodriguez, Karina; Rodriguez, Esther; Vanlerberghe, Veerle; Stuyft, Patrick Van der

2016-01-01

Information regarding the cost of implementing insecticide-treated curtains (ITCs) is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h). Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Cost analysis of options for management of African Animal Trypanosomiasis using interventions targeted at cattle in Tororo District; south-eastern Uganda.

PubMed

Muhanguzi, Dennis; Okello, Walter O; Kabasa, John D; Waiswa, Charles; Welburn, Susan C; Shaw, Alexandra P M

2015-07-22

Tsetse-transmitted African trypanosomes cause both nagana (African animal Trypanosomiasis-AAT) and sleeping sickness (human African Trypanosomiasis - HAT) across Sub-Saharan Africa. Vector control and chemotherapy are the contemporary methods of tsetse and trypanosomiasis control in this region. In most African countries, including Uganda, veterinary services have been decentralised and privatised. As a result, livestock keepers meet the costs of most of these services. To be sustainable, AAT control programs need to tailor tsetse control to the inelastic budgets of resource-poor small scale farmers. To guide the process of tsetse and AAT control toolkit selection, that now, more than ever before, needs to optimise resources, the costs of different tsetse and trypanosomiasis control options need to be determined. A detailed costing of the restricted application protocol (RAP) for African trypanosomiasis control in Tororo District was undertaken between June 2012 and December 2013. A full cost calculation approach was used; including all overheads, delivery costs, depreciation and netting out transfer payments to calculate the economic (societal) cost of the intervention. Calculations were undertaken in Microsoft Excel without incorporating probabilistic elements. The cost of delivering RAP to the project was US$ 6.89 per animal per year while that of 4 doses of a curative trypanocide per animal per year was US$ 5.69. However, effective tsetse control does not require the application of RAP to all animals. Protecting cattle from trypanosome infections by spraying 25%, 50% or 75% of all cattle in a village costs US$ 1.72, 3.45 and 5.17 per animal per year respectively. Alternatively, a year of a single dose of curative or prophylactic trypanocide treatment plus 50% RAP would cost US$ 4.87 and US$ 5.23 per animal per year. Pyrethroid insecticides and trypanocides cost 22.4 and 39.1% of the cost of RAP and chemotherapy respectively. Cost analyses of low cost tsetse control options should include full delivery costs since they constitute 77.6% of all project costs. The relatively low cost of RAP for AAT control and its collateral impact on tick control make it an attractive option for livestock management by smallholder livestock keepers.

Laboratory cost control and financial management software.

PubMed

Mayer, M

1998-02-09

Economical constraints within the health care system advocate the introduction of tighter control of costs in clinical laboratories. Detailed cost information forms the basis for cost control and financial management. Based on the cost information, proper decisions regarding priorities, procedure choices, personnel policies and investments can be made. This presentation outlines some principles of cost analysis, describes common limitations of cost analysis, and exemplifies use of software to achieve optimized cost control. One commercially available cost analysis software, LabCost, is described in some detail. In addition to provision of cost information, LabCost also serves as a general management tool for resource handling, accounting, inventory management and billing. The application of LabCost in the selection process of a new high throughput analyzer for a large clinical chemistry service is taken as an example for decisions that can be assisted by cost evaluation. It is concluded that laboratory management that wisely utilizes cost analysis to support the decision-making process will undoubtedly have a clear advantage over those laboratories that fail to employ cost considerations to guide their actions.

Modeling of Control Costs, Emissions, and Control Retrofits for Cost Effectiveness and Feasibility Analyses

EPA Pesticide Factsheets

Learn about EPA’s use of the Integrated Planning Model (IPM) to develop estimates of SO2 and NOx emission control costs, projections of futureemissions, and projections of capacity of future control retrofits, assuming controls on EGUs.

Impact and cost-effectiveness of a comprehensive Schistosomiasis japonica control program in the Poyang Lake region of China.

PubMed

Yu, Qing; Zhao, Geng-Ming; Hong, Xian-Lin; Lutz, Eric A; Guo, Jia-Gang

2013-11-28

Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003-2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%-544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%-1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence.

Impact and Cost-Effectiveness of a Comprehensive Schistosomiasis japonica Control Program in the Poyang Lake Region of China

PubMed Central

Yu, Qing; Zhao, Geng-Ming; Hong, Xian-Lin; Lutz, Eric A.; Guo, Jia-Gang

2013-01-01

Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003–2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%–544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%–1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence. PMID:24287861

Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41)

PubMed Central

Gray, Alastair; Raikou, Maria; McGuire, Alistair; Fenn, Paul; Stevens, Richard; Cull, Carole; Stratton, Irene; Adler, Amanda; Holman, Rury; Turner, Robert

2000-01-01

Objective To estimate the cost effectiveness of conventional versus intensive blood glucose control in patients with type 2 diabetes. Design Incremental cost effectiveness analysis alongside randomised controlled trial. Setting 23 UK hospital clinic based study centres. Participants 3867 patients with newly diagnosed type 2 diabetes (mean age 53 years). Interventions Conventional (primarily diet) glucose control policy versus intensive control policy with a sulphonylurea or insulin. Main outcome measures Incremental cost per event-free year gained within the trial period. Results Intensive glucose control increased trial treatment costs by £695 (95% confidence interval £555 to £836) per patient but reduced the cost of complications by £957 (£233 to £1681) compared with conventional management. If standard practice visit patterns were assumed rather than trial conditions, the incremental cost of intensive management was £478 (−£275 to £1232) per patient. The within trial event-free time gained in the intensive group was 0.60 (0.12 to 1.10) years and the lifetime gain 1.14 (0.69 to 1.61) years. The incremental cost per event-free year gained was £1166 (costs and effects discounted at 6% a year) and £563 (costs discounted at 6% a year and effects not discounted). Conclusions Intensive blood glucose control in patients with type 2 diabetes significantly increased treatment costs but substantially reduced the cost of complications and increased the time free of complications. PMID:10818026

A 20 Year Lifecycle Study for Launch Facilities at the Kennedy Space Center

NASA Technical Reports Server (NTRS)

Kolody, Mark R.; Li. Wenyan; Hintze, Paul E.; Calle, Luz-Marina

2009-01-01

The lifecycle cost analysis was based on corrosion costs for the Kennedy Space Center's Launch Complexes and Mobile Launch Platforms. The first step in the study involved identifying the relevant assets that would be included. Secondly, the identification and collection of the corrosion control cost data for the selected assets was completed. Corrosion control costs were separated into four categories. The sources of cost included the NASA labor for civil servant personnel directly involved in overseeing and managing corrosion control of the assets, United Space Alliance (USA) contractual requirements for performing planned corrosion control tasks, USA performance of unplanned corrosion control tasks, and Testing and Development. Corrosion control operations performed under USA contractual requirements were the most significant contributors to the total cost of corrosion. The operations include the inspection of the pad, routine maintenance of the pad, medium and large scale blasting and repainting activities, and the repair and replacement of structural metal elements. Cost data was collected from the years between 2001 and 2007. These costs were then extrapolated to future years to calculate the 20 year lifecycle costs.

Matters of Cost: Part I. Jones Learns about Balance Sheets: Part II. A Look at Budgetary Control: Part III. The Supervisor's "Do-It-Yourself" Series 3.

ERIC Educational Resources Information Center

Smith, J. E.; And Others

This guide, which is intended for new supervisors and managers to use in an independent study setting, deals with costing, balance sheets, and budgetary control. The first section, "Matters of Cost" by J. E. and J. F. Smith, deals with the following topics: profits and productivity, principles of costing, cost control and cost reduction, fixed and…

Cooperative Solutions in Multi-Person Quadratic Decision Problems: Finite-Horizon and State-Feedback Cost-Cumulant Control Paradigm

DTIC Science & Technology

2007-01-01

CONTRACT NUMBER Problems: Finite -Horizon and State-Feedback Cost-Cumulant Control Paradigm (PREPRINT) 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER...cooperative cost-cumulant control regime for the class of multi-person single-objective decision problems characterized by quadratic random costs and... finite -horizon integral quadratic cost associated with a linear stochastic system . Since this problem formation is parameterized by the number of cost

The B-747 flight control system maintenance and reliability data base for cost effectiveness tradeoff studies

NASA Technical Reports Server (NTRS)

1982-01-01

Primary and automatic flight controls are combined for a total flight control reliability and maintenance cost data base using information from two previous reports and additional cost data gathered from a major airline. A comparison of the current B-747 flight control system effects on reliability and operating cost with that of a B-747 designed for an active control wing load alleviation system is provided.

Concepts for Life Cycle Cost Control Required to Achieve Space Transportation Affordability and Sustainability

NASA Technical Reports Server (NTRS)

Rhodes, Russel E.; Zapata, Edgar; Levack, Daniel J. H.; Robinson, John W.; Donahue, Benjamin B.

2009-01-01

Cost control must be implemented through the establishment of requirements and controlled continually by managing to these requirements. Cost control of the non-recurring side of life cycle cost has traditionally been implemented in both commercial and government programs. The government uses the budget process to implement this control. The commercial approach is to use a similar process of allocating the non-recurring cost to major elements of the program. This type of control generally manages through a work breakdown structure (WBS) by defining the major elements of the program. If the cost control is to be applied across the entire program life cycle cost (LCC), the approach must be addressed very differently. A functional breakdown structure (FBS) is defined and recommended. Use of a FBS provides the visibifity to allow the choice of an integrated solution reducing the cost of providing many different elements of like function. The different functional solutions that drive the hardware logistics, quantity of documentation, operational labor, reliability and maintainability balance, and total integration of the entire system from DDT&E through the life of the program must be fully defined, compared, and final decisions made among these competing solutions. The major drivers of recurring cost have been identified and are presented and discussed. The LCC requirements must be established and flowed down to provide control of LCC. This LCC control will require a structured rigid process similar to the one traditionally used to control weight/performance for space transportation systems throughout the entire program. It has been demonstrated over the last 30 years that without a firm requirement and methodically structured cost control, it is unlikely that affordable and sustainable space transportation system LCC will be achieved.

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.

An economic evaluation of vector control in the age of a dengue vaccine.

PubMed

Fitzpatrick, Christopher; Haines, Alexander; Bangert, Mathieu; Farlow, Andrew; Hemingway, Janet; Velayudhan, Raman

2017-08-01

Dengue is a rapidly emerging vector-borne Neglected Tropical Disease, with a 30-fold increase in the number of cases reported since 1960. The economic cost of the illness is measured in the billions of dollars annually. Environmental change and unplanned urbanization are conspiring to raise the health and economic cost even further beyond the reach of health systems and households. The health-sector response has depended in large part on control of the Aedes aegypti and Ae. albopictus (mosquito) vectors. The cost-effectiveness of the first-ever dengue vaccine remains to be evaluated in the field. In this paper, we examine how it might affect the cost-effectiveness of sustained vector control. We employ a dynamic Markov model of the effects of vector control on dengue in both vectors and humans over a 15-year period, in six countries: Brazil, Columbia, Malaysia, Mexico, the Philippines, and Thailand. We evaluate the cost (direct medical costs and control programme costs) and cost-effectiveness of sustained vector control, outbreak response and/or medical case management, in the presence of a (hypothetical) highly targeted and low cost immunization strategy using a (non-hypothetical) medium-efficacy vaccine. Sustained vector control using existing technologies would cost little more than outbreak response, given the associated costs of medical case management. If sustained use of existing or upcoming technologies (of similar price) reduce vector populations by 70-90%, the cost per disability-adjusted life year averted is 2013 US$ 679-1331 (best estimates) relative to no intervention. Sustained vector control could be highly cost-effective even with less effective technologies (50-70% reduction in vector populations) and in the presence of a highly targeted and low cost immunization strategy using a medium-efficacy vaccine. Economic evaluation of the first-ever dengue vaccine is ongoing. However, even under very optimistic assumptions about a highly targeted and low cost immunization strategy, our results suggest that sustained vector control will continue to play an important role in mitigating the impact of environmental change and urbanization on human health. If additional benefits for the control of other Aedes borne diseases, such as Chikungunya, yellow fever and Zika fever are taken into account, the investment case is even stronger. High-burden endemic countries should proceed to map populations to be covered by sustained vector control.

An economic evaluation of vector control in the age of a dengue vaccine

PubMed Central

Haines, Alexander; Bangert, Mathieu; Farlow, Andrew; Hemingway, Janet; Velayudhan, Raman

2017-01-01

Introduction Dengue is a rapidly emerging vector-borne Neglected Tropical Disease, with a 30-fold increase in the number of cases reported since 1960. The economic cost of the illness is measured in the billions of dollars annually. Environmental change and unplanned urbanization are conspiring to raise the health and economic cost even further beyond the reach of health systems and households. The health-sector response has depended in large part on control of the Aedes aegypti and Ae. albopictus (mosquito) vectors. The cost-effectiveness of the first-ever dengue vaccine remains to be evaluated in the field. In this paper, we examine how it might affect the cost-effectiveness of sustained vector control. Methods We employ a dynamic Markov model of the effects of vector control on dengue in both vectors and humans over a 15-year period, in six countries: Brazil, Columbia, Malaysia, Mexico, the Philippines, and Thailand. We evaluate the cost (direct medical costs and control programme costs) and cost-effectiveness of sustained vector control, outbreak response and/or medical case management, in the presence of a (hypothetical) highly targeted and low cost immunization strategy using a (non-hypothetical) medium-efficacy vaccine. Results Sustained vector control using existing technologies would cost little more than outbreak response, given the associated costs of medical case management. If sustained use of existing or upcoming technologies (of similar price) reduce vector populations by 70–90%, the cost per disability-adjusted life year averted is 2013 US$ 679–1331 (best estimates) relative to no intervention. Sustained vector control could be highly cost-effective even with less effective technologies (50–70% reduction in vector populations) and in the presence of a highly targeted and low cost immunization strategy using a medium-efficacy vaccine. Discussion Economic evaluation of the first-ever dengue vaccine is ongoing. However, even under very optimistic assumptions about a highly targeted and low cost immunization strategy, our results suggest that sustained vector control will continue to play an important role in mitigating the impact of environmental change and urbanization on human health. If additional benefits for the control of other Aedes borne diseases, such as Chikungunya, yellow fever and Zika fever are taken into account, the investment case is even stronger. High-burden endemic countries should proceed to map populations to be covered by sustained vector control. PMID:28806786

[Cost-effectiveness and cost-benefit analysis on the integrated schistosomiasis control strategies with emphasis on infection source in Poyang Lake region].

PubMed

Lin, Dan-Dan; Zeng, Xiao-Jun; Chen, Hong-Gen; Hong, Xian-Lin; Tao, Bo; Li, Yi-Feng; Xiong, Ji-Jie; Zhou, Xiao-Nong

2009-08-01

To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. The integrated control strategy focusing on infection source control brings about triplex benefits in schistosomiasis control, social development (and ecological protection) and economic efficacy, and shows better effects and benefits than the conventional control strategy.

Strain actuated aeroelastic control

NASA Technical Reports Server (NTRS)

Lazarus, Kenneth B.

1992-01-01

Viewgraphs on strain actuated aeroelastic control are presented. Topics covered include: structural and aerodynamic modeling; control law design methodology; system block diagram; adaptive wing test article; bench-top experiments; bench-top disturbance rejection: open and closed loop response; bench-top disturbance rejection: state cost versus control cost; wind tunnel experiments; wind tunnel gust alleviation: open and closed loop response at 60 mph; wind tunnel gust alleviation: state cost versus control cost at 60 mph; wind tunnel command following: open and closed loop error at 60 mph; wind tunnel flutter suppression: open loop flutter speed; and wind tunnel flutter suppression: closed loop state cost curves.

Humans, 'things' and space: costing hospital infection control interventions.

PubMed

Page, K; Graves, N; Halton, K; Barnett, A G

2013-07-01

Previous attempts at costing infection control programmes have tended to focus on accounting costs rather than economic costs. For studies using economic costs, estimates tend to be quite crude and probably underestimate the true cost. One of the largest costs of any intervention is staff time, but this cost is difficult to quantify and has been largely ignored in previous attempts. To design and evaluate the costs of hospital-based infection control interventions or programmes. This article also discusses several issues to consider when costing interventions, and suggests strategies for overcoming these issues. Previous literature and techniques in both health economics and psychology are reviewed and synthesized. This article provides a set of generic, transferable costing guidelines. Key principles such as definition of study scope and focus on large costs, as well as pitfalls (e.g. overconfidence and uncertainty), are discussed. These new guidelines can be used by hospital staff and other researchers to cost their infection control programmes and interventions more accurately. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Lymphatic filariasis and onchocerciasis prevention, treatment, and control costs across diverse settings: a systematic review.

PubMed

Keating, Joseph; Yukich, Joshua O; Mollenkopf, Sarah; Tediosi, Fabrizio

2014-07-01

The control and eventual elimination of neglected tropical disease (NTD) requires the expansion of interventions such as mass drug administration (MDA), vector control, diagnostic testing, and effective treatment. The purpose of this paper is to present the evidence base for decision-makers on the cost and cost-effectiveness of lymphatic filariasis (LF) and onchocerciasis prevention, treatment, and control. A systematic review of the published literature was conducted. All studies that contained primary or secondary data on costs or cost-effectiveness of prevention and control were considered. A total of 52 papers were included for LF and 24 papers were included for onchocerciasis. Large research gaps exist on the synergies and cost of integrating NTD prevention and control programs, as well as research on the role of health information systems, human resource systems, service delivery, and essential medicines and technology for elimination. The literature available on costs and cost-effectiveness of interventions is also generally older, extremely focal geographically and of limited usefulness for developing estimates of the global economic burden of these diseases and prioritizing among various intervention options. Up to date information on the costs and cost-effectiveness of interventions for LF and onchocerciasis prevention are needed given the vastly expanded funding base for the control and elimination of these diseases. Copyright © 2014 Elsevier B.V. All rights reserved.

Economics of infection control surveillance technology: cost-effective or just cost?

PubMed

Furuno, Jon P; Schweizer, Marin L; McGregor, Jessina C; Perencevich, Eli N

2008-04-01

Previous studies have suggested that informatics tools, such as automated alert and decision support systems, may increase the efficiency and quality of infection control surveillance. However, little is known about the cost-effectiveness of these tools. We focus on 2 types of economic analyses that have utility in assessing infection control interventions (cost-effectiveness analysis and business-case analysis) and review the available literature on the economics of computerized infection control surveillance systems. Previous studies on the effectiveness of computerized infection control surveillance have been limited to assessments of whether these tools increase the sensitivity and specificity of surveillance over traditional methods. Furthermore, we identified only 2 studies that assessed the costs associated with computerized infection control surveillance. Thus, it remains unknown whether computerized infection control surveillance systems are cost-effective and whether use of these systems improves patient outcomes. The existing data are insufficient to allow for a summary conclusion on the cost-effectiveness of infection control surveillance technology. All future studies of computerized infection control surveillance systems should aim to collect outcomes and economic data to inform decision making and assist hospitals with completing business-cases analyses.

Development of weight and cost estimates for lifting surfaces with active controls

NASA Technical Reports Server (NTRS)

Anderson, R. D.; Flora, C. C.; Nelson, R. M.; Raymond, E. T.; Vincent, J. H.

1976-01-01

Equations and methodology were developed for estimating the weight and cost incrementals due to active controls added to the wing and horizontal tail of a subsonic transport airplane. The methods are sufficiently generalized to be suitable for preliminary design. Supporting methodology and input specifications for the weight and cost equations are provided. The weight and cost equations are structured to be flexible in terms of the active control technology (ACT) flight control system specification. In order to present a self-contained package, methodology is also presented for generating ACT flight control system characteristics for the weight and cost equations. Use of the methodology is illustrated.

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction.

PubMed

Fast, Shannon M; González, Marta C; Markuzon, Natasha

2015-01-01

Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response. The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy.

Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction

PubMed Central

Fast, Shannon M.; González, Marta C.; Markuzon, Natasha

2015-01-01

Background Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence. Methodology The spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response. Conclusions The model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy. PMID:26288274

Excess costs from functional somatic syndromes in Germany - An analysis using entropy balancing.

PubMed

Grupp, Helen; Kaufmann, Claudia; König, Hans-Helmut; Bleibler, Florian; Wild, Beate; Szecsenyi, Joachim; Herzog, Wolfgang; Schellberg, Dieter; Schäfert, Rainer; Konnopka, Alexander

2017-06-01

The aim of this study was to calculate disorder-specific excess costs in patients with functional somatic syndromes (FSS). We compared 6-month direct and indirect costs in a patient group with FSS (n=273) to a control group of the general adult population in Germany without FSS (n=2914). Data on the patient group were collected between 2007 and 2009 in a randomized controlled trial (speciAL). Data on the control group were obtained from a telephone survey, representative for the general German population, conducted in 2014. Covariate balance between the patient group and the control group was achieved using entropy balancing. Excess costs were calculated by estimating generalized linear models and two-part models for direct costs and indirect costs. Further, we estimated excess costs according to the level of somatic symptom severity (SSS). FSS patients differed significantly from the control group regarding 6-month costs of outpatient physicians (+€280) and other outpatient providers (+€74). According to SSS, significantly higher outpatient physician costs were found for mild (+€151), moderate (+€306) and severe (+€376) SSS. We also found significantly higher costs of other outpatient providers in patients with mild, moderate and severe SSS. Regarding costs of rehabilitation and hospital treatments, FSS patients did not differ significantly from the control group for any level of SSS. Indirect costs were significantly higher in patients with severe SSS (+€760). FSS were of major importance in the outpatient sector. Further, we found significantly higher indirect costs in patients with severe SSS. Copyright © 2017 Elsevier Inc. All rights reserved.

Playing Hardball with Facilities Expenses.

ERIC Educational Resources Information Center

Fickes, Michael

1997-01-01

Describes one school district manager's tactics for successfully controlling district costs and increasing capital improvements while only marginally increasing the facilities maintenance budget. Highlights guidelines for controlling personnel requirements and cost-reduction methods. Discusses specific cost-control measures involving telephone…

The cost of absenteeism and short-term disability associated with colorectal cancer: a case-control study.

PubMed

Yaldo, Avin; Seal, Brian S; Lage, Maureen J

2014-08-01

Examine the incremental impact of absenteeism and short-term disability associated with colorectal cancer (CRC). Absenteeism and short-term disability data were used for a case-control analysis of a healthy cohort (controls) compared with CRC patients (cases). Cases were matched to controls on the basis of age, sex, and region of residence. Multivariate regression models examined the costs of absenteeism and short-term disability, controlling for patient characteristics, prior medical costs, and patient general health. Compared with controls, CRC patients experience significantly higher short-term disability costs (mean, $45,716 vs $7367 [P < 0.0001]; median, $35,827 vs $7365 [P < 0.0001]), as well as significantly higher absenteeism costs (mean, $8841 vs $4596 [P < 0.0001]; median, $9971 vs $4795 [P < 0.0001]) in the 1 year after diagnosis of CRC. Colorectal cancer is associated with significant work-related productivity loss costs in the first year after diagnosis.

Active Control of the Forced and Transient Response of a Finite Beam. M.S. Thesis

NASA Technical Reports Server (NTRS)

Post, John Theodore

1989-01-01

When studying structural vibrations resulting from a concentrated source, many structures may be modelled as a finite beam excited by a point source. The theoretical limit on cancelling the resulting beam vibrations by utilizing another point source as an active controller is explored. Three different types of excitation are considered, harmonic, random, and transient. In each case, a cost function is defined and minimized for numerous parameter variations. For the case of harmonic excitation, the cost function is obtained by integrating the mean squared displacement over a region of the beam in which control is desired. A controller is then found to minimize this cost function in the control interval. The control interval and controller location are continuously varied for several frequencies of excitation. The results show that control over the entire beam length is possible only when the excitation frequency is near a resonant frequency of the beam, but control over a subregion may be obtained even between resonant frequencies at the cost of increasing the vibration outside of the control region. For random excitation, the cost function is realized by integrating the expected value of the displacement squared over the interval of the beam in which control is desired. This is shown to yield the identical cost function as obtained by integrating the cost function for harmonic excitation over all excitation frequencies. As a result, it is always possible to reduce the cost function for random excitation whether controlling the entire beam or just a subregion, without ever increasing the vibration outside the region in which control is desired. The last type of excitation considered is a single, transient pulse. A cost function representative of the beam vibration is obtained by integrating the transient displacement squared over a region of the beam and over all time. The form of the controller is chosen a priori as either one or two delayed pulses. Delays constrain the controller to be causal. The best possible control is then examined while varying the region of control and the controller location. It is found that control is always possible using either one or two control pulses. The two pulse controller gives better performance than a single pulse controller, but finding the optimal delay time for the additional controllers increases as the square of the number of control pulses.

Costs of dengue prevention and incremental cost of dengue outbreak control in Guantanamo, Cuba.

PubMed

Baly, Alberto; Toledo, Maria E; Rodriguez, Karina; Benitez, Juan R; Rodriguez, Maritza; Boelaert, Marleen; Vanlerberghe, Veerle; Van der Stuyft, Patrick

2012-01-01

To assess the economic cost of routine Aedes aegypti control in an at-risk environment without dengue endemicity and the incremental costs incurred during a sporadic outbreak. The study was conducted in 2006 in the city of Guantanamo, Cuba. We took a societal perspective to calculate costs in months without dengue transmission (January-July) and during an outbreak (August-December). Data sources were bookkeeping records, direct observations and interviews. The total economic cost per inhabitant (p.i.) per month. (p.m.) increased from 2.76 USD in months without dengue transmission to 6.05 USD during an outbreak. In months without transmission, the routine Aedes control programme cost 1.67 USD p.i. p.m. Incremental costs during the outbreak were mainly incurred by the population and the primary/secondary level of the healthcare system, hardly by the vector control programme (1.64, 1.44 and 0.21 UDS increment p.i. p.m., respectively). The total cost for managing a hospitalized suspected dengue case was 296.60 USD (62.0% direct medical, 9.0% direct non-medical and 29.0% indirect costs). In both periods, the main cost drivers for the Aedes control programme, the healthcare system and the community were the value of personnel and volunteer time or productivity losses. Intensive efforts to keep A. aegypti infestation low entail important economic costs for society. When a dengue outbreak does occur eventually, costs increase sharply. In-depth studies should assess which mix of activities and actors could maximize the effectiveness and cost-effectiveness of routine Aedes control and dengue prevention. © 2011 Blackwell Publishing Ltd.

Incremental healthcare resource utilization and costs in US patients with Cushing's disease compared with diabetes mellitus and population controls.

PubMed

Broder, Michael S; Neary, Maureen P; Chang, Eunice; Ludlam, William H

2015-12-01

Resource utilization and costs in Cushing's disease (CD) patients have not been studied extensively. We compared CD patients with diabetes mellitus (DM) patients and population-based controls to characterize differences in utilization and costs. Using 2008-2012 MarketScan® database, we identified three patient groups: (1) CD patients; (2) DM patients; and (3) population-based control patients without CD. DM and control patients were matched to CD patients by age, gender, region, and review year in a 2:1 ratio. Outcomes included annual healthcare resource utilization and costs. There were 1852 CD patients, 3704 DM patients and 3704 controls. Mean age was 42.9 years; 78.2 % were female. CD patients were hospitalized more frequently (19.3 %) than DM patients (11.0 %, p < .001) or controls (5.6 %, p < .001). CD patients visited the ED more frequently (25.4 %) than DM patients (21.1 %, p < .001) or controls (14.3 %, p < .001). CD patients had more office visits than DM patients (19.1 vs. 10.7, p < .001) or controls (7.1, p < .001). CD patients on average filled more prescriptions than DM patients (51.7 vs. 42.7, p < .001) or controls (20.5, p < .001). Mean total healthcare costs for CD patients were $26,269 versus $12,282 for DM patients (p < .001) and $5869 for controls (p < .001). CD patients had significantly higher annual rates of healthcare resource utilization compared to matched DM patients and population controls without CD. CD patient costs were double DM costs and quadruple control costs. This study puts into context the additional burdens of CD over DM, a common, chronic endocrine condition affecting multiple organ systems, and population controls.

Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

PubMed

Ellis, Charles; Hardy, Rose Y; Lindrooth, Richard C

2017-05-15

To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs. Hospital fixed effects were included to yield within-hospital estimates of disparities. GLM models demonstrated that Blacks with aphasia experienced 1.9days longer lengths of stay compared to Whites with aphasia after controlling for demographic characteristics, 1.4days controlling for stroke/illness severity, 1.2days controlling for observed hospital characteristics, and ~1 extra day controlling for unobserved hospital characteristics. Similarly, Blacks accrued ~$2047 greater total costs compared to Whites after controlling for demographic characteristics, $1659 controlling for stroke/illness severity, $1338 controlling for observed hospital characteristics, and ~$1311 greater total costs after controlling for unobserved hospital characteristics. In the acute hospital setting, Blacks with aphasia utilize greater hospital services during longer hospitalizations and at substantially higher costs in the state of NC. A substantial portion of the adjusted difference was related to the hospital treating the patient. However, even after controlling for the hospital, the differences remained clinically and statistically significant. Copyright © 2017 Elsevier B.V. All rights reserved.

Association of good glycemic control and cost of diabetes care: Experience from a tertiary care hospital in Bangladesh.

PubMed

Afroz, Afsana; Chowdhury, Hasina Akhter; Shahjahan, Md; Hafez, Md Abdul; Hassan, Md Nazmul; Ali, Liaquat

2016-10-01

The present study was undertaken to assess the cost-effectiveness of good glycemic control in a population of Bangladeshi people with type 2 diabetes mellitus (T2DM). A cross-sectional study was conducted among 496 registered patients with >1year duration of diabetes. Glycated hemoglobin A1c level <7% was judged as the cut-off value for good glycemic control. All treatment-related records from the last year were collected from patients' guide books and all cost components were calculated. Among patients, 31% had good glycemic control. The average annual cost was US$ 314 per patient. Patients with poor glycemic control were significantly more likely to have complications [(p=0.049) OR 1.5] and comorbidities [(p=0.02) OR 1.5]. The annual cost increased rapidly with complications/comorbidities. In multivariable logistic regression analysis, gender (p=0.003) and cost of care (p=0.006) were significantly associated with glycemic control, and the presence of any comorbidities/complications was associated with 1.8-fold higher odds of poor glycemic control (p=0.013 95% CI: 1.131-2.786). Good glycemic control can lead to substantial cost saving through prevention and control of complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Economic evaluation of infection control activities.

PubMed

Seko, T; Tachi, T; Kawashima, N; Maeda, T; Yasuda, M; Noguchi, Y; Teramachi, H

2017-08-01

Healthcare-associated infections by drug-resistant bacteria affect a patient's prognosis. Infection control activities at medical institutions in Japan are increasingly focused on the threat from these bacteria. To undertake a full cost analysis that included the costs of consumables and labour required for infection control activities. The cost of infection control activities undertaken by the infection control team (ICT) at Nishimino Kosei Hospital in Japan was surveyed from January 2013 to December 2015. The evaluation index of infection control activities used the meticillin-resistant Staphylococcus aureus detection rate. The cost:effectiveness ratio (CER) of each intervention was calculated. Consumables and labour costs increased over time, as did the ratio of labour cost to total cost over time. However, the CER of interventions was found to have decreased, from ¥164,177 in 2014 to ¥57,989 in 2015. There were increases not only in the amount of consumables, but also in ICT time, suggesting the possibility of improvements in the economic efficiency of infection control. Increasing the amount of consumables and the time input of the ICT could help improve the economic efficiency of infection control. Our research suggests the possibility for improvements in the economic efficiency of infection control. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

A retrospective cost-analysis of additional homeopathic treatment in Germany: Long-term economic outcomes

PubMed Central

Ostermann, Julia K.; Witt, Claudia M.; Reinhold, Thomas

2017-01-01

Objectives This study aimed to provide a long-term cost comparison of patients using additional homeopathic treatment (homeopathy group) with patients using usual care (control group) over an observation period of 33 months. Methods Health claims data from a large statutory health insurance company were analysed from both the societal perspective (primary outcome) and from the statutory health insurance perspective (secondary outcome). To compare costs between patient groups, homeopathy and control patients were matched in a 1:1 ratio using propensity scores. Predictor variables for the propensity scores included health care costs and both medical and demographic variables. Health care costs were analysed using an analysis of covariance, adjusted for baseline costs, between groups both across diagnoses and for specific diagnoses over a period of 33 months. Specific diagnoses included depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache. Results Data from 21,939 patients in the homeopathy group (67.4% females) and 21,861 patients in the control group (67.2% females) were analysed. Health care costs over the 33 months were 12,414 EUR [95% CI 12,022–12,805] in the homeopathy group and 10,428 EUR [95% CI 10,036–10,820] in the control group (p<0.0001). The largest cost differences were attributed to productivity losses (homeopathy: EUR 6,289 [6,118–6,460]; control: EUR 5,498 [5,326–5,670], p<0.0001) and outpatient costs (homeopathy: EUR 1,794 [1,770–1,818]; control: EUR 1,438 [1,414–1,462], p<0.0001). Although the costs of the two groups converged over time, cost differences remained over the full 33 months. For all diagnoses, homeopathy patients generated higher costs than control patients. Conclusion The analysis showed that even when following-up over 33 months, there were still cost differences between groups, with higher costs in the homeopathy group. PMID:28915242

[Prospective economic evaluation of image-guided radiation therapy for prostate cancer in the framework of the national programme for innovative and costly therapies assessment].

PubMed

Pommier, P; Morelle, M; Perrier, L; de Crevoisier, R; Laplanche, A; Dudouet, P; Mahé, M-A; Chauvet, B; Nguyen, T-D; Créhange, G; Zawadi, A; Chapet, O; Latorzeff, I; Bossi, A; Beckendorf, V; Touboul, E; Muracciole, X; Bachaud, J-M; Supiot, S; Lagrange, J-L

2012-09-01

The main objective of the economical study was to prospectively and randomly assess the additional costs of daily versus weekly patient positioning quality control in image-guided radiotherapy (IGRT), taking into account the modalities of the 3D-imaging: tomography (CBCT) or gold seeds implants. A secondary objective was to prospectively assess the additional costs of 3D versus 2D imaging with portal imaging for patient positioning controls. Economics data are issued from a multicenter randomized medico-economics trial comparing the two frequencies of patient positioning control during prostate IGRT. A prospective cohort with patient positioning control with PI (control group) was constituted for the cost comparison between 3D (IGRT) versus 2D imaging. The economical evaluation was focused to the radiotherapy direct costs, adopting the hospital's point of view and using a microcosting method applied to the parameters that may lead to cost differences between evaluated strategies. The economical analysis included a total of 241 patients enrolled between 2007 and 2011 in seven centres, 183 in the randomized study (128 with CBCT and 55 with fiducial markers) and 58 in the control group. Compared to weekly controls, the average additional cost per patient of daily controls was €847 (CBCT) and €179 (markers). Compared to PI, the average additional cost per patient was €1392 (CBCT) and €997 (fiducial markers) for daily controls; €545 (CBCT) and €818 (markers) in case of weekly controls. A daily frequency for image control in IGRT and 3D images patient positioning control (IGRT) for prostate cancer lead to significant additional cost compared to weekly control and 2D imaging (PI). Long-term clinical assessment will permit to assess the medico-economical ratio of these innovative radiotherapy modalities. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Stochastic optimal control as non-equilibrium statistical mechanics: calculus of variations over density and current

NASA Astrophysics Data System (ADS)

Chernyak, Vladimir Y.; Chertkov, Michael; Bierkens, Joris; Kappen, Hilbert J.

2014-01-01

In stochastic optimal control (SOC) one minimizes the average cost-to-go, that consists of the cost-of-control (amount of efforts), cost-of-space (where one wants the system to be) and the target cost (where one wants the system to arrive), for a system participating in forced and controlled Langevin dynamics. We extend the SOC problem by introducing an additional cost-of-dynamics, characterized by a vector potential. We propose derivation of the generalized gauge-invariant Hamilton-Jacobi-Bellman equation as a variation over density and current, suggest hydrodynamic interpretation and discuss examples, e.g., ergodic control of a particle-within-a-circle, illustrating non-equilibrium space-time complexity.

Costs and Cost-Effectiveness of Plasmodium vivax Control.

PubMed

White, Michael T; Yeung, Shunmay; Patouillard, Edith; Cibulskis, Richard

2016-12-28

The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review the existing published evidence on the costs and cost-effectiveness of interventions for controlling P. vivax, identifying nine studies focused on diagnosis and treatment and seven studies focused on vector control. Although many of the results from the much more extensive P. falciparum literature can be applied to P. vivax, it is not always possible to extrapolate results from P. falciparum-specific cost-effectiveness analyses. Notably, there is a need for additional studies to evaluate the potential cost-effectiveness of radical cure with primaquine for the prevention of P. vivax relapses with glucose-6-phosphate dehydrogenase testing. © The American Society of Tropical Medicine and Hygiene.

Costs and Cost-Effectiveness of Plasmodium vivax Control

PubMed Central

White, Michael T.; Yeung, Shunmay; Patouillard, Edith; Cibulskis, Richard

2016-01-01

The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax. The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review the existing published evidence on the costs and cost-effectiveness of interventions for controlling P. vivax, identifying nine studies focused on diagnosis and treatment and seven studies focused on vector control. Although many of the results from the much more extensive P. falciparum literature can be applied to P. vivax, it is not always possible to extrapolate results from P. falciparum–specific cost-effectiveness analyses. Notably, there is a need for additional studies to evaluate the potential cost-effectiveness of radical cure with primaquine for the prevention of P. vivax relapses with glucose-6-phosphate dehydrogenase testing. PMID:28025283

Costs analysis of a population level rabies control programme in Tamil Nadu, India.

PubMed

Abbas, Syed Shahid; Kakkar, Manish; Rogawski, Elizabeth Tacket

2014-02-01

The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million) and $2.2 million (Rs 119 million), respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million), $23 million (Rs 1,230 million) and $ 11 million (Rs 590 million), respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme.

Costs Analysis of a Population Level Rabies Control Programme in Tamil Nadu, India

PubMed Central

Abbas, Syed Shahid; Kakkar, Manish; Rogawski, Elizabeth Tacket

2014-01-01

The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million) and $2.2 million (Rs 119 million), respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million), $23 million (Rs 1,230 million) and $ 11 million (Rs 590 million), respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme. PMID:24587471

Active management of labor

PubMed Central

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

2000-01-01

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

Marginal abatement cost curve for nitrogen oxides incorporating controls, renewable electricity, energy efficiency, and fuel switching.

PubMed

Loughlin, Daniel H; Macpherson, Alexander J; Kaufman, Katherine R; Keaveny, Brian N

2017-10-01

A marginal abatement cost curve (MACC) traces out the relationship between the quantity of pollution abated and the marginal cost of abating each additional unit. In the context of air quality management, MACCs are typically developed by sorting control technologies by their relative cost-effectiveness. Other potentially important abatement measures such as renewable electricity, energy efficiency, and fuel switching (RE/EE/FS) are often not incorporated into MACCs, as it is difficult to quantify their costs and abatement potential. In this paper, a U.S. energy system model is used to develop a MACC for nitrogen oxides (NO x ) that incorporates both traditional controls and these additional measures. The MACC is decomposed by sector, and the relative cost-effectiveness of RE/EE/FS and traditional controls are compared. RE/EE/FS are shown to have the potential to increase emission reductions beyond what is possible when applying traditional controls alone. Furthermore, a portion of RE/EE/FS appear to be cost-competitive with traditional controls. Renewable electricity, energy efficiency, and fuel switching can be cost-competitive with traditional air pollutant controls for abating air pollutant emissions. The application of renewable electricity, energy efficiency, and fuel switching is also shown to have the potential to increase emission reductions beyond what is possible when applying traditional controls alone.

Integrating spread dynamics and economics of timber production to manage Chinese tallow invasions in southern U.S. forestlands.

PubMed

Wang, Hsiao-Hsuan; Grant, William E; Gan, Jianbang; Rogers, William E; Swannack, Todd M; Koralewski, Tomasz E; Miller, James H; Taylor, John W

2012-01-01

Economic costs associated with the invasion of nonnative species are of global concern. We estimated expected costs of Chinese tallow (Triadica sebifera (L.) Small) invasions related to timber production in southern U.S. forestlands under different management strategies. Expected costs were confined to the value of timber production losses plus costs for search and control. We simulated management strategies including (1) no control (NC), and control beginning as soon as the percentage of invaded forest land exceeded (2) 60 (Low Control), (3) 25 (Medium Control), or (4) 0 (High Control) using a spatially-explicit, stochastic, bioeconomic model. With NC, simulated invasions spread northward and westward into Arkansas and along the Gulf of Mexico to occupy ≈1.2 million hectares within 20 years, with associated expected total costs increasing exponentially to ≈$300 million. With LC, MC, and HC, invaded areas reached ≈275, 34, and 2 thousand hectares after 20 years, respectively, with associated expected costs reaching ≈$400, $230, and $200 million. Complete eradication would not be cost-effective; the minimum expected total cost was achieved when control began as soon as the percentage of invaded land exceeded 5%. These results suggest the importance of early detection and control of Chinese tallow, and emphasize the importance of integrating spread dynamics and economics to manage invasive species.

Integrating Spread Dynamics and Economics of Timber Production to Manage Chinese Tallow Invasions in Southern U.S. Forestlands

PubMed Central

Wang, Hsiao-Hsuan; Grant, William E.; Gan, Jianbang; Rogers, William E.; Swannack, Todd M.; Koralewski, Tomasz E.; Miller, James H.; Taylor, John W.

2012-01-01

Economic costs associated with the invasion of nonnative species are of global concern. We estimated expected costs of Chinese tallow (Triadica sebifera (L.) Small) invasions related to timber production in southern U.S. forestlands under different management strategies. Expected costs were confined to the value of timber production losses plus costs for search and control. We simulated management strategies including (1) no control (NC), and control beginning as soon as the percentage of invaded forest land exceeded (2) 60 (Low Control), (3) 25 (Medium Control), or (4) 0 (High Control) using a spatially-explicit, stochastic, bioeconomic model. With NC, simulated invasions spread northward and westward into Arkansas and along the Gulf of Mexico to occupy ≈1.2 million hectares within 20 years, with associated expected total costs increasing exponentially to ≈$300 million. With LC, MC, and HC, invaded areas reached ≈275, 34, and 2 thousand hectares after 20 years, respectively, with associated expected costs reaching ≈$400, $230, and $200 million. Complete eradication would not be cost-effective; the minimum expected total cost was achieved when control began as soon as the percentage of invaded land exceeded 5%. These results suggest the importance of early detection and control of Chinese tallow, and emphasize the importance of integrating spread dynamics and economics to manage invasive species. PMID:22442731

Cost-effectiveness and cost-utility of beclomethasone/formoterol versus fluticasone propionate/salmeterol in patients with moderate to severe asthma.

PubMed

Gerzeli, Simone; Rognoni, Carla; Quaglini, Silvana; Cavallo, Maria Caterina; Cremonesi, Giovanni; Papi, Alberto

2012-04-01

Asthma is a chronic disease characterized by acute symptomatic episodes with variable severity and duration. Pharmacological asthma management aims to achieve and maintain control without side effects, thus improving quality of life and reducing the economic impact. Recently, a clinical trial showed the non-inferiority of beclomethasone/formoterol (BDP/F) versus fluticasone propionate/salmeterol (FP/S) in adults with moderate to severe persistent asthma. However, this study did not provide evidence on costs and did not quantify quality-of-life parameters. The objective of the present study was to assess the cost effectiveness and cost utility of BDP/F versus FP/S in patients with moderate to severe asthma from the perspective of the Italian National Health Service (NHS). A Markov model (MM) was used, with five health states for the different levels of asthma control: successful control, sub-optimal control, outpatient-managed exacerbation, inpatient-managed exacerbation, and death. Model data were derived from the ICAT SE study and from expert panels. Three outcomes were considered: time spent in successful control state, costs and quality-adjusted life-years (QALYs). The model shows that BDP/F treatment led to a slight increase of weeks in successful control compared with FP/S, with a lower cost. The probabilistic sensitivity analysis highlights that in 64% and 68% of the Monte Carlo simulations, BDP/F outperformed FP/S in terms of weeks in successful control and QALYs. Considering the expected cost of the two strategies, in 90% of simulations BDP/F was the least expensive choice. In particular, BDP/F was cost saving as compared with FP/S in about 63% and 59% of simulations as shown by the cost-utility and cost-effectiveness analysis, respectively. Overall, from the Italian NHS perspective, BDP/F treatment is associated with a reduction in cost and offers a slight increase of effectiveness in terms of weeks spent in successful control and QALYs. © 2012 Adis Data Information BV. All rights reserved.

PRELIMINARY COST ESTIMATES OF POLLUTION CONTROL TECHNOLOGIES FOR GEOTHERMAL DEVELOPMENTS

EPA Science Inventory

This report provides preliminary cost estimates of air and water pollution control technologies for geothermal energy conversion facilities. Costs for solid waste disposal are also estimated. The technologies examined include those for control of hydrogen sulfide emissions and fo...

Cost-effectiveness of a nurse practitioner-family physician model of care in a nursing home: controlled before and after study.

PubMed

Lacny, Sarah; Zarrabi, Mahmood; Martin-Misener, Ruth; Donald, Faith; Sketris, Ingrid; Murphy, Andrea L; DiCenso, Alba; Marshall, Deborah A

2016-09-01

To examine the cost-effectiveness of a nurse practitioner-family physician model of care compared with family physician-only care in a Canadian nursing home. As demand for long-term care increases, alternative care models including nurse practitioners are being explored. Cost-effectiveness analysis using a controlled before-after design. The study included an 18-month 'before' period (2005-2006) and a 21-month 'after' time period (2007-2009). Data were abstracted from charts from 2008-2010. We calculated incremental cost-effectiveness ratios comparing the intervention (nurse practitioner-family physician model; n = 45) to internal (n = 65), external (n = 70) and combined internal/external family physician-only control groups, measured as the change in healthcare costs divided by the change in emergency department transfers/person-month. We assessed joint uncertainty around costs and effects using non-parametric bootstrapping and cost-effectiveness acceptability curves. Point estimates of the incremental cost-effectiveness ratio demonstrated the nurse practitioner-family physician model dominated the internal and combined control groups (i.e. was associated with smaller increases in costs and emergency department transfers/person-month). Compared with the external control, the intervention resulted in a smaller increase in costs and larger increase in emergency department transfers. Using a willingness-to-pay threshold of $1000 CAD/emergency department transfer, the probability the intervention was cost-effective compared with the internal, external and combined control groups was 26%, 21% and 25%. Due to uncertainty around the distribution of costs and effects, we were unable to make a definitive conclusion regarding the cost-effectiveness of the nurse practitioner-family physician model; however, these results suggest benefits that could be confirmed in a larger study. © 2016 John Wiley & Sons Ltd.

Microminiature rotary Stirling cryocooler for compact, lightweight, and low-power thermal imaging systems

NASA Astrophysics Data System (ADS)

Filis, Avishai; Bar Haim, Zvi; Pundak, Nachman; Broyde, Ramon

2009-05-01

Novel compact and low power consuming cooled infrared thermal imagers as used in gyro-stabilized payloads of miniature unmanned aerial vehicles, Thermal small arms sights and tactical night vision goggles often rely on integral rotary micro-miniature closed cycle Stirling cryogenic engines. Development of EPI Antimonides technology and optimization of MCT technology allowed decreasing in order of magnitudes the level of dark current in infrared detectors thus enabling an increase in the optimal focal plane temperature in excess of 95K while keeping the same radiometric performances as achieved at 77K using regular technologies. Maintaining focal plane temperature in the range of 95K to 110K instead of 77K improves the efficiency of Stirling thermodynamic cycle thus enlarging cooling power and enabling the development of a mini micro cooler similar to RICOR's K562S model which is three times smaller, lighter and more compact than a standard tactical cryocooler like RICOR's K508 model. This cooler also features a new type of ball bearings and internal components which were optimized to fit tight bulk constraints and maintain the required life span, while keeping a low level of vibration and noise signature. Further, the functions of management the brushless DC motor and temperature stabilization are delivered by the newly developed high performance sensorless digital controller. By reducing Dewar Detector thermal losses and increasing the focal plane temperature, longer life time operation is expected as was proved with RICOR's K508 model. Resulting from this development, the RICOR K562S model cryogenic engine consumes 1.2 - 3.0 WDC while operating in the closed loop mode and maintaining the typical focal plane arrays at 200-100K. This makes it compatible with very compact battery packages allowing further reduction of the overall thermal imager weight thus making it comparable with the compatible uncooled infrared thermal imager relying on a microbolometer detector in terms of power consumption and bulk.

System overview of the fully implantable destination therapy--ReinHeart-total artificial heart.

PubMed

Pelletier, Benedikt; Spiliopoulos, Sotirios; Finocchiaro, Thomas; Graef, Felix; Kuipers, Kristin; Laumen, Marco; Guersoy, Dilek; Steinseifer, Ulrich; Koerfer, Reiner; Tenderich, Gero

2015-01-01

Owing to the lack of suitable allografts, the demand for long-term mechanical circulatory support in patients with biventricular end-stage heart failure is rising. Currently available Total Artificial Heart (TAH) systems consist of pump units with only limited durability, percutaneous tubes and bulky external equipment that limit the quality of life. Therefore we are focusing on the development of a fully implantable, highly durable destination therapy total artificial heart. The ReinHeart-TAH system consists of a passively filling pump unit driven by a low-wear linear drive between two artificial ventricles, an implantable control unit and a compliance chamber. The TAH is powered by a transcutaneous energy transmission system. The flow distribution inside the ventricles was analysed by fluid structure interaction simulation and particle image velocimetry measurements. Along with durability tests, the hydrodynamic performance and flow balance capability were evaluated in a mock circulation loop. Animal trials are ongoing. Based on fluid structure interaction simulation and particle image velocimetry, blood stagnation areas have been significantly reduced. In the mock circulation loop the ReinHeart-TAH generated a cardiac output of 5 l/min at an operating frequency of 120 bpm and an aortic pressure of 120/80 mmHg. The highly effective preload sensitivity of the passively filling ventricles allowed the sensorless integration of the Frank Starling mechanism. The ReinHeart-TAH effectively replaced the native heart's function in animals for up to 2 days. In vitro and in vivo testing showed a safe and effective function of the ReinHeart-TAH system. This has the potential to become an alternative to transplantation. However, before a first-in-man implant, chronic animal trials still have to be completed. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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

PubMed

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

2018-04-24

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

A cost-analysis of complex workplace nutrition education and environmental dietary modification interventions.

PubMed

Fitzgerald, Sarah; Kirby, Ann; Murphy, Aileen; Geaney, Fiona; Perry, Ivan J

2017-01-09

The workplace has been identified as a priority setting to positively influence individuals' dietary behaviours. However, a dearth of evidence exists regarding the costs of implementing and delivering workplace dietary interventions. This study aimed to conduct a cost-analysis of workplace nutrition education and environmental dietary modification interventions from an employer's perspective. Cost data were obtained from a workplace dietary intervention trial, the Food Choice at Work Study. Micro-costing methods estimated costs associated with implementing and delivering the interventions for 1 year in four multinational manufacturing workplaces in Cork, Ireland. The workplaces were allocated to one of the following groups: control, nutrition education alone, environmental dietary modification alone and nutrition education and environmental dietary modification combined. A total of 850 employees were recruited across the four workplaces. For comparison purposes, total costs were standardised for 500 employees per workplace. The combined intervention reported the highest total costs of €31,108. The nutrition education intervention reported total costs of €28,529. Total costs for the environmental dietary modification intervention were €3689. Total costs for the control workplace were zero. The average annual cost per employee was; combined intervention: €62, nutrition education: €57, environmental modification: €7 and control: €0. Nutritionist's time was the main cost contributor across all interventions, (ranging from 53 to 75% of total costs). Within multi-component interventions, the relative cost of implementing and delivering nutrition education elements is high compared to environmental modification strategies. A workplace environmental modification strategy added marginal additional cost, relative to the control. Findings will inform employers and public health policy-makers regarding the economic feasibility of implementing and scaling dietary interventions. Current Controlled Trials: ISRCTN35108237 . Date of registration: The trial was retrospectively registered on 02/07/2013.

Local Government Planning Tool to Calculate Institutional and Engineering Control Costs for Brownfield Properties

EPA Pesticide Factsheets

This cost calculator is designed as a guide for municipal or local governments to assist in calculating their expected costs of implementing and conducting long-term stewardship of institutional controls and engineering controls at brownfield properties.

[Evaluation on cost-effectiveness of snail control project by environmental modification in hilly regions].

PubMed

Li, Shui-Ming; Chen, Shi-Jun; Wu, Xiao-Jun; Chen, Xi-Qing; Zhang, Rong-Ping; Zhang, Jian-Rong

2011-02-01

To evaluate the cost-effectiveness of the snail control project by environmental modification in order to provide the evidence for quickly interrupting the transmission of schistosomiasis in hilly regions. Field investigations were carried out. The changes of the snail habitat areas were compared before and after the snail control project. The direct costs of the snail control were calculated. The reduction rates of snail area and snail density were regarded as the evaluation indexes of the effectiveness. The costs for reduction of 1% of snail area and 1% of snail density were used as the unit for cost-effectiveness analysis. After the 15 projects were implemented, there were no snails in 12 areas. The reduction rates of snail areas were 72.22% to 100%. The reduction rates of the snail area and density were both 100% in the areas with digging new ditches to fill up the old ones and building reservoirs. The total cost of 15 projects was 1 450 800 Yuan. The average cost per unit was 0.56 Yuan/m2. After the snail control project by digging new ditches to fill up the old ones was implemented, the costs of snail area and density decreased by one unit were 300 -700 Yuan, by building reservoirs, the costs were 600 -2 600 Yuan, by building fishpond, the costs were 1 200 - 1 500 Yuan, by watershed comprehensive measures, the costs were 900 - 2 700 Yuan. The cost of digging new ditches to fill up the old ones was significantly lower than that of building reservoirs or watershed comprehensive measures, but there was no significant difference between building reservoirs and watershed comprehensive measures. In hilly regions, the implementation of snail control project by environmental modification combined with construction of water conservancy is effective, and the cost-effectiveness of the snail control with digging new ditches to fill up the old ones is excellent.

DOE/NETL's phase II mercury control technology field testing program: preliminary economic analysis of activated carbon injection.

PubMed

Jones, Andrew P; Hoffmann, Jeffrey W; Smith, Dennis N; Feeley, Thomas J; Murphy, James T

2007-02-15

Based on results of field testing conducted by the U.S. Department of Energy's National Energy Technology Laboratory (DOE/NETL), this article provides preliminary costs for mercury control via conventional activated carbon injection (ACI), brominated ACI, and conventional ACI coupled with the application of a sorbent enhancement additive (SEA) to coal prior to combustion. The economic analyses are reported on a plant-specific basis in terms of the cost required to achieve low (50%), mid (70%), and high (90%) levels of mercury removal "above and beyond" the baseline mercury removal achieved by existing emission control equipment. In other words, the levels of mercury control are directly attributable to ACI. Mercury control costs via ACI have been amortized on a current dollar basis. Using a 20-year book life, levelized costs for the incremental increase in cost of electricity (COE), expressed in mills per kilowatt-hour (mills/kWh), and the incremental cost of mercury control, expressed in dollars per pound of mercury removed ($/lb Hg removed), have been calculated for each level of ACI mercury control. For this analysis, the increase in COE varied from 0.14 mills/kWh to 3.92 mills/kWh. Meanwhile, the incremental cost of mercury control ranged from $3810/lb Hg removed to $166000/lb Hg removed.

Cost-benefit analysis of craniocerebral surgical site infection control in tertiary hospitals in China.

PubMed

Zhou, Jiong; Ma, Xiaojun

2015-02-19

Surgical site infection (SSI) is one of the most common postoperative complications. This study aimed to determine the cost of SSIs and to evaluate whether SSI control can reduce medical costs under the current medical payment system and wage rates in China. Prospective surveillance of craniocerebral surgery was conducted between July 2009 and June 2012. SSI patients and non-SSI patients were matched with a ratio of 1:2. Terms such as medical costs and length of hospital stay were compared between the two groups. Based on the economic loss of hospital infection, which causes additional expenditures and a reduction in the number of patients treated, the benefits of hospital infection control were estimated. The costs of human resources and materials of hospital infection surveillance and control were also estimated. Finally, the cost-benefit rates in different medical contexts and with different SSI-case ratios were calculated. The incidence of SSIs in this study was 4%. SSIs significantly prolonged hospital stay by 11.75 days (95% CI: 6.24-22.52), increased medical costs by US $3,412.48 (95% CI: $1,680.65-$5,879.89). The direct economic loss was $114,903 in a 40-bed ward. The cost of implementing infection control in such a unit was calculated to be approximately $5,555.47 CONCLUSIONS: Under the current fee-for-service healthcare model in China, the control of SSIs can hardly yield direct economic benefits, but can yield social benefits. With the implementation of a total medical cost pre-payment system, SSI control will present a remarkable benefit-cost ratio for hospitals.

Minimizing communication cost among distributed controllers in software defined networks

NASA Astrophysics Data System (ADS)

Arlimatti, Shivaleela; Elbreiki, Walid; Hassan, Suhaidi; Habbal, Adib; Elshaikh, Mohamed

2016-08-01

Software Defined Networking (SDN) is a new paradigm to increase the flexibility of today's network by promising for a programmable network. The fundamental idea behind this new architecture is to simplify network complexity by decoupling control plane and data plane of the network devices, and by making the control plane centralized. Recently controllers have distributed to solve the problem of single point of failure, and to increase scalability and flexibility during workload distribution. Even though, controllers are flexible and scalable to accommodate more number of network switches, yet the problem of intercommunication cost between distributed controllers is still challenging issue in the Software Defined Network environment. This paper, aims to fill the gap by proposing a new mechanism, which minimizes intercommunication cost with graph partitioning algorithm, an NP hard problem. The methodology proposed in this paper is, swapping of network elements between controller domains to minimize communication cost by calculating communication gain. The swapping of elements minimizes inter and intra communication cost among network domains. We validate our work with the OMNeT++ simulation environment tool. Simulation results show that the proposed mechanism minimizes the inter domain communication cost among controllers compared to traditional distributed controllers.

Innovative dengue vector control interventions in Latin America: what do they cost?

PubMed Central

Basso, César; Beltrán-Ayala, Efraín; Mitchell-Foster, Kendra; Cortés, Sebastián; Manrique-Saide, Pablo; Guillermo-May, Guillermo; Carvalho de Lima, Edilmar

2016-01-01

Background Five studies were conducted in Fortaleza (Brazil), Girardot (Colombia), Machala (Ecuador), Acapulco (Mexico), and Salto (Uruguay) to assess dengue vector control interventions tailored to the context. The studies involved the community explicitly in the implementation, and focused on the most productive breeding places for Aedes aegypti. This article reports the cost analysis of these interventions. Methods We conducted the costing from the perspective of the vector control program. We collected data on quantities and unit costs of the resources used to deliver the interventions. Comparable information was requested for the routine activities. Cost items were classified, analyzed descriptively, and aggregated to calculate total costs, costs per house reached, and incremental costs. Results Cost per house of the interventions were $18.89 (Fortaleza), $21.86 (Girardot), $30.61 (Machala), $39.47 (Acapulco), and $6.98 (Salto). Intervention components that focused mainly on changes to the established vector control programs seem affordable; cost savings were identified in Salto (−21%) and the clean patio component in Machala (−12%). An incremental cost of 10% was estimated in Fortaleza. On the other hand, there were also completely new components that would require sizeable financial efforts (installing insecticide-treated nets in Girardot and Acapulco costs $16.97 and $24.96 per house, respectively). Conclusions The interventions are promising, seem affordable and may improve the cost profile of the established vector control programs. The costs of the new components could be considerable, and should be assessed in relation to the benefits in reduced dengue burden. PMID:26924235

Reward Pays the Cost of Noise Reduction in Motor and Cognitive Control.

PubMed

Manohar, Sanjay G; Chong, Trevor T-J; Apps, Matthew A J; Batla, Amit; Stamelou, Maria; Jarman, Paul R; Bhatia, Kailash P; Husain, Masud

2015-06-29

Speed-accuracy trade-off is an intensively studied law governing almost all behavioral tasks across species. Here we show that motivation by reward breaks this law, by simultaneously invigorating movement and improving response precision. We devised a model to explain this paradoxical effect of reward by considering a new factor: the cost of control. Exerting control to improve response precision might itself come at a cost--a cost to attenuate a proportion of intrinsic neural noise. Applying a noise-reduction cost to optimal motor control predicted that reward can increase both velocity and accuracy. Similarly, application to decision-making predicted that reward reduces reaction times and errors in cognitive control. We used a novel saccadic distraction task to quantify the speed and accuracy of both movements and decisions under varying reward. Both faster speeds and smaller errors were observed with higher incentives, with the results best fitted by a model including a precision cost. Recent theories consider dopamine to be a key neuromodulator in mediating motivational effects of reward. We therefore examined how Parkinson's disease (PD), a condition associated with dopamine depletion, alters the effects of reward. Individuals with PD showed reduced reward sensitivity in their speed and accuracy, consistent in our model with higher noise-control costs. Including a cost of control over noise explains how reward may allow apparent performance limits to be surpassed. On this view, the pattern of reduced reward sensitivity in PD patients can specifically be accounted for by a higher cost for controlling noise. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Maintenance free gas bearing helium blower for nuclear plant

NASA Astrophysics Data System (ADS)

Molyneaux, A., Dr; Harris, M., Prof; Sharkh, S., Prof; Hill, S.; de Graaff, T.

2017-08-01

This paper describes the design, testing and operation of novel helium blowers used to recirculate the helium blanketing gas in the nuclear reactor used as a neutron source at the Institut Laue Langevan, Grenoble, France. The laser sintered shrouded centrifugal wheel operates at speeds up to 45000 rpm supported on helium lubricated hydrodynamic spiral groove bearings, and is driven by a sensorless permanent magnet motor. The entire machine is designed to keep the helium gas (polluted by a small amount of D2O) out of contact with any iron or copper materials which would contribute to the corrosion of parts of the circuit. It is designed to have zero maintenance during a lifetime of 40,000 hours of continuous operation. This paper will describe the spiral groove journal and thrust bearings. Design and manufacture of the 1 kW motor and centrifugal wheel will be explained including their CFD and FEA analyses. Measurements of rotor displacement will be presented showing the behaviour under factory testing as well as details of the measured centrifugal wheel and motor performances. Two machines are incorporated into the circuit to provide redundancy and the first blower has been in continuous operation since Jan 2015. The blower was designed, manufactured, assembled and tested in the UK using predominantly UK suppliers.

Estimating Tool–Tissue Forces Using a 3-Degree-of-Freedom Robotic Surgical Tool

PubMed Central

Zhao, Baoliang; Nelson, Carl A.

2016-01-01

Robot-assisted minimally invasive surgery (MIS) has gained popularity due to its high dexterity and reduced invasiveness to the patient; however, due to the loss of direct touch of the surgical site, surgeons may be prone to exert larger forces and cause tissue damage. To quantify tool–tissue interaction forces, researchers have tried to attach different kinds of sensors on the surgical tools. This sensor attachment generally makes the tools bulky and/or unduly expensive and may hinder the normal function of the tools; it is also unlikely that these sensors can survive harsh sterilization processes. This paper investigates an alternative method by estimating tool–tissue interaction forces using driving motors' current, and validates this sensorless force estimation method on a 3-degree-of-freedom (DOF) robotic surgical grasper prototype. The results show that the performance of this method is acceptable with regard to latency and accuracy. With this tool–tissue interaction force estimation method, it is possible to implement force feedback on existing robotic surgical systems without any sensors. This may allow a haptic surgical robot which is compatible with existing sterilization methods and surgical procedures, so that the surgeon can obtain tool–tissue interaction forces in real time, thereby increasing surgical efficiency and safety. PMID:27303591

Estimating Tool-Tissue Forces Using a 3-Degree-of-Freedom Robotic Surgical Tool.

PubMed

Zhao, Baoliang; Nelson, Carl A

2016-10-01

Robot-assisted minimally invasive surgery (MIS) has gained popularity due to its high dexterity and reduced invasiveness to the patient; however, due to the loss of direct touch of the surgical site, surgeons may be prone to exert larger forces and cause tissue damage. To quantify tool-tissue interaction forces, researchers have tried to attach different kinds of sensors on the surgical tools. This sensor attachment generally makes the tools bulky and/or unduly expensive and may hinder the normal function of the tools; it is also unlikely that these sensors can survive harsh sterilization processes. This paper investigates an alternative method by estimating tool-tissue interaction forces using driving motors' current, and validates this sensorless force estimation method on a 3-degree-of-freedom (DOF) robotic surgical grasper prototype. The results show that the performance of this method is acceptable with regard to latency and accuracy. With this tool-tissue interaction force estimation method, it is possible to implement force feedback on existing robotic surgical systems without any sensors. This may allow a haptic surgical robot which is compatible with existing sterilization methods and surgical procedures, so that the surgeon can obtain tool-tissue interaction forces in real time, thereby increasing surgical efficiency and safety.

Components of the costs of controlling quality: a transaction cost economics approach.

PubMed

Stiles, R A; Mick, S S

1997-01-01

This article identifies the components that contribute to a healthcare organization's costs in controlling quality. A central tenet of our argument is that at its core, quality is the result of a series of transactions among members of a diverse network. Transaction cost economics is applied internally to analyze intraorganizational transactions that contribute to quality control, and questions for future research are posed.

Dutch elm disease control: performance and costs

Treesearch

William N., Jr. Cannon; David P. Worley

1976-01-01

Municipal programs to suppress Dutch elm disease have had highly variable results. Performance as measured by tree mortality was unrelated to control strategies. Costs for control programs were 37 to 76 percent less than costs without control programs in the 15-year time-span of the study. Only those municipalities that conducted a high-performance program could be...

Dutch elm disease control: performance and costs

Treesearch

William N., Jr. Cannon; David P. Worley

1980-01-01

Municipal programs to suppress Dutch elm disease have had highly variable results. Performance as measured by tree mortality was unrelated to control strategies. Costs for control programs were 37 to 76 percent less than costs without control programs in the 15-year time-span of the study. Only those municipalities that conducted a high-performance program could be...

Improving BP control through electronic communications: an economic evaluation.

PubMed

Fishman, Paul A; Cook, Andrea J; Anderson, Melissa L; Ralston, James D; Catz, Sheryl L; Carrell, David; Carlson, James; Green, Beverly B

2013-09-01

Web-based collaborative approaches to managing chronic illness show promise for both improving health outcomes and increasing the efficiency of the healthcare system. Analyze the cost-effectiveness of the Electronic Communications and Home Blood Pressure Monitoring to Improve Blood Pressure Control (e-BP) study, a randomized controlled trial that used a patient-shared electronic medical record, home blood pressure (BP) monitoring, and web-based pharmacist care to improve BP control (<140/90 mm Hg). Incremental cost-effectiveness analysis conducted from a health plan perspective. Cost-effectiveness of home BP monitoring and web-based pharmacist care estimated for percent change in patients with controlled BP and cost per mm Hg in diastolic and systolic BP relative to usual care and home BP monitoring alone. A 1% improvement in number of patients with controlled BP using home BP monitoring and web-based pharmacist care-the e-BP program-costs $16.65 (95% confidence interval: 15.37- 17.94) relative to home BP monitoring and web training alone. Each mm HG reduction in systolic and diastolic BP achieved through the e-BP program costs $65.29 (59.91-70.67) relativeto home BP monitoring and web tools only. Life expectancy was increased at an incremental cost of $1850 (1635-2064) and $2220 (1745-2694) per year of life saved for men and women, respectively. Web-based collaborative care can be used to achieve BP control at a relatively low cost. Future research should examine the cost impact of potential long-term clinical improvements.

Implications of comorbidity on costs for patients with Alzheimer disease.

PubMed

Kuo, Tzu-Chun; Zhao, Yang; Weir, Sharada; Kramer, Marilyn Schlein; Ash, Arlene S

2008-08-01

No prior studies have used a comprehensive clinical classification system to examine the effect of differences in overall illness burden and the presence of other diseases on costs for patients with Alzheimer disease (AD) when compared with demographically matched nondemented controls. Of a total of 627,775 enrollees who were eligible for medical and pharmacy benefits for 2003 and 2004 in the MarketScan Medicare Supplemental and Coordination of Benefits Database, we found 25,109 AD patients. For each case, 3 demographically matched nondemented controls were selected using propensity scores. Applying the diagnostic cost groups (DCGs) model to all enrollees, 2003 diagnoses were used to estimate prospective relative risk scores (RRSs) that predict 2004 costs from all illness other than AD. RRSs were then used to control for illness burden to estimate AD's independent effect on costs. Compared with the control group, the AD cohort has more comorbid conditions (8.1 vs. 6.5) and higher illness burden (1.23 vs. 1.04). Individuals with AD are more likely to have mental health conditions, neurologic conditions, cognitive disorders, cerebrovascular disease, diabetes with acute complications, and injuries. Annual costs for AD patients are $3567 (34%) higher than for controls. Excess costs attributable to AD, after controlling for non-AD illness burden, are estimated at $2307 per year with outpatient pharmacy being the key driver ($1711 in excess costs). AD patients are sicker and more expensive than demographically matched controls. Even after adjusting for differences in illness burden, costs remain higher for AD patients.

A case-control comparison of direct healthcare-provider medical costs of chronic idiopathic constipation and irritable bowel syndrome with constipation in a community-based cohort

PubMed Central

Herrick, Linda M.; Spalding, William M.; Saito, Yuri A.; Moriarty, James; Schleck, Cathy

2017-01-01

Objective Patients with constipation account for 3.1 million United States physician visits a year, but care costs for patients with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC) compared to the general public have received little study. The study aim was to describe healthcare utilization and compare medical costs for patients with IBS-C or CIC versus matched controls from a community-based sample. Methods A nested case-control sample (IBS-C and CIC cases) and matched controls (1:2) for each case group were selected from Olmsted County, MN individuals responding to a community-based survey of gastrointestinal symptoms (2008) who received healthcare from a participating Rochester Epidemiology Project (REP) provider. Using REP healthcare utilization data, unadjusted and adjusted standardized costs were compared for the 2- and 10-year periods prior to the survey for 115 IBS-C patients and 230 controls and 365 CIC patients and 730 controls. Two time periods were chosen as these conditions are episodic but long-term. Results Outpatient costs for IBS-C ($6,800) and CIC ($6,284) patients over a 2-year period prior to the survey were significantly higher than controls ($4,242 and $5,254 respectively) after adjusting for co-morbidities, age, and sex. IBS-C outpatient costs ($25,448) and emergency room costs ($6,892) were significantly higher than controls ($21,024 and $3,962 respectively) for the 10-year period prior. Unadjusted data analyses of cases compared to controls demonstrated significantly higher imaging costs for IBS-C cases and procedure costs for CIC cases over the 10-year period. Limitations Data were collected from a random community sample primarily receiving care from a limited number of providers in that area. Conclusions Patients with IBS-C and CIC had significantly higher outpatient costs for the 2-year period compared with controls. IBS-C patients also had higher ER costs than the general population. PMID:27783533

Algorithm For Optimal Control Of Large Structures

NASA Technical Reports Server (NTRS)

Salama, Moktar A.; Garba, John A..; Utku, Senol

1989-01-01

Cost of computation appears competitive with other methods. Problem to compute optimal control of forced response of structure with n degrees of freedom identified in terms of smaller number, r, of vibrational modes. Article begins with Hamilton-Jacobi formulation of mechanics and use of quadratic cost functional. Complexity reduced by alternative approach in which quadratic cost functional expressed in terms of control variables only. Leads to iterative solution of second-order time-integral matrix Volterra equation of second kind containing optimal control vector. Cost of algorithm, measured in terms of number of computations required, is of order of, or less than, cost of prior algoritms applied to similar problems.

Towards canine rabies elimination: Economic comparisons of three project sites.

PubMed

Elser, J L; Hatch, B G; Taylor, L H; Nel, L H; Shwiff, S A

2018-02-01

An appreciation of the costs of implementing canine rabies control in different settings is important for those planning new or expanded interventions. Here we compare the costs of three canine rabies control projects in South Africa, the Philippines and Tanzania to identify factors that influence the overall costs of rabies control efforts. There was considerable variation in the cost of vaccinating each dog, but across the sites these were lower where population density was higher, and later in the projects when dog vaccination coverage was increased. Transportation costs comprised a much higher proportion of total costs in rural areas and where house-to-house vaccination campaigns were necessary. The association between the cost of providing PEP and human population density was less clear. The presence of a pre-existing national rabies management programme had a marked effect on keeping infrastructure and equipment costs for the project low. Finally, the proportion of the total costs of the project provided by the external donor was found to be low for the projects in the Philippines and South Africa, but likely covered close to the complete costs of the project in Tanzania. The detailed economic evaluation of three recent large-scale rabies control pilot projects provides the opportunity to examine economic costs across these different settings and to identify factors influencing rabies control costs that could be applied to future projects. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Developing Flexible Networked Lighting Control Systems

Science.gov Websites

, Bluetooth, ZigBee and others are increasingly used for building control purposes. Low-cost computation : Bundling digital intelligence at the sensors and lights adds virtually no incremental cost. Coupled with cost. Research Goals and Objectives This project "Developing Flexible, Networked Lighting Control

Readings in program control

NASA Technical Reports Server (NTRS)

Hoban, Francis T. (Editor); Lawbaugh, William M. (Editor); Hoffman, Edward J. (Editor)

1994-01-01

Under the heading of Program Control, a number of related topics are discussed: cost estimating methods; planning and scheduling; cost overruns in the defense industry; the history of estimating; the advantages of cost plus award fee contracts; and how program control techniques led to the success of a NASA development project.

A revolutionary approach to health care cost control: leveraging the power of Web-enabled employee "consumerism".

PubMed

Rozzi, M V

2001-09-01

The confluence of two trends--health care "consumerism" and employee self-service benefits programs--offers employers a promising opportunity for health care cost control. To take advantage of this opportunity, employers must take a fresh look at the health care cost dilemma and find ways to simultaneously offer employees a new kind of benefit and implement more effective cost-control measures.

Fuel-Burning Technology Alternatives for the Army.

DTIC Science & Technology

1985-01-01

control 0.85 2,287,000 Flue gas desulfurization 0.68 3,410,000 Total 12,478,000 *Capital cost estimate...34......... . . Particulate and sulfur dioxide control are needed. A baghouse and flue gas desulfurization (FD) scrubber system must be installed. Each item’s cost in...direct cost) Contingency (20% of 1,253,000 direct and indirect costs) Subtotal 7,518,000 Particulate control 1,342,000 Flue gas desulfurization

Adherence to infection control guidelines in surgery on MRSA positive patients : A cost analysis.

PubMed

Saegeman, V; Schuermans, A

2016-09-01

In surgical units, similar to other healthcare departments, guidelines are used to curb transmission of methicillin resistant Staphylococcus aureus (MRSA). The aim of this study was to calculate the extra costs for material and extra working hours for compliance to MRSA infection control guidelines in the operating rooms of a University Hospital. The study was based on observations of surgeries on MRSA positive patients. The average cost per surgery was calculated utilizing local information on unit costs. Robustness of the calculations was evaluated with a sensitivity analysis. The total extra costs of adherence to MRSA infection control guidelines averaged € 340.46 per surgical procedure (range € 207.76- € 473.15). A sensitivity analysis based on a standardized operating room hourly rate reached a cost of € 366.22. The extra costs of adherence to infection control guidelines are considerable. To reduce costs, the logistical planning of surgeries could be improved by for instance a dedicated room.

Minimization of bovine tuberculosis control costs in US dairy herds

PubMed Central

Smith, Rebecca L.; Tauer, Loren W.; Schukken, Ynte H.; Lu, Zhao; Grohn, Yrjo T.

2013-01-01

The objective of this study was to minimize the cost of controlling an isolated bovine tuberculosis (bTB) outbreak in a US dairy herd, using a stochastic simulation model of bTB with economic and biological layers. A model optimizer produced a control program that required 2-month testing intervals (TI) with 2 negative whole-herd tests to leave quarantine. This control program minimized both farm and government costs. In all cases, test-and-removal costs were lower than depopulation costs, although the variability in costs increased for farms with high holding costs or small herd sizes. Increasing herd size significantly increased costs for both the farm and the government, while increasing indemnity payments significantly decreased farm costs and increasing testing costs significantly increased government costs. Based on the results of this model, we recommend 2-month testing intervals for herds after an outbreak of bovine tuberculosis, with 2 negative whole herd tests being sufficient to lift quarantine. A prolonged test and cull program may cause a state to lose its bTB-free status during the testing period. When the cost of losing the bTB-free status is greater than $1.4 million then depopulation of farms could be preferred over a test and cull program. PMID:23953679

Investigating the relationship between costs and outcomes for English mental health providers: a bi-variate multi-level regression analysis.

PubMed

Moran, Valerie; Jacobs, Rowena

2018-06-01

Provider payment systems for mental health care that incentivize cost control and quality improvement have been a policy focus in a number of countries. In England, a new prospective provider payment system is being introduced to mental health that should encourage providers to control costs and improve outcomes. The aim of this research is to investigate the relationship between costs and outcomes to ascertain whether there is a trade-off between controlling costs and improving outcomes. The main data source is the Mental Health Minimum Data Set (MHMDS) for the years 2011/12 and 2012/13. Costs are calculated using NHS reference cost data while outcomes are measured using the Health of the Nation Outcome Scales (HoNOS). We estimate a bivariate multi-level model with costs and outcomes simultaneously. We calculate the correlation and plot the pairwise relationship between residual costs and outcomes at the provider level. After controlling for a range of demographic, need, social, and treatment variables, residual variation in costs and outcomes remains at the provider level. The correlation between residual costs and outcomes is negative, but very small, suggesting that cost-containment efforts by providers should not undermine outcome-improving efforts under the new payment system.

The cost of antibiotic mass drug administration for trachoma control in a remote area of South Sudan.

PubMed

Kolaczinski, Jan H; Robinson, Emily; Finn, Timothy P

2011-10-01

Mass drug administration (MDA) of antibiotics is a key component of the so-called "SAFE" strategy for trachoma control, while MDA of anthelminthics provides the cornerstone for control of a number of other neglected tropical diseases (NTDs). Simultaneous delivery of two or more of these drugs, renowned as "integrated NTD control," is being promoted to reduce costs and expand intervention coverage. A cost analysis was conducted alongside an MDA campaign in a remote trachoma endemic area, to inform budgeting for NTD control in South Sudan. A first round of antibiotic MDA was conducted in the highly trachoma endemic county of Mayom, Unity state, from June to August 2010. A core team of seven staff delivered the intervention, including recruitment and training of 44 supervisors and 542 community drug distributors. Using an ingredients approach, financial and economic costs were captured from the provider perspective in a detailed costing database. Overall, 123,760 individuals were treated for trachoma, resulting in an estimated treatment coverage of 94%. The economic cost per person treated was USD 1.53, excluding the cost of the antibiotic azithromycin. Ninety four per cent of the delivery costs were recurrent costs, with personnel and travel/transport costs taking up the largest share. In a remote setting and for the initial round, MDA of antibiotics was considerably more expensive than USD 0.5 per person treated, an estimate frequently quoted to advocate for integrated NTD control. Drug delivery costs in South Sudan are unlikely to decrease substantially during subsequent MDA rounds, as the major cost drivers were recurrent costs. MDA campaigns for delivery of one or more drugs in South Sudan should thus be budgeted at around USD 1.5 per person treated, at least until further costing data for delivery of other NTD drugs, singly or in combination, are available.

Cost Effectiveness and Cost Containment in the Era of Interferon-Free Therapies to Treat Hepatitis C Virus Genotype 1

PubMed Central

Morgan, Jake R.; Pho, Mai T.; Leff, Jared A.; Schackman, Bruce R.; Horsburgh, C. Robert; Assoumou, Sabrina A.; Salomon, Joshua A.; Weinstein, Milton C.; Freedberg, Kenneth A.; Kim, Arthur Y.

2017-01-01

Abstract Background. Interferon-free regimens to treat hepatitis C virus (HCV) genotype 1 are effective but costly. At this time, payers in the United States use strategies to control costs including (1) limiting treatment to those with advanced disease and (2) negotiating price discounts in exchange for exclusivity. Methods. We used Monte Carlo simulation to investigate budgetary impact and cost effectiveness of these treatment policies and to identify strategies that balance access with cost control. Outcomes included nondiscounted 5-year payer cost per 10000 HCV-infected patients and incremental cost-effectiveness ratios. Results. We found that the budgetary impact of HCV treatment is high, with 5-year undiscounted costs of $1.0 billion to 2.3 billion per 10000 HCV-infected patients depending on regimen choices. Among noncirrhotic patients, using the least costly interferon-free regimen leads to the lowest payer costs with negligible difference in clinical outcomes, even when the lower cost regimen is less convenient and/or effective. Among cirrhotic patients, more effective but costly regimens remain cost effective. Controlling costs by restricting treatment to those with fibrosis stage 2 or greater disease was cost ineffective for any patient type compared with treating all patients. Conclusions. Treatment strategies using interferon-free therapies to treat all HCV-infected persons are cost effective, but short-term cost is high. Among noncirrhotic patients, using the least costly interferon-free regimen, even if it is not single tablet or once daily, is the cost-control strategy that results in best outcomes. Restricting treatment to patients with more advanced disease often results in worse outcomes than treating all patients, and it is not preferred. PMID:28480259

Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis.

PubMed

Lo, Nathan C; Gurarie, David; Yoon, Nara; Coulibaly, Jean T; Bendavid, Eran; Andrews, Jason R; King, Charles H

2018-01-23

Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and cost-effectiveness of various snail control strategies. We extended previously published dynamic, age-structured transmission and cost-effectiveness models to simulate mass drug administration (MDA) and focal snail control interventions against Schistosoma haematobium across a range of low-prevalence (5-20%) and high-prevalence (25-50%) rural Kenyan communities. We simulated strategies over a 10-year period of MDA targeting school children or entire communities, snail control, and combined strategies. We measured incremental cost-effectiveness in 2016 US dollars per disability-adjusted life year and defined a strategy as optimally cost-effective when maximizing health gains (averted disability-adjusted life years) with an incremental cost-effectiveness below a Kenya-specific economic threshold. In both low- and high-prevalence settings, community-wide MDA with additional snail control reduced total disability by an additional 40% compared with school-based MDA alone. The optimally cost-effective scenario included the addition of snail control to MDA in over 95% of simulations. These results support inclusion of snail control in global guidelines and national schistosomiasis control strategies for optimal disease control, especially in settings with high prevalence, "hot spots" of transmission, and noncompliance to MDA. Copyright © 2018 the Author(s). Published by PNAS.

Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis

PubMed Central

Yoon, Nara; Coulibaly, Jean T.; Bendavid, Eran; Andrews, Jason R.; King, Charles H.

2018-01-01

Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and cost-effectiveness of various snail control strategies. We extended previously published dynamic, age-structured transmission and cost-effectiveness models to simulate mass drug administration (MDA) and focal snail control interventions against Schistosoma haematobium across a range of low-prevalence (5–20%) and high-prevalence (25–50%) rural Kenyan communities. We simulated strategies over a 10-year period of MDA targeting school children or entire communities, snail control, and combined strategies. We measured incremental cost-effectiveness in 2016 US dollars per disability-adjusted life year and defined a strategy as optimally cost-effective when maximizing health gains (averted disability-adjusted life years) with an incremental cost-effectiveness below a Kenya-specific economic threshold. In both low- and high-prevalence settings, community-wide MDA with additional snail control reduced total disability by an additional 40% compared with school-based MDA alone. The optimally cost-effective scenario included the addition of snail control to MDA in over 95% of simulations. These results support inclusion of snail control in global guidelines and national schistosomiasis control strategies for optimal disease control, especially in settings with high prevalence, “hot spots” of transmission, and noncompliance to MDA. PMID:29301964

Cost-Effectiveness of Tight Control of Inflammation in Early Psoriatic Arthritis: Economic Analysis of a Multicenter Randomized Controlled Trial.

PubMed

O'Dwyer, John L; Meads, David M; Hulme, Claire T; Mcparland, Lucy; Brown, Sarah; Coates, Laura C; Moverley, Anna R; Emery, Paul; Conaghan, Philip G; Helliwell, Philip S

2018-03-01

Treat-to-target approaches have proved to be effective in rheumatoid arthritis, but have not been studied in psoriatic arthritis (PsA). This study was undertaken to examine the cost-effectiveness of tight control (TC) of inflammation in early PsA compared to standard care. Cost-effectiveness analyses were undertaken alongside a UK-based, open-label, multicenter, randomized controlled trial. Taking the perspective of the health care sector, effectiveness was measured using the 3-level EuroQol 5-domain, which allows for the calculation of quality-adjusted life-years (QALYs). Incremental cost-effectiveness ratios (ICERs) are presented, which represent the additional cost per QALY gained over a 48-week time horizon. Sensitivity analyses are presented assessing the impact of variations in the analytical approach and assumptions on the cost-effectiveness estimates. The mean cost and QALYs were higher in the TC group: £4,198 versus £2,000 and 0.602 versus 0.561. These values yielded an ICER of £53,948 per QALY. Bootstrapped uncertainty analysis suggests that the TC has a 0.07 probability of being cost-effective at a £20,000 threshold. Stratified analysis suggests that with certain costs being controlled, an ICER of £24,639 can be calculated for patients with a higher degree of disease severity. A tight control strategy to treat PsA is an effective intervention in the treatment pathway; however, this study does not find tight control to be cost-effective in most analyses. Lower drug prices, targeting polyarthritis patients, or reducing the frequency of rheumatology visits may improve value for money metrics in future studies. © 2017, American College of Rheumatology.

PERFORMANCE AND COST OF MERCURY AND MULTIPOLLUTANT EMISSION CONTROL TECHNOLOGY APPLICATIONS ON ELECTRIC UTILITY BOILERS

EPA Science Inventory

The report presents estimates of the performance and cost of both powdered activated carbon (PAC) and multipollutant control technologies that may be useful in controlling mercury emissions. Based on currently available data, cost estimates for PAC injection range are 0.03-3.096 ...

Cost-Control Mechanisms in Canadian Private Drug Plans

PubMed Central

Kratzer, Jillian; McGrail, Kimberlyn; Strumpf, Erin; Law, Michael R.

2013-01-01

Approximately 68% of Canadians receive prescription drug coverage through an employer-sponsored private plan. However, we have very limited data on the structure of these plans. This study aims to identify and describe the use of cost-control mechanisms in private drug plans in Canada and describe what private coverage looks like for the average Canadian. Using 2010 data from over 113,000 different private drug plans, provided by Applied Management Consultants, we determined the overall use of key cost-control measures, and the cost-control tools that appear to be gaining currency compared to a report on benefits coverage in 1998. We found that the use of common cost-control measures is relatively low among Canadian private benefits programs. Co-insurance is much more common in private coverage plans than co-payments. Deductibles are uncommon in Canada and, when in place, are very small. The use of annual and lifetime maximums is increasing. Canadian private benefits programs use few cost-control measures to respond to increasing costs, particularly in comparison to their public counterparts. These results suggest there are ample opportunities for greater efficiency in private sector drug coverage plans. PMID:23968672

Cost-Effectiveness of Intensive versus Standard Blood-Pressure Control.

PubMed

Bress, Adam P; Bellows, Brandon K; King, Jordan B; Hess, Rachel; Beddhu, Srinivasan; Zhang, Zugui; Berlowitz, Dan R; Conroy, Molly B; Fine, Larry; Oparil, Suzanne; Morisky, Donald E; Kazis, Lewis E; Ruiz-Negrón, Natalia; Powell, Jamie; Tamariz, Leonardo; Whittle, Jeff; Wright, Jackson T; Supiano, Mark A; Cheung, Alfred K; Weintraub, William S; Moran, Andrew E

2017-08-24

In the Systolic Blood Pressure Intervention Trial (SPRINT), adults at high risk for cardiovascular disease who received intensive systolic blood-pressure control (target, <120 mm Hg) had significantly lower rates of death and cardiovascular disease events than did those who received standard control (target, <140 mm Hg). On the basis of these data, we wanted to determine the lifetime health benefits and health care costs associated with intensive control versus standard control. We used a microsimulation model to apply SPRINT treatment effects and health care costs from national sources to a hypothetical cohort of SPRINT-eligible adults. The model projected lifetime costs of treatment and monitoring in patients with hypertension, cardiovascular disease events and subsequent treatment costs, treatment-related risks of serious adverse events and subsequent costs, and quality-adjusted life-years (QALYs) for intensive control versus standard control of systolic blood pressure. We determined that the mean number of QALYs would be 0.27 higher among patients who received intensive control than among those who received standard control and would cost approximately $47,000 more per QALY gained if there were a reduction in adherence and treatment effects after 5 years; the cost would be approximately $28,000 more per QALY gained if the treatment effects persisted for the remaining lifetime of the patient. Most simulation results indicated that intensive treatment would be cost-effective (51 to 79% below the willingness-to-pay threshold of $50,000 per QALY and 76 to 93% below the threshold of $100,000 per QALY), regardless of whether treatment effects were reduced after 5 years or persisted for the remaining lifetime. In this simulation study, intensive systolic blood-pressure control prevented cardiovascular disease events and prolonged life and did so at levels below common willingness-to-pay thresholds per QALY, regardless of whether benefits were reduced after 5 years or persisted for the patient's remaining lifetime. (Funded by the National Heart, Lung, and Blood Institute and others; SPRINT ClinicalTrials.gov number, NCT01206062 .).

A randomized controlled trial of intensive care management for disabled Medicaid beneficiaries with high health care costs.

PubMed

Bell, Janice F; Krupski, Antoinette; Joesch, Jutta M; West, Imara I; Atkins, David C; Court, Beverly; Mancuso, David; Roy-Byrne, Peter

2015-06-01

To evaluate outcomes of a registered nurse-led care management intervention for disabled Medicaid beneficiaries with high health care costs. Washington State Department of Social and Health Services Client Outcomes Database, 2008-2011. In a randomized controlled trial with intent-to-treat analysis, outcomes were compared for the intervention (n = 557) and control groups (n = 563). A quasi-experimental subanalysis compared outcomes for program participants (n = 251) and propensity score-matched controls (n = 251). Administrative data were linked to describe costs and use of health services, criminal activity, homelessness, and death. In the intent-to-treat analysis, the intervention group had higher odds of outpatient mental health service use and higher prescription drug costs than controls in the postperiod. In the subanalysis, participants had fewer unplanned hospital admissions and lower associated costs; higher prescription drug costs; higher odds of long-term care service use; higher drug/alcohol treatment costs; and lower odds of homelessness. We found no health care cost savings for disabled Medicaid beneficiaries randomized to intensive care management. Among participants, care management may have the potential to increase access to needed care, slow growth in the number and therefore cost of unplanned hospitalizations, and prevent homelessness. These findings apply to start-up care management programs targeted at high-cost, high-risk Medicaid populations. © Health Research and Educational Trust.

Cost-benefit analysis of foot and mouth disease control in Ethiopia.

PubMed

Jemberu, Wudu T; Mourits, Monique; Rushton, Jonathan; Hogeveen, Henk

2016-09-15

Foot and mouth disease (FMD) occurs endemically in Ethiopia. Quantitative insights on its national economic impact and on the costs and benefits of control options are, however, lacking to support decision making in its control. The objectives of this study were, therefore, to estimate the annual costs of FMD in cattle production systems of Ethiopia, and to conduct an ex ante cost-benefit analysis of potential control alternatives. The annual costs of FMD were assessed based on production losses, export losses and control costs. The total annual costs of FMD under the current status quo of no official control program were estimated at 1354 (90% CR: 864-2042) million birr. The major cost (94%) was due to production losses. The costs and benefits of three potential control strategies: 1) ring vaccination (reactive vaccination around outbreak area supported by animal movement restrictions, 2) targeted vaccination (annual preventive vaccination in high risk areas plus ring vaccination in the rest of the country), and 3) preventive mass vaccination (annual preventive vaccination of the whole national cattle population) were compared with the baseline scenario of no official control program. Experts were elicited to estimate the influence of each of the control strategies on outbreak incidence and number of cases per outbreak. Based on these estimates, the incidence of the disease was simulated stochastically for 10 years. Preventive mass vaccination was epidemiologically the most efficient control strategy by reducing the national outbreak incidence below 5% with a median time interval of 3 years, followed by targeted vaccination strategy with a corresponding median time interval of 5 years. On average, all evaluated control strategies resulted in positive net present values. The ranges in the net present values were, however, very wide, including negative values. The targeted vaccination strategy was the most economic strategy with a median benefit cost ratio of 4.29 (90%CR: 0.29-9.63). It was also the least risky strategy with 11% chance of a benefit cost ratio of less than one. The study indicates that FMD has a high economic impact in Ethiopia. Its control is predicted to be economically profitable even without a full consideration of gains from export. The targeted vaccination strategy is shown to provide the largest economic return with a relatively low risk of loss. More studies to generate data, especially on production impact of the disease and effectiveness of control measures are needed to improve the rigor of future analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

Economics of Team-based Care in Controlling Blood Pressure: A Community Guide Systematic Review

PubMed Central

Jacob, Verughese; Chattopadhyay, Sajal K.; Thota, Anilkrishna B.; Proia, Krista K.; Njie, Gibril; Hopkins, David P.; Finnie, Ramona K.C.; Pronk, Nicolaas P.; Kottke, Thomas E.

2015-01-01

Context High blood pressure is an important risk factor for cardiovascular disease (CVD) and stroke, the leading cause of death in the U.S. and a substantial national burden through lost productivity and medical care. A recent Community Guide systematic review found strong evidence of effectiveness of team-based care in improving blood pressure control. The objective of the present review was to determine from the economic literature whether team-based care for blood pressure control is cost-beneficial and/or cost-effective. Evidence acquisition Electronic databases of papers published January 1980 – May 2012 were searched to find economic evaluations of team-based care interventions to improve blood pressure outcomes, yielding 31 studies for inclusion. Evidence synthesis In analyses conducted in 2012, intervention cost, healthcare cost averted, benefit-to-cost ratios, and cost-effectiveness were abstracted from the studies. The quality of estimates for intervention and healthcare cost from each study were assessed using three elements: intervention focus on blood pressure control; incremental estimates in the intervention group relative to a control group; and inclusion of major cost-driving elements in estimates. Intervention cost per unit reduction in systolic blood pressure was converted to lifetime intervention cost per quality-adjusted life-year (QALY) saved using algorithms from published trials. Conclusion Team-based care to improve blood pressure control is cost-effective based on evidence that 26 of 28 estimates of $/QALY gained from 10 studies were below a conservative threshold of $50,000. This finding is salient to recent health care reforms in the U.S. and coordinated patient-centered care through formation of Accountable Care Organizations (ACOs). PMID:26477804

40 CFR Appendix B to Part 76 - Procedures and Methods for Estimating Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers

Code of Federal Regulations, 2010 CFR

2010-07-01

... Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers B Appendix B to Part 76 Protection of... of Nitrogen Oxides Controls Applied to Group 1, Boilers 1. Purpose and Applicability This technical...; and which is comparable to the costs of nitrogen oxides controls set pursuant to subsection (b)(1) (of...

40 CFR Appendix B to Part 76 - Procedures and Methods for Estimating Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers

Code of Federal Regulations, 2012 CFR

2012-07-01

... Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers B Appendix B to Part 76 Protection of... of Nitrogen Oxides Controls Applied to Group 1, Boilers 1. Purpose and Applicability This technical...; and which is comparable to the costs of nitrogen oxides controls set pursuant to subsection (b)(1) (of...

40 CFR Appendix B to Part 76 - Procedures and Methods for Estimating Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers

Code of Federal Regulations, 2013 CFR

2013-07-01

... Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers B Appendix B to Part 76 Protection of... of Nitrogen Oxides Controls Applied to Group 1, Boilers 1. Purpose and Applicability This technical...; and which is comparable to the costs of nitrogen oxides controls set pursuant to subsection (b)(1) (of...

40 CFR Appendix B to Part 76 - Procedures and Methods for Estimating Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers

Code of Federal Regulations, 2011 CFR

2011-07-01

... Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers B Appendix B to Part 76 Protection of... of Nitrogen Oxides Controls Applied to Group 1, Boilers 1. Purpose and Applicability This technical...; and which is comparable to the costs of nitrogen oxides controls set pursuant to subsection (b)(1) (of...

40 CFR Appendix B to Part 76 - Procedures and Methods for Estimating Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers

Code of Federal Regulations, 2014 CFR

2014-07-01

... Costs of Nitrogen Oxides Controls Applied to Group 1, Boilers B Appendix B to Part 76 Protection of... of Nitrogen Oxides Controls Applied to Group 1, Boilers 1. Purpose and Applicability This technical...; and which is comparable to the costs of nitrogen oxides controls set pursuant to subsection (b)(1) (of...

Training Costs with Reference to the Industrial Training Act.

ERIC Educational Resources Information Center

Garbutt, Douglas

Provisions and implications of the British Industrial Training Act of 1964 (including the system of training grants and levies) are set forth. Procedures for accounting and budgeting for training costs, routines for collecting training information, documents (budgets, cost sheets, control statements) for collecting and controlling costs, means of…

The direct and indirect cost burden of clinically significant and symptomatic uterine fibroids.

PubMed

Lee, David W; Ozminkowski, Ronald J; Carls, Ginger Smith; Wang, Shaohung; Gibson, Teresa B; Stewart, Elizabeth A

2007-05-01

To estimate direct medical costs and indirect (productivity related) for women age 25 to 54 who had clinically significant and symptomatic uterine fibroids (UF). We compared direct medical expenditures among 30,659 women who had clinically significant and symptomatic UF to expenditures among an equal number of matched controls who did not. We also compared indirect costs for a sub-sample of 910 employed women in each group. Regression analyses controlled for demographic and casemix factors. Mean 12-month direct medical costs for women with UF were $11,720 versus $3257 for controls, and mean 12-month indirect costs for women with UF were $11,752 versus $8083 for controls. Differences were statistically significant (P<0.0001). UF is a costly disorder and merits thought as interventions are considered to improve women's health and productivity.

Cost-effectiveness of a health-social partnership transitional program for post-discharge medical patients.

PubMed

Wong, Frances Kam Yuet; Chau, June; So, Ching; Tam, Stanley Ku Fu; McGhee, Sarah

2012-12-24

Readmissions are costly and have implications for quality of care. Studies have been reported to support effects of transitional care programs in reducing hospital readmissions and enhancing clinical outcomes. However, there is a paucity of studies executing full economic evaluation to assess the cost-effectiveness of these transitional care programs. This study is therefore launched to fill this knowledge gap. Cost-effectiveness analysis was conducted alongside a randomized controlled trial that examined the effects of a Health-Social Transitional Care Management Program (HSTCMP) for medical patients discharged from an acute regional hospital in Hong Kong. The cost and health outcomes were compared between the patients receiving the HSTCMP and usual care. The total costs comprised the pre-program, program, and healthcare utilization costs. Quality of life was measured with SF-36 and transformed to utility values between 0 and 1. The readmission rates within 28 (control 10.2%, study 4.0%) and 84 days (control 19.4%, study 8.1%) were significantly higher in the control group. Utility values showed no difference between the control and study groups at baseline (p = 0.308). Utility values for the study group were significantly higher than in the control group at 28 (p < 0.001) and 84 days (p = 0.002). The study group also had a significantly higher QALYs gain (p < 0.001) over time at 28 and 84 days when compared with the control group. The intervention had an 89% chance of being cost-effective at the threshold of £20000/QALY. Previous studies on transitional care focused mainly on clinical outcomes and not too many included cost as an outcome measure. Studies examining the cost-effectiveness of the post-discharge support services are scanty. This study is the first to examine the cost-effectiveness of a transitional care program that used nurse-led services participated by volunteers. Results have shown that a health-social partnership transitional care program is cost-effective in reducing healthcare costs and attaining QALY gains. Economic evaluation helps to inform funders and guide decisions for the effective use of competing healthcare resources.

Cost-effectiveness of a distance lifestyle counselling programme among overweight employees from a company perspective, ALIFE@Work: a randomized controlled trial.

PubMed

Gussenhoven, A H M; van Wier, M F; Bosmans, J E; Dekkers, J C; van Mechelen, W

2013-01-01

The objective of this study was to determine whether a lifestyle intervention with individual counselling was cost-effective for reducing body weight compared with usual care from a company perspective. Overweight employees were recruited and randomly assigned to the intervention groups, either phone or Internet, or the control group. The intervention was based on a cognitive behavioural approach and addressed physical activity and diet. Self-reported body weight was collected at baseline and 12 months follow-up. Intervention costs and costs of sick leave days based on gross and net lost productivity days (GLPDs/NLPDs) obtained from the participating companies were calculated. Missing data were imputed using multiple imputation techniques. Uncertainty surrounding the differences in costs and the incremental cost-effectiveness ratios (ICER) was estimated by bootstrapping techniques, and presented on cost-effectiveness planes and cost-effectiveness acceptability curves. No statistically significant differences in total costs were found between the intervention groups and control group, though mean total costs in both intervention groups tended to be higher than those in the control group. The ICER of the Internet group compared with the control group was €59 per kilogram of weight loss based on GLPD costs. The probability of cost effectiveness of the Internet intervention was 45% at a willingness-to-pay of €0 per extra kilogram weight loss and 75% at a willingness-to-pay of €1500 per extra kilogram body weight loss. Comparable results were found for the phone intervention. The intervention was not cost effective in comparison with usual care from the company perspective. Due to the large amount of missing data, it is not possible to draw firm conclusions.

Our Cost Control Program Is Real, and Good PR Too.

ERIC Educational Resources Information Center

Harris, James; And Others

The cost control program of the Beaverton School District (Oregon) is presented in three sections. Reviewing the role of the school board in cost control development, Jean Holt (a board member) outlines the fiscal management system, long-range financial strategies, energy conservation, and utilization of facilities. The programs have resulted in a…

Neural-network-based online HJB solution for optimal robust guaranteed cost control of continuous-time uncertain nonlinear systems.

PubMed

Liu, Derong; Wang, Ding; Wang, Fei-Yue; Li, Hongliang; Yang, Xiong

2014-12-01

In this paper, the infinite horizon optimal robust guaranteed cost control of continuous-time uncertain nonlinear systems is investigated using neural-network-based online solution of Hamilton-Jacobi-Bellman (HJB) equation. By establishing an appropriate bounded function and defining a modified cost function, the optimal robust guaranteed cost control problem is transformed into an optimal control problem. It can be observed that the optimal cost function of the nominal system is nothing but the optimal guaranteed cost of the original uncertain system. A critic neural network is constructed to facilitate the solution of the modified HJB equation corresponding to the nominal system. More importantly, an additional stabilizing term is introduced for helping to verify the stability, which reinforces the updating process of the weight vector and reduces the requirement of an initial stabilizing control. The uniform ultimate boundedness of the closed-loop system is analyzed by using the Lyapunov approach as well. Two simulation examples are provided to verify the effectiveness of the present control approach.

Economic Effects of Introducing Alternative Salmonella Control Strategies in Sweden

PubMed Central

Sundström, Kristian; Wahlström, Helene; Ivarsson, Sofie; Sternberg Lewerin, Susanna

2014-01-01

The objective of the study was to analyse the economic effects of introducing alternative Salmonella control strategies in Sweden. Current control strategies in Denmark and the Netherlands were used as benchmarks. The true number of human Salmonella cases was estimated by reconstructing the reporting pyramids for the various scenarios. Costs were calculated for expected changes in human morbidity (Salmonella and two of its sequelae), for differences in the control programmes and for changes in cattle morbidity. The net effects (benefits minus costs) were negative in all scenarios (€ −5 to −105 million), implying that it would not be cost-effective to introduce alternative control strategies in Sweden. This result was mainly due to an expected increase in the incidence of Salmonella in humans (6035–57108 reported and unreported new cases/year), with expected additional costs of € 5–55 million. Other increased costs were due to expected higher incidences of sequelae (€ 3–49 million) and a higher cattle morbidity (€ 4–8 million). Benefits in terms of lower control costs amounted to € 4–7 million. PMID:24831797

Use of chromium picolinate and biotin in the management of type 2 diabetes: an economic analysis.

PubMed

Fuhr, Joseph P; He, Hope; Goldfarb, Neil; Nash, David B

2005-08-01

This paper addresses the potential economic benefits of chromium picolinate plus biotin (Diachrome) use in people with Type 2 diabetes (T2DM). The economic model was developed to estimate the impact on health care systems' costs by improved HbA1C levels with chromium picolinate plus biotin (Diachrome). Lifetimes cost savings were estimated by adjusting a benchmark from the literature, using a price index to adjust for inflation. The cost of diabetes is highly dependent on the HbA1C level with higher initial levels and higher annual increments increasing the cost. Improvement in glycemic control has proven to be cost-effective in delaying the onset and progression of T2DM, reducing the risk for diabetes-associated complications and lowering utilization and cost of care. Chromium picolinate plus biotin (Diachrome) showed greater improvement of glycemic control in poorly controlled T2DM patients (HbA(1C) > or = 10%) compared to their better controlled counterparts (HbA(1C) < 10%). This improvement was additive to that achieved by oral hypoglycemic medications and correlates to calculated levels of cost savings. Average 3-year cost savings for chromium picolinate plus biotin (Diachrome) use could range from 1,636 dollars for a poorly controlled patient with diabetes without heart diseases or hypertension, to 5,435 dollars for a poorly controlled patient with diabetes, heart disease, and hypertension. Average 3-year cost savings was estimated to be between 3.9 billion dollars and 52.9 billion dollars for the 16.3 million existing patients with diabetes. Chromium picolinate plus biotin (Diachrome) use among the 1.17 million newly diagnosed patients with T2DM each year could deliver lifetime cost savings of 42 billion dollars, or 36,000 dollars per T2DM patient. Affordable, safe, and convenient, chromium picolinate plus biotin (Diachrome) could prove to be a cost-effective complement to existing pharmacological therapies for controlling T2DM.

Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka.

PubMed

Thalagala, Neil; Tissera, Hasitha; Palihawadana, Paba; Amarasinghe, Ananda; Ambagahawita, Anuradha; Wilder-Smith, Annelies; Shepard, Donald S; Tozan, Yeşim

2016-02-01

Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health's perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216-609 for pediatric cases and between US$196-866 for adult cases according to disease severity and treatment setting. This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka.

Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka

PubMed Central

Thalagala, Neil; Tissera, Hasitha; Palihawadana, Paba; Amarasinghe, Ananda; Ambagahawita, Anuradha; Wilder-Smith, Annelies; Shepard, Donald S.; Tozan, Yeşim

2016-01-01

Background Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. Methods We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health’s perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. Results The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216–609 for pediatric cases and between US$196–866 for adult cases according to disease severity and treatment setting. Conclusions This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka. PMID:26910907

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.

Health economics in the United States: cost implications.

PubMed

Whitelaw, G N

1993-01-01

World health care costs are increasing uncontrollably and will continue to grow even if draconian controls are implemented immediately. In the United States, the health care objectives are to control the escalating costs of health care and increase access to quality care. To achieve these goals, new administrative controls will be put in place to respond to the cost pressures. New policies to accommodate these new controls will be made by the state and federal governments and by various private third parties. The policies will contain incentives and disincentives for private and institutional providers and beneficiaries. As a result, providers are responding with various cost-control techniques and payors are attempting to reduce costs. In addition, new decision makers in hospitals, insurance companies, and government will be evaluating new technologies by new standards. In order to gain or maintain significant market penetration for a product, drug and device manufacturers will have to develop a multifaceted strategy to present their products in the most favorable economic light.

Research on the optimization of quota design in real estate

NASA Astrophysics Data System (ADS)

Sun, Chunling; Ma, Susu; Zhong, Weichao

2017-11-01

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

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

PubMed

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

2016-05-01

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

Low-Cost Servomotor Driver for PFM Control

PubMed Central

Aragon-Jurado, David

2017-01-01

Servomotors have already been around for some decades and they are extremely popular among roboticists due to their simple control technique, reliability and low-cost. They are usually controlled by using Pulse Width Modulation (PWM) and this paper aims to keep the idea of simplicity and low-cost, while introducing a new control technique: Pulse Frequency Modulation (PFM). The objective of this paper is to focus on our development of a low-cost servomotor controller which will allow the research community to use them with PFM. A low-cost commercial servomotor is used as the base system for the development: a small PCB that fits inside the case and allocates all the electronic components to control the motor has been designed to replace the original. The potentiometer is retained as the feedback sensor and a microcontroller is responsible for controlling the position of the motor. The paper compares the performance of a PWM and a PFM controlled servomotor. The comparison shows that the servomotor with our controller achieves a faster mechanism for switching targets and a lower latency. This controller can be used with neuromorphic systems to remove the conversion from events to PWM. PMID:29301221

Low-Cost Servomotor Driver for PFM Control.

PubMed

Aragon-Jurado, David; Morgado-Estevez, Arturo; Perez-Peña, Fernando

2017-12-31

Servomotors have already been around for some decades and they are extremely popular among roboticists due to their simple control technique, reliability and low-cost. They are usually controlled by using Pulse Width Modulation (PWM) and this paper aims to keep the idea of simplicity and low-cost, while introducing a new control technique: Pulse Frequency Modulation (PFM). The objective of this paper is to focus on our development of a low-cost servomotor controller which will allow the research community to use them with PFM. A low-cost commercial servomotor is used as the base system for the development: a small PCB that fits inside the case and allocates all the electronic components to control the motor has been designed to replace the original. The potentiometer is retained as the feedback sensor and a microcontroller is responsible for controlling the position of the motor. The paper compares the performance of a PWM and a PFM controlled servomotor. The comparison shows that the servomotor with our controller achieves a faster mechanism for switching targets and a lower latency. This controller can be used with neuromorphic systems to remove the conversion from events to PWM.

Economic comparison of fabric filters and electrostatic precipitators for particulate control on coal-fired utility boilers

NASA Technical Reports Server (NTRS)

Cukor, P. M.; Chapman, R. A.

1978-01-01

The uncertainties and associated costs involved in selecting and designing a particulate control device to meet California's air emission regulations are considered. The basic operating principles of electrostatic precipitators and fabric filters are discussed, and design parameters are identified. The size and resulting cost of the control device as a function of design parameters is illustrated by a case study for an 800 MW coal-fired fired utility boiler burning a typical southwestern subbituminous coal. The cost of selecting an undersized particulate control device is compared with the cost of selecting an oversized device.

Costs and Effects of Abdominal versus Laparoscopic Hysterectomy: Systematic Review of Controlled Trials

PubMed Central

Bijen, Claudia B. M.; Vermeulen, Karin M.; Mourits, Marian J. E.; de Bock, Geertruida H.

2009-01-01

Objective Comparative evaluation of costs and effects of laparoscopic hysterectomy (LH) and abdominal hysterectomy (AH). Data sources Controlled trials from Cochrane Central register of controlled trials, Medline, Embase and prospective trial registers. Selection of studies Twelve (randomized) controlled studies including the search terms costs, laparoscopy, laparotomy and hysterectomy were identified. Methods The type of cost analysis, perspective of cost analyses and separate cost components were assessed. The direct and indirect costs were extracted from the original studies. For the cost estimation, hospital stay and procedure costs were selected as most important cost drivers. As main outcome the major complication rate was taken. Findings Analysis was performed on 2226 patients, of which 1013 (45.5%) in the LH group and 1213 (54.5%) in the AH group. Five studies scored ≥10 points (out of 19) for methodological quality. The reported total direct costs in the LH group ($63,997) were 6.1% higher than the AH group ($60,114). The reported total indirect costs of the LH group ($1,609) were half of the total indirect in the AH group ($3,139). The estimated mean major complication rate in the LH group (14.3%) was lower than in the AH group (15.9%). The estimated total costs in the LH group were $3,884 versus $3,312 in the AH group. The incremental costs for reducing one patient with major complication(s) in the LH group compared to the AH group was $35,750. Conclusions The shorter hospital stay in the LH group compensates for the increased procedure costs, with less morbidity. LH points in the direction of cost effectiveness, however further research is warranted with a broader costs perspective including long term effects as societal benefit, quality of life and survival. PMID:19806210

SOCIETAL COSTS ASSOCIATED WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN THE UNITED STATES.

PubMed

Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Tran, Irwin; Turpcu, Adam; Colman, Shoshana

2016-02-01

The purpose of this study was to use a cross-sectional prevalence-based health care economic survey to ascertain the annual, incremental, societal ophthalmic costs associated with neovascular age-related macular degeneration. Consecutive patients (n = 200) with neovascular age-related macular degeneration were studied. A Control Cohort included patients with good (20/20-20/25) vision, while Study Cohort vision levels included Subcohort 1: 20/30 to 20/50, Subcohort 2: 20/60 to 20/100, Subcohort 3: 20/200 to 20/400, and Subcohort 4: 20/800 to no light perception. An interviewer-administered, standardized, written survey assessed 1) direct ophthalmic medical, 2) direct nonophthalmic medical, 3) direct nonmedical, and 4) indirect medical costs accrued due solely to neovascular age-related macular degeneration. The mean annual societal cost for the Control Cohort was $6,116 and for the Study Cohort averaged $39,910 (P < 0.001). Study Subcohort 1 costs averaged $20,339, while Subcohort 4 costs averaged $82,984. Direct ophthalmic medical costs comprised 17.9% of Study Cohort societal ophthalmic costs, versus 74.1% of Control Cohort societal ophthalmic costs (P < 0.001) and 10.4% of 20/800 to no light perception subcohort costs. Direct nonmedical costs, primarily caregiver, comprised 67.1% of Study Cohort societal ophthalmic costs, versus 21.3% ($1,302/$6,116) of Control Cohort costs (P < 0.001) and 74.1% of 20/800 to no light perception subcohort costs. Total societal ophthalmic costs associated with neovascular age-related macular degeneration dramatically increase as vision in the better-seeing eye decreases.

Costs Of Using “Tiny Targets” to Control Glossina fuscipes fuscipes, a Vector of Gambiense Sleeping Sickness in Arua District of Uganda

PubMed Central

Shaw, Alexandra P. M.; Tirados, Inaki; Mangwiro, Clement T. N.; Esterhuizen, Johan; Lehane, Michael J.; Torr, Stephen J.; Kovacic, Vanja

2015-01-01

Introduction To evaluate the relative effectiveness of tsetse control methods, their costs need to be analysed alongside their impact on tsetse populations. Very little has been published on the costs of methods specifically targeting human African trypanosomiasis Methodology/Principal Findings In northern Uganda, a 250 km2 field trial was undertaken using small (0.5 X 0.25 m) insecticide-treated targets (“tiny targets”). Detailed cost recording accompanied every phase of the work. Costs were calculated for this operation as if managed by the Ugandan vector control services: removing purely research components of the work and applying local salaries. This calculation assumed that all resources are fully used, with no spare capacity. The full cost of the operation was assessed at USD 85.4 per km2, of which USD 55.7 or 65.2% were field costs, made up of three component activities (target deployment: 34.5%, trap monitoring: 10.6% and target maintenance: 20.1%). The remaining USD 29.7 or 34.8% of the costs were for preliminary studies and administration (tsetse surveys: 6.0%, sensitisation of local populations: 18.6% and office support: 10.2%). Targets accounted for only 12.9% of the total cost, other important cost components were labour (24.1%) and transport (34.6%). Discussion Comparison with the updated cost of historical HAT vector control projects and recent estimates indicates that this work represents a major reduction in cost levels. This is attributed not just to the low unit cost of tiny targets but also to the organisation of delivery, using local labour with bicycles or motorcycles. Sensitivity analyses were undertaken, investigating key prices and assumptions. It is believed that these costs are generalizable to other HAT foci, although in more remote areas, with denser vegetation and fewer people, costs would increase, as would be the case for other tsetse control techniques. PMID:25811956

Discrete-time Markovian-jump linear quadratic optimal control

NASA Technical Reports Server (NTRS)

Chizeck, H. J.; Willsky, A. S.; Castanon, D.

1986-01-01

This paper is concerned with the optimal control of discrete-time linear systems that possess randomly jumping parameters described by finite-state Markov processes. For problems having quadratic costs and perfect observations, the optimal control laws and expected costs-to-go can be precomputed from a set of coupled Riccati-like matrix difference equations. Necessary and sufficient conditions are derived for the existence of optimal constant control laws which stabilize the controlled system as the time horizon becomes infinite, with finite optimal expected cost.

Economic evaluations of tobacco control mass media campaigns: a systematic review

PubMed Central

Atusingwize, Edwinah; Lewis, Sarah; Langley, Tessa

2015-01-01

Background International evidence shows that mass media campaigns are effective tobacco control interventions. However, they require substantial investment; a key question is whether their costs are justified by their benefits. The aim of this study was to systematically and comprehensively review economic evaluations of tobacco control mass media campaigns. Methods An electronic search of databases and grey literature was conducted to identify all published economic evaluations of tobacco control mass media campaigns. The authors reviewed studies independently and assessed the quality of studies using the Drummond 10-point checklist. A narrative synthesis was used to summarise the key features and quality of the identified studies. Results 10 studies met the inclusion criteria and were included in the review. All the studies included a cost effectiveness analysis, a cost utility analysis or both. The methods were highly heterogeneous, particularly in terms of the types of costs included. On the whole, studies were well conducted, but the interventions were often poorly described in terms of campaign content and intensity, and cost information was frequently inadequate. All studies concluded that tobacco control mass media campaigns are a cost effective public health intervention. Conclusions The evidence on the cost effectiveness of tobacco control mass media campaigns is limited, but of acceptable quality and consistently suggests that they offer good value for money. PMID:24985730

The Psychological Cost of Making Control Responses in the Nonstereotype Direction.

PubMed

Chan, Alan H S; Hoffmann, Errol R

2016-12-01

The aim of this study was to develop a scale for the "psychological cost" of making control responses in the nonstereotype direction. Wickens, Keller, and Small suggested values for the psychological cost arising from having control/display relationships that were not in the common stereotype directions. We provide values of such costs specifically for these situations. Working from data of Chan and Hoffmann for 168 combinations of display location, control type, and display movement direction, we define values for the cost and compare these with the suggested values of Wickens et al.'s Frame of Reference Transformation Tool (FORT) model. We found marked differences between the values of the FORT model and the data of our experiments. The differences arise largely from the effects of the Worringham and Beringer visual field principle not being adequately considered in the previous research. A better indication of the psychological cost for use of incorrect control/display stereotypes is given. It is noted that these costs are applicable only to the factor of stereotype strength and not other factors considered in the FORT model. Effects of having controls and displays that are not arranged to operate with population expectancies can be readily determined from the data in this paper. © 2016, Human Factors and Ergonomics Society.

Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study.

PubMed

Baltussen, Rob; Smith, Andrew

2012-03-02

To determine the relative costs, effects, and cost effectiveness of selected interventions to control cataract, trachoma, refractive error, hearing loss, meningitis and chronic otitis media. Cost effectiveness analysis of or combined strategies for controlling vision and hearing loss by means of a lifetime population model. Two World Health Organization sub-regions of the world where vision and hearing loss are major burdens: sub-Saharan Africa and South East Asia. Biological and behavioural parameters from clinical and observational studies and population based surveys. Intervention effects and resource inputs based on published reports, expert opinion, and the WHO-CHOICE database. Cost per disability adjusted life year (DALY) averted, expressed in international dollars ($Int) for the year 2005. Treatment of chronic otitis media, extracapsular cataract surgery, trichiasis surgery, treatment for meningitis, and annual screening of schoolchildren for refractive error are among the most cost effective interventions to control hearing and vision impairment, with the cost per DALY averted <$Int285 in both regions. Screening of both schoolchildren (annually) and adults (every five years) for hearing loss costs around $Int1000 per DALY averted. These interventions can be considered highly cost effective. Mass treatment with azithromycin to control trachoma can be considered cost effective in the African but not the South East Asian sub-region. Vision and hearing impairment control interventions are generally cost effective. To decide whether substantial investments in these interventions is warranted, this finding should be considered in relation to the economic attractiveness of other, existing or new, interventions in health.

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania.

PubMed

Ngalesoni, Frida; Ruhago, George; Mayige, Mary; Oliveira, Tiago Cravo; Robberstad, Bjarne; Norheim, Ole Frithjof; Higashi, Hideki

2017-01-01

Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania. A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs) averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters. Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively. Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government's ability to implement these interventions.

Cost-effectiveness of a smokeless tobacco control mass media campaign in India.

PubMed

Murukutla, Nandita; Yan, Hongjin; Wang, Shuo; Negi, Nalin Singh; Kotov, Alexey; Mullin, Sandra; Goodchild, Mark

2017-08-10

Tobacco control mass media campaigns are cost-effective in reducing tobacco consumption in high-income countries, but similar evidence from low-income countries is limited. An evaluation of a 2009 smokeless tobacco control mass media campaign in India provided an opportunity to test its cost-effectiveness. Campaign evaluation data from a nationally representative household survey of 2898 smokeless tobacco users were compared with campaign costs in a standard cost-effectiveness methodology. Costs and effects of the Surgeon campaign were compared with the status quo to calculate the cost per campaign-attributable benefit, including quit attempts, permanent quits and tobacco-related deaths averted. Sensitivity analyses at varied CIs and tobacco-related mortality risk were conducted. The Surgeon campaign was found to be highly cost-effective. It successfully generated 17 259 148 additional quit attempts, 431 479 permanent quits and 120 814 deaths averted. The cost per benefit was US$0.06 per quit attempt, US$2.6 per permanent quit and US$9.2 per death averted. The campaign continued to be cost-effective in sensitivity analyses. This study suggests that tobacco control mass media campaigns can be cost-effective and economically justified in low-income and middle-income countries. It holds significant policy implications, calling for sustained investment in evidence-based mass media campaigns as part of a comprehensive tobacco control strategy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

COST EFFECTIVE VOC EMISSION CONTROL STARTEGIES FOR MILITARY, AEROSPACE,AND INDUSTRIAL PAINT SPRAY BOOTH OPERATIONS: COMBINING IMPROVED VENTILATION SYSTEMS WITH INNOVATIVE, LOW COST EMISSION CONTROL TECHNOLOGIES

EPA Science Inventory

The paper describes a full-scale demonstration program in which several paint booths were modified for recirculation ventilation; the booth exhaust streams are vented to an innovative volatile organic compound (VOC) emission control system having extremely low operating costs. ...

Lighting Control Systems

DTIC Science & Technology

2004-02-26

Shorter payback periods After 19 Cost Benefit of Powerlink Rule of Thumb for Powerlink: Powerlink becomes more cost effective beyond 16 controlled...web enabled control (and management software) Increase in level of integration between building systems Increase in new features, functions, benefits ...focus on reducing run-time via Scheduling, Sensing, Switching Growing focus on payback Direct energy cost (with demand) Additional maintenance benefits

Coal supply and cost under technological and environmental uncertainty

NASA Astrophysics Data System (ADS)

Chan, Melissa

This thesis estimates available coal resources, recoverability, mining costs, environmental impacts, and environmental control costs for the United States under technological and environmental uncertainty. It argues for a comprehensive, well-planned research program that will resolve resource uncertainty, and innovate new technologies to improve recovery and environmental performance. A stochastic process and cost (constant 2005) model for longwall, continuous, and surface mines based on current technology and mining practice data was constructed. It estimates production and cost ranges within 5-11 percent of 2006 prices and production rates. The model was applied to the National Coal Resource Assessment. Assuming the cheapest mining method is chosen to extract coal, 250-320 billion tons are recoverable. Two-thirds to all coal resource can be mined at a cost less than 4/mmBTU. If U.S. coal demand substantially increases, as projected by alternate Energy Information Administration (EIA), resources might not last more than 100 years. By scheduling cost to meet EIA projected demand, estimated cost uncertainty increases over time. It costs less than 15/ton to mine in the first 10 years of a 100 year time period, 10-30/ton in the following 50 years, and 15-$90/ton thereafter. Environmental impacts assessed are subsidence from underground mines, surface mine pit area, erosion, acid mine drainage, air pollutant and methane emissions. The analysis reveals that environmental impacts are significant and increasing as coal demand increases. Control technologies recommended to reduce these impacts are backfilling underground mines, surface pit reclamation, substitution of robotic underground mining systems for surface pit mining, soil replacement for erosion, placing barriers between exposed coal and the elements to avoid acid formation, and coalbed methane development to avoid methane emissions during mining. The costs to apply these technologies to meet more stringent environmental regulation scenarios are estimated. The results show that the cost of meeting these regulatory scenarios could increase mining costs two to six times the business as usual cost, which could significantly affect the cost of coal-powered electricity generation. This thesis provides a first estimate of resource availability, mining cost, and environmental impact assessment and cost analysis. Available resource is not completely reported, so the available estimate is lower than actual resource. Mining costs are optimized, so provide a low estimate of potential costs. Environmental impact estimates are on the high end of potential impact that may be incurred because it is assumed that impact is unavoidable. Control costs vary. Estimated cost to control subsidence and surface mine pit impacts are suitable estimates of the cost to reduce land impacts. Erosion control and robotic mining system costs are lower, and methane and acid mine drainage control costs are higher, than they may be in the case that these impacts must be reduced.

The roles of social bonds, personality, and perceived costs: an empirical investigation into Hirschi's "new" control theory.

PubMed

Intravia, Jonathan; Jones, Shayne; Piquero, Alex R

2012-12-01

Hirschi's reconceptualized control theory suggests that social bonds serve as the primary inhibitors to delinquency and that personality-based self-control (PBSC) is not relevant. He also indicates that the number of inhibitors, multiplied by their salience, influences the perceived costs of delinquency. These claims have not been widely tested. Using a large, school-based sample of adolescents, the authors test Hirschi's reconceptualization and find that certain inhibitors (e.g., parental monitoring) are more important than others (e.g., maternal attachment). There are also unique types of costs (e.g., parental costs, peer costs) with differential impacts. Salience exerts a main effect, but there was little evidence to suggest it interacts with costs. Finally, PBSC has the strongest effect. These findings not only offer support for some of Hirschi's claims but also provide directions to better formulate a more comprehensive and empirically supported control theory.

E-learning: controlling costs and increasing value.

PubMed

Walsh, Kieran

2015-04-01

E-learning now accounts for a substantial proportion of medical education provision. This progress has required significant investment and this investment has in turn come under increasing scrutiny so that the costs of e-learning may be controlled and its returns maximised. There are multiple methods by which the costs of e-learning can be controlled and its returns maximised. This short paper reviews some of those methods that are likely to be most effective and that are likely to save costs without compromising quality. Methods might include accessing free or low-cost resources from elsewhere; create short learning resources that will work on multiple devices; using open source platforms to host content; using in-house faculty to create content; sharing resources between institutions; and promoting resources to ensure high usage. Whatever methods are used to control costs or increase value, it is most important to evaluate the impact of these methods.

[Estimation of economic costs for the care of patients with nosocomial pneumonia in a regional peruvian hospital, 2009-2011].

PubMed

Dámaso-Mata, Bernardo; Chirinos-Cáceres, Jesús; Menacho-Villafuerte, Luz

2016-06-01

To estimate and compare the economic costs for the care of patients with and without nosocomial pneumonia at Hospital II Huánuco EsSalud during 2009-2011, in Peru. This was a partial economic evaluation of paired cases and controls. A collection sheet was used. nosocomial pneumonia. direct health costs, direct non-health costs, indirect costs, occupation, age, comorbidities, sex, origin, and education level. A bivariate analysis was performed. Forty pairs of cases and controls were identified. These patients were hospitalized for >2 weeks and prescribed more than two antibiotics. The associated direct health costs included those for hospitalization, antibiotics, auxiliary examinations, specialized assessments, and other medications. The direct non-health costs and associated indirect costs included those for transportation, food, housing, foregone payroll revenue, foregone professional fee revenue, extra-institutional expenses, and payment to caregivers during hospitalization and by telephone. The direct health costs for nosocomial pneumonia patients were more than three times and the indirect costs were more than two times higher than those for the controls. Variables with the greatest impact on costs were identified.

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.

Costs and benefits of urban erosion and sediment control: The North Carolina experience

NASA Astrophysics Data System (ADS)

Paterson, Robert G.; Luger, Michael I.; Burby, Raymond J.; Kaiser, Edward J.; Malcom, H. Rooney; Beard, Alicia C.

1993-03-01

The EPA’s new nonpoint source pollution control requirements will soon institutionalize urban erosion and sediment pollution control practices nationwide. The public and private sector costs and social benefits associated with North Carolina’s program (one of the strongest programs in the country in terms of implementation authority, staffing levels, and comprehensiveness of coverage) are examined to provide general policy guidance on questions relating to the likely burden the new best management practices will have on the development industry, the likely costs and benefits of such a program, and the feasibility of running a program on a cost recovery basis. We found that urban erosion and sediment control requirements were not particularly burdensome to the development industry (adding about 4% on average to development costs). Public-sector program costs ranged between 2.4 and 4.8 million in fiscal year 1989. Our contingent valuation survey suggests that urban households in North Carolina are willing to pay somewhere between 7.1 and 14.2 million a year to maintain current levels of sediment pollution control. Our benefit-cost analysis suggests that the overall ratio is likely to be positive, although a definitive figure is elusive. Lastly, we found that several North Carolina localities have cost recovery fee systems that are at least partially self-financing.

An Economic Evaluation of a Video- and Text-Based Computer-Tailored Intervention for Smoking Cessation: A Cost-Effectiveness and Cost-Utility Analysis of a Randomized Controlled Trial

PubMed Central

Stanczyk, Nicola E.; Smit, Eline S.; Schulz, Daniela N.; de Vries, Hein; Bolman, Catherine; Muris, Jean W. M.; Evers, Silvia M. A. A.

2014-01-01

Background Although evidence exists for the effectiveness of web-based smoking cessation interventions, information about the cost-effectiveness of these interventions is limited. Objective The study investigated the cost-effectiveness and cost-utility of two web-based computer-tailored (CT) smoking cessation interventions (video- vs. text-based CT) compared to a control condition that received general text-based advice. Methods In a randomized controlled trial, respondents were allocated to the video-based condition (N = 670), the text-based condition (N = 708) or the control condition (N = 721). Societal costs, smoking status, and quality-adjusted life years (QALYs; EQ-5D-3L) were assessed at baseline, six-and twelve-month follow-up. The incremental costs per abstinent respondent and per QALYs gained were calculated. To account for uncertainty, bootstrapping techniques and sensitivity analyses were carried out. Results No significant differences were found in the three conditions regarding demographics, baseline values of outcomes and societal costs over the three months prior to baseline. Analyses using prolonged abstinence as outcome measure indicated that from a willingness to pay of €1,500, the video-based intervention was likely to be the most cost-effective treatment, whereas from a willingness to pay of €50,400, the text-based intervention was likely to be the most cost-effective. With regard to cost-utilities, when quality of life was used as outcome measure, the control condition had the highest probability of being the most preferable treatment. Sensitivity analyses yielded comparable results. Conclusion The video-based CT smoking cessation intervention was the most cost-effective treatment for smoking abstinence after twelve months, varying the willingness to pay per abstinent respondent from €0 up to €80,000. With regard to cost-utility, the control condition seemed to be the most preferable treatment. Probably, more time will be required to assess changes in quality of life. Future studies with longer follow-up periods are needed to investigate whether cost-utility results regarding quality of life may change in the long run. Trial Registration Nederlands Trial Register NTR3102 PMID:25310007

Unit costs for house spraying and bednet impregnation with residual insecticides in Colombia: a management tool for the control of vector-borne disease.

PubMed

Kroeger, A; Ayala, C; Medina Lara, A

2002-06-01

A study of unit costs and cost components of two malaria-control strategies (house spraying and bednet impregnation with residual insecticides) was undertaken in 11 malaria-endemic states (departamentos) of Colombia, using data provided by control staff on self-administered questionnaires. The accuracy of the data was verified by personal visits, telephone conversations and complementary information from 10 other states. Allthe financial-cost components of the malaria-control operations carried out in the previous 6 months and the results of the control operations themselves (including the numbers of houses sprayed and numbers of bednets impregnated/day) were recorded. The information was stratified according to whether the target communities were 'near' or 'far away' from an operational base, the far-away communities being those that needed overnight stays by the control staff. The main variables analysed were unit costs/house treated, and annual cost/person protected. The results show that house spraying was generally more expensive for the health services than bednet impregnation. This is particularly the case in 'nearby' communities, where most of those at-risk live. In such communities, spraying one house was 7.2 times more expensive than impregnating one bednet. Even if only those sleeping under an impregnated net were assumed to be protected, the unit costs/person protected in a 'nearby' community were twice as high for house spraying than for bednet impregnation. In 'nearby' communities, where technicians could return to the operational base each evening, insecticides made up 80% of the total spraying costs and 42% of the costs of bednet impregnation. In 'far-away' communities, however, salaries and 'per diems' were the most important cost components, representing, respectively, 23% and 22% of the costs of spraying, and 34% plus 27% of the costs of impregnation. Insecticide wastage and non-use of discounts on insecticide prices (available through the national Ministry of Health) increased the overall costs considerably. The multiple uses of these cost calculations for district health managers are presented.

An economic evaluation of a video- and text-based computer-tailored intervention for smoking cessation: a cost-effectiveness and cost-utility analysis of a randomized controlled trial.

PubMed

Stanczyk, Nicola E; Smit, Eline S; Schulz, Daniela N; de Vries, Hein; Bolman, Catherine; Muris, Jean W M; Evers, Silvia M A A

2014-01-01

Although evidence exists for the effectiveness of web-based smoking cessation interventions, information about the cost-effectiveness of these interventions is limited. The study investigated the cost-effectiveness and cost-utility of two web-based computer-tailored (CT) smoking cessation interventions (video- vs. text-based CT) compared to a control condition that received general text-based advice. In a randomized controlled trial, respondents were allocated to the video-based condition (N = 670), the text-based condition (N = 708) or the control condition (N = 721). Societal costs, smoking status, and quality-adjusted life years (QALYs; EQ-5D-3L) were assessed at baseline, six-and twelve-month follow-up. The incremental costs per abstinent respondent and per QALYs gained were calculated. To account for uncertainty, bootstrapping techniques and sensitivity analyses were carried out. No significant differences were found in the three conditions regarding demographics, baseline values of outcomes and societal costs over the three months prior to baseline. Analyses using prolonged abstinence as outcome measure indicated that from a willingness to pay of €1,500, the video-based intervention was likely to be the most cost-effective treatment, whereas from a willingness to pay of €50,400, the text-based intervention was likely to be the most cost-effective. With regard to cost-utilities, when quality of life was used as outcome measure, the control condition had the highest probability of being the most preferable treatment. Sensitivity analyses yielded comparable results. The video-based CT smoking cessation intervention was the most cost-effective treatment for smoking abstinence after twelve months, varying the willingness to pay per abstinent respondent from €0 up to €80,000. With regard to cost-utility, the control condition seemed to be the most preferable treatment. Probably, more time will be required to assess changes in quality of life. Future studies with longer follow-up periods are needed to investigate whether cost-utility results regarding quality of life may change in the long run. Nederlands Trial Register NTR3102.

Eradication versus control for poliomyelitis: an economic analysis.

PubMed

Thompson, Kimberly M; Tebbens, Radboud J Duintjer

2007-04-21

Worldwide eradication of wild polioviruses is likely to yield substantial health and financial benefits, provided we finish the job. Challenges in the four endemic areas combined with continuing demands for financial resources for eradication have led some to question the goal of eradication and to suggest switching to a policy of control. We developed a dynamic model, based on modelling of the currently endemic areas in India, to show the importance of maintaining and increasing the immunisation intensity to complete eradication and to illustrate how policies based on perception about high short-term costs or cost-effectiveness ratios without consideration of long-term benefits could undermine any eradication effort. An extended model assesses the economic implications and disease burden of a change in policy from eradication to control. Our results suggest that the intensity of immunisation must be increased to achieve eradication, and that even small decreases in intensity could lead to large outbreaks. This finding implies the need to pay even higher short-run costs than are currently being spent, which will further exacerbate concerns about continued investment in interventions with high perceived cost-effectiveness ratios. We show that a wavering commitment leads to a failure to eradicate, greater cumulative costs, and a much larger number of cases. We further show that as long as it is technically achievable, eradication offers both lower cumulative costs and cases than control, even with the costs of achieving eradication exceeding several billion dollars more. A low-cost control policy that relies only on routine immunisation for 20 years with discounted costs of more than $3500 million could lead to roughly 200 000 expected paralytic poliomyelitis cases every year in low-income countries, whereas a low-case control policy that keeps the number of cases at about 1500 per year could cost around $10 000 million discounted over the 20 years. Focusing on the large costs for poliomyelitis eradication, without assessing the even larger potential benefits of eradication and the enormous long-term costs of effective control, might inappropriately affect commitments to the goal of eradication, and thus debate should include careful consideration of the options.

Cost-Effectiveness of a Physician-Pharmacist Collaboration Intervention to Improve Blood Pressure Control.

PubMed

Polgreen, Linnea A; Han, Jayoung; Carter, Barry L; Ardery, Gail P; Coffey, Christopher S; Chrischilles, Elizabeth A; James, Paul A

2015-12-01

Previous studies have demonstrated the cost-effectiveness of physician-pharmacist collaborations to improve hypertension control. However, most studies have limited generalizability, lacking minority and low-income populations. The Collaboration Among Pharmacist and Physicians to Improve Blood Pressure Now (CAPTION) trial randomized 625 patients from 32 medical offices in 15 states. Each office had an existing clinical pharmacist on staff. Pharmacists in intervention offices communicated with patients and made recommendations to physicians about changes in therapy. Demographic information, blood pressure (BP), medications, and physician visits were recorded. In addition, pharmacists tracked time spent with each patient. Costs were assigned to medications and pharmacist and physician time. Cost-effectiveness ratios were calculated based on changes in BP measurements and hypertension control rates. Thirty-eight percent of patients were black, 14% were Hispanic, and 49% had annual income <$25 000. At 9 months, average systolic BP was 6.1 mm Hg lower (±3.5), diastolic was 2.9 mm Hg lower (±1.9), and the percentage of patients with controlled hypertension was 43% in the intervention group and 34% in the control group. Total costs for the intervention group were $1462.87 (±132.51) and $1259.94 (±183.30) for the control group, a difference of $202.93. The cost to lower BP by 1 mm Hg was $33.27 for systolic BP and $69.98 for diastolic BP. The cost to increase the rate of hypertension control by 1 percentage point in the study population was $22.55. Our results highlight the cost-effectiveness of a clinical pharmacy intervention for hypertension control in primary care settings. © 2015 American Heart Association, Inc.

Total cost comparison of standard antenatal care with a weight gain restriction programme for obese pregnant women.

PubMed

de Keyser, N; Josefsson, A; Monfils, W G; Claesson, I M; Carlsson, P; Sydsjö, A; Sydsjö, G

2011-05-01

To perform a cost comparison of a weight gain restriction programme for obese pregnant women with standard antenatal care, and to identify if there were differences in healthcare costs within the intervention group related to degree of gestational weight gain or degree of obesity at programme entry. A comparison of mean healthcare costs for participants of an intervention study at antenatal care clinics with controls in south-east Sweden. In total, 155 women in an intervention group attempted to restrict their gestational weight gain to <7 kg. The control group comprised 193 women. Mean costs during pregnancy, delivery and the neonatal period were compared with the costs of standard care. Costs were converted from Swedish Kronor to Euros (€). Healthcare costs during pregnancy were lower in the intervention group. There was no significant difference in total healthcare costs (i.e. sum of costs during pregnancy, delivery and the neonatal period) between the intervention group and the control group. Within the intervention group, the subgroup that gained 4.5-9.5 kg had the lowest costs. The total cost, including intervention costs, was € 1283 more per woman/infant in the intervention group compared with the control group (P=0.025). The degree of obesity at programme entry had no bearing on the outcome. The weight gain restriction programme for obese pregnant women was effective in restricting gestational weight gain to <7 kg, but had a higher total cost compared with standard antenatal care. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

COSTS OF INTERSTITAL CYSTITIS IN A MANAGED CARE POPULATION

PubMed Central

Clemens, J. Quentin; Meenan, Richard T.; O’Keeffe Rosetti, Maureen C.; Kimes, Terry; Calhoun, Elizabeth A.

2008-01-01

Objective This study assessed the direct medical costs, medication and procedure use associated with interstitial cystitis (IC) in women in the Kaiser Permanente Northwest (KPNW) managed care population. Methods The KPNW electronic medical record was utilized to identify women diagnosed with interstitial cystitis (n=239). Each of these cases was matched with three controls based on age and duration in the health plan. Health plan cost accounting data were used to determine inpatient, outpatient, and pharmacy costs for 1998-2003. An analysis of prescription medication use, cystoscopic and urodynamic procedures commonly associated with IC was also performed. To evaluate for comorbidities, an automated risk-adjustment model (RxRisk) linked to 28 chronic medical conditions was applied to the administrative datasets from both groups. Results The mean duration from the date of IC diagnosis to the end of the study period was 36.6 months (range 1.4-60). Mean yearly costs were 2.4-fold greater in cases than controls ($7100 vs. $2994), and median yearly costs were 3.8-fold greater ($5000 vs. $1304). These cost differences were predominantly due to outpatient and pharmacy expenses. Medication and procedure use were significantly greater in cases than controls. These findings were consistent across RxRisk categories, which suggest that the observed cost differences are IC-specific. Conclusions The direct per-person costs of IC are high, with average yearly costs approximately $4000 greater than age-matched controls. This cost differential is an underestimate, as costs preceding the diagnosis, use of alternative therapies, indirect costs and costs of those with IC that is not diagnosed are not included. PMID:18329077

Cost effectiveness analysis of Year 2 of an elementary school-located influenza vaccination program-Results from a randomized controlled trial.

PubMed

Yoo, Byung-Kwang; Humiston, Sharon G; Szilagyi, Peter G; Schaffer, Stanley J; Long, Christine; Kolasa, Maureen

2015-11-16

School-located vaccination against influenza (SLV-I) has the potential to improve current suboptimal influenza immunization coverage for U.S. school-aged children. However, little is known about SLV-I's cost-effectiveness. The objective of this study is to establish the cost-effectiveness of SLV-I based on a two-year community-based randomized controlled trial (Year 1: 2009-2010 vaccination season, an unusual H1N1 pandemic influenza season, and Year 2: 2010-2011, a more typical influenza season). We performed a cost-effectiveness analysis on a two-year randomized controlled trial of a Western New York SLV-I program. SLV-I clinics were offered in 21 intervention elementary schools (Year 1 n = 9,027; Year 2 n = 9,145 children) with standard-of-care (no SLV-I) in control schools (Year 1 n = 4,534 (10 schools); Year 2 n = 4,796 children (11 schools)). We estimated the cost-per-vaccinated child, by dividing the incremental cost of the intervention by the incremental effectiveness (i.e., the number of additionally vaccinated students in intervention schools compared to control schools). In Years 1 and 2, respectively, the effectiveness measure (proportion of children vaccinated) was 11.2 and 12.0 percentage points higher in intervention (40.7 % and 40.4 %) than control schools. In year 2, the cost-per-vaccinated child excluding vaccine purchase ($59.88 in 2010 US $) consisted of three component costs: (A) the school costs ($8.25); (B) the project coordination costs ($32.33); and (C) the vendor costs excluding vaccine purchase ($16.68), summed through Monte Carlo simulation. Compared to Year 1, the two component costs (A) and (C) decreased, while the component cost (B) increased in Year 2. The cost-per-vaccinated child, excluding vaccine purchase, was $59.73 (Year 1) and $59.88 (Year 2, statistically indistinguishable from Year 1), higher than the published cost of providing influenza vaccination in medical practices ($39.54). However, taking indirect costs (e.g., averted parental costs to visit medical practices) into account, vaccination was less costly in SLV-I ($23.96 in Year 1, $24.07 in Year 2) than in medical practices. Our two-year trial's findings reinforced the evidence to support SLV-I as a potentially favorable system to increase childhood influenza vaccination rates in a cost-efficient way. Increased efficiencies in SLV-I are needed for a sustainable and scalable SLV-I program.

Costs of venous thromboembolism associated with hospitalization for medical illness.

PubMed

Cohoon, Kevin P; Leibson, Cynthia L; Ransom, Jeanine E; Ashrani, Aneel A; Petterson, Tanya M; Long, Kirsten Hall; Bailey, Kent R; Heit, Johm A

2015-04-01

To determine population-based estimates of medical costs attributable to venous thromboembolism (VTE) among patients currently or recently hospitalized for acute medical illness. Population-based cohort study conducted in Olmsted County, Minnesota. Using Rochester Epidemiology Project (REP) resources, we identified all Olmsted County residents with objectively diagnosed incident VTE during or within 92 days of hospitalization for acute medical illness over the 18-year period of 1988 to 2005 (n=286). One Olmsted County resident hospitalized for medical illness without VTE was matched to each case for event date (±1 year), duration of prior medical history, and active cancer status. Subjects were followed forward in REP provider-linked billing data for standardized, inflation-adjusted direct medical costs (excluding outpatient pharmaceutical costs) from 1 year before their respective event or index date to the earliest of death, emigration from Olmsted County, or December 31, 2011 (study end date). We censored follow-up such that each case and matched control had similar periods of observation. We used generalized linear modeling (controlling for age, sex, preexisting conditions, and costs 1 year before index) to predict costs for cases and controls. Adjusted mean predicted costs were 2.5-fold higher for cases ($62,838) than for controls ($24,464) (P<.001) from index to up to 5 years post index. Cost differences between cases and controls were greatest within the first 3 months after the event date (mean difference=$16,897) but costs remained significantly higher for cases compared with controls for up to 3 years. VTE during or after recent hospitalization for medical illness contributes a substantial economic burden.

Cost--effectiveness analysis of salpingectomy prior to IVF, based on a randomized controlled trial.

PubMed

Strandell, Annika; Lindhard, Anette; Eckerlund, Ingemar

2005-12-01

In patients with ultrasound-visible hydrosalpinges, salpingectomy prior to IVF increases the chance of a live birth. This study compared the cost-effectiveness of this strategy (intervention) with that of optional salpingectomy after a failed cycle (control). Data from a Scandinavian randomized controlled trial were used to calculate the individual number of treatments and their outcomes. Only patients with ultrasound-visible hydrosalpinges were considered in the main analysis, and a maximum of three fresh cycles were included. The costs for surgical procedures, IVF treatment, medication, complications, management of pregnancy and delivery as well as of early pregnancy losses were calculated from standardized hospital charges. Among the 51 patients in the intervention group, the live birth rate was 60.8% compared with 40.9% in 44 controls. The average cost per patient was 13,943 euro and 12,091 euro, respectively. Thus, the average cost per live birth was 22,823 euro in the intervention group and 29,517 euro in the control group. The incremental cost-effectiveness ratio for adopting the intervention strategy was estimated at 9306 euro. The incremental cost to achieve the higher birth rate of the intervention strategy seems reasonable.

Cost-Effectiveness of Interventions to Prevent and Control Diabetes Mellitus: A Systematic Review

PubMed Central

Li, Rui; Zhang, Ping; Barker, Lawrence E.; Chowdhury, Farah M.; Zhang, Xuanping

2010-01-01

OBJECTIVE To synthesize the cost-effectiveness (CE) of interventions to prevent and control diabetes, its complications, and comorbidities. RESEARCH DESIGN AND METHODS We conducted a systematic review of literature on the CE of diabetes interventions recommended by the American Diabetes Association (ADA) and published between January 1985 and May 2008. We categorized the strength of evidence about the CE of an intervention as strong, supportive, or uncertain. CEs were classified as cost saving (more health benefit at a lower cost), very cost-effective (≤$25,000 per life year gained [LYG] or quality-adjusted life year [QALY]), cost-effective ($25,001 to $50,000 per LYG or QALY), marginally cost-effective ($50,001 to $100,000 per LYG or QALY), or not cost-effective (>$100,000 per LYG or QALY). The CE classification of an intervention was reported separately by country setting (U.S. or other developed countries) if CE varied by where the intervention was implemented. Costs were measured in 2007 U.S. dollars. RESULTS Fifty-six studies from 20 countries met the inclusion criteria. A large majority of the ADA recommended interventions are cost-effective. We found strong evidence to classify the following interventions as cost saving or very cost-effective: (I) Cost saving— 1) ACE inhibitor (ACEI) therapy for intensive hypertension control compared with standard hypertension control; 2) ACEI or angiotensin receptor blocker (ARB) therapy to prevent end-stage renal disease (ESRD) compared with no ACEI or ARB treatment; 3) early irbesartan therapy (at the microalbuminuria stage) to prevent ESRD compared with later treatment (at the macroalbuminuria stage); 4) comprehensive foot care to prevent ulcers compared with usual care; 5) multi-component interventions for diabetic risk factor control and early detection of complications compared with conventional insulin therapy for persons with type 1 diabetes; and 6) multi-component interventions for diabetic risk factor control and early detection of complications compared with standard glycemic control for persons with type 2 diabetes. (II) Very cost-effective— 1) intensive lifestyle interventions to prevent type 2 diabetes among persons with impaired glucose tolerance compared with standard lifestyle recommendations; 2) universal opportunistic screening for undiagnosed type 2 diabetes in African Americans between 45 and 54 years old; 3) intensive glycemic control as implemented in the UK Prospective Diabetes Study in persons with newly diagnosed type 2 diabetes compared with conventional glycemic control; 4) statin therapy for secondary prevention of cardiovascular disease compared with no statin therapy; 5) counseling and treatment for smoking cessation compared with no counseling and treatment; 6) annual screening for diabetic retinopathy and ensuing treatment in persons with type 1 diabetes compared with no screening; 7) annual screening for diabetic retinopathy and ensuing treatment in persons with type 2 diabetes compared with no screening; and 8) immediate vitrectomy to treat diabetic retinopathy compared with deferred vitrectomy. CONCLUSIONS Many interventions intended to prevent/control diabetes are cost saving or very cost-effective and supported by strong evidence. Policy makers should consider giving these interventions a higher priority. PMID:20668156

Cost comparisons of raising a child from birth to 17 years among samples of abused, delinquent, violent, and homicidal youth using victimization and justice system estimates.

PubMed

Zagar, Agata Karolina; Zagar, Robert John; Bartikowski, Boris; Busch, Kenneth G

2009-02-01

Data from youth studied by Zagar and colleagues were randomly sampled to create groups of controls and abused, delinquent, violent, and homicidal youth (n=30 in each). Estimated costs of raising a nondelinquent youth from birth to 17 yr. were compared with the average costs incurred by other youth in each group. Estimates of living expenses, direct and indirect costs of victimization, and criminal justice system expenditures were summed. Groups differed significantly on total expenses, victimization costs, and criminal justice expenditures. Mean total costs for a homicidal youth were estimated at $3,935,433, while those for a control youth were $150,754. Abused, delinquent, and violent youth had average total expenses roughly double the total mean costs of controls. Prevention of dropout, alcoholism, addiction, career delinquency, or homicide justifies interception and empirical treatment on a cost-benefit basis, but also based on the severe personal costs to the victims and to the youth themselves.

Government Accounting

DTIC Science & Technology

1999-06-22

Commercial Industry • Financial Standards Accounting Board (GAAP) • Internal Revenue Service - Tax Accounting • DoD - Cost Accounting Standards...internal management control systems, managers shall focus on results, not process” Government Accounting • Intent EVM Accounting Criteria : – Record costs ...consistent with established budgets – Insure control of indirect costs – Insure disciplined accumulation of cost – Insure proper material accounting and

Migraine Nurses in Primary Care: Costs and Benefits.

PubMed

van den Berg, Jan S P; Steiner, Timothy J; Veenstra, Petra J L; Kollen, Boudewijn J

2017-09-01

We examined the costs and benefits of introducing migraine nurses into primary care. Migraine is one of the most costly neurological diseases. We analyzed data from our earlier nonrandomized cohort study comparing an intervention group of 141 patients, whose care was supported by nurses trained in migraine management, and a control group of 94 patients receiving usual care. Estimates of per-person direct costs were based on nurses' salaries and referrals to neurologists. Indirect costs were estimated as lost productivity, including numbers of days of absenteeism or with <50% productivity at work due to migraine, and notional costs related to lost days of household activities or days of <50% household productivity. Analysis was conducted from the payer's perspective. After 9 months the direct costs were €281.11 in the control group against €332.23 in the intervention group (mean difference -51.12; 95% CI: -113.20-15.56; P = .134); the indirect costs were €1985.51 in the control group against €1631.75 in the intervention group (mean difference 353.75; 95% CI: -355.53-1029.82; P = .334); and total costs were €2266.62 in the control group, against €1963.99 in the intervention group (mean difference 302.64; 95% CI: -433.46-1001.27; P = .438). When costs attributable to lost household productivity were included, total costs increased to €6076.62 in the control group and €5048.15 in the intervention group (mean difference 1028.47; 95% CI: -590.26-2603.67; P = .219). Migraine nurses in primary care seemed in this study to increase practice costs but decrease total societal costs. However, it was a nonrandomized study, and the differences did not reach significance. For policy-makers concerned with headache-service organization and delivery, the important messages are that we found no evidence that nurses increased overall costs, and investment in a definitive study would therefore be worthwhile. © 2017 American Headache Society.

Quantifying the energy-storage benefits of controlled plug-in electric vehicle charging

DOE PAGES

Xi, Xiaomin; Sioshansi, Ramteen

2016-01-01

Flexibility in plug-in electric vehicle (PEV) charging can reduce PEV charging costs. Moreover, controlled PEV charging can be viewed as a limited form of energy storage, insomuch as charging loads are shifted from high-cost periods to lower-cost ones. Energy storage that is used for generation shifting is used in much the same manner. In this paper, we study these benefits of PEV charging, demonstrating that controlled PEV charging can reduce generation costs. As a result, we also determine how much energy storage would be needed to provide the same cost-reduction benefits that the PEV fleet does.

Quantifying the energy-storage benefits of controlled plug-in electric vehicle charging

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

Xi, Xiaomin; Sioshansi, Ramteen

Flexibility in plug-in electric vehicle (PEV) charging can reduce PEV charging costs. Moreover, controlled PEV charging can be viewed as a limited form of energy storage, insomuch as charging loads are shifted from high-cost periods to lower-cost ones. Energy storage that is used for generation shifting is used in much the same manner. In this paper, we study these benefits of PEV charging, demonstrating that controlled PEV charging can reduce generation costs. As a result, we also determine how much energy storage would be needed to provide the same cost-reduction benefits that the PEV fleet does.

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

PubMed

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

Health sector costs of self-reported food allergy in Europe: a patient-based cost of illness study.

PubMed

Fox, Margaret; Mugford, Miranda; Voordouw, Jantine; Cornelisse-Vermaat, Judith; Antonides, Gerrit; de la Hoz Caballer, Belen; Cerecedo, Inma; Zamora, Javier; Rokicka, Ewa; Jewczak, Maciej; Clark, Allan B; Kowalski, Marek L; Papadopoulos, Nikos; Knulst, Anna C; Seneviratne, Suranjith; Belohlavkova, Simona; Asero, Roberto; de Blay, Frederic; Purohit, Ashok; Clausen, Michael; Flokstra de Blok, Bertine; Dubois, Anthony E; Fernandez-Rivas, Montserrat; Burney, Peter; Frewer, Lynn J; Mills, Clare E N

2013-10-01

Food allergy is a recognized health problem, but little has been reported on its cost for health services. The EuroPrevall project was a European study investigating the patterns, prevalence and socio-economic cost of food allergy. To investigate the health service cost for food-allergic Europeans and the relationship between severity and cost of illness. Participants recruited through EuroPrevall studies in a case-control study in four countries, and cases only in five countries, completed a validated economics questionnaire. Individuals with possible food allergy were identified by clinical history, and those with food-specific immunoglobulin E were defined as having probable allergy. Data on resource use were used to estimate total health care costs of illness. Mean costs were compared in the case-control cohorts. Regression analysis was conducted on cases from all 9 countries to assess impact of country, severity and age group. Food-allergic individuals had higher health care costs than controls. The mean annual cost of health care was international dollars (I$)2016 for food-allergic adults and I$1089 for controls, a difference of I$927 (95% confidence interval I$324-I$1530). A similar result was found for adults in each country, and for children, and was not sensitive to baseline demographic differences. Cost was significantly related to severity of illness in cases in nine countries. Food allergy is associated with higher health care costs. Severity of allergic symptoms is a key explanatory factor.

Back-door cost-benefit analysis under a safety-first Clean Air Act

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

Barnes, D.W.

The Clean Air Act emphasizes safety over cost considerations, but a cost-conscious administration which emphasizes economic impacts has not enforced the letter of the safety-first law. A solution could be to budget cost-justified rather than safety-first levels of pollution reduction. A comparison of cost-benefit balancing and budgetary control measures examines administrative procedures and probable outcomes in terms of enforcement costs. The author notes that the two concepts require different technology. The higher cost of safety-first technology tend to discourage investment, and could lead to less pollution control than the cost-benefit approach. 59 references, 12 figures. (DCK)

Proportional costs in trauma and acute care surgery patients: dominant role of intensive care unit costs.

PubMed

Fakhry, Samir M; Martin, Brad; Al Harakeh, Hasan; Norcross, E Douglas; Ferguson, Pamela L

2013-04-01

Controlling inpatient costs is increasingly important. Identifying proportionately larger cost categories may help focus cost control efforts. The purpose of this study was to identify proportionate patient cost categories in trauma and acute care surgery (TACS) patients and determine subgroups in which the largest opportunities for cost savings might exist. Administrative data from our academic, urban, level I trauma center were used to identify all adult TACS patients from FY07 through FY11. We determined, on average, what proportion of the whole each cost category contributed to patients' total costs and examined the same proportions for subgroups of patients. We identified 6,008 TACS patients. Trauma patients (n = 3,904) made up 65% of the cohort (mean Injury Severity Score 13.2). Payers were: 22% government (Medicare, Medicaid, Champus), 27% private, 43% self-pay/indigent, 3% other, and 5% workers compensation. Nontrauma (general surgery) patients (n = 2,104) made up 35% of the cohort. Payers were: 44% government, 24% private, 29% self-pay/indigent, 2% other, and 1% workers compensation. Total inpatient costs were $141,304,993. Per patient costs rose from $17,245 in FY07 to $26,468 in FY11. In the aggregate, supplies, ICU stays, and ward stays represented the largest proportionate cost categories. On a per patient basis, however, ICU stays were by far the largest cost. Patients with ICU stay greater than 10 days were only 7% of all patients but accounted for 41% of total costs. Trauma and acute care surgery patients represent a significant and increasing institutional cost. Per patient ICU costs were the largest single category, suggesting that cost control efforts should focus heavily on critically ill patients. Nontrauma patients who require critical care have the highest per patient ICU costs and may represent a previously underappreciated opportunity for cost control. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Control and Effort Costs Influence the Motivational Consequences of Choice

PubMed Central

Sullivan-Toole, Holly; Richey, John A.; Tricomi, Elizabeth

2017-01-01

The act of making a choice, apart from any outcomes the choice may yield, has, paradoxically, been linked to both the enhancement and the detriment of intrinsic motivation. Research has implicated two factors in potentially mediating these contradictory effects: the personal control conferred by a choice and the costs associated with a choice. Across four experiments, utilizing a physical effort task disguised as a simple video game, we systematically varied costs across two levels of physical effort requirements (Low-Requirement, High-Requirement) and control over effort costs across three levels of choice (Free-Choice, Restricted-Choice, and No-Choice) to disambiguate how these factors affect the motivational consequences of choosing within an effortful task. Together, our results indicated that, in the face of effort requirements, illusory control alone may not sufficiently enhance perceptions of personal control to boost intrinsic motivation; rather, the experience of actual control may be necessary to overcome effort costs and elevate performance. Additionally, we demonstrated that conditions of illusory control, while otherwise unmotivating, can through association with the experience of free-choice, be transformed to have a positive effect on motivation. PMID:28515705

Out-of-pocket medical costs and third-party healthcare costs for children with Down syndrome.

PubMed

Kageleiry, Andrew; Samuelson, David; Duh, Mei Sheng; Lefebvre, Patrick; Campbell, John; Skotko, Brian G

2017-03-01

Prior analyses have estimated the lifetime total societal costs of a person with Down syndrome (DS); however, no studies capture the expected medical costs that patients with DS can expect to incur during childhood. The study utilized the OptumHealth Reporting and Insights administrative claims database from 1999 to 2013. Children with a diagnosis of DS were identified, and their time was divided into clinically relevant age categories. Patients with DS in each age category were matched to controls without chromosomal conditions. Out-of-pocket medical costs and third-party expenditures were compared between the patient-age cohorts with DS and matched controls. Patients with DS had significantly higher mean annual out-of-pocket costs than their matched controls within each age and cost category. Total annual incremental out-of-pocket costs associated with DS were highest among individuals from birth to age 1 ($1,907, P < 0.001). The main drivers of the incremental out-of-pocket costs associated with DS were inpatient costs in the 1st year of life ($925, P < 0.001) and outpatient costs in later years (ranging $183-$623, all P < 0.001). Overall, patients with DS incurred incremental out-of-pocket medical costs of $18,248 between birth and age 18 years; third-party payers incurred incremental costs of $230,043 during the same period. Across all age categories, mean total out-of-pocket annual costs were greater for individuals with DS than those of matched controls. On average, parents of children with DS pay an additional $84 per month for out-of-pocket medical expenses when costs are amortized over 18 years. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry meat food supply.

PubMed

Lake, Robin J; Horn, Beverley J; Dunn, Alex H; Parris, Ruth; Green, F Terri; McNickle, Don C

2013-07-01

An analysis of the cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry supply examined a series of interventions. Effectiveness was evaluated in terms of reduced health burden measured by disability-adjusted life years (DALYs). Costs of implementation were estimated from the value of cost elements, determined by discussions with industry. Benefits were estimated by changing the inputs to a poultry food chain quantitative risk model. Proportional reductions in the number of predicted Campylobacter infections were converted into reductions in the burden of disease measured in DALYs. Cost-effectiveness ratios were calculated for each intervention, as cost per DALY reduction and the ratios compared. The results suggest that the most cost-effective interventions (lowest ratios) are at the primary processing stage. Potential phage-based controls in broiler houses were also highly cost-effective. This study is limited by the ability to quantify costs of implementation and assumptions required to estimate health benefits, but it supports the implementation of interventions at the primary processing stage as providing the greatest quantum of benefit and lowest cost-effectiveness ratios.

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.

Cost effectiveness of a mail-delivered individually tailored physical activity intervention for Latinas vs. a mailed contact control.

PubMed

Larsen, Britta; Gilmer, Todd; Pekmezi, Dori; Napolitano, Melissa A; Marcus, Bess H

2015-11-11

Physical inactivity is high in Latinas, as are chronic health conditions. There is a need for physical activity (PA) interventions that are not only effective but have potential for cost-effective widespread dissemination. The purpose of this paper was to assess the costs and cost effectiveness of a Spanish-language print-based mail-delivered PA intervention that was linguistically and culturally adapted for Latinas. Adult Latinas (N = 266) were randomly assigned to receive mail-delivered individually tailored intervention materials or wellness information mailed on the same schedule (control). PA was assessed at baseline, six months (post-intervention) and 12 months (maintenance phase) using the 7-Day Physical Activity Recall Interview. Costs were calculated from a payer perspective, and included personnel time (wage, fringe, and overhead), materials, equipment, software, and postage costs. At six months, the PA intervention cost $29/person/month, compared to $15/person/month for wellness control. These costs fell to $17 and $9 at 12 months, respectively. Intervention participants increased their PA by an average of 72 min/week at six months and 94 min/week at 12 months, while wellness control participants increased their PA by an average of 30 min/week and 40 min/week, respectively. At six months, each minute increase in PA cost $0.18 in the intervention group compared to $0.23 in wellness control, which fell to $0.07 and $0.08 at 12 months, respectively. The incremental cost per increase in physical activity associated with the intervention was $0.15 at 6 months and $0.05 at 12 months. While the intervention was more costly than the wellness control, costs per minute of increase in PA were lower in the intervention. The print-based mail-delivered format has potential for broad, cost-effective dissemination, which could help address disparities in this at-risk population. NCT01583140; Date of Registration: 03/06/2012; Funding Source of Trial: National Institute of Nursing Research (NINR); Name of Institutional Review Board: Brown University IRB; Date of Approval: 05/19/2009.

"A manager in the minds of doctors:" a comparison of new modes of control in European hospitals.

PubMed

Kuhlmann, Ellen; Burau, Viola; Correia, Tiago; Lewandowski, Roman; Lionis, Christos; Noordegraaf, Mirko; Repullo, Jose

2013-07-02

Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals. The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources. The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) 'integrated' control with high levels of coordination and coherent patterns for cost and quality controls; (2) 'partly integrated' control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) 'fragmented' control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management. Our comparison highlights how organisations matter and brings the crucial relevance of 'coordination' of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective.

Cost effectiveness analysis of elementary school-located vaccination against influenza--results from a randomized controlled trial.

PubMed

Yoo, Byung-Kwang; Humiston, Sharon G; Szilagyi, Peter G; Schaffer, Stanley J; Long, Christine; Kolasa, Maureen

2013-04-19

School-located vaccination against influenza (SLV-I) has been suggested to help meet the need for annual vaccination of large numbers of school-aged children with seasonal influenza vaccine. However, little is known about the cost and cost-effectiveness of SLV-I. We conducted a cost-analysis and a cost-effectiveness analysis based on a randomized controlled trial (RCT) of an SLV-I program implemented in Monroe County, New York during the 2009-2010 vaccination season. We hypothesized that SLV-I is more cost effective, or less-costly, compared to a conventional, office-located influenza vaccination delivery. First and second SLV-I clinics were offered in 21 intervention elementary schools (n=9027 children) with standard of care (no SLV-I) in 11 control schools (n=4534 children). The direct costs, to purchase and administer vaccines, were estimated from our RCT. The effectiveness measure, receipt of ≥1 dose of influenza vaccine, was 13.2 percentage points higher in SLV-I schools than control schools. The school costs ($9.16/dose in 2009 dollars) plus project costs ($23.00/dose) plus vendor costs excluding vaccine purchase ($19.89/dose) was higher in direct costs ($52.05/dose) than the previously reported mean/median cost [$38.23/$21.44 per dose] for providing influenza vaccination in pediatric practices. However SLV-I averted parent costs to visit medical practices ($35.08 per vaccine). Combining direct and averted costs through Monte Carlo Simulation, SLV-I costs were $19.26/dose in net costs, which is below practice-based influenza vaccination costs. The incremental cost-effectiveness ratio (ICER) was estimated to be $92.50 or $38.59 (also including averted parent costs). When additionally accounting for the costs averted by disease prevention (i.e., both reduced disease transmission to household members and reduced loss of productivity from caring for a sick child), the SLV-I model appears to be cost-saving to society, compared to "no vaccination". Our findings support the expanded implementation of SLV-I, but also the need to focus on efficient delivery to reduce direct costs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Optimal Guaranteed Cost Sliding Mode Control for Constrained-Input Nonlinear Systems With Matched and Unmatched Disturbances.

PubMed

Zhang, Huaguang; Qu, Qiuxia; Xiao, Geyang; Cui, Yang

2018-06-01

Based on integral sliding mode and approximate dynamic programming (ADP) theory, a novel optimal guaranteed cost sliding mode control is designed for constrained-input nonlinear systems with matched and unmatched disturbances. When the system moves on the sliding surface, the optimal guaranteed cost control problem of sliding mode dynamics is transformed into the optimal control problem of a reformulated auxiliary system with a modified cost function. The ADP algorithm based on single critic neural network (NN) is applied to obtain the approximate optimal control law for the auxiliary system. Lyapunov techniques are used to demonstrate the convergence of the NN weight errors. In addition, the derived approximate optimal control is verified to guarantee the sliding mode dynamics system to be stable in the sense of uniform ultimate boundedness. Some simulation results are presented to verify the feasibility of the proposed control scheme.

Implementing Lean Six Sigma to achieve inventory control in supply chain management

NASA Astrophysics Data System (ADS)

Hong, Chen

2017-11-01

The inventory cost has important impact on the production cost. In order to get the maximum circulation of funds of enterprise with minimum inventory cost, the inventory control with Lean Six Sigma is presented in supply chain management. The inventory includes both the raw material and the semi-finished parts in manufacturing process. Though the inventory is often studied, the inventory control in manufacturing process is seldom mentioned. This paper reports the inventory control from the perspective of manufacturing process by using statistical techniques including DMAIC, Control Chart, and Statistical Process Control. The process stability is evaluated and the process capability is verified with Lean Six Sigma philosophy. The demonstration in power meter production shows the inventory is decreased from 25% to 0.4%, which indicates the inventory control can be achieved with Lean Six Sigma philosophy and the inventory cost in production can be saved for future sustainable development in supply chain management.

Cost-utility of laparoscopic Nissen fundoplication versus proton pump inhibitors for chronic and controlled gastroesophageal reflux disease: a 3-year prospective randomized controlled trial and economic evaluation.

PubMed

Goeree, Ron; Hopkins, Rob; Marshall, John K; Armstrong, David; Ungar, Wendy J; Goldsmith, Charles; Allen, Christopher; Anvari, Mehran

2011-01-01

Very few randomized controlled trials (RCTs) have compared laparoscopic Nissen fundoplication (LNF) to proton pump inhibitors (PPI) medical management for patients with chronic gastroesophageal reflux disease (GERD). Larger RCTs have been relatively short in duration, and have reported mixed results regarding symptom control and effect on quality of life (QOL). Economic evaluations have reported conflicting results. To determine the incremental cost-utility of LNF versus PPI for treating patients with chronic and controlled GERD over 3 years from the societal perspective. Economic evaluation was conducted alongside a RCT that enrolled 104 patients from October 2000 to September 2004. Primary study outcome was GERD symptoms (secondary outcomes included QOL and cost-utility). Resource utilization and QOL data collected at regular follow-up intervals determined incremental cost/QALY gained. Stochastic uncertainty was assessed using bootstrapping and methodologic assumptions were assessed using sensitivity analysis. No statistically significant differences in GERD symptom scores, but LNF did result in fewer heartburn days and improved QOL. Costs were higher for LNF patients by $3205/patient over 3 years but QOL was also higher as measured by either QOL instrument. Based on total costs, incremental cost-utility of LNF was $29,404/QALY gained using the Health Utility Index 3. Cost-utility results were sensitive to the utility instrument used ($29,404/QALY for Health Utility Index 3, $31,117/QALY for the Short Form 6D, and $76,310/QALY for EuroQol 5D) and if current lower prices for PPIs were used in the analysis. Results varied depending on resource use/costs included in the analysis, the QOL instrument used, and the cost of PPIs; however, LNF was generally found to be a cost-effective treatment for patients with symptomatic controlled GERD requiring long-term management. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Analysis of real-world health care costs among immunocompetent patients aged 50 years or older with herpes zoster in the United States.

PubMed

Meyers, Juliana L; Madhwani, Shweta; Rausch, Debora; Candrilli, Sean D; Krishnarajah, Girishanthy; Yan, Songkai

2017-08-03

Few peer-reviewed publications present real-world United States (US) data describing resource utilization and costs associated with herpes zoster (HZ) and postherpetic neuralgia (PHN). The primary objective of this analysis (GSK study identifier: HO-14-14270) was to assess direct costs associated with HZ and PHN in the US using a retrospective managed care insurance claims database. Patients ≥ 50 y at HZ diagnosis were selected. Patients were excluded if they were immunocompromised before diagnosis or received an HZ vaccine at any time. A subsample of patients with PHN was identified. Each patient with HZ was matched to ≤ 4 controls without HZ based on age, sex, and health plan enrollment. Incremental differences in mean HZ-related costs ("incremental costs") were assessed overall and stratified by age. Multivariable regression models controlled for the effect of demographic characteristics, prediagnosis costs, and comorbidity burden on costs using a recycled predictions approach. Overall, 142,519 patients with HZ (9,470 patients [6.6%] had PHN) and 357,907 matched controls without HZ were identified. Resource utilization was greater among patients with HZ than controls. After adjusting for demographic and clinical characteristics, annual incremental health care costs for HZ patients vs. controls were $1,210 for patients aged 50-59 years, $1,629 for those 60-64 years, $1,876 for those 65-69 years, $2,643 for those 70-79 years, and $3,804 for those 80+ years; adjusted annual incremental costs among PHN patients vs. controls were $4,670 for patients 50-59 years, $6,133 for those 60-64 years, $6,451 for those 65-69 years, $8,548 for those 70-79 years, and $11,147 for those 80+ years. HZ is associated with a significant cost burden, which increases with advancing patient age. Vaccination may reduce costs associated with HZ through case avoidance.

[Experiences in maintenance and repair cost control of medical equipments].

PubMed

Liu, Jin-chu; Wu, Yun-fang

2005-07-01

This paper introduces methods to control the cost of maintenance and repair for medical equipments through service team training, service contract control, system establishment and outside service resources, etc..

[Health economics analysis of specific immunotherapy in allergic rhinitis accompanied with asthma].

PubMed

Chen, Jianjun; Xiang, Jisheng; Wang, Yanjun; Shi, Qiumei; Tan, Huifang; Kong, Weijia

2013-09-01

To investigate the cost-effectiveness of standardized specific immunotherapy (SIT) for allergic rhinitis patients accompanied with asthma (ARAS) in China. Forty ARAS patients sensitized with house dust mite (HDM) were administered with SIT (SIT group) or merely medicine treatment (control group). Alutard dermatophagoides pteronyssinus vaccine from ALK company was used for immunotherapy. The usage of symptom control medicine was according to the ARIA and GINA guideline. Cost-effectiveness ratio (CER) and Incremental cost-effectiveness ratio(ICER) analysis was conducted. The effectiveness was measured in terms of symptom scores, quality of life, objective improvement of rhinitis and asthma. Sensitive analysis was conducted to verify the stability of the results. The cost of SIT group for 1 year (6578 yuan) was higher than that of control group (1733.3 yuan), while the cost-effectiveness ratio and incremental cost-effectiveness ratio of SIT group were significant better than that of control group in all items. CER was 1686.7 yuan in SIT group compared with 3466.6 yuan in control group for nasal symptom scores, 4698.6 yuan in SIT group compared with 5777.8 yuan in control group for asthma symptom scores, 3462.1 yuan in SIT group compared with 8666.7 yuan in control group. The sensitive analysis of the price 10 percent higher or lower showed the same results. The cost-effectiveness of specific immunotherapy (SIT) for mite sensitized ARAS patients was better than that of merely medicine treatment.

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania

PubMed Central

Ngalesoni, Frida; Ruhago, George; Mayige, Mary; Oliveira, Tiago Cravo; Robberstad, Bjarne; Norheim, Ole Frithjof; Higashi, Hideki

2017-01-01

Background Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. Aims We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania. Materials and methods A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs) averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters. Results Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively. Conclusions Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government’s ability to implement these interventions. PMID:28767722

Costs and cost-effectiveness of malaria control interventions - a systematic review

PubMed Central

2011-01-01

Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment (IPT), diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54) for ITNs, $6.70 (range $2.22-$12.85) for IRS, $0.60 (range $0.48-$1.08) for IPT in infants, $4.03 (range $1.25-$11.80) for IPT in children, and $2.06 (range $0.47-$3.36) for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34). The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65) and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87). Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110) for ITNs, $143 (range $135-$150) for IRS, and $24 (range $1.08-$44.24) for IPT. Conclusions A transparent evidence base on the costs and cost-effectiveness of malaria control interventions is provided to inform rational resource allocation by donors and domestic health budgets and the selection of optimal packages of interventions by malaria control programmes. PMID:22050911

User Delay Cost Model and Facilities Maintenance Cost Model for a Terminal Control Area : Volume 2. User's Manual and Program Documentation for the User Delay Cost Model

DOT National Transportation Integrated Search

1978-05-01

The User Delay Cost Model (UDCM) is a Monte Carlo simulation of certain classes of movement of air traffic in the Boston Terminal Control Area (TCA). It incorporates a weather module, an aircraft generation module, a facilities module, and an air con...

Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

PubMed Central

Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

2015-01-01

Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; p<0.0001) with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

A Subject Reference: Benefit-Cost Analysis of Toxic Substances, Hazardous Materials and Solid Waste Control (1977)

EPA Pesticide Factsheets

Discussion of methodological issues for conducting benefit-cost analysis and provides guidance for selecting and applying the most appropriate and useful mechanisms in benefit-cost analysis of toxic substances, hazardous materials, and solid waste control

An Introduction to the Cost of Engineering and Institutional Controls at Brownfield Properties

EPA Pesticide Factsheets

This fact sheet introduces and explores the costs of site cleanup and, where cleanup leaves site contamination that restricts reuse, outlines the engineering and institutional controls and their monitoring and maintenance costs over a longer time frame.

Costs of Managing Patients with Diabetes in a Large Health Maintenance Organization in Israel: A Retrospective Cohort Study.

PubMed

Porath, Avi; Fund, Naama; Maor, Yasmin

2017-02-01

The aim of this study was to evaluate the direct costs of patients with diabetes ensured in a large health maintenance organization, Maccabi Health Services (MHS), in order to compare the medical costs of these patients to the medical costs of other patients insured by MHS and to assess the impact of poorly controlled diabetes on medical costs. A retrospective analysis of patients insured in MHS during 2012 was performed. Data were extracted automatically from the electronic database. A glycated hemoglobin (HbA1c) level of >9% (75 mmol/mol) was considered to define poorly controlled diabetes, and that of <7% (53 mmol/mol) and <8% (64 mmol/mol) to define controlled diabetes for patients aged <75 and ≥75 years, respectively. Multivariate analysis analyses were done to assess factors affecting cost. Data on a total of 99,017 patients with diabetes were obtained from the MHS database for 2012. Of these, 54% were male and 72% were aged 45-75 years. The median annual cost of treating diabetes was 4420 cost units (CU), with hospitalization accounting for 56% of the total costs. The median annual cost per patient in the age groups 35-44 and 75-84 years was 2836 CU and 7033 CU, respectively. Differences between costs for patients with diabetes and those for patients without diabetes was 85% for the age group 45-54 years but only 24% for the age group 75-84 years. Medical costs increased similarly with age for patients with controlled diabetes and those with poorly controlled diabetes costs, as did additional co-morbidities. Costs were significantly impacted by kidney disease. The costs for patients with an HbA1c level of 8.0-8.99% (64-74 mmol/mol) and 9.0-9.99% (75-85 mmol/mol) were 5722 and 5700 CU, respectively. In a multivariate analysis the factors affecting all patients' costs were HbA1C level, male gender, chronic diseases, complications of diabetes, disease duration, and stage of kidney function. The direct medical costs of patients with diabetes were significantly higher than those of patients without diabetes. The main drivers of these higher costs were hospitalizations and renal function. In poorly controlled patients the effect of HbA1c on costs was limited. These findings suggest that it is cost effective to identify patients with diabetes early in the course of the disease. The work was sponsored by internal funds of the authors. Article processing charges for this study was funded by Novo Nordisk.

Costs of interstitial cystitis in a managed care population.

PubMed

Clemens, J Quentin; Meenan, Richard T; Rosetti, Maureen C O'Keeffe; Kimes, Terry; Calhoun, Elizabeth A

2008-05-01

To assess the direct medical costs, medication, and procedure use associated with interstitial cystitis (IC) in women in the Kaiser Permanente Northwest (KPNW) managed care population. The KPNW electronic medical record was used to identify women diagnosed with IC (n = 239). Each of these patients was matched with three controls according to age and duration in the health plan. Health plan cost accounting data were used to determine the inpatient, outpatient, and pharmacy costs for 1998 to 2003. An analysis of the prescription medication use and cystoscopic and urodynamic procedures commonly associated with IC was also performed. To evaluate for co-morbidities, an automated risk-adjustment model linked to 28 chronic medical conditions was applied to the administrative data sets from both groups. The mean duration from the date of IC diagnosis to the end of the study period was 36.6 months (range 1.4 to 60). The mean yearly costs were 2.4-fold greater for the patients than for the controls ($7100 versus $2994), and the median yearly costs were 3.8-fold greater ($5000 versus $1304). These cost differences were predominantly due to outpatient and pharmacy expenses. Medication and procedure use were significantly greater for the patients than for the controls. These findings were consistent across risk-adjustment model categories, which suggest that the observed cost differences are IC specific. The direct per-person costs of IC are high, with average yearly costs approximately $4000 greater than for the age-matched controls. This cost differential is an underestimate, because the costs preceding the diagnosis, the use of alternative therapies, indirect costs, and the costs of those with IC that is not diagnosed were not included.

Health, social and economic consequences of dementias: a comparative national cohort study.

PubMed

Frahm-Falkenberg, S; Ibsen, R; Kjellberg, J; Jennum, P

2016-09-01

Dementia causes morbidity, disability and mortality, and as the population ages the societal burden will grow. The direct health costs and indirect costs of lost productivity and social welfare of dementia were estimated compared with matched controls in a national register based cohort study. Using records from the Danish National Patient Registry (1997-2009) all patients with a diagnosis of Alzheimer's disease, vascular dementia or dementia not otherwise specified and their partners were identified and compared with randomly chosen controls matched for age, gender, geographical area and civil status. Direct health costs included primary and secondary sector contacts, medical procedures and medication. Indirect costs included the effect on labor supply. All cost data were extracted from national databases. The entire cohort was followed for the entire period - before and after diagnosis. In all, 78 715 patients were identified and compared with 312 813 matched controls. Patients' partners were also identified and matched with a control group. Patients had lower income and higher mortality and morbidity rates and greater use of medication. Social- and health-related vulnerability was identified years prior to diagnosis. The average annual additional cost of direct healthcare costs and lost productivity in the years before diagnosis was 2082 euros per patient over and above that of matched controls, and 4544 euros per patient after the time of diagnosis. Dementias cause significant morbidity and mortality, consequently generating significant socioeconomic costs. © 2016 EAN.

Automatic control of electric thermal storage (heat) under real-time pricing. Final report

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

Daryanian, B.; Tabors, R.D.; Bohn, R.E.

1995-01-01

Real-time pricing (RTP) can be used by electric utilities as a control signal for responsive demand-side management (DSM) programs. Electric thermal storage (ETS) systems in buildings provide the inherent flexibility needed to take advantage of variations in prices. Under RTP, optimal performance for ETS operations is achieved under market conditions where reductions in customers` costs coincide with the lowering of the cost of service for electric utilities. The RTP signal conveys the time-varying actual marginal cost of the electric service to customers. The RTP rate is a combination of various cost components, including marginal generation fuel and maintenance costs, marginalmore » costs of transmission and distribution losses, and marginal quality of supply and transmission costs. This report describes the results of an experiment in automatic control of heat storage systems under RTP during the winter seasons of 1989--90 and 1990--91.« less

Benefit-cost analysis of spruce budworm (Choristoneura fumiferana Clem.) control: incorporating market and non-market values.

PubMed

Chang, Wei-Yew; Lantz, Van A; Hennigar, Chris R; MacLean, David A

2012-01-01

This study employs a benefit-cost analysis framework to estimate market and non-market benefits and costs of controlling future spruce budworm (Choristoneura fumiferana) outbreaks on Crown forest lands in New Brunswick, Canada. We used: (i) an advanced timber supply model to project potential timber volume saved, timber value benefits, and costs of pest control efforts; and (ii) a recent contingent valuation method analysis that evaluated non-market benefits (i.e., changes in recreation opportunities and existence values) of controlling future spruce budworm outbreaks in the Province. A total of six alternative scenarios were evaluated, including two uncontrolled future budworm outbreak severities (moderate vs. severe) and, for each severity, three control program levels (protecting 10%, 20%, or 40% of the susceptible Crown land forest area). The economic criteria used to evaluate each scenario included benefit-cost ratios and net present values. Under severe outbreak conditions, results indicated that the highest benefit-cost ratio (4.04) occurred when protecting 10% (284,000 ha) of the susceptible area, and the highest net present value ($111 M) occurred when protecting 20% (568,000 ha) of the susceptible area. Under moderate outbreak conditions, the highest benefit-cost ratio (3.24) and net present value ($58.7 M) occurred when protecting 10% (284,000 ha) of the susceptible area. Inclusion of non-market values generally increased the benefit-cost ratios and net present values of the control programs, and in some cases, led to higher levels of control being supported. Results of this study highlight the importance of including non-market values into the decision making process of forest pest management. Copyright © 2011 Elsevier Ltd. All rights reserved.

Implementation of a guideline for low back pain management in primary care: a cost-effectiveness analysis.

PubMed

Becker, Annette; Held, Heiko; Redaelli, Marcus; Chenot, Jean F; Leonhardt, Corinna; Keller, Stefan; Baum, Erika; Pfingsten, Michael; Hildebrandt, Jan; Basler, Heinz-Dieter; Kochen, Michael M; Donner-Banzhoff, Norbert; Strauch, Konstantin

2012-04-15

Cost-effectiveness analysis alongside a cluster randomized controlled trial. To study the cost-effectiveness of 2 low back pain guideline implementation (GI) strategies. Several evidence-based guidelines on management of low back pain have been published. However, there is still no consensus on the effective implementation strategy. Especially studies on the economic impact of different implementation strategies are lacking. This analysis was performed alongside a cluster randomized controlled trial on the effectiveness of 2 GI strategies (physician education alone [GI] or physician education in combination with motivational counseling [MC] by practice nurses)--both compared with the postal dissemination of the guideline (control group, C). Sociodemographic data, pain characteristics, and cost data were collected by interview at baseline and after 6 and 12 months. low back pain-related health care costs were valued for 2004 from the societal perspective. For the cost analysis, 1322 patients from 126 general practices were included. Both interventions showed lower direct and indirect costs as well as better patient outcomes during follow-up compared with controls. In addition, both intervention arms showed superiority of cost-effectiveness to C. The effects attenuated when adjusting for differences of health care utilization prior to patient recruitment and for clustering of data. Trends in cost-effectiveness are visible but need to be confirmed in future studies. Researchers performing cost-evaluation studies should test for baseline imbalances of health care utilization data instead of judging on the randomization success by reviewing non-cost parameters like clinical data alone.

Adaptive Incentive Controls for Stackelberg Games with Unknown Cost Functionals.

DTIC Science & Technology

1984-01-01

APR EZT:: F I AN 73S e OsL:-: UNCLASSI?:-- Q4~.’~- .A.., 6, *~*i i~~*~~*.- U ADAPTIVE INCENTIVE CONTROLS FOR STACKELBERG GAMES WITH UNKNOWN COST...AD-A161 885 ADAPTIVE INCENTIVE CONTROLS FOR STACKELBERG GAMES WITH i/1 UNKNOWN COST FUNCTIONALSCU) ILLINOIS UNIV AT URBANA DECISION AND CONTROL LAB T...ORGANIZATION 6b. OFFICE SYMBOL 7.. NAME OF MONITORING ORGANIZATION CoriaeLcenef~pda~ Joint Services Electronics Program Laboratory, Univ. of Illinois N/A

Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali.

PubMed

Maccario, Roberta; Rouhani, Saba; Drake, Tom; Nagy, Annie; Bamadio, Modibo; Diarra, Seybou; Djanken, Souleymane; Roschnik, Natalie; Clarke, Siân E; Sacko, Moussa; Brooker, Simon; Thuilliez, Josselin

2017-06-12

The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN), and Intermittent Parasite Clearance in schools (IPCs) in southern Mali. Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children). A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41) with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%), $5.53 (53.3%) and $2.72 (26.2%) per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.

Cost-benefit of infection control interventions targeting methicillin-resistant Staphylococcus aureus in hospitals: systematic review.

PubMed

Farbman, L; Avni, T; Rubinovitch, B; Leibovici, L; Paul, M

2013-12-01

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) incur significant costs. We aimed to examine the cost and cost-benefit of infection control interventions against MRSA and to examine factors affecting economic estimates. We performed a systematic review of studies assessing infection control interventions aimed at preventing spread of MRSA in hospitals and reporting intervention costs, savings, cost-benefit or cost-effectiveness. We searched PubMed and references of included studies with no language restrictions up to January 2012. We used the Quality of Health Economic Studies tool to assess study quality. We report cost and savings per month in 2011 US$. We calculated the median save/cost ratio and the save-cost difference with interquartile range (IQR) range. We examined the effects of MRSA endemicity, intervention duration and hospital size on results. Thirty-six studies published between 1987 and 2011 fulfilled inclusion criteria. Fifteen of the 18 studies reporting both costs and savings reported a save/cost ratio >1. The median save/cost ratio across all 18 studies was 7.16 (IQR 1.37-16). The median cost across all studies reporting intervention costs (n = 31) was 8648 (IQR 2025-19 170) US$ per month; median savings were 38 751 (IQR 14 206-75 842) US$ per month (23 studies). Higher save/cost ratios were observed in the intermediate to high endemicity setting compared with the low endemicity setting, in hospitals with <500-beds and with interventions of >6 months. Infection control intervention to reduce spread of MRSA in acute-care hospitals showed a favourable cost/benefit ratio. This was true also for high MRSA endemicity settings. Unresolved economic issues include rapid screening using molecular techniques and universal versus targeted screening. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

40 CFR Appendix A to Part 57 - Primary Nonferrous Smelter Order (NSO) Application

Code of Federal Regulations, 2011 CFR

2011-07-01

... Profit and Loss Summary A.4 Historical Capital Investment Summary B.1 Pre-Control Revenue Forecast B.2 Pre-Control Cost Forecast B.3 Pre-Control Forecast Profit and Loss Summary B.4 Constant Controls Revenue Forecast B.5 Constant Controls Cost Forecast B.6 Constant Controls Forecast Profit and Loss...

Financial Impact of Dual Vendor, Matrix Pricing, and Sole-Source Contracting on Implant Costs.

PubMed

Althausen, Peter L; Lapham, Joan; Mead, Lisa

2016-12-01

Implant costs comprise the largest proportion of operating room supply costs for orthopedic trauma care. Over the years, hospitals have devised several methods of controlling these costs with the help of physicians. With increasing economic pressure, these negotiations have a tremendous ability to decrease the cost of trauma care. In the past, physicians have taken no responsibility for implant pricing which has made cost control difficult. The reasons have been multifactorial. However, industry surgeon consulting fees, research support, and surgeon comfort with certain implant systems have played a large role in slowing adoption of cost-control measures. With the advent of physician gainsharing and comanagement agreements, physicians now have impetus to change. At our facility, we have used 3 methods for cost containment since 2009: dual vendor, matrix pricing, and sole-source contracting. Each has been increasingly successful, resulting in massive savings for the institution. This article describes the process and benefits of each model.

Oxygen cost of treadmill and over-ground walking in mildly disabled persons with multiple sclerosis

PubMed Central

Suh, Yoojin; Dlugonski, Deirdre; Weikert, Madeline; Agiovlasitis, Stamatis; Fernhall, Bo; Goldman, Myla

2011-01-01

Walking impairment is a ubiquitous feature of multiple sclerosis (MS) and the O2 cost of walking might quantify this dysfunction in mild MS. This paper examined the difference in O2 cost of walking between persons with MS who have mild disability and healthy controls and the correlation between the O2 cost of walking and disability. Study 1 included 18 persons with mild MS and 18 controls and indicated that the O2 cost of walking was significantly higher in MS than controls and that disability was significantly associated with the O2 cost of slow, moderate, and fast treadmill walking. Study 2 included 24 persons with mild MS and indicated that disability was significantly correlated with O2 cost of comfortable, fast, and slow over-ground walking. We provide evidence that the O2 cost of walking is an indicator of walking dysfunction in mildly disabled persons with MS and should be considered in clinical research and practice. PMID:20798968

Oxygen cost of treadmill and over-ground walking in mildly disabled persons with multiple sclerosis.

PubMed

Motl, Robert W; Suh, Yoojin; Dlugonski, Deirdre; Weikert, Madeline; Agiovlasitis, Stamatis; Fernhall, Bo; Goldman, Myla

2011-04-01

Walking impairment is a ubiquitous feature of multiple sclerosis (MS) and the O(2) cost of walking might quantify this dysfunction in mild MS. This paper examined the difference in O(2) cost of walking between persons with MS who have mild disability and healthy controls and the correlation between the O(2) cost of walking and disability. Study 1 included 18 persons with mild MS and 18 controls and indicated that the O(2) cost of walking was significantly higher in MS than controls and that disability was significantly associated with the O(2) cost of slow, moderate, and fast treadmill walking. Study 2 included 24 persons with mild MS and indicated that disability was significantly correlated with O(2) cost of comfortable, fast, and slow over-ground walking. We provide evidence that the O(2) cost of walking is an indicator of walking dysfunction in mildly disabled persons with MS and should be considered in clinical research and practice.

Emissions and Cost Implications of Controlled Electric Vehicle Charging in the U.S. PJM Interconnection.

PubMed

Weis, Allison; Michalek, Jeremy J; Jaramillo, Paulina; Lueken, Roger

2015-05-05

We develop a unit commitment and economic dispatch model to estimate the operation costs and the air emissions externality costs attributable to new electric vehicle electricity demand under controlled vs uncontrolled charging schemes. We focus our analysis on the PJM Interconnection and use scenarios that characterize (1) the most recent power plant fleet for which sufficient data are available, (2) a hypothetical 2018 power plant fleet that reflects upcoming plant retirements, and (3) the 2018 fleet with increased wind capacity. We find that controlled electric vehicle charging can reduce associated generation costs by 23%-34% in part by shifting loads to lower-cost, higher-emitting coal plants. This shift results in increased externality costs of health and environmental damages from increased air pollution. On balance, we find that controlled charging of electric vehicles produces negative net social benefits in the recent PJM grid but could have positive net social benefits in a future grid with sufficient coal retirements and wind penetration.

Economic Evaluation of a Multifaceted Implementation Strategy for the Prevention of Hand Eczema Among Healthcare Workers in Comparison with a Control Group: The Hands4U Study.

PubMed

van der Meer, Esther W C; van Dongen, Johanna M; Boot, Cécile R L; van der Gulden, Joost W J; Bosmans, Judith E; Anema, Johannes R

2016-05-01

The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n=1,649) were randomly allocated to the implementation strategy or the control group. Data on hand eczema and costs were collected at baseline and every 3 months. Cost-effectiveness analyses were performed using linear multilevel analyses. The probability of the implementation strategy being cost-effective gradually increased with an increasing willingness-to-pay, to 0.84 at a ceiling ratio of €590,000 per person with hand eczema prevented (societal perspective). The implementation strategy appeared to be not cost-effective in comparison with the control group (societal perspective), nor was it cost-beneficial to the employer. However, this study had some methodological problems which should be taken into account when interpreting the results.

Oilwell Power Controller (OPC)

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

Not Available

1993-08-01

The Oil Well Power Controller (OPC) prototype units is nearing completion. This device is an oilwell beam pump controller and data logger. Applications for this device have been for an electrical power saving device, pump off control, parafffin detection, demand power load control, chemical treatment data, dynamometer and pump efficiency data. Preliminary results appear vary promising. A total of ten OPC rod pump controllers were assembled and installed on oilwells in several areas of Central and Western United States. Data was analyzed on these wells and forwarded to the participating oil companies. Cost savings on each individual oil well participatingmore » in the OPC testing vary considerably, savings on some situations have been outstanding. In situations where the pump efficiency was determined to be low, the cost savings have been considerable. Cost savings due to preventive maintenance are also present, but are difficult to pin point an exact dollar amount at the present time. A break out of actual cost data obtained on some of the oilwells controlled and monitored with the oilwell power controller.« less

Active control of panel vibrations induced by boundary-layer flow

NASA Technical Reports Server (NTRS)

Chow, Pao-Liu

1991-01-01

Some problems in active control of panel vibration excited by a boundary layer flow over a flat plate are studied. In the first phase of the study, the optimal control problem of vibrating elastic panel induced by a fluid dynamical loading was studied. For a simply supported rectangular plate, the vibration control problem can be analyzed by a modal analysis. The control objective is to minimize the total cost functional, which is the sum of a vibrational energy and the control cost. By means of the modal expansion, the dynamical equation for the plate and the cost functional are reduced to a system of ordinary differential equations and the cost functions for the modes. For the linear elastic plate, the modes become uncoupled. The control of each modal amplitude reduces to the so-called linear regulator problem in control theory. Such problems can then be solved by the method of adjoint state. The optimality system of equations was solved numerically by a shooting method. The results are summarized.

Triggering factors of primary care costs in the years following type 2 diabetes diagnosis in Mexico.

PubMed

Castro-Ríos, Angélica; Nevárez-Sida, Armando; Tiro-Sánchez, María Teresa; Wacher-Rodarte, Niels

2014-07-01

Diabetes represents a high epidemiological and economic burden worldwide. The cost of diabetes care increases slowly during early years, but it accelerates once chronic complications set in. There is evidence that adequate control may delay the onset of complications. Management of diabetes falls almost exclusively into primary care services until chronic complications appear. Therefore, primary care is strategic for reducing the expedited growth of costs. The objective of this study was to identify predictors of primary care costs in patients without complications in the years following diabetes diagnosis. Direct medical costs for primary care were determined from the perspective of public health services provider. Information was obtained from medical records of 764 patients. Microcosting and average cost techniques were combined. A generalized linear regression model was developed including characteristics of patients and facilities. Primary health care costs for different patient profiles were estimated. The mean annual primary care cost was USD$465.1. Gender was the most important predictor followed by weight status, insulin use, respiratoty infections, glycemic control and dyslipidemia. A gap in costs was observed between genders; women make greater use of resources (42.1% on average). Such differences are reduced with obesity (18.1%), overweight (22.8%), respiratory infection (20.8%) and age >80 years (26.8%). Improving glycemic control shows increasing costs but at decreasing rates. Modifiable factors (glycemic control, weight status and comorbidities) drive primary care costs the first 10 years. Those factors had a larger effect in costs for males than in for females. Copyright © 2014 IMSS. Published by Elsevier Inc. All rights reserved.

Losses from effluent taxes and quotas under uncertainty

USGS Publications Warehouse

Watson, W.D.; Ridker, R.G.

1984-01-01

Recent theoretical papers by Adar and Griffin (J. Environ. Econ. Manag.3, 178-188 (1976)), Fishelson (J. Environ. Econ. Manag.3, 189-197 (1976)), and Weitzman (Rev. Econ. Studies41, 477-491 (1974)) show that,different expected social losses arise from using effluent taxes and quotas as alternative control instruments when marginal control costs are uncertain. Key assumptions in these analyses are linear marginal cost and benefit functions and an additive error for the marginal cost function (to reflect uncertainty). In this paper, empirically derived nonlinear functions and more realistic multiplicative error terms are used to estimate expected control and damage costs and to identify (empirically) the mix of control instruments that minimizes expected losses. ?? 1984.

Burden of epilepsy: a prevalence-based cost of illness study of direct, indirect and intangible costs for epilepsy.

PubMed

Gao, Lan; Xia, Li; Pan, Song-Qing; Xiong, Tao; Li, Shu-Chuen

2015-02-01

We aimed to gauge the burden of epilepsy in China from a societal perspective by estimating the direct, indirect and intangible costs. Patients with epilepsy and controls were enrolled from two tertiary hospitals in China. Patients were asked to complete a Cost-of-Illness (COI), Willingness-to-Pay (WTP) questionnaires, two utility elicitation instruments and Mini Mental State Examination (MMSE). Healthy controls only completed WTP questionnaire, and utility instruments. Univariate analyses were performed to investigate the differences in cost on the basis of different variables, while multivariate analysis was undertaken to explore the predictors of cost/cost component. In total, 141 epilepsy patients and 323 healthy controls were recruited. The median total cost, direct cost and indirect cost due to epilepsy were US$949.29, 501.34 and 276.72, respectively. Particularly, cost of anti-epileptic drugs (AEDs) (US$394.53) followed by cost of investigations (US$59.34), cost of inpatient and outpatient care (US$9.62) accounted for the majority of the direct medical costs. While patients' (US$103.77) and caregivers' productivity costs (US$103.77) constituted the major component of indirect cost. The intangible costs in terms of WTP value (US$266.07 vs. 88.22) and utility (EQ-5D, 0.828 vs. 0.923; QWB-SA, 0.657 vs. 0.802) were both substantially higher compared to the healthy subjects. Epilepsy is a cost intensive disease in China. According to the prognostic groups, drug-resistant epilepsy generated the highest total cost whereas patients in seizure remission had the lowest cost. AED is the most costly component of direct medical cost probably due to 83% of patients being treated by new generation of AEDs. Copyright © 2014 Elsevier B.V. All rights reserved.

The economic consequences of irritable bowel syndrome: a US employer perspective.

PubMed

Leong, Stephanie A; Barghout, Victoria; Birnbaum, Howard G; Thibeault, Crystal E; Ben-Hamadi, Rym; Frech, Feride; Ofman, Joshua J

2003-04-28

The objective of this study was to measure the direct costs of treating irritable bowel syndrome (IBS) and the indirect costs in the workplace. This was accomplished through retrospective analysis of administrative claims data from a national Fortune 100 manufacturer, which includes all medical, pharmaceutical, and disability claims for the company's employees, spouses/dependents, and retirees. Patients with IBS were identified as individuals, aged 18 to 64 years, who received a primary code for IBS or a secondary code for IBS and a primary code for constipation or abdominal pain between January 1, 1996, and December 31, 1998. Of these patients with IBS, 93.7% were matched based on age, sex, employment status, and ZIP code to a control population of beneficiaries. Direct and indirect costs for patients with IBS were compared with those of matched controls. The average total cost (direct plus indirect) per patient with IBS was 4527 dollars in 1998 compared with 3276 dollars for a control beneficiary (P<.001). The average physician visit costs were 524 dollars and 345 dollars for patients with IBS and controls, respectively (P<.001). The average outpatient care costs to the employer were 1258 dollars and 742 dollars for patients with IBS and controls, respectively (P<.001). Medically related work absenteeism cost the employer 901 dollars on average per employee treated for IBS compared with 528 dollars on average per employee without IBS (P<.001). Irritable bowel syndrome is a significant financial burden on the employer that arises from an increase in direct and indirect costs compared with the control group.

Hospital cost control in Norway: a decade's experience with prospective payment.

PubMed Central

Crane, T S

1985-01-01

Under Norway's prospective payment system, which was in existence from 1972 to 1980, hospital costs increased 15.8 percent annually, compared with 15.3 percent in the United States. In 1980 the Norwegian national government started paying for all institutional services according to a population-based, morbidity-adjusted formula. Norway's prospective payment system provides important insights into problems of controlling hospital costs despite significant differences, including ownership of medical facilities and payment and spending as a percent of GNP. Yet striking similarities exist. Annual real growth in health expenditures from 1972 to 1980 in Norway was 2.2 percent, compared with 2.4 percent in the United States. In both countries, public demands for cost control were accompanied by demands for more services. And problems of geographic dispersion of new technology and distribution of resources were similar. Norway's experience in the 1970s demonstrates that prospective payment is no panacea. The annual budget process created disincentives to hospitals to control costs. But Norway's changes in 1980 to a population-based methodology suggest a useful approach to achieve a more equitable distribution of resources. This method of payment provides incentives to control variations in both admissions and cost per case. In contrast, the Medicare approach based on Diagnostic Related Groups (DRGs) is limited, and it does not affect variations in admissions and capital costs. Population-based methodologies can be used in adjusting DRG rates to control both problems. In addition, the DRG system only applies to Medicare payments; the Norwegian experience demonstrates that this system may result in significant shifting of costs onto other payors. PMID:3927385

The Use of Probability Theory as a Basis for Planning and Controlling Overhead Costs in Education and Industry. Final Report.

ERIC Educational Resources Information Center

Vinson, R. B.

In this report, the author suggests changes in the treatment of overhead costs by hypothesizing that "the effectiveness of standard costing in planning and controlling overhead costs can be increased through the use of probability theory and associated statistical techniques." To test the hypothesis, the author (1) presents an overview of the…

Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

PubMed Central

2010-01-01

Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI) and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass) infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases) and patients without CLABSI (controls) were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days) associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143); 56% of the cases and 57% of the controls were females (p = 0.922). The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p < 0.001). Overall, the mean total costs of patients with and without CLABSI were € 18,241 and € 9,087, respectively (p < 0.001). On average, the extra cost for drugs was € 843 (p < 0.001), for supplies € 133 (p = 0.116), for lab tests € 171 (p < 0.001), and for specialist visits € 15 (p = 0.019). The mean extra cost for hospital stay (overhead) was € 7,180 (p < 0.001). The closed infusion container was a dominant strategy. It resulted in lower CLABSI rates (3.5 vs. 8.2 CLABSIs per 1000 central line days for closed vs. open infusion container) without any significant difference in total production costs. The higher acquisition cost of the closed infusion container was offset by savings incurred in other phases of production, especially waste management. Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets. PMID:20459753

Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy.

PubMed

Tarricone, Rosanna; Torbica, Aleksandra; Franzetti, Fabio; Rosenthal, Victor D

2010-05-10

The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI) and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass) infusion containers. A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases) and patients without CLABSI (controls) were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days) associated with the two infusion containers. A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143); 56% of the cases and 57% of the controls were females (p = 0.922). The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p < 0.001). Overall, the mean total costs of patients with and without CLABSI were euro 18,241 and euro 9,087, respectively (p < 0.001). On average, the extra cost for drugs was euro 843 (p < 0.001), for supplies euro 133 (p = 0.116), for lab tests euro 171 (p < 0.001), and for specialist visits euro 15 (p = 0.019). The mean extra cost for hospital stay (overhead) was euro 7,180 (p < 0.001). The closed infusion container was a dominant strategy. It resulted in lower CLABSI rates (3.5 vs. 8.2 CLABSIs per 1000 central line days for closed vs. open infusion container) without any significant difference in total production costs. The higher acquisition cost of the closed infusion container was offset by savings incurred in other phases of production, especially waste management. CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

Rising Cost of Cancer Pharmaceuticals: Cost Issues and Interventions to Control Costs.

PubMed

Glode, Ashley E; May, Megan Brafford

2017-01-01

The rising cost of pharmaceuticals and, in particular, cancer drugs has made headline news in recent years. Several factors contribute to increasing costs and the burden this places on the health care system and patients. Some of these factors include costly cancer pharmaceutical research and development, longer clinical trials required to achieve drug approval, manufacturing costs for complex compounds, and the economic principles surrounding oncology drug pricing. Strategies to control costs have been proposed, and some have already been implemented to mitigate cancer drug costs such as the use of clinical treatment pathways and tools to facilitate cost discussions with patients. In this article, we briefly review some of the potential factors contributing to increasing cancer pharmaceutical costs and interventions to mitigate costs, and touch on the role of health care providers in addressing this important issue. © 2016 Pharmacotherapy Publications, Inc.

Experimental Determination of Demand Response Control Models and Cost of Control for Ensembles of Window-Mount Air Conditioners

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

Geller, Drew Adam; Backhaus, Scott N.

Control of consumer electrical devices for providing electrical grid services is expanding in both the scope and the diversity of loads that are engaged in control, but there are few experimentally-based models of these devices suitable for control designs and for assessing the cost of control. A laboratory-scale test system is developed to experimentally evaluate the use of a simple window-mount air conditioner for electrical grid regulation services. The experimental test bed is a single, isolated air conditioner embedded in a test system that both emulates the thermodynamics of an air conditioned room and also isolates the air conditioner frommore » the real-world external environmental and human variables that perturb the careful measurements required to capture a model that fully characterizes both the control response functions and the cost of control. The control response functions and cost of control are measured using harmonic perturbation of the temperature set point and a test protocol that further isolates the air conditioner from low frequency environmental variability.« less

Planning, budgeting, and controlling--one look at the future: case-mix cost accounting.

PubMed Central

Thompson, J D; Averill, R F; Fetter, R B

1979-01-01

This paper outlines the system for cost accounting and managerial control which is an extension of the usually accepted departmental costing systems and takes as its units the 383 Diagnosis Related Groups (DRGs) considered to be the hospital's products. It is held that such an approach offers hospital managers a more powerful, analytic, budgeting, and cost-finding tool and offers the opportunity to involve the medical staff in the issues of how their practice patterns are affecting hospital costs. PMID:511578

Planning, budgeting, and controlling--one look at the future: case-mix cost accounting.

PubMed

Thompson, J D; Averill, R F; Fetter, R B

1979-01-01

This paper outlines the system for cost accounting and managerial control which is an extension of the usually accepted departmental costing systems and takes as its units the 383 Diagnosis Related Groups (DRGs) considered to be the hospital's products. It is held that such an approach offers hospital managers a more powerful, analytic, budgeting, and cost-finding tool and offers the opportunity to involve the medical staff in the issues of how their practice patterns are affecting hospital costs.

Costs of Rabies Control: An Economic Calculation Method Applied to Flores Island

PubMed Central

Wera, Ewaldus; Velthuis, Annet G. J.; Geong, Maria; Hogeveen, Henk

2013-01-01

Background Rabies is a zoonotic disease that, in most human cases, is fatal once clinical signs appear. The disease transmits to humans through an animal bite. Dogs are the main vector of rabies in humans on Flores Island, Indonesia, resulting in about 19 human deaths each year. Currently, rabies control measures on Flores Island include mass vaccination and culling of dogs, laboratory diagnostics of suspected rabid dogs, putting imported dogs in quarantine, and pre- and post-exposure treatment (PET) of humans. The objective of this study was to estimate the costs of the applied rabies control measures on Flores Island. Methodology/principal findings A deterministic economic model was developed to calculate the costs of the rabies control measures and their individual cost components from 2000 to 2011. The inputs for the economic model were obtained from (i) relevant literature, (ii) available data on Flores Island, and (iii) experts such as responsible policy makers and veterinarians involved in rabies control measures in the past. As a result, the total costs of rabies control measures were estimated to be US$1.12 million (range: US$0.60–1.47 million) per year. The costs of culling roaming dogs were the highest portion, about 39 percent of the total costs, followed by PET (35 percent), mass vaccination (24 percent), pre-exposure treatment (1.4 percent), and others (1.3 percent) (dog-bite investigation, diagnostic of suspected rabid dogs, trace-back investigation of human contact with rabid dogs, and quarantine of imported dogs). Conclusions/significance This study demonstrates that rabies has a large economic impact on the government and dog owners. Control of rabies by culling dogs is relatively costly for the dog owners in comparison with other measures. Providing PET for humans is an effective way to prevent rabies, but is costly for government and does not provide a permanent solution to rabies in the future. PMID:24386244

Cost-utility of exercise therapy in patients with hip osteoarthritis in primary care.

PubMed

Tan, S S; Teirlinck, C H; Dekker, J; Goossens, L M A; Bohnen, A M; Verhaar, J A N; van Es, P P; Koes, B W; Bierma-Zeinstra, S M A; Luijsterburg, P A J; Koopmanschap, M A

2016-04-01

To determine the cost-effectiveness (CE) of exercise therapy (intervention group) compared to 'general practitioner (GP) care' (control group) in patients with hip osteoarthritis (OA) in primary care. This cost-utility analysis was conducted with 120 GPs in the Netherlands from the societal and healthcare perspective. Data on direct medical costs, productivity costs and quality of life (QoL) was collected using standardised questionnaires which were sent to the patients at baseline and at 6, 13, 26, 39 and 52 weeks follow-up. All costs were based on Euro 2011 cost data. A total of 203 patients were included. The annual direct medical costs per patient were significantly lower for the intervention group (€ 1233) compared to the control group (€ 1331). The average annual societal costs per patient were lower in the intervention group (€ 2634 vs € 3241). Productivity costs were higher than direct medical costs. There was a very small adjusted difference in QoL of 0.006 in favour of the control group (95% CI: -0.04 to +0.02). Our study revealed that exercise therapy is probably cost saving, without the risk of noteworthy negative health effects. NTR1462. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

The Cost of Dengue Vector Control Activities in Malaysia by Different Service Providers.

PubMed

Packierisamy, P Raviwharmman; Ng, Chiu-Wan; Dahlui, Maznah; Venugopalan, B; Halasa, Yara A; Shepard, Donald S

2015-11-01

We examined variations in dengue vector control costs and resource consumption between the District Health Departments (DHDs) and Local Authorities (LAs) to assist informed decision making as to the future roles of these agencies in the delivery of dengue vector control services in Malaysia. Data were collected from the vector control units of DHDs and LAs in 8 selected districts. We captured costs and resource consumption in 2010 for premise inspection for mosquito breeding sites, fogging to destroy adult mosquitoes and larviciding of potential breeding sites. Overall, DHDs spent US$5.62 million or US$679 per case and LAs spent US$2.61 million or US$499 per case. The highest expenditure for both agencies was for fogging, 51.0% and 45.8% of costs for DHDs and LAs, respectively. The DHDs had higher resource costs for human personnel, vehicles, pesticides, and equipment. The findings provide some evidence to rationalize delivery of dengue vector control services in Malaysia. © 2015 APJPH.

Cost-Effectiveness of Wisconsin TEAM Model for Improving Adherence and Hypertension Control in Black Patients

PubMed Central

Shireman, Theresa I.; Svarstad, Bonnie L.

2016-01-01

Objective To assess the cost-effectiveness of the 6-month Team Education and Adherence Monitoring (TEAM) intervention for black patients with hypertension in community pharmacies using prospectively collected cost data. Design Cost-effectiveness analysis of a cluster-randomized trial. Setting 28 chain pharmacies in five Wisconsin cities from December 2006 to February 2009. Participants 576 black patients with uncontrolled hypertension Intervention Pharmacists and pharmacy technicians using novel tools for improving adherence and feedback to patients and physicians as compared to information only control group. Main outcome measure(s) Incremental cost analysis of variable costs from the pharmacy perspective captured prospectively at the participant level. Outcomes (effect measures) were 6-month refill adherence, changes in SBP and DBP, and proportion of patients achieving BP control. Results Mean cost of intervention personnel time and tools was $104.8± 45.2. Incremental variable costs per mmHg decrease in SBP and DBP were $22.2 ± 16.3 and $66.0 ± 228.4, respectively. The cost of helping one more person achieve the BP goal (< 140/90) was $665.2 ± 265.2; the cost of helping one more person achieve good refill adherence was $463.3 ± 110.7. Prescription drug costs were higher for the TEAM group ($392.8, SD = 396.3 versus $307.0, SD = 295.2, p = 0.02). The start-up cost for pharmacy furniture, equipment, and privacy screen was $168 per pharmacy. Conclusions Our randomized, practice based intervention demonstrated that community pharmacists can implement a cost-effective intervention to improve hypertension control in blacks. This approach imposes a nominal expense at the pharmacy level, can be integrated into the ongoing pharmacist-patient relationship, and can enhance clinical and behavioral outcomes. PMID:27184784

EVALUATING THE COSTS OF PACKED-TOWER AERATION AND GAC FOR CONTROLLING SELECTED ORGANICS

EPA Science Inventory

This article focuses on a preliminary cost analysis that compares liquid-phase granular activated carbon (GAC) treatment with packed-tower aeration (PTA) treatment, with and without air emissions control. The sensitivity of cost to design and operating variables is also discussed...

Co-control of urban air pollutants and greenhouse gases in Mexico City.

PubMed

West, J Jason; Osnaya, Patricia; Laguna, Israel; Martínez, Julia; Fernández, Adrián

2004-07-01

This study addresses the synergies of mitigation measures to control urban air pollutant and greenhouse gas (GHG) emissions, in developing integrated "co-control" strategies for Mexico City. First, existing studies of emissions reduction measures--PROAIRE (the air quality plan for Mexico City) and separate GHG studies--are used to construct a harmonized database of options. Second, linear programming (LP) is developed and applied as a decision-support tool to analyze least-cost strategies for meeting co-control targets for multiple pollutants. We estimate that implementing PROAIRE measures as planned will reduce 3.1% of the 2010 metropolitan CO2 emissions, in addition to substantial local air pollutant reductions. Applying the LP, PROAIRE emissions reductions can be met at a 20% lower cost, using only the PROAIRE measures, by adjusting investments toward the more cost-effective measures; lower net costs are possible by including cost-saving GHG mitigation measures, but with increased investment. When CO2 emission reduction targets are added to PROAIRE targets, the most cost-effective solutions use PROAIRE measures for the majority of local pollutant reductions, and GHG measures for additional CO2 control. Because of synergies, the integrated planning of urban-global co-control can be beneficial, but we estimate that for Mexico City these benefits are often small.

Cost-effectiveness of reducing sulfur emissions from ships.

PubMed

Wang, Chengfeng; Corbett, James J; Winebrake, James J

2007-12-15

We model cost-effectiveness of control strategies for reducing SO2 emissions from U.S. foreign commerce ships traveling in existing European or hypothetical U.S. West Coast SO(x) Emission Control Areas (SECAs) under international maritime regulations. Variation among marginal costs of control for individual ships choosing between fuel-switching and aftertreatment reveals cost-saving potential of economic incentive instruments. Compared to regulations prescribing low sulfur fuels, a performance-based policy can save up to $260 million for these ships with 80% more emission reductions than required because least-cost options on some individual ships outperform standards. Optimal simulation of a market-based SO2 control policy for approximately 4,700 U.S. foreign commerce ships traveling in the SECAs in 2002 shows that SECA emissions control targets can be achieved by scrubbing exhaust gas of one out of ten ships with annual savings up to $480 million over performance-based policy. A market-based policy could save the fleet approximately $63 million annually under our best-estimate scenario. Spatial evaluation of ship emissions reductions shows that market-based instruments can reduce more SO2 closer to land while being more cost-effective for the fleet. Results suggest that combining performance requirements with market-based instruments can most effectively control SO2 emissions from ships.

National Stormwater Calculator: Low Impact Development ...

EPA Pesticide Factsheets

The National Stormwater Calculator (NSC) makes it easy to estimate runoff reduction when planning a new development or redevelopment site with low impact development (LID) stormwater controls. The Calculator is currently deployed as a Windows desktop application. The Calculator is organized as a wizard style application that walks the user through the steps necessary to perform runoff calculations on a single urban sub-catchment of 10 acres or less in size. Using an interactive map, the user can select the sub-catchment location and the Calculator automatically acquires hydrologic data for the site.A new LID cost estimation module has been developed for the Calculator. This project involved programming cost curves into the existing Calculator desktop application. The integration of cost components of LID controls into the Calculator increases functionality and will promote greater use of the Calculator as a stormwater management and evaluation tool. The addition of the cost estimation module allows planners and managers to evaluate LID controls based on comparison of project cost estimates and predicted LID control performance. Cost estimation is accomplished based on user-identified size (or auto-sizing based on achieving volume control or treatment of a defined design storm), configuration of the LID control infrastructure, and other key project and site-specific variables, including whether the project is being applied as part of new development or redevelopm

Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive–compulsive disorder: results from a randomised controlled trial

PubMed Central

Lenhard, Fabian; Ssegonja, Richard; Andersson, Erik; Feldman, Inna; Mataix-Cols, David; Serlachius, Eva

2017-01-01

Objectives To evaluate the cost-effectiveness of a therapist-guided internet-delivered cognitive behaviour therapy (ICBT) intervention for adolescents with obsessive–compulsive disorder (OCD) compared with untreated patients on a waitlist. Design Single-blinded randomised controlled trial. Setting A research clinic within the regular child and adolescent mental health service in Stockholm, Sweden. Participants Sixty-seven adolescents (12–17 years) with a Diagnostic and Statistical Manual of Mental Disorders Fifth Edition diagnosis of OCD. Interventions Either a 12-week, therapist-guided ICBT intervention or a wait list condition of equal duration. Primary outcome measures Cost data were collected at baseline and after treatment, including healthcare use, supportive resources, prescription drugs, prescription-free drugs, school absence and productivity loss, as well as the cost of ICBT. Health outcomes were defined as treatment responder rate and quality-adjusted life years gain. Bootstrapped mixed model analyses were conducted comparing incremental costs and health outcomes between the groups from the societal and healthcare perspectives. Results Compared with waitlist control, ICBT generated substantial societal cost savings averaging US$−144.98 (95% CI −159.79 to –130.16) per patient. The cost reductions were mainly driven by reduced healthcare use in the ICBT group. From the societal perspective, the probability of ICBT being cost saving compared with waitlist control was approximately 60%. From the healthcare perspective, the cost per additional responder to ICBT compared with waitlist control was approximately US$78. Conclusions The results suggest that therapist-guided ICBT is a cost-effective treatment and results in societal cost savings, compared with patients who do not receive evidence-based treatment. Since, at present, most patients with OCD do not have access to evidence-based treatments, the results have important implications for the increasingly strained national and healthcare budgets. Future studies should compare the cost-effectiveness of ICBT with regular face-to-face CBT. Trial registration number NCT02191631. PMID:28515196

RETROFITTING CONTROL FACILITIES FOR WET-WEATHER FLOW CONTROL

EPA Science Inventory

Available technologies were evaluated to demonstrate the feasibility and cost effectiveness of retrofitting existing facilities to handle wet-weather flow (WWF). Cost/benefit relationships were compared to construction of new conventional control and treatment facilities. Desktop...

Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of the SPORTSMART pilot randomised controlled trial

PubMed Central

Jackson, Louise J; Roberts, Tracy E; Fuller, Sebastian S; Sutcliffe, Lorna J; Saunders, John M; Copas, Andrew J; Mercer, Catherine H; Cassell, Jackie A; Estcourt, Claudia S

2015-01-01

Background The objective of this study was to compare the costs and outcomes of two sexually transmitted infection (STI) screening interventions targeted at men in football club settings in England, including screening promoted by team captains. Methods A comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms: (1) captain-led and poster STI screening promotion; (2) sexual health advisor-led and poster STI screening promotion and (3) poster-only STI screening promotion (control/comparator). For all study arms, resource use and cost data were collected prospectively. Results There was considerable variation in uptake rates between clubs, but results were broadly comparable across study arms with 50% of men accepting the screening offer in the captain-led arm, 67% in the sexual health advisor-led arm and 61% in the poster-only control arm. The overall costs associated with the intervention arms were similar. The average cost per player tested was comparable, with the average cost per player tested for the captain-led promotion estimated to be £88.99 compared with £88.33 for the sexual health advisor-led promotion and £81.87 for the poster-only (control) arm. Conclusions Costs and outcomes were similar across intervention arms. The target sample size was not achieved, and we found a greater than anticipated variability between clubs in the acceptability of screening, which limited our ability to estimate acceptability for intervention arms. Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated. PMID:25512670

Cost effectiveness of tobacco control policies in Vietnam: the case of population-level interventions.

PubMed

Higashi, Hideki; Truong, Khoa D; Barendregt, Jan J; Nguyen, Phuong K; Vuong, Mai L; Nguyen, Thuy T; Hoang, Phuong T; Wallace, Angela L; Tran, Tien V; Le, Cuong Q; Doran, Christopher M

2011-05-01

Tobacco smoking is one of the leading public health problems in the world. It is also possible to prevent and/or reduce the harm from tobacco use through the use of cost-effective tobacco control measures. However, most of this evidence comes from developed countries and little research has been conducted on this issue in developing countries. The objective of this study was to analyse the cost effectiveness of four population-level tobacco control interventions in Vietnam. Four tobacco control interventions were evaluated: excise tax increase; graphic warning labels on cigarette packs; mass media campaigns; and smoking bans (in public or in work places). A multi-state life table model was constructed in Microsoft® Excel to examine the cost effectiveness of the tobacco control intervention options. A government perspective was adopted, with costing conducted using a bottom-up approach. Health improvement was considered in terms of disability-adjusted life-years (DALYs) averted. All assumptions were subject to sensitivity and uncertainty analysis. All the interventions fell within the definition of being very cost effective according to the threshold level suggested by the WHO (i.e.

Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia.

PubMed

Humphreys, Ioan; Thomas, Shirley; Phillips, Ceri; Lincoln, Nadina

2015-01-01

To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for stroke patients with aphasia. Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. Community. Participants identified as having low mood on either the Visual Analog Mood Scale sad item (≥50) or Stroke Aphasic Depression Questionnaire Hospital version 21 (SADQH21) (≥6) were recruited. Participants were randomly allocated to behavioural therapy or usual care using internet-based randomisation generated in advance of the study by a clinical trials unit. Outcomes were assessed at six months after randomisation, blind to group allocation. The costs were assessed from a service use questionnaire. Effectiveness was defined as the change in SADQH21 scores and a cost-effectiveness analysis was performed comparing the behavioural group with the usual care control group. The cost analysis was undertaken from the perspective of the UK NHS and Social Services. The greatest difference was in home help costs where there was a saving of £56.20 in the intervention group compared to an increase of £61.40 in the control group. At six months the SADQH21 score for the intervention group was 17.3 compared to the control group value of 20.4. This resulted in a mean increase of 0.7 in the control group, compared to a mean significant different decrease of 6 in the intervention group (P = 0.003). The Incremental Cost-Effectiveness Ratio indicated that the cost per point reduction on the SADQH21 was £263. Overall the behavioural therapy was found to improve mood and resulted in some encouraging savings in resource utilisation over the six months follow-up. © The Author(s) 2014.

What Does it Really Cost? Allocating Indirect Costs.

ERIC Educational Resources Information Center

Snyder, Herbert; Davenport, Elisabeth

1997-01-01

Better managerial control in terms of decision making and understanding the costs of a system/service result from allocating indirect costs. Allocation requires a three-step process: selecting cost objectives, pooling related overhead costs, and selecting costs bases to connect the objectives to the pooled costs. Argues that activity-based costing…

Economic analysis of temperature-controlled laminar airflow (TLA) for the treatment of patients with severe persistent allergic asthma.

PubMed

Brazier, Peter; Schauer, Uwe; Hamelmann, Eckard; Holmes, Steve; Pritchard, Clive; Warner, John O

2016-01-01

Chronic asthma is a significant burden for individual sufferers, adversely impacting their quality of working and social life, as well as being a major cost to the National Health Service (NHS). Temperature-controlled laminar airflow (TLA) therapy provides asthma patients at BTS/SIGN step 4/5 an add-on treatment option that is non-invasive and has been shown in clinical studies to improve quality of life for patients with poorly controlled allergic asthma. The objective of this study was to quantify the cost-effectiveness of TLA (Airsonett AB) technology as an add-on to standard asthma management drug therapy in the UK. The main performance measure of interest is the incremental cost per quality-adjusted life year (QALY) for patients using TLA in addition to usual care versus usual care alone. The incremental cost of TLA use is based on an observational clinical study monitoring the incidence of exacerbations with treatment valued using NHS cost data. The clinical effectiveness, used to derive the incremental QALY data, is based on a randomised double-blind placebo-controlled clinical trial comprising participants with an equivalent asthma condition. For a clinical cohort of asthma patients as a whole, the incremental cost-effectiveness ratio (ICER) is £8998 per QALY gained, that is, within the £20 000/QALY cost-effectiveness benchmark used by the National Institute for Health and Care Excellence (NICE). Sensitivity analysis indicates that ICER values range from £18 883/QALY for the least severe patients through to TLA being dominant, that is, cost saving as well as improving quality of life, for individuals with the most severe and poorly controlled asthma. Based on our results, Airsonett TLA is a cost-effective addition to treatment options for stage 4/5 patients. For high-risk individuals with more severe and less well controlled asthma, the use of TLA therapy to reduce incidence of hospitalisation would be a cost saving to the NHS.

Cost accounting, management control, and planning in health care.

PubMed

Siegrist, R B; Blish, C S

1988-02-01

Advantages and pharmacy applications of computerized hospital management-control and planning systems are described. Hospitals must define their product lines; patient cases, not tests or procedures, are the end product. Management involves operational control, management control, and strategic planning. Operational control deals with day-to-day management on the task level. Management control involves ensuring that managers use resources effectively and efficiently to accomplish the organization's objectives. Management control includes both control of unit costs of intermediate products, which are procedures and services used to treat patients and are managed by hospital department heads, and control of intermediate product use per case (managed by the clinician). Information from the operation and management levels feeds into the strategic plan; conversely, the management level controls the plan and the operational level carries it out. In the system developed at New England Medical Center, Boston, Massachusetts, the intermediate product-management system enables managers to identify intermediate products, develop standard costs, simulate changes in departmental costs, and perform variance analysis. The end-product management system creates a patient-level data-base, identifies end products (patient-care groupings), develops standard resource protocols, models alternative assumptions, performs variance analysis, and provides concurrent reporting. Examples are given of pharmacy managers' use of such systems to answer questions in the areas of product costing, product pricing, variance analysis, productivity monitoring, flexible budgeting, modeling and planning, and comparative analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Effective tree hazard control on forested recreation sites...losses and protection costs evaluated

Treesearch

Lee A. Paine

1967-01-01

Effectiveness of hazard control was evaluated by analyzing data on tree failures, accidents, and control costs on California recreation sites. Results indicate that reduction of limb hazard in oaks and bole hazard in conifers is the most effective form of control. Least effective is limb hazard reduction in conifers. After hazard control goals or control budgets have...

Quality control in diagnostic immunohistochemistry: integrated on-slide positive controls.

PubMed

Bragoni, A; Gambella, A; Pigozzi, S; Grigolini, M; Fiocca, R; Mastracci, L; Grillo, F

2017-11-01

Standardization in immunohistochemistry is a priority in modern pathology and requires strict quality control. Cost containment has also become fundamental and auditing of all procedures must take into account both these principles. Positive controls must be routinely performed so that their positivity guarantees the appropriateness of the immunohistochemical procedure. The aim of this study is to develop a low cost (utilizing a punch biopsy-PB-tool) procedure to construct positive controls which can be integrated in the patient's tissue slide. Sixteen frequently used control blocks were selected and multiple cylindrical samples were obtained using a 5-mm diameter punch biopsy tool, separately re-embedding them in single blocks. For each diagnostic immunoreaction requiring a positive control, an integrated PB-control section (cut from the appropriate PB-control block) was added to the top right corner of the diagnostic slide before immunostaining. This integrated control technique permitted a saving of 4.75% in total direct lab costs and proved to be technically feasible and reliable. Our proposal is easy to perform and within the reach of all pathology labs, requires easily available tools, its application costs is less than using external paired controls and ensures that a specific control for each slide is always available.

Mission management, planning, and cost: PULSE Attitude And Control Systems (AACS)

NASA Technical Reports Server (NTRS)

1990-01-01

The Pluto unmanned long-range scientific explorer (PULSE) is a probe that will do a flyby of Pluto. It is a low weight, relatively low costing vehicle which utilizes mostly off-the-shelf hardware, but not materials or techniques that will be available after 1999. A design, fabrication, and cost analysis is presented. PULSE will be launched within the first decade of the twenty-first century. The topics include: (1) scientific instrumentation; (2) mission management, planning, and costing; (3) power and propulsion systems; (4) structural subsystem; (5) command, control, and communication; and (6) attitude and articulation control.

Economic and Social Factors in Designing Disease Control Strategies for Epidemics on Networks

NASA Astrophysics Data System (ADS)

Kleczkowski, A.; Dybiec, B.; Gilligan, C. A.

2006-11-01

Models for control of epidemics on local, global and small-world networks are considered, with only partial information accessible about the status of individuals and their connections. The main goal of an effective control measure is to stop the epidemic at a lowest possible cost, including treatment and cost necessary to track the disease spread. We show that delay in detection of infectious individuals and presence of long-range links are the most important factors determining the cost. However, the details of long-range links are usually the least-known element of the social interactions due to their occasional character and potentially short life-span. We show that under some conditions on the probability of disease spread, it is advisable to attempt to track those links, even if this involves additional costs. Thus, collecting some additional knowledge about the network structure might be beneficial to ensure a successful and cost-effective control.

Synthesizing epidemiological and economic optima for control of immunizing infections.

PubMed

Klepac, Petra; Laxminarayan, Ramanan; Grenfell, Bryan T

2011-08-23

Epidemic theory predicts that the vaccination threshold required to interrupt local transmission of an immunizing infection like measles depends only on the basic reproductive number and hence transmission rates. When the search for optimal strategies is expanded to incorporate economic constraints, the optimum for disease control in a single population is determined by relative costs of infection and control, rather than transmission rates. Adding a spatial dimension, which precludes local elimination unless it can be achieved globally, can reduce or increase optimal vaccination levels depending on the balance of costs and benefits. For weakly coupled populations, local optimal strategies agree with the global cost-effective strategy; however, asymmetries in costs can lead to divergent control optima in more strongly coupled systems--in particular, strong regional differences in costs of vaccination can preclude local elimination even when elimination is locally optimal. Under certain conditions, it is locally optimal to share vaccination resources with other populations.

Medical costs associated with non-Hodgkin's lymphoma in the United States during the first two years of treatment.

PubMed

Kutikova, Lucie; Bowman, Lee; Chang, Stella; Long, Stacey R; Arning, Michael; Crown, William H

2006-08-01

To determine the direct costs of medical care associated with aggressive and indolent non-Hodgkin's lymphoma (NHL) in the United States; to show how costs for aggressive NHL change over time by examining costs related to initial, secondary and palliative treatment phases; and to evaluate the economic consequences of treatment failure in aggressive NHL. A retrospective cohort analysis of 1999 - 2000 direct costs in newly diagnosed NHL patients and controls (subjects without any cancer) was conducted using the MarketScan medical and drug claims database of large employers across the United States. Treatment failure analysis was conducted for aggressive NHL patients, and was defined by the need for secondary treatment or palliative care after initial therapy. Cost of treatment failure was calculated as difference in regression-adjusted costs between patients with initial therapy only and patients experiencing initial treatment failure. Patients with aggressive (n = 356) and indolent (n = 698) NHL had significantly greater health service utilization and associated costs (all P < 05) than controls (n = 1068 for aggressive, n = 2094 for indolent). Mean monthly costs were 5871 dollars for aggressive NHL vs. 355 dollars for controls (P < 0001) and 3833 dollars for indolent NHL vs. 289 dollars for controls (P < 0001). The primary cost drivers were hospitalization (aggressive NHL = 44% of total costs, indolent NHL = 50%) and outpatient office visits (aggressive NHL = 39%, indolent NHL = 34%). For aggressive NHL, mean monthly initial treatment phase costs (10,970 dollars) and palliative care costs (9836 dollars) were higher than costs incurred during secondary phase (3302 dollars). The mean cost of treatment failure in aggressive NHL was 14,174 dollars per month, and 85,934 dollars over the study period. The treatment of NHL was associated with substantial health care costs. Patients with aggressive lymphomas tended to accrue higher costs, compared with those with indolent lymphomas. These costs varied over time, with the highest costs occurring during the initial treatment and palliative care phases. Treatment failure was the most expensive treatment pattern. New strategies to prevent or delay treatment failure in aggressive NHL could help reduce the economic burden of NHL.

Indirect costs associated with metastatic breast cancer.

PubMed

Wan, Yin; Gao, Xin; Mehta, Sonam; Wang, Zhixiao; Faria, Claudio; Schwartzberg, Lee

2013-10-01

To compare the indirect costs of productivity loss between metastatic breast cancer (MBC) and early stage breast cancer (EBC) patients, as well as their respective family members. The MarketScan Health and Productivity Management database (2005-2009) was used. Adult BC patients eligible for employee benefits of sick leave and/or short-term disability were identified with ICD-9 codes. Difference in sick leave and short-term disability days was calculated between MBC patients and their propensity score matched EBC cohort and general population (controls) during a 12-month follow-up period. Generalized linear models were used to examine the impact of MBC on indirect costs to patients and their families. A total of 139 MBC, 432 EBC, and 820 controls were eligible for sick leave and 432 MBC, 1552 EBC, and 4682 controls were eligible for short-term disability (not mutually exclusive). After matching, no statistical difference was found in sick leave days and the associated costs between MBC and EBC cohorts. However, MBC patients had significantly higher short-term disability costs than EBC patients and controls (MBC: $6166 ± $9194 vs. EBC: $3690 ± $6673 vs. $558 ± $2487, both p < 0.001). MBC patients had more sick leave cost than controls ($2383 ± $5539 vs. $1282 ± $2083, p < 0.05). Controlling for covariates, MBC patients incurred 47% more short-term disability costs vs EBC patients (p = 0.009). Older patients (p = 0.002), non-HMO payers (p < 0.05), or patients not receiving chemotherapy during follow-up (p < 0.001) were associated with lower short-term disability costs. MBC patients' families incurred 39.7% (p = 0.06) higher indirect costs compared to EBC patients' families after controlling for key covariates. Productivity loss and associated costs in MBC patients are substantially higher than EBC patients or the general population. These findings underscore the economic burden of MBC from a US societal perspective. Various treatment regimens should be evaluated to identify opportunities to reduce the disease burden from the societal perspective.

Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: a decision-making approach.

PubMed

Barrett, Barbara; Byford, Sarah; Crawford, Mike J; Patton, Robert; Drummond, Colin; Henry, John A; Touquet, Robin

2006-01-04

We present the cost and cost-effectiveness of referral to an alcohol health worker (AHW) and information only control in alcohol misusing patients. The study was a pragmatic randomised controlled trial conducted from April 2001 to March 2003 in an accident and emergency department (AED) in a general hospital in London, England. A total of 599 adults identified as drinking hazardously according to the Paddington Alcohol Test were randomised to referral to an alcohol health worker who delivered a brief intervention (n = 287) or to an information only control (n = 312). Total societal costs, including health and social services costs, criminal justice costs and productivity losses, and clinical measures of alcohol consumption were measured. Levels of drinking were observably lower in those referred to an AHW at 12 months follow-up and statistically significantly lower at 6 months follow-up. Total costs were not significantly different at either follow-up. Referral to AHWs in an AED produces favourable clinical outcomes and does not generate a significant increase in cost. A decision-making approach revealed that there is at least a 65% probability that referral to an AHW is more cost-effective than the information only control in reducing alcohol consumption among AED attendees with a hazardous level of drinking.

Enhancing TSM&O strategies through life cycle benefit/cost analysis : life cycle benefit/cost analysis & life cycle assessment of adaptive traffic control systems and ramp metering systems.

DOT National Transportation Integrated Search

2015-05-01

The research team developed a comprehensive Benefit/Cost (B/C) analysis framework to evaluate existing and anticipated : intelligent transportation system (ITS) strategies, particularly, adaptive traffic control systems and ramp metering systems, : i...

PERFORMANCE AND COST OF MERCURY EMISSION CONTROL TECHNOLOGY APPLICATIONS ON ELECTRIC UTILITY BOILERS

EPA Science Inventory

The report presents estimates of the performance and cost of powdered activated carbon (PAC) injection-based mercury control technologies and projections of costs for future applications. (NOTE: Under the Clean Air Act Amendments of 1990, the U.S. EPA has to determine whether mer...

33 CFR 241.5 - Procedures for estimating the alternative cost-share.

Code of Federal Regulations, 2014 CFR

2014-07-01

... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

33 CFR 241.5 - Procedures for estimating the alternative cost-share.

Code of Federal Regulations, 2011 CFR

2011-07-01

... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

33 CFR 241.5 - Procedures for estimating the alternative cost-share.

Code of Federal Regulations, 2010 CFR

2010-07-01

... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

33 CFR 241.5 - Procedures for estimating the alternative cost-share.

Code of Federal Regulations, 2013 CFR

2013-07-01

... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

33 CFR 241.5 - Procedures for estimating the alternative cost-share.

Code of Federal Regulations, 2012 CFR

2012-07-01

... THE ARMY, DEPARTMENT OF DEFENSE FLOOD CONTROL COST-SHARING REQUIREMENTS UNDER THE ABILITY TO PAY.... Determine the maximum possible reduction in the level of non-Federal cost-sharing for any project. (1) Calculate the ratio of flood control benefits (developed using the Water Resources Council's Principles and...

Economic evaluations of Internet interventions for mental health: a systematic review.

PubMed

Donker, T; Blankers, M; Hedman, E; Ljótsson, B; Petrie, K; Christensen, H

2015-12-01

Internet interventions are assumed to be cost-effective. However, it is unclear how strong this evidence is, and what the quality of this evidence is. A comprehensive literature search (1990-2014) in Medline, EMBASE, the Cochrane Central Register of Controlled Trials, NHS Economic Evaluations Database, NHS Health Technology Assessment Database, Office of Health Economics Evaluations Database, Compendex and Inspec was conducted. We included economic evaluations alongside randomized controlled trials of Internet interventions for a range of mental health symptoms compared to a control group, consisting of a psychological or pharmaceutical intervention, treatment-as-usual (TAU), wait-list or an attention control group. Of the 6587 abstracts identified, 16 papers met the inclusion criteria. Nine studies featured a societal perspective. Results demonstrated that guided Internet interventions for depression, anxiety, smoking cessation and alcohol consumption had favourable probabilities of being more cost-effective when compared to wait-list, TAU, group cognitive behaviour therapy (CBGT), attention control, telephone counselling or unguided Internet CBT. Unguided Internet interventions for suicide prevention, depression and smoking cessation demonstrated cost-effectiveness compared to TAU or attention control. In general, results from cost-utility analyses using more generic health outcomes (quality of life) were less favourable for unguided Internet interventions. Most studies adhered reasonably to economic guidelines. Results of guided Internet interventions being cost-effective are promising with most studies adhering to publication standards, but more economic evaluations are needed in order to determine cost-effectiveness of Internet interventions compared to the most cost-effective treatment currently available.

Low cost attitude control system scanwheel development

NASA Astrophysics Data System (ADS)

Bialke, William; Selby, Vaughn

1991-03-01

In order to satisfy a growing demand for low cost attitude control systems for small spacecraft, development of low cost scanning horizon sensor coupled to a low cost/low power consumption Reaction Wheel Assembly was initiated. This report addresses the details of the versatile design resulting from this effort. Tradeoff analyses for each of the major components are included, as well as test data from an engineering prototype of the hardware.

Low cost attitude control system scanwheel development

NASA Technical Reports Server (NTRS)

Bialke, William; Selby, Vaughn

1991-01-01

In order to satisfy a growing demand for low cost attitude control systems for small spacecraft, development of low cost scanning horizon sensor coupled to a low cost/low power consumption Reaction Wheel Assembly was initiated. This report addresses the details of the versatile design resulting from this effort. Tradeoff analyses for each of the major components are included, as well as test data from an engineering prototype of the hardware.

Minimum cost to control bovine tuberculosis in cow-calf herds

PubMed Central

Smith, Rebecca L.; Tauer, Loren W.; Sanderson, Michael W.; Grohn, Yrjo T.

2014-01-01

Bovine tuberculosis (bTB) outbreaks in US cattle herds, while rare, are expensive to control. A stochastic model for bTB control in US cattle herds was adapted to more accurately represent cow-calf herd dynamics and was validated by comparison to 2 reported outbreaks. Control cost calculations were added to the model, which was then optimized to minimize costs for either the farm or the government. The results of the optimization showed that test-and-removal costs were minimized for both farms and the government if only 2 negative whole-herd tests were required to declare a herd free of infection, with a 2–3 month testing interval. However, the optimal testing interval for governments was increased to 2–4 months if the model was constrained to reject control programs leading to an infected herd being declared free of infection. Although farms always preferred test-and-removal to depopulation from a cost standpoint, government costs were lower with depopulation more than half the time in 2 of 8 regions. Global sensitivity analysis showed that indemnity costs were significantly associated with a rise in the cost to the government, and that low replacement rates were responsible for the long time to detection predicted by the model, but that improving the sensitivity of slaughterhouse screening and the probability that a slaughtered animal’s herd of origin can be identified would result in faster detection times. PMID:24703601

Minimum cost to control bovine tuberculosis in cow-calf herds.

PubMed

Smith, Rebecca L; Tauer, Loren W; Sanderson, Michael W; Gröhn, Yrjo T

2014-07-01

Bovine tuberculosis (bTB) outbreaks in US cattle herds, while rare, are expensive to control. A stochastic model for bTB control in US cattle herds was adapted to more accurately represent cow-calf herd dynamics and was validated by comparison to 2 reported outbreaks. Control cost calculations were added to the model, which was then optimized to minimize costs for either the farm or the government. The results of the optimization showed that test-and-removal costs were minimized for both farms and the government if only 2 negative whole-herd tests were required to declare a herd free of infection, with a 2-3 month testing interval. However, the optimal testing interval for governments was increased to 2-4 months if the model was constrained to reject control programs leading to an infected herd being declared free of infection. Although farms always preferred test-and-removal to depopulation from a cost standpoint, government costs were lower with depopulation more than half the time in 2 of 8 regions. Global sensitivity analysis showed that indemnity costs were significantly associated with a rise in the cost to the government, and that low replacement rates were responsible for the long time to detection predicted by the model, but that improving the sensitivity of slaughterhouse screening and the probability that a slaughtered animal's herd of origin can be identified would result in faster detection times. Copyright © 2014 Elsevier B.V. All rights reserved.

Epidemiology and economic impact of health care-associated infections and cost-effectiveness of infection control measures at a Thai university hospital.

PubMed

Rattanaumpawan, Pinyo; Thamlikitkul, Visanu

2017-02-01

Data on clinical and economic impact of health care-associated infections (HAIs) from resource limited countries are limited. We aimed to determine epidemiology and economic impact of HAIs and cost-effectiveness of infection prevention and control measures in a resource-limited setting. A retrospective cohort study was conducted among hospitalized patients at Siriraj Hospital, Thailand. Results from the cohort were subsequently used to conduct cost-effective analysis (CEA) to compare the comprehensive implementation of individualized bundling infection control measures (IBICMs) with regular infection control care. From February-May 2013, there were 515 hospitalizations (497 patients) with 7,848 hospitalization days. Cumulative incidence of HAIs was 23.30%, and the incidence rate of HAIs was 18.66 ± 44.19 per 1,000 hospitalization days. Hospital mortality among those with and without HAIs was 33.33% and 20.00%, respectively (P < .001). The adjusted cost attributable to HAIs was $704.72 ± $226.73 (P < .001). CEA identified IBICMs as a non-dominated strategy, with an incremental cost-effectiveness ratio of -$20,444.62 per life saved. HAI is significantly related with higher hospital mortality, longer length of stay, and higher hospitalization costs. IBICMs were confirmed to be cost-effective at Siriraj Hospital. Implementing this intervention could improve care quality and save costs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

An educational intervention to improve cost-effective care among medicine housestaff: a randomized controlled trial.

PubMed

Sommers, Benjamin D; Desai, Nihar; Fiskio, Julie; Licurse, Adam; Thorndike, Mary; Katz, Joel T; Bates, David W

2012-06-01

High medical costs create significant burdens. Research indicates that doctors have little awareness of costs. This study tested whether a brief educational intervention could increase residents' awareness of cost-effectiveness and reduce costs without negatively affecting patient outcomes. The authors conducted a clustered randomized controlled trial of 33 teams (96 residents) at an internal medicine residency program (2009-2010). The intervention was a 45-minute teaching session; residents reviewed the hospital bill of a patient for whom they had cared and discussed reducing unnecessary costs. Primary outcomes were laboratory, pharmacy, radiology, and total hospital costs per admission. Secondary measures were length of stay (LOS), intensive care unit (ICU) admission, 30-day readmission, and 30-day mortality. Multivariate adjustment controlled for patient demographics and health. A follow-up survey assessed resident attitudes three months later. Among 1,194 patients, there were no significant cost differences between intervention and control groups. In the intervention group, 30-day readmission was higher (adjusted odds ratio 1.51, P = .010). There was no effect on LOS or the composite outcome of readmission, mortality, and ICU transfer. In a subgroup analysis of 835 patients newly admitted during the study, the intervention group incurred $163 lower adjusted lab costs per admission (P = .046). The follow-up survey indicated persistent differences in residents' exposure to concepts of cost-effectiveness (P = .041). A brief intervention featuring a discussion of hospital bills can fill a gap in resident education and reduce laboratory costs for a subset of patients, but may increase readmission risk.

Projectile Roll Dynamics and Control With a Low-Cost Skid-to-Turn Maneuver System

DTIC Science & Technology

2013-03-01

scheme. The mechatronics of the maneuver system was provided. The suitability of this design for survival at gun launch was assessed through...Projectile Roll Dynamics and Control With a Low-Cost Skid-to-Turn Maneuver System by Frank Fresconi, Ilmars Celmins, Mark Ilg, and James...5069 ARL-TR-6363 March 2013 Projectile Roll Dynamics and Control With a Low-Cost Skid-to-Turn Maneuver System Frank Fresconi, Ilmars

Electronics Controls Assessment for the PATRIOT Air Conditioner System. Revision

DTIC Science & Technology

1986-04-28

electronic controls in Army Air Conditioner Systems. This assessment used criteria which included: cost (initial and life cycle), efficiency, weight ...each of the twelve selected controllers as to cost and size Iqualifications was accomplished b) assigning reasonable weight factors according to the...following table:I COST SIZE5 WEIGHT FACTOR (Per Unit Price Range) (Volumetric Range) 1 Under $1000 Under 700 in 3 3 $1000 to $1500 700-1000 in 3 5 $1501

Policy interactions and underperforming emission trading markets in China.

PubMed

Zhang, Bing; Zhang, Hui; Liu, Beibei; Bi, Jun

2013-07-02

Emission trading is considered to be cost-effective environmental economic instrument for pollution control. However, the ex post analysis of emission trading program found that cost savings have been smaller and the trades fewer than might have been expected at the outset of the program. Besides policy design issues, pre-existing environmental regulations were considered to have a significant impact on the performance of the emission trading market in China. Taking the Jiangsu sulfur dioxide (SO2) market as a case study, this research examined the impact of policy interactions on the performance of the emission trading market. The results showed that cost savings associated with the Jiangsu SO2 emission trading market in the absence of any policy interactions were CNY 549 million or 12.5% of total pollution control costs. However, policy interactions generally had significant impacts on the emission trading system; the lone exception was current pollution levy system. When the model accounted for all four kinds of policy interactions, the total pollution control cost savings from the emission trading market fell to CNY 39.7 million or 1.36% of total pollution control costs. The impact of policy interactions would reduce 92.8% of cost savings brought by emission trading program.

Terminal spacecraft rendezvous and capture with LASSO model predictive control

NASA Astrophysics Data System (ADS)

Hartley, Edward N.; Gallieri, Marco; Maciejowski, Jan M.

2013-11-01

The recently investigated ℓasso model predictive control (MPC) is applied to the terminal phase of a spacecraft rendezvous and capture mission. The interaction between the cost function and the treatment of minimum impulse bit is also investigated. The propellant consumption with ℓasso MPC for the considered scenario is noticeably less than with a conventional quadratic cost and control actions are sparser in time. Propellant consumption and sparsity are competitive with those achieved using a zone-based ℓ1 cost function, whilst requiring fewer decision variables in the optimisation problem than the latter. The ℓasso MPC is demonstrated to meet tighter specifications on control precision and also avoids the risk of undesirable behaviours often associated with pure ℓ1 stage costs.

Economic Evaluation of Pharmacologic Pre- and Postconditioning With Sevoflurane Compared With Total Intravenous Anesthesia in Liver Surgery: A Cost Analysis.

PubMed

Eichler, Klaus; Urner, Martin; Twerenbold, Claudia; Kern, Sabine; Brügger, Urs; Spahn, Donat R; Beck-Schimmer, Beatrice; Ganter, Michael T

2017-03-01

Pharmacologic pre- and postconditioning with sevoflurane compared with total IV anesthesia in patients undergoing liver surgery reduced complication rates as shown in 2 recent randomized controlled trials. However, the potential health economic consequences of these different anesthesia regimens have not yet been assessed. An expostcost analysis of these 2 trials in 129 patients treated between 2006 and 2010 was performed. We analyzed direct medical costs for in-hospital stay and compared pharmacologic pre- and postconditioning with sevoflurane (intervention) with total IV anesthesia (control) from the perspective of a Swiss university hospital. Year 2015 costs, converted to US dollars, were derived from hospital cost accounting data and compared with a multivariable regression analysis adjusting for relevant covariables. Costs with negative prefix indicate savings and costs with positive prefix represent higher spending in our analysis. Treatment-related costs per patient showed a nonsignificant change by -12,697 US dollars (95% confidence interval [CI], 10,956 to -36,352; P = .29) with preconditioning and by -6139 US dollars (95% CI, 6723 to -19,000; P = .35) with postconditioning compared with the control group. Results were robust in our sensitivity analysis. For both procedures (control and intervention) together, major complications led to a significant increase in costs by 86,018 US dollars (95% CI, 13,839-158,198; P = .02) per patient compared with patients with no major complications. In this cost analysis, reduced in-hospital costs by pharmacologic conditioning with sevoflurane in patients undergoing liver surgery are suggested. This possible difference in costs compared with total IV anesthesia is the result of reduced complication rates with pharmacologic conditioning, because major complications have significant cost implications.

Economic Evaluation of Pharmacologic Pre- and Postconditioning With Sevoflurane Compared With Total Intravenous Anesthesia in Liver Surgery: A Cost Analysis

PubMed Central

Urner, Martin; Twerenbold, Claudia; Kern, Sabine; Brügger, Urs; Spahn, Donat R.; Beck-Schimmer, Beatrice; Ganter, Michael T.

2017-01-01

BACKGROUND: Pharmacologic pre- and postconditioning with sevoflurane compared with total IV anesthesia in patients undergoing liver surgery reduced complication rates as shown in 2 recent randomized controlled trials. However, the potential health economic consequences of these different anesthesia regimens have not yet been assessed. METHODS: An expostcost analysis of these 2 trials in 129 patients treated between 2006 and 2010 was performed. We analyzed direct medical costs for in-hospital stay and compared pharmacologic pre- and postconditioning with sevoflurane (intervention) with total IV anesthesia (control) from the perspective of a Swiss university hospital. Year 2015 costs, converted to US dollars, were derived from hospital cost accounting data and compared with a multivariable regression analysis adjusting for relevant covariables. Costs with negative prefix indicate savings and costs with positive prefix represent higher spending in our analysis. RESULTS: Treatment-related costs per patient showed a nonsignificant change by −12,697 US dollars (95% confidence interval [CI], 10,956 to −36,352; P = .29) with preconditioning and by −6139 US dollars (95% CI, 6723 to −19,000; P = .35) with postconditioning compared with the control group. Results were robust in our sensitivity analysis. For both procedures (control and intervention) together, major complications led to a significant increase in costs by 86,018 US dollars (95% CI, 13,839-158,198; P = .02) per patient compared with patients with no major complications. CONCLUSIONS: In this cost analysis, reduced in-hospital costs by pharmacologic conditioning with sevoflurane in patients undergoing liver surgery are suggested. This possible difference in costs compared with total IV anesthesia is the result of reduced complication rates with pharmacologic conditioning, because major complications have significant cost implications. PMID:28067701

Health care resource use and costs among patients with cushing disease.

PubMed

Swearingen, Brooke; Wu, Ning; Chen, Shih-Yin; Pulgar, Sonia; Biller, Beverly M K

2011-01-01

To assess health care costs associated with Cushing disease and to determine changes in overall and comorbidity-related costs after surgical treatment. In this retrospective cohort study, patients with Cushing disease were identified from insurance claims databases by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes for Cushing syndrome (255.0) and either benign pituitary adenomas (227.3) or hypophysectomy (07.6×) between 2004 and 2008. Each patient with Cushing disease was age- and sex-matched with 4 patients with nonfunctioning pituitary adenomas and 10 population control subjects. Comorbid conditions and annual direct health care costs were assessed within each calendar year. Postoperative changes in health care costs and comorbidity-related costs were compared between patients presumed to be in remission and those with presumed persistent disease. Of 877 identified patients with Cushing disease, 79% were female and the average age was 43.4 years. Hypertension, diabetes mellitus, and hyperlipidemia were more common among patients with Cushing disease than in patients with nonfunctioning pituitary adenomas or in control patients (P<.01). For every calendar year studied, patients with Cushing disease had significantly higher total health care costs (2008: $26 440 [Cushing disease] vs $13 708 [nonfunctioning pituitary adenomas] vs $5954 [population control], P<.01). Annual outpatient costs decreased significantly for patients in remission after surgery, and there was a trend towards improvement in overall disease-related costs with remission. A significant increase in postoperative health care costs was observed in those patients not in remission. Patients with Cushing disease had more comorbidities than patients with nonfunctioning pituitary adenomas or control patients and incurred significantly higher annual health care costs; these costs decreased after successful surgery and increased after unsuccessful surgery.

Cost-effectiveness of dabigatran for stroke prophylaxis in atrial fibrillation.

PubMed

Shah, Shimoli V; Gage, Brian F

2011-06-07

Recent studies have investigated alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation (AF), but whether these alternatives are cost-effective is unknown. On the basis of the results from Randomized Evaluation of Long Term Anticoagulation Therapy (RE-LY) and other trials, we developed a decision-analysis model to compare the cost and quality-adjusted survival of various antithrombotic therapies. We ran our Markov model in a hypothetical cohort of 70-year-old patients with AF using a cost-effectiveness threshold of $50 000/quality-adjusted life-year. We estimated the cost of dabigatran as US $9 a day. For a patient with an average risk of major hemorrhage (≈3%/y), the most cost-effective therapy depended on stroke risk. For patients with the lowest stroke rate (CHADS2 stroke score of 0), only aspirin was cost-effective. For patients with a moderate stroke rate (CHADS2 score of 1 or 2), warfarin was cost-effective unless the risk of hemorrhage was high or quality of international normalized ratio control was poor (time in the therapeutic range <57.1%). For patients with a high stroke risk (CHADS(2) stroke score ≥3), dabigatran 150 mg (twice daily) was cost-effective unless international normalized ratio control was excellent (time in the therapeutic range >72.6%). Neither dabigatran 110 mg nor dual therapy (aspirin and clopidogrel) was cost-effective. Dabigatran 150 mg (twice daily) was cost-effective in AF populations at high risk of hemorrhage or high risk of stroke unless international normalized ratio control with warfarin was excellent. Warfarin was cost-effective in moderate-risk AF populations unless international normalized ratio control was poor.

Direct medical costs attributable to type 2 diabetes mellitus: a population-based study in Catalonia, Spain.

PubMed

Mata-Cases, Manel; Casajuana, Marc; Franch-Nadal, Josep; Casellas, Aina; Castell, Conxa; Vinagre, Irene; Mauricio, Dídac; Bolíbar, Bonaventura

2016-11-01

We estimated healthcare costs associated with patients with type 2 diabetes compared with non-diabetic subjects in a population-based primary care database through a retrospective analysis of economic impact during 2011, including 126,811 patients with type 2 diabetes in Catalonia, Spain. Total annual costs included primary care visits, hospitalizations, referrals, diagnostic tests, self-monitoring test strips, medication, and dialysis. For each patient, one control matched for age, gender and managing physician was randomly selected from a population database. The annual average cost per patient was €3110.1 and €1803.6 for diabetic and non-diabetic subjects, respectively (difference €1306.6; i.e., 72.4 % increased cost). The costs of hospitalizations were €1303.1 and €801.6 (62.0 % increase), and medication costs were €925.0 and €489.2 (89.1 % increase) in diabetic and non-diabetic subjects, respectively. In type 2 diabetic patients, hospitalizations and medications had the greatest impact on the overall cost (41.9 and 29.7 %, respectively), generating approximately 70 % of the difference between diabetic and non-diabetic subjects. Patients with poor glycaemic control (glycated haemoglobin >7 %; >53 mmol/mol) had average costs of €3296.5 versus €2848.5 for patients with good control. In the absence of macrovascular complications, average costs were €3008.1 for diabetic and €1612.4 for non-diabetic subjects, while its presence increased costs to €4814.6 and €3306.8, respectively. In conclusion, the estimated higher costs for type 2 diabetes patients compared with non-diabetic subjects are due mainly to hospitalizations and medications, and are higher among diabetic patients with poor glycaemic control and macrovascular complications.

Value associated with mindfulness meditation and moderate exercise intervention in acute respiratory infection: The MEPARI Study

PubMed Central

2013-01-01

Background and objectives. Acute respiratory infection (ARI) is among the most common, debilitating and expensive human illnesses. The purpose of this study was to assess ARI-related costs and determine if mindfulness meditation or exercise can add value. Methods. One hundred and fifty-four adults ≥50 years from Madison, WI for the 2009–10 cold/flu season were randomized to (i) wait-list control (ii) meditation or (iii) moderate intensity exercise. ARI-related costs were assessed through self-reported medication use, number of missed work days and medical visits. Costs per subject were based on cost of generic medications, missed work days ($126.20) and clinic visits ($78.70). Monte Carlo bootstrap methods evaluated reduced costs of ARI episodes. Results. The total cost per subject for the control group was $214 (95% CI: $105–$358), exercise $136 (95% CI: $64–$232) and meditation $65 (95% CI: $34–$104). The majority of cost savings was through a reduction in missed days of work. Exercise had the highest medication costs at $16.60 compared with $5.90 for meditation (P = 0.004) and $7.20 for control (P = 0.046). Combining these cost benefits with the improved outcomes in incidence, duration and severity seen with the Meditation or Exercise for Preventing Acute Respiratory Infection study, meditation and exercise add value for ARI. Compared with control, meditation had the greatest cost benefit. This savings is offset by the cost of the intervention ($450/subject) that would negate the short-term but perhaps not long-term savings. Conclusions. Meditation and exercise add value to ARI-associated health-related costs with improved outcomes. Further research is needed to confirm results and inform policies on adding value to medical spending. PMID:23515373

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

PubMed Central

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

2016-01-01

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

Value associated with mindfulness meditation and moderate exercise intervention in acute respiratory infection: the MEPARI Study.

PubMed

Rakel, David; Mundt, Marlon; Ewers, Tola; Fortney, Luke; Zgierska, Aleksandra; Gassman, Michele; Barrett, Bruce

2013-08-01

Acute respiratory infection (ARI) is among the most common, debilitating and expensive human illnesses. The purpose of this study was to assess ARI-related costs and determine if mindfulness meditation or exercise can add value. One hundred and fifty-four adults ≥50 years from Madison, WI for the 2009-10 cold/flu season were randomized to (i) wait-list control (ii) meditation or (iii) moderate intensity exercise. ARI-related costs were assessed through self-reported medication use, number of missed work days and medical visits. Costs per subject were based on cost of generic medications, missed work days ($126.20) and clinic visits ($78.70). Monte Carlo bootstrap methods evaluated reduced costs of ARI episodes. The total cost per subject for the control group was $214 (95% CI: $105-$358), exercise $136 (95% CI: $64-$232) and meditation $65 (95% CI: $34-$104). The majority of cost savings was through a reduction in missed days of work. Exercise had the highest medication costs at $16.60 compared with $5.90 for meditation (P = 0.004) and $7.20 for control (P = 0.046). Combining these cost benefits with the improved outcomes in incidence, duration and severity seen with the Meditation or Exercise for Preventing Acute Respiratory Infection study, meditation and exercise add value for ARI. Compared with control, meditation had the greatest cost benefit. This savings is offset by the cost of the intervention ($450/subject) that would negate the short-term but perhaps not long-term savings. Meditation and exercise add value to ARI-associated health-related costs with improved outcomes. Further research is needed to confirm results and inform policies on adding value to medical spending.

A cost-analysis of two approaches to infection control in a lung function laboratory.

PubMed

Side, E A; Harrington, G; Thien, F; Walters, E H; Johns, D P

1999-02-01

The Thoracic Society of Australia and New Zealand (TSANZ) guidelines for infection control in respiratory laboratories are based on a 'Universal Precautions' approach to patient care. This requires that one-way breathing valves, flow sensors, and other items, be cleaned and disinfected between patient use. However, this is impractical in a busy laboratory. The recent introduction of disposable barrier filters may provide a practical solution to this problem, although most consider this approach to be an expensive option. To compare the cost of implementing the TSANZ infection control guidelines with the cost of using disposable barrier filters. Costs were based on the standard tests and equipment currently used in the lung function laboratory at The Alfred Hospital. We have assumed that a barrier filter offers the same degree of protection against cross-infection between patients as the TSANZ infection control guidelines. Time and motion studies were performed on the dismantling, cleaning, disinfecting, reassembling and re-calibrating of equipment. Conservative estimates were made as to the frequency of replacing pneumotachographs and rubber mouthpieces based on previous equipment turnover. Labour costs for a scientist to reprocess the equipment was based on $20.86/hour. The cost of employing a casual cleaner at an hourly rate of $14.07 to assist in reprocessing equipment was also investigated. The new high efficiency HyperFilter disposable barrier filter, costing $2.95 was used in this cost-analysis. The cost of reprocessing equipment required for spirometry alone was $17.58 per test if a scientist reprocesses the equipment, and $15.56 per test if a casual cleaner is employed to assist the scientist in performing these duties. In contrast, using a disposable filter would cost only $2.95 per test. Using a filter was considerably less expensive than following the TSANZ guidelines for all tests and equipment used in this cost-analysis. The TSANZ infection control guidelines are expensive and impractical to implement. However, disposable barrier filters provide a practical and inexpensive method of infection control.

Evaluation of costs associated with atmospheric mercury emission reductions from coal combustion in China in 2010 and projections for 2020.

PubMed

Zhang, Yue; Ye, Xuejie; Yang, Tianjun; Li, Jinling; Chen, Long; Zhang, Wei; Wang, Xuejun

2018-01-01

Coal combustion is the most significant anthropogenic mercury emission source in China. In 2013, China signed the Minamata Convention affirming that mercury emissions should be controlled more strictly. Therefore, an evaluation of the costs associated with atmospheric mercury emission reductions from China's coal combustion is essential. In this study, we estimated mercury abatement costs for coal combustion in China for 2010, based on a provincial technology-based mercury emission inventory. In addition, four scenarios were used to project abatement costs for 2020. Our results indicate that actual mercury emission related to coal combustion in 2010 was 300.8Mg, indicating a reduction amount of 174.7Mg. Under a policy-controlled scenario for 2020, approximately 49% of this mercury could be removed using air pollution control devices, making mercury emissions in 2020 equal to or lower than in 2010. The total abatement cost associated with mercury emissions in 2010 was 50.2×10 9 RMB. In contrast, the total abatement costs for 2020 under baseline versus policy-controlled scenarios, having high-energy and low-energy consumption, would be 32.0×10 9 versus 51.2×10 9 , and 27.4×10 9 versus 43.9×10 9 RMB, respectively. The main expense is associated with flue gas desulfurization. The unit abatement cost of mercury emissions in 2010 was 288×10 3 RMB/(kgHg). The unit abatement costs projected for 2020 under a baseline, a policy-controlled, and an United Nations Environmental Programme scenario would be 143×10 3 , 172×10 3 and 1066×10 3 RMB/(kgHg), respectively. These results are much lower than other international ones. However, the relative costs to China in terms of GPD are higher than in most developed countries. We calculated that abatement costs related to mercury emissions accounted for about 0.14% of the GDP of China in 2010, but would be between 0.03% and 0.06% in 2020. This decrease in abatement costs in terms of GDP suggests that various policy-controlled scenarios would be viable. Copyright © 2017 Elsevier B.V. All rights reserved.

Costs and absence of HCV-infected employees by disease stage.

PubMed

Baran, Robert W; Samp, Jennifer C; Walker, David R; Smeeding, James E; Young, Jacob W; Kleinman, Nathan L; Brook, Richard A

2015-01-01

Quantify the costs and absenteeism associated with stages of the Hepatitis C virus (HCV). Retrospective analysis of the HCMS integrated database from multiple geographically diverse, US-based employers with employee information on medical, prescription, and absenteeism claims. Employee data were extracted from July 2001-March 2013. Employees with HCV were identified by ICD-9-CM codes and classified into disease severity cohorts using diagnosis/procedure codes assigning the first date of most severe claim as the index date. Non-HCV employees (controls) were assigned random index dates. Inclusion required 6-month pre-/post-index eligibility. Medical, prescription, and absenteeism cost and time were analyzed using two-part regression (logistic/generalized linear) models, controlling for potentially confounding factors. Costs were inflation adjusted to September 2013. All direct costs comparisons were statistically significant (p ≤ 0.05) with mean medical costs of $1813 [SE = $3] for controls (n = 727,588), $4611 [SE = $211] for non-cirrhotic (n = 1007), $4646 [SE = $721] for compensated cirrhosis (CC, n = 87), $12,384 [SE = $1122] for decompensated cirrhosis (DCC, n = 256), $33,494 [SE = $11,753] for hepatocellular carcinoma (HCC, n = 17) and $97,724 [SE = $32,437] for liver transplant (LT, n = 19) cohorts. Mean short-term disability days/costs were significantly greater for the non-cirrhotic (days = 2.03 [SE = 0.36]; $299 [SE = $53]), DCC (days = 6.20 [SE = 1.36]; $763 [SE = $169]), and LT cohorts (days = 21.98 [SE = 8.21]; $2537 [SE = $972]) compared to controls (days = 1.19 [SE = 0.01]; $155 [SE = $1]). Mean sick leave costs were significantly greater for non-cirrhotic ($373 [SE = $22]) and DCC ($460 [SE = $54]) compared to controls ($327 [SE = $1]). Employees with HCV were shown to have greater direct and indirect costs compared to non-HCV employee controls. Costs progressively increased in the more severe HCV disease categories. Slowing or preventing disease progression may avert the costs of more severe liver disease stages and enable employees with HCV to continue as productive members of the workforce.

Health care costs in US patients with and without a diagnosis of osteoarthritis

PubMed Central

Le, T Kim; Montejano, Leslie B; Cao, Zhun; Zhao, Yang; Ang, Dennis

2012-01-01

Background Osteoarthritis is a chronic and costly condition affecting 14% of adults in the US, and has a significant impact on patient quality of life. This retrospective cohort study compared direct health care utilization and costs between patients with osteoarthritis and a matched control group without osteoarthritis. Methods MarketScan® databases were used to identify adult patients with an osteoarthritis claim (ICD-9-CM, 715.xx) in 2007, and the date of first diagnosis served as the index. Patients were excluded if they did not have 12 months of continuous health care benefit prior to and following the index date, were aged <18 years, or lacked a second diagnosis code for osteoarthritis between 15 and 365 days pre-index or post-index. Osteoarthritis patients were matched 1:1 to patients without osteoarthritis for age group, gender, geographic region, health plan type, and Medicare eligibility. Multivariate analyses were conducted to assess for differences in utilization and costs, controlling for differences between cohorts. Results The study sample included 258,237 patients with osteoarthritis and 258,237 matched controls without osteoarthritis. Most patients were women and over 55 years of age. Patients with osteoarthritis had significantly higher pre-index rates of comorbidity than controls. Mean total adjusted direct costs for osteoarthritis patients were more than double those for the control group at US$18,435 (95% confidence interval [CI]: US$18,318–US$18,560) versus US$7494 (95% CI: US$7425–US$7557). Osteoarthritis patients incurred significantly higher inpatient costs at US$6668 (95% CI: US$6587–US$6744) versus US$1756 (95% CI: US$1717–US$1794), outpatient costs at US$7840 (95% CI: US$7786–US$7902) versus US$3675 (95% CI: US$3637–US$3711), and prescription drug costs at US$3213 (95% CI: US$3195–US$3233) versus US$2245 (95% CI: US$2229–US$2262) compared with the controls. Conclusion The direct health care costs of osteoarthritis patients were over two times higher than those of similar patients without the condition. The primary drivers of the cost difference were comorbidities and inpatient costs. PMID:22328832

Does cost-benefit analysis or self-control predict involvement in two forms of aggression?

PubMed

Archer, John; Fernández-Fuertes, Andrés A; Thanzami, Van Lal

2010-01-01

The main aim of this research was to assess the relative association between physical aggression and (1) self-control and (2) cost-benefit assessment, these variables representing the operation of impulsive and reflective processes. Study 1 involved direct and indirect aggression among young Indian men, and Study 2 physical aggression to dating partners among Spanish adolescents. In Study 1, perceived benefits and costs but not self-control were associated with direct aggression at other men, and the association remained when their close association with indirect aggression was controlled. In Study 2, benefits and self-control showed significant and independent associations (positive for benefits, negative for self-control) with physical aggression at other-sex partners. Although being victimized was also correlated in the same direction with self-control and benefits, perpetration and being victimized were highly correlated, and there was no association between being victimized and these variables when perpetration was controlled. These results support the theory that reflective (cost-benefit analyses) processes and impulsive (self-control) processes operate in parallel in affecting aggression. The finding that male adolescents perceived more costs and fewer benefits from physical aggression to a partner than female adolescents did is consistent with findings indicating greater social disapproval of men hitting women than vice versa, rather than with the view that male violence to women is facilitated by internalized patriarchal values. (c) 2010 Wiley-Liss, Inc.

Shipping emission forecasts and cost-benefit analysis of China ports and key regions' control.

PubMed

Liu, Huan; Meng, Zhi-Hang; Shang, Yi; Lv, Zhao-Feng; Jin, Xin-Xin; Fu, Ming-Liang; He, Ke-Bin

2018-05-01

China established Domestic Emission Control Area (DECA) for sulphur since 2015 to constrain the increasing shipping emissions. However, future DECA policy-makings are not supported due to a lack of quantitive evaluations. To investigate the effects of current and possible Chinese DECAs policies, a model is presented for the forecast of shipping emissions and evaluation of potential costs and benefits of an DECA policy package set in 2020. It includes a port-level and regional-level projection accounting for shipping trade volume growth, share of ship types, and fuel consumption. The results show that without control measures, both SO 2 and particulate matter (PM) emissions are expected to increase by 15.3-61.2% in Jing-Jin-Ji, the Yangtze River Delta, and the Pearl River Delta from 2013 to 2020. However, most emissions can be reduced annually by the establishment of a DECA that depends on the size of the control area and the fuel sulphur content limit. Costs range from 0.667 to 1.561 billion dollars (control regional shipping emissions) based on current fuel price. A social cost method shows the regional control scenarios benefit-cost ratios vary from 4.3 to 5.1 with large uncertainty. Chemical transportation model combined with health model method is used to get the monetary health benefits and then compared with the results from social cost method. This study suggests that Chinese DECAs will reduce the projected emissions at a favorable benefit-cost ratio, and furthermore proposes policy combinations that provide high cost-effective benefits as a reference for future policy-making. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

The Cost Implications of Less Tight Versus Tight Control of Hypertension in Pregnancy (CHIPS Trial).

PubMed

Ahmed, Rashid J; Gafni, Amiram; Hutton, Eileen K; Hu, Zheng Jing; Pullenayegum, Eleanor; von Dadelszen, Peter; Rey, Evelyne; Ross, Susan; Asztalos, Elizabeth; Murphy, Kellie E; Menzies, Jennifer; Sanchez, J Johanna; Ganzevoort, Wessel; Helewa, Michael; Lee, Shoo K; Lee, Terry; Logan, Alexander G; Moutquin, Jean-Marie; Singer, Joel; Thornton, Jim G; Welch, Ross; Magee, Laura A

2016-10-01

The CHIPS randomized controlled trial (Control of Hypertension in Pregnancy Study) found no difference in the primary perinatal or secondary maternal outcomes between planned "less tight" (target diastolic 100 mm Hg) and "tight" (target diastolic 85 mm Hg) blood pressure management strategies among women with chronic or gestational hypertension. This study examined which of these management strategies is more or less costly from a third-party payer perspective. A total of 981 women with singleton pregnancies and nonsevere, nonproteinuric chronic or gestational hypertension were randomized at 14 to 33 weeks to less tight or tight control. Resources used were collected from 94 centers in 15 countries and costed as if the trial took place in each of 3 Canadian provinces as a cost-sensitivity analysis. Eleven hospital ward and 24 health service costs were obtained from a similar trial and provincial government health insurance schedules of medical benefits. The mean total cost per woman-infant dyad was higher in less tight versus tight control, but the difference in mean total cost (DM) was not statistically significant in any province: Ontario ($30 191.62 versus $24 469.06; DM $5723, 95% confidence interval, -$296 to $12 272; P=0.0725); British Columbia ($30 593.69 versus $24 776.51; DM $5817; 95% confidence interval, -$385 to $12 349; P=0.0725); or Alberta ($31 510.72 versus $25 510.49; DM $6000.23; 95% confidence interval, -$154 to $12 781; P=0.0637). Tight control may benefit women without increasing risk to neonates (as shown in the main CHIPS trial), without additional (and possibly lower) cost to the healthcare system. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01192412. © 2016 The Authors.

A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention.

PubMed

Klatt, Maryanna D; Sieck, Cynthia; Gascon, Gregg; Malarkey, William; Huerta, Timothy

2016-08-01

To compare healthcare costs and utilization among participants in a study of two active lifestyle interventions implemented in the workplace and designed to foster awareness of and attention to health with a propensity score matched control group. We retrospectively compared changes in healthcare (HC) utilization among participants in the mindfulness intervention (n=84) and the diet/exercise intervention (n=86) to a retrospectively matched control group (n=258) drawn for this study. The control group was matched from the non-participant population on age, gender, relative risk score, and HC expenditures in the 9 month preceding the study. Measures included number of primary care visits, number and cost of pharmacy prescriptions, number of hospital admissions, and overall healthcare costs tracked for 5 years after the intervention. Significantly fewer primary care visits (p<.001) for both intervention groups as compared to controls, with a non-significant trend towards lower overall HC utilization (4,300.00 actual dollar differences) and hospital admissions for the intervention groups after five years. Pharmacy costs and number of prescriptions were significantly higher for the two intervention groups compared to controls over the five years (p<0.05), yet still resulted in less HC utilization costs, potentially indicating greater self-management of care. This study provides valuable information as to the cost savings and value of providing workplace lifestyle interventions that focus on awareness of one's body and health. Health economic studies validate the scale of personal and organization health cost savings that such programs can generate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Direct medical costs of constipation from childhood to early adulthood: a population-based birth cohort study.

PubMed

Choung, Rok Seon; Shah, Nilay D; Chitkara, Denesh; Branda, Megan E; Van Tilburg, Miranda A; Whitehead, William E; Katusic, Slavica K; Locke, G Richard; Talley, Nicholas J

2011-01-01

Although direct medical costs for constipation-related medical visits are thought to be high, to date there have been no studies examining whether longitudinal resource use is persistently elevated in children with constipation. Our aim was to estimate the incremental direct medical costs and types of health care use associated with constipation from childhood to early adulthood. A nested case-control study was conducted to evaluate the incremental costs associated with constipation. The original sample consisted of 5718 children in a population-based birth cohort who were born during 1976 to 1982 in Rochester, MN. The cases included individuals who presented to medical facilities with constipation. The controls were matched and randomly selected among all noncases in the sample. Direct medical costs for cases and controls were collected from the time subjects were between 5 and 18 years of age or until the subject emigrated from the community. We identified 250 cases with a diagnosis of constipation in the birth cohort. Although the mean inpatient costs for cases were $9994 (95% Confidence interval [CI] 2538-37,201) compared with $2391 (95% CI 923-7452) for controls (P = 0.22) during the time period, the mean outpatient costs for cases were $13,927 (95% CI 11,325-16,525) compared with $3448 (95% CI 3771-4621) for controls (P < 0.001) during the same time period. The mean annual number of emergency department visits for cases was 0.66 (95% CI 0.62-0.70) compared with 0.34 (95% CI 0.32-0.35) for controls (P < 0.0001). Individuals with constipation have higher medical care use. Outpatient costs and emergency department use were significantly greater for individuals with constipation from childhood to early adulthood.

Direct medical costs of constipation in children over 15 years: a population-based birth cohort

PubMed Central

Choung, Rok Seon; Shah, Nilay D.; Chitkara, Denesh; Branda, Megan E.; Van Tilburg, Miranda A.; Whitehead, William E.; Katusic, Slavica K.; Locke, G. Richard; Talley, Nicholas J.

2011-01-01

Background Although direct medical costs for constipation-related medical visits are thought to be high, to date there have been no studies examining if longitudinal resource utilization is persistently elevated in children with constipation. Our aim was to estimate the incremental direct medical costs and types of health care utilization associated with constipation from childhood to early adulthood. Methods A nested case-control study was conducted to evaluate the incremental costs associated with constipation. The original sample consisted of 5,718 children in a population-based birth cohort who were born during 1976–1982 in Rochester, MN. The cases included individuals who presented to medical facilities with constipation. The controls were matched and randomly selected among all non-cases in the sample. Direct medical costs for cases and controls were collected from the time subjects were between 5–18 years of age or until the subject emigrated from the community. Results We identified 250 cases with a diagnosis of constipation in the birth cohort. While the mean inpatient costs for cases were $9994 (95% CI=2538, 37201) compared to $2391 (95% CI=923, 7452) for controls (p=0.22) over the time period, the mean outpatient costs for cases were $13927 (95% CI=11325, 16525) compared to $3448 (95% CI=3771, 4621) for controls (p<0.001) over the same time period. The mean annual number emergency department visits for cases were 0.66 (95% CI=0.62, 0.70) compared to 0.34 (95% CI=0.32, 0.35) for controls (p<0.0001). Conclusion Individuals with constipation have higher medical care utilization. Outpatient costs and ER utilization were significantly greater for individuals with constipation from childhood to early adulthood. PMID:20890220

Bibliographic Control at the Crossroads: Do We Get Our Money's Worth?

ERIC Educational Resources Information Center

Koel, Ake I.

1981-01-01

Contrasts traditional objectives for library catalogs with current bibliographic control practices to protest the increasing complexity and cost of cataloging. Research is urged to develop more cost-effective bibliographic control procedures and techniques. Eight references are listed. (RAA)

Costs and Effects of a Telephonic Diabetes Self-Management Support Intervention Using Health Educators

PubMed Central

Schechter, Clyde B.; Walker, Elizabeth A.; Ortega, Felix M.; Chamany, Shadi; Silver, Lynn D.

2015-01-01

Background Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Methods Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. Oneway sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. Results The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Conclusions Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. PMID:26750743

Costs and effects of a telephonic diabetes self-management support intervention using health educators.

PubMed

Schechter, Clyde B; Walker, Elizabeth A; Ortega, Felix M; Chamany, Shadi; Silver, Lynn D

2016-03-01

Self-management is crucial to successful glycemic control in patients with diabetes, yet it requires patients to initiate and sustain complicated behavioral changes. Support programs can improve glycemic control, but may be expensive to implement. We report here an analysis of the costs of a successful telephone-based self-management support program delivered by lay health educators utilizing a municipal health department A1c registry, and relate them to near-term effectiveness. Costs of implementation were assessed by micro-costing of all resources used. Per-capita costs and cost-effectiveness ratios from the perspective of the service provider are estimated for net A1c reduction, and percentages of patients achieving A1c reductions of 0.5 and 1.0 percentage points. One-way sensitivity analyses of key cost elements, and a Monte Carlo sensitivity analysis are reported. The telephone intervention was provided to 443 people at a net cost of $187.61 each. Each percentage point of net A1c reduction was achieved at a cost of $464.41. Labor costs were the largest component of costs, and cost-effectiveness was most sensitive to the wages paid to the health educators. Effective telephone-based self-management support for people in poor diabetes control can be delivered by health educators at moderate cost relative to the gains achieved. The costs of doing so are most sensitive to the prevailing wage for the health educators. Copyright © 2016 Elsevier Inc. All rights reserved.

“A manager in the minds of doctors:” a comparison of new modes of control in European hospitals

PubMed Central

2013-01-01

Background Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals. Methods The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources. Results The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) ‘integrated’ control with high levels of coordination and coherent patterns for cost and quality controls; (2) ‘partly integrated’ control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) ‘fragmented’ control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management. Conclusions Our comparison highlights how organisations matter and brings the crucial relevance of ‘coordination’ of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective. PMID:23819578

Cost effectiveness of recombinant activated factor VII for the control of bleeding in patients with severe blunt trauma injuries in the United Kingdom.

PubMed

Morris, S; Ridley, S; Munro, V; Christensen, M C

2007-01-01

The aim of this study was to assess the lifetime cost effectiveness of recombinant activated factor VII vs placebo as adjunctive therapy for control of bleeding in patients with severe blunt trauma in the UK. We developed a cost-effectiveness model based on patient level data from a 30-day international, randomised, placebo-controlled Phase II trial. The data were supplemented with secondary data from UK sources to estimate lifetime costs and benefits. The model produced a baseline estimate of the incremental cost per life year gained with recombinant activated factor VII relative to placebo of 12 613 UK pounds. The incremental cost per quality adjusted life year gained was 18 825 UK pounds. These estimates are sensitive to the choice of discount rate and health state utility values used. Preliminary results suggest that relative to placebo, recombinant activated factor VII may be a cost-effective therapy to the UK National Health Service.

The effect of accountable care organizations on oncology practice.

PubMed

Shulman, Lawrence N

2014-01-01

Cancer care accounts for a significant portion of the rise in health care costs, and therefore, as national efforts escalate to control cost, cancer care will be a focus of concern. Cost increases in cancer care are related to many factors, including increasing cancer incidence in an aging population, the introduction of new high-cost therapeutics, and the high cost of end-of-life care. Accountable care organizations (ACOs) have been one of the major efforts directed at controlling health care costs. How cancer care will fit into the rubric of ACOs is not entirely clear but will certainly evolve over the coming years. The oncology profession has the opportunity to play a role in this evolution or could leave the evolution to others driving the process, such as the Centers for Medicare and Medicaid Services (CMS), private payers, and ACOs. Ideally all parties will work together to provide a construct for high-value, high-quality care for patients with cancer while contributing to cost control in overall health care.

The cost of routine Aedes aegypti control and of insecticide-treated curtain implementation.

PubMed

Baly, Alberto; Flessa, Steffen; Cote, Marilys; Thiramanus, Thirapong; Vanlerberghe, Veerle; Villegas, Elci; Jirarojwatana, Somchai; Van der Stuyft, Patrick

2011-05-01

Insecticide-treated curtains (ITCs) are promoted for controlling the Dengue vector Aedes aegypti. We assessed the cost of the routine Aedes control program (RACP) and the cost of ITC implementation through the RACP and health committees in Venezuela and through health volunteers in Thailand. The yearly cost of the RACP per household amounted to US$2.14 and $1.89, respectively. The ITC implementation cost over three times more, depending on the channel used. In Venezuela the RACP was the most efficient implementation-channel. It spent US$1.90 (95% confidence interval [CI]: 1.83; 1.97) per curtain distributed, of which 76.9% for the curtain itself. Implementation by health committees cost significantly (P = 0.02) more: US$2.32 (95% CI: 1.93; 2.61) of which 63% for the curtain. For ITC implementation to be at least as cost-effective as the RACP, at equal effectiveness and actual ITC prices, the attained curtain coverage and the adulticiding effect should last for 3 years.

The Cost of Routine Aedes aegypti Control and of Insecticide-Treated Curtain Implementation

PubMed Central

Baly, Alberto; Flessa, Steffen; Cote, Marilys; Thiramanus, Thirapong; Vanlerberghe, Veerle; Villegas, Elci; Jirarojwatana, Somchai; Van der Stuyft, Patrick

2011-01-01

Insecticide-treated curtains (ITCs) are promoted for controlling the Dengue vector Aedes aegypti. We assessed the cost of the routine Aedes control program (RACP) and the cost of ITC implementation through the RACP and health committees in Venezuela and through health volunteers in Thailand. The yearly cost of the RACP per household amounted to US$2.14 and $1.89, respectively. The ITC implementation cost over three times more, depending on the channel used. In Venezuela the RACP was the most efficient implementation-channel. It spent US$1.90 (95% confidence interval [CI]: 1.83; 1.97) per curtain distributed, of which 76.9% for the curtain itself. Implementation by health committees cost significantly (P = 0.02) more: US$2.32 (95% CI: 1.93; 2.61) of which 63% for the curtain. For ITC implementation to be at least as cost-effective as the RACP, at equal effectiveness and actual ITC prices, the attained curtain coverage and the adulticiding effect should last for 3 years. PMID:21540384

Marginal abatement cost curves for NOx that account for ...

EPA Pesticide Factsheets

A marginal abatement cost curve (MACC) traces out the relationship between the quantity of pollution abated and the marginal cost of abating each additional unit. In the context of air quality management, MACCs typically are developed by sorting end-of-pipe controls by their respective cost effectiveness. Alternative measures, such as renewable electricity, energy efficiency, and fuel switching (RE/EE/FS), are not considered as it is difficult to quantify their abatement potential. In this paper, we demonstrate the use of an energy system model to develop a MACC for nitrogen oxides (NOx) that incorporates both end-of-pipe controls and these alternative measures. We decompose the MACC by sector, and evaluate the cost-effectiveness of RE/EE/FS relative to end-of-pipe controls. RE/EE/FS are shown to produce considerable emission reductions after end-of-pipe controls have been exhausted. Furthermore, some RE/EE/FS are shown to be cost-competitive with end-of-pipe controls. Demonstrate how the MARKAL energy system model can be used to evaluate the potential role of renewable electricity, energy efficiency and fuel switching (RE/EE/FS) in achieving NOx reductions. For this particular analysis, we show that RE/EE/FSs are able to increase the quantity of NOx reductions available for a particular marginal cost (ranging from $5k per ton to $40k per ton) by approximately 50%.

The difference between energy consumption and energy cost: Modelling energy tariff structures for water resource recovery facilities.

PubMed

Aymerich, I; Rieger, L; Sobhani, R; Rosso, D; Corominas, Ll

2015-09-15

The objective of this paper is to demonstrate the importance of incorporating more realistic energy cost models (based on current energy tariff structures) into existing water resource recovery facilities (WRRFs) process models when evaluating technologies and cost-saving control strategies. In this paper, we first introduce a systematic framework to model energy usage at WRRFs and a generalized structure to describe energy tariffs including the most common billing terms. Secondly, this paper introduces a detailed energy cost model based on a Spanish energy tariff structure coupled with a WRRF process model to evaluate several control strategies and provide insights into the selection of the contracted power structure. The results for a 1-year evaluation on a 115,000 population-equivalent WRRF showed monthly cost differences ranging from 7 to 30% when comparing the detailed energy cost model to an average energy price. The evaluation of different aeration control strategies also showed that using average energy prices and neglecting energy tariff structures may lead to biased conclusions when selecting operating strategies or comparing technologies or equipment. The proposed framework demonstrated that for cost minimization, control strategies should be paired with a specific optimal contracted power. Hence, the design of operational and control strategies must take into account the local energy tariff. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessment of regional management strategies for controlling seawater intrusion

USGS Publications Warehouse

Reichard, E.G.; Johnson, T.A.

2005-01-01

Simulation-optimization methods, applied with adequate sensitivity tests, can provide useful quantitative guidance for controlling seawater intrusion. This is demonstrated in an application to the West Coast Basin of coastal Los Angeles that considers two management options for improving hydraulic control of seawater intrusion: increased injection into barrier wells and in lieu delivery of surface water to replace current pumpage. For the base-case optimization analysis, assuming constant groundwater demand, in lieu delivery was determined to be most cost effective. Reduced-cost information from the optimization provided guidance for prioritizing locations for in lieu delivery. Model sensitivity to a suite of hydrologic, economic, and policy factors was tested. Raising the imposed average water-level constraint at the hydraulic-control locations resulted in nonlinear increases in cost. Systematic varying of the relative costs of injection and in lieu water yielded a trade-off curve between relative costs and injection/in lieu amounts. Changing the assumed future scenario to one of increasing pumpage in the adjacent Central Basin caused a small increase in the computed costs of seawater intrusion control. Changing the assumed boundary condition representing interaction with an adjacent basin did not affect the optimization results. Reducing the assumed hydraulic conductivity of the main productive aquifer resulted in a large increase in the model-computed cost. Journal of Water Resources Planning and Management ?? ASCE.

Total quality assurance

NASA Astrophysics Data System (ADS)

Louzon, E.

1989-12-01

Quality, cost, and schedule are three factors affecting the competitiveness of a company; they require balancing so that products of acceptable quality are delivered, on time and at a competitive cost. Quality costs comprise investment in quality maintenance and failure costs which arise from failure to maintain standards. The basic principle for achieving the required quality at minimum cost is that of prevention of failures, etc., through production control, attention to manufacturing practices, and appropriate management and training. Total quality control involves attention to the product throughout its life cycle, including in-service performance evaluation, servicing, and maintenance.

Cost-Effectiveness of Financial Incentives to Promote Adherence to Depot Antipsychotic Medication: Economic Evaluation of a Cluster-Randomised Controlled Trial

PubMed Central

Henderson, Catherine; Knapp, Martin; Yeeles, Ksenija; Bremner, Stephen; Eldridge, Sandra; David, Anthony S.; O’Connell, Nicola; Burns, Tom; Priebe, Stefan

2015-01-01

Background Offering a modest financial incentive to people with psychosis can promote adherence to depot antipsychotic medication, but the cost-effectiveness of this approach has not been examined. Methods Economic evaluation within a pragmatic cluster-randomised controlled trial. 141 patients under the care of 73 teams (clusters) were randomised to intervention or control; 138 patients with diagnoses of schizophrenia, schizo-affective disorder or bipolar disorder participated. Intervention participants received £15 per depot injection over 12 months, additional to usual acute, mental and community primary health services. The control group received usual health services. Main outcome measures: incremental cost per 20% increase in adherence to depot antipsychotic medication; incremental cost of ‘good’ adherence (defined as taking at least 95% of the prescribed number of depot medications over the intervention period). Findings Economic and outcome data for baseline and 12-month follow-up were available for 117 participants. The adjusted difference in adherence between groups was 12.2% (73.4% control vs. 85.6% intervention); the adjusted costs difference was £598 (95% CI -£4 533, £5 730). The extra cost per patient to increase adherence to depot medications by 20% was £982 (95% CI -£8 020, £14 000). The extra cost per patient of achieving 'good' adherence was £2 950 (CI -£19 400, £27 800). Probability of cost-effectiveness exceeded 97.5% at willingness-to-pay values of £14 000 for a 20% increase in adherence and £27 800 for good adherence. Interpretation Offering a modest financial incentive to people with psychosis is cost-effective in promoting adherence to depot antipsychotic medication. Direct healthcare costs (including costs of the financial incentive) are unlikely to be increased by this intervention. Trial Registration ISRCTN.com 77769281 PMID:26448540

Cost and Cost-Effectiveness of a Demand Creation Intervention to Increase Uptake of Voluntary Medical Male Circumcision in Tanzania: Spending More to Spend Less.

PubMed

Torres-Rueda, Sergio; Wambura, Mwita; Weiss, Helen A; Plotkin, Marya; Kripke, Katharine; Chilongani, Joseph; Mahler, Hally; Kuringe, Evodius; Makokha, Maende; Hellar, Augustino; Schutte, Carl; Kazaura, Kokuhumbya J; Simbeye, Daimon; Mshana, Gerry; Larke, Natasha; Lija, Gissenge; Changalucha, John; Vassall, Anna; Hayes, Richard; Grund, Jonathan M; Terris-Prestholt, Fern

2018-03-19

Although voluntary medical male circumcision (VMMC) reduces the risk of HIV acquisition, demand for services is lower among men in most at-risk age groups (ages 20-34 years). A randomised controlled trial was conducted to assess the effectiveness of locally-tailored demand creation activities (including mass media, community mobilisation and targeted service delivery) in increasing uptake of campaign-delivered VMMC among men aged 20-34 years. We conducted an economic evaluation to understand the intervention's cost and cost-effectiveness. Tanzania (Njombe and Tabora regions). Cost data were collected on surgery, demand creation activities and monitoring and supervision related to VMMC implementation across clusters in both trial arms, as well as start-up activities for the intervention arm. The Decision Makers' Program Planning Tool was used to estimate the number of HIV infections averted and related cost savings given total VMMCs per cluster. Disability-adjusted life years were calculated and used to estimate incremental cost-effectiveness ratios. Client load was higher in the intervention arms than in the control arms: 4394 v. 2901, respectively, in Tabora and 1797 v. 1025 in Njombe. Despite additional costs of tailored demand creation, demand increased more than proportionally: mean costs per VMMC in the intervention arms were $62 in Tabora and $130 in Njombe, and in the control arms $70 and $191, respectively. More infections were averted in the intervention arm than in the control arm in Tabora (123 v. 67, respectively) and in Njombe (164 v. 102, respectively). The intervention dominated the control as it was both less costly and more effective. Cost-savings were observed in both regions stemming from the antiretroviral treatment costs averted as a result of the VMMCs performed. Spending more to address local preferences as a way to increase uptake of VMMC can be cost-saving.This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Economic evaluation of a pharmaceutical care program for elderly diabetic and hypertensive patients in primary health care: a 36-month randomized controlled clinical trial.

PubMed

Obreli-Neto, Paulo Roque; Marusic, Srecko; Guidoni, Camilo Molino; Baldoni, André de Oliveira; Renovato, Rogério Dias; Pilger, Diogo; Cuman, Roberto Kenji Nakamura; Pereira, Leonardo Régis Leira

2015-01-01

Most diabetic and hypertensive patients, principally the elderly, do not achieve adequate disease control and consume 5%-15% of annual health care budgets. Previous studies verified that pharmaceutical care is useful for achieving adequate disease control in diabetes and hypertension. To evaluate the economic cost and the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) of pharmaceutical care in the management of diabetes and hypertension in elderly patients in a primary public health care system in a developing country. A 36-month randomized controlled clinical trial was performed with 200 patients who were divided into a control group (n = 100) and an intervention group (n = 100). The control group received the usual care offered by the Primary Health Care Unit (medical and nurse consultations). The intervention group received the usual care plus a pharmaceutical care intervention. The intervention and control groups were compared with regard to the direct costs of health services (i.e., general practitioner, specialist, nurse, and pharmacist appointments; emergency room visits; and drug therapy costs) and the ICER per QALY. These evaluations used the health system perspective. No statistically significant difference was found between the intervention and control groups in total direct health care costs ($281.97 ± $49.73 per patient vs. $212.28 ± $43.49 per patient, respectively; P = 0.089); pharmaceutical care added incremental costs of $69.60 (± $7.90) per patient. The ICER per QALY was $53.50 (95% CI = $51.60-$54.00; monetary amounts are given in U.S. dollars). Every clinical parameter evaluated improved for the pharmaceutical care group, whereas these clinical parameters remained unchanged in the usual care group. The difference in differences (DID) tests indicated that for each clinical parameter, the patients in the intervention group improved more from pre to post than the control group (P < 0.001). While pharmaceutical care did not significantly increase total direct health care costs, significantly improved health outcomes were seen. The mean ICER per QALY gained suggests a favorable cost-effectiveness.

Impact of air pollution control costs on the cost and spatial arrangement of cellulosic biofuel production in the U.S.

PubMed

Murphy, Colin W; Parker, Nathan C

2014-02-18

Air pollution emissions regulation can affect the location, size, and technology choice of potential biofuel production facilities. Difficulty in obtaining air pollutant emission permits and the cost of air pollution control devices have been cited by some fuel producers as barriers to development. This paper expands on the Geospatial Bioenergy Systems Model (GBSM) to evaluate the effect of air pollution control costs on the availability, cost, and distribution of U.S. biofuel production by subjecting potential facility locations within U.S. Clean Air Act nonattainment areas, which exceed thresholds for healthy air quality, to additional costs. This paper compares three scenarios: one with air quality costs included, one without air quality costs, and one in which conversion facilities were prohibited in Clean Air Act nonattainment areas. While air quality regulation may substantially affect local decisions regarding siting or technology choices, their effect on the system as a whole is small. Most biofuel facilities are expected to be sited near to feedstock supplies, which are seldom in nonattainment areas. The average cost per unit of produced energy is less than 1% higher in the scenarios with air quality compliance costs than in scenarios without such costs. When facility construction is prohibited in nonattainment areas, the costs increase by slightly over 1%, due to increases in the distance feedstock is transported to facilities in attainment areas.

Regional and sectoral marginal abatement cost curves for NOx incorporating controls, renewable electricity, energy efficiency and fuel switching

EPA Science Inventory

A marginal abatement cost curve (MACC) traces out the relationship between the quantity of pollution abated and the marginal cost of abating each additional unit. In the context of air quality management, MACCs typically are developed by sorting end-of-pipe controls by their resp...

Marginal abatement cost curve for NOx incorporating controls, renewable electricity, energy efficiency and fuel switching

EPA Science Inventory

A marginal abatement cost curve (MACC) traces out the relationship between the quantity of pollution abated and the marginal cost of abating each additional unit. In the context of air quality management, MACCs typically are developed by sorting end-of-pipe controls by their resp...

48 CFR 215.404-71-2 - Performance risk.

Code of Federal Regulations, 2010 CFR

2010-10-01

...—the technical uncertainties of performance. (2) Management/cost control—the degree of management... Technical (1) (2) N/A N/A 22 Management/Cost Control (1) (2) N/A N/A 23 Performance Risk (Composite) N/A (3...(percent) Assignedvalue (percent) Weightedvalue (percent) Technical 60 5.0 3.0 Management/Cost Control 40 4...

User Delay Cost Model and Facilities Maintenance Cost Model for a Terminal Control Area : Volume 1. Model Formulation and Demonstration

DOT National Transportation Integrated Search

1978-05-01

The User Delay Cost Model (UDCM) is a Monte Carlo computer simulation of essential aspects of Terminal Control Area (TCA) air traffic movements that would be affected by facility outages. The model can also evaluate delay effects due to other factors...

Marginal abatement cost curve for NOx incorporating controls, renewable electricity, energy efficiency and fuel switching

EPA Science Inventory

A marginal abatement cost curve (MACC) traces out the relationship between the quantity of pollution abated and the marginal cost of abating each additional unit. In the context of air quality management, MACCs typically are developed by sorting end-of-pipe controls by their rela...

An alternative arrangement of metered dosing fluid using centrifugal pump

NASA Astrophysics Data System (ADS)

Islam, Md. Arafat; Ehsan, Md.

2017-06-01

Positive displacement dosing pumps are extensively used in various types of process industries. They are widely used for metering small flow rates of a dosing fluid into a main flow. High head and low controllable flow rates make these pumps suitable for industrial flow metering applications. However their pulsating flow is not very suitable for proper mixing of fluids and they are relatively more expensive to buy and maintain. Considering such problems, alternative techniques to control the fluid flow from a low cost centrifugal pump is practiced. These include - throttling, variable speed drive, impeller geometry control and bypass control. Variable speed drive and impeller geometry control are comparatively costly and the flow control by throttling is not an energy efficient process. In this study an arrangement of metered dosing flow was developed using a typical low cost centrifugal pump using bypass flow technique. Using bypass flow control technique a wide range of metered dosing flows under a range of heads were attained using fixed pump geometry and drive speed. The bulk flow returning from the system into the main tank ensures better mixing which may eliminate the need of separate agitators. Comparative performance study was made between the bypass flow control arrangement of centrifugal pump and a diaphragm type dosing pump. Similar heads and flow rates were attainable using the bypass control system compared to the diaphragm dosing pump, but using relatively more energy. Geometrical optimization of the centrifugal pump impeller was further carried out to make the bypass flow arrangement more energy efficient. Although both the systems run at low overall efficiencies but the capital cost could be reduced by about 87% compared to the dosing pump. The savings in capital investment and lower maintenance cost very significantly exceeds the relatively higher energy cost of the bypass system. This technique can be used as a cost effective solution for industries in Bangladesh and have been implemented in two salt iodization plants at Narayangang.

PROCEEDINGS: EIGHTH SYMPOSIUM ON THE TRANSFER AND UTILIZATION OF PARTICULATE CONTROL TECHNOLOGY - VOLUME 2. BAGHOUSES AND PARTICULATE CONTROL FOR NEW APPLICATIONS

EPA Science Inventory

The two-volume proceedings describe the latest research and development efforts to improve particulate control devices, while treating traditional concerns of operational cost and compliance. Overall, particulate control remains a key issue in the cost and applicability of furnac...

Guaranteed cost control of polynomial fuzzy systems via a sum of squares approach.

PubMed

Tanaka, Kazuo; Ohtake, Hiroshi; Wang, Hua O

2009-04-01

This paper presents the guaranteed cost control of polynomial fuzzy systems via a sum of squares (SOS) approach. First, we present a polynomial fuzzy model and controller that are more general representations of the well-known Takagi-Sugeno (T-S) fuzzy model and controller, respectively. Second, we derive a guaranteed cost control design condition based on polynomial Lyapunov functions. Hence, the design approach discussed in this paper is more general than the existing LMI approaches (to T-S fuzzy control system designs) based on quadratic Lyapunov functions. The design condition realizes a guaranteed cost control by minimizing the upper bound of a given performance function. In addition, the design condition in the proposed approach can be represented in terms of SOS and is numerically (partially symbolically) solved via the recent developed SOSTOOLS. To illustrate the validity of the design approach, two design examples are provided. The first example deals with a complicated nonlinear system. The second example presents micro helicopter control. Both the examples show that our approach provides more extensive design results for the existing LMI approach.

Model predictive controller design for boost DC-DC converter using T-S fuzzy cost function

NASA Astrophysics Data System (ADS)

Seo, Sang-Wha; Kim, Yong; Choi, Han Ho

2017-11-01

This paper proposes a Takagi-Sugeno (T-S) fuzzy method to select cost function weights of finite control set model predictive DC-DC converter control algorithms. The proposed method updates the cost function weights at every sample time by using T-S type fuzzy rules derived from the common optimal control engineering knowledge that a state or input variable with an excessively large magnitude can be penalised by increasing the weight corresponding to the variable. The best control input is determined via the online optimisation of the T-S fuzzy cost function for all the possible control input sequences. This paper implements the proposed model predictive control algorithm in real time on a Texas Instruments TMS320F28335 floating-point Digital Signal Processor (DSP). Some experimental results are given to illuminate the practicality and effectiveness of the proposed control system under several operating conditions. The results verify that our method can yield not only good transient and steady-state responses (fast recovery time, small overshoot, zero steady-state error, etc.) but also insensitiveness to abrupt load or input voltage parameter variations.

Integrated Design and Implementation of Embedded Control Systems with Scilab

PubMed Central

Ma, Longhua; Xia, Feng; Peng, Zhe

2008-01-01

Embedded systems are playing an increasingly important role in control engineering. Despite their popularity, embedded systems are generally subject to resource constraints and it is therefore difficult to build complex control systems on embedded platforms. Traditionally, the design and implementation of control systems are often separated, which causes the development of embedded control systems to be highly time-consuming and costly. To address these problems, this paper presents a low-cost, reusable, reconfigurable platform that enables integrated design and implementation of embedded control systems. To minimize the cost, free and open source software packages such as Linux and Scilab are used. Scilab is ported to the embedded ARM-Linux system. The drivers for interfacing Scilab with several communication protocols including serial, Ethernet, and Modbus are developed. Experiments are conducted to test the developed embedded platform. The use of Scilab enables implementation of complex control algorithms on embedded platforms. With the developed platform, it is possible to perform all phases of the development cycle of embedded control systems in a unified environment, thus facilitating the reduction of development time and cost. PMID:27873827

Integrated Design and Implementation of Embedded Control Systems with Scilab.

PubMed

Ma, Longhua; Xia, Feng; Peng, Zhe

2008-09-05

Embedded systems are playing an increasingly important role in control engineering. Despite their popularity, embedded systems are generally subject to resource constraints and it is therefore difficult to build complex control systems on embedded platforms. Traditionally, the design and implementation of control systems are often separated, which causes the development of embedded control systems to be highly timeconsuming and costly. To address these problems, this paper presents a low-cost, reusable, reconfigurable platform that enables integrated design and implementation of embedded control systems. To minimize the cost, free and open source software packages such as Linux and Scilab are used. Scilab is ported to the embedded ARM-Linux system. The drivers for interfacing Scilab with several communication protocols including serial, Ethernet, and Modbus are developed. Experiments are conducted to test the developed embedded platform. The use of Scilab enables implementation of complex control algorithms on embedded platforms. With the developed platform, it is possible to perform all phases of the development cycle of embedded control systems in a unified environment, thus facilitating the reduction of development time and cost.

Cost effectiveness of novel oral anticoagulants for stroke prevention in atrial fibrillation depending on the quality of warfarin anticoagulation control.

PubMed

Janzic, Andrej; Kos, Mitja

2015-04-01

Vitamin K antagonists, such as warfarin, are standard treatments for stroke prophylaxis in patients with atrial fibrillation. Patient outcomes depend on quality of warfarin management, which includes regular monitoring and dose adjustments. Recently, novel oral anticoagulants (NOACs) that do not require regular monitoring offer an alternative to warfarin. The aim of this study was to evaluate whether cost effectiveness of NOACs for stroke prevention in atrial fibrillation depends on the quality of warfarin control. We developed a Markov decision model to simulate warfarin treatment outcomes in relation to the quality of anticoagulation control, expressed as percentage of time in the therapeutic range (TTR). Standard treatment with adjusted-dose warfarin and improved anticoagulation control by genotype-guided dosing were compared with dabigatran, rivaroxaban, apixaban and edoxaban. The analysis was performed from the Slovenian healthcare payer perspective using 2014 costs. In the base case, the incremental cost-effectiveness ratio for apixaban, dabigatran and edoxaban was below the threshold of €25,000 per quality-adjusted life-years compared with adjusted-dose warfarin with a TTR of 60%. The probability that warfarin was a cost-effective option was around 1%. This percentage rises as the quality of anticoagulation control improves. At a TTR of 70%, warfarin was the preferred treatment in half the iterations. The cost effectiveness of NOACs for stroke prevention in patients with nonvalvular atrial fibrillation who are at increased risk for stroke is highly sensitive to warfarin anticoagulation control. NOACs are more likely to be cost-effective options in settings with poor warfarin management than in settings with better anticoagulation control, where they may not represent good value for money.

Mission possible: creating a technology infrastructure to help reduce administrative costs.

PubMed

Alper, Michael

2003-01-01

Controlling administrative costs associated with managed care benefits has traditionally been considered a "mission impossible" in healthcare, with the unreasonably high cost of paperwork and administration pushing past the $420 billion mark. Why administrative costs remain a critical problem in healthcare while other industries have alleviated their administrative burdens must be carefully examined. This article looks at the key factors contributing to high administrative costs and how these costs can be controlled in the future with "mission possible" tools, including business process outsourcing, IT outsourcing, technology that helps to bring "consumerism" to managed care, and an IT infrastructure that improves quality and outcomes.

Healthcare utilization and costs in persons with insomnia in a managed care population.

PubMed

Anderson, Louise H; Whitebird, Robin R; Schultz, Jennifer; McEvoy, Charlene E; Kreitzer, Mary Jo; Gross, Cynthia R

2014-05-01

To better understand the direct costs of insomnia. Our study aimed to compare healthcare costs and utilization of patients diagnosed with insomnia who received care in a managed care organization with a set of matched controls. Our observational, retrospective cohort study compared 7647 adults with an insomnia diagnosis with an equally sized matched cohort of health plan members without an insomnia diagnosis between 2003 and 2006. We also compared a subset of patients diagnosed with and treated for insomnia with those diagnosed with insomnia but not treated. A large Midwestern health plan with more than 600,000 members. Multivariate analysis was used to estimate the association between insomnia diagnosis and costs, controlling for covariates, in the baseline and follow-up periods. Although we cannot conclude a causal relationship between insomnia and healthcare costs, our analysis found that insomnia diagnosis was associated with 26% higher costs in the baseline and 46% in the 12 months after diagnosis. When comorbidities were recognized, the insomnia cohort had 80% higher costs, on average, than the matched control cohort. These outcomes suggest the need to look beyond the direct cost of insomnia to how its interaction with comorbid conditions drives healthcare cost and utilization.

Controlled trial of pharmacist intervention in general practice: the effect on prescribing costs.

PubMed

Rodgers, S; Avery, A J; Meechan, D; Briant, S; Geraghty, M; Doran, K; Whynes, D K

1999-09-01

It has been suggested that the employment of pharmacists in general practice might moderate the growth in prescribing costs. However, empirical evidence for this proposition has been lacking. We report the results of a controlled trial of pharmacist intervention in United Kingdom general practice. To determine whether intervention practices made savings relative to controls. An evaluation of an initiative set up by Doncaster Health Authority. Eight practices agreed to take part and received intensive input from five pharmacists for one year (September 1996 to August 1997) at a cost of 163,000 Pounds. Changes in prescribing patterns were investigated by comparing these practices with eight individually matched controls for both the year of the intervention and the previous year. Prescribing data (PACTLINE) were used to assess these changes. The measures used to take account of differences in the populations of the practices included the ASTRO-PU for overall prescribing and the STAR-PU for prescribing in specific therapeutic areas. Differences between intervention and control practices were subjected to Wilcoxon matched-pairs, signed-ranks tests. The median (minimum to maximum) rise in prescribing costs per ASTRO-PU was 0.85 Pound (-1.95 Pounds to 2.05 Pounds) in the intervention practices compared with 2.55 Pounds (1.74 Pounds to 4.65 Pounds) in controls (P = 0.025). Had the cost growth of the intervention group been as high as that of the controls, their total prescribing expenditure would have been around 347,000 Pounds higher. This study suggests that the use of pharmacists did control prescribing expenditure sufficiently to offset their employment costs.

44 CFR 204.43 - Ineligible costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Ineligible costs. 204.43... Ineligible costs. Costs not directly associated with the incident period are ineligible. Ineligible costs include the following: (a) Costs incurred in the mitigation, management, and control of undeclared fires...

Population-based home care services in breast cancer: utilization and costs

PubMed Central

Mittmann, N.; Isogai, P.K.; Saskin, R.; Liu, N.; Porter, J.M.; Cheung, M.C.; Leighl, N.B.; Hoch, J.S.; Trudeau, M.E.; Evans, W.K.; Dainty, K.N.; Earle, C.C.

2012-01-01

Objective To determine utilization and costs of home care services (hcs) for individuals with a diagnosis of breast cancer (bc). Methods Incident cases of invasive bc in women were extracted from the Ontario Cancer Registry (2005–2009) and linked with other Ontario health care administrative databases. Control patients were selected from the population of women never diagnosed with any type of cancer. The types and proportions of hcs used were determined and stratified by disease stage. Attributable home care utilization and costs for bc patients were determined. Factors associated with hcs costs were assessed using regression analysis. Results Among the 39,656 bc and 198,280 control patients identified (median age: 61.6 years for both), 75.4% of bc patients used hcs (62.1% stage i; 85.7% stage ii; 94.6% stage iii; 79.1% stage iv) compared with 14.6% of control patients. The number of hcs used per patient–year were significantly higher for the bc patients than for the control patients (14.97 vs. 6.13, p < 0.01), resulting in higher costs per patient–year ($1,210 vs. $325; $885 attributable cost to bc, p < 0.01). The number of hcs utilized and the associated costs increased as the bc stage increased. In contrast, hcs costs decreased as income increased and as previous health care exposure decreased. Interpretation Patients with bc used twice as many hcs, resulting in costs that were almost 4 times those observed in a matched control group. Less than an additional $1000 per bc patient per year were spent on hcs utilization in the study population. PMID:23300362

The economic effect of Planet Health on preventing bulimia nervosa.

PubMed

Wang, Li Yan; Nichols, Lauren P; Austin, S Bryn

2011-08-01

To assess the economic effect of the school-based obesity prevention program Planet Health on preventing disordered weight control behaviors and to determine the cost-effectiveness of the intervention in terms of its combined effect on prevention of obesity and disordered weight control behaviors. On the basis of the intervention's short-term effect on disordered weight control behaviors prevention, we projected the number of girls who were prevented from developing bulimia nervosa by age 17 years. We further estimated medical costs saved and quality-adjusted life years gained by the intervention over 10 years. As a final step, we compared the intervention costs with the combined intervention benefits from both obesity prevention (reported previously) and prevention of disordered weight control behaviors to determine the overall cost-effectiveness of the intervention. Middle schools. A sample of 254 intervention girls aged 10 to 14 years. The Planet Health program was implemented during the school years from 1995 to 1997 and was designed to promote healthful nutrition and physical activity among youth. Intervention costs, medical costs saved, quality-adjusted life years gained, and cost-effectiveness ratio. An estimated 1 case of bulimia nervosa would have been prevented. As a result, an estimated $33 999 in medical costs and 0.7 quality-adjusted life years would be saved. At an intervention cost of $46 803, the combined prevention of obesity and disordered weight control behaviors would yield a net savings of $14 238 and a gain of 4.8 quality-adjusted life years. Primary prevention programs, such as Planet Health, warrant careful consideration by policy makers and program planners. The findings of this study provide additional argument for integrated prevention of obesity and eating disorders.

Direct Medical Costs Attributable to Cancer-Associated Venous Thromboembolism: A Population-Based Longitudinal Study.

PubMed

Cohoon, Kevin P; Ransom, Jeanine E; Leibson, Cynthia L; Ashrani, Aneel A; Petterson, Tanya M; Long, Kirsten Hall; Bailey, Kent R; Heit, John A

2016-09-01

The purpose of this study is to estimate medical costs attributable to venous thromboembolism among patients with active cancer. In a population-based cohort study, we used Rochester Epidemiology Project (REP) resources to identify all Olmsted County, Minn. residents with incident venous thromboembolism and active cancer over the 18-year period, 1988-2005 (n = 374). One Olmsted County resident with active cancer without venous thromboembolism was matched to each case on age, sex, cancer diagnosis date, and duration of prior medical history. Subjects were followed forward in REP provider-linked billing data for standardized, inflation-adjusted direct medical costs from 1 year prior to index (venous thromboembolism event date or control-matched date) to the earliest of death, emigration from Olmsted County, or December 31, 2011, with censoring on the shortest follow-up to ensure a similar follow-up duration for each case-control pair. We used generalized linear modeling to predict costs for cases and controls and bootstrapping methods to assess uncertainty and significance of mean adjusted cost differences. Outpatient drug costs were not included in our estimates. Adjusted mean predicted costs were 1.9-fold higher for cases ($49,351) than for controls ($26,529) (P < .001) from index to up to 5 years post index. Cost differences between cases and controls were greatest within the first 3 months (mean difference = $13,504) and remained significantly higher from 3 months to 5 years post index (mean difference = $12,939). Venous thromboembolism-attributable costs among patients with active cancer contribute a substantial economic burden and are highest from index to 3 months, but may persist for up to 5 years. Copyright © 2016 Elsevier Inc. All rights reserved.

47 CFR 24.243 - The cost-sharing formula.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; monitoring or control equipment; engineering costs (design/path survey); installation; systems testing; FCC filing costs; site acquisition and civil works; zoning costs; training; disposal of old equipment; test...

Improving hospital cost accounting with activity-based costing.

PubMed

Chan, Y C

1993-01-01

In this article, activity-based costing, an approach that has proved to be an improvement over the conventional costing system in product costing, is introduced. By combining activity-based costing with standard costing, health care administrators can better plan and control the costs of health services provided while ensuring that the organization's bottom line is healthy.

Understanding and Controlling Cost in Total Joint Arthroplasty.

PubMed

Alvarado, Carlos M; Bosco, Joseph

2015-06-01

Total joint arthrosplasty (TJA) is both a commonly performed successful intervention and an expensive procedure.As our population ages, the expense of these interventions is expected to grow and hence its impact on healthcare costs will also grow. To ensure that TJA is available to all those who would benefit, it is incumbent that healthcare providers control the cost of these procedures. As orthopaedic surgeons, we must be at the forefront of this effort. The purpose of this review is to outline strategies to control or even decrease TJA cost without negatively affecting outcomes.This concept is at the center of value-based medicine and must guide our decision-making processes.

Does pharmacist-supervised intervention through pharmaceutical care program influence direct healthcare cost burden of newly diagnosed diabetics in a tertiary care teaching hospital in Nepal: a non-clinical randomised controlled trial approach.

PubMed

Upadhyay, Dinesh Kumar; Ibrahim, Mohamed Izham Mohamed; Mishra, Pranaya; Alurkar, Vijay M; Ansari, Mukhtar

2016-02-29

Cost is a vital component for people with chronic diseases as treatment is expected to be long or even lifelong in some diseases. Pharmacist contributions in decreasing the healthcare cost burden of chronic patients are not well described due to lack of sufficient evidences worldwide. In developing countries like Nepal, the estimation of direct healthcare cost burden among newly diagnosed diabetics is still a challenge for healthcare professionals, and pharmacist role in patient care is still theoretical and practically non-existent. This study reports the impact of pharmacist-supervised intervention through pharmaceutical care program on direct healthcare costs burden of newly diagnosed diabetics in Nepal through a non-clinical randomised controlled trial approach. An interventional, pre-post non-clinical randomised controlled study was conducted among randomly distributed 162 [control (n = 54), test 1 (n = 54) and test 2 (n = 54) groups] newly diagnosed diabetics by a consecutive sampling method for 18 months. Direct healthcare costs (direct medical and non-medical costs) from patients perspective was estimated by 'bottom up' approach to identify their out-of-pocket expenses (1USD = NPR 73.38) before and after intervention at the baseline, 3, 6, 9 and 12 months follow-ups. Test groups' patients were nourished with pharmaceutical care intervention while control group patients only received care from physician/nurses. Non-parametric tests i.e. Friedman test, Mann-Whitney U test and Wilcoxon signed rank test were used to find the differences in direct healthcare costs among the groups before and after the intervention (p ≤ 0.05). Friedman test identified significant differences in direct healthcare cost of test 1 (p < 0.001) and test 2 (p < 0.001) groups patients. However, Mann-Whitney U test justified significant differences in direct healthcare cost between control group and test 1 group, and test 2 group patients at 6-months (p = 0.009, p = 0.010 respectively), 9-months (p = 0.005, p = 0.001 respectively) and 12-months (p < 0.001, p < 0.001 respectively). Pharmacist supervised intervention through pharmaceutical care program significantly decreased direct healthcare costs of diabetics in test groups compared to control group and hence describes pharmacist's contribution in minimizing direct healthcare cost burden of patients.

Is a Mass Prevention and Control Program for Pandemic (H1N1) 2009 Good Value for Money? Evidence from the Chinese Experience.

PubMed

Wang, Biyan; Xie, Jinliang; Fang, Pengqian

2012-01-01

In order to provide guidance on the efficient allocation of health resources when handling public health emergencies in the future, the study evaluated the H1N1 influenza prevention and control program in Hubei Province of China using cost-benefit analysis. The costs measured the resources consumed and other expenses incurred in the prevention and control of H1N1. The assumed benefits include resource consumption and economic losses which could be avoided by the measures for the prevention and control of H1N1. The benefit was evaluated by counterfactual thinking, which estimates the resource consumption and economic losses could be happened without any measures for the prevention and control, which have been avoided after measures were taken to prevent and control H1N1 in Hubei Province, these constitutes the benefit of this project. The total costs of this program were 38.81 million U.S. dollars, while the total benefit was assessed as 203.71 million U.S. dollars. The net benefit was 164.9 million U.S. dollars with a cost-effectiveness ratio of 1:5.25. The joint prevention and control strategy introduced by Hubei for H1N1 influenza is cost-effective.

Costs after hip fracture in independently living patients: a randomised comparison of three rehabilitation modalities.

PubMed

Lahtinen, A; Leppilahti, J; Vähänikkilä, H; Harmainen, S; Koistinen, P; Rissanen, P; Jalovaara, P

2017-05-01

To evaluate costs and cost-effectiveness of physical and geriatric rehabilitation after hip fracture. Prospective randomised study (mean age 78 years, 105 male, 433 female) in different rehabilitation settings: physically oriented (187 patients), geriatrically oriented (171 patients), and healthcare centre hospital (control, 180 patients). At 12 months post-fracture, we collected data regarding days in rehabilitation, post-rehabilitation hospital treatment, other healthcare service use, number of re-operations, taxi use by patient or relative, and help from relatives. Control rehabilitation (4945,2€) was significantly less expensive than physical (6609.0€, p=0.002) and geriatric rehabilitation (7034.7€ p<0.001). Total institutional care costs (primary treatment, rehabilitation, and post-rehabilitation hospital care) were lower for control (13,438.4€) than geriatric rehabilitation (17,201.7€, p<0.001), but did not differ between control and physical rehabilitation (15659.1€, p=0.055) or between physical and geriatric rehabilitation ( p=0.252). Costs of help from relatives (estimated as 30%, 50% and 100% of a home aid's salary) with physical rehabilitation were lower than control ( p=0.016) but higher than geriatric rehabilitation ( p=0.041). Total hip fracture treatment costs were lower with physical (36,356€, 51,018€) than control rehabilitation (38,018€, 57,031€) at 50% and 100% of salary ( p=0.032, p=0.014, respectively). At one year post-fracture, 15D-score was significantly higher in physical rehabilitation group (0.697) than geriatric rehabilitation group (0.586, p=0.008) and control group (0.594, p=0.009). Considering total costs one year after hip fracture the treatment including physical rehabilitation is significantly more cost-effective than routine treatment. This effect could not be seen between routine treatment and treatment including geriatric rehabilitation.

Maximising profits for an EPQ model with unreliable machine and rework of random defective items

NASA Astrophysics Data System (ADS)

Pal, Brojeswar; Sankar Sana, Shib; Chaudhuri, Kripasindhu

2013-03-01

This article deals with an economic production quantity (EPQ) model in an imperfect production system. The production system may undergo in 'out-of-control' state from 'in-control' state, after a certain time that follows a probability density function. The density function varies with reliability of the machinery system that may be controlled by new technologies, investing more costs. The defective items produced in 'out-of-control' state are reworked at a cost just after the regular production time. Occurrence of the 'out-of-control' state during or after regular production-run time is analysed and also graphically illustrated separately. Finally, an expected profit function regarding the inventory cost, unit production cost and selling price is maximised analytically. Sensitivity analysis of the model with respect to key parameters of the system is carried out. Two numerical examples are considered to test the model and one of them is illustrated graphically.

Insecticide Resistance and Malaria Vector Control: The Importance of Fitness Cost Mechanisms in Determining Economically Optimal Control Trajectories

PubMed Central

Brown, Zachary S.; Dickinson, Katherine L.; Kramer, Randall A.

2014-01-01

The evolutionary dynamics of insecticide resistance in harmful arthropods has economic implications, not only for the control of agricultural pests (as has been well studied), but also for the control of disease vectors, such as malaria-transmitting Anopheles mosquitoes. Previous economic work on insecticide resistance illustrates the policy relevance of knowing whether insecticide resistance mutations involve fitness costs. Using a theoretical model, this article investigates economically optimal strategies for controlling malaria-transmitting mosquitoes when there is the potential for mosquitoes to evolve resistance to insecticides. Consistent with previous literature, we find that fitness costs are a key element in the computation of economically optimal resistance management strategies. Additionally, our models indicate that different biological mechanisms underlying these fitness costs (e.g., increased adult mortality and/or decreased fecundity) can significantly alter economically optimal resistance management strategies. PMID:23448053

Does Coordinated Postpartum Care Influence Costs?

PubMed Central

Zemp, Elisabeth; Signorell, Andri; Reich, Oliver

2017-01-01

Questions under study: To investigate changes to health insurance costs for post-discharge postpartum care after the introduction of a midwife-led coordinated care model. Methods: The study included mothers and their newborns insured by the Helsana health insurance group in Switzerland and who delivered between January 2012 and May 2013 in the canton of Basel Stadt (BS) (intervention canton). We compared monthly post-discharge costs before the launch of a coordinated postpartum care model (control phase, n = 144) to those after its introduction (intervention phase, n = 92). Costs in the intervention canton were also compared to those in five control cantons without a coordinated postpartum care model (cross-sectional control group: n = 7, 767). Results: The average monthly post-discharge costs for mothers remained unchanged in the seven months following the introduction of a coordinated postpartum care model, despite a higher use of midwife services (increasing from 72% to 80%). Likewise, monthly costs did not differ between the intervention canton and five control cantons. In multivariate analyses, the ambulatory costs for mothers were not associated with the post-intervention phase. Cross-sectionally, however, they were positively associated with midwifery use. For children, costs in the post-intervention phase were lower in the first month after hospital discharge compared to the pre-intervention phase (difference of –114 CHF [95%CI –202 CHF to –27 CHF]), yet no differences were seen in the cross-sectional comparison. Conclusions: The introduction of a coordinated postpartum care model was associated with decreased costs for neonates in the first month after hospital discharge. Despite increased midwifery use, costs for mothers remained unchanged. PMID:29042849

Glycemic control and diabetes-related health care costs in type 2 diabetes; retrospective analysis based on clinical and administrative databases.

PubMed

Degli Esposti, Luca; Saragoni, Stefania; Buda, Stefano; Sturani, Alessandra; Degli Esposti, Ezio

2013-01-01

Diabetes is one of the most prevalent chronic diseases, and its prevalence is predicted to increase in the next two decades. Diabetes imposes a staggering financial burden on the health care system, so information about the costs and experiences of collecting and reporting quality measures of data is vital for practices deciding whether to adopt quality improvements or monitor existing initiatives. The aim of this study was to quantify the association between health care costs and level of glycemic control in patients with type 2 diabetes using clinical and administrative databases. A retrospective analysis using a large administrative database and a clinical registry containing laboratory results was performed. Patients were subdivided according to their glycated hemoglobin level. Multivariate analyses were used to control for differences in potential confounding factors, including age, gender, Charlson comorbidity index, presence of dyslipidemia, hypertension, or cardiovascular disease, and degree of adherence with antidiabetic drugs among the study groups. Of the total population of 700,000 subjects, 31,022 were identified as being diabetic (4.4% of the entire population). Of these, 21,586 met the study inclusion criteria. In total, 31.5% of patients had very poor glycemic control and 25.7% had excellent control. Over 2 years, the mean diabetes-related cost per person was: €1291.56 in patients with excellent control; €1545.99 in those with good control; €1584.07 in those with fair control; €1839.42 in those with poor control; and €1894.80 in those with very poor control. After adjustment, compared with the group having excellent control, the estimated excess cost per person associated with the groups with good control, fair control, poor control, and very poor control was €219.28, €264.65, €513.18, and €564.79, respectively. Many patients showed suboptimal glycemic control. Lower levels of glycated hemoglobin were associated with lower diabetes-related health care costs. Integration of administrative databases and a laboratory database appears to be suitable for showing that appropriate management of diabetes can help to achieve better resource allocation.

German EstSmoke: estimating adult smoking-related costs and consequences of smoking cessation for Germany.

PubMed

Sonntag, Diana; Gilbody, Simon; Winkler, Volker; Ali, Shehzad

2018-01-01

We compared predicted life-time health-care costs for current, never and ex-smokers in Germany under the current set of tobacco control polices. We compared these economic consequences of the current situation with an alternative in which Germany were to implement more comprehensive tobacco control policies consistent with the World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC) guidelines. German EstSmoke, an adapted version of the UK EstSmoke simulation model, applies the Markov modelling approach. Transition probabilities for (re-)currence of smoking-related diseases were calculated from large German disease-specific registries and the German Health Update (GEDA 2010). Estimations of both health-care costs and effect sizes of smoking cessation policies were taken from recent German studies and discounted at 3.5%/year. Germany. German population of prevalent current, never and ex-smokers in 2009. Life-time cost and outcomes in current, never and ex-smokers. If tobacco control policies are not strengthened, the German smoking population will incur €41.56 billion life-time excess costs compared with never smokers. Implementing tobacco control policies consistent with WHO FCTC guidelines would reduce the difference of life-time costs between current smokers and ex-smokers by at least €1.7 billion. Modelling suggests that the life-time healthcare costs of people in Germany who smoke are substantially greater than those of people who have never smoked. However, more comprehensive tobacco control policies could reduce health-care expenditures for current smokers by at least 4%. © 2017 Society for the Study of Addiction.

Personal Computer Based Controller For Switched Reluctance Motor Drives

NASA Astrophysics Data System (ADS)

Mang, X.; Krishnan, R.; Adkar, S.; Chandramouli, G.

1987-10-01

Th9, switched reluctance motor (SRM) has recently gained considerable attention in the variable speed drive market. Two important factors that have contributed to this are, the simplicity of construction and the possibility of developing low cost con-trollers with minimum number of switching devices in the drive circuits. This is mainly due to the state-of-art of the present digital circuits technology and the low cost of switching devices. The control of this motor drive is under research. Optimized performance of the SRM motor drive is very dependent on the integration of the controller, converter and the motor. This research on system integration involves considerable changes in the control algorithms and their implementation. A Personal computer (PC) based controller is very appropriate for this purpose. Accordingly, the present paper is concerned with the design of a PC based controller for a SRM. The PC allows for real-time microprocessor control with the possibility of on-line system parameter modifications. Software reconfiguration of this controller is easier than a hardware based controller. User friendliness is a natural consequence of such a system. Considering the low cost of PCs, this controller will offer an excellent cost-effective means of studying the control strategies for the SRM drive intop greater detail than in the past.

Efficacy of Seprafilm for preventing adhesive bowel obstruction and cost-benefit analysis in pediatric patients undergoing laparotomy.

PubMed

Inoue, Mikihiro; Uchida, Keiichi; Otake, Kohei; Nagano, Yuka; Ide, Shozo; Hashimoto, Kiyoshi; Matsushita, Kohei; Koike, Yuhki; Mohri, Yasuhiko; Kusunoki, Masato

2013-07-01

This aim of the study is to determine whether the use of Seprafilm reduces the incidence and the medical costs of adhesive bowel obstruction (ABO) in children. Pediatric patients undergoing laparotomy were prospectively assigned to the Seprafilm group, n = 441). A historical control group consisted of children without using Seprafilm (n = 409). The incidence of ABO during a 24-month follow-up period was compared between the groups. To clarify the cost-benefit relations, expenses for Seprafilm and medical costs for hospitalization related to ABO in the Seprafilm group were compared with the ABO-associated hospitalization costs in the control group. The cumulative incidence rate of ABO in the control group was significantly higher than in the Seprafilm group (4.9% vs. 2.0%, p = 0.015). Nearly all cases that required adhesiolysis had adhesions to areas other than the incision in both groups. In cost-benefit analysis, cost per patient was $105 higher in the control group than in the Seprafilm group, but this did not reach significance (p = 0.63). Seprafilm reduces the incidence of ABO in the pediatric patients undergoing laparotomy. Although associated medical costs in the Seprafilm group were not significantly reduced, use of Seprafilm did not lead to an increase in cost. Wider range of Seprafilm application or an additional anti-adhesion device may help in preventing adhesion to areas other than the incision. Copyright © 2013 Elsevier Inc. All rights reserved.

Cost-effectiveness of steroid (methylprednisolone) injections versus anaesthetic alone for the treatment of Morton's neuroma: economic evaluation alongside a randomised controlled trial (MortISE trial).

PubMed

Edwards, Rhiannon Tudor; Yeo, Seow Tien; Russell, Daphne; Thomson, Colin E; Beggs, Ian; Gibson, J N Alastair; McMillan, Diane; Martin, Denis J; Russell, Ian T

2015-01-01

Morton's neuroma is a common foot condition affecting health-related quality of life. Though its management frequently includes steroid injections, evidence of cost-effectiveness is sparse. So, we aimed to evaluate whether steroid injection is cost-effective in treating Morton's neuroma compared with anaesthetic injection alone. We undertook incremental cost-effectiveness and cost-utility analyses from the perspective of the National Health Service, alongside a patient-blinded pragmatic randomised trial in hospital-based orthopaedic outpatient clinics in Edinburgh, UK. Of the original randomised sample of 131 participants with Morton's neuroma (including 67 controls), economic analysis focused on 109 (including 55 controls). Both groups received injections guided by ultrasound. We estimated the incremental cost per point improvement in the area under the curve of the Foot Health Thermometer (FHT-AUC) until three months after injection. We also conducted cost-utility analyses using European Quality of life-5 Dimensions-3 Levels (EQ-5D-3L), enhanced by the Foot Health Thermometer (FHT), to estimate utility and thus quality-adjusted life years (QALYs). The unit cost of an ultrasound-guided steroid injection was £149. Over the three months of follow-up, the mean cost of National Health Service resources was £280 for intervention participants and £202 for control participants - a difference of £79 [bootstrapped 95% confidence interval (CI): £18 to £152]. The corresponding estimated incremental cost-effectiveness ratio was £32 per point improvement in the FHT-AUC (bootstrapped 95% CI: £7 to £100). If decision makers value improvement of one point at £100 (the upper limit of this CI), there is 97.5% probability that steroid injection is cost-effective. As EQ-5D-3L seems unresponsive to changes in foot health, we based secondary cost-utility analysis on the FHT-enhanced EQ-5D. This estimated the corresponding incremental cost-effectiveness ratio as £6,400 per QALY. Over the recommended UK threshold, ranging from £20,000 to £30,000 per QALY, there is 80%-85% probability that steroid injection is cost-effective. Steroid injections are effective and cost-effective in relieving foot pain measured by the FHT for three months. However, cost-utility analysis was initially inconclusive because the EQ-5D-3L is less responsive than the FHT to changes in foot health. By using the FHT to enhance the EQ-5D, we inferred that injections yield good value in cost per QALY. Current Controlled Trials ISRCTN13668166.

Association Between Surgeon Scorecard Use and Operating Room Costs.

PubMed

Zygourakis, Corinna C; Valencia, Victoria; Moriates, Christopher; Boscardin, Christy K; Catschegn, Sereina; Rajkomar, Alvin; Bozic, Kevin J; Soo Hoo, Kent; Goldberg, Andrew N; Pitts, Lawrence; Lawton, Michael T; Dudley, R Adams; Gonzales, Ralph

2017-03-01

Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting. Intervention participants were attending surgeons in orthopedic surgery, otolaryngology-head and neck surgery, and neurological surgery (n = 63). Control participants were attending surgeons in cardiothoracic surgery, general surgery, vascular surgery, pediatric surgery, obstetrics/gynecology, ophthalmology, and urology (n = 186). From January 1 to December 31, 2015, each surgeon in the intervention group received standardized monthly scorecards showing the median surgical supply direct cost for each procedure type performed in the prior month compared with the surgeon's baseline (July 1, 2012, to November 30, 2014) and compared with all surgeons at the institution performing the same procedure at baseline. All surgical departments were eligible for a financial incentive if they met a 5% cost reduction goal. The primary outcome was each group's median surgical supply cost per case. Secondary outcome measures included total departmental surgical supply costs, case mix index-adjusted median surgical supply costs, patient outcomes (30-day readmission, 30-day mortality, and discharge status), and surgeon responses to a postintervention study-specific health care value survey. The median surgical supply direct costs per case decreased 6.54% in the intervention group, from $1398 (interquartile range [IQR], $316-$5181) (10 637 cases) in 2014 to $1307 (IQR, $319-$5037) (11 820 cases) in 2015. In contrast, the median surgical supply direct cost increased 7.42% in the control group, from $712 (IQR, $202-$1602) (16 441 cases) in 2014 to $765 (IQR, $233-$1719) (17 227 cases) in 2015. This decrease represents a total savings of $836 147 in the intervention group during the 1-year study. After controlling for surgeon, department, patient demographics, and clinical indicators in a mixed-effects model, there was a 9.95% (95% CI, 3.55%-15.93%; P = .003) surgical supply cost decrease in the intervention group over 1 year. Patient outcomes were equivalent or improved after the intervention, and surgeons who received scorecards reported higher levels of cost awareness on the health care value survey compared with controls. Cost feedback to surgeons, combined with a small departmental financial incentive, was associated with significantly reduced surgical supply costs, without negatively affecting patient outcomes.

The economic burden of a Salmonella Thompson outbreak caused by smoked salmon in the Netherlands, 2012-2013.

PubMed

Suijkerbuijk, Anita W M; Bouwknegt, Martijn; Mangen, Marie-Josee J; de Wit, G Ardine; van Pelt, Wilfrid; Bijkerk, Paul; Friesema, Ingrid H M

2017-04-01

In 2012, the Netherlands experienced the most extensive food-related outbreak of Salmonella ever recorded. It was caused by smoked salmon contaminated with Salmonella Thompson during processing. In total, 1149 cases of salmonellosis were laboratory confirmed and reported to RIVM. Twenty percent of cases was hospitalised and four cases were reported to be fatal. The purpose of this study was to estimate total costs of the Salmonella Thompson outbreak. Data from a case-control study were used to estimate the cost-of-illness of reported cases (i.e. healthcare costs, patient costs and production losses). Outbreak control costs were estimated based on interviews with staff from health authorities. Using the Dutch foodborne disease burden and cost-of-illness model, we estimated the number of underestimated cases and the associated cost-of-illness. The estimated number of cases, including reported and underestimated cases was 21 123. Adjusted for underestimation, the total cost-of-illness would be €6.8 million (95% CI €2.5-€16.7 million) with productivity losses being the main cost driver. Adding outbreak control costs, the total outbreak costs are estimated at €7.5 million. In the Netherlands, measures are taken to reduce salmonella concentrations in food, but detection of contamination during food processing remains difficult. As shown, Salmonella outbreaks have the potential for a relatively high disease and economic burden for society. Early warning and close cooperation between the industry, health authorities and laboratories is essential for rapid detection, control of outbreaks, and to reduce disease and economic burden. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Cost of opioid-treated chronic low back pain: Findings from a pilot randomized controlled trial of mindfulness meditation-based intervention.

PubMed

Zgierska, Aleksandra E; Ircink, James; Burzinski, Cindy A; Mundt, Marlon P

Opioid-treated chronic low back pain (CLBP) is debilitating, costly, and often refractory to existing treatments. This secondary analysis aims to pilot-test the hypothesis that mindfulness meditation (MM) can reduce economic burden related to opioid-treated CLBP. Twenty-six-week unblinded pilot randomized controlled trial, comparing MM, adjunctive to usual-care, to usual care alone. Outpatient. Thirty-five adults with opioid-treated CLBP (≥30 morphine-equivalent mg/day) for 3 + months enrolled; none withdrew. Eight weekly therapist-led MM sessions and at-home practice. Costs related to self-reported healthcare utilization, medication use (direct costs), lost productivity (indirect costs), and total costs (direct + indirect costs) were calculated for 6-month pre-enrollment and postenrollment periods and compared within and between the groups. Participants (21 MM; 14 control) were 20 percent men, age 51.8 ± 9.7 years, with severe disability, opioid dose of 148.3 ± 129.2 morphine-equivalent mg/d, and individual annual income of $18,291 ± $19,345. At baseline, total costs were estimated at $15,497 ± 13,677 (direct: $10,635 ± 9,897; indirect: $4,862 ± 7,298) per participant. Although MM group participants, compared to controls, reduced their pain severity ratings and pain sensitivity to heat stimuli (p < 0.05), no statistically significant within-group changes or between-group differences in direct and indirect costs were noted. Adults with opioid-treated CLBP experience a high burden of disability despite the high costs of treatment. Although this pilot study did not show a statistically significant impact of MM on costs related to opioid-treated CLBP, MM can improve clinical outcomes and should be assessed in a larger trial with long-term follow-up.

Peripartum hysterectomy: an economic analysis of direct healthcare costs using routinely collected data.

PubMed

Achana, F A; Fleming, K M; Tata, L J; Sultan, A A; Petrou, S

2017-10-03

To estimate resource use and costs associated with peripartum hysterectomy for the English National Health Service. Analysis of linked Clinical Practice Research Datalink and Hospital Episodes Statistics (CPRD-HES) data. Women undergoing peripartum hysterectomy between 1997 and 2013 and matched controls. Inverse probability weighted generalised estimating equations were used to model the non-linear trend in healthcare service use and costs over time, accounting for missing data, adjusting for maternal age, body mass index, delivery year, smoking and socio-economic indicators. Primary care, hospital outpatient and inpatient attendances and costs (UK 2015 prices). The study sample included 1362 women (192 cases and 1170 controls) who gave birth between 1997 and 2013; 1088 (153 cases and 935 controls) of these were deliveries between 2003 and 2013 when all categories of hospital resource use were available. Based on the 2003-2013 delivery cohort, peripartum hysterectomy was associated with a mean adjusted additional total cost of £5380 (95% CI £4436-6687) and a cost ratio of 1.76 (95% CI 1.61-1.98) over 5 years of follow up compared with controls. Inpatient costs, mostly incurred during the first year following surgery, accounted for 78% excluding or 92% including delivery-related costs. Peripartum hysterectomy is associated with increased healthcare costs driven largely by increased post-surgery hospitalisation rates. To reduce healthcare costs and improve outcomes for women who undergo hysterectomy, interventions that reduce avoidable repeat hospitalisations following surgery such as providing active follow up, treatment and support in the community should be considered. A large amount of NHS data on peripartum hysterectomy suggests active community follow up could reduce costs, #HealthEconomics. © 2017 Royal College of Obstetricians and Gynaecologists.

Incremental cost effectiveness of proton pump inhibitors for the prevention of non-steroidal anti-inflammatory drug ulcers: a pharmacoeconomic analysis linked to a case-control study.

PubMed

Vonkeman, Harald E; Braakman-Jansen, Louise M A; Klok, Rogier M; Postma, Maarten J; Brouwers, Jacobus R B J; van de Laar, Mart A F J

2008-01-01

We estimated the cost effectiveness of concomitant proton pump inhibitors (PPIs) in relation to the occurrence of non-steroidal anti-inflammatory drug (NSAID) ulcer complications. This study was linked to a nested case-control study. Patients with NSAID ulcer complications were compared with matched controls. Only direct medical costs were reported. For the calculation of the incremental cost effectiveness ratio we extrapolated the data to 1,000 patients using concomitant PPIs and 1,000 patients not using PPIs for 1 year. Sensitivity analysis was performed by 'worst case' and 'best case' scenarios in which the 95% confidence interval (CI) of the odds ratio (OR) and the 95% CI of the cost estimate of a NSAID ulcer complication were varied. Costs of PPIs was varied separately. In all, 104 incident cases and 284 matched controls were identified from a cohort of 51,903 NSAID users with 10,402 NSAID exposition years. Use of PPIs was associated with an adjusted OR of 0.33 (95% CI 0.17 to 0.67; p = 0.002) for NSAID ulcer complications. In the extrapolation the estimated number of NSAID ulcer complications was 13.8 for non-PPI users and 3.6 for PPI users. The incremental total costs were euro 50,094 higher for concomitant PPIs use. The incremental cost effectiveness ratio was euro 4,907 per NSAID ulcer complication prevented when using the least costly PPIs. Concomitant use of PPIs for the prevention of NSAID ulcer complications costs euro 4,907 per NSAID ulcer complication prevented when using the least costly PPIs. The price of PPIs highly influenced the robustness of the results.

The Impact of Electronic Health Records on Ambulatory Costs Among Medicaid Beneficiaries

PubMed Central

Adler-Milstein, Julia; Salzberg, Claudia; Franz, Calvin; Orav, E. John; Bates, David Westfall

2013-01-01

Background Broad adoption of electronic health records (EHRs) is a potential strategy for curbing healthcare cost growth, which is particularly vital for Medicaid. Despite limited evidence for EHR-related cost savings, the 2009 HITECH Act included incentives for providers to become meaningful users of EHRs. We evaluated a large Massachusetts EHR pilot to obtain early insight into the potential for the national strategy to reduce short-run healthcare costs in the Medicaid population. Methods We calculated monthly ambulatory cost and visit measures from Medicaid claims data for beneficiaries receiving the majority of their care in the three Massachusetts eHealth Collaborative (MAeHC) pilot communities or in six matched control communities. Using a difference-in-differences of slope analysis, we assessed whether cost and visit trajectories differed in the pre-implementation period compared to the post-implementation period for intervention and control community members. Results We found evidence that EHR adoption impacted ambulatory medical cost in two of the three communities, but the effects were in opposite directions. Ambulatory medical costs increased more slowly in one intervention compared to its control communities in the pre-to-post period (difference-in-differences=-1.98%, p<0.001; PMPM savings of $41.60). In contrast, for a second pilot community, ambulatory medical cost increased more slowly in the control communities (difference-in-differences=2.56%, p=0.005; PMPM increase of $43.34). Conclusions As a stand-alone approach, adoption of commercially-available EHRs in community practices did not consistently impact Medicaid costs in the short-run. This suggests that future meaningful use criteria may need to specifically target cost savings and coordinate with payment reform efforts. PMID:24753965

Patient-controlled analgesia versus intramuscular analgesic therapy.

PubMed

Smythe, M; Loughlin, K; Schad, R F; Lucarroti, R L

1994-06-01

The pharmacy and nursing time requirements, quality of postoperative pain control, and cost of patient-controlled analgesia (PCA) and intramuscular (i.m.) analgesic therapy were studied. All timings were conducted with a stopwatch on a single nursing unit that primarily receives gynecologic surgery patients. The various work elements involved in each type of therapy were timed individually. Both quality of analgesia and cost were evaluated in a prospective, randomized study in hysterectomy patients. I.M. patients received meperidine hydrochloride 75-100 mg every three to four hours as needed. PCA patients had access to morphine sulfate 1 mg or meperidine hydrochloride 10 mg, with a six-minute lockout period. The patients scored their pain every four hours. Direct costs for PCA were calculated as drug cost plus tubing cost plus form cost plus maintenance cost plus depreciation cost. Direct costs for i.m. therapy consisted of the cost of drugs. The total mean nursing time per patient was 16.9 minutes for PCA and 10.7 minutes for i.m. therapy. Pharmacy time per patient was 5.1 minutes longer for PCA than for i.m. therapy. Thirty-six hysterectomy patients (17 i.m. and 19 PCA) were enrolled in the study of pain control and cost. Among i.m. patients, 64% of the pain scores were mild or worse, compared with 40% for PCA patients. The median pain scores were moderate for i.m. patients and mild for PCA patients. Scores tended to be lower for PCA patients at 16 and 20 hours. Although equal numbers of patients in the two groups experienced nausea, i.m. patients needed more doses of antiemetics than PCA patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of comprehensive cardiac telerehabilitation on one-year cardiovascular rehospitalization rate, medical costs and quality of life: A cost-effectiveness analysis.

PubMed

Frederix, Ines; Hansen, Dominique; Coninx, Karin; Vandervoort, Pieter; Vandijck, Dominique; Hens, Niel; Van Craenenbroeck, Emeline; Van Driessche, Niels; Dendale, Paul

2016-05-01

Notwithstanding the cardiovascular disease epidemic, current budgetary constraints do not allow for budget expansion of conventional cardiac rehabilitation programmes. Consequently, there is an increasing need for cost-effectiveness studies of alternative strategies such as telerehabilitation. The present study evaluated the cost-effectiveness of a comprehensive cardiac telerehabilitation programme. This multi-centre randomized controlled trial comprised 140 cardiac rehabilitation patients, randomized (1:1) to a 24-week telerehabilitation programme in addition to conventional cardiac rehabilitation (intervention group) or to conventional cardiac rehabilitation alone (control group). The incremental cost-effectiveness ratio was calculated based on intervention and health care costs (incremental cost), and the differential incremental quality adjusted life years (QALYs) gained. The total average cost per patient was significantly lower in the intervention group (€2156 ± €126) than in the control group (€2720 ± €276) (p = 0.01) with an overall incremental cost of €-564.40. Dividing this incremental cost by the baseline adjusted differential incremental QALYs (0.026 QALYs) yielded an incremental cost-effectiveness ratio of €-21,707/QALY. The number of days lost due to cardiovascular rehospitalizations in the intervention group (0.33 ± 0.15) was significantly lower than in the control group (0.79 ± 0.20) (p = 0.037). This paper shows the addition of cardiac telerehabilitation to conventional centre-based cardiac rehabilitation to be more effective and efficient than centre-based cardiac rehabilitation alone. These results are useful for policy makers charged with deciding how limited health care resources should best be allocated in the era of exploding need. © The European Society of Cardiology 2015.

Cost of malaria control in China: Henan's consolidation programme from community and government perspectives.

PubMed Central

Jackson, Sukhan; Sleigh, Adrian C.; Liu, Xi-Li

2002-01-01

OBJECTIVE: To assist with strategic planning for the eradication of malaria in Henan Province, China, which reached the consolidation phase of malaria control in 1992, when only 318 malaria cases were reported. METHODS: We conducted a prospective two-year study of the costs for Henan's malaria control programme. We used a cost model that could also be applied to other malaria programmes in mainland China, and analysed the cost of the three components of Henan's malaria programme: suspected malaria case management, vector surveillance, and population blood surveys. Primary cost data were collected from the government, and data on suspected malaria patients were collected in two malaria counties (population 2 093 100). We enlisted the help of 260 village doctors in six townships or former communes (population 247 762), and studied all 12 325 reported cases of suspected malaria in their catchment areas in 1994 and 1995. FINDINGS: The average annual government investment in malaria control was estimated to be US$ 111 516 (case-management 59%; active blood surveys 25%; vector surveillance 12%; and contingencies and special projects 4%). The average cost (direct and indirect) for patients seeking treatment for suspected malaria was US$ 3.48, equivalent to 10 days' income for rural residents. Each suspected malaria case cost the government an average of US$ 0.78. CONCLUSION: Further cuts in government funding will increase future costs when epidemic malaria returns; investment in malaria control should therefore continue at least at current levels of US$ 0.03 per person at risk. PMID:12219157

Vaccination and treatment as control interventions in an infectious disease model with their cost optimization

NASA Astrophysics Data System (ADS)

Kumar, Anuj; Srivastava, Prashant K.

2017-03-01

In this work, an optimal control problem with vaccination and treatment as control policies is proposed and analysed for an SVIR model. We choose vaccination and treatment as control policies because both these interventions have their own practical advantage and ease in implementation. Also, they are widely applied to control or curtail a disease. The corresponding total cost incurred is considered as weighted combination of costs because of opportunity loss due to infected individuals and costs incurred in providing vaccination and treatment. The existence of optimal control paths for the problem is established and guaranteed. Further, these optimal paths are obtained analytically using Pontryagin's Maximum Principle. We analyse our results numerically to compare three important strategies of proposed controls, viz.: vaccination only; with both treatment and vaccination; and treatment only. We note that first strategy (vaccination only) is less effective as well as expensive. Though, for a highly effective vaccine, vaccination alone may also work well in comparison with treatment only strategy. Among all the strategies, we observe that implementation of both treatment and vaccination is most effective and less expensive. Moreover, in this case the infective population is found to be relatively very low. Thus, we conclude that the comprehensive effect of vaccination and treatment not only minimizes cost burden due to opportunity loss and applied control policies but also keeps a tab on infective population.

The manager's financial handbook. Cost concepts and breakeven analysis.

PubMed

Butros, F A

1997-01-01

As the health-care environment becomes more competitive, laboratory managers need to become skillful in using and controlling their resources. Controlling resources usually means managing cost. By analyzing cost and understanding its different components, the laboratory manager can make rational decisions. This article describes and analyzes different categories within which cost can be characterized and shows how breakeven analysis can be used when dealing with fixed-price payers or multiple payment purchases of health-care services.

Will joint regional air pollution control be more cost-effective? An empirical study of China's Beijing-Tianjin-Hebei region.

PubMed

Wu, Dan; Xu, Yuan; Zhang, Shiqiu

2015-02-01

By following an empirical approach, this study proves that joint regional air pollution control (JRAPC) in the Beijing-Tianjin-Hebei region will save the expense on air pollution control compared with a locally-based pollution control strategy. The evidences below were found. (A) Local pollutant concentration in some of the cities is significantly affected by emissions from their surrounding areas. (B) There is heterogeneity in the marginal pollutant concentration reduction cost among various districts as a result of the cities' varying contribution of unit emission reduction to the pollutant concentration reduction, and their diverse unit cost of emission reduction brought about by their different industry composition. The results imply that the cost-efficiency of air pollution control will be improved in China if the conventional locally based regime of air pollution control can shift to a regionally based one. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

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.

Active control of the forced and transient response of a finite beam. M.S. Thesis

NASA Technical Reports Server (NTRS)

Post, John T.

1990-01-01

Structural vibrations from a point force are modelled on a finite beam. This research explores the theoretical limit on controlling beam vibrations utilizing another point source as an active controller. Three different types of excitation are considered, harmonic, random, and transient. For harmonic excitation, control over the entire beam length is possible only when the excitation frequency is near a resonant frequency of the beam. Control over a subregion may be obtained even between resonant frequencies at the cost of increasing the vibration outside of the control region. For random excitation, integrating the expected value of the displacement squared over the required interval, is shown to yield the identical cost function as obtained by integrating the cost function for harmonic excitation over all excitation frequencies. As a result, it is always possible to reduce the cost function for random excitation whether controlling the entire beam or just a subregion, without ever increasing the vibration outside the region in which control is desired. The last type of excitation considered is a single, transient pulse. The form of the controller is specified as either one or two delayed pulses, thus constraining the controller to be casual. The best possible control is examined while varying the region of control and the controller location. It is found that control is always possible using either one or two control pulses.

Cost-effectiveness of the Health X Project for tuberculosis control in China.

PubMed

Wang, W-B; Zhang, H; Petzold, M; Zhao, Q; Xu, B; Zhao, G-M

2014-08-01

Between 2002 and 2008, China's National Tuberculosis Control Programme created the Health X Project, financed in part by a World Bank loan, with additional funding from the UK Department for International Development. To assess the cost-effectiveness of the Project and its impact from a financial point of view on tuberculosis (TB) control in China. A decision-analytic model was used to evaluate the cost-effectiveness of the Project. Sensitivity analysis was used to assess the impact of different scenarios and assumptions on results. The primary outcome of the study was cost per disability-adjusted life-year (DALY) saved and incremental DALYs saved. In comparison with alternative scenario 1, the Project detected 1.6 million additional cases, 44 000 deaths were prevented and a total of 18.4 million DALYs saved. The Project strategies cost approximately Chinese yuan (CNY) 953 per DALY saved (vs. CNY1140 in the control areas), and saved an estimated CNY17.5 billion in comparison with the unchanged alternative scenario (scenario 1) or CNY10.8 billion with the control scenario (scenario 2). The Project strategies were affordable and of comparable cost-effectiveness to those of other developing countries. The results also provide strong support for the existing policy of scaling up DOTS in China.

Cost analysis of impacts of climate change on regional air quality.

PubMed

Liao, Kuo-Jen; Tagaris, Efthimios; Russell, Armistead G; Amar, Praveen; He, Shan; Manomaiphiboon, Kasemsan; Woo, Jung-Hun

2010-02-01

Climate change has been predicted to adversely impact regional air quality with resulting health effects. Here a regional air quality model and a technology analysis tool are used to assess the additional emission reductions required and associated costs to offset impacts of climate change on air quality. Analysis is done for six regions and five major cities in the continental United States. Future climate is taken from a global climate model simulation for 2049-2051 using the Intergovernmental Panel on Climate Change (IPCC) A1B emission scenario, and emission inventories are the same as current ones to assess impacts of climate change alone on air quality and control expenses. On the basis of the IPCC A1B emission scenario and current control technologies, least-cost sets of emission reductions for simultaneously offsetting impacts of climate change on regionally averaged 4th highest daily maximum 8-hr average ozone and yearly averaged PM2.5 (particulate matter [PM] with an aerodynamic diameter less than 2.5 microm) for the six regions examined are predicted to range from $36 million (1999$) yr(-1) in the Southeast to $5.5 billion yr(-1) in the Northeast. However, control costs to offset climate-related pollutant increases in urban areas can be greater than the regional costs because of the locally exacerbated ozone levels. An annual cost of $4.1 billion is required for offsetting climate-induced air quality impairment in 2049-2051 in the five cities alone. Overall, an annual cost of $9.3 billion is estimated for offsetting climate change impacts on air quality for the six regions and five cities examined. Much of the additional expense is to reduce increased levels of ozone. Additional control costs for offsetting the impacts everywhere in the United States could be larger than the estimates in this study. This study shows that additional emission controls and associated costs for offsetting climate impacts could significantly increase currently estimated control requirements and should be considered in developing control strategies for achieving air quality targets in the future.

Using Length of Stay to Control for Unobserved Heterogeneity When Estimating Treatment Effect on Hospital Costs with Observational Data: Issues of Reliability, Robustness, and Usefulness.

PubMed

May, Peter; Garrido, Melissa M; Cassel, J Brian; Morrison, R Sean; Normand, Charles

2016-10-01

To evaluate the sensitivity of treatment effect estimates when length of stay (LOS) is used to control for unobserved heterogeneity when estimating treatment effect on cost of hospital admission with observational data. We used data from a prospective cohort study on the impact of palliative care consultation teams (PCCTs) on direct cost of hospital care. Adult patients with an advanced cancer diagnosis admitted to five large medical and cancer centers in the United States between 2007 and 2011 were eligible for this study. Costs were modeled using generalized linear models with a gamma distribution and a log link. We compared variability in estimates of PCCT impact on hospitalization costs when LOS was used as a covariate, as a sample parameter, and as an outcome denominator. We used propensity scores to account for patient characteristics associated with both PCCT use and total direct hospitalization costs. We analyzed data from hospital cost databases, medical records, and questionnaires. Our propensity score weighted sample included 969 patients who were discharged alive. In analyses of hospitalization costs, treatment effect estimates are highly sensitive to methods that control for LOS, complicating interpretation. Both the magnitude and significance of results varied widely with the method of controlling for LOS. When we incorporated intervention timing into our analyses, results were robust to LOS-controls. Treatment effect estimates using LOS-controls are not only suboptimal in terms of reliability (given concerns over endogeneity and bias) and usefulness (given the need to validate the cost-effectiveness of an intervention using overall resource use for a sample defined at baseline) but also in terms of robustness (results depend on the approach taken, and there is little evidence to guide this choice). To derive results that minimize endogeneity concerns and maximize external validity, investigators should match and analyze treatment and comparison arms on baseline factors only. Incorporating intervention timing may deliver results that are more reliable, more robust, and more useful than those derived using LOS-controls. © Health Research and Educational Trust.

MCCx C3I Control Center Interface Emulator

NASA Technical Reports Server (NTRS)

Mireles, James R.

2010-01-01

This slide presentation reviews the project to develop and demonstrate alternate Information Technologies and systems for new Mission Control Centers that will reduce the cost of facility development, maintenance and operational costs and will enable more efficient cost and effective operations concepts for ground support operations. The development of a emulator for the Control Center capability will enable the facilities to conduct the simulation requiring interactivity with the Control Center when it is off line or unavailable, and it will support testing of C3I interfaces for both command and telemetry data exchange messages (DEMs).

Costs of newly diagnosed neovascular age-related macular degeneration among medicare beneficiaries, 2004-2008.

PubMed

Qualls, Laura G; Hammill, Bradley G; Wang, Fang; Lad, Eleonora M; Schulman, Kevin A; Cousins, Scott W; Curtis, Lesley H

2013-04-01

To examine associations between newly diagnosed neovascular age-related macular degeneration and direct medical costs. This retrospective observational study matched 23,133 Medicare beneficiaries diagnosed with neovascular age-related macular degeneration between 2004 and 2008 with a control group of 92,532 beneficiaries on the basis of age, sex, and race. The index date for each case-control set corresponded to the first diagnosis for the case. Main outcome measures were total costs per patient and age-related macular degeneration-related costs per case 1 year before and after the index date. Mean cost per case in the year after diagnosis was $12,422, $4,884 higher than the year before diagnosis. Postindex costs were 41% higher for cases than controls after adjustment for preindex costs and comorbid conditions. Age-related macular degeneration-related costs represented 27% of total costs among cases in the postindex period and were 50% higher for patients diagnosed in 2008 than in 2004. This increase was attributable primarily to the introduction of intravitreous injections of vascular endothelial growth factor antagonists. Intravitreous injections averaged $203 for patients diagnosed in 2004 and $2,749 for patients diagnosed in 2008. Newly diagnosed neovascular age-related macular degeneration was associated with a substantial increase in total medical costs. Costs increased over time, reflecting growing use of anti-vascular endothelial growth factor therapies.

Report to the Legislature on Controlling School Employee Health Care Costs (Chapter 303, Laws of 1986).

ERIC Educational Resources Information Center

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

This document comprises the mandatory report of the Superintendent of Public Instruction to the Washington State legislature on proposed methods of controlling health care costs for school employees. It focuses on the costs to Washington's 296 school districts of providing health care coverage for approximately 80,000 employees. The introduction…

Using Technology to Control Costs

ERIC Educational Resources Information Center

Ho, Simon; Schoenberg, Doug; Richards, Dan; Morath, Michael

2009-01-01

In this article, the authors examines the use of technology to control costs in the child care industry. One of these technology solutions is Software-as-a-Service (SaaS). SaaS solutions can help child care providers save money in many aspects of center management. In addition to cost savings, SaaS solutions are also particularly appealing to…